? Bile salt malabsorption

[Ruthy1960]

Hi everyone, I would appreciate some advice from you all. I was diagnosed with IBS many years ago and have never been convinced I suffer from it. I also eat gluten free as a gastroenterologist told me years ago that he thought I was gluten intolerant. I also get these irregular bouts of severe stomach cramps that double me over followed by orangy/yellowy diarrhoea (excuse the graphic description. None of the so called medical professionals have come to any conclusions apart from oh it's your IBS! I have had every scan under the sun and all have proved negative. Does anyone think like me it could be bile salt malabsorption. I'm at my wits end and don't go very far these days due to the unpredictable diarrhoea, my family don't understand. Help. 😖

[asbayford]

Fructans are in gluten products, aswell as onions, garlic and more and drs are just realising that's what some ibs sufferers are intolerant to. Have you tried the low fodmap diet? Its changed my life. Sounds like it could be bile salt malabsorption yes but please do look into the fructan intolerance too 😊 maybe limit your fat intake too? I hope this helps x I had the same thing x

[Ruthy1960 in reply to asbayford]

Thank you so much I see my GP on Fri. I'll push for the medication. 😊

[Bellacat21]

Hi ask you GP for a SEHCAT test (apologies if spelt wrong) this is pain free and will help with your diagnosis... my came back positive and on tablets now coveselam which help with food digestion and bile salts etc ..

[Ruthy1960 in reply to Bellacat21]

Thanks ever so much I will. 😊

[Houseofpain]

I also had issues that I didn't just have IBS, so had another colonoscopy which was clear and than had a SEHcat to establish whether I had what you have described - BAD/ BAM and I do. It's a radioactive pill you take and then go back a week to find out what the results are.It would be worth you doing it so you know. I am now on Colesevelam which basically hasn't made a massive difference and I have no idea what to do next asa I'm not taking it properly now. I sometimes fast (not always intentionally) and then eat too much at night which only leads to a dodgy stomach. I'm at my wits end with it - I know I should be on a low fat diet, having gone fodmap mad previously...again I didn't do it properly but was always conscious of good and bad stuff to eat. I haven't slept all night soI hope this makes sense. Obviously I am not doing things the right way so others may be able to help more, but at least it may be good to do the test to know for sure ..

[Ruthy1960 in reply to Houseofpain]

Thanks very much I'll discuss all this on Friday with my GP. 😊

[sweetsusie in reply to Ruthy1960]

Up your dose, Houseofpain: I had to take SIX tablets of Colestipol when I was first started on this med...now down to 4 tablets a day...

[Moijoy]

This might be worth looking at drhyman.com/blog/2015/04/17...

My herbalist put me on the GAPS diet with supplements and I now after a year of being on the diet have normal stools.

[Ruthy1960 in reply to Moijoy]

Thanks for your advice. 😊

[Hidden]

Hi Ruthy1960

I had not heard of bile salt malabsorption before reading your post. Google-ing it seems to bring up bile acid or BAM. There is advice on several NHS health care sites discussing it but there is little on sites like PubMed for research papers.

It seems that this is considered to be a symptom of Crohn's or IBS amongst others. As usual the suggestion is medication without dietary intervention! The meds do not seem to cure but just suppress.

Ask for a stool Calprotectin test if you have not had one already. This will determine if you have IBD (Crohn's or Colitis). Health authorities often set age limits for this test. In my case I am well beyond the 45 year old limit...obviously you can't get IBD if you are 46 or older!!!! Message me and I can tell you who offers an inexpensive test without the need for a referral.

The only reliable test for Celiac disease is a biopsy taken during an endoscopy. There are less reliable blood tests. There is a widely held belief in some quarters of non celiac gluten sensitivity (NCGS) being a real condition. The NHS poo-poo's (pun intended!) this notion (like they believed a hundred years ago that Alzheimer's and Asthma were conditions only exhibited by hypochondriacs...they do catch up, eventually!).

