Anyone experiencing malabsorption?

A tumor in the head of the pancreas can affect the production and secretion of the digestive enzymes. When Exocrine Pancreas Insufficiency occurs, malabsorption of nutrients and vitamins results. The condition is treated with pancreatic enzymes replacement therapy using a pancrealipase such an Rx Creon, Zenpep or others.

Some obvious signs of EPI are foul smelling stool that floats and leaves a greasy sheen on the toilet water surface, can be light tan, light yellow or light orange in color. Oil droplets might be noticed after a meal heavy in dietary fats. Excessive foul smelling gas, cramping and urgency to use the toilet.

Another condition seen in advanced stage cancer patients is cachexia. This is a metabolic issue and more difficult to treat. Replacement enzymes and exercise to maintain muscle tone are recommended. A Registered Dietitian with the credential C.S.O. (Certification Specialist Oncology) is the most knowledgeable team member to address these conditions. They will be found assigned to a GI Oncology Unit and have advanced training working with the needs of GI Cancer patients. A GI specialist can do a diagnostic work-up to rule in/out other GI tract pathologies such as Small Intestine Bacterial Overload (SIBO), Lactose intolerance, Celiac Disease, IBD/IBS, Crohn’s disease and others. The test done to determine if digestive enzymes are causing the issue is the fecal elastase-1 test. This is often done when weight loss is the only symptom.

Thank you. Because my CA 19 numbers are heading down, I feel as though it might be SIBO. However my onco won’t order the test. Have to get into a GI Dr. and that will take a month of very little nutrition!

Can you ask the onco for a high-priority referral to both the GI doc and the CSO dietitian?

If the GI could at least order the GI test "remotely," you could get it done first and have that result/data in hand by the time a consultation actually takes place. Better than waiting until the consultation and starting everything serially from there. If there's anything abnormal or alarming in the test result, the GI could expedite your consultation or another appropriate referral.

My oncologist prescribed the Creon. Saved my life my body was melting down. The hepato pancreatic dietician at MSKCC helped me adjust the medication. Took me a while to get to the GI

After MRI today, said I have colitis. However they are finally getting around to stool samples which will tell more. However still no test for SIBO. Until I see gastro guy

Are you currently taking any digestive enzymes? One thing that you may want to consider before the stool sample test is going off of those for 5 or so days. I had all of the symptoms of EPI when I took my first EPI test but results came back fine. After doing more research on my own, I found recommendations regarding temporarily stopping the use of digestive supplements. I asked my GI doc to reorder fecal elastase test and this time it came back indicating EPI.
Also, I did test positive for SIBO which was ordered by a dietitian. The antibiotic prescribed for that helped a lot but it did take a couple rounds of using it. Best of luck to you.

Thank you. I am on enzymes, and had the test, all negative. See a GI Dr next week. Will discuss this.