My digestive tract is FRACKED
February 26, 2013 10:13 AM   Subscribe

YANMD: Looking for tips to maintan my health until my doctors figures out why my body has decided to stop digesting food. GROSS DETAILS WITHIN (but not many).

Went on antibiotics. Diarrhea commenced. Went to Dr. Dr. prescribed Align, an OTC probiotic, and said, 'bring us your poop!' Took Align for two days, the heavens open, the angels sang, and lo, my body was actually digesting food.

Cut to a month later. Two days off the Align. The non-digestion returned with a vengence. Went back on the Align. A week later, nope, body is not happy with food. I am bringing poop to my dr this Friday. Waiting til this Friday because of work obligations, transportation issues, and because I am very visibly disabled (wheelchair user) I am super paranoid about letting other people know, 'hey, I have this other thing going on.' The calculation is that people see me in a wheelchair and after they see me do my thing, they're like, well, she can't walk but she does everything fine -- and then they here about another health illness and they'll be like, 'don't hire her for another semester, she may be hospitalized before spring break.' I work as adjunct faculty, so I have zero job security.

Issue 1: It's hard to know for sure but I think that I've lost maybe ten pounds or so, and I am underweight to begin with. What can I do until this gets resolved to a) keep my weight up and b) get vitamins/amino acids/whatever? (I do take a multivitamin already).

Issue 2: Balancing work with illness. (I am working on this continuously with my therapist, but am looking for other input). It's not that this is a gross condition that is keeping me from keeping it under wraps; it's just that I am, well, petrified, as seen as unreliable because of illness. How have you, Gentle Reader, managed such a situation?
posted by angrycat to Health & Fitness (26 answers total) 2 users marked this as a favorite
Response by poster: jeez sorry about the typos guys.
posted by angrycat at 10:17 AM on February 26, 2013

When my digestive system isn't working, I have this magic nutrition powder recommended to me by a fancy rheumatologist (apparently it was created to help Crohn's patients get nutrition during a flare). It's expensive but I think it helps---I mix it with almond milk, because apparently milk milk can be irritating to already-inflamed intestines.

Nut butter is another staple for me when the insides aren't working. On a rice cake, rather than my usual apple, but white bread would probably be even better if you can eat that. It's super calorie dense.

Did your doctor rule out taking any antimotility agents (Immodium, Lomotil, etc.)? Because those can help.

Best of luck.
posted by Sidhedevil at 10:35 AM on February 26, 2013 [2 favorites]

That sucks, I'm sorry you're going through this.

I was having all kinds of digestive issues, then I did the Elimination Diet to see if I was having sensitivities. It turns out I have a major gluten intoloerance (boo!), peanuts are not my friend, and chocolate was causing itching and hiving (double boo!).

I feel much better and my poop is normal for the first time in forever.

I suspect you have a gut flora issue, but this can't hurt anything.
posted by Ruthless Bunny at 10:42 AM on February 26, 2013 [1 favorite]

After being on boatloads of antibiotics and other drugs, I did a yeast elimination diet for three months and ate lots of organic yogurt because it contains more varieties of flora than other yogurt.

I later learned that coconut oil, sea salt and glyconutrients are all good for the gut. Both coconut oil and sea salt can be taken transdermally. You can put sea salt in your bath and coconut oil on your skin. Coconut oil can be absorbed and used by the body without digestion, which is part of why it has a history of being prescribed medically for various gut issues.

Inability to digest food is common for my medical condition. You can buy digestive enzymes to help you process food temporarily. Your doctor can prescribe them or you can go to a place like GNC or order them online without a prescription. If this discussion does not get you enough information to help you heal your gut, some autism lists know a lot about resolving such issues. Joining one could get you ongoing support until you get this sorted out.
posted by Michele in California at 10:56 AM on February 26, 2013 [1 favorite]

Are you sure you can't bring in your stool sample earlier? (or have someone else do it for you? triple plastic bag it, perhaps?) Make sure they test for C diff (clostridium difficile). C diff doesn't mess around, and it's increasingly common in people who were on antibiotics.
posted by Maarika at 11:02 AM on February 26, 2013 [3 favorites]

I am definitely definitely not any kind of nutritionist or doctor... buuuuut.... antibiotics kill off all the good flora in your gut that allow you to break down nutrients more efficiently and just generally digest well. The good news is you can replenish them. Maybe grab some probiotics, or, for a cheaper and more delicious option, drink some kefir? That's my go-to when I have to take antibiotics and it really helps on the GI upset. Your local grocery store should have it in the hippie food section.

