My post and blog, they are not intended to treat or diagnose you. It is meant to stimulate your desire to read and learn. With your knowledge and research articles in hand, go visit your favorite healthcare practitioner. Ask them what’s right for you. The things I try may be detrimental to your health or have serious consequences that I may not even know about.
Dear Reader,
For about 20 months I have scoured the internet, looking to solve my lifelong, severe, medication-dependent constipation issue. Constipation persisted for years as my only symptom, albeit worsening each decade of my life, until in my thirties other symptoms started creeping in like bloating, headaches, and fatigue. In my stint as a practicing medical doctor, I saw at least two colectomies specifically for chronic constipation. This scared me a lot because I do not want to have colon surgery. However, nothing in my arsenal or in the arsenal of the doctors I chose could help me.
So about 20 months ago I started working with my diet (gluten-free, dairy-free). About 17 months ago I started what sounded like a crazy, voodoo diet called GAPS, in an attempt to prove to myself that no diet “so extreme” could possibly be effective. I wanted to check diet intervention off of my list as an alternative treatment choice. “I am a trained medical doctor; I know that won’t work. Diet won’t work.” Actually, I had some minor success using GAPS, figuring out food intolerances, and piling on the magnesium to effect (which I had tried very unsuccessfully to do in the past). I decided to stay on board with this strange, new way of eating (with a couple of boots by my husband when I cried around about it being too hard).
I have putzed along on GAPS, steady enough, but no real gains, trying this a bit and that a bit–all within the confines of GAPS. I recently followed a lead regarding short chain fatty acids, particularly butyrate, helping restore the enteric nervous system. In severe, lifelong constipation, researchers have found actual neurologic changes so I really thought this might be the tip I needed.
Resistant starch increases butyrate production in the colon. But I am on GAPS, and many of the starches aren’t legal. Plus, during my initial findings on butyrate, I was trying out very low carb to see if that would be my ticket. So what to do?
How about just go get some butyrate? I mulled it over. It’s supposed to be absorbed before it reaches the colon and therefore not have its desired effect, at least in the common preparations. But I went for it; I had nothing to lose except barrels of magnesium. I bought some magnesium-calcium butyrate from Amazon, and I started taking two capsules three times daily. It said to take it with food, but I thought I’d mix it up a bit. I took it sometimes with meals and sometimes right before bed on an empty stomach.
For twenty days I have been on magnesium-calcium butyrate (250 mg total per day of magnesium versus the plus two grams of magnesium I’ve been taking). For 19 days my GI tract peristalsis hasn’t missed a beat. Best ever, even while on medicines. I am trying to contain my excitement because perhaps it will stop working. But I don’t know. I mean, I’m completely off of my magnesium! I am on nothing but a GAPS diet tailored for my hard-earned knowledge of my food intolerances, fish oil/vit D about three times a week, and VSL #3 probiotic at night. None of that is new besides the butyrate. I have not changed my diet, if anything I’ve pushed nuts too much trying to get butyrate to prove itself. And it has.
I don’t like supplements. My next goal is to see if I can add resistant starch to my diet and get the same effect. I am very hopeful. However, I think my pure GAPS saga may be winding to a close. I believe my diet will now be GAPS but I will need to add in things like green bananas, cold potatoes, potato starch, and sweet potato. I am not entirely sure yet. I’m going to ride out a complete month on butyrate to complete a full monthly cycle. However, when my problem was always at its worst before, it was smooth sailing! I am very optimistic about this one.
I am currently composing a series encompassing all that I have learned going down this rabbit hole. It will cover short chain fatty acids, butyrate, sources of butyrate, resistant starch, things known to increase and decrease butyrate/SCFAs. My sisters are editing it for me now.
