I'm wondering why nutrient absorption may be limited for folks with active MC, since MC affects the colon and it is my understanding that nutrients are absorbed in the small intestine.
From reading Tex's book, I gather that there is evidence that MC may also affect the small intestine--so I'm assuming this is why?
Thank you for helping me better understand this!
Sonia
Nutrient absorbtion
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Re: Nutrient absorbtion
Hello Sonia,
Yes, there is overwhelming evidence (and many research articles verifying this in the medical literature) that in most MC cases, the small intestine Is also inflamed. Unfortunately, apparently most gastroenterologists have never bothered to read any of those articles, and so they're unaware of the small intestinal association.
The nutrient malabsorption problem is caused by the fact that when the small intestine is inflamed, digestive enzyme production is compromised, so that much of our food is only partially digested. Because the foods are not broken down adequately, many of the nutrients are not available for absorption. In addition, the inflamed lining of the small intestine is limited in its ability to property absorb nutrients also, due to the inflammation. Eating smaller, more frequent meals helps, because smaller meals are better digested before the small intestine exceeds its enzyme-production capabilities.
The nutrient malabsorption problem is worse for some of us, than others, depending upon the degree to which our small intestine is inflamed. This is why some of us Tend to lose so much weight, when I MC is active, while others don't seem to lose much weight, if any.
I hope this helps,
Tex
Yes, there is overwhelming evidence (and many research articles verifying this in the medical literature) that in most MC cases, the small intestine Is also inflamed. Unfortunately, apparently most gastroenterologists have never bothered to read any of those articles, and so they're unaware of the small intestinal association.
The nutrient malabsorption problem is caused by the fact that when the small intestine is inflamed, digestive enzyme production is compromised, so that much of our food is only partially digested. Because the foods are not broken down adequately, many of the nutrients are not available for absorption. In addition, the inflamed lining of the small intestine is limited in its ability to property absorb nutrients also, due to the inflammation. Eating smaller, more frequent meals helps, because smaller meals are better digested before the small intestine exceeds its enzyme-production capabilities.
The nutrient malabsorption problem is worse for some of us, than others, depending upon the degree to which our small intestine is inflamed. This is why some of us Tend to lose so much weight, when I MC is active, while others don't seem to lose much weight, if any.
I hope this helps,
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.
Re: Nutrient absorbtion
Hi Tex,
This is super helpful, thank you. I have had regular upper endoscopies because I also have celiac; is the microscopic colitis something that wouldn't show up even if they are doing biopsies? Or they have to be looking for it in particular to find it? I've been told that my small intestine is "healed", but I don't know how much of the small intestine they look at...
I have not, by the way, had significant weight loss; but I am already a pretty slim person and so this concerns me.
Thank you!
Sonia
This is super helpful, thank you. I have had regular upper endoscopies because I also have celiac; is the microscopic colitis something that wouldn't show up even if they are doing biopsies? Or they have to be looking for it in particular to find it? I've been told that my small intestine is "healed", but I don't know how much of the small intestine they look at...
I have not, by the way, had significant weight loss; but I am already a pretty slim person and so this concerns me.
Thank you!
Sonia
Re: Nutrient absorbtion
Hi Sonia,
If you have any celiac symptoms at all, they will mask any MC symptoms in the small intestine. This is because at least a March level of 3 or 4 is normally necessary in order to receive a celiac diagnosis, and the damage to the Villi of the small intestine rarely exceeds a Marsh level of I, with MC. Normally, most endoscopies only barely enter the duodenum, and although MC may inflame the duodenum in some cases, it's normally confined to the Ilium, and occasionally the jejunum.
MC is mostly limited to the terminal ileum (where most electrolytes and bile acids are absorbed, incidentally), and the colon(where magnesium and sodium are absorbed, and potassium is either absorbed or secreted, depending on the potassium level in the lumen). Calcium is mostly absorbed in the duodenum although some may be absorbed in the entire intestinal tract. The inflammation of the terminal ileum is the reason why bile acid recycling is compromised when MC is active.if you haven't had significant weight loss, your upper small intestine is probably not inflamed, at least not significantly, although the terminal ileum may be inflamed if you're having MC symptoms.
I hope this helps,
Tex
If you have any celiac symptoms at all, they will mask any MC symptoms in the small intestine. This is because at least a March level of 3 or 4 is normally necessary in order to receive a celiac diagnosis, and the damage to the Villi of the small intestine rarely exceeds a Marsh level of I, with MC. Normally, most endoscopies only barely enter the duodenum, and although MC may inflame the duodenum in some cases, it's normally confined to the Ilium, and occasionally the jejunum.
MC is mostly limited to the terminal ileum (where most electrolytes and bile acids are absorbed, incidentally), and the colon(where magnesium and sodium are absorbed, and potassium is either absorbed or secreted, depending on the potassium level in the lumen). Calcium is mostly absorbed in the duodenum although some may be absorbed in the entire intestinal tract. The inflammation of the terminal ileum is the reason why bile acid recycling is compromised when MC is active.if you haven't had significant weight loss, your upper small intestine is probably not inflamed, at least not significantly, although the terminal ileum may be inflamed if you're having MC symptoms.
I hope this helps,
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.
Re: Nutrient absorbtion
Thank you--this is all so interesting. The "masking" issue makes sense for me personally, as I think I was a Marsh 4, and then was diagnosed with CC a few months later after not getting significantly better on a GF diet.
With gratitude,
Sonia
With gratitude,
Sonia