(Also coconut oil is delicious as a replacement for butter in baked goods.)
posted by WidgetAlley at 11:09 AM on February 26, 2013 [1 favorite]

I have ulcerative colitis and this sounds a little bit like when I was first diagnosed. Obviously your doctor will figure out what's actually going on with your digestive tract, so I'll just give you a few tips for dealing with the diarrhea part of things.

1. Stop all caffeine completely. It makes things move faster, which is exactly the opposite of what you want right now.
2. Eating more than a tiny quantity of food, chewing gum, or drinking cold beverages will also move things along pretty quickly, so don't do these right before you have to go teach a class.
3. Conversely, you can use this to your advantage if you need to. If it's getting close to class time and you're worried you might have to go during class, try one of the above strategies to, er... clear things out before class starts. That way you avoid the "will I or won't I need to go" panic that can lead to the need for a swift bathroom visit.
4. Cold temperatures also seem to get the ol' Angry Gut moving. Bring a sweater if your workplace is cold.
5. Immodium! Even if it doesn't stop the diarrhea it might buy you that extra amount of time you need to be able to make your bathroom visits more unobtrusive.
posted by MsMolly at 11:10 AM on February 26, 2013 [2 favorites]

Yeah, I was going to suggest c diff, too. I had c diff (after clindamycin, for a tooth abscess). It was hell, recurrent hell. A strong dose of really really awful antibiotics (flagyl) is the only thing that helped. It made me feel absolutely terrible, but at least I stopped pooping.
posted by PhoBWanKenobi at 11:17 AM on February 26, 2013

I had the exact same symptoms and guess what? It was hardcore temporary lactose intolerance! I eliminated all forms of dairy from your diet (even the stuff you might find in crackers and breads). All the dairy-based probiotics in the world couldn't help because even the added benefit of replenishing my intestinal flora wasn't enough to combat the serious lactose intolerance I had developed. I spent four months with no dairy taking lactose pills and a dairy-free acidophilus blend every single day and I am 100% better now. The allergist and gastroenterologist I worked with were super embarassed that they forced me through a colonoscopy and all sorts of other useless stuff when all it was was temporary intolerance.

Eliminate dairy completely and see if you start experiencing any changes. Good luck!
posted by These Birds of a Feather at 11:38 AM on February 26, 2013

*My diet, not yours. Brain fail.
posted by These Birds of a Feather at 11:48 AM on February 26, 2013

Totally glossed over the fact that you had already tried an over-the-counter probiotic, whoops. In that case, I'm going to agree with These Birds of a Feather. I had temporary lactose intolerance when I was a wee lass and it also sounds like what you're describing.
posted by WidgetAlley at 11:53 AM on February 26, 2013

Yes, I'm going to agree with These Birds of a Feather here.

Cut dairy, or, if this seems impossible, at least take a minimum of two Lactaid Fast-Act when you eat it (or more, depending on how much you're going to eat). And I'd say for the time being, just don't go near pizza or ice cream.

I had your symptoms and it was a 'mystery' to me and to my gastroenterologist for almost a year (!?). Our 'research' included a colonoscopy, Align, Prilosec, Immodium gelcaps, skin-prick allergy tests, and finally a lactose breath test which showed...yup, I was pretty freaking lactose intolerant (despite truly believing I could not be). I wasn't aware that you could lose the ability to break down lactose as you aged, but apparently it is so.

Things are so, so much better now. I couldn't believe it was that simple and pretty much broke down crying with joy when I realized it was under control and I could have my life back and stop doing the incessant Texas two-step to and from the washroom.

If dairy doesn't seem to be the culprit, try the elimination diet and keep a food journal.

