Podcast Episode #83: All about digestion: bloating, constipation, IBS & more

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Did you know? I assault the world weekly with my “external monologue” (which, coincidentally, is no different from my internal monologue) … and, of course, talk nutrition along with New York Times best-selling author Diane Sanfilippo of Balanced Bites! It all happens on the Balanced Bites Podcast.

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EVENT UPDATE!
This weekend (Saturday, April 20), Diane will be signing books in Rochester, NY – for more information and to RSVP, please click here. There is a special Paleo dinner being hosted Saturday evening as well, April 20 – contact Pittsford Performance Care and ask for Kelly: 585-203-1050 for more information, to RSVP and pay for your seats! See you there!

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Last week’s episode post now has a written transcript available. We will be playing a lot of catch-up, but bear with us as they’re on their way! We’ll also be trying to get current episode transcripts up-to-date and loaded with each podcast but it’ll take another couple of weeks before we catch up there as well. We hope you’re enjoying them!

1. Multiple Digestive issues
2. Shy Bowel Syndrome

3. Bloated all the time
4. Child with too much stomach acid?
5. Chronic IBS

Click here to download this episode as an MP3.

The episodes are currently available in iTunes, Stitcher & Blog Talk Radio.

1. Multiple Digestive issues

Jared says,

My name is Jared and i am 22 years old. “Digestive discomfort,” i believe, is the best umbrella term for establishing context as to the range of my symptoms that have plagued me in both minor and major ways throughout a large percentage of my lifetime.

I have always been one to have bowel movements quite regularly, maybe even on the “too regular” side– avg 5x per day. I have also always been one to have an ever greater number of bowel movements when in the presence of nervousness tied to a particular present event.

Digestive issues really plagued me about 4 years ago. I was beginning my freshman year at whitman college in washington, and i started experiencing symptoms of nausea, and abdominal pains during, after, and before eating. The symptoms were both present when i was consciously in a stressful state, and when i was far from one. I remember being in class after breakfast and feeling like my insides were tearing themselves apart. Now, keep in mind, this was two years prior to my introduction to CrossFit and Paleo and all its magic; therefore, as i began to seek help, i was being prescribed heavy doses of antacids, and, eventually upon seeing my first of three GI docs over the duration of the next year, a host of non over the counter pharmaceuticals as well. I got an endoscopy, colonoscopy, barrium (sp?) test, gastric emptying test, celiac disease test, the list goes on. More drugs were prescribed with no mention of nutrition nor any decrease in my symptoms. Spring of 2009, i was &q uot;treated” for h pylori with antibiotics, which did nothing to improve my symptoms, and, worse, i wonder if today im still paying the price of the attack that took out my potential good bacteria as well. September of 2009, i was back at whitman for my sophomore year and ended up taking a leave of absence by october in order to try and get a handle on the chronic irritable symptoms as well as weight loss that had gotten too much to bear with school. When i returned home, i started seeing a psychiatrist who prescribed me with a couplet of SSRI’s and eventually lithium which, for the first time, allowed for enough relief from the symptoms for me to start having an appetite again and enough of a buffer to begin rebuilding myself physically and emotionally.

Fast forward, i found crossfit and that was a huge catalyst in me productively taking a real preventive, educational, and empowering route to getting things even more on track both health and passion wise. Fall of 2010, i was back at school but now in california. I was still heavily medicated at this point, which had its own cascade of effects later into the year. By about the beginning of 2011, i was full blown paleo, working to get off meds, and trying to get everything i could get my hands on educationally as far as strength and conditioning training as well as nutrition training, e.g., wolf, chris kresser, sean croxton, yourself, etc.

Fast forward to now: i feel very confident in my extra curricular work that has taken place over the past 2 years and led me to being ever more informed and passionate as far as my own lifestyle practices and how i wish to help educate others both recreationally and as a crossfit coach. However, my digestive issues still plague me in some round about way that keeps suggesting i have yet to REALLY address the underlying cause. I have listented to your podcast on digestion with Chris Kresser mutliple times as well as just recently purchased your book, and I am so overwhelmed tackling this without more individualized, personal direction. I am auditory/personal relationship learner at best.

Most currently, my symptoms are indigestion with bloating, and the longest bout of loose stools that i have ever witnessed (been three months), with intermittent abdominal pains, often when i wake up.

