Category Archives: Constipation

Do Slow Guts Need Loved?

Three and one-half years ago I started skeptically experimenting with alternative health ideas to fix my gut.  I feel a little “out there,”–yes, I do– but I can’t argue with success that exceeds Miralax, Metamucil, and Smooth Move Tea.  You can read Part 1, Part 2, and Part 3 of my slow-to-stop gut story if you feel so inclined.  Okay.  Here we go.  Welcome to The Fites Medical Funnies, where nothing is intended to be used for medical advice and any appealing ideas should be run by your favorite healthcare practitioner.  Because yoga and gargling could be dangerous.

Alone Time First Thing in the Morning

The gut makes a large movement when we wake up in the morning, before we’ve even eaten anything.  I’ve found that if my gut is going to eliminate, it’s going to do so early in the morning when I’m sitting alone quietly.  If I hear my husband get up to shower, if I shower,  or if I decide to start breakfast early, the game is over for the day.  Rarely, if I get some time in the afternoon to sit and check email or something and the kids are quietly playing in the basement or outside–and Mars aligns with the moon– then, my gut may relax enough to move.

This tells me my gut can work and bring about normal defecation.  This also tells me that my sympathetic tone is VERY strong and easily over-rides the parasympathetic control of my gut. The sympathetic nervous system is what gets the body geared up and ready to go.  It is described as the system that kicks in “when you’re running from an ax-murderer.”  Your parasympathetic control is the “rest and digest” control system.  I’d say, in general, my sympathetic control system predominates my life.

Bottom-line:  The parasympathetic nervous system promotes defecation.  My sympathetic tone responds quickly to any perceived task, even if it’s as simple as saying “good-bye” to my husband in the morning or changing into clothes for the day.  (Yeah.  I know.  I’m working on it.)  Getting up before everybody in the house wakes up and sitting quietly promotes movement of my gut.  It’s almost a necessity in the equation.

Ileocecal Valve Massage, Gargling, and Gagging

Hey.  This may be whacko at its finest, but it’s cheap, safe, and easy to do.  About seven months ago, I started thinking about something called small intestinal bowel overgrowth (SIBO) hard.  If a person has SIBO, constipation can be an outcome, particularly if the “bacteria” make extra methane.  I suspect I have a mild case of SIBO but have never tested myself for SIBO because 1) it’s one more test 2) nobody in my area tests for methane predominant SIBO that I know of 3) there’s no good treatment for it 4) I’d already tried the treatment for it a few years ago (and it helped a little with bloating but not for long) and 5) my symptoms were/are not that significant to me (and my constipation has been life-long and I feel it led to my SIBO rather than SIBO causing it).

But, I thought, if I have SIBO, the only way I’m going to get that better is if my ileocecal valve (a “valve” which separates the small intestine from the large intestine) is opening and closing the way it should.  AND if my vagal tone (parasympathetic tone)  to the gut is promoting sweeping forward and peristaltic motions as it should be.  With my long-term history of constipation, I figured this indicated that my gut does not sweep forward like it ought to, allowing bacteria to migrate up inappropriately through the ICV to the small intestine, leading to my middle-aged SIBO symptoms.  To get my gut moving forward better and to stop the retrograde flow of bacteria, I felt I needed to work on my ICV and my vagal tone.

Mmm.  Yes.  You following this crazy?  So, with some internet research, I decided to rub my ICV.  (It’s in the right lower quadrant, kind of above the hipbone but over a bit toward the belly button.)  This usually ended up being about 2-3 times a day:  when waking up in the morning, when going to bed at night, and during the day if I could steal a second to lay flat.  I noticed that my ICV was actually quite tender, like a sore muscle or “trigger point.”  I also noticed that my gut started gurgling and growling after massaging the ICV.  Just for the heck of it, I then, after massaging my ICV continued to massage the colon around.  Really.  You can find this all on the internet.

Okay, if rubbing ICVs and colons is not cutting edge enough for you, I proceeded to work on vagal tone.  When I brushed my teeth, I would stimulate the gag response five times and call that enough.  I would also then gargle water at the end.  When I showered, I’d also gargle and try to gargle periodically through the day, for example when I’d use the bathroom.  Gargling and gagging stimulate the vagus nerve.

I’ve been doing this for quite some time now, and I get no immediate response.  None.  But I’ve kept doing them at least once a day for about six months.  My SIBO does seems much improved, and my gut is moving a lot better.  This could be so many things, but these are easy things to do and try.  I have nothing to lose in trying these things.  Obviously, you shouldn’t throw up your food or hurt yourself gagging.  Duh.

Bottom-line:  These are simple things to try.  My ICV is rarely sore anymore, but it does seem when the bloating flares again, it is more sore.  Whatever.  I’m going to keep this routine going longer.

