First of all, a big thank you to all of you for your informative posts. I started reading this site early in the spring of this year while trying to figure out what was suddenly wrong with me, and many of the posts proved very helpful.
Briefly, right around thanksgiving 2010 my digestion went haywire. Suddenly, no matter what I ate it would 'move right on through' within about 90 minutes. I lost 20 pounds. Most frustrating was, despite the suddenness, my GP was sure it was 'IBS' or 'anxiety', and refused to do any testing until January (instead, he prescribed klonopin). Then he tested for intestinal parasites only because I demanded it, and referred me to a GI whose first available appointment was in March.
So in January in an attempt to fix things I started an elimination diet. It was useful, but not particularly informative (confirming what I already knew about dairy, and adding eggs and cauliflower as bad bad foods!). I found out my aunt had been diagnosed with microscopic colitis so I read up on that and found all of you. After I read this site, I reduced the amount of gluten I ate, while continuing to stay off dairy and eggs. Prior to this, I had been ovo-lacto vegetarian for 10 years; now, I am vegan+fish (adding fish for protein).
The GI, seen in March, did a celiac gene test and told me I didn't have celiac. Also a colonoscopy, and told me at the follow-up appointment that while there was evidence of 'something' (increased white blood cell count), it looked like it should be cleaning up. (At this point I had been dairy free for four months.) I saw another GI for a second opinion, and he recommended an endoscopy to confirm no celiac (which it did), and a HIDA scan w/ CCK to see if it was bile salt diarrhea. The second-opinion GI I chose because he doesn't believe in 'IBS'. For example, he published a paper showing that of his own patients over a span of several years, none had 'IBS'; many had colitis or bile salt diarrhea.
In fact, it did turn out to be bile salt diarrhea; my gallbladder is terribly inefficient and so the bile gets into the large intestines where it acts more or less as a laxative. It is treatable with questran, which is what I am taking now, very successfully. The GI says this is more common in women over 40 who are overweight, or in people whose gallbladders have been removed, but that it can start suddenly. Crucially, it exhibits as (a) watery diarrhea shortly after meals, (b) with little or no pain in the digestive system (which distinguishes it from 'IBS').
It seems to me a crying shame that more doctors do not test for this (it may be called bile salt diarrhea or cholecystitis or lazy gallbladder or Habba syndrome), and I encourage any of you who meet these criteria to ask for the testing. The procedure is simple: they inject you with a radioactive dye, and then take pictures every 15 minutes until the dye reaches your gallbladder (after four hours, they give up - then you have something else wrong with you). Then, they inject you with CCK (the thing the liver uses to tell the gallbladder to work) and take pictures every 10 minutes for another hour, to see how much the gallbladder contracts. In my case, it was obvious from the pictures that it wasn't really working.
Anyway, here is my question. I read about Enterolab on this site so in April, between GI 1 and GI 2, I did the testing. The results are below, and you can see they were positive for everything, especially the fecal fat score. But the bile salt diarrhea causes fat malabsorption (the gall bladder releases bile to digest fats). So, how much of this might be due simply to the lazy gallbladder versus actual intolerances? My husband is worried that I am becoming irrational about food, because of the combined impact of cutting out dairy, wheat, eggs, soy and non-fish meat.
Enterolab results (at this point in time, I was eating very little gluten, no dairy at all, and no eggs, but still enjoying edamame):
A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value
Fecal Anti-gliadin IgA 574 Units (Normal Range is less than 10 Units)
Fecal Anti-tissue Transglutaminase IgA 113 Units (Normal Range is less than 10 Units)
Quantitative Microscopic Fecal Fat Score 561 Units (Normal Range is less than 300 Units)
Fecal Anti-casein (cow’s milk) IgA 58 Units (Normal Range is less than 10 Units)
HLA-DQB1 Molecular analysis, Allele 1 0301
HLA-DQB1 Molecular analysis, Allele 2 0503
Serologic equivalent: HLA-DQ 3,1 (Subtype 7,5)
C) Egg, Yeast, and Soy Food Sensitivity Stool Panel
Fecal Anti-ovalbumin (chicken egg) IgA 17 Units (Normal Range is less than 10 Units)
Fecal Anti-Saccharomyces cerevisiae (dietary yeast) IgA 57 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 74 Units (Normal Range is less than 10 Units)
Enterolab, gallbladder, and a big thank you
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
WOW, you must be reeling with all of this information.
