Do smelly stools run your life?  Is your poop a piddle and your stomach in constant turmoil?  Is everyone telling you to take a pill such as Devrom, Acid-X, or something similar, to poop out the mess and get rid of the gas?  Before you run for the "easy" answer, here are 13 important questions to ask yourself.  Why?  If you rely on the "easy" answer, it could be at the cost of your life.

(1) Are you upside down on eating carbs vs. protein? By carbs, I'm speaking of white food, white bread, McDonald's and any other fast foods, or enjoying the fats in French Fries, or fried foods (to the anguish and consternation of your pouch).  

(2) How much pure water do you consume daily?  As a minimum, you should have 64 oz. of water daily.  If you exercise, then, 96 oz. works much better to keep your body lubricated.

(3) Drink milk? Milk for anyone who has had RNY is a "no no" because milk causes the body to be sluggish and retain weight.

(4) How is your sleep? Disturbed? Sleep through the night? 

(5) Do you poop 3 times a day? You should poop after every meal.

(6) How about exercise? Do you? Do you vary your routine? Are you a couch-potato?

(7) Do you take your vitamins and supplements daily? Do you stretch them out throughout the day? Do you ignore taking vitamins? (8) Do you get exhaustive blood work tests done more than 1 time a year checking for your Vitamin A, B1, B2, B6, B12, C, D, Calcium, Magnesium, Iron, Potassium, etc. levels? Do you ignore getting exhaustive blood work tests?

(9)  Do your daily vitamin / supplement levels take into consideration your malabsorption you have from your weight loss surgery? You didn't somehow grow back 80% of your small intestines did you? 

(10)  What type of protein are you consuming? Whey Protein Isolate? Chicken? Nuts? Fish? Look at the discussion I have at my support group on the Bioavailability of Protein, in considering your response. It is at www.obesityhelp.com/group/BellevueWA. 

(11)  Do you have smelly stools? Gas? Are you bloated?
 
If you are, it is because you are upside down on your protein level, your metabolism is out of kilter, and perhaps you have an urgent medical issue which needs to be addressed by your physician.    But, check out the protein level first and get your protein ramped up to where it must be if you wish to live.   Simply because you have had an RNY does not automatically mean your face drains away and you look gaunt.  Neither is it normal to have smelly stools.  Nor should you have to rely on stool softeners, or using your finger to get the poop moving out of your rectum.

It is a mistake by doctors, nutritionists, and other "professionals" who commonly refer folks to taking stool softeners as a matter of course to control this issue.  In my opinion, those folks do a severe disservice to folks who have gas or smelly stools.    All that said, it is common for folks who have had an RNY, that when their bowels move, they fill up the toilet so much it may take flushing the toilet 3 times to get rid of the stuff.  That is OK.  The toilet is working fine.  So are you! 

Smelly stools or gas is not fine.  You have a very serious issue here!

Fortunately, last Saturday (January 16, 2010), I had the great opportunity to take a refresher course in nutrition, to keep my ObesityHelp.com "license" as an Obesity Help Support Group Leader.  Each time I take this exhausting and exhaustive course, I come away learning something new.  This time, I learned a lot about gas and smelly stools because of the recent Q&A OH postings on this subject.

I quote from some of my materials:  "A greasy character and truly rancid odor are indicative of increased stool fat, but are often absent until late.  What this means is that if symptoms are intermittent or if they progress slowly over many years, patients may exhibit vague, seemingly unrelated symptoms such as chronic fatigue and depression, long before the physician considers the possibility of serious organic disease.

"Carbohydrate malabsorption will result in symptoms of diarrhea and excessive flatus (gas).  malabsorbed carbohydrates that enter the colon are fermented by colon bacteria into gases.  Stools seem to float on the water because of their increased gas content not because of their fat content.  This often happens when the gastric bypass patient begins to eat more carbohydrates, instead of protein.  Given sufficient time, fat and muscle will be catabolized."

Now, don't confuse floating stools and think all floating stools are bad.  Those that come from not getting sufficient protein are bad floating stools.  Floating stools which come from using a Vita Mix and blending fresh greens along with fresh fruits so your body is naturally getting an abundance of B, C, E etc. vitamins, is a good floating stool.  That is a subject for another posting. I'm talking about having a quart of Green Smoothies daily added to your diet.  So, floating stools can be a good thing; but, with smelly stools and gas, bloating, etc., floating stools is a very bad thing because your body is being cannibalized to the detriment of your health and life.

"When fat and muscle become catabolized, this function is destructive to the body because living tissue is changed into waste products of a simpler chemical composition."  In better English, this means, cannibalism of your liver, pancreas, heart, kidneys, brain, etc.