Core Exercise

I have a very weak core due to having a pretty large umbilical hernia and diastasis recti from having four kids.  During the summer, I thought, “I’m going to fix this hernia.” and I tried a program called MuTu at the recommendation of a friend.  I liked it a lot, and my core definitely got stronger.  Could this have contributed to GI improvement?  Maybe so.  Don’t know.  I haven’t done the exercises for three months now, and my gut kept on working.  I have exercised plenty in the past (and continue to do so), so I don’t feel like exercise in general moves my gut.

Changing Perception

Over the last four years, I’ve observed that my food intolerances and gut do better when I’m less stressed.  I’m a pretty intense person, and I walk around looking for stuff to do, even if it’s just folding a blanket nicely on the couch.

If my vagus nerve and parasympathetic nervous system are going to function optimally to help me get off of all supplements for my gut, then I’m going to have to do some major brain rearranging.  My brain has to stop sometimes and/or I have to learn that I don’t need to always listen to my busy brain.

In light of this, I have a good friend who teaches therapeutic, problem-focused type yoga.  It was time to sign up for some individual work.  Like with acupuncture, when I quietly worked with her on breathing, stretching, awareness of body and thoughts, meditation and learned some of the techniques she taught, my tummy would sit there and rumble during the class.  It’s like my gut is singing, “Hel-loh-oh.  I like this stuff.”

Bottom-line:  I’ve been doing this yoga/meditation/self-awareness jazz for about four months.  The last two of those four months were completely normal bowel movements.  Is it the acupuncture?  The K2?  The butyrate?  The resistant starch?  The gargling?  The yoga.  The mediation?  Who cares!  I’ll take it.

Loving My Body’s Limitations

So I read about this woman who cured her autoimmune disease by choosing to love it.  Yes, my brain sang “Hoakie.” (Singing loudly is supposed to stimulate the vagus, too.)  But I’m in a place where I’ve tried it all, and I’m totally game to try something that’s free, painless, and completely safe!  So for a time, I would lay in bed as I woke up or went to sleep or at my yoga lessons, and I’d tell my colon it was doing a good job.  That it had a hard job digesting and moving all that food under the conditions I gave it.  That we, the rest of the body, would do whatever it took to help the colon do its job better.  And even if it never did its job any differently, we loved it as a part of this wonderful body.  We told it thank you.  We told it good job.  We quit telling it sucked.  It was broken.  It was harming the rest of the body.  It needed fixed.  It was ugly and gross and dysbiotic.

Did it work?  Well, not directly.  But whatever.  I tried it for a month.

Bottom-line:  Worked for some other chic but not for me.  But it still was a very nice thing to do for my colon.  And why not be nice?  I think it was worth a try.

Diet

What do I eat?  My diet is usually pretty clean, and I’ve tailored it over the last three and 1/2 years with an elimination diet to where I feel the best.  I started with GAPS diet and have branched my diet out (or unbranched it, in the case of some GAPS allowed foods I avoid eating).  I try to avoid completely adhering to dogma now (for example, never eating legumes or dairy or sugar or grains for the theory of it) and instead prefer to use close scrutiny (which usually leaves me avoiding legumes, dairy, most grains, and sugar for the reality of it! 🙂 ).  I eat lots of vegetables, both cooked and uncooked–all kinds.  I eat meat about once a day, sometimes twice–to satiety.  I eat a lot of seafood, and also lamb, beef, and pork.  I eat fruit about once a day, about 1-2 servings unless it’s summer and something I love is in season.  My gut now likes nuts and moves fine and actually very well on them, but my headaches don’t like them.  So I have to go easy on nuts and seeds, even though I seem to think that things like hemp, seed-based granola bars, etc promote gut movement for me.  Potatoes and rice seem to go well for me, especially when eaten cooked and cooled, and I make a point to try to eat either cold rice, cold potatoes, or green banana daily for resistant starch.

Besides the rice, I don’t eat many grains.  My gut always slows for a few days after I try to re-introduce gluten, so I keep it off the menu.  As far as dairy, I don’t eat it much, but for a time, I seemed to be doing fine with sheep and goat cheese and my homemade yogurt from a local Jersey cow.  I don’t eat eggs unless they’re long-cooked in something, and even then I use extreme caution.

I’ve played around with carbohydrate levels, fat levels, protein levels, calories, raw foods, all cooked foods.  Baby, I’ve tried it.  I seek out the freshest, most stable fats I can find to use, usually fresh olive oil and drippings from cooking meats that I save.  I usually eat organic, but it’s not usually a deal-breaker.

There is NO doubt in my mind that my diet change plays a HUGE role in relieving my constipation.  And I think a good elimination diet is nothing short of miraculous.  I know my gut would not be moving if I hadn’t watched, listened, and felt closely.

