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How bad is the 48 hour stool collection for fat and bile?
I've had numerous tests attempting to find the cause of my chronic diarrhea. Bile Acid Malabsorption seemed the most likely, but my 7AC4, Bile Acid Synthesis test came back normal. My GI doc asked if I want to take the 48-hour stool collection for fat and bile on a high-fat diet.
The thought of spending two days on the toilet, due to the high-fat diet, trying to catch my sometimes explosive diarrhea, does not appeal.
Is it that bad? Do you have any tips on getting through it? It sounds much worse than a colonoscopy. (2 colonoscopies and 3 upper endoscopies in the last 6 months).
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I had the 72 hour fecal fat test. Is that similar enough? It was unpleasant, especially the last day. I wish it had only been 48 hours. My origin testing (primarily a FE-1 test) had been borderline and the doctor wasn't sure I needed to take PERT which is so expensive and inconvenient. After the test there was no doubt whatsoever that I had problems with fat malabsorption. After a capsule endoscopy the Exocrine Pancreatic Insufficiency is what it make sense to treat.
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2 Reactionswow wish my gastro doc would do those tests....she absolutely said no and basically threw colistopol at me and said here try this for 8 weeks see if it helps. She seems to think I had classic sysmptoms of BAM even tho as she listed symptoms i'm shaking my head no in response. once she saw i had my gallbladder removed and had diarreha she made that diagnosis. Even after saying can we take these two tests to verify before i shove drugs in my system? nope would not do. she said go to a functional medicine doctor and have them order the tests if you want them. So went to my PCP who is a PA and has special interest/certificate iin functional medicine. and she ordered them. unfortunately the lab at the clinic doesn't do these and we are geetting the run around with mayo clinic. mayo clinci said yes she can order the tests to be done with mayo and they cna be mailed in...she just needs to do the collection and I can mail it in to mayo. but when she called she was told no but Quest Diagnostics does them you will have to go thru them. But when I went to quest they don't do the 48 hr test as the code number we have from mayo doesn't show up in their system. she said check with mayo thye probably have the code wrong. Well quest has the test when I type in the name of it for the 48 hr stool test but it it's description it says it a serum collection. So WTF people? So very frustrating. Right now am waiting for an email from Mayo to advise where to get this test done! And some will need to give me the collection kit if i am to collect poop for 2 days!
Where are you getting it done? have heard in this forum others get it done, but nobody is answering yet this week on where they got it done.
hopefully your my hero of the day!
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2 Reactionshad the 7aC4 test done at labcorp just yesterday so waiting for that result. They didn't do the stool test but did say when they inquired that Quest does it..hahahaha.
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1 ReactionFirst, the GI is with Stanford University and the referral was to Quest ... but remember this was
for the 72 hour test. My health care provider is actually Sutter Health, and in the past they have done my lab work even if it was ordered by an out of network provider like Stanford. I started at Sutter health labs. They gave me the plastic bucket , but told me that only Quest did the test locally and I should drop the bucket off at Quest when it was ready. My drop off day was Sunday and all convenient test offices were closed. Rather than hold on to the specimen another minute, I went back to the Sutter Lab and they apparently sent it on to Quest. The results came back in about a week.
I know this is very detailed, but I hope it might help you somehow. t appears I th
the bottom line is that the test is unpleasant for the patient and technician The FE test is much less unpleasant, and it's gradually becoming all that is available outside amazing facilities like the Mayo Clinic and Stanford Medical Center.
Ironically, after all this, it was very clear that I have a significant problem with steatorrhea. I wondered whether it was worth the effort, but my GI became clear about how to proceed with my care. Subsequently, I've felt other testing is going quickly and efficiently.
The best to you.
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1 ReactionAlso I should mention that I went off Creon for about 5 days. At the time I was doing well and my poop was formed and sank. I feared that when I came off Creon I'd have huge amounts of diarrhea. That is not what happened. It did get mushy which wasn't pleasant, but it it wasn't diarrhea. And presumably you'll be off Creon one day less which will work to your advantage. When I went back on Creon it took a while for the mushy texture ro change for the better. The upside was I forgot eat food like fried chicken and hamburgers for 5 days. I made the best of it because I avoid them generally.
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1 ReactionI'm sorry that you are getting such a run-around. That's why I decided to go to Mayo, which is only a couple of hours from where I live. I was having to look up tests myself.
I did the shorter test, which is both a serum and a single fecal test, but it was inconclusive & I have classic symptoms. Maybe that is the test that required the serum?
I'm getting it done at Mayo Rochester, but I can do the samples at home. I just am not sure how I'm going to collect it - it sounds like I'll be spending 2 days in the bathroom.
Good luck!
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1 ReactionWell good to know that Quest actually does the stool test. I just gotta get them to admit it. lol and maybe find a new gastro doc that is willing to do test and not guess. I really hate taking meds but if i have to I have to but lets find out first with a test is my philosophy and she wasn't willing to even do that.
I know Mayo also does a random sample (one stool collection) fecal test instead of the 48 hr one, but it is only done at Mayo as they are the inventor of it and it only came available thru them very recently I understand.
A. year ago i had a gi map and it did't show any steatorrhea. Also my pancreatic enzymes were normal. and the test of intestinal inflammation and my colonoscopy all came back just fine. No hpylori or sibo or parasites.
So am working on increasing fiber to get to 20-30 grams and reducing fat grams to 50 and below. Seems everything i've researched these are two things that really affect diarrhead/bam/ibs. But these last couple days I can officially say sugar is a big trigger for me, and that's a hard one for me to reduce i'm such a sugaraholic!
At this point to get the 48 hr test, i'd be happy to drive 3-4 hrs to get to the Rochester Mayo.
Good luck on your GI journey. It is one of high self advocacy for sure from all the stories I read on many forums.
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2 Reactions@kwhatlestad
1. did you call Mayo Rochester directly and make an appointment? I know they like to do the two tests together with the serum and one stool sample.
2. Or did you have to have a GI doctor visit first at Mayo? I've got orders from my PCP.
3. Did you have to drive there first to get the collection kit even for the one stool test? Or did they mail it to you? Or if lucky you had to actually poop while there getting the blood sample. lol (about the time you have to poop to give a sample is when you can't right...otherwise we have no problem lol)
From what i understand the 48 hr test is the 'gold standard' for bile acid. They invented the single fecal test for those who had difficulty wanting to do the 48 hr collection.
1. I did call Mayo directly. I first saw a GI, then down twice more for GI tests prior to this test.
2. I think that they like to have an in-person visit with their GI to be sure that they are ordering & coordinating all of the tests. I had 7 tests in 36 hours on one visit!
3. I drove down for the test, hoping to avoid the 48-hour test. I had my blood drawn and shortly after was able to leave a fecal sample. Since I often have 6 - 8 BM a day, I wasn't concerned about needing to go! 😉
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!
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