It's great news that you don't have the celiac gene, but you certainly do have a tenacious intolerance to gluten, and both the genes you list predispose to gluten sensitivity - as I'm sure you've realized from these results already.
Good for you, firing that first GI doc. Good for you, starting an elimination diet.
It's certainly possible that the fecal fat score was so elevated because of the gallbladder issues, though it's also possible that your body was really taking a hit, once the gluten sensitivity was triggered and along with the gallbladder problems. The high value for anti-tissue transglutaminase indicates that some autoimmune process has been going on, and though Enterolab cautions that "high means high" (so your score of 113 may not mean your result is 'worse' than my score on that front, which was 16, we both have antibodies against that enzyme, and an elevated likelihood of autoimmune response, either in the gut or elsewhere).
I would say you weren't being irrational at all in restricting your diet, and I applaud you for having the gumption to start that while feeling lousy, and before you had these test results to convince you it was necessary (and after GI #1 ruled out celiac - about which, ironically, he was technically correct, though he probably is not up-to-date on non-celiac gluten sensitivity... even the hard-core old celiac snobs are now admitting that this is real).
My understanding is that once gluten sensitivity is triggered, it's like a switch that's permanently fused to "ON" and doesn't go away. But it is theoretically possible that a period of squeaky-clean dieting, plus treatment for the gallbladder condition, might let you heal enough to return at least some of these foods to your diet. I would wait (I am the queen of risk avoidance in this arena, but I am older than you and have been taking on gluten-caused damage for a lot longer... so I'm more scared and have fewer decades to get that turned around). The least likely food to get back is gluten, followed by dairy... (I have a dream about eggs, some day.)
I totally sympathize - a friend of mine recently said, "You're like some kind of weird vegan." Yes, I am now a meat-eating vegan. Go figure.
I know my comments are a little all over the place... here's one more thing to consider: given your high value for anti-tissue transglutaminase, it's possible that your gallbladder stopped working properly *because* of the gluten intolerance, rather than that problem triggering your gluten sensitivity. It could have been the target of an autoimmune process that was initially kicked off by a response to gluten. (I suppose it's possible that a GF diet might help it recover, too - I am not familiar with the likelihood of that, but several of us have had improvement in neurological symptoms, of the sort that aren't expected to reverse... and you are young and it sounds as though you were pretty healthy before everything went blooey.)
You clearly have what it takes to get your health back on track, and are already well on your way. Maybe one helpful outcome of your Enterolab results will be to reassure your husband that you're not being over-cautious or needlessly fearful. Rather, you're one smart cookie, and the recipe-tweaking and pantry-purging have been bold and clever moves on your part... I also totally sympathize that when we make major diet changes, it affects those closest to us as well. I had just taken my husband along with my on a serious 'gluten-free vegan' month of eating when I got sick, and now am basically eating a Paleo diet.
Brendan Brazier is a competitive triathlete who's also vegan, and most of his recipes don't use legumes or grains at all (what *does* that man eat?). His 'Thrive' books might be worth a look for you. He spends a lot more time than I do thinking about which balance of carbs/protein/fat is better for post-exercise, versus mid-marathon, versus recovery the next day, so it's not a resource you need to run out and buy, but if you can flip through it in a bookstore or library, he might have some insights for you.
I hope your aunt is doing as well with her MC as you've been doing so far.
Again, welcome,
Sara
It's great news that you don't have the celiac gene, but you certainly do have a tenacious intolerance to gluten, and both the genes you list predispose to gluten sensitivity - as I'm sure you've realized from these results already.
Good for you, firing that first GI doc. Good for you, starting an elimination diet.
