Digestive Health and Healing: My Story (Part II)

In Part I, I talked about the nightmare I went through with my digestive health in my early 20s. Now for the fun stuff! Below are tips, tricks, and suggestions that helped my gut heal and flourish.

Keep in mind that I started feeling better before I implemented these lifestyle changes. Shortly after my nausea subsided, I decided to become as healthy as possible so I could fight back against the chronic illnesses that made my life miserable for so long. In order to gain back the weight I had lost in a healthy manner, I changed my diet, my exercise routine, and several other aspects of my life. I truly believe the reason my health and weight have been stable for almost two years now is because of these changes and my holistic approach to self-care and medicine.

FOOD

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It took awhile to figure out how to eat after I started healing. As a gastroparesis patient, my doctors advised me to stay away from fruits and veggies for years. I basically lived off crackers, potato chips, and processed foods. However, I knew I needed to start eating real food. Over time, I trashed everything in my pantry and fridge that contained gluten, dairy, genetically modified oils, and artificial sweeteners. Then, I filled my kitchen with organic sweet potatoes, cauliflower, broccoli, beets, zucchini, mushrooms, carrots, kale, and butternut squash. To my surprise, my body didn't revolt after I started eating real food. In fact, I had way more energy. I felt great. The last major step of my diet overhaul was to replace the soda in my fridge with cold-pressed juice and kombucha. The only beverage my stomach would tolerate for months was soda, so this was a big victory for me.

Changing my diet made a huge impact on my life. When I started eating real, organic food, I immediately felt like a new person. When I think about how vitamin deficient I must have been in my early 20s, it honestly scares me. My doctors always told me to stick to bland, processed foods, like crackers and toast...but they never talked to me about the importance of nutrition. After filling my diet with veggies for a few weeks, I started adding chicken and fish to my meals. I also slowly incorporated quinoa and brown rice. After that, I experimented with healthy fats (nuts, avocados, and eggs). My stomach tolerated everything, as long as I ate small portions. Since then, I've never looked back.

FOODS THAT CAUSE INFLAMMATION

  • Red meat
  • Dairy
  • Vegetable oil
  • Fried food
  • Artificial Sweeteners (aspartame, splenda, equal, sweet 'n low, etc.)
  • Soda
  • Refined flour (white bread, pastries)

FOODS/SPICES THAT COMBAT INFLAMMATION

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  • Turmeric: I sprinkle turmeric and nutritional yeast on mushrooms, cauliflower, and broccoli before I roast them. Turmeric is a strong antioxidant, boosts cognitive function, and supports heart health.
  • Cinnamon: I sprinkle cinnamon on sweet potatoes, butternut squash, and carrots before I roast them. Cinnamon reduces the risk of heart disease and blocks abnormal cell growth, which can protect against cancer.
  • Coconut oil: I use this for everything. I scramble my eggs in it, roast veggies with it, and bake with it. Not only does coconut oil combat inflammation, it also supports heart health, aids digestion, boosts cognitive function, and supports the body's natural hormone production.
  • Nuts: Hella nutritious and loaded with antioxidants/vitamins/minerals, nuts are a perfect snack. They support heart health, and they're high in fiber. Brazil nuts, almonds, walnuts and pistachios are great options.
  • Fatty fish (salmon, tuna): Fatty fish have higher levels of omega-3 fatty acids, which are crucial for optimal brain and body function. Fish is one of the best foods you can eat for a healthy heart and is linked to a reduced risk of autoimmune disease.
  • Dark, leafy greens (spinach, kale): Dark, leafy greens support heart health, are a great source of folate and fiber, and help purify your blood.
  • Sauerkraut: Sauerkraut is fantastic for your gut. It's filled with probiotics that help prevent against leaky gut syndrome and other digestive issues, and it helps protect against food allergies and autoimmune disease. 
  • Dark chocolate: Praise the universe, because I'm addicted to dark chocolate. It reduces inflammation, promotes heart health, and boosts cognitive function. Make sure to choose a cacao percentage that's greater than 70%.

