Babs wrote:so you are saying the inflammation has spread to my pancreas? which is why I have fat malabsorption issues?
That's just my unprofessional opinion, based on the fact that so many of us here on this board have pancreas problems while we are reacting. Virtually everyone who has MC has fat malabsorption problems, and that suggests that the pancreas isn't producing enough lipase to finish the digestion process after the bile emulsifies the fat. Here's what I say about it in my book (beginning on page 21):
Other issues that can complicate the disease
Bile is released by the gallbladder into the small intestine to aid in the digestion of fats. Normally, about 90 % of excreted bile acids are reabsorbed from the intestines and recycled back to the liver and the gallbladder. The reabsorption takes place in the terminal ileum (the bottom end of the small intestine). The reabsorption process may be compromised when the ileum, along with nearby areas in the colon, becomes inflamed. If these bile salts cannot be reabsorbed and they remain in the fecal stream, they will often tend to initiate diarrhea and possibly other symptoms as well. It’s quite common for the inflammation associated with MC to extend into the terminal ileum.11
Logical analysis suggests that a possible reason why the bile fatty acids may not be properly recycled when they get to the terminal ileum (as they should be, if the digestive process were proceeding normally) might be because they are still coating the fat globules when they reach the ileum and consequently they are in a state where they cannot be absorbed. In other words, if the pancreatic lipase does not successfully hydrolyze the fats, then the bile salts cannot be reabsorbed. Since they cannot be absorbed and recycled, they pass on into the colon, contributing to diarrhea in the process.
That doesn't necessarily mean that the excess bile is the primary reason for the diarrhea, however. The failure of the pancreatic enzymes to hydrolyze the fats may be the cause of the problem, and the ultimate reason for the compromised pancreatic function is very likely connected with widespread digestive system inflammation that leads to pancreatic inflammation, known as pancreatitis. Also, consider that if most of the bile is lost, rather than recycled, the total demand for bile can increase to as high as approximately 10 times the normal amount. In the long run, losing all that recycled bile is bound to place abnormal demands upon the liver and gallbladder to keep up with the body's needs. This might at least partially explain why gallbladder problems are so commonly associated with microscopic colitis.
Those bile fatty acids are feedstock material that the body uses to manufacture cholesterol to supply its normal needs. If 90 % (more of less) of the bile salts that would normally be recycled, are instead lost due to malabsorption, then the body would obviously need to produce much more cholesterol from scratch. Since as noted above, that could be as high as roughly 10 times the normal production requirements, it would seem logical that serum cholesterol levels might go down, as a function of a long-term malabsorption issue.
In fact, that phenomenon has been documented for active Crohn’s disease.12, 13 It seems likely, then, that the other inflammatory bowel diseases, including microscopic colitis, could also be associated with this phenomenon.
Here are references 11, 12, and 13 from that quote:
11. Koskela, R. (2011). Microscopic colitis: Clinical features and gastroduodenal and immunogenic findings. (Doctoral dissertation, University of Oulu). Retrieved from
http://herkules.oulu.fi/isbn97895142941 ... 294150.pdf
12. Hrabovský, V., Zadák, Z., Bláha, V., Hyspler, R., & Karlík, T. (2007). [Changes in lipid metabolism in patients in the active phase of Crohn's disease]. [Article in Czech]. Vnitr Lek., 53(10), 1035–1039. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/18072426
13. Hrabovský, V., Zadák, Z., Bláha, V., Hyšpler, R., Karlík, T., Martínek,, A., & Mendlová, A. (2009). Cholesterol metabolism in active Crohn's disease. Wiener Klinische Wochenschrift,
121(7–8), 270–275. Retrieved from
https://www.ncbi.nlm.nih.gov/m/pubmed/1 ... 26/related
Babs wrote:How do I know what food causes inflammation?? Basically I should eat just chicken,beef, green beans and carrots for how long until I know this work for me? 2 weeks? 1 week? I will lose even more weight if I do that?? I am already too skinny. But if you suggest that is what I do to find out I will DO IT!! :)
I have no way of knowing exactly which foods might be safe for you. The best way to determine which foods are safe is to order the Panel C test from EnteroLab, because it includes several of the foods that you are eating.
https://www.enterolab.com/StaticPages/TestInfo.aspx
The point is, as long as we eat foods that cause us to react, we lose weight. If we get rid of the foods that cause us to react, our gut has a chance to heal, and we can begin to gain weight again, even on a very limited diet.
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