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Functional reasons for Low Digestive Enzymes Production
Hi Dear Friends,
I have been suffering with Slow Digestion and weight loss issue from past 3 years. Many Tests are done. So far one thing was found. Fecal Elastase was low two times in stool test. My stool is extra soft and not in good solid shape. Many cooked veggies and other foods cause this Extra soft wettish stools. Only sometimes i get solid shape. I am 36 years old male.
Ultrasound of abdomen done two times and CT scan with contrast for chest, abdomen, pelvis is done. No issues in pancreas at all and no pain anywhere in the body.
Endoscopy EGD with duodenum biopsy done. Following is duodenum biopsy report description.
Sections show multiple fragments of small bowel mucosa with well maintained crypt villous ratio and no increase in intraepithelial lymphocytes. The lamina propria shows mild to moderate inflammation by lymphocytes and plasma cells along with few ectatic vessels and very occasional neutrophils. There is mild submucosal brunner's gland hyperplasia. No evidence of parasites, dysplasia or malignancy.
IMPRESSION:
(Method: F)
Features are suggestive of Mild Brunner's gland hyperplasia.
No evidence of organisms, increased IELs, atypia or malignancy.
Doctor said it is IBS but i don’t have any pain but my stool shape is not normal for many foods and fats are taking very longer to digest and sitting longer in stomach when i eat fats and chicken.
When i drink coffee then digestion is faster i see. I think stimulation of nervous system and enzyme production happening. Digestive enzymes pills did not work.
Symptoms:
1. Fats are taking very long to digest and empty stomach. Proteins also similar experience. If i ear fats then need to wait for 9 hours to get appetite again and it is sitting in stomach fir longer.
2. Weight loss
3. Mal Absorption (mal digestion of fats and other hard things)
3. Vitamins deficiency. So far checked B1, B2, B12, D deficient. Have not tested many other like magnesium and other
4. Sleep disturbances for no reason at 3-4am and feeling like incomplete sleep.
5. Stool is wettish and extra soft for many foods. Only little solid for few foods without fibre or sugars
6. Food intolerances started from 6 months. Whole issue of slow digestion started 3 years back.
I have been doing research on finding functional reasons of Low digestive enzymes production when pancreas has no issues at all. Found following things online but need to know of any one of these causing my issues
1. Low Melatonin harmone production
2. Any vitamin, mineral deficiency causing this entire issue? Like Thiamin B1 or Magnesium
3. PH is not strong acidic to stimulate enzymes?
4. Bacterial or fungal biofilm?
5. Amino acids deficiency?
6. Do you think any Bile Acid Malabsorption happening?
Is it Liver issue in digesting fats. Previously onetime fatty liver happened after i lost rapid weight loss but it was normal in 3 months. Blood tests of fibrosis, autoimmune hepatitis was done. All normal.
Doctor simply said IBS but my symptoms matching with Low digestive enzymes clearly but do not know how to fix. Does IBS cause low Digestive Enzymes specially for fats, proteins?
I feel like stimulation through nervous system like autonomic nervous system for motility and vitamins deficiency causing it but how to fix it. Lost lots of my body fat and muscle. Consulted four GI docs and pancreas doc but final doc said IBS but i am not convinced yet and my symptoms are not going away and not able to eat good fats like coconut oil in cooking or any other oils and other foods too. And not sure why my stool shape is not normal.
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I too had diarrhea and weight loss with abdominal pain for years. Fecal elastase stol test showed extreme low so was diagnosed with EPI. Digestive enzymes helped tremendously.
Had 2 endoscopies and colonoscopy , and CT showed healthy pancreas. Dr. Said I have pancreas of a 20 year old (I’m 65) and that I do not have a pancreas problem, no EPI. Only thing showing was a little SIBO. Starting a course of antibiotics for it.
Doesn’t make sense 🤷♀️ just hope I don’t keep losing weight.
Did you say you had vitamin deficiencies? That seems like a good place to start. Can you get some supplements?