MEAL IDEAS

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BREAKFAST: Overnight oats, granola with almond milk or dairy-free yogurt, scrambled eggs, a bar (RXBAR, LARABAR, or MacroBar), gluten-free/sprouted toast with almond butter and honey

LUNCH: Avocado toast (topped with hummus and/or an egg), roasted veggies, tuna/avocado salad, a hearty salad

DINNER: Cauliflower rice stir fry (made with egg, liquid aminos, garlic, ginger, and whatever veggies you desire), fish/chicken with quinoa/rice and veggies, "pasta" with butternut squash noodles/zoodles and tomato sauce

DESSERT: Paleo fudge brownies, no bake peanut butter bars, cashew honey cookies, Hail Merry cups

SNACKS: Simple Mills crackers with hummus/bean dip, nuts, Siete tortilla chips, roasted veggies, a spoonful of nut butter, organic popcorn

SUGAR

There's sugar in almost everything. It's actually kind of scary. Crackers, bread, pasta, potato chips, beef jerky, things that aren't even sweet...they all have sugar in them. Even heathy staples, like fruits and vegetables, contain a ton of natural sugar. For people with SIBO, it's important to reduce your overall sugar intake (even natural sugars and sweeteners like honey, maple syrup, and dates). Sugars and starches feed bacteria in the gut and intensify symptoms. But for people who don't suffer from SIBO, you should primarily avoid ADDED SUGARS. According to the American Heart Association, women should only consume 25 grams of sugar each day, and men should only consume 37 grams. Once I started limiting how much sugar I was consuming, my skin cleared up, I felt less bloated, and I had more energy.

EXERCISE

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I used to tell people I was allergic to exercise. Cardio always made my legs red and itchy, so I avoided it for years. My doctors also forbid exercise when I was sick because I was too underweight. However, after I changed my diet around and reached a healthy weight, I wanted to make exercise a regular part of my routine. Exercise improves digestion, protects and strengthens the GI tract, and acts as a natural stress reliever. I started out with yoga and took a few studio classes. I also discovered a few sequences and routines I could do from home. Simply stretching out my body soothed my stomach and mentally refreshed me. After that, I joined a local gym. For the past few months, I've been doing cardio 3x a week (for about 40 minutes) along with some light weight training. The gym has become my happy place.

Something important to remember is that we're all different. What works for me might not work for you. Jogging and the elliptical are my go-to cardio routines at the gym, but you might benefit more from swimming or cycling. Figuring out what kind of exercise you genuinely enjoy is key. You want the gym to feel like a positive place, not a prison. 

SELF-CARE

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I know, I know....everyone is crazy about "self-care" now. It's truly so important to tend to your mind and body, though. What exactly is self-care? It's defined as identifying and meeting your mental, emotional, physical, and spiritual needs. Self-care is an active choice. You have to schedule it in your calendar just like you would a coffee date or a work meeting. And just like everything else in life, self-care is different for everyone. For me, self-care means getting a massage every few months, carving out time in my schedule to read, prepping delicious meals and desserts so I can properly nourish my body, getting enough sleep, taking care of my skin, and working out. Why is self-care important? It relieves stress. And stress can wreak havoc on your body. Stress promotes disease, weakens your immune system, negatively impacts digestion, and can physically damage your heart. When I'm stressed or anxious, I feel like my stomach is in a knot. So for me, self-care and mind/body relaxation is essential.

MEDICATION

This is where things get tricky. Medication is absolutely necessary for some people, and I won't deny that some prescriptions have major benefits and help people regain a better quality of life. However, prescriptions almost always made me feel worse. Many drugs slow motility (including many painkillers, antidepressants, and birth control options), so it's a hard path to navigate for those with gastroparesis. In addition, everyone's body is so different. Because of this, medication is very much a personal choice. 

With that being said, I can't stress the importance of advocating for yourself and urging your doctors to search for the root cause of your digestive issues. If you don't have support from a reliable, trustworthy doctor, do your own research or consult a functional medicine physician. Western medicine is all about prescribing drugs to treat surface symptoms of a disease. Meanwhile, functional medicine aims to treat the person as a whole and works to identify and understand the underlying root cause of a disease. My health started to improve before I sought treatment with a functional medicine physician, but if my health ever goes downhill again, this will be the first thing I do.

HOW DO I DEAL WITH FLARES?

I still suffer from symptoms, and flares hit me out of nowhere every now and then...they're all different in length of time and severity, but some of them really kick my butt. Here are the things I reach for and the things I avoid when I'm not feeling great.

