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Not digesting fat properly

I'm due for a big show down in a couple hours with my GIs. Basically, I'm not digesting fat properly for one reason or another and it's causing me malabsorption which is resulting in fat soluble vitamin deficiencies. It's causing me horrible joint pain and so on that's getting disabling. I'm sure they'll fight with me for the hell of it but the undigested fat being rocketted from my ass on a regular basis is a little obvious.

They did a scope a little while back and found inflammation and erosion (mild ulceration) in my stomach and duodenum. They decided it was nothing and couldn't be bad enough to cause me problems and didn't want to talk about it despite the fact that it was matching precisely with where the pain was (quite literally they told me they just didn't want to talk about it). Before that they sent me to a rheumatologist who found a vitamin D deficiency, gave me a vitamin D mega-supplement for a couple months, and then refused to do anything more (including retest to see that the vitamin D level was back to normal).

As far as they're concerned it's just IBS because while on steroids I had a negative colonoscopy and a couple negative CRPs (I had positive tests in the past but it was so long ago the records were destroyed and they seem to think I'm lying about it). Of course none of the IBS drugs or acid reducers do anything but give me terrible side-effects that required the intervention of my cardiologist to stop. On the other hand steroids have always worked on my symptoms really well.

So, any advice? I need to somehow make these guys treat me before I end up losing my job and basic quality of life. I've been suffering from the abdominal pain, bleeding, etc for nearly a decade now and as long as I can get a small supply of mild narcotics I'll be fine. But now, with the malabsorption, there's something going on that's going to not just make me suffer, but damage my body. My joints are already pinching and slipping. I doubt osteoporosis is far off if it's not in the early stages now. That's just the vitamin D that I know has been a problem. The other deficiencies are more insidious.

Frankly I don't care what they think is the cause. If they're dead set on not confirming the earlier crohn's diagnosis then fine, but I want the inflammation in my stomach and duodenum gone so I can at least healthy enough to not lose everything and end up on the street. I'm just at a loss as to how I'm going to get that done.
 
How did the 'showdown' go? I have taken Prednisone at low levels for 29 years. Currently take 1 mg to control the 'joint pain'. I test negative for arthritis, so bone doc says it's just joint pain related to Crohn's. I do have a bit of osteoperosis, and take Calcium/VitaminD supplements. My malabsorbtion problem was due to the medication I was taking for diarrhea. Questran and Imodium together. When I stopped that combination, my absorbtion got better.
Is there any reason you can't take the steroid? It might address the inflamation and pain.
 
Well, I have no idea how this happened, but they practically did a 180. All of a sudden they're talking about crohn's again, saying "The evidence for IBD in you is pretty slim but if it's the only thing that's ever provided you any relief maybe we should at least try a low dose of prednisone that's not enough to suppress your adrenal gland or anything. There shouldn't be any real risks with that and we'll see it works."

I was dumbfounded. The doctor was extremely polite, asked me what I thought, listened to me, and even paid attention to what I was saying. That's never happened at this clinic. Usually they're terribly combative, hostile, and antagonistic in just about every way. Now all of a sudden they care about how I'm feeling and they're willing to actually do something just to help me. I thought I'd have to fight to get help and then they just hand it to me. It went better than I ever thought it could.

They also ordered a fecal fat test and fecal and blood vitamin D to establish if the vitamin D is simply not being absorbed or whatever. If the fat breakdown is a real issue the pancreas is also going to become a candidate giving us another diagnostic avenue as well. As for the inflammation and such their best guess was irritation from having hard pills rolling around in there. That's pretty silly but at this point it doesn't matter because they're looking into it anyway.
 
Wonderful news for you. It sure does make a difference to have them work with us doesn't it? Physicians need to remember that we know our bodies better than anyone and when something isn't right, it just isn't right.
I hope the Prenisone works for you. 5mg would generally get me leveled out. I take 1mg a day now, but for joint pain only.
Again, great news for you!
 

forum contributor

Captain Obvious
crohnsproof said:
It sure does make a difference to have them work with us doesn't it? Physicians need to remember that we know our bodies better than anyone and when something isn't right, it just isn't right.
You are SO right - we know our own bodies!!! It's like, I KNOW what I'm feeling isn't right. I don't care if I sound insane to you.

I had to go through 4 docs before I found my PCP/GI who listens to me (luckily, it's the same doc - he's wonderful). He knows that I know when there's something wrong. The other docs either dismissed me or mocked me.
 
A doctor that listens and actually asks for your opinion, is rare. I have had some good ones and bad ones. The good ones are the ones that listen more than they talk.

Hope they get to the bottom of it. You have been bounced around more than enough. It kind of gets to the point where they should do something, even if they are not 100% on the diagnosis. Successful treatment can also point them in the right direction.

Dan
 
Glad to hear that you got some good doctors on your side this time. That makes all the difference. And I second the statement that a good doctor listens more than he talks. Good luck with the prenisone.
 
The funny thing is that these same doctors have a history of not being good about these things. Apparently they just got together one day recently and decided to change their ways.
 
Well, my first thought is maybe they gave misinformation to someone and they don't want a lawsuit. Just maybe they're becoming more alert to the disease since being made aware....who knows.
I just hope you benefit from their change of 'bedside' manner.
Since my actual diagnosis 29 years ago, I've only had 3 physicians that were total jerks, and I let them know it when I fired them!
 
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