How bad is the 48 hour stool collection for fat and bile?

My symptoms and journey are very similar to mine although I was diagnosed with bile acid malabsorption, particularly because a urine-type secretion was appearing in my bowel movements. My fat absorption stool tests were normal. Pancreatic insufficiency was also ruled out. What caught my attention was that you mentioned that sugar is a big trigger for you. It just so happens that I have the very same problem. I am going to be asking my PCP to test me for ASID or acquired sucrase and isomaltase deficiency syndrome. I honestly believe that it's exactly what I'm fighting. These enzymes required for digestion are made in the small intestine. I believe this is the big mystery I've been fighting. I'm going to work on my gut as I believe I suffer from a Leaky Gut and that's what's causing my food intolerances and sensitivities including what I just mentioned. Also, it can masquerade as IBS and SIBO and fat malabsorption. Hope this helps. Good luck to you on your journey!

My symptoms and journey are very similar to mine although I was diagnosed with bile acid malabsorption, particularly because a urine-type secretion was appearing in my bowel movements. My fat absorption stool tests were normal. Pancreatic insufficiency was also ruled out. What caught my attention was that you mentioned that sugar is a big trigger for you. It just so happens that I have the very same problem. I am going to be asking my PCP to test me for ASID or acquired sucrase and isomaltase deficiency syndrome. I honestly believe that it's exactly what I'm fighting. These enzymes required for digestion are made in the small intestine. I believe this is the big mystery I've been fighting. I'm going to work on my gut as I believe I suffer from a Leaky Gut and that's what's causing my food intolerances and sensitivities including what I just mentioned. Also, it can masquerade as IBS and SIBO and fat malabsorption. Hope this helps. Good luck to you on your journey!

YES!!! My granddaughter told me about the genetic sugar malfunction but that was more determined and found at birth or shortly there after so didn't think I had that. But i didn't know there was also an acquired one! Thank you so much for that juicy tidbit! I will research that more.

My PCP does functional medicine so we've been on a two year journey with GI mapping, vitamin/mineral testing/ and food intolerances. Lots of various supplements to deal with the dysbiosis in my gut, yet nothing would really pinpoint the diarrhea issue after my gallbladder was removed prior to seeing her. She labeled it as IBS which basically is a catch all name. My candida was sky high on one GI map and so i was put on antibiotic for 8 weeks. still had diarrhea.

I think back before the gallbladder and for years I'd have unexplained diarrhea and well almost always blamed it on something I ate. Kids would say maybe you have IBS. Then things got so bad and pain came and then gallbladder was removed.

Is there a fix if you have ASID? not eat sugar i'm sure, but what about fruits or small amounts of sugar say in a spagetti sauce that has sugar in it? etc. What ahve you learned so far about ASID and I assume there are tests for this?

My PCP is super good about working with me and taking on my suggestions so I'm sure she would order any test for this.

I'm excited now again. Thank you so much for that mention of ASID! Will be wanting to get retested with a GI map/vitamins/food intolerances to see if anything has changed since last ones a year ago with all the supplementation i've been on trying to fix the diarrhea and dysbiosis. Leaky guts are a real thing! and too many medical doctors don't go there at all. One almost needs to find a fucntional medicine doctor and so gladd I found a medical doc PA who has her certificate in functional medicine also. Best of both worlds really.
Again thank you.

Hydrogen breath test, stool test for malabsorption of sugar, and intestinal biopsies while undergoing a colonoscopy are tests available for ASID. I believe mine developed due to gut dysbiosis and leaky gut. Toxins are being released in my bloodstream as a result of damage to the small intestine. Although I have not been diagnosed officially, this does make sense. It's difficult, as you well know, to get a correct diagnosis especially with traditional medicine. So we're on our own to be our own advocates. I have learned a lot from the elimination diet but it is a rather time-consuming way of finding things out. No sucrose, fructans, or lactose. I drink Horizon 2% (due to fat malabsorption) and lactose-free milk. I soak Oats for oatmeal because of phytates but I also take vitamin C since that's supposed to help with that because oatmeal can actually give you leaky gut. Strawberries help with diarrhea, so I try to eat a little every day and I eat only green bananas. Unripened bananas are a prebiotic (food for the good bacteria). Currently I'm taking a broc elite supplement and a good probiotic as well as keeping up with prebiotics. Hopefully, this will help. I've been suffering with a weight-loss issue that I can't seem to get past but I just started eating more often and smaller meals and it seems to be getting better. It very well may be from a combination of all of the above. We'll see. You are more than welcome!

I forgot to mention something I find rather important. I'd like to refer you to Jenna Volpe, RDN, LD, CLT from Whole-istic Living. She's the one that actually opened up my eyes to the possibility of having ASID (acquired sucrase and isomaltase deficiency syndrome). In retrospect, it makes sense now why cholestyramine was a trigger to me. I was initially put on that medication for the BAM (bile acid malabsorption) and decided to discontinue usage due to the fact that aspartame (orange-flavored) can cause cancer of the liver. I found this out due to extensive research on NIH, I believe. Additionally, the lemon-flavored powder contains sucrose which would explain what triggered what I initially thought was IBS! I find that to be very interesting. What if it is ASID all along. That would have a huge bearing on the type of treatment! However, I'm not ruling out a possible parasitic infestation. I plan on getting tested for that in about a month. I'm thinking of getting tested with Thorne. It appears they have a pretty good reputation for such matters. I am open to suggestions. Take care, all and good luck.