Closing

I’m in a good place now, and it has taken three and 1/2 years.  Maybe doing it my way took longer, but when I tried to ask for help, of both conventional and alternative providers, it cost a lot of money and didn’t make my gut work much better.  So this is where I am.  Don’t use my story as medical advice.

If you’re still reading, I think you must have a vested interest in constipation.  Good luck to you.  If my symptoms flare up again, I’m not worried.  There’s a few more tricks out there to try when I’m no longer nursing.  But no matter what, my gut can now move with the simple help of magnesium.  This ought to save me from a colectomy, and for that, anyone can be truly grateful.

Terri

Maybe Slow Guts Need Poked

Everyone tells you its simple.  Everyone tells you, “Oh, if you’d only try this, then…”

You don’t know whether to feel stupid or insulted and mad.  Then, rashly, you fork out money to try X, Y, or Z sometimes–which fails–and then you feel stupid AND mad.

I’ve got today’s post and one more on my personal story on severe, chronic, idiopathic constipation.  I’m not here to tell you it’s simple or even that I know what I’m talking about when it comes to constipation.  My blog is not for medical advice anyhow.  (It’s to make you wonder what kind of person would type about this.  Is she normal?  Or not normal?  Hmmm…)  If you missed them, I wrote this post first and this post second in my personal update series on trying to cure my refractory, lifelong constipation.

512px-Tea_in_different_grade_of_fermentation

Smooth Move Tea and Laxatives

A few years ago I went to a gastroenterologist for my constipation.  She recommended that I stop the magnesium preparation that I was taking and sip Smooth Move Tea (a senna product). I didn’t like this recommendation so I didn’t do it.  I’d tried senna products before, and they never worked for me.  I felt the doctor clearly wasn’t listening to my story, so I found a different doctor.  I mean, I’d told her I had given up pizza and bread and ice cream to try to beat my severe, chronic constipation–did she really think that sipping a simple tea was going to work?  Like she blew me off, I blew her off and did not try that blasted tea.  Last year, however, after having the baby, my constipation had some bad spells.  So I decided to get off my high horse and try the stupid tea.  The tea did nothing but cause severe cramps. (Point: Patients usually know their bodies.)  I also tried some other OTC laxatives, but they also did nothing but cause cramps and create no bowel movement.

Bottom-line:  These products don’t work well for me.  They never have, and they still don’t.  I get terrible cramping and little to no bowel movement.  To get a bowel movement, I have to take like 12 or more pills of whatever.  I’d better stick to giving up pizza.

Herbs and Spices

I use a lot of herbs and spices when I cook, both fresh and dried.  I’ve tried increasing these over the last several months.  Nothing has seemed to jump up and shout that it is making my gut move specifically.  But they taste good and have many great properties.  Could they be doing slow magical work?  Sure.  I’ll keep using my herbs and spices:  turmeric, Ceylon cinnamon, cardamom, fresh-pressed garlic allowed to sit ten minutes, coriander, allspice, nutmeg, saffron, fresh cilantro, fresh parsley, rosemary, and so on and so forth.

Bottom-line:  Herbs and spices are worth adding in for overall health even if they don’t clearly seem to make a definable difference in my GI motility.

Diverse Fiber

I’ve read some fascinating anecdotes about people who tanked up on diverse fibers and reversed their GI, SIBO, and food issues.  (Fiber is a VERY complex term.  Please consider reading about it here.)  Fiber in the forms of legumes, Metamucil, and whole grains has never worked for me.  But as I’ve researched, I’ve come to find that I’m not needing the “skin” fiber of foods that I thought I needed for bulk–or even “soluble” or “insoluble” fiber.  There are other, less definable, carbohydrates that the bacteria in our guts may chomp on to produce by-products that stimulate and repair the gut.  So I devoted a couple of months to trying high dose “fibers”:  glucommannan (cramping), FOS/inulin/beta glucan (no change), psyllium (no increase in movement but more bulk), and oatmeal/blueberry/potato starch smoothies three times a day (no change).  I had no significant set-backs from these attempts, but I still needed tons of magnesium.

The “fiber” that seems to do me best is resistant starch “fiber” via green bananas (in smoothies), cold cooked rice (as in rice salad), and cold cooked potatoes (great over a salad topped with vinaigrette).  I also occasionally pop a bit of raw potato.  I do feel these “fiber” foods help me if consumed daily.

Also, over the summer I inadvertently upped my raw vegetable intake with delicious Israeli-inspired salads a good friend taught me to make.  Raw vegetable intake at the beginning of my journey killed my bloating problems.  Not anymore.  Once a gut’s environment is improved, I think raw vegetables and fruits are important.  Maybe the addition of these salads helped.

Bottom-line:  I can’t be 100% sure, but I do think that the resistant starch foods eaten daily and the salads play a role in the recent progress of my gut.  (And these are amazing salads!  Not the kind boring ones I used to make.)  The powders and supplements I tried didn’t work for me. (Too easy.)

