On several occasions I have tried MCT oil and experienced sharp stomach pains between 12 and 24 hours after ingestion. On the first occasion, I tried 1 tsp. straight-up in the evening, without food. The next day (about 12 hours later) I had a very sharp/stabbing pain in the right-side of my abdomen. I never experienced any symptoms whatsoever of "disaster pants." (lol) Thinking I just needed to "ease" into it, I waited a week and started with 1/4 tsp. added to a meal-replacement-type shake (i.e. with food). I had no symptoms, so I moved up by 1/4 tsp. each day. When I reached 3/4 tsp. I experienced pain (again, 12-24 hours after ingestion). To be sure, I did 3/4 tsp. again and got the same pain. (Not as severe as the 1 tsp. dosage.)
I do not believe I have a problem digesting fats in general. I have been on a lower-carb, high-fat Paleo diet for a few months (or more, depending on your definition of LCHF), and have never had problems digesting fats before. I can also digest 3 Tbsp of coconut oil without any problems. I'm currently on a ketogenic diet without any problems digesting fats. (But wasn't keto at the time I was experimenting with MCT oil.)
One idea is that the MCTs are overwhelming my liver (too much at once). Which is logical, except that the pain response is so delayed. I thought that MCTs went pretty much straight to the liver because bile wasn't necessary for their digestion. So I'm not sure why it would take so long for the MCTs to arrive in the liver. I do have a very slow digestive system (my "transit time" is running around 56 hours; I have been trying to fix this for quite some time and am working with a practitioner on it, along with other things) - but even with a slow system 12 hours to go from the stomach to the liver still seems really slow.
Another idea was that this was a possible herxheimer reaction. My only symptom was the sharp pain (no other herxing symptoms) and no other anti-microbial foods or supplements have ever caused this reaction.
I certainly have other things going on with my gut, however, I just wanted to put the question out there to see if anyone has experienced this, or if anyone has any other ideas. I'm looking for clues as to what might be going on with my digestive system.