FOOD/DRINKS THAT HEAL

Matcha is filled with antioxidants, increases memory levels, and fortifies the immune system.

Matcha is filled with antioxidants, increases memory levels, and fortifies the immune system.

  • Bone broth: Bone broth is insanely good for your gut. I tried making my own a few times, but it's a lengthy process. There should be several pre-made options at your local health food store. Why is bone broth so great? First of all, the gelatin found in bone broth heals the gut by repairing the intestinal lining (which SIBO damages) and reducing inflammation caused by disease. Second, bone broth is packed with collagen. Collagen is basically the glue that holds your body together. It soothes the gut, reduces joint pain, helps your skin and hair shine, and strengthens your nails and teeth.
  • Apple cider vinegar drinks: Your first reaction to this one might be "ew", but there are a lot of tasty apple cider vinegar drinks available now! Apple cider vinegar helps good bacteria grow and kills bad bacteria. It also eases heartburn and digestive discomfort. If you want to drink apple cider vinegar straight up, remember to dilute it in water or it will burn your esophagus. 
  • Kombucha: Filled with probiotics, enzymes, and amino acids, kombucha is wonderful for your gut. It can prevent and heal stomach ulcers, and it can heal candida overgrowth by restoring balance to your digestive system. Kombucha often makes me bloated, so I only drink half a bottle each day.
  • Coconut water: Coconut helps with inflammation, slow motility, and poor nutrient absorption. It also helps repair the lining of the digestive tract, which is essential for those with digestive issues. My favorite brand is Harmless Harvest.
  • Ginger: Helps break down food, promotes motility, and soothes stomach pain...what's not to love? I'm a huge fan of ginger tea, especially when I'm flaring.
  • Peppermint: The soothing, numbing, and antispasmodic effects of peppermint are great for nausea. I personally prefer to inhale peppermint oil. 
  • Vital Proteins collagen peptides: I use collagen peptides in drinks and baked goods. You can't taste it or smell it, and it adds a little extra boost of collagen to my day.
  • Water: Staying hydrated is so important...and it's key to keeping my POTS under control. The more water I drink, the better I feel. Summer is challenging for me...dehydration and heat intolerance are a recipe for disaster. I often forget to drink water, but always having a bottle on hand reminds me to take sips throughout the day.

FOODS/DRINKS TO AVOID

  • Coffee: I love coffee, but the acidity kills my stomach. I stick to low acid coffee beans now, and I only drink it occasionally. (When I need a caffeine boost, I now order matcha lattes!)
  • Alcohol: Drinking alcohol causes your stomach to produce more acid, which leads to inflammation. In addition, cocktails and wine are filled with sugar...which means fermentation and more bacteria. 
  • Beans and legumes (peanuts, soy): Beans and legumes contain lectins, which damage the intestinal wall and contribute to leaky gut syndrome. As for soy, it's particularly scary because it contains phytoestrogens. These chemicals mimic the action of estrogen in the body. This can lead to hormonal imbalances and infertility in women. 
  • Sugar (cane sugar, high fructose corn syrup, brown sugar, fructose): Avoid high fructose corn syrup at all costs! It contains chemical toxins and contaminants, and it should never, ever enter your body. Seriously...trash everything in your house that contains this garbage.

NATURAL REMEDIES FOR QUICK RELIEF...

  • Iberogast: This is an all natural motility stimulant. It works well for a lot of people, so it may work for you! Just be sure to tell your doctor that you're taking it. (Swedish Bitters is another option.)
  • Essential oils: Essential 7 actually has a page dedicated to healing gastroparesis. They have oil blends for nausea, stomach pain, sore muscles, and more. I bought a ton of these blends when I was sick and walked around smelling like peppermint, cumin, and ginger for the better part of a year. I still reach for these oils when I'm flaring. I like to massage them directly on my stomach or the bottoms of my feet.
  • Exercise: When I'm flaring and unable to consume as many calories as I need, I have to be more careful about the intensity of my exercise. During these times, I avoid cardio and focus more on gentle exercise, like yoga and walking. Even when my nausea is severe and I don't want to move, I always feel better after taking a walk.

Digestive Health and Healing: My Story (Part I)

If you know me personally or you've kept up with my blog, you know I've struggled with my digestive health for years. Over the last few months, I've received a lot of questions about how I healed my gut, what my diet is like now, and how I've managed to maintain a stable weight for almost two years. I decided to write a two part series about my story. Part I will outline the health struggles I've experienced, and Part II will outline tips, tricks, suggestions, and all that good stuff.