It's certainly possible that the fecal fat score was so elevated because of the gallbladder issues, though it's also possible that your body was really taking a hit, once the gluten sensitivity was triggered and along with the gallbladder problems. The high value for anti-tissue transglutaminase indicates that some autoimmune process has been going on, and though Enterolab cautions that "high means high" (so your score of 113 may not mean your result is 'worse' than my score on that front, which was 16, we both have antibodies against that enzyme, and an elevated likelihood of autoimmune response, either in the gut or elsewhere).
I would say you weren't being irrational at all in restricting your diet, and I applaud you for having the gumption to start that while feeling lousy, and before you had these test results to convince you it was necessary (and after GI #1 ruled out celiac - about which, ironically, he was technically correct, though he probably is not up-to-date on non-celiac gluten sensitivity... even the hard-core old celiac snobs are now admitting that this is real).
My understanding is that once gluten sensitivity is triggered, it's like a switch that's permanently fused to "ON" and doesn't go away. But it is theoretically possible that a period of squeaky-clean dieting, plus treatment for the gallbladder condition, might let you heal enough to return at least some of these foods to your diet. I would wait (I am the queen of risk avoidance in this arena, but I am older than you and have been taking on gluten-caused damage for a lot longer... so I'm more scared and have fewer decades to get that turned around). The least likely food to get back is gluten, followed by dairy... (I have a dream about eggs, some day.)
I totally sympathize - a friend of mine recently said, "You're like some kind of weird vegan." Yes, I am now a meat-eating vegan. Go figure.
I know my comments are a little all over the place... here's one more thing to consider: given your high value for anti-tissue transglutaminase, it's possible that your gallbladder stopped working properly *because* of the gluten intolerance, rather than that problem triggering your gluten sensitivity. It could have been the target of an autoimmune process that was initially kicked off by a response to gluten. (I suppose it's possible that a GF diet might help it recover, too - I am not familiar with the likelihood of that, but several of us have had improvement in neurological symptoms, of the sort that aren't expected to reverse... and you are young and it sounds as though you were pretty healthy before everything went blooey.)
You clearly have what it takes to get your health back on track, and are already well on your way. Maybe one helpful outcome of your Enterolab results will be to reassure your husband that you're not being over-cautious or needlessly fearful. Rather, you're one smart cookie, and the recipe-tweaking and pantry-purging have been bold and clever moves on your part... I also totally sympathize that when we make major diet changes, it affects those closest to us as well. I had just taken my husband along with my on a serious 'gluten-free vegan' month of eating when I got sick, and now am basically eating a Paleo diet.
Brendan Brazier is a competitive triathlete who's also vegan, and most of his recipes don't use legumes or grains at all (what *does* that man eat?). His 'Thrive' books might be worth a look for you. He spends a lot more time than I do thinking about which balance of carbs/protein/fat is better for post-exercise, versus mid-marathon, versus recovery the next day, so it's not a resource you need to run out and buy, but if you can flip through it in a bookstore or library, he might have some insights for you.
I hope your aunt is doing as well with her MC as you've been doing so far.
Again, welcome,
Sara
p.s.
I meant to add, you can view the Enterolab results of many other members of this forum here, if you're interested:
Food intolerances (plus genetics if available):
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=10089
Just the genetics:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=10084
We've been pondering as a group whether certain genes or combinations of genes are more likely to predispose to multiple food sensitivities, or to more severe sensitivities - it's not so easy to categorize in this way. One thing I'm persuaded of - you don't have to have a "true" celiac gene to be quite ill from gluten sensitivity. And you are certainly a case in point that it's possible for an autoimmune response to be activated without a celiac gene. Seizing the reins of your diet may prevent autoimmune disease from developing - and you're off to a great start.
--Sara
I meant to add, you can view the Enterolab results of many other members of this forum here, if you're interested:
Food intolerances (plus genetics if available):
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=10089
Just the genetics:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=10084
We've been pondering as a group whether certain genes or combinations of genes are more likely to predispose to multiple food sensitivities, or to more severe sensitivities - it's not so easy to categorize in this way. One thing I'm persuaded of - you don't have to have a "true" celiac gene to be quite ill from gluten sensitivity. And you are certainly a case in point that it's possible for an autoimmune response to be activated without a celiac gene. Seizing the reins of your diet may prevent autoimmune disease from developing - and you're off to a great start.
