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Gastroenterology (Expert Forum)
Allergic colitis
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Allergic colitis
by Freddie Mitchell, Feb 06, 2000 12:00AM
Dear All
My father has really suffered for years. I'm about to qualify as a veterinary surgeon and he's been supporting me for years so now it's my turn to try to help him. However, his symptoms have got me really confused.
(1) ulcerative colitis - diagnosed 1994
(2) haemarrhoids
(3) frequent nose bleeds
(4) intolerance of several food types including (citric acid, green veg, alcohol, food additives)
(5) fatty clear diarrhoea (leaves fat globules floating on water surface)
(6) non-specific symptoms such are migraine-like heachaches, nausea, lethargy, exercise intolerance (not dyspnoea or collapse)
Any food that has been processed with additives etc. leave him with painful headaches, nausea, weakness. He's been on his own version of an exclusion diet for years. His diet is very low fat. A recent blood test revealed that he has very low blood cholesterol (not necessarily a good thing!). However, I am unaware of any other abnormalities detected.
If his colitis were to have a hypersensitivity component then many of his intolerances could be explained. It would appear that fat is getting broken down successfully since it is liquified when he defecates. However, the speed at which he produces this diarrhoea post-prandially and the apparent lack of bile pigments etc. has got me wondering if he may have a cholestatic/hypermotility problem as well as colitis.
Fat soluble vitamins such as A,D,E,K would not be absorbed well if he had a malabsorption problem. The lack of green veg in his diet could lead to vit K deficiency and this could relate to his frequent nose bleeds.
Recently he discovered a drug called Questram which he persuaded his doctor to prescribe. This contains cholesterolamine and its action is primarily to reduce blood cholesterol by reducing absorption of fats through the g.i. tract. After altering the dose slightly, he managed to stop his diarrhoea for the first time in years. However, his nose bleeds have been recurring more frequently and lasting longer. He has just started taking alfalfa tablets which are supposed to contain Vit K and his nose bleeds are greatly reduced, as are his haemorrahoids, but now he is off the questram again and his diarrhoea has returned.
My main question is how best to proceed from here. Can we desensitise allergic components of colitis? Should he go back onto the questram or is that just solving one problem and creating a whole lot more? Should he start taking a vit A,D,E,K supplement (he can't take a complete multivitamin because it gives him a headache)? Does it sound as though there may be a cholestatic component to all this? Or perhaps an underlying pancreatic problem that I am inadvertently overlooking? Does anyone else out there show similar symptoms? How are you managing? What papers should I read on this?
The doctors here in the UK are pretty apathetic about my father's problems and tend to deal with him symptomatically rather than working hard to find an underlying cause. He is only 52, slim and otherwise "healthy" with the whole of the rest of his life to enjoy if he can overcome the restrictions his body is placing on him.
Thank you for taking the time to read this.
My father has really suffered for years. I'm about to qualify as a veterinary surgeon and he's been supporting me for years so now it's my turn to try to help him. However, his symptoms have got me really confused.
(1) ulcerative colitis - diagnosed 1994
(2) haemarrhoids
(3) frequent nose bleeds
(4) intolerance of several food types including (citric acid, green veg, alcohol, food additives)
(5) fatty clear diarrhoea (leaves fat globules floating on water surface)
(6) non-specific symptoms such are migraine-like heachaches, nausea, lethargy, exercise intolerance (not dyspnoea or collapse)
Any food that has been processed with additives etc. leave him with painful headaches, nausea, weakness. He's been on his own version of an exclusion diet for years. His diet is very low fat. A recent blood test revealed that he has very low blood cholesterol (not necessarily a good thing!). However, I am unaware of any other abnormalities detected.
If his colitis were to have a hypersensitivity component then many of his intolerances could be explained. It would appear that fat is getting broken down successfully since it is liquified when he defecates. However, the speed at which he produces this diarrhoea post-prandially and the apparent lack of bile pigments etc. has got me wondering if he may have a cholestatic/hypermotility problem as well as colitis.
