Guest guest Posted July 22, 2005 Report Share Posted July 22, 2005 If you are concerned about fat malabsorption you should ask her about the consistency of her stools....oily? floating? Also you may want to check a fecal fat test as well as checking EFA profile and fat soluble vits. Did she start any new medication lately? And she needs to keep food records...I've had patients who thought they were getting enough kcal/pro but then they really look at their intake it did NOT equal thier goals. Lastly, is she at risk of an eating disorder??? Is she taking laxatives? Probiotics are a great idea but what I'd still find the etiology of the diarrhea. Hope this helps, Boyer, RD Boston, MA > I have a bypass pt 2 yrs out of surgery who is now 18# below her ideal body weight and still losing. She is very scared and reports average of 6 watery BMs per day. Her Hair is still thick, The labs her PCP drew were within normal limits including alb, H/H, MCV/MCH. I am assuming she is having some major fat malabsorption and the reason her labs are WNL is becuase her body is compensating. I was considering the use of peptinex for oral intake and additional Omega 3s. Any suggestions would greatly be appreciated. > > Thank you > > Jerry Elizondo RD/LD > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2005 Report Share Posted July 22, 2005 Thank you for all the advice. I will definitely ask her when she comes in for her appointment. She is keeping a food diary for me as well as number and times of day she has bowel movements to see if there may be a correlation between certain foods and her bowels. I apologize but I am not familiar with the labs to request for a EFA profile or for the fat soluble vitamins. Again, thank you for the suggestions and sorry for my neediness. Jerry __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2005 Report Share Posted July 22, 2005 EFA= essential fatty acids Fat Soluble vitamins= A, D, E, and K...K would be less likely since it is synthesized by the liver. Happy Friday! > Thank you for all the advice. I will definitely ask her when she comes in for her appointment. She is keeping a food diary for me as well as number and times of day she has bowel movements to see if there may be a correlation between certain foods and her bowels. I apologize but I am not familiar with the labs to request for a EFA profile or for the fat soluble vitamins. > > Again, thank you for the suggestions and sorry for my neediness. > > > Jerry > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2005 Report Share Posted July 22, 2005 Thanks , I think I was a little vague. I called the Lab in our hospital and they can draw labs for A Fatty Acid Profile I just wasn't sure if there is a more specific lab strictly for EFAs. Thanks again for your help and Have a happy friday as well. Jerry <kboyer@...> wrote: EFA= essential fatty acidsFat Soluble vitamins= A, D, E, and K...K would be less likely since it is synthesized by the liver. Happy Friday!> Thank you for all the advice. I will definitely ask her when she comes in for her appointment. She is keeping a food diary for me as well as number and times of day she has bowel movements to see if there may be a correlation between certain foods and her bowels. I apologize but I am not familiar with the labs to request for a EFA profile or for the fat soluble vitamins. > > Again, thank you for the suggestions and sorry for my neediness.> > > Jerry > > > __________________________________________________> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2005 Report Share Posted July 22, 2005 Has she been worked up by GI? How long has she had the diarrhea? I would want to rule out CDiff or other organisms...depending on the type of procedure you could also get bacterial overgrowth in the biliopancreatic limb (she would have corresponding elevation in acid levels). Medications, including herbal supplements, could also cause diarrhea. Has celiac been ruled out? The etiology of the diarrhea is important in finding the right treatment rather than just reducing symptoms. If this is chronic diarrhea, be sure to check her zinc level -- this wasn't mentioned in the labs that the PCP drew. My experience with post-gb patients who become Zinc deficient is not so much that they lose hair on their head, but when queried, they report pubic hair loss, not something we routinely would observe... Keep us posted! Jeanne Blankenship, MS RD Fat Malabsorption I have a bypass pt 2 yrs out of surgery who is now 18# below her ideal body weight and still losing. She is very scared and reports average of 6 watery BMs per day. Her Hair is still thick, The labs her PCP drew were within normal limits including alb, H/H, MCV/MCH. I am assuming she is having some major fat malabsorption and the reason her labs are WNL is becuase her body is compensating. I was considering the use of peptinex for oral intake and additional Omega 3s. Any suggestions would greatly be appreciated. Thank you Jerry Elizondo RD/LD __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2005 Report Share Posted July 23, 2005 Thank you Jeanne and the rest who have offered suggestions. I am going to be much more prepared for her appointment. Jerry Elizondo RD/LDJeanne Blankenship <jbship@...