Slow Guts Need Care

“Colectomy rates for constipation are rising, are associated with significant morbidity and do not decrease resource utilisation, raising questions about the true benefit of surgery for slow transit constipation… (1)”

Whew!  From second chakras to acupuncture to triphala, I have been taking this alternative medicine front by storm to cure my slow gastrointestinal (GI) transit.  If all conventional medicine has to offer is a colectomy, then there is no shame in yoga and Squatty Potties.  Where do I stand?  Pretty good.  Pretty good.  Not yet cured.  Definitely have some ups and downs, but overall, my gut has totally reversed itself.  Knock on stinking wood.  Or incense sticks–or something–just so my gut doesn’t fall back again.  (Which those with this problem know is quite easily possible.)

Constipation isn’t talked about.  But it should be.  Colons are cut out because of it (seriously–see opening quote).  And people go to the ER for it (quite embarrassing, quite).  Not to mention hemorrhoids and anal fissures and horrible cramping (ouch).  Sometimes all it takes is simple diet maneuvers to get things back on track.  Other times, like in my case, it takes exploring your sanity and motivation.  (For the record, I am completely sane.  I ask my husband and friends every day.  Although I question some of my friends–so maybe you ought to wonder about me…Which brings me to the necessary disclaimer that this is only my story.  It is not medical advice.  You should absolutely discuss anything you try for your health with your doctor.  I am not your doctor.  I quit that jazz for Oz and its Munchkins.)

My History

I’m going to take a few posts to lay out what I do or have tried for my slow transit.  Let me briefly get you up to speed on my gut history.  I’ve had constipation all of my life.  As long as I can remember.  It worsened, just like the medical texts said it would, every decade of my life.  Until I was pooping once a month WITH Miralax, fiber, and a probiotic.  (Magnesium simply did not work at all.)  This was about age 35, and I had to start cranking on the stimulant medicines (which until this point I had only used as needed for the most part).  Not only was this ineffective, the high doses led to ouchy cramping.  I knew something else had to be done, so I turned to the halls of the internet clinic (because my doctors didn’t have any good answers for me–I mean, how could they?  I didn’t have any for myself!) after I quit working to homeschool my kids and I had “time.”

Now I must say, there have been three times, each lasting a mere few months, in my life where I have had what I feel are completely normal people bowel movements with little to no use of supplemental pills or powders. Once in my twenties after being treated for ulcer type symptoms with a PrevPac (involves amoxicillin and clarithromycin). Second time was two years ago just before getting pregnant.  Pregnancy and lactation proceeded to undo the hard-earned success I had achieved using diet, lifestyle changes, and focused supplementation. Finally, the third time I feel my gut has been reliable has been the last few months.  So, here I am with about daily Bristol 4 stools.  I’ll admit, I’m nervous going to bed each night, wondering, “Will I go tomorrow?”  Thinking the next day will be the beginning of the end of my GI success.  Unless you have a very bad problem with constipation, you may simply just not get this.   But I’m hoping if that’s you, I lost you at the first paragraph.

Getting to the Details

I have tried A LOT of stuff.  Since pregnancy and nursing, it has been focused on things that are safe to my baby.  I am still nursing, so I am still careful about what I try.  Let’s get started with more of my story.  There is a lot to write, and I will break it up.  If you have severe constipation and you expect a quick-fix, you may need to reset your expectations.

I am going to start with the supplements I take or have taken.  Some I don’t even take for the constipation, but I have to wonder about the role they play in my gut progress.  I only have room to cover vitamin K2 in this post.  MUCH more to come.  And, please, supplements really need to pass the approval of your doctor.

Vitamin K2

Briefly about:  Vitamin K2 is a relatively recent health-related discovery. It helps shuttle calcium where it’s supposed to go, whether we’re talking about shuttling it TO the bones or shuttling OUT of the heart blood vessels where it doesn’t belong. Getting enough vitamin K2 in our modern diet is tough for anyone because our meat, egg and dairy sources are not eating what they would eat if turned out of the pen. Vitamin K2 is present in the egg yolks of birds who eat worms, seeds, and other things they peck at in nature; the fat of grass-grazing animals; liver; and the milk-fat products of grass-grazing animals (butter and full-fat milk). It is also formed by bacterial action on milk-fat when cheese is being made or by bacterial action when natto (from soybeans) is being made. One last rich source is fish eggs. Vitamin K2 is a fat-soluble vitamin, and therefore likes to be in fat and is best absorbed when eaten with fat.

My story:  I started taking vitamin K2 because I realized with my dairy and egg intolerance, I was not getting any K2 to support my bones, blood vessels, and gums/teeth. (Vitamin K2 plays a large role in the structure and health of the oral region.) (Aside:  Vitamin K2 is supplemented in conventional chickens and so it is a source of vitamin K2; I strangely can’t eat chicken either.) I don’t know if vitamin K2 has helped my STC or not as an individual agent. However, it is a supplement I have taken daily for the last four months or so.

Is there research that may lend itself to the idea that vitamin K2 may be helping my gut move forward? I found an abstract in which bone morphogenetic protein 2 (BMP2) helped improve slow transit constipation. Vitamin K2 does impact BMP 2:

Mol Med Rep. 2015 Nov;12(5):6547-54. doi: 10.3892/mmr.2015.4297. Epub 2015 Sep 7. Bone morphogenetic protein 2 regulates the differentiation of nitrergic enteric neurons by modulating Smad1 signaling in slow transit constipation. Liu X1, Liu S2, Xu Y3, Liu X4, Sun D1.

 

And then here is a connection linking vitamin K2’s effect on BMP 2, a vitamin K dependent protein:

Oman Med J. 2014 May; 29(3): 172–177. doi: 10.5001/omj.2014.44PMCID: PMC4052396. Vitamin K Dependent Proteins and the Role of Vitamin K2 in the Modulation of Vascular Calcification: A Review. Margueritta S. El Asmar,1 Joseph J. Naoum,2 and Elias J. Arbid2,*

Bottom line for me: Vitamin K2 modulates BMP2. BMP2 may help slow transit constipation. MAYBE my vitamin K2 supplement is helping my slow transit. (Big question mark.)

Closing

Next post will have lots more.  It’s a long, long story.  Eat right.  Sleep right.  Look up the second chakra.  Love your gut.  Question your sanity.  Keep going.  🙂

Terri

 

 

  1.  Aliment Pharmacol Ther. 2015 Dec;42(11-12):1281-93. doi: 10.1111/apt.13415. Epub 2015 Oct 1. Colectomy for constipation: time trends and impact based on the US Nationwide Inpatient Sample, 1998-2011. Dudekula A1, Huftless S2, Bielefeldt K1,3.

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