Living with ibs (part 2)
TLDR
Sometimes IBS or constipation and gut upset is from a lack of hydration from electrolytes, stress, and inadequate fiber intake and timing, not necessarily food choice or disease.
Scroll to the reference links for 3 powerful, simple, and accessible Vagus Nerve tools for making the nervous system less nervous.
How food logging may do more harm than good. Remember food logging is for data collection and insight. If you’ve dealt with disordered eating or controlling perceived body image with food, limit logging to 6-8 weeks max. It may feel better moving on to food journaling with general AM & PM notes. Talk therapy can be helpful if you feel food is disrupting your well being.
Thank you coconut water, thank you for access to breath, and thank you squatty potty.
Quick recap from Part 1:
Since I last left you I found out I was dealing with increased methane in my small intestine due to constipation. I have no other pathologies from colonoscopy or stool sample (YAY).
Now, here I am since my follow up with my GI. In our last appointment, following the colonoscopy, she offered to put me on a two week prescription of Rifaximin and Neomycin to clear the methane causing archaea in my small intestine. However, I requested to work with a Nutritionist instead.
Firstly, I’m grateful for my GI doc, Dr. Nicole Ruiz (1) at Mount Sinai, because she truly partnered with me in my recovery. When I told her I’d rather try three months of nutrition as medicine instead of the two week antibiotic course, she offered referrals, remained optimistic and positive toward my wishes, also scheduling me for timely follow up appoitments.
My thought for nutrition alternatively to medication is that through an increased understanding of food and stress, since this seemed to be a contributor to the problem with no pathological red flags, I could have better long term health results rather than with medication to temporarily solve the problem.
This is what I learned working with a Certified Dietitian for the first time.
I ended up working with Nourish Nutrition (2) , through their free tracking app, and pay as you go Dietitian program, I leared a lot about the food I was eating, the food (and beverages) that would help me heal, and ways to integrate new and challenging FODMAP foods like black beans, onions and garlic that I had to omit due to symptoms and had missed so much.
My top 3 takeaways working with Nourish:
1.Discovery, tracking food for macronutrients, fiber content and timing, and hydration, for a short period of time is helpful and can be necessary! For example, I didn’t realize that sometimes I was getting too much fiber at certain meals, and none at others. So, the fiber game changer here was to break up my fiber intake, for example, 7-8 grams per meal with additional fiber in snacks for 30 grams per day. When I eat too much fiber in one meal, I noticed through food logging, this caused GI cramping.
Insight! I caution against food logging for longer than 6-8 weeks and to tread food logging as true data entry for insight. As someone who has lived with disordered eating, some of my symptoms came back, like obsessing over calories and keeping track of everything I ate as compared to my weight gain. That being said, others may rely on food tracking to offer insight for what they eat and to avoid unnecessary calories.
As a solution, and in working with my therapist on this, food journaling about my experience eating in AM and PM helps. I note how food makes me feel, what I notice after eating, and certain new food that I may now be able to integrate into my diet and any limitation to portion frequency.
2.I learned how certain foods are beneficial for digestion. For example, pineapple before and after high fat meals work as a digestive enzyme, so do tums!
3.Also that while I’m hydrating like crazy with my big heavy water bottle and all, I’m still not hydrated. I drink 80-120 ounces per day! This was causing some of the constipation and tough to pass poops. This here was a big eye opener because it makes sense I have this build up of archaea/methane in my gut because I’m constipated, because I’m dehydrated!
The hydration solution, drinking electrolytes such as coconut water daily helps with motility. Gentle walking after dinner, and not eating too close to bedtime also seems to help.
Now, I’m beginning to add in new foods and beverages slowly. Up to ¼ cup to 1 tablespoon at a time and doubling the portion consecutively for three days without symptoms. I’ve integrated black beans, garlic, and onion again which opens up my food options and I can now order a lot more delivery and not have to cook all the time! This has given me more free time and pleasure out of my meals.
Now the part on stress…
Additionally, I’ve been studying stress management through the ventral vagal nervous system. I highly recommend these books, Anchored, by Deb Dana (3), for her accessible mindfulness exercises and palatable and visual breakdown of the ventral vagal nerves. Also this book, Accessing the Healing Power of the Vagus Nerve, by Stanley Rosenburg (4), for his gentle physical lessons that take very little time and are transforming in moments of needed reset. Check out this fun IG reel I made on one of the exercises outlined in his book. Also, for anyone who feels a card deck with visuals is more accessible, check out this 75 Vagus Nerve exercise card deck by Mellissa Romano, LGSW (5).
In resolution and with time, I’ve gained some weight back, have increased energy so I feel more like myself, and have poops more regularly without laxatives.
All that being said, I still live with some symptoms, and travel is a new challenge, but the frequency and severity of IBS overall have decreased. I continue to slowly add in foods and am way more curious about their effect on my GI tract.
As with anything insight is beneficial for foresight and a little planning here can make a big difference.
References
(1)Gastroenterologist Dr. Nicole Ruiz
(4) Accessing the Healing Power of the Vagus Nerve, by Stanley Rosenburg
(5) 75 Vagus Nerve exercise card deck by Mellissa Romano, LGSW
