Diarrhea and unable to digest fats.

[JJkate]

Hi, I've had digestive problems for years. Regular diarrhea (most days). Can't seem to digest fats as that makes it v bad and brings on night sweats as well as upset digestion. I've had referral to gastroenterologist who did a colonoscopy and Sechat scan and also had blood tests re liver and celiac etc. Nothing was found. I have had endoscopy which found small hiatal hernia and gastroparesis. I was discharged by gastro who said diarrhea won't kill me and it's probably just food intolerances or my microbiome. I've tried so many things none of which help much including gf diet, lactose free, probiotics and vitamins. I eat a wholefood diet with low fat and have a very low BMI. I'm currently on iron tablets as have developed anemia, probably from having a restricted diet. Any ideas what this might be and how I can get it diagnosed and treated?

Coeliac blood tests can give a false negative, especially if you eat GF. You need to eat gluten containing products for, iirc, around 6 weeks before a coeliac blood test.

A biopsy via endoscope maybe needed for a coeliac diagnosis.

Have they also done stool tests for fecal elastase, fecal fat test or other pancreatic function tests to check for low digestive enzymes?

Pancreatic enzymes, such as creon, help people who have these issues. Might be worth another chat with the gp to check if you’ve had all possible tests, I’m assuming with a low BMI you are also still suffering weight loss with all this going on. Very unfair to just say ‘it won’t kill you’ and discharge you, what about quality of life?!

I'm not sure about those other tests I will check thanks. I ate gluten for 6 months in the hopes of having a proper coeliac test but they refused as the blood test and colonoscopy was normal. I will ask about Creon etc.

Yes it's hard work. Some friends, family and Drs seem to think I'm just fussy, neurotic or anorexic and don't seem to believe it's real or it's (just IBS). I paid to see private Gastro (£230!) and he said could be SIBO which I researched, the treatment is lots of antibiotics and it often comes back and it sounds like a new thing that they aren't sure about. I am working up to going back and being assertive about another referral and different tests. Thanks for your help 😊