There is no perfect diet for anyone, but I think finding a good diet platform (such as Paleo, autoimmune Paleo, SCD, Whole30, Terry Wahls’, Perfect Health Diet, GAPS, etc) will allow you to slowly and surely figure your body out. And then with some nips and tucks, you can achieve your endpoint. I think. But it takes the patience of Job. Seriously. The patience of Job. And a good supporter; my husband has been super in helping me stay the course. It has been hard because I am a “sweetaholic.” I can’t tell you the diet and the supplements you need. But I will be more than happy to be your cheerleader and encourager if you drop a comment or an e-mail.
In closing, a good diet, I think, must not only incorporate foods that are full of their own natural nutrients, but a good diet must also TAKE OUT COMPLETELY foods that are either commonly known to be inflammatory or known to cause symptoms–whatever they may be, acne, depressed-like mood, sore throat, eczema, bloating, etc–in a particular individual. At this point, a broken body will need a little extra nutrition/supplementation in certain departments. Perhaps a little magnesium, perhaps a little resistant starch, perhaps a little coconut oil, perhaps a little glutamine, perhaps a little fish oil, perhaps a few B vitamins, perhaps low-carb, and so on.
I wish you only success.
Sincerely,
Terri
The HSD 
So happy to read about this point in your journey. “The patience of Job”, I’ve never read more truer words when it comes to healing what ails us.
Thank you; I am beginning to see an “endpoint” and true results. A relief. And MY mom will be happy if I eat potatoes again. (Chuckle.) On “patience”–too many people give up too easily. Thanks for reading.
This is so encouraging! I think I will try this mag-calc butyrate. If that goes well, I’ll try potato starch.
I know! I feel utter disbelief. But for some reason I suspect if I had simply added it on two years ago, it would not have been enough. And I don’t really understand how butyrate brings it’s effect this way because literature says it wouldn’t make it to the colon to exert its effect. Anyhow, it is a good, good lead! Best to you! Have a great day! If you have any luck let us know! I will post updates periodically.
You should come over and see what we are doing at AnimalPharm. You will like! Lots of butyrate being produced and guts being healed!
http://www.drbganimalpharm.blogspot.com/2013/11/how-to-cure-sibo-small-intestinal-bowel_18.html
Tim
Thank you, Tim. I’ve been poring over your posts. I think I’m a “follower” even! I appreciate your comment. Thanks.
OK, great! You know Dr. BG (Grace) and I were doing this stuff completely isolated from each other and recently connected. It was amazing how we found the exact same outcomes using RS, fermented foods, etc… Hope all your efforts prove successful!
It is amazing. I’m putting it all together in my mind, and I’ll have some questions for you guys! Lots of questions! But mostly this month, I’m just so selfishly happy! N of 1, you know! Have a great week!
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Fantastic news! I completely agree with you in regards to there is not one diet that is good for everyone, but a paleo template is a great stepping stone in the right direction. I am trying to figure out what is causing my daughter’s keratosis pilaris to act up. I thought it was dairy so we took that out and it got better but now it’s back. She’s doesn’t eat dairy daily at all. Maybe a little here and there on GF pizza as a treat. I hear on the Paleo View podcast that it could be an insulin regulation issue….Have any words of wisdom?
I think the Paleo template is a great place to start, too! I will keep my eyes out for keratosis pilaris as I read, Pam; I could see it as an “insulin regulation” type nebulous issue. Right now, I likely don’t have more to add than you already know. I’m sure you’re familiar with the “Four Horsemen” (as described by SCD Lifestyle Steve and Jordan: http://scdlifestyle.com/2011/03/what-to-do-when-the-scd-diet-isnt-working/)? Nuts, eggs, dairy, nightshades? I know for my kids, I try to strengthen their gut as much as I can by remembering to incorporate bone broths (soup) and ferments–that way when I can’t figure out a reaction, at least maybe I can help the body have what it needs to take care of it. We are seeing a resurgence of eczema in ours. Hope work is going well. Take care.
