My Enterolab results are back and really worry me. Would appreciate some input.
Fecal Fat Score 1137 Units Normal less than 300 units
Anti-gliadin IgA 7 units normal less than 10 units
Anti-casein 34 units normal less than 10 units
Anti-ovalbumin 16 units normal less than 10 units
Anti- soy 10 units normal less than 10 units
Mean value 11 antigenic foods 9 units normal range less than 10 units
Food with no significant reactivity: rice, beef, pork, tuna, walnut, cashew, white potato
Food with +1 reactivity: oats, corn, chicken, almond
Food with +2 reactivity: none
Food with +3 reactivity: none
I was not expecting fecal fat to be 1137. Don't know what direction to go from here.
I was diagnosed celiac 30 years ago. Have been 100% gluten free (including oats) since that time. I considered myself quite healthy until 2 1/2 years ago when urgent, watery diarrhea started out of nowhere. Was under a lot of stress at the time.
During the last 2 1/2 years I've tried various diets. Was dairy free for at least 2 different months and don't eat a lot of dairy anyway, but did eat cheese and butter when I wasn't dairy free. Nearly 5 months ago I tried low fodmap - no change. 4 months ago started SCD. Eat meat (chicken, beef, pork, some fish & liver), meat stock, SCD 24 hour cultured yogurt which gets rid of lactose and changes casein into a more digestible protein, bananas, a little diluted apple juice. Still drinking coffee and wine (4 - 12 oz per evening). Diarrhea improved quite a bit with SCD - almost no D at night, and usually 2-3 trips to bathroom in the morning, but still no form to BM and enough inconsistency that I always have to worry about needing a restroom in a hurry.
1 month ago I was diagnosed with LC. Biopsies were taken.
This is my first post and I am hoping I get it posted to the right area. Thank you for any help you can give me. I joined this group as soon as I heard about it and find it very helpful.
Carol C
Enterolab results - help please
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rcchild@gpcom.net
- Little Blue Penguin
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Hi Carol,
Welcome to the group. Your low anti-gliadin score proves that you have done a good job of avoiding gluten, so your high fecal fat score must be due to some other food or foods. Since most of us are casein-sensitive (and your casein score was the highest of all the foods tested), I'm pretty sure that your persistent small intestinal inflammation is due to the casein in your diet (assuming that you are avoiding chicken eggs and soy).
All of those specified diets have a flaw for MC patients. The main problem with the SCD (as far as most MC patients are concerned) is that it allows casein. It doesn't matter how digestible it might be in yogurt, it's still casein and we simply cannot tolerate it. I'm pretty sure that after you cut casein completely out of your diet, your fecal fat score will begin to decline as your intestines begin to heal.
You got a lucky break on the 11 other antigenic foods result, with a score of 9. That means that none of those foods are likely to be a problem for you. That said, it's always possible to react to a food despite a safe test result (because we can react to a protein in that food that was not tested), so if a certain food obviously bothers you, avoid it (or at least limit it). Also, if it were me, I would definitely avoid oats, because virtually all of us react to oats. The molecular structure of the avenin in oats is too close to the molecular structure of the gluten in wheat, and it triggers a reaction from our immune systems.
All food sensitivities are initially caused by increased intestinal permeability (leaky gut), which for most of us, was caused by gluten sensitivity. The chronic inflammation that resulted eventually caused us to develop MC. However, remember that a leaky gut can be caused by other triggers. It can be caused by, among other things, high sugar consumption (which probably doesn't apply to you), and high alcohol consumption. IOW, a few ounces of wine doesn't contain much alcohol, but while you're recovering, it might speed up the recovery process if you limit (not necessarily avoid) alcohol intake. That said, it would only make a difference if your immune system is currently hypersensitive.
I hope that some of this is helpful. Again, welcome aboard, and please feel free to ask anything.
Tex
Welcome to the group. Your low anti-gliadin score proves that you have done a good job of avoiding gluten, so your high fecal fat score must be due to some other food or foods. Since most of us are casein-sensitive (and your casein score was the highest of all the foods tested), I'm pretty sure that your persistent small intestinal inflammation is due to the casein in your diet (assuming that you are avoiding chicken eggs and soy).