Triphala

I tried some triphala.  No luck.  Nothing bad.  But nothing improved, and although it is listed as safe in some places for nursing (and other places not), I thought my baby had looser stools when I titrated up the dose.  So I ditched triphala.

Essential Oils

Oh man.  I love the way these smell.  Some people swear success in helping their constipation with essential oils.  I’ve tried two different times and no go for me.

 

Acupuncture

Japanese_kudabariI told a medical school friend, who is married to another medical school friend, that I was trying acupuncture for my gut.  She laughed and jokingly said, “I won’t tell Jeff that you’re trying that.  He’d never let me talk to you again…”

Anyhow, I have received acupuncture now for about 5 months (with some quite extended breaks for traveling).  When those tiny needles poke me, you can hear my gut start rumbling.  It’s a little embarrassing.  Sometimes after a treatment, I will have to go to the bathroom.  Usually not.  However, in the several months of acupuncture I’ve had, my gut has improved. The acupuncturist I go to only does acupuncture, but he draws on chiropractic, ancient Chinese medicine, Ayurvedic principles, and kinesiology.  When we first started, I asked him, “So, do you think you’ll be able to fix me?”  He was super honest and said, “Well–you’ve had this a long time–but we can try.”  I love that answer!  I have the utmost respect for what he does, but I do have to say it feels like “voodoo” at its finest to a conventional doctor.

I think that acupuncture has been a piece of the progressive improvement of my gut (but only as a part of the plan).  For the first 6 weeks, treatments were weekly.  Then, he spaced it to every two weeks.  And then slowly we are stretching it out further.  It does seem to help.  On the down side, it is not cheap.  In fact, it’s expensive.  Some insurances pay for acupuncture, but mine does not.

Here are some links to check out about acupuncture and constipation:

Efficacy of acupuncture for chronic constipation: a systematic review.:  This is an abstract to a positive Chinese study on acupuncture for constipation.

Use acupuncture to treat functional constipation: study protocol for a randomized controlled trial :  Here is a full-text summary of the study protocol for the above-linked study, in case you want to take it to your acupuncturist to see what points were used.  🙂

Acupuncture for functional constipation: protocol of an individual patient data meta-analysis : And here it looks like the British Medical Journal is gearing up to explore acupuncture for functional constipation.

Bottom-line:  Acupuncture definitely seemed to add some motility to my gut.

Closing

I will try to wrap up this long story in the next post which will cover things like yoga, acceptance, meditation, getting up early, and my favorite topic–diet.  It seems like a lot of stuff to try–and it is–but I know these things will impact my marriage, my parenting, and my life forever.  Here is a funny thought:  I am a better person because of my constipation.  Oh, my.  Did I just type that?Insane.

I appreciate the comments you’ve all left.  And I like to hear of people doing well and what and who they used to achieve that.  Have a super week.

Terri

 

 

 

 

Slow Guts Need Tenacity

256px-Pieter_Lastman_-_Jonah_and_the_Whale_-_Google_Art_ProjectTenacity.  Word for the day.  Word for a season.  Word for life.  I can hear mom’s voice even now, “Oh, Terrrr-rrrri.  You have a one-track mind.”  She said it like it was a bad thing!  Pshaw.  But, tenacity got her to buy me some black parachute pants; I think it’s restoring my gut too.  I’ve worked very hard to get this gut moving.  Very.  I’ll be laying out all that I can think of that I tried and how I think it affected my gut and me.  There is no ONE thing that worked for my colon regularity and stool consistency.  Geesh.  What would I have to write about if it was that easy?  I’ve turned down more cookies, cakes, and cheese platters than you can even imagine.  I’ve made myself go to bed early more than I’ve ever made my kids go to bed early.  I’ve attacked my gut on all fronts that I can.  Tenacity.

I’m starting out by writing about the supplements I’ve tried.  That does NOT mean that the supplements are the most important.  Just that I’m postponing talking about acupuncture and gargling and chakras.  I’ve already mentioned vitamin K2 in the last post.  These posts will just keep rolling.  So let’s continue.  Don’t use this as medical advice.  It’s my story.  If it gives you ideas to try, talk about them with your doctor.  Be SAFE.

Iodine

I’ve taken iodine for about two years now. I don’t have much in the way of a reliable iodine source in my diet, so I supplement. Iodine comes to a conventional diet via egg yolks, dairy, seafood, and iodized salt.   Iodine didn’t seem to have any particular impact on MY constipation, although other people have reported to me that when they started taking iodine it did seem to improve their constipation; I experienced other positive benefits from taking iodine. I was able to have my thyroid labs followed to make sure I was safely supplementing. Hypothyroidism (low thyroid) causes constipation. I was never categorized as hypothyroid. However, iodine supplementation did slowly drive my TSH down over time, which was medically interesting to watch.

