Fat Malabsorption-* Updated question for belleenstien*

I was reading in another post about fat malabosorption... is this a common occurance after resection?  I've noticed that I have floaty poo and sometimes it looks like little puddles of oil floating on top of the water.   Can someone explain this to me in more detail?  If my body is not abosorbing fat from the food I eat, does this mean weight loss may result or is that wishful thinking?

You very well may be malabsorbing fats if you've had a resection. Fat absorption is a complicated process but when you remove part of the intestine, you decrease the surface area in there that allows for full digestion. I think the main problem with malabsorption is that you will tend to lose the fat-soluble vitamins that you ingest as part of your diet (vitamins A, D, E, K) and so you should talk with your physician about how best to avoid deficiencies in these. Weight loss may or may not result based on what you're eating and how much intestine is gone...so I think your main concern at this point would be getting the nutrients you need and then the weight loss you can worry about later :)

I don't think that the problem with fat-malabsorption, as far as diarrhea is concerned, for people with TI resections has anything to do with vitamin deficiencies. Theoretically the treatment itself could cause vitamin k deficiencies because it binds the fat as it binds the bile salts, making some fat soluable vitamins even less available.

The terminal ileum is where bile acids, excreted by the gall bladder/liver to aid in digestion, are reabsorbed back into the body. When the system works right it is very efficient. The reabsorbed bile acids actually recirculate back to the liver where they are reused. When enough of the terminal ileum is damaged or removed, the bile acids aren't re-absorbed through the bowel wall. Left to exit into the colon these bile acids pull in excessive water and salt to the colon and cause a kind of diarrhea that is called steatorrhea. It is typically identified by its large volume, greasy, oily appearance and smell. And is often preceded by loud explosive rumblings in the large bowel. Cholestyramine binds to the bile acids and neutralizes the laxative effect.

It is true that people with extensive terminal ileum resections also have problems absorbing many micro-nutrients but I don't think that is the cause of this particular problem with diarrhea.

Point taken Mike, but taking b-12 or other vitamins will not reduce the diarrhea caused by fat-malabsorption.

Everyone experiences these things differently, but I think I would have to say foul in a way that is different from normal. Normal stool, even for us crohnies sort of smells like well, poop! I just find when I've had a high-fat meal or haven't taken my cholestyramine the stool smells more cloying. Rancid? I keep wanting to say sickly sweet, but that's not right. Sorry I'm at a loss for words. maybe someone else can do a better job.