Your liver produces bile salts which are stored in your gall bladder. When you eat your gall bladder squirts out tiny bits of these bile salts through the common bile duct along with some pancreatic juices from your pancreas and it mixes with your food to help you break down fats and such so you can digest your food. By the time your bile salt acid/food mixture reaches the end of your small intestines and the beginning of your colon, your intestines will take any of the excess bile salts and and send them back up to your liver where the process can start again the next time you eat a meal. Your colon then absorbs the excess water out of your digested food and then you poop. Normal poop. Solid (ish) poop. This is the process. The normal process of eating and digestion and pooping.
Bile salts from your liver are not supposed to end up in your colon because if they do, they cause a laxative effect and you poop - a lot - of yellowish, yucky watery diarrhea. All the time. Even if you are asleep. Or driving your kid to work. Or walking down to get the mail. Or attempting to make dinner. Or in a coma. Or whatever.
I have no gall bladder. I have no end of my small intestine or beginning of my colon. I have a messed up pancreas. I do, however have a liver that is apparently continually excreting bile salts acid 24/7 that goes directly into my intestines because there is no gall bladder to store it. There is no part of my intestines to reroute this excess bile back to my liver. There is no part of my colon to absorb the excess water out of my food. The bile salts are in my colon where they should not be, causing that laxative effect and I am left with constant (and I literally mean constant) diarrhea. It doesn't stop. It doesn't matter what I do, this process of the bile salt acid is trying to work but I'm lacking every part to make it work properly. Crohn's disease - active or inactive - is going to exasperate the situation. There is scar tissue. There is inflammation. There is a complete and total catastrophe of chaos happening inside my body every second of every day. Something called Bile Acid Malabsorption (BAM!) I'm still researching and learning.
This information was finally explained to me today by my GI in a way that made sense for the first time in nearly 20 years. It makes perfect sense really. This is probably what is happening inside my body. This may be why I feel like I am actually shitting myself to death. Well, it's either this or a Crohn's flare up. Blood work has been done to check for inflammation but that will come back normal....it always does. (UPDATE: 12/23/15 - Blood work was normal. Go figure!)
Dr GI compared bile salt diarrhea to cholera or dysentery - the absolute worst kind of diarrhea one could have. I swear, those were his words. But there are these pills, these new type of bile salt binders that I am willing to try and with some changes to my diet (diet change being my choice - not any advice given to me by my doctor) I am hoping work. I've tried bile salt binders before. I didn't have good results. But maybe I couldn't give them a good enough of a chance. Maybe because I had a job where I sat at a desk for 8 straight hours and couldn't really get up and move around a lot, they caused a lot of gassy bloaty pain. Now that I'm home and can move around and stretch and walk around and try to fart it out if the gas gets bad so they might work. I'm willing to try. I'm willing to try anything. At this point I have absolutely nothing to lose.
So maybe I'm not really dying. Maybe there is a way to slow this bile salt acid diarrhea mess. Maybe these pills can help. Maybe I'll feel better.
I received a letter in the mail yesterday from a wonderful lady who started a little business called The Mailing Spoons Project. She is a Chronic Illness Advocate and she mails letters and cards to the chronically ill. She herself is a Crohn's warrior. In her note she included a quote that has just resonated with me. I love it. She made me feel strong again just by sending me a little card to let me know she cared. I'll leave you with the quote and her information. Thanks again, That Bailey Gal!
"She made broken look beautiful and strong look invincible. She walked with the universe on her shoulders and made it look like wings..." ~Unknown