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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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Maybe some kind of genetic testing. Try 10X optimizer
What about getting a Hida scan to see if the fat malabsorption is due to your gallbladder? I don’t normally have pain except when I eat a fatty meal, like a cheese burger, which I had for the 1st time in a years. I have the fat malabsorption for 1 1/2 years and all I eat is scrambled eggs and chicken. My doctor is sending me for the Hida scan test. Since all other tests showed normal. Good luck!
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1 ReactionSounds like EPI (exocrine pancreatic insufficiency) to me.
Hi, @connectmayo1. You're long-term digestive problems seemed at first similar to mine, but on reading more of your posting, I became puzzled. Your reference to fat going undigested in your stomach is hard to understand. Digestion of consumed fat foods is addressed mainly by bile manufactured in the liver. Bile and other substances produced by the liver are sent through a common duct to the duodenum, the first section of the small intestine which is beyond the stomach. Similarly, the pancreas transmits its digestive enzymes through a duct that also deposits them in the duodenum, not the stomach. If my understanding here is correct, I hope your doctor will take the time to explain whether your digestive problems are affecting you through their presence in the small intestine rather than the stomach. We'd be grateful to hear of the outcome of such discussions. Martin
I have trouble digesting fats too -- they can make me feel pretty sick and affect my digestion for more than a week (to work through). I eat scant fat, mostly from olive oil, coconut oil, 1% Lactaid milk, ground chia seeds and the nuts I can tolerate.
I feel I have a slow digestion. Meats, for example, feel like they are just sitting around in my gut. So I avoid anything but scant meats and instead get my protein from egg whites, pea protein isolate (usually with the eggs whites for a complete protein, hopefully), and low-fat fin fish.
Bragg Apple Cider Vinegar capsules, one with every one of my three main meals (two if I am cheating and eating more meat), eliminates my slow digestion/feeling of being too full feeling.
As far as the IBS diagnosis goes, I do seem to have IBS-C and I take IBGuard before my three main meals. A less expensive (but for me, less effective) alternative is Heather's Tummy Tamers Peppermint capsules. She offers a great peppermint tea though, medicinal strength, that is very useful.
I had a bowel resection for Crohn’s in April (my third one in 22 years) and since then have lost 20 pounds (down to 150 pounds - I’m 6’1”). All my stool tests and bloodwork are fairly normal but I have persistent, horrible gas all day with frequent diarrhea. My stool elastase test measured 150, which is somewhat low. I’ve been taking digestive enzymes, which don’t seem to really help. I have tried low fodmap. Now on a course of steroids. Also prescribed Bentyl. I feel like I am trying so many things at once that I am somewhat shooting in the dark.
Any suggestions? I only have 150 cm of small intestine left and perhaps this is a chronic problem I’ll just have to deal with? I hope this isn’t the case as it is negatively impacting my quality of life. Is it worth a visit to Mayo Clinic? I’m currently being treated in Colorado.
I am at a loss here.
Thanks.
I have had serious digestive issues since the covid booster. I’ve seen 6 Doctors. Finally getting some relief from my new Gastro DO. No gallbladder so bile Rubin was making me sick every day.
I would go to Mayo.
Yes… go to Mayo! Try a different perspective. Good Luck!
Iron deficient what to do?
If you don't want to see if eating iron-rich foods does the trick, prescription iron pills are cheap and work, but useful in my view only if they don't cause constipation. If they do, try Floradix iron pills or liquid. I know people (like my husband) who use the product and are very happy with its results -- their iron numbers go up and they don't experience constipation. Floradix is made from plants.