--Sara
-
alclarkson
- Adélie Penguin
- Posts: 54
- Joined: Sat May 28, 2011 5:03 pm
- Location: Missouri
Oh goodness your story seems a bit like mine minus the entero results and dieting. I got the diagnosis, started the pepto routine, felt better, except for my gallbladder. I just had it taken out 2 weeks ago. I'm keeping a food & BM log to see if it will be better or worse. I never had a hida scan or got tested for the bile salts thing. I had one stone taking up 1/3 of my gallbladder and the lab results showed chronic cholecystitis. I've had 1-2 days of what I'd call the dumping syndrome and today I had a bad day. Besides that, I've actually been sort of, dare I say, normal. I'll keep updated and maybe start a blog that way it's easier to follow.
Diarrhea, nausea, abd. pain 3/31/11. Confirmed gallstone/sludge 4/15/11. Confirmed Lymphocytic Colitis 5/6/11 via colonoscopy. Started Pepto 5/21/11 & stopped 6/21/11. Stopped Cymbalta 6/9/11- D stopped temporarily. 7-19-11- lap chole
Hi astent,
Welcome to our internet family. Looking at your test results, you are extremely reactive, so you have apparently had these sensitivities for quite a while. With test results that high, the only reason why you do not have fully-developed celiac disease, is because you do not have a celiac gene, so you are at least lucky on that aspect. Why on earth did your GI prescribe klonopin?
That's an anti-seizure drug.
I have a question. You say:
I totally agree with your second GI that "IBS" does not exist, (except in the minds of doctors who can't figure out what is wrong with some of their patients). However, if he is treating you for "bile salt diarrhea", rather than treating your MC, then he is doing you a grave disservice, because in the meantime, the untreated inflammation can lead to additional autoimmune diseases. You don't mention whether or not you're taking a bile acid sequestrant, but I would assume that you probably are, (based on your second GI's "findings").
It's certainly possible that your gallbladder is malfunctioning, because that is a very common condition associated with microscopic colitis. However, the main reason why your bile salts were/are showing up in your colon, is because of your malabsorption problem, (as is obvious by your high fat malabsorption score). Normally, bile salts are absorbed in the terminal ileum, where they are recycled for the production of cholesterol, as needed by the body for normal functioning. MC causes serious malabsorption issues, resulting in not just bile, but all sorts of unabsorbed nutrients to pass into the colon. Yes, the bile acids can make the D worse, (they should cause green pigmentation of the stool), but the primary reason for the malabsorption problem is not the bile, (nor the malfunctioning of the gallbladder), but the inflammation associated with MC.
The point is, gallbladder and/or bile salt issues do not cause malabsorption issues - it's the other way around. Malabsorption problems cause bile salt issues. If your bile salts are getting past the terminal ileum, then that is due to a malabsorption issue in your terminal ileum, and that occurs because the inflammation that causes MC is typically more pronounced, (more concentrated), in the terminal ileum and the right-side colon, in most cases.
You don't say if you are symptomatic now, of if the bile acid sequestrant is controlling your D, (assuming that you are taking one). If it is, then that is evidence that your MC is asymptomatic, meaning that the inflammation and damage continues, even though you do not have clinical symptoms. One of the side effect of bile acid sequestrants is constipation, and many GIs prescribe it to MC patients hoping that it will stop their D, (and sometimes it does), but it does nothing to address the inflammation issue. If the bile acid sequestrant is not controlling your D, then it's not really doing anything for you.
You also don't say whether you are following a GF, DF, etc., diet. If you are, then when it takes effect, your bile salt issues will very likely disappear, also, without the need for any bile acid sequestrant. If you are not following a GF, DF, etc., diet, they your inflammation is continuing, putting you at an elevated risk for additional autoimmune diseases.
