Trust the process?

Trust the Process

I have the message above in my office. It frequently reminds me to slow down and trust the process. There are so many processes in life. And, for things to go smoothly trusting the process is necessary. When working with clients who have digestive issues, there is a process I follow. FODMAPs are a part of the process.

If you haven’t read the last post, FODMAPs are types of sugars that many people don’t digest. This leads to all sorts of digestive drama and distress. In order to figure out if FODMAPs are an issue, and if so which ones and in what amounts a specific process needs to be followed. (If you want to read the last post, you can do so here.) Here is the basic outline of the process I use with clients.

Phase 1: Elimination

The goal of the Elimination Phase is to get you feeling better. Fast. Most people feel better within three to five days. In the Elimination Phase you eliminate all high and medium FODMAP foods for a period of time. Foods that contain FODMAPs are: milk and milk products, honey, most fruits, high-fructose corn syrup, wheat and rye-containing foods, certain vegetables, inulin, chicory root, some vegetables, some sugar-free foods, dried peas and beans. This phase can last anywhere from one to four weeks. I recommend two weeks or until having seven days of no or minimal symptoms. Although the list of foods to eliminate may seem daunting, there are a lot of foods that you can have.

Phase 2: Challenge

The goal of the Challenge Phase is to determine which FODMAPs don’t get along with your body. It could be one or more. And, it could be the “dose” of the food. During the Challenge Phase you stick with the elimination diet and add in a food that contains on FODMAP in three dose sizes – small, medium, and large. If you have symptoms from any of the doses you can decide whether to try the next dose up or stop and move into a washout period. The washout period is usually three days and allows your body to return to a symptom-free state. Then, you can move on to the next FODMAP-containing food. If you don’t experience symptoms with the large dose, you can move onto the next FODMAP-containing food without the washout period.

Phase 3: Personalization

The goal of the Personalization Phase is to determine how much of combined FODMAPs you can have without causing symptoms. In the Challenge Phase you tried foods with one FODMAP. In the Personalization Phase you try foods with multiple FODMAPs to see how much total FODMAPs you can have without having symptoms.

The whole FODMAP Protocol can take 8 to 12 weeks. While this may seem like a lot of time, is it really that much time to invest to start feeling better? To have a list of foods and amounts of foods that you know you can eat without symptoms?

If you want to know more, you can always contact me using the Contact link at the top of the page. Click on the link to get the FODMAP Resources I use with my clients.

Tired of trying to figure out where to start? Confused about all the information out there? This can help!

Fruit.

Fruit.

Where to start? What works? When you’ve been having stomach issues for a while, figuring out where to start can be confusing. So much so, that it can be easier just to go along with the symptoms rather than spending the energy to figure out where to start.

It seems simple, right? Figure out what foods are causing the problems. But, it can be really complicated. Think about what you ate yesterday. All of it. How many foods did you eat? What about things that you drank? Usually, the plethora of things we put in our mouth makes figuring it out too confusing.

You may also have a hard time figuring it out because you’ll eat something one day and be fine. You’ll eat it the next day and end up having problems. It makes no sense! Trust me, I’ve been there.

You research on the internet and find all sorts of conflicting information. You don’t have the time or energy to search through all of the information out there to figure out what to do. You’ve been to a GI Doc who didn’t help either.

After personally dealing with everything talked about above, I’ve started using a FODMAP protocol as the starting point for my clients who have digestive issues. The FODMAP diet was developed by Monash University in Australia. They still continue the program today by testing foods and giving them FODMAP ratings. And, the FODMAP diet has been studied by universities and shown to help relieve digestive issues and symptoms.

What are FODMAPs anyway? FODMAPs are types of sugars that a lot of people have problems digesting. When these sugars reach the small intestine, fluid is drawn in to dilute them and you feel bloated and uncomfortable. Then, the sugars and fluid move into the large intestine where some of the bacteria of your microbiome eat the sugars. Then, the microbes produce gas. Now, you’ve got gas and extra fluid in your large intestine which leads to you feeling more bloated and uncomfortable.

