Pale Stool and Bile Salts

[dave11]

so you did have pale stools!?

Very pale. And for a long time. Thought the problem was insufficient bile. I was wrong. The problem was the bacteria in the gut.

 

[BeADocToGoTo1]

Very pale. And for a long time. Thought the problem was insufficient bile. I was wrong. The problem was the bacteria in the gut.

Hi @dave11
Sorry if this was already brought up, but did you have a stool pancreatic elastase test done?

 

[GreenEdge]

I currently have this issue and have had it many times. I believe it's caused by sluggish bowel or slow gut, a condition with symptoms of constipation and painful bowel movements. The slow transit time leaves more time for the bile salts to be reabsorbed by the colon - hence the very pale, hard to pass stools.

And also more time for moisture to be reabsorbed, thus making the problem worse.

I treat the constipation with an osmatic laxative (OsmoLax containing Macrogol 3350), but I only use it every second or third day, so that I don't become dependent on it (as I once was). I also make an effort to drink regularly throughout the day because prevention is far better than cure.

To help treat the inflamed bowel wall, I take 1000mg of vitamin C, several times a day until it settles down.

This is in addition to the supplement I usually take, NAC (N-Acetyl Cysteine) a precursor to Glutathione (an antioxidant produced within the body). It maintains exogenous antioxidants such as vitamins C and E in their reduced (active) states.

 

[dave11]

Hi @dave11
Sorry if this was already brought up, but did you have a stool pancreatic elastase test done?

I don't even know what that is.

 

[BeADocToGoTo1]

...
I treat the constipation with an osmatic laxative (OsmoLax containing Macrogol 3350), but I only use it every second or third day, so that I don't become dependent on it (as I once was). I also make an effort to drink regularly throughout the day because prevention is far better than cure...

Have you tried magnesium supplements for the constipation?

 

[GreenEdge]

Have you tried magnesium supplements for the constipation?

Yes, I once tried Magnesium sulfate (epsom salt) encapsulated myself which I gradually increased the dosage of; expecting a laxative effect to occur at some point, but it didn't work for me so I discontinued.

BTW - Magnesium sulfate poses a greater risk of overdose and is not considered to be a safe dietary form of magnesium.

I'm currently taking a daily supplement of either magnesium L-threonate or magnesium taurate; both are easily absorbed so have no laxative properties at all.

Now that you mention it, maybe I should try other forms of magnesium that are known for their laxative effect. I think if you want to restore normal function, it's still probably best not to take everyday - to prevent the body dependent on it and then having to increase dose over time.

 

[Jwarrior77]

Have any of you guys tried the TUDCA supplement? Its supposed to detoxify the liver, and help promote the flow and production of the good forms of bile. Many people with liver and gallbladder issues say its amazing. TUDCA even has neuroprotective qualities. Its also given as a treatment for cholestasis. I'm going to try it out.

I went to a couple gastroenterologists and all they wanted to do were endoscopies. They didn't want to do any other investigative work whatsoever. I have severe neck instability so I couldn't have that done plus its most likely not my problem. I'm back to trying to treat myself as yet again no doctors want to ever dig deeper.

 

[Eastman]

TUDCA apparently did restore my mother's bowel regularity.

Just a warning though if you have gallstones. TUDCA will likely dissolve the stones. Before they are fully dissolved, the stones are likely to simply become loosened and get secreted out of the gallbladder into the bile duct, where they may get stuck and cause jaundice, cholecystitis or pancreatitis. You may then still end up with an endoscopy to remove the stone or, even worse, have to undergo surgery to remove the gallbladder.

 

[judyinthesky]

I second that you could do an elastase test just to be on the safe side and exclude that. I am also one of those with fatigue syndrome and pancreas issues.

 

[BeADocToGoTo1]

Yes, I once tried Magnesium sulfate (epsom salt) encapsulated myself which I gradually increased the dosage of; expecting a laxative effect to occur at some point, but it didn't work for me so I discontinued..

Hi GreenEdge,
I was thinking more of supplements like magnesium citrate, oxide or glycenate.

 

[GreenEdge]

Since your earlier question I've been doing some research to identify the most suitable form of Magnesium with a laxative effect. So next time I order more supplements I'll get some Magnesium Citrate. Thank you for your suggestion.

