Mysterious gallbladder disease - can't digest fat for no apparent reason
-
I'm unable to digest even tiny amounts of fat (or sugar), it trigger symptoms of gallbladder attack. I had my gallbladder checked many times and there are no signs of gallstones, also nothing in my bloodwork that would suggest gallbladder disease. The only abnormal thing about my gallbladder is its position in the abdomen - it is pushed slightly out of place, which squeezes my bile duct a little bit. But all doctors that ever did an ultrasound of my gallbladder agree that this should have no effect on my digestion.
I did multiple stool tests for parasites (always clean), and multiple prophylactic courses of antiparasitics, with no effect whatsoever.
Cholagogues, choleretics, and bile salt supplements doesn't relieve the symptoms (they sometimes make the symptoms worse), and cause constipation.
The disease seems to be getting progressively worse over time.
It feels like I have exhausted all reasonable diagnostic options, any suggestion on what to try next would be greatly appreciated!
-
@BearWithMe
what symptoms and whats the timing? -
Have you tried small amounts of alcoholic bitters? For example a small shot of fernet-branca. Cinchona bark tea if you want to avoid alcohol.
-
@cs3000 Nausea, feeling of fullness, pressure and pain on the right side of my abdomen (sometimes also in the solar plexus area). Can eat only small portions and only easy-to-digest foods. Also floating stool and undigested food in stool.
Sometimes it take an hour or two to develop, but most often the symptoms start minutes after eating.
@foxgelb Yes I did. It caused constipation (gut irritation?) but no improvement in symptoms
-
What is your diet like?
-
Have you tried TUDCA ?
I can only digest fats with tudca, otherwise chronic diarrhea
-
-
Pancreas involvement?
The pancreas plays a crucial role in fat digestion by producing and releasing the enzyme lipase.
Lipase works alongside bile from the liver to break down dietary fats into smaller molecules that can be absorbed into the body. -
@Peatful My stool pancreatic enzymes, blood amylase and blood lipase are always perfectly within the range. I definitely have symptoms of pancreatitis, though. Including mild flud sequestration and permanent dehydration that can't be fixed no matter what I do.
CRP and ESR are always elevated for no apparent reason, but that could have many causes.
-
@BearWithMe said in Mysterious gallbladder disease - can't digest fat for no apparent reason:
@Peatful My stool pancreatic enzymes, blood amylase and blood lipase are always perfectly within the range. I definitely have symptoms of pancreatitis, though. Including mild flud sequestration and permanent dehydration that can't be fixed no matter what I do.
CRP and ESR are always elevated for no apparent reason, but that could have many causes.
Déhydration, you cant quench your thirst? Were you drinking milk past months/years before you reduced fat?
-
@BearWithMe said in Mysterious gallbladder disease - can't digest fat for no apparent reason:
Cholagogues, choleretics, and bile salt supplements doesn't relieve the symptoms (they sometimes make the symptoms worse), and cause constipation.
Pressure and pain aside, does TUDCA and the other bile helpers also increase or decrease this:
Also floating stool and undigested food in stool.
So far it sounds as if any expediting of bowel movements alleviates your symptoms whereas those things that others think would support "proper" digestion, or any foods which require and trigger "proper" digestion in all its harshness, worsen your symptoms. Hypothetically you could be in dire need of the latter but aren't fit for it.
From that there could be either something seriously wrong with forward peristalsis,
or it could be a matter of chronic mucosal infection. Or both in a mutually supportive way.
Have you tested for H.pylori and gastric/duodenal ulcers as well as for blood, calprotectin, bacterial intestinal pathogens (PCR on stool specimen)?
Was there mild hepatic or splenic enlargments seen in the ultrasound?
