Saturday, May 5, 2012

Dude, TMI. (Part Two)

After years of worsening GI problems (described in gory detail in Part One), I finally got back to normal by eliminating all forms of dairy and heavily restricting my intake of gluten, a protein found in wheat, barley, and rye. Alleviating my symptoms required me to go outside of conventional medicine, leaving their diagnosis of IBS behind. Actually fixing the problem and healing my body took an even larger leap out of the box and introduced me to the amazing field of naturopathic medicine.

From TMI to TIM.

I attended the Ancestral Health Symposium 2011 as a volunteer interviewer. I was assigned several speakers to work with, which meant that I sat in on talks I might not have otherwise. One such talk was entitled, “The Rainforest in Your Gut” by Tim Gerstmar, naturopathic doctor, and “Dr. BG”, pharmacist, blogger, and author. I honestly had no idea what this talk would be about. I certainly never thought it could change my life!

The rainforest in your gut.

It turns out that we have a whole biome of critters living in our digestive systems. In fact, there are more bacteria in your gut than there are cells in your body! And that’s a good thing because these bacteria keep your gut in good working order. Poor diet, especially one rich in foods that irritate the gut, can disrupt the gut biome leading to all kinds of GI symptoms, nutrient malabsorption, food intolerance, and even a condition called leaky gut. That’s when the lining of your gut is perforated, allowing toxins to enter the bloodstream and wreak havoc throughout your body.

In the first half of the talk, Dr. BG described in detail the inner workings of the gut and the different pathways by which an unhealthy gut can cause a whole host of problems. Some specific health problems she mentioned, that aren’t necessarily ones you would associate with diet, included fibromyalgia, rosacea, congestive heart failure, hypothyroidism, asthma, infant colic, and autism. These conditions are very highly correlated with intestinal permeability (leaky gut). In addition, IBS, obesity, hypertension, Type 2 diabetes, Crohn’s disease, ulcerative colitis, and fatty liver disease can be caused by diet and treated through diet and gut rehab.

Dr. BG also described her own experiences with both her daughter and her niece. Her daughter had chronic constipation since birth and constantly complained of stomach pain. Her niece, Jillian, was born with mild autism. Both kids saw tremendous improvement by switching to a less-irritating Paleo diet (Dr. BG and her sister are writing a book on their experience with Jillian's autism and diet, but as of this writing, it has not been released.). However, as Dr. BG explained, not everyone can be cured by simply adopting a more ancestral diet. Some people require more aggressive treatment, which can include an even stricter diet, adding fermented foods, or taking probiotic supplements to help restore the gut. As she said, to rehab the gut, we need to “seal it, heal it, and deal with the consequences”.

After Dr. BG's part of the presentation, Tim Gerstmar took over (~29 minutes into the video; slide 21). Tim is a naturopathic doctor at Aspire Natural Health in Washington State. His specialty is GI health, and he blew my mind with his description of basically all of my symptoms and all the tests and treatments he routinely performs, which I’d never heard of before.

Gut dysbiosis, as Tim explained, is caused by either pathogens or imbalance in the gut and is connected to food intolerance, malabsorption, inflammation, and gut permeability. He listed 5 symptoms that suggest a person might have gut dysbiosis: significant health problems that may or may not be obviously related to diet, chronic gas or bloating, chronic heartburn, chronic constipation or diarrhea, and poo that contains blood, mucus, or undigested food. This list definitely got my attention as it contains pretty much every symptom I had been suffering from! Even the undigested food that hadn’t set off any red flags with my regular doctor. Sadly, as Tim said, many of these ailments are common, but common is not the same as normal.

Tim described the types of tests he runs and how they can both diagnose the specific problems in someone’s gut and also show how well the person would respond to certain treatments. There are five treatment categories, which are often used together depending on how sick a person is and in what ways: diet, herbal medications, prescription medications, gut healing formulas, probiotics, and “brain support”.

When it comes to diet, the recommendations are stricter depending on how much healing your gut needs. Bacteria and pathogens that cause gut dysbiosis feed on carbs, so sugars, grains, and most fruit are the first things to go. Then, because the gut is already messed up, other irritants should also be avoided, including dairy, soy, alcohol, and even legumes and nightshades (like tomatoes). In time, as the gut becomes better able to process these foods, they may be worked back into the diet.

Now, this may sound like a lot of restrictions, but there is still a whole world of food out there that you can eat on a gut-healing diet. Vegetables (other than nightshades), meat, fish, nuts, coconut, perhaps some fruit, and fermented foods are all great. The diet recommendations for gut-healing are very similar to those of the Paleo, Primal, and other ancestral diets, although you may need to be more restrictive. There are many resources available online if you want to test out a gut-healing diet on your own (like here and here). The length of the diet (weeks to months) and how restrictive you would need to be would depend on the level of gut dysbiosis and permeability that you have.

Herbal or prescription medications and gut-healing formulas can really help bring the gut back into working order, but for these, you should be working with a doctor. For example, Tim uses cultures (i.e. poo) to identify the ways in which a person’s gut is malfunctioning, and that helps him decide which types of medications to use.

The long and winding road… to recovery.