Bottom line for me: Iodine did not seem to make my constipation better, but it helped other things for me. I think that a TSH needs periodically checked and symptoms need closely monitored if a person is going to take iodine.  In case you’re counting, this is the second supplement I take routinely.

Probiotics and Probiotic Foods

I’ve tried dozens of probiotics. Not A DOZEN—but DOZENS. There is no probiotic that makes my motility improve directly. I’ve tried soil based. I’ve tried VSL. I’ve now tried the Japanese kind. I’ve tried Klaire Labs. I’ve tried pickles, pickle juice, sauerkraut, sauerkraut juice and kimchi. I’ve made my own fermented pickles, sauerkraut, and beets. I’ve tried 24 hour homemade yogurt. I’ve tried homemade coconut yogurt. Tenacity.  There is one probiotic source I haven’t tried, but I’d like to try: Mutaflor. It has studies showing it helps constipation. However, it’s only available in certain countries, and the USA isn’t one of them.

Probiotics aren’t the “cure” for my STC.  I’ve tried many kinds, and I’ve tried driving up the doses.  Tenacity.  In fact, for a couple of months this summer, I even stopped probiotics completely!!!!  I suffered no ill GI effects and my gut still moved! Why did I stop them? I think that I have a mild case of small intestinal bowel overgrowth (SIBO).  (Why not test?  1) I already eat a tailored diet.  2) Things are improving.  3)  I’ve tried antibiotics before for it, and it came right back.  And now, I won’t take antibiotics because I’m nursing.  4)  My case isn’t that bad.)  I now waffle between probiotics and no probiotics.

What is SIBO?  This is where the bacteria from the colon track up into the small intestine in larger numbers and/or with different species than those that should be there. It leads to significant bloating, distention, bowel movement changes, fatigue, and other symptoms. There is a dispute in the SIBO arena about whether one should take probiotics with this disorder. Having no vested interest and an open mind, I could see both sides. So since I’d tried probiotics like crazy for years, I thought I’d try without. (Another aside: I have not always had SIBO symptoms. They started at about age 35. I think it was a result of chronic non-movement of my gut.  I think to effectively treat SIBO, a person HAS to address the underlying issues.)

Bottom-line for me: I tried coming off my probiotic. My gut still moved off the probiotic! However, my gut also moved normally for a couple of months before I got pregnant a couple of years ago and I was ON a probiotic. So for my body, I’m not yet sure whether it prefers a probiotic or not.  LOTS of people swear by probiotics for constipation.  I have been trying to utilize normal portions of Bubbie’s pickles, Bubbie’s sauerkraut, and eating my home-grown produce.

Butyrate

Butyrate has kick-started my gut twice in my life now. In 2013, I started taking it after a big dose of magnesium and immediately I had normal bowel movements daily. I then titrated up resistant starch using potato starch (which leads to natural butyrate production) and came off of the butyrate pills. I then titrated up food sources of resistant starch (green bananas, plantains, cooked and cooled potatoes and rice, raw potato and sweet potato sparingly) and stopped the powder forms of resistant starch.

BINGO. I thought I was a diet-controlled constipetic and the story was over! (I always told God I was going to stop blogging when my constipation was cured.  Never tell God what to do or what you think YOU’RE going to do.  Instead, when you hear “Jump.” from the Big Man, you say, “How high?”  Got it?) But I got pregnant in 2013 and I’ve been chasing GI rainbows ever since. Finally, late this summer of 2015, I decided to get back on butyrate. I took a good dose of magnesium to try to propel that butyrate deep into my intestines (just in case that would help, you know).  BAM.  My gut has been doing pretty well since then. Knock on wood. And I’m working on building back up my food sources of resistant starch again and working on other areas I’ll elaborate on through these posts (like stress management, core strength, etc). THIS IS NOT A SIMPLE QUICK-FIX JOURNEY. You want that? Go somewhere else.  Tenacity.

I KNOW butyrate does NOT work for all people. They’ve told me. More people have told me that butyrate did NOT help them than people have told me that butyrate DOES help them. I’d like to also point out that during pregnancy and post-partum, my gut kind of stopped working and I was on high dose magnesium. Butyrate did not work at this time—even though this summer I tried again and it did! This leads me to suspect that hormones play a huge role in constipation—which I already suspected and this simply pounded into my heat that I need to make sure and learn about this (and hopefully write it up too—although I must say the other day in my research, I saw a new review article that was downplaying hormones…).