I can appreciate your husbands concerns about possibly taking these food issues too seriously, but trust me, with the relatively high numbers in your Enterolab test results, there is no way that you can take them too seriously - this is for real. You have very serious food sensitivities that need to be addressed, 100%.
Look at it this way, the bile is there to digest fats, and yet, according to the Enterolab test results, (fat malabsorption score), you are most definitely not absorbing fats. Obviously, the bile is doing nothing - it's not helping to digest the fats. Therefore, the bile salt issue is a result of the inflammation and the diarrhea caused by MC, not the cause of it. As is so often the case, your GI is mistakenly treating a single symptom of MC, rather than treating the disease that is causing the malabsorption of bile salts.
If you did not have lymphocytic colitis, then the bile salt issue might indeed be a valid issue, and worth pursuing. However, for someone with LC, bile salts, and all the other digestive system issues that are present when we are reacting, are secondary to the LC, and they should only be addressed if their symptoms still exist after the symptoms of LC are completely controlled. Typically, once the LC, CC, MC, or whatever type of colitis we might have, is resolved, then all those satellite issues will disappear.
Again, welcome aboard, and please feel free to ask anything.
Tex
P. S. Do you mind if I add your Enterolab test results to our collection?
Welcome to our internet family. Looking at your test results, you are extremely reactive, so you have apparently had these sensitivities for quite a while. With test results that high, the only reason why you do not have fully-developed celiac disease, is because you do not have a celiac gene, so you are at least lucky on that aspect. Why on earth did your GI prescribe klonopin?
That's an anti-seizure drug. I have a question. You say:
Did your GI ever actually inform you that you have lymphocytic colitis? Without seeing your pathology report, I can only make an educated guess at what it says, but your wording, "evidence of 'something' (increased white blood cell count)", describes, (in a roundabout way), the primary marker of lymphocytic colitis.The GI, seen in March, did a celiac gene test and told me I didn't have celiac. Also a colonoscopy, and told me at the follow-up appointment that while there was evidence of 'something' (increased white blood cell count), it looked like it should be cleaning up.
I totally agree with your second GI that "IBS" does not exist, (except in the minds of doctors who can't figure out what is wrong with some of their patients). However, if he is treating you for "bile salt diarrhea", rather than treating your MC, then he is doing you a grave disservice, because in the meantime, the untreated inflammation can lead to additional autoimmune diseases. You don't mention whether or not you're taking a bile acid sequestrant, but I would assume that you probably are, (based on your second GI's "findings").
It's certainly possible that your gallbladder is malfunctioning, because that is a very common condition associated with microscopic colitis. However, the main reason why your bile salts were/are showing up in your colon, is because of your malabsorption problem, (as is obvious by your high fat malabsorption score). Normally, bile salts are absorbed in the terminal ileum, where they are recycled for the production of cholesterol, as needed by the body for normal functioning. MC causes serious malabsorption issues, resulting in not just bile, but all sorts of unabsorbed nutrients to pass into the colon. Yes, the bile acids can make the D worse, (they should cause green pigmentation of the stool), but the primary reason for the malabsorption problem is not the bile, (nor the malfunctioning of the gallbladder), but the inflammation associated with MC.
The point is, gallbladder and/or bile salt issues do not cause malabsorption issues - it's the other way around. Malabsorption problems cause bile salt issues. If your bile salts are getting past the terminal ileum, then that is due to a malabsorption issue in your terminal ileum, and that occurs because the inflammation that causes MC is typically more pronounced, (more concentrated), in the terminal ileum and the right-side colon, in most cases.
You don't say if you are symptomatic now, of if the bile acid sequestrant is controlling your D, (assuming that you are taking one). If it is, then that is evidence that your MC is asymptomatic, meaning that the inflammation and damage continues, even though you do not have clinical symptoms. One of the side effect of bile acid sequestrants is constipation, and many GIs prescribe it to MC patients hoping that it will stop their D, (and sometimes it does), but it does nothing to address the inflammation issue. If the bile acid sequestrant is not controlling your D, then it's not really doing anything for you.