As far as avoiding fats, is there a small amount that you can tolerate? Such as one or two teaspoons of peanut butter? Or is it zero?
I don't digest any meat well. I have switched to easy-to-digest proteins: egg whites, pea protein powder/egg white combo (as both complement each other to form a complete protein), lactose-free nonfat milk, and fin fish, like cod and tilapia (salmon is too rich).
I take IBGuard before a meal as directed (for IBS) and a Bragg Cider Vinegar capsule while eating a meal (each capsule equals 1 tablespoon of the same in liquid form). The vinegar speeds up my slow digestion (and I believe there is research supporting this). It could help you.
I don't know how much oil you are consuming, but try to consume only 1-2 teaspoons max at a sitting. Less is more. Avoid animal fat.
Whole food carbs would hopefully digest quickly for you. I doubt you were the sugar-fiend I was, but if you have a sweet tooth, lay off fruit and any type of sweetened item. Potatoes convert to sugar quickly, so just a bit of them.
I lost 25+ pounds while I was trying to figure out what was happening to me. A big part of my IBS trigger was due to anxiety. CBT hypnosis therapy cured that. Seven weekly sessions only. GI Psychology in Burke, VA does telehealth appointments. Tons of research shows that CBT works.
And last but not least, I avoid most FODMAP foods and all grains. Even rice doesn't agree with me. It took a lot of research and experimenting to figure it out. If you have IBS, a functional problem, you really need to look at diet and stress. Also, a gastro clinic (Mayo, Cleveland) or a Gastro doctor that specializes in IBS may be useful for a second opinion. They could have more ideas of what works if they specialize in IBS. Many do telehealth appointments. I see Dr. Asma Kaphra in the Northern VA region.
Could you please share the name of the GI Psychologist in Burke Virginia? Thank you!
Looking for top high quality multi vitamin brand but not able to find. Whole food may be absorbed or not.
Any high quality multi vitamins and pure one in usa.
Small fat is digestible but takes little longer to digest. Peanuts hard to digest.
Food intolerances causing gas and malabsorption. Like onion, garlic, sugars, cooked veggies, cabbage, …. Matching with FODMAP foods. Need to write avoid foods.
There are some vitamins that are available individually, not as a multivitamin. Is that something you would consider?
The psychologist/therapist is Dr. Tina Kavarligos of GI Psychology, Burke, VA. Mid-40s. Good level of experience. Telehealth is all that practice does. Seven weeks of therapy. Good luck!
New Chapter has a great multi-vitamin selection.
I can eat only about 15 things, and I eat trace or zero FODMAP a lot. Sugar ruins me -- even if in sweet squash or fruit.
Attached is some of what I do.
Don't give up -- You will figure it out.
Lately IBGard is really helping me, as well as Bragg Apple Cider Vinegar capsules.
I had a lousy (but fun) diet when I was young and middle-aged. Now it is payback and I counsel younger people to eat better 🙂
My IBS routine 10022023 (My-IBS-routine-10022023-2.pdf)
Yes.
I want Thiamin (highly bio available without affecting sensitive Gut). I heard about Benfothiamine but it’s synthetic and fat soluble so want to make sure it won’t hurt liver.
Magnesium (i want)
Zinc
Currently taking low dose b-complex liquid by Pureencapsulations brand.
Does Thiamine or Magnesium deficiency affects pancreas enzymes?
Doctor is not telling why pancreas is not producing enzymes. Glucose, HBA1C, C-Peptide all normal. Blood Amylase is 88 (reference range max is 110), Lipase is not closer to high reference number and not too closer to lower reference range.
Stomach acid PH or Bile quality from liver might not be enough to stimulate pancreas to produce enzymes.
Not sure why i got deficiency is B1, B2, B12 —— these are water soluble vitamins. I need to fix this malabsorption issue first so vitamins and minerals may help pancreas to produce enzymes. No physical issue in pancreas at all.