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cucciaman OP t1_itvm2j3 wrote

Reply to comment by CatKitKatCat in We're a group of people with gut health issues, microbiome researchers, and physicians here to answer your questions on the gut microbiome and digestive health (IBS, IBD, and more). Ask us anything! by cucciaman

Thanks for your question u/CatKitKatCat!

How is it possible that a person can have totally normal colonoscopy results even if they have such severe gut issues?

This is a very frustrating issue that we get asked about all the time.

A colonoscopy is mainly focused on examining the colon for growths (such as polyps), inflammation and other physical abnormalities such as sores. As a result, colonoscopies are great when it comes to detecting things such as colon cancer and in most cases Crohn’s and Colitis (visible inflammation), but are of little value when it comes to something such as IBS. Except when ruling out other conditions of course. In the case of IBS, which is not a single condition but instead a combination of symptoms caused by gastrointestinal dysfunction, it is highly unlikely anything indicating its presence would be seen. This is an issue that is also experienced in the case of celiac disease and some drug side effects.

If a person has ‘absorption issues’ with low vitamin/mineral levels, how does the gut influence that?

Another great question!

Malabsorption of vitamins and minerals is a big concern for those with conditions such as IBD. In the case of Crohn’s, up to 75% of patients might be malnourished. There are a few reasons for this: their intestines are too inflamed to properly absorb nutrients, their microbiome has been impacted so they are unable to produce the necessary vitamins ‘themselves’, and they might simply be eating less due to the medications they’re taking or the symptoms they’re experiencing.

Different vitamins and minerals are also absorbed at different points along the digestive tract. So if a patient’s Crohn’s is primarily localized to their ileum they would have issues absorbing vitamin B12 since this is the only place in the body it can be absorbed.

If you’re curious to learn more, we wrote a blog post to break down how the different areas of the gut are responsible for absorbing different vitamins and minerals! Feel free to check it out!

https://www.injoy.bio/post/nutrition-and-ibd-why-you-could-be-missing-out-on-key-nutrients

LC

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