"Physical examination may reveal signs of weight loss from both fat stores and lean body mass.  The patient will be weak and will easily develop fatigue.  Fat loss will generally be noted as sunken cheeks and flat buttocks, with wrinkled or loose skin indicative of loss of subcutaneous fat stores.  There may be a direct evidence of a reduced metabolic rate.  The patient will often be mentally slowed.

"Severe loss of body protein may occur before you see bad lab tests.  Clinically, protein deficiency results in edema and diminished muscle mass.  Since the immune system is dependent upon adequate proteins, protein deficiency results in growth retardation, mental apathy and irritability, weakness and muscle atrophy, edema, hair loss, deformity of skeletal bone, anorexia, vomiting and diarrhea.  Protein malnutrition by itself is known as kwashiorkor."  Other issues arise with long lines on your fingernails and brittle nails. 

OK, 'nuf said about gas.  Except, one product you can use which is good for your body aiding you while you aggressively work to straighten out your protein consumption and eliminate the pooping issues, is to take from 1 to 3 teaspoons of Magnesium citrate in your nighttime beverage.  The Magnesium citrate is excellent for your body.   A great resource for this is Vitamin Shoppe (get it on line if you don't have a Vitamin Shoppe in your area). It contains 615 mg of Magnesium, which is 150% of daily value.  In our RNY bodies, if you need to, and believe me, you have to work up to taking even 3 teaspoons; you could increase it because of our malabsorption issue.  It comes in a raspberry-lemon flavor which I dearly love as well as other flavors.  At least, after staying with it and having pooping issues (before I started adding yummy green smoothies to my diet) I developed a liking for it.  Now, I love it.  So, it becomes for me, an acquired taste.  Whereas, I found daily drinking a quart of green smoothies to be love at first taste.

(12)  How is your energy level? 

(13)  Do you generally feel well and strong with a sense of well-being?

SIMPLE FORMULA FOR DETERMINING HOW MUCH PROTEIN YOU SHOULD HAVE DAILY:

 Now, for a simple formula for determining how much protein you should have daily to continue to lose weight, I use the formula developed by Sally Myers RD who regularly contributed to "Beyond Change," a publication devoted to folks who had bariatric surgery for weight loss. 

Take your current weight, say 240 lbs. Subtract 120. Take the difference 120 and divide that by 4. That gives us 30. Take the 120 and add the 30 = 150 grams of protein daily. OK. Not 240 lbs? How about 200 lbs? Then, the answer is 140 grams. OK. Not 200 lbs? What about 160 lbs. and still wanting to lose a few more lbs? The answer is 110 grams.

Do you think it is hard to consume this much protein? It is. 

A SIMPLER METHOD TO DETERMINE HOW MUCH PROTEIN YOU SHOULD HAVE DAILY

Another method utilized by some folks is to take their current weight and divide in half. That amount becomes the amount of protein to have daily. Yet, for the same folks who promote this method, they continually talk about “Getting Back on Track.?

For myself, I’m struggling to get my protein amount up to the amount recommended by Sally Myers, MD. I’m getting better at it; but, I do have vibrant health now, although I’ve had real issues take out chunks of years. But, I’ve lost 150# and have kept the weight off. I’m still working to get rid of the last 30 lbs. So, I’m still striving to get my own protein level to the amount recommended for me by Sally Myers. 

MY PERSONAL TESTIMONY TO GREEN SMOOTHIES

Now that I’ve added green smoothies to my daily diet, I believe I’ll be able to do get rid of this last 30 lbs! Read what I wrote at my group website, and consider your sources before you pick up the cheese bar. Instead, use Isopure, Any Whey, or Unjury Whey Protein Isolate. Any Way which is a protein blend. You can also mix 2 scoops Any Way, Unjury unflavored, or even Isopure's Vanilla into your green smoothie and think you've died and gone to Heaven, because the flavor is so delectable, nourishing, invigorating, and simply delicious. You would blend the mixtures using your Magic Bullet. Hope all this info helps. 

Blessings, Christine Gibson, MS, MA, Bariatric University Support Group Coach, Obesity Help Support Group Coach, Obesity Help Support Group Leader.