I'd bet on an infectious background also messing with thirst & glucose metabolism & renal functions. -
This post is deleted! -
@random Can't quench my thirst, yes. But also other symtpoms like very dry skin, dry eyes, heat intolerance, exhaustion, sometimes confusion... In the past, I was drinking up to a quart of milk a day, but lost my ability to digest milk sometime around 2021
-
@BearWithMe said in Mysterious gallbladder disease - can't digest fat for no apparent reason:
@random Can't quench my thirst, yes. But also other symtpoms like very dry skin, dry eyes, heat intolerance, exhaustion, sometimes confusion... In the past, I was drinking up to a quart of milk a day, but lost my ability to digest milk sometime around 2021
I got unquenchable thirst drinking raw milk+ sun exposure, sometimes you need more liquid, if liquid doesnt quench your thirst you need more nutrients. sometimes organs Can make the thirst disapear, and sometimes sun exposure specifically midday increase it
-
@CrumblingCookie Sometimes the food sits in my stomach for 2 days (no exaggeration). There is definitely something wrong with my peristaltis. The GI issues are also highly correlated to "stickyness" of the food I eat. I can digest rice noodles without issue (as they are very slippery), but plain rice (sticky) would sit in my stomach forever. I can digest any kind of pasta without problems (wheat, corn, rice...), but porridge made from the same grain would sit in my stomach forever.
I was tested for H. pylori and gastric/duodenal ulcers in 2014 (upper GI endoscopy). I was not tested for blood in stool, calprotectin or bacterial intestinal pathogens. No enlargement seen on the ultrasound. My liver is abnormally small.
I think bile helpers improved the floating stool.
-
@BearWithMe said in Mysterious gallbladder disease - can't digest fat for no apparent reason:
@random Can't quench my thirst, yes. But also other symtpoms like very dry skin, dry eyes, heat intolerance, exhaustion, sometimes confusion... In the past, I was drinking up to a quart of milk a day, but lost my ability to digest milk sometime around 2021
Did you already have thèse symptoms in 2021?
-
There is an hormone called secretin which is linked to peristalsis, bile and water homeostasis.
It tends to slow digestion in the stomach but with respect to water homeostasis, it's more anti-diuretic.
-
@CrumblingCookie I'm struggling to find any lab that would do the tests you mentioned (Eastern Europe), but will continue searching.
What would be the best course of action in the situation you described?
For the mucosal infection, I'd assume some kind of antibiotic / antifungal, but one have to be very careful not to make things worse? Having the bacterial intestinal pathogens test done would be useful also because one can precisely target the specific pathogen?
How can be fixed broken forward peristaltis?
-
@BearWithMe
Calprotection as an inflammatory marker should be widely available?
For the bacterial pathogens (nowadays it's usually a single multiplex-PCR kit being used) maybe look for yersinia, campylobacter, enteramoeba etc. which are covered by it. Yeasts or specifically candida-antigen in stool is separate.
H. pylori could be detected with a blood antibody at-home quick test (one of those little laminar flow kits) or per antigen in stool sent in to a laboratory. If you can't get another gastroduodoscopy.
Yes it would be helpful to narrow down what it is. Or narrow down what it isn't.
By all the antiparasitic things you have thrown at it it's more likely bacterial or fungal or malignant or chemically induced.
If there's no specific pathogen to be found maybe it's "tropical sprue" which essentially is SIBO and treated with doxycyclin or rifaximine. Those are on the more alright side of the antibiotic range. Camphoric acid or haidut's CamphoSal could be nonspecific treatment. If it's (nonspecific) anaerobes, teicoplanin or nitazoxanide could be an idea. If it's fungal, generous amounts of nystatin and/or generous amounts of borax for a while. Things would become much more extensive in case of intestinal Tb. It can't really be bile acid malabsorption as that would lead to chologenic diarrhea from bile stimulation, not constipation.
Weirdly, most infectious scenarious should lead to diarrhea, which you don't complain about and so there's something confounding going on.
GABA (powder) promotes downward(forward)-peristalsis.
Sufficient dietary choline could be necessary (acetylcholine signalling). Sufficient serum B12 is always essential. -
@CrumblingCookie That was super informative post. Thank you. Appreciate your comments very much! Will try to get the pathogen diagnosed and treated according to your recommendations.
I have textbook symptoms of decreased GABA activity, minus epilepsy and seizures. I had these symptoms since I was born, long before my digestive issues started. My digestive flareups seems to coincide with restlessness, insomnia, depression, anxiety and autism flareups.
Is taking GABA powder enough to fix this? Should I take vitamin B6 + magnesium + maybe Bifidobacterium adolescentis-containing probiotic?