After extensive trial and error testing, it appears that I can now eat most (possibly all) nut butters without serious consequences. That said, eating nut butters is not entirely without consequence, just sans serious adverse consequences.
By that I mean that eating almond butter or peanut butter (such as the "Natural" peanut butter versions made with just peanuts and palm oil (so that they do not separate at normal room temp), offered with a Peter Pan label, or a Skippy label, do not trigger an MC reaction for me. Nor do they promote active D. They do however cause a slightly looser stool consistency, presumably due to all the oil (when I eat nut butters, I don't just eat a tiny amount).
Remember that with an ileostomy, I can never have a "normally formed" stool, because that would cause a blockage of the ostoma. So with an ileostomy, one always deals with various levels of what most people would classify as D, but which is strictly normal with an ilesostomy. "D" with an ileostomy is borderline (or can become almost identical to) watery D for people who have intact digestive systems.
Eating the nuts themselves does not work as well, however. I haven't tried peanuts recently, but cashews and almonds tend to cause a belly ache, apparently due to gas. Probably I just no longer have an adequate level of the enzymes necessary to digest most nuts, though I might be able to improve enzyme production if I continued to eat those nuts.
If I eat a relatively small amount, then I sometimes don't even notice the problem because the gas will not be a major problem, and I will automatically belch and the discomfort will be resolved. The more I eat, however, the more significant the gas problem becomes, and the more difficult it sometimes becomes to belch (reminiscent of a common MC symptom). If/when I belch, the problem disappears, but until that happens, it's irritating enough that I just don't crave to eat any nuts. By contrast, the nut butters seem fine. Maybe after I eat nut butters for a while, my ability to tolerate whole nuts will improve.
And as always, remember that YMMV.
Tex