Were you able to get the 13C sucrose breath test? I suggested it to my regular doctor and she got it confused with the 13C urea for hpylori. so corrected her on that to see if she will order the sucrose one. she might not have known about the sucrose one. but sent her a link to order it and send it directly to me if her lab doesn't do it. I had a GI map done that covers all of parasites, good and bad bacteria hpylori and lots of stuff. doctor ordered it through Diagnostic Solutions via Rupa Health. Insurance won't cover it but it cost around $315.

I got the serum test for Bile Acid and it came back in the grey range, not low enough to be positively a no and not high enough to be a positively yes that I've got BAM. So it is said that you can have bam issues in that range still (perhaps not as severe?) So the next verification is the 48 hr stool test. Which is the booger to locate. I have tested negative for fat in stool, pancreatic insufficiency coloscopy was normal, no intestinal inflamation.

My GI map did indicate a very low level of Hpylori but she wasn't too worried about that as many people have it in their system. BUT...am i the one that even a low level is being affected by it? will approach that with next visit.
I'm finding it super hard to completely eliminate sugar in my foods! I've always been a sugaraholic.

So yes it is either truly BAM or sugar, is what I beleive. And since I can't seem to get the 48 hr test I have to battle it out with getting rid of sugar completely. Fingers crossed that doctor will order the breath test for the sucrose enzyme. At least eliminate or verify one more thing.

Need to ask...did the stool and serum test verify it was BAM? And since the choylesyrtamine for BAM contains aspartame I know i need to avoid it cause i've known for years that artificial sweeteners give me the runs big time. Never could tolerate them. Although the gi doc gave me colistipol which is a pill form so have to research if it contains any artifical sweeteners. I've read a lot of people can't tolerate the powered form and all too often after a while it stops helping. So that puts it back into what's the problem? (maybe sugar is the true culprit?).

I didn't have a stool test to verify BAM. She knew I had it from the symptoms I reported to her. She also mentioned that she didn't do any testing because my insurance company wouldn't pay for it. What's the sense of having insurance when they won't even pay for what you need?

I believe there are two different breath tests you can take for ASID. One is for sucrose absorption and the other tests for enzymes. Not sure which I would receive and not sure if my PCP is willing to adminster it to me. The inability to break down sucrose can be misdiagnosed as having IBS. I had difficulty with the 'lemon-flavored' cholestyramine. It was a trigger to my IBS. In retrospect, if I do indeed have ASID that would explain it since the lemon-flavored cholestyramine contains sucrose. Most likely the orange-flavored cholestyramine did as well but it wasn't labeled on the package. That doesn't mean anything, though, because, if I'm not mistaken aspartame wasn't labeled on the package as well. It's been over a year since I discontinued it so I no longer have the packages. And that one also seemed to have been a trigger which I was blaming on caffeine from just one cup of coffee. Wonder how many others out there are also blaming everything on coffee.
Have to ask this. How happy were you with the GI-Map from Diagnostic Solutions through Rupa Health. I held off on getting any tests done simply because I didn't think my doctor would order it for me but now I'm seeing such bad reviews. Everyone with good credentials I might add are saying don't waste your money at least for now. They're saying to hold off for at least a few years and that there is no way that they're accurate and just trying to sell supplements. I'm so torn about it. I wish I could find some reputable sources that say that they can indeed be accurate and diagnostic. Would like to hear your thoughts on the subject or any references you may have to reliable documentation that recommends any one of them.

I believe there are two different breath tests you can take for ASID. One is for sucrose absorption and the other tests for enzymes. Not sure which I would receive and not sure if my PCP is willing to adminster it to me. The inability to break down sucrose can be misdiagnosed as having IBS. I had difficulty with the 'lemon-flavored' cholestyramine. It was a trigger to my IBS. In retrospect, if I do indeed have ASID that would explain it since the lemon-flavored cholestyramine contains sucrose. Most likely the orange-flavored cholestyramine did as well but it wasn't labeled on the package. That doesn't mean anything, though, because, if I'm not mistaken aspartame wasn't labeled on the package as well. It's been over a year since I discontinued it so I no longer have the packages. And that one also seemed to have been a trigger which I was blaming on caffeine from just one cup of coffee. Wonder how many others out there are also blaming everything on coffee.
Have to ask this. How happy were you with the GI-Map from Diagnostic Solutions through Rupa Health. I held off on getting any tests done simply because I didn't think my doctor would order it for me but now I'm seeing such bad reviews. Everyone with good credentials I might add are saying don't waste your money at least for now. They're saying to hold off for at least a few years and that there is no way that they're accurate and just trying to sell supplements. I'm so torn about it. I wish I could find some reputable sources that say that they can indeed be accurate and diagnostic. Would like to hear your thoughts on the subject or any references you may have to reliable documentation that recommends any one of them.