All of those specified diets have a flaw for MC patients. The main problem with the SCD (as far as most MC patients are concerned) is that it allows casein. It doesn't matter how digestible it might be in yogurt, it's still casein and we simply cannot tolerate it. I'm pretty sure that after you cut casein completely out of your diet, your fecal fat score will begin to decline as your intestines begin to heal.
You got a lucky break on the 11 other antigenic foods result, with a score of 9. That means that none of those foods are likely to be a problem for you. That said, it's always possible to react to a food despite a safe test result (because we can react to a protein in that food that was not tested), so if a certain food obviously bothers you, avoid it (or at least limit it). Also, if it were me, I would definitely avoid oats, because virtually all of us react to oats. The molecular structure of the avenin in oats is too close to the molecular structure of the gluten in wheat, and it triggers a reaction from our immune systems.
All food sensitivities are initially caused by increased intestinal permeability (leaky gut), which for most of us, was caused by gluten sensitivity. The chronic inflammation that resulted eventually caused us to develop MC. However, remember that a leaky gut can be caused by other triggers. It can be caused by, among other things, high sugar consumption (which probably doesn't apply to you), and high alcohol consumption. IOW, a few ounces of wine doesn't contain much alcohol, but while you're recovering, it might speed up the recovery process if you limit (not necessarily avoid) alcohol intake. That said, it would only make a difference if your immune system is currently hypersensitive.
I hope that some of this is helpful. Again, welcome aboard, and please feel free to ask anything.
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.
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rcchild@gpcom.net
- Little Blue Penguin
- Posts: 44
- Joined: Sun May 26, 2019 2:09 pm
- Location: Nebraska
Tex,
Thank you so much.
I will give up the yogurt and chicken (I've eaten quite a bit of chicken and chicken stock in the last 4 months). I haven't eaten oats since the celiac diagnosis (tried them, but never could tolerate) and haven't eaten corn for a year or so. Eat eggs on occasion, but will avoid going forward. Have had no almonds or any other seeds for months. Will make sure the wine consumption is on the low end. If things don't improve, I will give it up completely. I AM going to master LC and hopefully without drugs! A few months ago, before Low Fodmap, Gaps, and SCD, I was eating only meat - beef and pork for the most part - and rice, but it did not help at all. But I wasn't eating meat stock, maybe that is the difference. Because I did improve some, just not enough and then I stalled out.
Could you explain the high fecal fat a little bit for me? Is it a problem with the Pancreas? Should I be taking digestive enzymes? If the fecal fat goes down, does that mean that my Pancreas is getting healthier? Does this problem have any connection to a lack of bile? Is there anything else I should be doing right now, besides a very limited diet and waiting for my gut to heal?
Thanks again,
Carol C
Thank you so much.
I will give up the yogurt and chicken (I've eaten quite a bit of chicken and chicken stock in the last 4 months). I haven't eaten oats since the celiac diagnosis (tried them, but never could tolerate) and haven't eaten corn for a year or so. Eat eggs on occasion, but will avoid going forward. Have had no almonds or any other seeds for months. Will make sure the wine consumption is on the low end. If things don't improve, I will give it up completely. I AM going to master LC and hopefully without drugs! A few months ago, before Low Fodmap, Gaps, and SCD, I was eating only meat - beef and pork for the most part - and rice, but it did not help at all. But I wasn't eating meat stock, maybe that is the difference. Because I did improve some, just not enough and then I stalled out.
Could you explain the high fecal fat a little bit for me? Is it a problem with the Pancreas? Should I be taking digestive enzymes? If the fecal fat goes down, does that mean that my Pancreas is getting healthier? Does this problem have any connection to a lack of bile? Is there anything else I should be doing right now, besides a very limited diet and waiting for my gut to heal?
