Is this EPI or IBS?

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I'm hoping that someone will help shed some light on my situation. Back in early May, I started feeling crampy and constipated, like I need to use the bathroom but had a hard time getting it out. I thought it was a bad constipation and after about a week the feeling went away. However, at the end of May, the episode started again, bloating, gas and constant urge to go, even though only a little would come out. My stool started going between mush or constipated, back and forth. I went to see a doctor who said it sounded like IBS and referred me to gasto. While waiting for the gasto, I did my own research and was pretty successful at treating my symptoms with peppermint supplements, oregano oil, ACV, and slippery elm. I was pretty much able to control the bloating and gas and the only thing that still remains is the inconsistent stool that still goes back and forth between mushy and undigested to constipated-sometimes in the same day. It also gets aggravated around my period and becomes mushy, which tells me that it is consistent with IBS and hormonal changes. When I finally went to see the gasto he did all possible tests-full blood count, abdominal X-rays, autoimmune panel, celiac, crohns food allergy, stool studies and thyroid as well as inflammation tests. Everything came back normal -no inflammation or infection except for Fecal Fat-my fecal fat was abnormal and suggests that I have some malabsorption-fat in my feces. I know that this has to do with pancreas? I have no ab pain or any other pancreatic symptoms. Could this be EPI instead of IBS or could I have both? I'm worried while I wait for my follow up in early September. Meanwhile my gastro sent me a letter and suggested to eat a low fat diet and said that we would be discussing pancreatic enzymes during the follow-up. I'm otherwise a healthy 39 year old female and already eat a pretty healthy, low fat diet. If you had a similar situation I would appreciate any advice!

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  • Posted

    If your pancreas isn't producing enough enzymes then you're not digesting foods properly and your stools will be abnormal. You could just have EPI and no other pancreas related issues. It's an easy fix and all you would have to do is take digestive enzymes with every meal. As long as you stay on a low fat/carb diet you should be fine. You could still have IBS but I would journal your symptoms with foods and see if your stressed out when you have mushy stools etc. I am usually constipated and can only go to the bathroom twice a week even on a prescription laxative but I have chronic pancreatitis due to Pancreas Divisum (rare condition where your pancreatic ducts never fuse together). I have to take digestive enzymes everyday because I cannot digest fats. Everyone is different but the enzymes usually help with gas, bloating and stools. If you're still experiencing them after taking enzymes, the dose might not be high enough. There's also another condition called gastroparesis (slow digestion) but usually that's caused by being on certain medications for years or CP. You're young like me, therefore not likely but I developed it due to medications. Since it's aggravated around your periods have you been checked for endometrosis? I don't know if there's any connection but it might be something you may want to look into. Constipation is a symptom of endometrosis but mushy stools aren't … just something to consider. Hope you're able to find answers and feel better soon.

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    • Posted

      Thank you so much for taking the time to reply! It can be very stressful while waiting for weeks and sometimes over a month to follow-up with a doctor knowing that there is some issue with test result/s. I'm already on a low carb/low fat diet and will wait to peak to my doctor before starting taking pancreatic enzymes with my meals, I just want to make sure it is endeed EPI. I know for sure I will be taking natural enzyme supplements and not the pharma version because I stay away from medication which can sometimes be worse than the actual illness. My mushy stools are not related to any food intolerance and I can pretty much eat anything without feeling bad, it's just that my stools are unpredictable, either mushy or constipated, unrelated to food. But my stomach has always been a "nervous stomach"-every time there is stress it explodes or I get sick to my stomach, I've been this way since I was a young child. I've never been on any medications or had any health issues either. I don't have endometriosis, but I suspect that my digestive issues might be related to SIBO because I have been plagued with BV infections and UTI's for the last two years and now this IBS and perhaps EPI showed up. I will be asking my gastro if he can test me for SIBO. Mushy stools and IBS do go along hand in hand though because they say hormonal changes in women trigger digestive track. Thank you again for listening and I wish you the best of luck and health as well!

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    • Posted

      Thank you! That was my though as well. I'm uneasy waiting that long to see a doctor for a follow up and trying digestive enzymes couldn't hurt. Is there any particular brand that you recommend of know of? Thanks again!

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    • Posted

      Thank you! That was my thought as well. I'm uneasy waiting that long to see a doctor for a follow-up and trying digestive enzymes couldn't hurt. Is there any particular brand that you recommend or know of?

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    • Posted

      Cool, they were a good transition for me as I realized they do help. Uhh the ones I used were called Digestive Enzymes by ZenWise i think it was? Should be one of the first searches on Amazon. FYI - I am not a doctor, just advising what worked for me.

      Hope you feel better!

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    • Posted

      There's Creon or ZenPep but I don't know what they offer online. I do know I have to take 60,000 with meals and 30,000 with a snack. If your stools don't change you may need to up your dose.

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  • Posted

    i find EPI very confusing even my doctor didn't seem to know maybe someone here could explain. i just read a reply that you could have EPI and non pancreas issues but for someone to develop EPI its wen 90% of the pancreas has been damaged and this was also confirmed by my consultant yet he also said it could be due to IBS so he contradicted himself. it just don't make sense to me. if your pancreas is damaged is not a non pancreas issue?

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