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The background hyperpigmentation histologically has the features of a lentigo or caf-au-lait macule
Smith AC, Liao JT, Page JG, Wientjes MG, Grieshaber CK
2.3.1 Sweet and umami receptors (TAS1Rs) L and K cells in the intestine express taste receptors that sense luminal carbohydrates and amino acids, triggering secretion of gut hormones such as GLP-1 and GIP
BPC-157: Experimental Peptide Creates Risk for Athletes
Notably, in patients with SBS or after jejuno-ileal bypass surgery, delivery of an increased amount of undigested carbohydrates to the colon can result in excess d-lactate accumulation (185, 186)
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