The doctor was responding to a question from a concerned caller. The caller was concerned about her blood pressure medication that she was prescribed (for her high blood pressure). She was concerned because she was noticing it in her stool. She would take the medication, and in her next bowel movement, she would find it. So, she explained, she told her doctor about it, who told her to take it with food. She tried that, and now she wasn’t noticing it in her stool every day, but still most days she would find the undigested tablet in her stool.
The doctor asked if her blood pressure was controlled, and the caller didn’t really give her a straight answer, more of a “kind of”, which the doctor some how interpreted as a yes, and went on to say that she was probably digesting enough of it to control her blood pressure and that she shouldn’t worry about. Which, I think was hasty, but if indeed, her blood pressure was controlled, then “okay”, I can maybe let this one go (even though I personally would want to correct the mechanism causing the heightened blood pressure in the first place, but that’s a different discussion!). My problem is with what she said next!
The doctor went on to say that, because you aren’t experiencing diarrhea, we aren’t worried about your ability to digest or absorb nutrients.
um…. what?!?! Since when is it necessary to have diarrhea to have malabsorption??!!
Okay, I can follow her logic, a little bit. A lot of absorption does, indeed happen in the large intestine… however, most of that is excess fluid AND THEN what’s nutrient might have gotten left behind from previous nutrients not getting absorbed. So, if you have diarrhea, either your peristalsis (the movement of your intestines) is moving too fast, so it’s not absorbing that fluid, or you have too much fluid in the first place so it’s kind of overloaded. So yes, diarrhea can be a cause of malabsorption…. but…. it’s not THE ONLY cause of malabsorption, and better well be darned sure that you can even have malabsorption with constipation!
If the tablet is intact in the stool, it definitely wasn’t absorbed… furthermore… it wasn’t even digested! It wasn’t broken down, so it basically just slid on through! (pretty, I know).
So we have many possible problems here, but the first is what we should address first and foremost, and that is digestion! The callers’ absorption might be just fine, but if she isn’t first digesting, and breaking up the larger pieces into absorbable ones, then there’s a problem. And it just so happens that this is a very common problem today!
The problem is often low stomach acid. Without enough stomach acid in the stomach, we cannot break down our food into absorbable pieces. This is the first (well, actually not the first, digestion begins in the mouth…) big step in breaking down our food. If you miss that step, the rest is going to be problematic as well! Taking something like Betaine HCL can be a huge help with this sort of digestive problem. There could be other problems too: like lack of pancreatic enzymes, not enough bile salts, etc. So if you’re finding undigested pills or food in your stool, don’t just go run and pick up some betaine hcl, but rather get evaluated by a qualified healthcare provider and see if something like betaine hcl, or other digestive aids might be helpful for you (and hopefully, you’ll be able to reverse the damage so that your body can go on regulating itself as opposed to having to take digestive aids the rest of your life!).
Now I can go on a slew of other rants from here: what is absorbed in the stomach, what are other signs of low stomach acid, and one of my favorites, could your acid reflux actually be from LOW stomach acid? But I’ll stop here and just state my point from this article, and why I was so outraged this morning…. Sometimes doctors, and we as humans in general, over generalize or take for granted certain knowledge. Yes diarrhea can cause poor absorption… but it’s not the ONLY cause. We can’t take the rest of the digestive tract for granted, but rather must look at the whole, and review it systematically. Very simply, if we aren’t BREAKING DOWN our food/nutrients/medications/etc. then we sure as heck aren’t absorbing them either. (SMH that this medical “expert” missed this).