You also don't say whether you are following a GF, DF, etc., diet. If you are, then when it takes effect, your bile salt issues will very likely disappear, also, without the need for any bile acid sequestrant. If you are not following a GF, DF, etc., diet, they your inflammation is continuing, putting you at an elevated risk for additional autoimmune diseases.
I can appreciate your husbands concerns about possibly taking these food issues too seriously, but trust me, with the relatively high numbers in your Enterolab test results, there is no way that you can take them too seriously - this is for real. You have very serious food sensitivities that need to be addressed, 100%.
Look at it this way, the bile is there to digest fats, and yet, according to the Enterolab test results, (fat malabsorption score), you are most definitely not absorbing fats. Obviously, the bile is doing nothing - it's not helping to digest the fats. Therefore, the bile salt issue is a result of the inflammation and the diarrhea caused by MC, not the cause of it. As is so often the case, your GI is mistakenly treating a single symptom of MC, rather than treating the disease that is causing the malabsorption of bile salts.
If you did not have lymphocytic colitis, then the bile salt issue might indeed be a valid issue, and worth pursuing. However, for someone with LC, bile salts, and all the other digestive system issues that are present when we are reacting, are secondary to the LC, and they should only be addressed if their symptoms still exist after the symptoms of LC are completely controlled. Typically, once the LC, CC, MC, or whatever type of colitis we might have, is resolved, then all those satellite issues will disappear.
Again, welcome aboard, and please feel free to ask anything.
Tex
P. S. Do you mind if I add your Enterolab test results to our collection?
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thank you, Tex, again another example of a doctor who quit learning when handed the diploma.
astent, please read everything you can and become your own doctor. I understand your husband's concerns, as this can be overwhelming to grasp. Give him the task of researching this and he will know that you aren't taking food issues too seriously.
astent, please read everything you can and become your own doctor. I understand your husband's concerns, as this can be overwhelming to grasp. Give him the task of researching this and he will know that you aren't taking food issues too seriously.
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Interesting conversations, thank you all.
Having been diagnosed with MC in November 2014, and with the information garnered from Enterolab test results, I have chosen to be GF, Sf, and Lactose free (following the CSD allowance for 24 hr fermented yogurt), with occasional good results of softly formed BMs instead of ongoing WD, although the WD was most persistent until I began LDN (low dose neltrexon), 3 mg. In less then a week the WD cleared up. All went well for a couple of months until, considering LDN to be the holy grail, I began adding foods that I had no business eating and caused a severe gastrointestinal reaction...WD as well as severe upper abdominal pain. Right away I cleaned up my diet, and symptoms subsided but upper abdominal pain continued along with burning mainly at night. Last week an upper Gi series and blood work came back normal. Today I had a abdominal ultrasound and received a call from by MD within 2 hrs of its completion saying that I have Gallbladder Sludge (a nasty term) and that she is referring me to a surgeon. Yikes.
I know that Tex has said that MC and gallbladder problems seem to go together, but is there no recourse other then removal? Any thoughts?
Thank you, Nan
Having been diagnosed with MC in November 2014, and with the information garnered from Enterolab test results, I have chosen to be GF, Sf, and Lactose free (following the CSD allowance for 24 hr fermented yogurt), with occasional good results of softly formed BMs instead of ongoing WD, although the WD was most persistent until I began LDN (low dose neltrexon), 3 mg. In less then a week the WD cleared up. All went well for a couple of months until, considering LDN to be the holy grail, I began adding foods that I had no business eating and caused a severe gastrointestinal reaction...WD as well as severe upper abdominal pain. Right away I cleaned up my diet, and symptoms subsided but upper abdominal pain continued along with burning mainly at night. Last week an upper Gi series and blood work came back normal. Today I had a abdominal ultrasound and received a call from by MD within 2 hrs of its completion saying that I have Gallbladder Sludge (a nasty term) and that she is referring me to a surgeon. Yikes.