Many people write to ask what butyrate I take. I simply tell this as part of my story. Listen. I do not support this brand, other than it has worked best for me out of all the ones I’ve tried. I don’t pretend to think this brand or even butyrate will help you. Heck, it may even set YOU back, while it sets me forward.  I use Body Bio Mag-Cal Butyrate 600 mg (two three times daily, usually, but not always with a meal). If you decide to try this, flash it to your doctor so he/she can make sure it’s going to be fine for you. A commenter, Vicki, has noted that Body Bio has received some reprimands. You may read about this by scrolling down to the comments and looking for an interchange between Vicki and me.  Sometimes, I have a strange feeling that some bottles work better than others.  I don’t know, though.  I have NO proof of that.

Bottom-line: Butyrate has some good evidence supporting its role in promoting gut motility.  I have many posts on that in my butyrate series.  Some people have tried it and found that it helped their food intolerances and gut motility. Others have tried it without success—and with a loss of hard earned cash.  If your’e counting, this is the third, and final, supplement that I currently take routinely.

Magnesium (Natural Calm)

What did I take during pregnancy and post-partum when hormones gripped my gut so tightly? I took three tablespoons of Natural Calm magnesium citrate in a tall glass of water nightly–every night. This is WAY too much magnesium. I am well aware that most of us are magnesium deficient, but this is a lot much! One electrolyte at a high dose is not good for the other electrolytes and their balances.  So even though this got things moving (diarrhea), this is not a good place to live for the rest of my life if I can help it.  Tenacity.

I tried some different forms of magnesium because the taste of this, although the unflavored is really okay, is becoming repulsive after four years or so of using it. The other forms, both topical and oral types of magnesium, just don’t work. And Epsom salts bath, although relaxing, don’t do anything at all for my GI.  This is the only brand of magnesium that has worked for me.  Again, I’ve no vested interest in this supplement, and I’m not saying it will work for you.

At my best right before pregnancy and also the last two months now, I was able to get off of the magnesium.  I still had/have to use it about once a week, and usually at a much lower dose– a heaping tablespoon.  But I only use it when I skip a day or things are too hard.

Bottom-line: Calm magnesium citrate now can keep my gut going (although with diarrhea) through thick and thin. Before I changed my eating and lifestyle four years ago, high dose magnesium did not work. So the fact that it works is great! But I still want off of it entirely! I am currently down to about once a week.  So I guess, if you are a nickel and dime counter, we would call this 3 and 1/2 regular supplements—since I only have to take it as needed and this only about once a week now.

Closing

I am going to stop now.  I have LOTS more to say.  You will be so bored by the time I finish.  You’ll think I talk and think about nothing but moving GI tracts. But, finish I will.  Tenacity.  Get those parachute pants.

Terri

Click here for Slow Guts Need Care, the first post in this series.

 

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.

Digestive Link Sharing

Fall leavesThere are so many helpful, fascinating topics I really want to get a chance to read on and summarize for my blog posts.  Writing and explaining helps solidify the information in my mind and hopefully the summarized information helps some readers too.  Sadly, I just can’t keep up with all that I want to do in a timely fashion.  So today I’m going to share three links which have been shared with me that some readers may be interested in.  Eventually, I’d like to read and summarize on the methanogens and progesterone links.  But, honestly, I can see it may take me a year to do it.

Link ONE is about how certain microorganisms in the gut make methane which then slows the intestinal transit leading to chronic constipation.  This may lead to the idea that a breath test could be diagnostic and certain antibiotics helpful.

Methanogens in Human Health and Disease
http://www.nature.com/ajgsup/journal/v1/n1/full/ajgsup20126a.html

Link TWO is about the effect of progesterone and prostaglandins on women’s colons.  Women with chronic constipation and slow transit have been found to have abnormal levels of prostaglandins and cyclooxygenases in their colons.  When researchers applied progesterone to colon cells from women without constipation, they were able to bring about the abnormal levels seen in cells from constipated colons.  So there is clearly a role between progesterone, prostaglandins, and chronic constipation. 

Chronic constipation in women linked to prostaglandins
http://www.modernmedicine.com/modern-medicine/news/modernmedicine/welcome-modernmedicine/chronic-constipation-women-linked-prostag?page=full

Link THREE is about an online, digestive conference coming up.  It is free.  There are some good speakers involved who are on the cutting edge, or at least reading up on the cutting edge, of digestive health.  The speakers are from a wide variety of backgrounds, some MDs and some not.  Usually something like this is a good place to listen, generate ideas, and then verify ideas with research or run them by your doctor.

The Digestion Sessions
http://digestionsessions.com/

Closing

Information is key.  Help your doctor help you by learning the new information out there.  Your doctor is like a good coach.  They have strong knowledge and experiences, but they’re trying to orchestrate many, many players all day long.  There is no way on God’s great earth doctors can ever keep up on all of the new information.  Print off credible articles, highlight important information in it which you think applies to you, and then say, “Hey, Doc.  I found this article about my problem.  Could we try it for me or do you think it’s a bad idea?”

Thank you Ashwin, Nishka, and Toni for the links.  I can’t wait to delve into them more.