I have been strict paleo for about a year, aside from the occasional ice cream and used to cook with grassfed butter, but have since eliminated to see if that would effect my loose stools. Stools actually began to normalize with the removal of diary (really just the butter) but didnt stay that way. I was trying the now foods super enzyme tablets and went through the protocol but never experienced any heat near my sternum. I also recently went through a bottle of just betaine hcl. I experienced some changes in symptoms but nothing really substantial or lasting. I recently started using a bitter tincture before eating in the mornings for digestive enzymatic support.

I have hashimoto’s and have been taking 60 mg of armour for about half a year, before that i was on synthroid.

Supplementing with pharmax hlc high potency probiotics one a day, fermented cod liver oil/butter blend 2 capsules once a day, 200 mcg of selenium once a day, and 2000 iu of carlson vit d drops once a day.

I have been working with a naturopath for about a year now. Most recent blood work (done in June) looks pretty good. Vitamin D is 69 ng/mL. Some not so good things being total testosterone is 174, and free testosterone is 2.65. Whit blood cell count is 3.7. Bilirubin, total is 1.3, and bilirubin direct is .3. TSH is 2.245. Thyroid Peroxidase AB is 152 H IU/ML. I had an asi test done in the fall and was put on some adrenal support for that of which i feel my adrenal state is no longer an issue.

Im very cognizant of not being over trained and how to program my training accordingly to not be spinning my wheels unnecessarily. I havent been taken protein powder in the last 6 months. Lately, i have been trying to incorporate more bone broth as well as raw sauerkraut. I also just did a comprehensive stool analysis/parasitology x3 test conducted by Doctor’s Data inc. Results: Muscle fibers were found in the stool. Slightly elevated lysozyme levels. Secretory igA was 254mg/dl (range being 51-204mg/dl). Percentage of propionate short chain fatty acids was 8.7 (range being 9-32%)

I have been being mindful of fodmaps as well as veggie consumption. Diet is consisting of lots of sardines, tuna, salmon, chicken, meat, starchy potatoes both regular as well as yams/sweet potatoes, olive oil, some avocado, bananas, apple sauce, some berries, very little nuts, coconut oil, and occasional dark chocolate.

I am 150ish pounds, 5 8′, muscular build. Normally im sitting some where between 155 and 160, as of late sub 155 with the weight creeping down.

Its been particularly difficult trying to manage all of this, especially from a continual elimination approach when also trying to stay competitively conditioned and strong, most specifically from a caloric stand point and i worry about from a nutritionally sufficient state as well with how my stools are looking.

My naturopath has been fine; however, he lacks a complete paleo “buy in” as well as an understanding of the interplay between the fitness heavy side of my life as well.

I feel like im biting off more than i can chew, especially when im the one recommending methods of treatment to my naturopath via kresser and wolf info, e.g., low dose naltrexone? Sibo? Micronutrient deficient? Gut/brain axis?

Diane, thanks for all you do. I understand completely if at this time you cannot be of service. I appreciate you taking the time to read this.

2. Shy Bowel Syndrome

Lydia says,

Hi Diane and Liz, have you ever heard about a shy bowel ‘syndrome’? We hear about shy bladders, but in my googling to learn about others with a shy bowel, I come up with not much of anything. I seem to have a shy bowel, and have a difficult time eliminating when away from home, for the weekend, or longer. Now, I am able to poo outside my home, this isn’t a psychosis THAT bad, but when I go away for a weekend, I am unable to go #2. This summer I was away for 2 weeks, and didn’t have a bowel movement for the first 10 days. I was beside myself. I didn’t even have the urge to go! I know the desirable transit time is between 18-24 hrs. And when I am home during the week, I have no problem eliminating, ~1-2 times/day, usually a little looser stool, even. I am concerned, as traveling becomes uncomfortable. After several days I begin to feel full, yet have no physiological urge to poop. I have heard you mention low stomach acid as a possible cause…but what can I do to make this go away when I’m away for weekends, or longer? Pop a handful of magnesium? (Is this even safe?)Take HCl? Any suggestions? Thanks!

Supplements:

  • Garden of Life Primal Defense Probiotic every morning.
  • Carlson Norwegian Cod Liver Oil in the morning.
  • Carlson Ddrops in the morning.
  • Glutamine to heal a leaky gut. Have had intestinal issues in the past. Gluten-intolerant/sensitive.
  • Magnesium-Calcium in the evenings.
  • Occasional Milk Thistle Seed extract in H20 for liver detox.(For the fun of it, I guess. Heard that sometimes the liver needs a little pick-me-up).