I know that Tex has said that MC and gallbladder problems seem to go together, but is there no recourse other then removal? Any thoughts?
Thank you, Nan
64 years old. Diagnosed with MC in November. Mesalamine taken but pleuricy developed 2 weeks later; they are linked. No meds being taken. Full panel from Enterolab.
Hi Nan,
Gallbladder sludge? I had to look that one up. The term reminds me of "IBS". GI specialists seem to be particularly adept at coining "colorful" terms to describe non-existent diseases when they can't figure out what's wrong with a patient. That always seems (to them at least) so much more professional than to simply admit that they don't have the foggiest idea what might be wrong.
The odds are very high that this is just a transient condition, probably associated with your recent MC flare), and with any luck at all, it should slowly fade away. Without actual gallstones, or some other obviously-serious problem, please don't let them talk you into surgical removal, because then you will almost surely be stuck with bile acid diarrhea (without a gallbladder). Here's a reference you might be interested in. The last line in the abstract says it all:
That said, it's not impossible that if the symptoms continue indefinitely, you might have to reconsider some sort of treatment, but if I were in that situation, I would give it some time to sort itself out naturally, as your intestines heal again.
Tex
Gallbladder sludge? I had to look that one up. The term reminds me of "IBS". GI specialists seem to be particularly adept at coining "colorful" terms to describe non-existent diseases when they can't figure out what's wrong with a patient. That always seems (to them at least) so much more professional than to simply admit that they don't have the foggiest idea what might be wrong.
The odds are very high that this is just a transient condition, probably associated with your recent MC flare), and with any luck at all, it should slowly fade away. Without actual gallstones, or some other obviously-serious problem, please don't let them talk you into surgical removal, because then you will almost surely be stuck with bile acid diarrhea (without a gallbladder). Here's a reference you might be interested in. The last line in the abstract says it all:
Gallbladder sludge: what is its clinical significance?Medical therapy is limited, although some approaches may show promise in the future.
That said, it's not impossible that if the symptoms continue indefinitely, you might have to reconsider some sort of treatment, but if I were in that situation, I would give it some time to sort itself out naturally, as your intestines heal again.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hello Tex,
Thank you for taking the time to respond. I concur with your assessment...when up against a diagnostic challenge, the prescription tends to be medications that simply mask symptoms, or fallback surgeries. I spent a good part of my sleepless night researching gallbladder disfunction and agree that there is much to be tried before I settle on surgery. My primary effort will be to mitigate inflammation and to effect a cleanse of my liver and gallbladder if I can find a way to do that in a way that isn't rediculously radical. Ah, yet another journey.
By the way, the Enterolab result on my fat absorption was normal. From what I have read if my gallbladder was shot that would not have been the case.
Your involvement and knowledge is much appreciated.
Thank you for taking the time to respond. I concur with your assessment...when up against a diagnostic challenge, the prescription tends to be medications that simply mask symptoms, or fallback surgeries. I spent a good part of my sleepless night researching gallbladder disfunction and agree that there is much to be tried before I settle on surgery. My primary effort will be to mitigate inflammation and to effect a cleanse of my liver and gallbladder if I can find a way to do that in a way that isn't rediculously radical. Ah, yet another journey.
By the way, the Enterolab result on my fat absorption was normal. From what I have read if my gallbladder was shot that would not have been the case.
Your involvement and knowledge is much appreciated.
64 years old. Diagnosed with MC in November. Mesalamine taken but pleuricy developed 2 weeks later; they are linked. No meds being taken. Full panel from Enterolab.