> wrote: Has she been worked up by GI? How long has she had the diarrhea? I would want to rule out CDiff or other organisms...depending on the type of procedure you could also get bacterial overgrowth in the biliopancreatic limb (she would have corresponding elevation in acid levels). Medications, including herbal supplements, could also cause diarrhea. Has celiac been ruled out? The etiology of the diarrhea is important in finding the right treatment rather than just reducing symptoms. If this is chronic diarrhea, be sure to check her zinc level -- this wasn't mentioned in the labs that the PCP drew. My experience with post-gb patients who become Zinc deficient is not so much that they lose hair on their head, but when queried, they report pubic hair loss, not something we routinely would observe... Keep us posted! Jeanne Blankenship, MS RD Fat Malabsorption I have a bypass pt 2 yrs out of surgery who is now 18# below her ideal body weight and still losing. She is very scared and reports average of 6 watery BMs per day. Her Hair is still thick, The labs her PCP drew were within normal limits including alb, H/H, MCV/MCH. I am assuming she is having some major fat malabsorption and the reason her labs are WNL is becuase her body is compensating. I was considering the use of peptinex for oral intake and additional Omega 3s. Any suggestions would greatly be appreciated. Thank you Jerry Elizondo RD/LD __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 25, 2005 Report Share Posted July 25, 2005 We had a pt last week who was six weeks post-op with similar symptoms. Diarrhea x1wk. It ended up he had giardia (sp?) which is usually caused by contaminated water or food. It’s very rare for someone who hasn’t left the country, which he hadn’t. I’m not saying that this is your patient’s problem, but you just never know. It could be something that nobody is considering. Kamin, RD, CD-N Bariatric Surgery New Britain General Hospital 100 Grand Street New Britain, CT 06050 From: [mailto: ] On Behalf Of jeremiah elizondo Sent: Saturday, July 23, 2005 5:01 PM Subject: Re: Fat Malabsorption Thank you Jeanne and the rest who have offered suggestions. I am going to be much more prepared for her appointment. Jerry Elizondo RD/LD Jeanne Blankenship <jbship@...> wrote: Has she been worked up by GI? How long has she had the diarrhea? I would want to rule out CDiff or other organisms...depending on the type of procedure you could also get bacterial overgrowth in the biliopancreatic limb (she would have corresponding elevation in acid levels). Medications, including herbal supplements, could also cause diarrhea. Has celiac been ruled out? The etiology of the diarrhea is important in finding the right treatment rather than just reducing symptoms. If this is chronic diarrhea, be sure to check her zinc level -- this wasn't mentioned in the labs that the PCP drew. My experience with post-gb patients who become Zinc deficient is not so much that they lose hair on their head, but when queried, they report pubic hair loss, not something we routinely would observe... Keep us posted! Jeanne Blankenship, MS RD Fat Malabsorption I have a bypass pt 2 yrs out of surgery who is now 18# below her ideal body weight and still losing. She is very scared and reports average of 6 watery BMs per day. Her Hair is still thick, The labs her PCP drew were within normal limits including alb, H/H, MCV/MCH. I am assuming she is having some major fat malabsorption and the reason her labs are WNL is becuase her body is compensating. I was considering the use of peptinex for oral intake and additional Omega 3s. Any suggestions would greatly be appreciated. Thank you Jerry Elizondo RD/LD __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2006 Report Share Posted June 7, 2006 Hi all, Recently, to increase my good fat intake, I have been eating butter (good, organic stuff) by the tablespoon as a snack between meals. But I have noticed my digestion getting gradually worse. I think that the butter on its own must be hard for my system to digest, and maybe I have a fat malabsorption problem. Would you recommend that I take lipase supplements with my meals? Also, am I right in thinking that eating coconut oil between meals would be ok as it is easier to digest? Thanks, Helena Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2006 Report Share Posted June 8, 2006 Helena wrote: > > Hi all, > > Recently, to increase my good fat intake, I have been eating butter > (good, organic stuff) by the tablespoon as a snack between meals. But > I have noticed my digestion getting gradually worse. I think that the > butter on its own must be hard for my system to digest, and maybe I > have a fat malabsorption problem. Would you recommend that I take lipase supplements with my meals? ==>Fats are better taken with other foods esp. protein, i.e. Bee's raw egg drink. If you have a complete meal and do not have digestive problems you won't need the lipase, but if complete meals cause a problem start with HCl to increase stomach acid - see the Digestion Folder on how to test for it - and if that doesn't help you can also take lipase, or even better take Ox Bile supplements. > > Also, am I right in thinking that eating coconut oil between meals > would be ok as it is easier to digest? ==>Coconut oil is okay between meals. Bee Quote Link to comment Share on other sites More sharing options...
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