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Hi everyone,
I've been dealing with fat malabsorption, fatty stools and significant weight loss for a few years now, after about 7 blissful years with my J-pouch. I'm 5'10" and I weigh 120lbs. Used to weigh 155 about 4 years ago. I cannot gain weight, and it is no wonder, when I see the the steatohrrea and undigested food particles in the toilet all of the time. It has led to deficiencies, including iron and vitamin D. B12 is OK. It's pretty serious, and I can't seem to get much help from all of the MDs and naturalpaths I have seen.

I eat a healthy diet: gluten and dairy free, no sugar, no fodmops. I take creon with every meal. I have been tested for food sensitivities, and I avoid the reactive foods. IOW, I think I am doing everything right.

I'm pretty sure I have SIBO, which can lead to malabsorption and the other problems. I've tried different antibiotic combos: cipro, rifaximin, flagyl. These have only brought about small improvements, that don't last. The funny thing is, I don't have pouchitis, my J-pouch operates fine.

Anyone have experience with this problem? Can anyone shed any light here?
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First off, happy New Year...
Next, were you diagnosised with lactose intollerance? Are you allergic to Gluten?
If not then you may want to reintroduce them...milk products (if you are not intollerant) are a fabulous source of fats and sugars and trust me, they can pack on the pounds very quickly...ditto for carbs.
Even if you are lactose intollerant you won't be intollerant to butter (no lactose)and may wish to integrate it into your diet...nut butters are great too (peanut, almond and cachew are full of calories as well as protiens and vitamins).
Just because you see undigested pieces in the bowl does not mean that you are not absorbing...I have constant bits of undigested stuff...my digestion can be as quick as 1/2hr or less for fruits on an empty stomach and I am not suffering from too many difficiencies...I do take a chewable multi every day, liquid Bs, chewable Ds and cal plus an assortment of other stuff.
My best friend has been a hand-held blender that I used to reduce most fruit and veggies into smoothies and soups...no problems with undigested pieces that way...Add some easily digestible protiens to the mix and you have a very healthy way to pack on the pounds....
Hope that this helps
Sharon
hi

I am pretty much the same as you, creon with each meal. But I take antibiotics all the time, rotating them. Thats the only way of treating SIBO. With fat malabsorption one needs to stick to a low fat diet. Jpouchers in generally should stick to low fodmap. Research has shown that fodmaps are poorly absorbed from the small bowel.
wazzou2, I had the same issues you did with malabsorption, iron deficincy and low weight. I do not believe in all the antibiotics doctors like to use. I ultimately ran a hard cycle of GHRP-6 (3xs a day) from Aug until Dec, then once december started im running ipamorelin 3x's a day. Most people will shoot this down on here...I am med free since i started these and my bloodwork keeps coming back as above normal now.
wazzou sounds like sibo for sure. If you haven't already done so - try hunting down a GI doc that specializes in nutrition issues. Seems lots of docs are pretty clueless about sibo. and don't give it attention it deserves until they see the weight loss and bad bloodwork.
I have bad sibo. Right now I am rotating three different antibiotics every 2 weeks and on a strict fodmap diet. As winterwish posted.. there is significant scientific evidence about the fodmap diet. But even with all of this I am still having significant problems: nausea, vomiting, and underweight.

Has anyone checked for underlying causes of sibo for you? Motility problems - mechanical ones like a kink or other things like other autoimmune issues that could be causing a motility problem?

sibo is a very serious problem...people can end up on tpn for life if it can't be controlled.
good luck
I had j-pouch aspirate and hydrogen breath test done to confirm sibo and therefore on continuous antibiotcs. But it wasn't until I was started on Creon for pancreatic insufficiency that i got real results. Quality of life definitely improved. Maybe worth asking for a trial of Creon, doctors over here don't recommend imaging for it but just to trial the creon as see does things improve.
Definitely right!! sibo can cause serious malabsorption problems.

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