Hi Nan,
I had a first gallbladder ultrasound in 2008. They saw something tiny and were not sure if it was sludge or possibly polyps. I was diagnosed with LC in fall last year. During all the GI tests, they also did another ultrasound and the radiologist described polyps with a size of up to 3 mm. My gastroenterologist told me I would need an ultrasound every six months to keep an eye on the polyps. So, in spring of this year, I had another gallbladder ultrasound and soon got a call from the gastroenterologist's office that he was referring me to a surgeon as the polyps now measured 4 mm. The surgeon is a very good friend of mine that I have known for many years. He told me that the removal of the gallbladder was a routine surgery, explaining how it is done, but told me that he hated to remove organs that do not absolutely need to be removed and that his fear was that the removal of my gallbladder might make my gastrointestinal situation a lot worse and that was the last thing he would want to do. He did say that a few people have less diarrhea after the surgery which does not make sense to him, but that there is the other group of patients who end up with a lot more diarrhea. He said he measured the polyps they saw in 2008 and again in spring 2014 and that they only went from 1 mm to 4 mm and that it was very possible that they would not change in size at all for a few years and to just continue with the ultrasounds every six months. So, I went for another ultrasound about a month ago, expecting another report detailing how many millimeters the polyps were this time. To my surprise, the radiologist that evaluated the ultrasound this time did not specify a size at all. He wrote that as before there was something small visible in the gallbladder, which could represent polyps, sludge, or cholesterolosis. I was surprised to see the word sludge again after all these years and cholesterolosis (a deposit of cholesterol esters). By the way, my LDL cholesterol has always been low (being the lowest right before my LC diagnosis) and my HDL cholesterol has always been high.
I am writing all of this to let you know that sludge does not have to be anything worrisome and that it can stay like that for many years without causing any problems or symptoms whatsoever.
Love, Patricia
I had a first gallbladder ultrasound in 2008. They saw something tiny and were not sure if it was sludge or possibly polyps. I was diagnosed with LC in fall last year. During all the GI tests, they also did another ultrasound and the radiologist described polyps with a size of up to 3 mm. My gastroenterologist told me I would need an ultrasound every six months to keep an eye on the polyps. So, in spring of this year, I had another gallbladder ultrasound and soon got a call from the gastroenterologist's office that he was referring me to a surgeon as the polyps now measured 4 mm. The surgeon is a very good friend of mine that I have known for many years. He told me that the removal of the gallbladder was a routine surgery, explaining how it is done, but told me that he hated to remove organs that do not absolutely need to be removed and that his fear was that the removal of my gallbladder might make my gastrointestinal situation a lot worse and that was the last thing he would want to do. He did say that a few people have less diarrhea after the surgery which does not make sense to him, but that there is the other group of patients who end up with a lot more diarrhea. He said he measured the polyps they saw in 2008 and again in spring 2014 and that they only went from 1 mm to 4 mm and that it was very possible that they would not change in size at all for a few years and to just continue with the ultrasounds every six months. So, I went for another ultrasound about a month ago, expecting another report detailing how many millimeters the polyps were this time. To my surprise, the radiologist that evaluated the ultrasound this time did not specify a size at all. He wrote that as before there was something small visible in the gallbladder, which could represent polyps, sludge, or cholesterolosis. I was surprised to see the word sludge again after all these years and cholesterolosis (a deposit of cholesterol esters). By the way, my LDL cholesterol has always been low (being the lowest right before my LC diagnosis) and my HDL cholesterol has always been high.
I am writing all of this to let you know that sludge does not have to be anything worrisome and that it can stay like that for many years without causing any problems or symptoms whatsoever.
Love, Patricia
Hi Patricia,
Thank you so much for Sharing your story, and being so thorough with your information. You have helped convince me that I can take my time to make a decision about my treatment, and have no reason to rush into surgery. I've continued to do research and believe that there are ways to mitigate the sludge using dietary and supplemental means. I'll give it time, and believe it's certainly worth a try.
I appreciate your taking the time to respond.
My best, Nan
Thank you so much for Sharing your story, and being so thorough with your information. You have helped convince me that I can take my time to make a decision about my treatment, and have no reason to rush into surgery. I've continued to do research and believe that there are ways to mitigate the sludge using dietary and supplemental means. I'll give it time, and believe it's certainly worth a try.
I appreciate your taking the time to respond.
My best, Nan
64 years old. Diagnosed with MC in November. Mesalamine taken but pleuricy developed 2 weeks later; they are linked. No meds being taken. Full panel from Enterolab.