For me, cutting out dairy improved my daily GI health the most. Cutting out gluten also helped. At that point, I found that I didn’t have problems with nightshades or fruit. However, foods with anti-nutrients akin to gluten did give me problems. Some legumes, like kidney beans, split peas, and certain kinds of lentils cause me a good deal of irritation, and the supposed super-food quinoa is virtually indigestible! 

Tim also helped me start on a daily regiment of probiotics. I took a ¼ teaspoon of Ther-biotic Complete powder each day, mixed in with my morning nut butter. Because I saw such a vast improvement from changing my diet, and because I got pregnant shortly after the symposium, I decided not to pursue further treatment aside from the probiotics. Even though I am feeling so much better, I still plan to continue taking probiotics in addition to my reformed diet. Our bodies used to get these important bacteria from traditionally-prepared fermented foods and even from dirt! However, our modern sterilization and pasteurization techniques (which are definitely good for keeping us safe from some life-threatening pathogens) kill off a lot of the beneficial bacteria that our bodies need. That makes it much harder in a modern diet to keep up a healthy gut biome. Incorporating traditionally-prepared fermented foods like kim chee, sauerkraut, and (unpasteurized) yogurt into your daily menu is a great way to keep yourself healthy. For me, though, the probiotics offer a more practical solution.

Over the past nine months, I have had a remarkable recovery. I now know the real meaning of “regular”. And, I can even eat dairy again! I keep my intake low – some organic pastured butter on our homemade popcorn or some yogurt with nuts and berries – but I don’t have to panic if I find a little cheese on my salad or if there is butter baked into a treat. I don’t know what would happen if I ate a slice of pizza or a plate of lasagna. I’m guessing I would feel pretty crappy, but I doubt I would have the painful cramps, bleeding, or week-long diarrhea that had become commonplace in my life. The interesting thing is, I don’t really miss those foods. I didn’t change my diet solely to rehabilitate my gut. I also did it because I realized how little actual nutrition was getting on my plate and in my body. Focusing on vegetables and other nutrient-dense foods has helped me gain energy, feel happier, lose weight, and cure my gut dysbiosis. There is simply nothing a slice of pizza, a giant soda, or a bowl of cereal can offer me that can compete with that!

Unfortunately, our industrial food system and the vast marketing machine that goes along with it makes it seem like cheaper and faster is the way to go when it comes to food. They highlight the use of whole grains or antioxidants as though they can magically transform any food into something healthy. But true health comes from fresh produce, clean eggs, meat, and fish, nuts, coconut, traditionally-prepared legumes, and fermented foods. These foods are more expensive and harder to market, but they are the nutritional winners and the best foods for us humans to eat. A truly ethical food system would provide more of these foods and less of the processed foods that our bodies are simply not able to handle. You, the consumer, can help by demanding the types of foods that keep us healthy and rejecting nutritionally-poor, potentially irritating foods. If we want to be healthy, we have to fight for it.

A full belly; a happy body.

When I was told I had IBS, it was like being told I was a flawed human being. My digestive system simply didn’t work properly, and it never would. When I removed dairy and gluten, I improved my health and my life, but I still thought of my body as broken. I could reduce my symptoms with certain behaviors, but I would never be cured. Now, I know otherwise. I do have to make smart choices – focusing on healthy foods rather than irritating ones – but I can feel good every day and still indulge in a treat now and then. And most of the foods I restrict really don’t have much to offer me anyway.

If you are struggling with GI symptoms, autoimmune problems, metabolic disorder, or depression, please consider changing your diet and seeking out a gut-specialist. Most importantly, do not give up! Do not go on suffering in silence because you are embarrassed or because a doctor has told you nothing can be done. Even if you do have a condition that can’t be “fixed”, such as Celiac disease, you can feel better. You deserve to be healthy.

 A few more notes:

- Think you might have gut dysbiosis? Tim explains an easy, do-it-yourself test on slide 33: take ¼ to 1 teaspoon of inulin, a natural soluble fiber found in chicory root and other foods. If it gives you a lot of gas and bloating, you have tested positive.

- Probiotics are especially important when taking antibiotics, another useful tool of modern medicine that can unfortunately cause gut dysbiosis. Birth control pills and a daily aspirin regiment can also mess with the bacteria in your gut, so both speakers highly recommended taking probiotics if you are also taking either of these medications.

- If you are in the hunt for a gut-specialist, Tim Gerstmar at Aspire Natural Health may be just the person you are looking for!

- Pregnant or trying to conceive? Gut dysbiosis in mom can lead to greater sensitivity and even autoimmune problems in baby. If you have GI problems before/during pregnancy, seriously consider a change of diet and incorporating fermented foods or probiotics. If you already have kids, and they are experiencing GI issues or suffering from autism or other developmental problems, they may need a diet change. This isn’t intended to place blame or make anyone feel guilty; there isn’t a lot of focus in prenatal care on these issues. We all know to take folic acid to prevent spinal problems, but no one mentions the dangers of gut irritants. So don’t waste time feeling bad, just get the help you and your baby need!

- I had the opportunity to interview Tim and Dr. BG at the symposium, but the video of the interview has still yet to become available. Should it surface, I'll be sure to add a link!