Over the course of months it's become apparent that Ellie cannot tolerate saturated fats. The foods she has reacted worst to are very high in saturated fat: ghee, coconut oil, beef, tallow, cacao butter and eggs. A couple of weeks ago I trialed cacao butter in my diet and it was immediately apparent it was a problem. Ellie suddenly wouldn't go down for bed, telling us her tummy hurt and having the jerky cramping abdomen during sad awakenings overnight. I had thought duck eggs were fine, but Ellie hadn't been doing well for about a month and so three days ago I pulled the duck eggs and suddenly she was a different person. The last two nights she's slept nearly 12 hours in a row! Hallelujah.
Both ghee and coconut oil caused similar symptoms (ouchie tummy and cramping) and they both gave Ellie a crazy rash all over her torso and under her eyes. And with ghee she actually vomited. Our nutritionist has been educating us on fats and the role of the liver and gallbladder. She explained that the liver produces bile, which helps the body digest fats. The gallbladder holds the bile, releasing it when it is needed. The other day in an email she wrote this sentence:
But if the gallbladder isn't functioning properly, the bile is not as readily secreted into the body, and the liver can become overwhelmed when faced with large amounts of any fats, especially saturated fats.She sent us this chart, which shows the proportion of saturated fatty acids to other types of fatty acids in various fats. And it's crazy. If you go from the fats with the most saturated fats backward down the list to the fats with the least saturated fats you've got a list of the fats Ellie is most to least reactive to.
You know when you've looked at an issue from every direction and you just can't figure it out, and then someone says something or you learn something and it just breaks open your tunnel vision and let's you see the whole picture? I feel like that's what happened when I read that sentence.
Maybe Ellie never had an allergic reaction or a sensitivity reaction to these foods like dairy or coconut, but it was all about her body's inability to digest the fats. It seems so forehead-smackingly simple, but of course it wasn't easy in the slightest to figure out (and that is assuming that we having figured it out).
So I spent some time yesterday researching gallbladder disease. There are several different forms it can take. Apparently the most common form of gallbladder disease is gallstones, but those are very rare in young'uns and the gallbladder can be diseased without there being gallstones present.
Chronic cholecystitis - also called biliary colic - is chronic inflammation of the gallbladder. Symptoms include pain in the abdomen that comes after eating food and can last for several hours. Sounds pretty dead-on to me.
Here are some passages I read about gallbladder disease and some of the dots I've been connecting:
Recurrent painful attacks, if mild, can be treated with over-the-counter painkillers. Placing something warm on your stomach may be helpful, taking care not to scald the skin. The frequency of attacks may be reduced by a low-fat diet.
Before we started SCD we gave Ellie Tylenol all the time. We used to think she was perpetually teething and then when we went on SCD we got specially compounded Tylenol for her but after about two months she no longer needed the Tylenol. But back in the day she'd wake up in extreme pain and the Tylenol always helped. Perhaps she wasn't teething in all of those instances, but having some other sort of pain. Also, the few times we were functional enough at night to get a warm compress on her tummy, that helped a lot.
Ellie got so much worse when we went on GAPS. I believed people when they said it was a sign she was healing (and maybe partly that was true) but now I can see she was reacting horribly to the high-fat diet. When we introduced raw vegetables Ellie made a huge turnaround and for the past two days I've kept her diet quite low in fat and she's been doing great.
The symptoms vary widely from discomfort to severe pain which mainly begins after food.
Ellie's symptoms have always been connected to food. She's most likely to experience pain at the end of her nap (several hours after lunch) and between 9 pm-2 am.
People with diseases such as chronic intestinal inflammation (are at risk of developing gallbladder disease)
So perhaps the gallbladder theory is interrelated with the theory that Ellie does have intestinal inflammation in the form of Crohn's disease, Ulcerative Colitis or IBS.
An attack can last from a few minutes to two to three hours before getting better. The frequency and severity of attacks is very variable. Attacks can be triggered by eating fatty foods such as chocolate, cheese or pastry.
This was very intriguing because back when Ellie was regularly having what we thought were allergic reactions (pre-SCD), if she woke in the night we knew she would be up for 3 hours exactly. It was like clockwork. Now if she has a really bad night she wakes up over and over for about that time frame. So perhaps she's having a gallbladder attack that's just running its course over 3 hours.
Chocolate in my diet was always a huge trigger for Ellie, as was the raw cacao butter I tried recently. And it's interesting to note that when we first introduced dairy when Ellie was about 10 months old she did so-so on it, until I gave her cheese and she was a wreck. I couldn't figure it out then, and just assumed that it took her body a while to build up an allergy, but maybe it was always about the fats!
It feels so good to finally at least have a sense that we're figuring this mystery out. Next steps are talking with the naturopath, getting in to see a GI and likely having an ultrasound done to take a look at Ellie's liver and gallbladder.