Continuing Mike's thread on bile acid malabsorption

CAMary · Post by **CAMary** » Fri Nov 10, 2006 10:06 am

Katy-

Popping in here to wish you improved health. I think you are getting fabulous advice from some very knowledgeable folks!!

1-Why do you think you are ill from the transfusion 1.5 years ago? Are you having specific symptoms suggesting that, or do you think it is your anxiety kicking in??? Just wondering the basis for that concern? There was a time (early 80s) my youngest bro had heart surgery - since it was done in SF at the beginning of the AIDS crisis, he had to be tested...but in general the blood supply is very well-screened...Hope you can get that checked out so you feel resolution w/ the issue...

2 - c-diff makes you VERY ill. I went to urgent care with gut-wrenching cramps and "can't leave the house-type D". The doc there actually thought I had some sort of food poisoning (until the culture came back) the symptoms are quite acute and render you virtually non-functional. I did not have blood in my stool, but was passing gobs and gobs of yellowish-tinged mucous.

I never eat soup when I'm out of my own house. I'd venture to guess 90% or more contains gluten - esp a cream - based one likely is thickened w/ flour...

I hope you find some answers and begin to feel better, Katy!

Mary

kate_ce1995 · Post by **kate_ce1995** » Fri Nov 10, 2006 10:25 am

Well, lets see, the exhaustion is from Geoff's mom's crisis (and resulting stress) 2 weeks ago, combined with the time change, combined with a subsequent week of business at work and then the retreat (so away from home and no sleeping in Saturday), plus we had to take the girls to church on Sunday so no sleeping in (they usually go with their grandparents but Kayla got her bible so it was a special sunday). Its not a long term thing for sure (yet) but it has been a crazy couple of weeks. I think the back and neck pain was contributing to sleeplessness too. The last couple mornings since seeing the chiro, my back is not hurting so I don't feel like I have to get out of bed to relieve the pain. My neck is still stiff, but I expect it will take a while to reduce the cramped up muscle tension from several weeks of intense stiffness.

I'm just a worrier about my health. Especially when I don't feel well. Hmmm, must be where the anxiety comes from.

Katy

mle_ii · Post by **mle_ii** » Sat Nov 11, 2006 7:21 pm

Well, well, well... here's more on bile and CC.

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

Budesonide treatment is associated with increased bile acid absorption in collagenous colitis.
Background Bile acid malabsorption is frequent in collagenous colitis and harmful bile acids may play a pathophysiological role. Glucocorticoids increase ileal bile acid transport. Budesonide have its main effect in the terminal ileum. Aims To evaluate whether the symptomatic effect of budesonide is linked to increased uptake of bile acids. Methods Patients with collagenous colitis were treated with budesonide 9 mg daily for 12 weeks. Prior to and after 8 weeks of treatment, the (75)SeHCAT test, an indirect test for the active uptake of bile acid-s, measurements of serum 7alpha-hydroxy-4-cholesten-3-one, an indicator of hepatic bile acid synthesis, and registration of symptoms were performed. Results The median (75)SeHCAT retention increased from 18% to 35% (P < 0.001, n = 25) approaching the values of healthy controls (38%). The 7alpha-hydroxy-4-cholesten-3-one values decreased significantly among those with initially high synthesis (from 36 to 23 ng/mL, P = 0.04, n = 9); however, for the whole group the values were not altered (19 ng/mL vs. 13 ng/mL, P = 0.23, N.S., n = 19). Conclusion The normalization of the (75)SeHCAT test and the reduction of bile acid synthesis in patients with initially high synthetic rate, suggests that the effect of budesonide in collagenous colitis may be in part due to decreased bile acid load on the colon.

Post by **tex** » Sun Nov 12, 2006 12:14 am

That's a good article.

Tex

cludwig · Post by **cludwig** » Mon Nov 13, 2006 2:17 pm

Hi Mike,

If that's the case with entocort then I would have to conclude that bile acid is not my problem given that cholestyramine powder also didn't help me. As long as I don't eat any of my intolerances I don't think inflammation is my problem either. At least the pancreatic enzymes seem to be helping somewhat. BTY Mike, have you found a probiotic that you want to try yet?

Love,
Cristi

mle_ii · Post by **mle_ii** » Mon Nov 13, 2006 3:05 pm

Yeah, I'm trying the Primal Defense Ultra by Garden of Life. Has a lot of the bacteria that is actuallly resident in the GI. Missing a few I'd like to see in it, but looks good overall. This is the second day. No adverse reactions thus far.

FYI depending on the level of malabsorption the cholestyramine powder or entocort might not help enough. From reading the full study it only appeard to have a significant effect in around 25% of those with CC. Why it did or didn't help is up for debate.

Have you tried taking something like Caltrate with each meal to see what that does? Maybe start with 1/2 a tablet per meal and go up to see what it does. I'm betting that timing is important for this to work right. If it will indeed help you.

Like I mentioned elsewhere more and more each day I'm seeing MC as a symptom of something else.

Mike

cludwig · Post by **cludwig** » Mon Nov 13, 2006 6:51 pm

Hi Mike,

In my case I definitely think I have MC...I just have something else as well...I'm not sure if it caused it or is complicating my recovery from it.

I want to try the caltrate but it will have to wait until after my Mayo visit as I am already on this diflucan probiotic experiment. I start the probiotic a week from this wednesday.

I'm glad the probiotics are going well for you...I'm anxious to give them a try myself.

I was wondering if you or anyone else here ever has problems with really tight muscles. I have problems with my abdominal wall tightening as well as my intestines seem to have problems with contractions. Sometimes I have to lie down flat to get them to relax. I know I have complained about my eyes and I think the problem is related to the muscles. When I google muscle cramps it generally talks about problems with mineral imbalances. Is there anything about MC that would cause problems of this type or vise versa mineral imbalance cause MC to get worse?

Love,
Cristi

mle_ii · Post by **mle_ii** » Mon Nov 13, 2006 7:30 pm

Well, I'm thinking that MC would cause mineral imbalances for sure. So that's one strike for it causing muscle tightness. That and vitamin and calorie deficiences. That and if the body is having to spend a lot of energy/resources on the inflammation we could get imbalances.

I get muscle tightness, though it's mainly in my upper back. A bunch of this caused by bad posture and stress for sure. Though I haven't had this tighness for a while. Now that I think about it.

I was very deficient in the B vitamins B12 and folate for sure.

Mike