Thanks again,
Carol C
Hi Carol,
Fat digestion and absorption is a rather complex process, and there are a number of ways that it can be compromised. Basically, as food enters the small intestine, bile enters through the common bile duct (along with lipase from the pancreas). The bile emulsifies the fat particles (breaking them into smaller droplets, and these are digested by the lipase. But absorption requires some further stages in the breakdown process that are required before fat can be absorbed. Rather than to try to explain it, I'll provide a link with an explanation.
https://courses.washington.edu/conj/bess/fats/fats.html
But the hitch here is that if the villi in the small intestine are flattened, or otherwise significantly damaged (as in mature celiac disease), the fat absorption will be very limited, because a high percentage of the enterocytes in the villi will be inaccessible and/or non-functioning. So no matter how well the bile salts and pancreatic lipase break down the fat, it can't be absorbed effectively if the absorption locations are severely damaged.
I'm hoping that this is the problem, and as the villi recover, your fat absorption will improve.
That said, yes, the pancreas becomes inflamed (when the intestines become inflamed) just like the rest of the digestive system, so that pancreatic digestive enzyme production is usually reduced among MC patients. For virtually all of us, as we get the MC under control and our intestines begin to heal, our pancreas also heals and resumes normal (or close to normal) production.
Some people take enzyme supplements. I never did. I tried them one day and got so sick that I would never try them again.
I believe that avoiding casein (in addition to chicken eggs, soy, and gluten) will take you to remission. It may take a while, because you apparently have a lot of intestinal damage that must be healed, but hopefully, that should be sufficient.
Tex
PS I would think that if you had low bile production, your cholesterol level should be low.
Fat digestion and absorption is a rather complex process, and there are a number of ways that it can be compromised. Basically, as food enters the small intestine, bile enters through the common bile duct (along with lipase from the pancreas). The bile emulsifies the fat particles (breaking them into smaller droplets, and these are digested by the lipase. But absorption requires some further stages in the breakdown process that are required before fat can be absorbed. Rather than to try to explain it, I'll provide a link with an explanation.
https://courses.washington.edu/conj/bess/fats/fats.html
But the hitch here is that if the villi in the small intestine are flattened, or otherwise significantly damaged (as in mature celiac disease), the fat absorption will be very limited, because a high percentage of the enterocytes in the villi will be inaccessible and/or non-functioning. So no matter how well the bile salts and pancreatic lipase break down the fat, it can't be absorbed effectively if the absorption locations are severely damaged.
I'm hoping that this is the problem, and as the villi recover, your fat absorption will improve.
That said, yes, the pancreas becomes inflamed (when the intestines become inflamed) just like the rest of the digestive system, so that pancreatic digestive enzyme production is usually reduced among MC patients. For virtually all of us, as we get the MC under control and our intestines begin to heal, our pancreas also heals and resumes normal (or close to normal) production.
Some people take enzyme supplements. I never did. I tried them one day and got so sick that I would never try them again.
I believe that avoiding casein (in addition to chicken eggs, soy, and gluten) will take you to remission. It may take a while, because you apparently have a lot of intestinal damage that must be healed, but hopefully, that should be sufficient.
Tex
PS I would think that if you had low bile production, your cholesterol level should be low.
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.
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rcchild@gpcom.net
- Little Blue Penguin
- Posts: 44
- Joined: Sun May 26, 2019 2:09 pm
- Location: Nebraska
Thank you Brandy & Tex,
Yes I know that de-stressing is so important and I've worked on it in the last 2 years, but life keeps happening. Anyway I'm really working on it. At 69 and semi-retired, it is time to say "no" when I really don't want to take on the next project.
Tex I now have my next plan in place and we'll see if I can get some healing going.
I will be reading the posts and go back and reread your book to get more ideas.
Carol C
Yes I know that de-stressing is so important and I've worked on it in the last 2 years, but life keeps happening. Anyway I'm really working on it. At 69 and semi-retired, it is time to say "no" when I really don't want to take on the next project.
Tex I now have my next plan in place and we'll see if I can get some healing going.
I will be reading the posts and go back and reread your book to get more ideas.
Carol C
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rcchild@gpcom.net
- Little Blue Penguin
- Posts: 44
- Joined: Sun May 26, 2019 2:09 pm
- Location: Nebraska