Exercise: 4-5 days/week. LOVE the fasted, low-intensity cardio. Mix of running 4-5 miles at an easy pace. Fasted I run about 9 min/mile, non-fasted, 8 min/mile with a weekly sprint thrown in there (8 x 30 sec., 1 min walk in between) and bike rides. No gym for weights at the moment. Grad school starts in 1 month and will begin weight training again. Have done it 4 days/week for the last year, and stopped in July when my gym membership ended.

Food: Breakfasts: eggs in coconut oil with sauteed greens and avocado. Occasionally bacon or CSA pork sausages. Coffee. Lunches: Salad-y things: greens with veggies, salmon, or sardines or tuna. Avocado, olives, the like. Dinner: CSA lamb or veal or store-bought chicken thighs, roasted. CSA veggies sauteed or roasted: beets, chard, fennel, zucchini, tomatoes, peppers. Occasionally starchy veg like sweet potato or butternut squash. Snacks: raw nuts, almond butter (by the spoonful), dark chocolate. OCCASIONALLY (1x/month) do intermittent fasting. Will stop eating around 4 in the afternoon, and not have a meal until 9 or 10am the next day, after a nice and easy slow jog.

Sleep: Usually pretty good, though almost always have problems falling asleep. So, I’ve been taking magnesium (with calcium) at night, and sometimes melatonin. The melatonin seems to put me right out.

Fat-adapted! Cocktail or wine 1x/week, Ice cream MAYBE 1x/month, Cheese 1x/week, Kefir or other yogurt 2-3x/month, Fruit 1-2x/month

3. Bloated all the time

Leah says,

It’s been about 4 months and I’ve been bloated. I eat gluten, dairy, egg, soy free and pretty strict sugar free. I’m not sure what’s causing it. Doctor has ordered candida igg, iga, igm blood test. I’ve done fodmap, scd diet as well. I have results for genova diagnostics comprehensive stool analysis too. Issues with stomach acid- I’ve been on azeo pangen and betain & pepsin as well as calcium d-glucarate. Thank you.

4. Child and too much acid?

Holly asks,

How can a paleo diet/lifestyle help with heartburn or ‘gastritis’. My daughter was diagnosed with gastritis when she was 5. The Dr. told us that her stomach produces too much acid. Ulcers run in her fathers family. She was on daily Prevacid for 3 years and then her condition improved and she was able to stop the daily meds. We were hopeful that she had outgrown the condition. Recently her condition has gotten worse and she is back on the daily Prevacid. She is 11. I have been told about how some of the heartburn meds may be depleting people of magnesium. I worry about her being on a daily preventative medicine. I have recently discovered paleo and we are making the transition. I am considering doing something like the 21 day sugar detox with her in hopes we can fix this naturally. Any advice will be greatly appreciated

5. Chronic IBS

Jennifer says,

First, let me say thank you! thank you! thank you! from the bottom of my well adjusted belly. I ADORE your book and listening to your podcasts and following the blog has helped begin to heal so many of my digestive issues. I can’t begin to tell you how much better I feel since starting a paleo diet. You have been my hero (heros – Liz, I love you too!) Anywho… My question is not about the chronic constipation/IBS symptoms that I have had for years, but about a 10+ year battle with psoriasis. It’s on my elbow. Sometimes shows itself in other places, isn’t very big (about the size of a quarter) but I can’t seem to get rid of it! I realized in the past few years the connection to whole foods and autoimmune conditions, which I believe this is one, right?, and have been trying to figure out the cause

I have eaten gluten free for the past several (5?) years, with occasional cheats, but have been 100% Paleo for a few months now. My typical breakfast is eggs, avocado, bacon or sausage, a non starchy veg. Lunch is a protein, veg and salad, usually with lots of butter and/or olive oil, dinner is a repeat of lunch with the (not so occasional) glass of wine (or two if the mood strikes). Some daily good quality dark chocolate. I find fruit generally upsets my tummy. I occasional throw some berries on my breakfast plate but pretty much stay away from fruit. I sleep as much as I can with a 15 month old at home. Generally 6-8 hours, depending. I know I have a gluten intolerance so I stay away from that and have been super conscience of sugar since discovering you and the 21 day sugar detox. My exercise is sporadic. Sometimes crossfit. sometimes just stroller walks and yoga. Sometimes nothing. I stay at home with my daughter and work evenings teaching Pilates and between the two I have very little energy to ‘work out.’

Thanks for listening!
Diane & Liz

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