Fat soluble vitamins such as A,D,E,K would not be absorbed well if he had a malabsorption problem. The lack of green veg in his diet could lead to vit K deficiency and this could relate to his frequent nose bleeds.
Recently he discovered a drug called Questram which he persuaded his doctor to prescribe. This contains cholesterolamine and its action is primarily to reduce blood cholesterol by reducing absorption of fats through the g.i. tract. After altering the dose slightly, he managed to stop his diarrhoea for the first time in years. However, his nose bleeds have been recurring more frequently and lasting longer. He has just started taking alfalfa tablets which are supposed to contain Vit K and his nose bleeds are greatly reduced, as are his haemorrahoids, but now he is off the questram again and his diarrhoea has returned.
My main question is how best to proceed from here. Can we desensitise allergic components of colitis? Should he go back onto the questram or is that just solving one problem and creating a whole lot more? Should he start taking a vit A,D,E,K supplement (he can't take a complete multivitamin because it gives him a headache)? Does it sound as though there may be a cholestatic component to all this? Or perhaps an underlying pancreatic problem that I am inadvertently overlooking? Does anyone else out there show similar symptoms? How are you managing? What papers should I read on this?
The doctors here in the UK are pretty apathetic about my father's problems and tend to deal with him symptomatically rather than working hard to find an underlying cause. He is only 52, slim and otherwise "healthy" with the whole of the rest of his life to enjoy if he can overcome the restrictions his body is placing on him.
Thank you for taking the time to read this.
Doctor's Answer
by HFHSm.D.-Gastro-rf, Feb 12, 2000 12:00AM
Dear Freddie,
I too am puzzled by your description of your father's problems. Food hypersensitivities are difficult to prove and would not explain all th estmptoms. For example, fat globules in th estool are usually indicative of fat malabsorption and could be associated with the vit K deficiency and nose bleeds. However, fat malaborption is not a consequence of ulcerative colitis. It is the result of either pancreatic disease, small bowel disease or bile acid deconjugation. Cholestyramine should make the fat malabsorption worse not better.
With regatrd to your specific questions, there is no proven hypersensitivity component to ulcerative colitis and therefore no desensitization protocol. Vitamen supplements would be a good idea if there is documented malabsorption. However, before starting a replacement regimen, attempts should be made to document the malabsorption and to look for treatble causes. Based on what you describe I do jnot beleive that there is a cholestatic component although liver tests would be helpful in deciding the answer to your question. Is there any reason to suspect that your father has disease of the small intestine causing the fat malabsorption?
I too am puzzled by your description of your father's problems. Food hypersensitivities are difficult to prove and would not explain all th estmptoms. For example, fat globules in th estool are usually indicative of fat malabsorption and could be associated with the vit K deficiency and nose bleeds. However, fat malaborption is not a consequence of ulcerative colitis. It is the result of either pancreatic disease, small bowel disease or bile acid deconjugation. Cholestyramine should make the fat malabsorption worse not better.
With regatrd to your specific questions, there is no proven hypersensitivity component to ulcerative colitis and therefore no desensitization protocol. Vitamen supplements would be a good idea if there is documented malabsorption. However, before starting a replacement regimen, attempts should be made to document the malabsorption and to look for treatble causes. Based on what you describe I do jnot beleive that there is a cholestatic component although liver tests would be helpful in deciding the answer to your question. Is there any reason to suspect that your father has disease of the small intestine causing the fat malabsorption?
couldn't find an answer, except "Are you under any stress?".
This seemed to be the questions everywhere I went. Anyway, I
discovered I have Celiac Disease. Especially the fat in your stool, being lethargic, nausea and headaches; these were all my symptoms. I went on a gluten free diet and have felt soooo
much better since then. Look under Celiac Disease in your search engine and you will find alot of helpful info.
This may not be your problem, but maybe the info. will help.
Good Luck!