From the Research
The patient should immediately consult a healthcare provider to address potential malabsorption issues and consider adding digestive enzymes, such as pancreatic enzyme supplements, to their regimen while continuing benfotiamine supplementation. The presence of undigested food in stool and severe symptoms of diarrhea and bloating suggest impaired digestive enzyme production or activity, which can be addressed with enzyme supplementation 1. A low-FODMAP diet may also be beneficial in reducing symptoms by eliminating fermentable carbohydrates that can exacerbate symptoms.
Potential Underlying Conditions
The patient should be evaluated for potential small intestinal bacterial overgrowth (SIBO) or pancreatic insufficiency, which can develop following severe malnutrition. Thiamine deficiency can damage the autonomic nervous system controlling gut motility and secretion, and while benfotiamine helps restore thiamine levels, the digestive tract may need additional time and support to recover.
Additional Therapeutic Options
Probiotics containing Lactobacillus and Bifidobacterium species (10-20 billion CFU daily) might also help restore gut flora balance, but should be introduced gradually to avoid worsening symptoms. The use of dietary fibre, as discussed in a 2021 review 2, may also have benefits for gastrointestinal health, although the optimal dose, type, and source of fibre required for managing clinical symptoms and preventing gastrointestinal disorders are still unclear.
Key Considerations
- The patient's symptoms suggest a need for immediate medical attention to address potential malabsorption issues and underlying conditions such as SIBO or pancreatic insufficiency.
- Enzyme supplementation, particularly with pancreatic enzyme supplements, may be beneficial in addressing impaired digestive enzyme production or activity.
- A low-FODMAP diet and probiotics may also be useful in managing symptoms, but should be introduced under the guidance of a healthcare provider.