A Fat Chance

I suffer from intestinal lymphangiectasia, an extremely rare disorder which gave me a chance to change my life. A fat chance.

Location: Pisa, Tuscany, Italy

Medical student (Psychiatry), online and face-to-face facilitation, CoP practitioner, writer for and about mental illness (mainly in psychiatric rehabilitation, volunteerism and ICT) but also facilitation nonprofit and CoPs, person with mental illness in recovery.

Saturday, April 08, 2006

Gas Colic

Sometimes, you can get a gas colic, just like babies'. In this case the pain is different from usual IL's, in that it:
1. is localized around the navel and below the stomach,
2. gets far worse when you stand up
3. also worsens when you tighten your abdominal muscles

What can you do to make it go away?

Lay on your left side, because that will relax your abdominal muscles and diminish the pain. This position will also help you release gas without straining (that is, it will help painlessly).

Use a hot water bottle that will keep contractions in check.

If you can, sleep and allow the bowel to do its stuff.

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Intestinal Lymphangiectasia Damange Control

What to do when the sh*ts hit? There are many things that I found helpful and I'm going to list them here so that every surfer stumbling on this site can benefit from them.

When the whole thing starts and you get nauseated, you can lay down on your left side: that will prevent vomit and ease your nausea. Because of its anatomy, the Gubaroff valve will keep your stomach closed.

When the pain hits, put a hot water bottle on your tummy: heat relieves the cramps you undergo due to diarrhoea.

After loosing all those liters of fluids, rember to rehydrate your body! In order to do it correctly, you have to weight how much you loose.

If you don't have oedema, you can drink isotonic solution (1 liter, 9 grams of salt, 30 gr of sugar) and use the equation for burnt people to establish at which pace to rehydrate (half of the total losses in 8 hours and the other half in the next 16 hours). If you do have oedema, add a protein mix (such as Meritene) to the whole solution.

Stop eating for a while. Your diarrhoea is of the osmotic type, which means it will go on as long as there is food in your bowel. Therefore, fast for some number of hours, usually 12, meanwhile living on isotonic solution and solution of water and sugar.

Re-start getting eating those foods that block your bowel. It's pretty personal, but mine are canned tuna, french bread and cous cous, together with unheated skim milk/dairies.

Eat foods with a very low fat content for a couple of days before restarting pushing toward a higher percentage. My personal threshold is 3%, and I eat food below 1% for a day or two after an "episode".

If you are eating a fattier meal, take some simethicone (Mylicon): that will prevent unabsorbed fats from being used as food by bacteria, with consequent production of gas that will overstretch your bowel's wall (which is already full of oedema by itself!) and accelerate your bowel movement speed.

Taking 1 teaspoon of lecithin per meal helps emulsifying the fats, thereby enhancing absorption and diminishing the symptoms. A food that can help you hugely, because of its content in phospholipids (emulsifiers) is egg.

The way you eat is also very important.
1. try to eat MAINLY polyunsaturated fatty acids: they are absorbed via a protein, not through the "fat" part of cell membranes the way saturated fats are and create far less pain for you because they put less pressure on your lymphatics;
2. avoid transfats COMPLETELY: they enhance diarrhoea even in healthy individuals, so.. bake your own tarts, cakes, muffins, etc.
3. don't give up on making tasty food, there are zillions of ways you can substitute, for example, butter in bakery or use spices. Just learn, learn, learn

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How Intestinal Lymphangiectasia Feels

Right after a fatty meal (in 20-30 minutes), I start burping a lot and having some stomachache. It's like eating too
much: you feel swollen and your digestion takes longer. It is uncomfortable but not painful (yet).

Then, the food progresses into the beginning of the small bowel, and it feels like when you have motion sickness: you get irritable, can't stand and tend to lay down on your left side and wish for it to go away. That is when you start complaining.

After a while you start hearing noises out of your belly. That is when the REAL pain begins. Pain gets worse and worse till you have to go to the bathroom. It's pretty much like a stomach bug BUT it's a lot more painful. I can't even move my legs, cause the pain radiates to my feet (it's similar to menses', if you have the painful
form of them, or the first stage of labor, with shivers, nausea, inability to walk, and pain).

At this point, I will start passing the fatty food in 6 hours or so (sometimes even 4) and go on passing more and more liquid stools till at some point will feel hungry when in the bathroom. That's the signal I am having my "last" run due to that food.