Good luck to you, wishing you the very best & as swift a recovery as possible as I know firsthand how debilitating this can be.
posted by xiaolongbao at 11:59 AM on February 26, 2013

And sorry, as for you know, it's difficult. On the weight angle, try to see what you can keep down (so to speak) and just eat that. You could try the BRAT diet, recommended to me by a family friend who is a nurse.

Truth be told, you are sick, and I think disclosure (but no oversharing, trust me, nobody in a professional setting wants to know the deets) that you are coping with a minor (or whatever severity you want to place it) medical issue and actively working to get it resolved ASAP is better than trying to hide it and being perceived as not pulling your weight. Let people know what you need, i.e. "I may need to take a short break every now and then while I sort this out, thanks for understanding." You might be surprised how it'll be no big deal if you project an air of confidence (even if it's tough since you do feel uncertain).

Value yourself and take care of yourself.
posted by xiaolongbao at 12:12 PM on February 26, 2013 [1 favorite]

I had terrible digestive issues earlier this year, but they seemed to clear up after I took an antibiotic for an unrelated reason. Since antibiotics seemed to trigger this for you, I'm guessing taking more wouldn't be helpful.

A few thoughts:

One thing that made a difference: eliminating all acidic food from my diet. No tomatoes in any form. No strawberries. No oranges, etc.

The doctors also recommended I avoid all dairy products, though this had no impact.

One other recommendation is to avoid all gluten, which similarly did nothing to help me, but may be useful for you.

I hope you get this sorted out.
posted by helloimjohnnycash at 12:43 PM on February 26, 2013

Like MsMolly I have ulcerative colitis. When you say you're "not digesting food" I'm going to assume what you mean is that you have diarrhea after eating. I know you have a lot going on right now but my first piece of advice is that your GI tract is not shameful, everyone has one, few of them work the way we think everyone's is "supposed to," and you will get better medical care and advice if you say exactly what is going on without couching it in euphemism. Even if you don't know the official term to describe what you're talking about, just say exactly what you mean (I have said the word "turd" to one of the preeminent living IBD experts... it happens).

First of all, I absolutely do not mean to scare you, but also like MsMolly I was diagnosed in the midst of a situation that is very similar to what you're going through. I went on antibiotics, I had diarrhea, it got a little better with some treatments, got worse, got better, got worse and worse until a colonoscopy confirmed I had ulcerative colitis.

MsMolly's practical recommendations for slowing down your GI tract are spot on in my experience. Especially with regard to eating triggering bowel movement. Even a bite. Sucks but it's true. As an alternative to Immodium, if you have access to opiates, they can slow down your GI tract tremendously. Anecdotally, at a time when I was having 30 bowel movements per day, I could take one Tylenol 3 (30 mg of codeine) and be totally fine for twelve hours. This is a short term stopgap solution until you figure out what is actually going on. This is not a cure.

Regarding your poop sample, they are notoriously delicate and it's really really hard to get an accurate stool test if you aren't in the hospital. Usually by the time you poop at home, collect it, bring it to the doctor, and the doctor sends it to the lab the stool is too old to be accurately tested. If there's any way you can poop the sample at the doctor's office that would help. I agree that you should definitely be tested for C. diff. Please don't be scared off by accounts above of Flagyl being horrible -- it has some weird side effects sometimes and the pills themselves taste horrible, but if you have C. diff the trade off is so, so worth it.

Now, on to your explicitly stated questions. Issue 1: The foods that digest the most, so to speak, are different for everyone, but when I was trying to stop losing weight, the most reliable foods for me were white bread, boiled chicken breast, pasta, and rice. Bland and white-ish are generally the names of the game here. If you're going to have banana, go for one that's very ripe with brown speckles on the skin, no green peels. Dairy tolerance varies for everyone but if you've historically been OK with dairy, Greek yogurt with live cultures (e.g. Fage) could be good for you, plus it's a good source of protein.

Your multivitamin might not be getting absorbed if you're having the runs all day -- you'll get more out of it if you switch to a chewable or liquid vitamin. That said, I would be much more concerned right now with getting to the bottom of your diarrhea. Vitamin or not, I wouldn't waste energy on this particular issue.

