I have found coconut fat (coconut oil, cream and butter), olive oil, goats ghee to be good for gaining weight and seems to be good for my gut. I have no idea what impact eating alot of these fats has on PCS? Is it safe to assume they will just go down the loo if I eat more than I can digest or could there be an impact on PSC?
Most dietary fats are long-chain triglycerides and these can be a problem as PSC progresses. These fats require liver bile to be broken down and absorbed (they also induce bile production in the liver). With cholestasis, or restricted bile flow, these fats can pass through and go down the loo. This is a problem for a couple reasons: 1) fats are over twice as calorie dense compared to carbs and protein, so one is missing out on a lot of calories, and 2) fats are necessary to absorb fat soluble vitamins (vits A, D, E, K) and this can contribute to vitamin deficiency and related health problems like osteoporosis.
Short- and medium-chain fats are a way to work around this problem. These fats do not require liver bile to be broken down and are absorbed directly, even with cholestasis (these also do not induce bile production in the liver). The problem is that these fats are rare in natural sources with coconut oil having the highest content. There are also 100% medium-chain triglyceride (MCT) supplements and these may make sense as the disease progresses and if weight loss and vitamin deficiency become issues.
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As jtb says some foods provoke increases in bile . These need avoiding. Any impairment to bile processing and it’s not gonna reach the toilet.Its gonna go back where it came from,into the liver and do it’s dirty work and start destroying all those lovely little tree shaped ducts there.Fibrosis of the liver follows. I’m not a biologist but I avoid all man made fats that can’t be digested .
At all costs avoid stress that really affects metabolism.