# Can't digest fat



## quarky

I can't seem to digest fat at all. If I eat more than about 5 grams in one sitting, I get awful abdominal cramps and oily diarrhea. Even Imodium, which usually works wonders for me, doesn't help much after a high-fat meal.

Is there anything I can do, other than cutting out fat completely? I am constantly hungry and quite underweight.

I'm worried I might have broken my fat-digestion capability by sticking to a vegan diet for several years. I've been doing some research into fat digestion and it appears that the amino acids used to make bile are mostly found in animal sources. Is it possible that the body can lose the ability to digest fat?

Anyone have any experience of dealing with impaired fat digestion? My doctor diagnosed me with IBS and put me on mebeverine, which does help as long as I stick to a very strict diet. My blood tests showed no signs of inflammation, or any other issues, and I don't want to bother her again because she seems to think I'm a timewaster


----------



## Kathleen M.

Well it may not be digesting fat it may also be that the more fat in the meal the more active the gut becomes so even if you digest fat just fine you can find fatty meals really sets off the diarrhea (is the diarrhea during the gasto-colic reflex time--from the time of the meal to about an hour or so later, or is it the next day when the fat comes out the other end?)

I thought the bile acids were more made from Cholesterol, as you can get all the amino acids from plants if you eat the right combination of them. After all one of the ways to reduce cholesterol is to bind up the bile so you poop it out rather than recycle it and then you need to make more bile from the cholesterol in your blood. Most people make enough of their own Cholesterol to make bile. Are your stools extremely pale, almost white or are they still some shade of yellow to brown?

I don't think you permanently break anything with diet. You may have to adjust once you change your diet, but that shouldn't take more than a few days to get back to making the right stuff again. It isn't like you lose the genes if you don't use them.


----------



## Brownish72

Do you struggle with Coconut Oil? Or have your tried Coconut Oil? It is a Medium Chain triglyceride, which is a fancy term for explaining how it is absorbed and digested in the body. Although one can certainly overdo it with coconut oil, it is easy to break down because of its molecular structure, and its a healthy to consume  I add some to my coffee every morning. Great way to add 50-100 calories to your diet .

Good luck!


----------



## quarky

I guess I could try coconut oil as a fat source... I've had banana chips made with coconut oil and they do seem to digest slightly better than other foods with a similar fat content. I'd always assumed it was because bananas are one of my safest foods than because of the type of fat used.

Are some types of fat more recommended for IBS than others?


----------



## BQ

I would try to stick more to the healthier fats..... avacados.. salmon etc.... as opposed to fried foods etc.


----------



## quarky

BQ said:


> I would try to stick more to the healthier fats..... avacados.. salmon etc.... as opposed to fried foods etc.


I made this post after eating half an avocado gave me bad diarrhea the next morning. I haven't eaten fried food in years.



Kathleen M. said:


> Well it may not be digesting fat it may also be that the more fat in the meal the more active the gut becomes so even if you digest fat just fine you can find fatty meals really sets off the diarrhea (is the diarrhea during the gasto-colic reflex time--from the time of the meal to about an hour or so later, or is it the next day when the fat comes out the other end?)
> 
> I thought the bile acids were more made from Cholesterol, as you can get all the amino acids from plants if you eat the right combination of them. After all one of the ways to reduce cholesterol is to bind up the bile so you poop it out rather than recycle it and then you need to make more bile from the cholesterol in your blood. Most people make enough of their own Cholesterol to make bile. Are your stools extremely pale, almost white or are they still some shade of yellow to brown?


It's usually about 12 hours after eating fat, and is a paler shade of brown than my usual stools (which are naturally loose but can be made solid using a very low dose of Imodium).

That's interesting information, thanks.

Don't you need fat to make cholesterol? I've been consuming very little fat for years.


----------



## Kathleen M.

I know a high fat diet can increase the amount of cholesterol some people make, but I don't know the synthesis pathway off the top of my head. I can check, but I think you still make some even on very low fat diets (like Dean Ornish's diet that is very low fat and no meat products).

Usually for a fecal fat test you have to eat a high fat diet for a few days. Have you had any tests done or talked to the doctor about this? When I have some time later I think there are some herbs that are supposed to up the bile output, but again I don't remember them off the top of my head but I think I know where to look if that is something that you might be interested in.

Do you have any upper right quadrant gall bladder pain, or ever had liver enzymes checked or gall bladder looked at? If the gall bladder is blocked the stools can be very pale, it does take time for the bile to change from yellow to dark brown, so any shade of brown usually means you release bile, when it has less time inside it may be lighter brown (more of a yellow tan, or sometiems greenish tan) but if it tends to be like that off-white like computers used to be (ecru) that is the most worrisome color as then there isn't anything in there to turn dark brown even if it had the time.