 

Terri

What Role Could Constipation Be Playing in Your Child’s Bed Wetting and Bowel Habits?

Miralax (polyethylene glycol)Someone sent me a link, “What Every Parent Should Know About Bedwetting, Accidents, and Potty Training,” relating constipation to bedwetting, and I found it a good read.  Constipation is prevalent in our society, and kids are not exempt.  The author of the article is a physician, specifically a pediatric urologist, who deals with urinary issues in children day in and day out.  He feels that constipation–which can be difficult to diagnose in children because they leak liquid stool around hard, large impeding stools in the rectum, appearing to have diarrhea instead–is a leading cause of urinary problems in kids.  He also, like me, is frustrated at the medical community’s blasé “just take Miralax and eat fiber” treatment of constipation.

“Constipation is a distasteful subject. No one wants to talk about it.”

As distasteful as it is, constipation is a health condition that needs talked about.  Headaches.  Back aches.  Tooth aches.  Poop aches.

I had a child who used Miralax daily and still had constipation issues.  She would sit on the toilet screaming and crying for her “poop medicine” as I stood there trying to decide whether or not to torture her further with a suppository.  Traumatized by constipation issues, we decided to figure out what was causing constipation problems.  We eventually found that complete dairy elimination cured her constipation.   We next undertook a complete overhaul of our family’s diet, providing foods to help her GI tract recover a good barrier so the foods she ate wouldn’t cause her problems anymore.  Luckily we succeeded, and on the way we learned the importance of proper fuel and the devastation caused by improper fuels–and how each body is unique.

I believe, unlike my conventional medicine colleagues, that bowel habits are a good indicator of health.  Band-Aids won’t help a festering wound, and Miralax won’t really change chronic constipation.  Causes and good treatments for constipation and urinary issues should be sought.  Sometimes it’s as simple as feeding your kids real food. Or identifying a sensitivity to gluten or dairy, even minute quantities.  Or incorporating probiotics or probiotic foods.  Treatment may require more diligence with a bowel retraining program or an elimination diet.  But I am confident that constipation can be improved, especially in young children.

I encourage you to check out “What Every Parent Should Know About Bedwetting, Accidents, and Potty Training” written by Dr. Steve Hodges. Click on the blue texted excerpts below to go there.:

 

“Reality: Most children wet the bed because their rectums are clogged with poop. The hard, bulging poop mass presses against the bladder, compromising its capacity and irritating the nerves feeding it… The most rigorous studies ever conducted on childhood wetting were led by Sean O’Regan, a kidney specialist drawn to the topic because his 5-year-old son wet the bed every night. A test called anal manometry showed his son’s rectum was so stretched by stool that the boy couldn’t detect a tangerine-sized air balloon inflated in his bottom…

Ultimately, O’Regan’s Canadian research team tested several hundred children with enuresis, encopresis, and recurrent UTIs. Virtually all were, like O’Regan’s son, stuffed with poop. When their rectums were cleaned out with enemas, the wetting, soiling, and infections stopped… A couple years back, I tracked down Dr. O’Regan, now retired and living in Arizona. I asked him why he thought his research, compelling as it was, never made a splash.

He told me: ‘Constipation is a distasteful subject. No one wants to talk about it.'”

If you have kids who have urinary issues or constipation, check it out.

Nothing on my blog should be construed and used as medical advice.  But I do hope it makes you think and start asking questions.

Health to you and yours–

Terri

The Unglorious Call to Action

IntestineThat is a personal problem.  Not a medical problem.

Here’s the poop.  No.  No.  I mean scoop.  My call to nutritional voodoo was, well, to say the least, not a glorious one.  Other nutritional blog hosts–oh such extraordinary, amazing recovery stories from horrible illnesses like multiple sclerosis and ulcerative colitis.  Motivating and inspiring us all to higher eating!  My issue–hmmm.  Right.  Not so inspiring.  Considered by the uninformed to be a personal problem, not a medical problem.  Ah, well.  Even if I arrived in Nutritional Nirvana via a clumsy fall on my derriere, I am here all the same.  My gut is working.  And the pursuit of that goal is pretty much what started this blog.

My History

I’m a 39 year-old female.  I have had chronic constipation all of my life.  Although not a common issue, I can remember twice in high school when I had horrible stomach cramps prompting me to head to the nurse’s office.  On the way, the visceral pain overcame me, and I passed out leaning against the lockers in the hall.  As a sixteen year-old girl I did not make the connection between constipation and these symptoms.  Neither did anyone else!  “You just need to eat more.”  Mmm-kay.  It never dawned on me that my gut was trying to move against a brick and it hurt!  I thought bricks were normal.  I mean, nobody talks about bowel movements at 16!  (I suppose I’m not supposed to talk about them ever.  But since I’m a medical doctor, no orifice or function makes me blush.)

