Ideas for handling liver fluke medication food requirement

March 21, 2014 12:37 AM

I have a friend who has been diagnosed with liver flukes; the protocol for medication she is taking (twice per day) suggests that the medication is made optimal if accompanied by the ingestion of 40grams of fat. Yes, that's 40 grams of fat, twice per day, at two sittings. Having to ingest this much fat at one sitting is making her nauseous. She has tried various mixes of healthy vegetable fats mixed into salads but she's pretty miserable. She has a rather sensitive stomach; she also had her gallbladder removed some years ago. She is supposed to take the medication for a few more weeks.

I suggested she take a little vinegar or wine, but she can't consume either one (allergies). I also suggested bile tablets, because her gall bladder is missing.

Does anyone have other ideas on how to make the consumption of that much fat palatable for someone who is sensitive to it? Is there a way to make temporarily high consumption of fat made necessary by medical protocol more palatable for someone who is sensitive to high fat ingestion/consumption?

posted by Vibrissae to Health & Fitness (17 answers total)

Is she just pouring oil on raw veg? It seems like cooked food that is full of fat would be more palatable? A full recipe of Joël Robuchon's potato purée has, according to Google, about 184g of fat.

Other things I like that are full of fat: quiche, made using heavy cream (up the egg yolks, don't skimp on cheese), lemon posset, avocados with a creamy dressing in the dent left by the pit, curried veg with loads of coconut milk, these scalloped potatoes, creamed peas made by sauteeing onion in a boatload of butter, adding heavy cream and reducing, and then adding a few egg yolks. And, macadamia nuts! 102g fat in a cup. Apparently it's smooth sailing for me if I am ever on this medication.
posted by kmennie at 1:05 AM on March 21, 2014 [10 favorites]

As Julia Child used to say, "if you don't like butter, use heavy cream."
posted by three blind mice at 1:10 AM on March 21, 2014 [5 favorites]

By bile tablets, do you mean OTC supplements or prescription sequestrants, like cholestyramine or Questran? Note that the first (OTC supplements) will likely make her situation worse. The lack of a gall bladder means bile salts are being continually dumped into the intestinal tract, which causes irritation; supplementing a diet with more bile will just worsen symptoms for someone without a gall bladder. Sequestrants bind bile salts and make them less active, causing less irritation, but require a doctor's prescription. Apologies if you already know this.
posted by Blazecock Pileon at 1:50 AM on March 21, 2014 [1 favorite]

Coconut milk hot chocolate. Should be 1 cup at each meal.
posted by bfranklin at 1:54 AM on March 21, 2014

So your friend has a prescription for a Big Mac and fries. Or hummus with some extra olive oil stirred in would also work. Don't try too hard to find a healthy way to eat 40g of fat in one sitting. What you're looking for are comfort foods: things with a lot of butter or cheese, fried foods, fatty meats like burgers and sausages.
posted by ryanrs at 2:14 AM on March 21, 2014 [1 favorite]

Well, while fat isn't inherently unhealthy, 40 grams can take quite the caloric toll if its being eaten between meals, So my first suggestion would to take the pills with meals.

Ideas:

a PB/PBJ sandwich with lots of peanut butter,the fiber of some whole grain bread might soothe the influx of fat.

Pasta with butter, add 3-4 tbsp and you have 40 grams of fat

Coconut oil (very little taste on its own) in cocoa straight

High fat dips on crackers

Sour cream on strawberries

Fatty deli meats wrapped around cream cheese

Omelette fried in butter

A few handfuls of macadamia nuts or pecans (mot fatty nuts)

other than that I have nothing off the top of my head,so good luck and I hope I helped.
posted by tahu363 at 2:35 AM on March 21, 2014

avocado has a lot of fat - maybe she likes guacamole?
posted by 5_13_23_42_69_666 at 3:30 AM on March 21, 2014 [1 favorite]

A cup of Haagen Dazs ice cream?
posted by rosa at 4:35 AM on March 21, 2014 [1 favorite]

Avocado seems like the obvious choice. Heavenly.
posted by KokuRyu at 5:05 AM on March 21, 2014 [1 favorite]

I am also grossed out by eating most fatty foods (though I do have a gall bladder so not sure about that aspect of it) and some of these suggestions like butter and ice cream...I couldn't do it. Some high-fat things that don't trigger that "ick, fat, hell no" feeling for me are olive oil (when on vegetables), chocolate, eggs, some kinds of cheese, and avocado. I also sometimes don't mind butter or cream as long as they're baked into something where the rich taste of the ingredient is not detectable in the finished product. Blech, I feel bad for her having to do this.
posted by DestinationUnknown at 5:07 AM on March 21, 2014

Bacon!
posted by mareli at 5:20 AM on March 21, 2014

A pint of premium ice cream should more than do it, and it's very easy to eat an entire pint in one sitting (source: I am a disgusting pig).
posted by Jacqueline at 5:22 AM on March 21, 2014 [5 favorites]

I suspect the problem isn't that she doesn't know about foods that are high in fat -- she's probably really, really aware of them. The problem, with no gallbladder, is that high-fat meals cause diarrhea because she doesn't have enough bile to digest it. If I were her, I'd ask a doctor about it, because it's a medical question not a cooking question.
posted by Houstonian at 5:25 AM on March 21, 2014 [11 favorites]

yeah, this is a totally different situation for someone without a gallbladder. because any high fat foods are more difficult for someone to digest if they don't have their gallbladder helping them out. are these pills specifically for someone in her condition? she should check with her doctor to see if this high-fat thing actually applies to her. most people who lose their gallbladders also lose their ability to have a big mac and fries on a regular basis (or suffer for it later.)
posted by andreapandrea at 6:22 AM on March 21, 2014 [1 favorite]

Is your friend sure she understood the directions correctly? Did she get this medicine from a medical doctor (not alternative medicine doctor), and the medicine was prescribed and filled at a pharmacy? If your friend is taking alternative medicines that give her diarrhea for several weeks, that's a pretty dangerous thing to do. She could become dehydrated, she'll lose her fat-soluble vitamins for that time period, and so on. The CDC says this type of parasite infection is treated with triclabendazole, in only one or two doses, not several weeks of doses.
posted by Houstonian at 7:25 AM on March 21, 2014 [5 favorites]

Yeah, I wonder whether the 40g of fat is optimal for her. Because eating that much fat with no gallbladder sounds miserable. Does the person who prescribed the drugs know she has no gall bladder, and did he/she recommend the high fat?
posted by mskyle at 7:34 AM on March 21, 2014 [2 favorites]

If your doctor prescribes you medication that doesn't actually work to relieve symptoms or actually makes you feel worse, they are not such monsters that they object to you contacting them to tell them that and ask for advice. Probably be helpful to figure out how much she can eat without causing undue distress; the absorption with a reduction to 30g, I imagine, is probably going to be considerably better than if it's only 5g. It might be that there's an alternative drug that would work better for her, or maybe it's fine. But just in general, she needs to be addressing this with the expert.
posted by Sequence at 9:14 AM on March 21, 2014