Truth is that a reliable test has not yet been devised for NCGS. My dietician suspected that I exhibited this condition and made a simple suggestion. Eat some Waitrose Number One (Brand name) Spelt Sourdough bread. It has Gluten in it but is low in FODMAP's so it a good isolation food to test your sensitivity to gluten, or not. It seemed very popular in my nearest Waitrose so you might need to get there early! 😊

I know how debilitating Diarrhoea can be and ultimately it means your gut is missing out on so much goodness! There is a preoccupation in mainstream medicine with medication. They often only serve to suppress not cure causal roots. IBD/IBS/SIBO are all affected by the standard western diet. Processed foods, sugar additives, junk. But also complex sugars and starches, soluble and insoluble fibres.

Why then does your GP not recommend restricted diets? Maybe they just don't understand the impact. It can be seen in the same way the local doc prescribes drugs then insulin for type 2 diabetes...its a lifestyle disease, rubbish in rubbish [high blood sugar] out! It pains me that so many chronic conditions can be altered or even cured by what we put in our mouths!!

Rant over...try a low FODMAP diet. It can't make matters worse and it might even help! There is no 'one size fits all' here of course but I am convinced of it efficacy.

I follow scientific evidence when I tried something new for my IBS & SIBO and low fod's worked for me. I'm now cured!

Start here, might I suggest.... monashfodmap.com kcl.ac.uk/lsm/schools/life-...

Both reliable organisations! Good luck. Let me know if you want any more info...

[Ruthy1960 in reply to Hidden]

Thanks ever so much for your help, I see my GP on Friday. 😊

[Houseofpain in reply to Hidden]

I got very mixed up in all these diets. I was told to abandon fodmap when i got diagnosed with BAD and embark on a lo fat diet, but i was also looking at a generic foodplan and got overwhelmed. Iwas worried have chrons as a parent had it. But now i hear BAD can be a sympton of chrons, i wonder if it is just as bad. Are there any meal replacements I can try while i am all this pain?

[Hidden in reply to Houseofpain]

Houseofpain

I wish I could give you a simple answer, I know from my own experience how frustrating this process can be, especially when you might be receiving diagnosis's that might not be accurate. But I am not qualified or familiar with your case

I challenge what I am told by specialists if I do not understand the result, their advice or I am sceptical that the diagnosis does not stand up to scrutiny. At the end of the day always ask for evidence to justify their response. Doctors are human, fallible and often are using very out dated practises or treatments...and ultimately you pay their wages! 🙂

Start with the Calprotectin Stool test, that will hopefully take that worry off the table. If you are too old by NHS standards Medichecks do the analysis for £99. medichecks.com/tests/calpro...

Good luck

[Houseofpain in reply to Hidden]

Thank you for the message. I do challenge stuff when I am concerned or feel further investigations need to be made. Had a stooltest may back when, when i was worried about chrons. Is that a calprotection one or is that a generic test? Not sure.

[Hidden in reply to Houseofpain]

Calprotectin is the standard IBD test I believe.

[BabsyWabsy]

Before you ask for a Sehcat test, you could ask your GP to prescribe a sequestrant such as Questran to see if it makes any improvement. If it is BAM, the sequestrant will bind to the bile acid, preventing large quantities from entering the large bowel and creating osmotic diarrhoea as your bowel tries to get rid of the irritant as fast as possible. Might be worth a try before you take the definitive test.

[Ruthy1960 in reply to BabsyWabsy]

Thanks ever so much for your help. 😊

[sweetsusie in reply to BabsyWabsy]

I agree..BabsyWabsy....I take 4 tablets of Colestipol a day for chronic diarrhea...works like a charm...no longer bothered with with this crap (pun intended!).