Each decade, my GI function worsened, and I did finally realize in pharmacy school that my gut was abnormal.  The next ten years brought rounds of different fiber preparations (I can make darn tasty desserts with Metamucil wafers), docusate, milk of magnesia, magnesium supplements, suppositories, Miralax, yogurt, probiotics, prunes, shredded wheat (half a box a day), and finally, despite my attempts to only use them sparingly, daily stimulant laxative became required.  Mind you, even with those stimulant laxatives which were needed at doses which would kill a normal human being, my bowel movements still only occurred about every five to ten days and still were not easy to pass.  My gut was slowing down from slow to stop and becoming refractory to everything I knew to try.  I visited several doctors through the years and I always got the same answer:  more fiber and water.  Got a colonoscopy.  Pretty negative.  Got checked for low thyroid and celiac disease.  Negative.

I decided to think outside of the box and took to the wilderness of internet medicine.  Talk about crazy.  How do some of these people say these things without a license?  Guess I’m glad they can because it tipped me off in the right direction, and I embarked on the odd diet called GAPS (at least that founder has a medical license)–before I knew about Paleo which sounds way cooler than GAPS.  (Ha!  Ha!  I actually have landed on a diet which has no name but uses the templates of several diets.)  GAPS helped me identify food intolerances and taught me how to eat a nutrient dense diet.  It got my gut usually responding again to high dose magnesium (Natural Calm), but I don’t think high dose magnesium is good to take for the rest of my life.  So my endeavors persisted.  My goal is NO supplement for my constipation.  For myself, I try to use supplements as a bridge to achieve my health goals.  Once my health goal is achieved, I’d like to try to maintain it with food choices if I can.  However, I recognize there are conditions which will require lifelong dependence on medicines and/or supplements, not to mention declining content of certain nutrients in our food sources.

Achieving Success

This week I’ve lived large, taken a chance, and dropped the magnesium which sustained me through pregnancy.  My gut is working daily!  Back in November 2013, my gut was also working very well daily, and I was set to write this post back then.  I had started butyrate (butyric acid), and although it isn’t supposed to make it to the colon, it worked like a charm on my gut.  My GI tract moved daily and even my stupid food intolerances seemed diminished just in time for Thanksgiving.

But I hate supplements (please know that I do take some). I wanted to allow my body (I consider those bacteria in my gut to be part of my body.) to make its own butyrate, so  I tried to incorporate green bananas, green plantains, cold potatoes, occasional bites of raw potato and sweet potato, some legumes, and potato starch slurried up in water each night to get my own gut bacteria to make butyrate.  Things were going great.  Just great!  I was able to stop my butyrate and still have the same effects.  Wow.  Wow.  Wow.

Then, we were blessed with pregnancy.  Let me rephrase that.  We were blessed with a baby.  Pregnancy is no sleigh ride with jingle bells. (Increased constipation has always been in an issue in pregnancy.  This time was much better.  There was a time at about 14 weeks along where my gut completely stopped and nothing I did made it move.  I got worried, but after a couple of weeks, that lifted and magnesium helped again.)  However, I worked through all the food and supplement aversions and stomached magnesium, which I needed again every single day in excessive doses.  I bid “good-bye” to butyrate and resistant starch foods, which sounded disgusting during this time.  I delivered in July a beautiful, healthy girl.

About two weeks ago, I decided it was again time to get rid of that excessive magnesium and all that it was probably doing to my calcium balance.  Besides that, the magnesium didn’t always work daily.  I decided to take butyrate again and started incorporating resistant starch foods into my diet.  Would the experiment work for me again?  I was nervous since I had proclaimed success with butyrate in fall of 2013.  What if it failed?  I would have reported it, you know.  But I would have felt very stupid because I never want to lead anyone astray.  The experiment for me has successfully repeated itself.  Now all that needs to happen is to continue the resistant starch foods and see if I can taper myself off of the butyrate supplement.

Closing

So you see, mine is not the most glorious nutritional conversion story there is.  But it’s real.  It has convinced me that eating a nutrient dense diet, excluding inflammatory foods, and supporting the body’s bacterial flora is key to health and curing disease.  I am pretty much 100% convinced that this experiment would never have worked two and one-half years ago in the gut that I had then.  I’ve worked very hard and tried a lot of things to rehabilitate my broken colon.  In the next post, I am going to list what I feel has been most important for getting my gut peristalsis in working order.  I will report what worked for me.  Don’t assume that what works for me will work for you.  I want to make sure you seek the advice of your doctor; I don’t want you to overlook serious health conditions because you’ve given up on conventional medicine.  Don’t use my story as medical advice.  That it is not.  This is my story.

~~Terri
Photo credit:

Originally from en.wikipeida.  Author Dflock.  Now public domain.