I also read that Magnesium Malate is a great choice for people who suffer from fatigue. I found a product (KAL, Malic Acid with Magnesium) that contains both Magnesium Citrate and Malate Acid, so I will try that one too.

 

[Jwarrior77]

Just thought this was an interesting side note, my endo says that I have Gilbert's syndrome based on my blood tests. This doesn't cause the pale stools by any means but it's interesting that I have a slightly weak liver by birth. The consensus is that it's a benign condition but I've heard of many ME patients say they have Gilbert's syndrome as well so I think there is a connection to be made given the prevalence of it in the community. My endo doesn't know how to help my gut issues but he takes me more seriously than the gastroenterologists ever do. I wonder if any of you guys have Gilbert's.

 

[bread.]

Any updates anyone on these issues?

 

[GreenEdge]

I've been improving gradually; the color is now about half way to becoming normal and I'm straining far less now than I was.

To make progress, I found I needed to take osmatic laxative on consecutive days. So instead of every second or third day; I cycled 2 days on, 1 day off. Going forward, as my stools become more normal, I'll switch to every second day, then as things improve further, every third day and so on until I no longer need to take a laxative. Then if ever a no poo day, take laxative that night or the following day.

Weirdly, even thou I'm drinking more water my pee has become very dark. I guess more water being drawn into my bowels (from taking the laxative) has caused my urine to become more concentrated. So I will need to increase my water intake even more.

Google say normal bowel transit time can vary anywhere between 12 and 48 hours from ingestion to excretion. After a curry meal, I've noted passing that meal 10 days later. When I told my doctor he didn't believe me. I think for me, the pale stool issue occurs from a transit time somewhere beyond 10 days.

 

[bread.]

I've been improving gradually; the color is now about half way to becoming normal and I'm straining far less now than I was.

To make progress, I found I needed to take osmatic laxative on consecutive days. So instead of every second or third day; I cycled 2 days on, 1 day off. Going forward, as my stools become more normal, I'll switch to every second day, then as things improve further, every third day and so on until I no longer need to take a laxative. Then if ever a no poo day, take laxative that night or the following day.

Weirdly, even thou I'm drinking more water my pee has become very dark. I guess more water being drawn into my bowels (from taking the laxative) has caused my urine to become more concentrated. So I will need to increase my water intake even more.

Google say normal bowel transit time can vary anywhere between 12 and 48 hours from ingestion to excretion. After a curry meal, I've noted passing that meal 10 days later. When I told my doctor he didn't believe me. I think for me, the pale stool issue occurs from a transit time somewhere beyond 10 days.

thank you. why would increased transit time make it more pale?

 

[GreenEdge]

The brown color of stools comes from left over bile salts. Usually over 95% of the bile acids are absorbed in the terminal ileum (the final section of the small intestine). My theory is that increased transit time results in a higher percentage being absorbed.

 

[Eastman]

...the color is now about half way to becoming normal ...

...my pee has become very dark...

Have you considered Cholestasis?

 

[GreenEdge]

Have you considered Cholestasis?

Thankyou, I shall raise this with my doctor at my next checkup.

 

[Jwarrior77]

Just an update. Had to convince the gastro to get a bile acids test which is just a simple blood test to check for cholestaisis. Just got results in and my bile acids are high and double the normal amount. This can indicate cholestaisis or other problems with the liver. If you have pale stools this should be a no brainer test to get. I dont know why it's so hard to get help sometimes. My total and direct bilirubin is also high.

 

[Joopiter76]

Just an update. Had to convince the gastro to get a bile acids test which is just a simple blood test to check for cholestaisis. Just got results in and my bile acids are high and double the normal amount. This can indicate cholestaisis or other problems with the liver. If you have pale stools this should be a no brainer test to get. I dont know why it's so hard to get help sometimes. My total and direct bilirubin is also high.

do you feel toxic, poisoned or so?
do you have dark/orange urine? I have this sometimes and when I have it I feel better. I‘m feeling so bad and different compared to the time when illness started 13 years ago that I think there is something wrong with my liver.
Can you please let me know what was tested for „bile salts“ I know bilirubin but not the other test.

4 years ago this shit started with having suddenly low yellow coloured urine. And I became suddenly intolerant to simple things/meds and foods. Do you have intolerances? Thanks.