Raising Awareness of BAM

To be fair, I haven't done a ton of research because honestly, there isn't a ton out there. BAM is not a condition that gets diagnosed very often and is overlooked by even gastroenterologists. I'm also not 100% sure that I suffer from it.

Let me start at the beginning. As most of you know, a few months ago I got my gallbladder out. I was blessed with not having any issues or side-effects from the removal. But then I decided to start fasting twice a week with the 5:2 diet. Never having had any side effects from fasting prior to my surgery, I didn't expect this.

TMI

Every morning after my fast, I have a single bout of diarrhea. (My old PCP told me that it "can't be diarrhea because that would infer more than one instance in a day" ; not an exact quote but I digress). So, I don't know what you would call having watery stools only once, but that is what happened - because the day before I had only ingested roughly 500 calories, most of it in my dinner that I'd had about 14 hours prior.

I couldn't attach it to anything specific. I could change my dinner, I could skip my coffee, I could eat breakfast before coffee - it didn't matter. About 98% of the time, twice a week, I would have this issue. I tried Imodium first. Once. When that caused more problems than it solved, I researched. I discovered a condition called BAM.

Bile acid malabsorption (BAM) is a condition that occurs when your intestines can't absorb bile acids properly. This results in extra bile acids in your intestines, which can cause watery diarrhea.

also:

In other cases, BAM results from an underlying condition. For example, it’s been estimated that about one-third of people with irritable bowel syndrome and diarrhea (IBS-D) have BAM. 

But mainly, I think it's due to the combination of not having a gallbladder and not having food to digest. See, when you don't have a gallbladder, your liver trickles a constant stream of bile into your small intestine. Generally, this wouldn't be a problem if you're constantly in a cycle of eating or digesting food. But when you fast, your small intestine is empty. If I'm not properly reabsorbing the bile that is going unused, it could cause diarrhea when I finally do eat a meal. 

I had read that a cholesterol-lowering medication could help with the condition. The medication binds with the bile acids in the intestine, forcing the liver to use cholesterol to make more bile (sounds like a vicious cycle to me but okay), which in turn lowers your cholesterol. But because of how it functions, it could also potentially be used to treat BAM. So, I went to my PCP, who promptly gave me an incredulous look and said it probably wouldn't work but prescribed it to me anyways.

Guess what? It does.

That's right, bitches. I diagnosed and cured myself. I mean, I needed the script from my PCP - who is no longer my current practitioner, but whatever. Do your research, even if you don't understand half the words you're reading. I obviously don't have a medical degree, but I know enough about basic biology to make some educated guesses. And if your PCP doesn't agree but doesn't offer up any other possible solutions, then get a second opinion. Advocate for your health.