----------



## quarky

Kathleen M. said:


> I know a high fat diet can increase the amount of cholesterol some people make, but I don't know the synthesis pathway off the top of my head. I can check, but I think you still make some even on very low fat diets (like Dean Ornish's diet that is very low fat and no meat products).
> 
> Usually for a fecal fat test you have to eat a high fat diet for a few days. Have you had any tests done or talked to the doctor about this? When I have some time later I think there are some herbs that are supposed to up the bile output, but again I don't remember them off the top of my head but I think I know where to look if that is something that you might be interested in.
> 
> Do you have any upper right quadrant gall bladder pain, or ever had liver enzymes checked or gall bladder looked at? If the gall bladder is blocked the stools can be very pale, it does take time for the bile to change from yellow to dark brown, so any shade of brown usually means you release bile, when it has less time inside it may be lighter brown (more of a yellow tan, or sometiems greenish tan) but if it tends to be like that off-white like computers used to be (ecru) that is the most worrisome color as then there isn't anything in there to turn dark brown even if it had the time.


I mentioned problems digesting fat to the doctor when I first went with IBS. At the time she was convinced I had Celiacs, so she had me take a fasting blood test for that. A lot of other things were measured from the same blood sample (iron levels, inflammation markers, blood sugar) - I don't know whether liver enzymes were one of them. I don't have a copy of the results but they are in my notes.

Almost all the pain I get is in the lower-middle abdomen. I've never had liver/gall bladder looked at.


----------



## Kathleen M.

Hmmm, now the other issue that can happen with fat is that if you are releasing more bile with the fat you could be releasing too much. If you release more than you recycle it can loosen up the stools and you do relelase more bile when you eat more fat (or you are supposed to).

Gall bladder pain is pretty distinctive and usually they do a liver panel when they do a pretty full work up like you had.

Is there any kind of burning sensation with the looser stools? Bile often irritates the colon and anus so can feel burny and sometimes people release more mucus to protect the colon and that can look greasy (shiny).

Some people find Calcium Carbonate helps when there is actually too much bile (since this is coming more when the stools come out than an immediate reaction).

It might be worth trying some Calcium with meals and see if that allows you to eat a bit more fat.

I guess the question is whether the issue is not enough bile to digest the fat, or too much bile so the stools are loose and the body wants them out faster than usual.


----------



## faze action

You might want to try apple cider vinegar or digestive enzymes. Both are supposed to help with digestion of fats to some extent (I've used enzymes in the past and just started the ACV).

BTW, I brought this up numerous times to my GI doctor i n the past (fat malabsorption) and he really wasn't able to give me any advice or help at all in this area...


----------



## dakotahrose

Hi,

I have the same problem with fats. I can't digest them, so I end up with diarrhea, and stomach cramps. I have learned to avoid pork, peppermint candies, spicy foods, and to stay away from processed foods. Have you ever read the labels on processed foods, and wondered why they put all that junk in them? I try to eat more natural types of foods. I avoid eating sugars, and wheat. I'd been ill since New Year's day, after eating pizza in which the toppings had MSG (monosodium glutamate). I was unaware that this popular chain pizza store puts MSG, a flavor enhancer) in almost every food on their menu. MSG makes me very ill, so I will have to quit eating at restaurants I know put it in their foods.

I eat bananas, long-grain rice cooked with extra virgin olive oil, cream of rice (stay away from wheat which gives gas), mashed potatoes, egg white only (allergic to yolks) I eat pancakes, salmon, chicken, fresh baby spinach, and I drink herbal teas, and lots of water. When my IBS begins to manifest itself; I take Pepto Bismol to cool and coat the lining of my stomach for several days. I don't take Imodium, unless I absolutely have to. I stay away from citric juices. I end up putting myself on an IBS diet until the symptoms go away, and I am back to normal. Usually, it's something I inadvertently eat that triggers the IBS. I cannot eat lunch meats because they trigger IBS. Corn is hard to digest. I would keep a diary of the foods you eat, and liquids you drink, and find out what in those foods make you symptoms worse, and begin eliminating them from your diet. You will be able to know which foods you are sensitive to. I used to eat Granola Bars, and now, I have to stay away from them. This forum has helped me a lot, and I am able to share my experiences. Maybe, we can help each other. Don't give up. Soon, you will be able to control your symptoms, and keep them from returning. I was doing great, until I ate that pizza.  Have you been evaluated to find out if you may have high yeast in your GI system, or parasites? I have been taking an anti-fungal for almost a week, and I am feeling better.