The FODMAP protocol eliminated foods that are have FODMAPs in them for a period of time then challenges your body with the different FODMAP foods.

Next week we’ll dive into the FODMAP protocol and how it works.

If You Want To Be Able To Close Those Doors, You’ve Got To Fix The Foundation

Cracked concrete

If your home was damaged, would you fix it? If there were holes in the ceiling or walls, would you patch them? If the heating or air conditioning systems weren’t working, you’d call someone ASAP. Right? If you keep getting cracks in the walls and doors don’t close in your house, you eventually have to look at the foundation.

Your digestive tract is 24 to 30 feet long. That’s a lot of space for things to go wrong. It would be equivalent to a multi-storied house with multiple basements, lots of rooms, plumbing, and heating and air conditioning systems.

If your digestive system is damaged it also needs to be fixed. And, just like your house, the fix depends on what is wrong with it. You wouldn’t try to fix the foundation with a plunger, right?

When I work with clients, the main things I look at doing are:

  • Reducing inflammation
  • Repairing the mucus layer (remember your entire digestive tract has a layer of mucus to help keep the digesting food moving)
  • Strengthening and repairing the lining of the small intestine

The “repair” R of the 5Rs goes hand-in-glove with the other R’s (Remove, Replace, Reinoculate and Rebalance). Doing the work to repair the inflammation or the lining of the small intestine won’t work if you haven’t removed the foods that are causing the inflammation and damage. It’s like when you keep patching the cracks rather than looking at the foundation of your house.

How do you repair your digestive tract? Typically, it involves supplements because getting the nutrients needed to repair the digestive tract in food can be a challenge. The supplements I use with clients depends on a lot of things. Two of the key things are: what’s going on, and where the damage is. The key supplements I look at include:

  • Glutamine for repair of the lining of the digestive tract
  • Aloe Vera for mucosal healing and anti-inflammatory properties
  • Curcumin as an anti-inflammatory
  • DGL-Licorice root for gut lining repair
  • Demulcents to soothe irritated intestinal lining
  • Fish oil as an anti-inflammatory
  • Glutathione-enhancing supplements for mucosal lining repair and anti-inflammatory properties

There are a lot more supplements that come into play. I’m not saying you need any or all of these or other supplements. My goal is for you to be aware that the targeted use of supplements can help repair damage done to the digestive tract.

As with any other supplement, you want to be sure to buy quality brands and brands that have been tested for purity and contamination. (Here’s a link to a post about reading the supplement facts panel. And another post with a lot of details about supplements and how to check that you’re buying quality supplements.)

Repairing a damaged digestive tract is one of the steps of improving your overall health. The first place I start when working with clients is looking for foods and drinks that could be causing damage and removing it – the first R – Remove. If you’d like help identifying those thigs that could be causing your issues, using a food log is a great place to start. If you want to get the food log I use with my clients, click here to get your Symptom Log.

Reinoculate Your Gut – The Third “R”

syringe

Do you remember going in as a kid to get your inoculations? Vaccines? Do you love going in to the doctor’s office to get a shot? I don’t.

When working through the 5 R’s of Gut Restoration, Reinoculate is the third “R”. (I skipped over the second “R” because I covered it a few weeks ago. Here’s the link to it.)

Fortunately, you can reinoculate your microbiome without using a needle. You can use food and supplements. That’s right, food can help your microbiome. And, it has to be the right kind of food. Specifically, fermented foods.

I’ve talked about fermented foods before (here’s a link to the post on The Magical Microbiome). Those fermented foods contain the microbes that help reinoculate your microbiome. Each different food contains different microbes. This is why you should eat a variety of fermented foods like sauerkraut, Kim Chi, yogurt with live cultures, kefir, and kombucha.