Issue 2: Honesty is how I did it. I'm not familiar with your work situation but IBD sufferers are protected by the Americans With Disabilities Act. If it turns out that you do have any kind of GI illness, the language that makes IBD included under ADA should cover whatever is going on with you as well (the symptoms are effectively identical). I too was very scared of being seen as unreliable, so as soon as I could I told my supervisor what was going on, to the best of my knowledge. I proposed the accommodations that were necessary, in light of my knowledge of my capabilities and limitations, for me to continue to perform my job. I know you don't want to be seen as "the sick one," but I assure you it is 100% better than being seen as "the mysteriously lazy one." You don't have to tell your supervisor and coworkers "I shit pure liquid with bits of lettuce floating in it every half hour," but I would strongly recommend throwing them a bone ("I've been having really bad digestive problems recently" isn't going to put anyone off their lunch).

I'm sure this is an overwhelming and totally annoying situation for you so please don't hesitate to MeMail me if you want to chat about anything. I've been through the wringer w.r.t. all things GI.

On preview, I don't recommend coconut oil. Healthy for a healthy gut? Yes. Will trigger slimy fatty diarrhea? Also yes.
posted by telegraph at 2:22 PM on February 26, 2013 [1 favorite]

Just to be clear: As someone with a condition where you actually can be not digesting food, I assumed the meaning was "undigested food bits are coming out the other end." If that is the case, that is what digestive enzymes are for.
posted by Michele in California at 2:29 PM on February 26, 2013

By any chance are you taking Aleve? Someone I know took it for a long stretch of time and ended up with horrible stomach problems that only Align has been able to fix, and she says she knows another person who had the same thing happen.

For weight: Ensure? Spirutein? They've both worked for me and one of my kids -- one of us liked one, the other the other -- but neither of us had stomach issues at the time so I don't know how useful they'll be for you.
posted by The corpse in the library at 2:41 PM on February 26, 2013

Response by poster: Hmm no Aleve.
Yeah, I was going to suggest c diff, too. I had c diff (after clindamycin, for a tooth abscess). It was hell, recurrent hell. A strong dose of really really awful antibiotics (flagyl) is the only thing that helped. It made me feel absolutely terrible, but at least I stopped pooping.
HA HA YES THAT WAS THE DRUG FUCK THAT DRUG IN THE EYE (I mean clindamycin). Okay, so my doc like six weeks ago asked, is your poop yellow and no it definitely is not yellow, green, purple, red. Then doc said, definitely not C-diff. So, we'll see what the poop results say.

Uh I am hoping it is the lactose intolerance because I went on a serious ice cream party after the most recent Metafilter Ben and Jerry's thread.

Thanks all. Thanks so much for all your answers. My body really disgusts me now, and the kindness helps mucho.
posted by angrycat at 3:11 PM on February 26, 2013 [1 favorite]

I'd say go with much stronger probiotics like BioKult or Prescript Assist (haven't tried the latter, but it gets great recommendations).
posted by Neekee at 3:42 PM on February 26, 2013

This is palliative, but my GI guy always recommends immodium when the sluices open up as a stop-gap measure.

I agree with BRAT for food and if you're using probiotics, make sure they came refrigerated.
posted by plinth at 4:55 PM on February 26, 2013

Recommended probiotic: VSL3. My Costco carries it (refrigerated).
posted by apartment dweller at 5:50 PM on February 26, 2013

angrycat, I think you should show this thread to your GP and then you won't be leaving out any information.

The ER probably wouldn't have released you if you are in as much immediate danger as you fear.

If you can, try to get a friend to stay with you overnight, for your peace of mind.
posted by tel3path at 5:36 PM on March 28, 2013

Response by poster: thanks telepath, posted in wrong thread. Here's my comment:

Hi, update, with further questions. I am wondering if I need more
medical attention than I'm getting.

I began taking the max amount of Immodium. I had a stool sample taken
at the doctor's office, but the lab did not analyze it because it was
"too well formed."

I went into a bit of a crisis mode about a week ago. Immodium was not
controlling the symptoms. Neither was Align. I went into eating
perhaps five hundred cals per day to avoid accidents at work.