----------



## skip1000

Besides the all-in-one enzymes available in the market, there are also lypase enzymes available that you can take in addition to the all-in-one enzymes. For me, I usually have problems w/ large amounts of fats sourced from animals (including cream and butter). While I can tolerate some in moderation, I usually just cut/slice/scrape or spit out the fat from meats... it's second nature now. Pay attention to ground meats used in fillings, etc. They usually have high fat contents as well. Also, palm oil is difficult to digest and can cause cramps. They are popular in vegan recipes, so I would read the labels before buying. Personally, I prefer butter as shortening over palm oil, but if you are sensitive to fats, then either reduce or avoid them. Foods from fryers are the worst since you don't know what kind of oil is used (they might even be shortening for all I know), and they can contain all the collective melted fats from meats. Basically the older the fryer oil, the more garbage is in there.


----------



## Emily Condit

If you're having trouble digesting fat, fat is fat is fat except for coconut oil and palm kernel oil. No bile is needed to breakdown coconut or palm kernel oil. The only fat I can digest are those (medium-chains). Most fat, whether you're eating fried chicken or avacado, is long chain and it doesn't matter how "healthy" a fat is, if you can't digest long-chain fatty acids, you are going to get sick and you are going to have stratorrhea (oily diarrhea) unless you emulsify those fats before putting them in your body. Someone mentioned above that you might have excess bile. I do not think that is the case based on the OILY diarrhea. If you eat a high fat meal and you have diarrhea and there is OIL floating on top of the water in the toilet, you are not breaking down fats. Nothing in the world is going to stop that diarrhea because your body can't absorb it in unemulsified form. It's a completely foreign substance that greases your intestinal tract. Everything is coming out.

If you are seeing OIL, you likely have a problem with your gallbladder. Get thee to a doctor to make sure. That is the simplest explanation for your symptoms.

You may not have huge gallstones. I didn't. I had gall crystals that don't show up on ultrasounds but do leak into your pancreas and cause pancreatitis. This can happen with small stones as well. The important test to have is the gallbladder function test. Blood tests may show absolutely nothing. Mine didn't until my 5th trip to the ER in 10 days and I had slightly elevated pancreatic enzyme levels. My ultrasound showed no abnormalities. My gallbladder function test failed though. I had no upper right quadrant pain though which is generally associated with gallbladder problems. The pathology report on my removed gallbladder showed scar tissue and the "sludge" of gall crystals.

I do not recommend getting your gallbladder removed unless you absolutely have to. My life has been an absolute nightmare since I had mine out. A lot of people do fine without it. I didn't. It's a cr*p shoot (no pun intended).

If you are NOT having upper right quadrant pain, lie to the doctor and tell him/her that you are. Severe upper right quadrant pain and oily diarrhea. This is going to set off his/her simple diagnosis signals which is what most doctors require to do a darn thing to help you. Do what you have to do to get the ultrasound and the gallbladder function test. Say you have the pain intermittently and when they ask you how severe the pain is say "10". These are known as gallbladder attacks.

If the test returns abnormal, don't immediately opt for surgery if it is offered unless a stone is blocking your bile duct (this could kill you). Get copies of the results. Research your options. There are ways to clear your stones without surgery. But it's important to know what's going on if you can before attempting a solution. For now, stop eating all fat. Buy some coconut oil. You should be able to digest it without a problem and it will help you gain weight. Eat lots of no-fat protein (Chicken breast is best) and vegetables. If you need to ingest something fatty, try taking it with some lecithin (you can buy lecithin and coconut oil on Amazon. I prefer the granules to liquid lecithin. I mix it in with anything that has fat in it.) Keep in mind that lecithin can only do so much though. Keep your long-chain fat intake very low.

If it's not your gallbladder, I'd be really surprised but if it isn't, then you can look at the too-much-bile option.


----------



## Kentaro

quarky said:


> I mentioned problems digesting fat to the doctor when I first went with IBS. At the time she was convinced I had Celiacs, so she had me take a fasting blood test for that. A lot of other things were measured from the same blood sample (iron levels, inflammation markers, blood sugar) - I don't know whether liver enzymes were one of them. I don't have a copy of the results but they are in my notes.
> 
> Almost all the pain I get is in the lower-middle abdomen. I've never had liver/gall bladder looked at.


Hi,

Few years past. Did you have any improvement?


----------