how long did it take before you noticed a difference….were you also taking otc laxatives? I use vitamin c magnesium, otc laxatives…plus I still have major issues with brain fog and everything else…I had a hydrogen breath test last thursday and for some reason I had brain fog all weekend from the glucose (i guess) i see an allergist friday….this is 10+ years of it getting worse….i don’t know what to do anymore
Hello! Ugh! What a struggle! I am so sorry. For my story, GAPS piggy-backed with autoimmune Paleo for quite awhile and subtraction of chicken,took much honey, and coconut products also—this controlled my headaches, fatigue, brain fog, irritability, etc and I did start noticing GI urges, just nothing with it–but urges had disappeared pre GAPS. For quite some time now, I have had BM about 5 days of 7 using only magnesium Natural Calm, at least two Tbsp every night. I could never get success with vit C, no matter how high I drove the dose. Since magnesium worked and magnesium deficiency is so common, I just stuck with magnesium. Once over the last year I was occasionally able to start titrating that dose down, but not lately. It took all of it every day. And it wouldn’t be what I call normal. However, at the end of October, I started adding in green bananas for resistant starch to induce butyrate production. But that worsens bloating. So I bought the butyrate for a “what the heck, medicine has been wrong before.” I think I started butyrate maybe on a Friday. Friday night I took magnesium as normal and things kept chugging on their own from there, without magnesium, about 20 days now, although one time after too many nuts it was kind of ouch so I took 2 teaspoons of magnesium, like the dose says on the bottle, rather than 2 tbsp. I worry I will jinx myself sharing this too early, but things seem so “normal.” Really. And no significant magnesium for 20 days for me is really something considering normally with something like Miralax before GAPS I would go 20 days with nothing (lots of any anythings and nothings in there–follow?). I will try to post periodically on my progress, good or bad. We all know with this problem that a regimen that worked well for us once–later lets us down. Good, good luck. I hope you find something. I think my success has just been a culmination, and butyrate helping is just a piece, but a final needed piece. Somebody else’s last piece of the puzzle may be something else. Sorry for the book.
I am very happy for you! I really hope you’ve found a solution to your problem!
Love this Terri, great read. And I love the fact you will be our cheerleader if we need you. Thank you!
🙂 (What comes around goes around)
Hello- came across your site while trying to figure myself out! I’m hoping you may be able to give me a small insight on where to look next. A brief history..
31 y/o and recently dx as having “slow colonic transit”. Have had some problems for years- but got worse post delivery of my 2nd child. Tried the highest dose of amitiza and linzess with no help. Have also tried miralax. Nothing helped and I’d rather not be on prescriptions anyway. GI has also done colonscopy and said everything looked normal- but I have a “torturous” colon.
I started a whole30 Jan 1 to try and see if there were any foods that may be contributing to the problem. I am also taking digestive enzymes (garden of life- 3 with each meal). So far no improvement- but only on day 15 of course. I’m also incorporating fermented foods daily (kraut mainly- farmhouse culture brand).
My next step after finding your blog was to try the butyrate and a high dose probiotic. But there are so many probiotics out there (I feel overwhelmed in whole foods when looking at them!)! I have tried a probiotic in the past and didn’t seem to do anything. Would the VSL3 be too high of a dose to start out on?
Thank you for any insight!
Dear Emily,
Hello! This will be a complete ramble for the sake of time! So sorry!
Lots of people like the Whole 30 type of diet (there are others similar), closely watching for any signs of food intolerances and tweaking then as needed. Adjusting the diet with tweaks to make it tolerable and provide staying power. This is to lower systemic inflammation so the body can focus on healing the gut, not necessarily because each food causes constipation. And the backbone of these diets provide good nutrients to help cells repair/function: omega 3, magnesium, zinc, iodine, sulfur, calcium, anti-oxidants, choline, biotin, folate, B12, co Q, saturated fats, selenium, etc. The gut relies on hormonal factors and feedback loops, so all pistons need to be firing in the body. So support the whole body to support the gut.