Depending on what’s going on with your microbiome, you may also want to use probiotic supplements. When choosing probiotics, I recommend looking for ones that are proven to have live microbes in them. Usually, these are refrigerated. If you are sensitive, intolerant, or allergic to dairy, do your homework! Many probiotics are dairy-based. This may mean spending time on the company/product website or even calling or emailing them. Honestly, I recommend calling. They respond quicker than an email or using a “Contact” form on their website. Also, if you’re going to use probiotics, I recommend alternating them every month or every-other month. And, be sure that when you alternate that you choose probiotics that have different strains in them. How do you know? Look at the supplement facts panel. It will (or should) list the strains that are included in the probiotic. If you’re only switching brands and not looking at the strains, there’s a good chance that you’re getting the same strains from a different brand.

Finally, once you reinoculate your gut, you’ve got to feed those microbes. What kind of food do your microbes need?  Typically, your microbes do well on foods that you can’t digest. That means fiber. Lots, and lots of fiber. Fiber isn’t just good for keeping you full and helping keep you bowels moving. They’re food for your microbiome! We want those little guys to work hard digesting all that fiber. What are good sources of prebiotics? Here’s a list of some of the best prebiotic-containing foods:

  • Jerusalem artichokes
  • Garlic
  • Leeks
  • Onion
  • Bananas (greener ones are great)
  • Asparagus

The 5 R’s of Gut Restoration aren’t necessarily in order. Next week, I’ll talk about Repair, which usually comes before Reinoculate when working with clients.

If your tummy isn’t happy and you don’t know why, take a look at the new online program I’m offering – the Happy Tummy Bunch. It just may help you get a happy tummy. And, who doesn’t want that?

Removing What’s Bugging You – Part 3

If you find something where it isn’t supposed to be, you take it from where it shouldn’t be and put it where it should. Right? For example, if you found a sharp knife in a child’s toy box, you’d take it out of the toy box and put it where it belongs. Right?

This can happen with microbes in your gut. Yes, really.

(FYI – This is the third in a series of Removing What’s Bugging You. You can find the prior posts here: Got Gut Issues? The 5R’s Can Help, Removing What’s Bugging You – Part 1, Removing What’s Bugging You – Part 2.)

Sometimes the microbes in your microbiome, microbes that should be in your large intestine, move to your small intestine. Those sneaky little suckers. Some of them can actually swim upstream and move from your large to your small intestine.

Once they reach the small intestine, the party begins!

Remember the small intestine is where the final part of digestion happens and absorption of the food molecules occurs. If microbes end up in the small intestine, they start digesting the food they find there, rather than waiting until the leftover food gets into the large intestine.

Why is this a problem? Because after these guys digest the food, one of the things they produce is gas. This means that you end up with gas in your small intestine. And, you feel it. You’ll feel gas and bloating along with, potentially, all the other GI symptoms we’ve talked about – constipation, diarrhea, maybe heartburn, acid reflux, and nausea. And, other symptoms as well.

Again, these symptoms are non-specific. Which can be confusing when trying to figure out what is causing your problems.

This issue, microbes in the small intestine, is called Small Intestine Bacterial Overgrowth (SIBO – pronounced See-Bō).

How do you know if you have SIBO? The best way is through a hydrogen breath test. You eat a restricted diet for a day, fast for 24 hours, drink a special drink, then blow into some tubes it given intervals for a period of time.

If it turns out you do have SIBO, you can work with your doctor to formulate a plan to address the issue and get those bad guys out of your small intestine. Some dietary interventions may help, too.

You can also start figuring out if SIBO may be an issue by logging your food, drinks, symptoms, etc. This will help you narrow down if it could be SIBO. Symptoms from SIBO appear within a couple of hours of eating when symptoms from other parts of your body happen at other times – earlier sooner or later after eating.

If you want to get the food log I use with my clients, click here to get your Symptom Log. If you want to learn more about food sensitivity testing, you use the “Contact” area on my website.