Low-Fat Diet Causing Bowel Urgency?

I have been on a very low-fat diet for 4 weeks after a diagnosis of actue pancreatitis. I had very ill for 5 months, including five hospitalizations, prior to the diagnosis.  I am now taking Pengestyme, 4 capsules, three times a day (before each meal).  Since starting the diet, my normal bowel movements have changed.  I now, most days, have a normal movement in the early afternoon, which is quickly followed by 3-5 increasing soft movements; they come with increasing urgency with the final one being mostly water.  By "increasing urgency," I mean that I have just a couple of minutes to make it to the bathroom once I feel the urge. This is causing me great distress, because I teach from noon to 3:00 pm at a local college -- just when my bowels are demanding my attention!  My diet consists most days of ceral, skim milk, and fruit for breakfast (about 8-9am); a turkey breast sandwich for lunch; and something like lean mean, pasta or another sandwich and fresh vegetables for dinner.  My doctor believes my bowel issues come from the diet. He urged me NOT to increase fiber (either through food or a supplement) because I also have diverticulitis and constipation has been a problem in the past.  Is there any way to reduce the number of bowel movements or to "reset" them to occur in the early morning or evening?

[Kevin Pho, MD]

Further tests to evaluate for malabsorption can be considered.  Ensure that you are not lactose intolerant (which can certainly worsen your symptoms), which can be evaluated via a lactose tolerance test.  

A lower endoscopy (either flexible sigmoidoscopy or colonoscopy) can also be considered to evaluate for any masses, chronic infection or inflammatory bowel disease, as well as blood tests to evaluate for celiac disease.  Each of these disease can lead to your symptoms.  

I would discuss these options with your GI specialist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[yoshi]

what is Pengestyme ??
this sounds like diarhea (diarrhea)/
there are many causes -magnesium (medication such as milk of magnesia,or medication coated with magnesium),bacterial in GI tract from too much antibiotics,flora imbalance in your body,poor absorption.

[ceh]

Pentanstyme is drug taken before meals that, as I understand it, replaces the chemcials produced by the pancreasis.  In other words, it lets the pancreaes rest so that it can heal.

Any ideas on how to change the "clock" so that I have these episodes in the morning or evening instead of the afternoon?

[yoshi]

there are several OTC medication for stopping diarhea (diarrhea),the tourists take them/

[ceh]

Kevin - Many, many thanks for your comments.  I had never considered lactose intolerance since I am 57 years old and never had a problem with dairy problems before.  However, I've done my own little test here -- some days breakfast of skim milk and cereal, some days no milk.  Like clockwork, on the days I drink milk in the morning, I get very loose bowels about 1:00 pm.  I did some research on the internet and found articles that suggest that intolerance is increased when diary products are eaten with carbohydrates alone and no fat.  That is exactly what I was doing.

I'll follow up with my GI...but in the meantime am eating no diary...and feeling great!