“Fibers” can be beneficial–not cellulose stuff like they always say for us to eat. But things like resistant starch, inulin, FOS, pectin, etc. These won’t necessarily help in the short term, but they provide nutrients for the bacteria that live in the gut so they can make proper pH, proper byproducts (like butyrate and SCFA) which nurse the gut and the human gut actually has learned to rely on. Practice caution in case there is small intestinal bowel overgrowth (SIBO) or FODMAP absorption issues because it may flare bloating/gas/fatigue/constipation/diarrhea/etc. A conventional doctor can probably help you diagnose SIBO! Check out Pimental’s work out in California. Hydrogen breath test looking at methane helps with GI diagnosis too–run the test longer because slow transit may take longer for the test solution to make it to the bacteria in the gut where the hydrogen and methane are formed. Often constipation predominant symptoms are caused by methane formers in the gut. They can then try some rifaxamin/neomycin combo to see if there is this. It’s fairly newer information so you may need to take in some actual research study/reports to back yourself up if they look at you like you don’t know what you’re talking about. Here’s a nice readable blog post: http://blog.katescarlata.com/2014/01/22/small-intestinal-bacterial-overgrowth/
Probiotics/probiotic foods: Everybody has a favorite. You’ll have to play a bit to find your own. Sadly, too expensive. Some people like Prescript Assist for constipation. I didn’t have luck with it, but some do! I do fine with VLS#3. I buy the packets, that way I can adjust as needed and titrate up. Garden of Life is fine. Everybody is a bit different! THAT IS A KEY POINT. I do know I have to titrate my probiotic dose very high to help me. Like 40 billion and beyond (With VSL#3, I take 1/2 to one packet a day which is WAY beyond). Sometimes I stop my probiotic to see where I’m at because like you, sometimes I don’t notice anything.
Nobody can tell you for sure how to get this working. AND there will be spurts of gain and setbacks. I don’t know why. I just know there have been months I thought I was cured with just some occasional magnesium Natural Calm, and then a month later, I was back to two tablespoons of it and still struggling and I have no idea why (at this point). Hormones, I believe, are key. Progesterone seems to wreak havoc on my gut. So explore that area.
I’ve heard wonderful reports on a probiotic called Mutaflor in constipation, but the USA doesn’t allow it. 😦 But we love to travel, so maybe I’ll make it to a place I can try it!
And lastly before I have to close, it was helpful for me to find out when my strongest GI movement of the day was. I discovered it was early in the morning. So I try to have quiet, uninterrupted time sipping a warm drink at that time.(This is not so easy!) There are several times a day where the gut makes massive movements to move things forward. We have to try to figure that out when that is for us so we can “catch the wave.” My best time is early AM. Also, “the wave” is better if I don’t graze. Large meals when I eat. Not grazing. Those help force the gastro-colic reflex.
Some people have good luck with digestive enzymes and HCL. Stimulates the pancreatic enzyme/bile so the gut gets notified to move. And I’ve been reading some crazy stuff on vagal nerve stimulation by gargling, etc. That sounds weird. But what do I know?
Good, good luck! I’d love to hear if anything ever “cures” you! Please!
Terri
Thank you so much for all the info! I’m definantly staying the course and completing my whole30. Day 18! But can’t say its had a direct impact on the transit (but I also understand it’s about more than that and a piece of the puzzle). I’ve also been trying to avoid some of the high FODMAP veggies. But I love broccoli, cauliflower, and brussels :(. I just received my order of butyrate and bought a probiotic (50 billion). On day 2 of that. Have thought about adding in a magnesium supplement too. I just don’t want to do everything at once- so I can see what does or doesn’t help .
I’ll have to look into the other fibers that you mentioned.
I have a follow up with my GI in a couple weeks and plan on putting together some of the info I’ve come across to talk to him about. Hopeful I can figure out something!