[Whitesugar]

I had 'IBS' for over 40 years. Most of my life has been spent as a victim to unpredictable diarrhoea. After countless visits to GPs I saw a gastroenterologist with an interest in IBS last summer. I had the usual tests to eliminate any sinister disease or inflammatory conditions of the bowel. He then asked me to take a trial of Questran. I have not had the diarrhoea once since then, proving that I have Bile Acid Malabsorption (or Bile Acid Diarrhoea). It really is a life changer if you have the condition. No amount of manipulating the diet will make any difference if your bile salts are getting into the large bowel where they shouldn't be in any quantity. I didn't have a SeCHAT test as the consultant said it is unnecessary if the medication works. I have also taken Colestid which works in the same way. There are currently problems with supply of these powders and I have found I can take either with no change to the bowel.

[Ruthy1960 in reply to Whitesugar]

Thanks very much for your reply. I see my GP on Friday and I'm going to push for another gastro referral. 😊

[Houseofpain in reply to Whitesugar]

Is questran available in the uk?

[Whitesugar in reply to Houseofpain]

Yes it is. I'm currently taking a generic brand as the branded Questran is out of stock, but it's working fine.

[sweetsusie]

Sounds like bile acid malabsorption to me, Ruthy1960. I have never been tested for it, but had the same kind of yellow in my stools. I researched it and the miracle cure for this awful thing are: Welchol, Colestipol (which is the one I take...4 tablets, twice a day...2 in the morning and 2 in the evening), and Questran (which I am hearing doesn't work as well). Tell your doctor to prescribe one of these for you..you'll have your life back, as do I!

[Ruthy1960 in reply to sweetsusie]

Thank you so much for your reply. I see my GP on Friday and will get her to sort it out. I can't believe I've suffered with the awful pain and diarrhoea for years and no health professionals have ever mentioned it. I've researched it myself! 😊

[sweetsusie in reply to Ruthy1960]

Yes..same here...no doctor I ever went to mentioned any of these to me..I don't know if they're not aware or they're just uncaring or whatever. I'm just glad I researched it and that my doctor was willing to give the med. a try!! Hopepfully, your doctor will have "ears," and will listen to you!

[Ruthy1960 in reply to sweetsusie]

Thanks either she helps me or I'll sit there all day. Ha ha. 😂

[sweetsusie in reply to Ruthy1960]

HAHA!!! Whatever it takes, girl!!

[Ruthy1960 in reply to sweetsusie]

Hi,Managed to get my GP to start me on treatment. Thanks for your info and support. Fingers crossed it will work. 😊

[sweetsusie in reply to Ruthy1960]

YIPPEE!!! Please keep me posted! I had to experiment a bit with it...first it was 6 tablets a day...now I do 4 a day...still working well!

[Ruthy1960 in reply to sweetsusie]

Hi, sweet Susie, Just a few extra questions. Are you on the tablet or powder sequestrants and are you troubled with side effects. I read bloating and tummy pains can get worse. Many thanks. 😊

[sweetsusie in reply to Ruthy1960]

I'm on Colestipol, which is a tablet form...can't stand to take anything that you have to mix with water or whatever (wine, perhaps...hehe??). I have had no side effects...no bloating...no tummy paints...nada....what did the doctor prescribe for your, Ruthy1960?

[Ruthy1960 in reply to sweetsusie]

Hi, I pick them up tomorrow but I think it's sachets. I'll have to see how it goes probably. He did say go back if any issues. Many thanks. 😊

[sweetsusie in reply to Ruthy1960]

It's probably the Questran, then. I've heard it sometimes doesn't work as well as Welchol and Colestipol, but I hope it works very well for you. If not..yes! Definitely call your doctor and tell him that you'd like to try one of the other 2. Good luck!

[Ruthy1960 in reply to sweetsusie]

Thanks Sweet Susie 😊

[sweetsusie in reply to Ruthy1960]

You're very welcome, Ruthy1960.....

[Fancyshark]

Have your been checked fir EPI? Perhaps find another gastro who understands fat malabsorption or bile salt issues. I’m in the same boat. It’s horrible. All the best to you