Analysis by Christine Gibson, MS, MA OH Coach & OH WLS Support Group Leader North West Weight Loss Surgery Support Group [email protected] 425-885-2634 February 19, 2009  



How to Calculate NPFV (Net Protein Food Value) 

Gross Protein Value = GPV ¨
Malabsorption = MA 
Biologic Value (or Bioavailability of Protein) = BV 
Net Protein Food Value = NPFV of food. The USEABLE AMOUNT OF PROTEIN FOR THE HUMAN BODY
MPS = Protein Blends (Mixed Protein Sources) ¨
 WPC = Whey Protein Concentrate (Lactalbumin) ¨       WPI = Whey Protein Isolate  

Protein Type	BV	Calories per ounce	Gross Protein	Useable Protein (NPFV)  for RNY folks[i]	Useable Protein (NPFV) for Lap Band folks and General Public[ii]	Sources
MPS	100—159%	70 (scoop)	17	8.5 g – 13.5 g	17 g – 27 g	Any Whey
WPI	104%	110 (scoop)	25	10.4 g	26 g	Isopure
Whole Egg	100%	75 (large)	6	3 g	6 g
Cows Milk	91%	14 ¼ (ounce)	1	.5 g	3.6 g
WPC	90%	120 (scoop)	24	10.8 g	21.6 g	Optimum Nutrition 100% Whey
Cheese	84%	101 (ounce)	6	2.5 g	5 g
Beef	80%	82 (ounce)	7	2.8 g	5.6 g
Chicken Drumstick	79%	105 (drumstick / ounce)	13	5.1 g	10.3 g
Chicken Thigh	79%	69 (thigh/ounce)	7	2.8 g	5.5 g
Chicken Breast	79%	55 (breast/ounce)	8	3.2 g	6.3 g
Fish Baked/Broiled	76%	76 (ounce)	4	1.5 g	3 g
Rice	74%	37 (ounce)	1	.4 g	.7 g
Soy Protein Isolate	59%	96 (ounce)	23	6.8 g	13.6 g
Soy Nuts	59%	134 (ounce)	10	3 g	5.9 g
Wheat Durum	54%	96 (ounce)	4	1 g	2.2 g
Beans, Navy	49%	95 (ounce)	6	1.5 g	2.9 g
Peanuts	43%	165 (ounce)	7	1.5 g	3 g

 

WHY PROTEIN SUPPLEMENTATION? It’s all about Absorption

 Protein forms the body’s mains structural elements and is found in every cell and tissue. Take away the water, and about 75% of your weight is protein. Your body uses proteins: 

*  For growth
*¨ To build and repair 
               Bone
        Muscles
                Hair
               Connective tissue 
        Skin 
                Internal organs 
        Blood 
              Virtually every other body part or tissue

Lack of protein can cause:   

        Growth failure
        Loss of muscle mass 
        Decreased immunity
          Weakening of the heart and respiratory system 
          Hair loss
        Death

Besides building cells and repairing tissue, [proteins form antibodies to combat invading bacteria & viruses; they build nucleoproteins (RNA & DNA). They make up the enzymes that power many chemical reactions. They also carry oxygen throughout the body and participate in muscle activity.   At least 10,000 different proteins make you what you are and keep you that way.   Hormones, antibodies and enzymes that regulate the body’s chemical reactions are all made of protein. Without the right proteins, blood won’t clot properly and cuts won’t heal.   Each protein is a large complex molecule made up of a string of building blocks called amino acids. The 20 amino acids the body needs can be linked in thousands of different ways to form thousands of different proteins, each with a unique function in the body. 

Your food can’t use food protein directly. So after protein is ingested, digestive enzymes break the protein into shorter amino acid chains, and then into individual amino acids. In the gastric bypass patient, this normal digestive process is bypassed. These digestive enzymes are not available until they meet with the food protein in the common channel of the small intestine, and then have only about 5 to 7 ½ feet compared to 20 feet in a “normal? digestive tract to do their job. The amino acids then enter the blood stream and travel to the cells where they are incorporated into proteins the body needs.  

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[i] Formula used to calculate NPFV for RNY folks: Gross Protein x .50 x BV = Net Protein Food Value (NPFV). i.e   Chicken Thigh. 7 x .5 = 3.5, then 3.5 x .79 = 2.8 useable grams of protein per ounce.  [ii] Formula used to calculate NPFV for General Public including folks who have had lap band WLS: Gross Protein x BV = Net Protein Food Value (NPFV). i.e. Chicken Thigh. 7 x .79% = 5.5 useable grams of protein per ounce.

How much protein should I be eating every day?  That subject came up yesterday on another part of OH.  The person who wrote in is concerned because her hair has not been coming back in, and she is 2 years post RNY!  What gives?  I decided, i needed to get the North West Weight Loss Surgery Support Group Blog site off to a good start.  Our first blog, will be to talk about protein.