Contacted doctor. She advised me that my blood work was fine and the
stool sample had been rejected. I told her of my current symptoms,
which included abdominal distention in the context of my eating very
little, with frequent diarrhea. She started me on Flagyl and advised
me to come in after work.

So, post work, went to doctor's office after three doses of the
Flagyl, my friends, I am not exaggerating when I say I was so tired I
was falling asleep while wheeling my wheelchair. It was more than
fatigue; it was like fatigue plus brain death.

My doctor asked me frequently if I was experiencing abdominal pain. I
said, well, I have limited sensation below the waist (L-1). Sometimes
things like menstrual cramps manifest as neuropathic pain, but I also
have the pain if the weather changes, like it is now in Philly. So
I've been having some intense neuropathic pain but that can happen on
a day that ends in Y so who knows.

My doctor observed that I had some but limited abdominal distention.
Well, yeah, but I know my body, and my stomach is flat on a day with
adequate food, and when I am eating very little it's concave so, I

At any rate, she sent me to an ER. She said that way I would get
hydration, they would take a stool sample, and I am not sure because
this is where things get hazy but I also think she said the ER would
do an image scan and get a consult with a specialist. She said she
wanted to make sure that X was not an issue, but I'm not sure what X

So, by the time I get to the ER I am like a zombie from the Walking
Dead only no desire to consume flesh. I mean, fatigue that was like a
minute from collapse. They hydrated me, took a stool sample, let me
sleep for about 8 hours, and turned me out, saying that they would let
me know if I tested positive for c. diff.

So, here's my question when I call my g.p. tomorrow: What should I
raise as concerns an issues? I have not seen a specialist to date, and
I am aware this is the next step, but Friday approaches. Every time I
take a flagyl I'm pretty much asleep within an hour or two. Trying to
stay hydrated.

Here's what I'm scared of: the c. diff is perforating my gut and if I
don't deal with it like, tomorrow, I could be experiencing sepsis or I
don't know what. I can't go by abdominal pain, because my wires are
fucked up. I'm trying to eat. I dunno. Any advice? Thanks group, for
continuing to deal with my quite disgusting condition.
posted by angrycat at 8:13 PM on March 28, 2013

Are you still on the flagyl? Because that will make you feel tired and awful (my mother once described it as "like traveling through time"). It's also the first-line drug to treat c.diff as well as a host of other abdominal problems like parasites. So you're "dealing with it." You're being treated by the doctor.

You will be okay. (I know it doesn't feel like it, but I promise you, you will.)

If you--or your doctor--suspects c. diff you should not take imodium.

If it's c. diff, you really want to get through the course of flagyl. You should see improvement soon, gutwise. If the flagyl doesn't work (it did for me), the next treatment will be vancomycin, which is superexpensive but, if I recall correctly, more effective with fewer side effects. If it's c. diff and you have good insurance you might ask your doctor about switching.
posted by PhoBWanKenobi at 8:48 AM on March 29, 2013

Response by poster: I am still on the flagyl. This may have been because I ate something way off the BRAT diet, but the runs are continuing, even worse.

The flagyl is debilitating stuff. I am on a three-dose a day, but it makes me nauseous to the point I've been skipping doses so I can say, go to the corner store to get a few essentials. A friend is coming by tomorrow to help, so hopefully I can stay on the three-dose regimen.

I am sort of seriously freaked about what seems to be not-great info from my doctors. That I have not had a referral to a GI specialist or infectious disease specialist is troubling, given that this has been going on since January. And because I have limited sensation from the waist down.My doctor didn't warn me of flagyl's side effects (although I knew something about it from this thread) and thus I was very ill-prepared for the sort of really not being able to leave the house and take my meds at the same time.

Nor was I warned of the Immodium/c. diff contraindication.

Iam considering going to the ER again, but for the fact that last week it was an exhausting and fruitless endeavor.
posted by angrycat at 4:10 PM on March 31, 2013

Call up your doctor and say specifically that you'd like a referral to a GI specialist. You're well within your rights to do so. And good luck on all of this. I hope you feel better soon!
posted by PhoBWanKenobi at 8:00 PM on March 31, 2013

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