Disclaimer: I am not a medical professional or a registered dietician. Everything I write is merely my opinion and what's worked for me. I really hope some of you can benefit from this post, though.

MY STORY

It all started in high school. My stomach hurt almost every morning, which often made me late for class. My pediatrician diagnosed me with IBS, which is a common disorder that causes abdominal pain and discomfort. However, my parents were concerned enough to make an appointment with a gastroenterologist. He ordered an endoscopy, which didn't show anything unusual. But based on my symptoms, he diagnosed me with idiopathic gastroparesis (delayed stomach emptying). Gastroparesis is a disorder that slows or stops the movement of food from the stomach to the small intestine. The vagus nerve controls the stomach muscles, and in many cases of gastroparesis, that nerve is damaged. Symptoms include nausea, vomiting, bloating, and early fullness. There's no cure for gastroparesis, but it can typically be managed with medication. I was told to order Domperidone from Canada (a motility stimulant that isn't FDA approved in the U.S.), and I took 80mg/day for the next six years. I was also on a low dose birth control pill.

2014

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Domperidone worked for me...throughout college, at least. I still had symptoms, but I was able to live a pretty normal life. Right after my 23rd birthday, however, everything changed. My nausea and stomach pain became severe, and I could barely eat. Over the span of three months, I lost 30 pounds. I made an appointment with a new gastroenterologist for a second opinion, and he ordered an endoscopy, a colonoscopy, an ultrasound of my abdomen, extensive bloodwork, and a gastric emptying scan (which is the gold standard used to diagnose gastroparesis, but the results are often inaccurate). Once again, everything came back normal...even the gastric emptying scan. I knew something was wrong with my body, but my gastroenterologist told me it was just a bad case of IBS. Needless to say, I went back to my original gastroenterologist. My primary doctor wasn't helpful, either. When I told her what was going on, she accused me of having an eating disorder. I felt so hopeless after that (and immediately got a new primary doctor). If the medical community didn't believe me or know how to help me, who would? Soon after, I realized I had to take matters into my own hands. I joined digestive health message boards, reached out to others who were also struggling, and wrote down medications I wanted to try. One medication was Mirtazapine, an antidepressant that doubles as an appetite stimulant. My new primary doctor agreed to prescribe 15mg/day, and after two weeks, my appetite returned in full force. I was finally able to eat without nausea, and I regained the weight I had lost. I thought I had found my miracle drug.

For eight months, I lived like there was no tomorrow. I traveled, ate dozens of doughnuts, lived in Seattle for a few months, got a new job, and started to believe I was out of the woods. However, my health plummeted again right after my 24th birthday. 

2015

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My first ER visit occurred on Memorial Day. I hadn't been able to eat or drink in six days, and I could barely walk. I felt like thick tar was sitting inside my stomach and throat. I remember trying to drink juice and feeling miserable after only two or three sips. The ER doctor gave me a "gastroparesis cocktail", but it didn't help. My symptoms expanded beyond debilitating nausea and stomach pain and included painful bloating, acid reflux, abdominal cramping, extreme fatigue, dehydration, brain fog, lightheadedness, dizziness...the list goes on and on. At my lowest weight, I was 79 pounds. My doctors didn't know what to do. They told me to drink Ensure, but that only made me feel worse. My gastroenterologist gave me an emergency endoscopy with a botox injection, but it didn't relieve any of my symptoms. In fact, nothing helped. I had to stop taking Domperidone because it was giving me heart palpitations, and my body had become immune to Mirtazapine. I ate Zofran like candy because I was nauseous around the clock, but it did nothing. My gastroenterologist ordered a CT scan of my abdomen, an ultrasound of my gallbladder, more bloodwork, and a hydrogen breath test. Everything came back normal, except for the hydrogen breath test. My results were positive for SIBO (small intestinal bacterial overgrowth), which added another perplexing layer to my digestive issues. SIBO interferes with digestion of food and absorption of nutrients, and it damages the cells lining the small intestine. Coincidentally, gastroparesis causes SIBO. When food digests slowly and sits in the stomach/small intestine for too long, it begins to ferment...which causes a surplus of bacteria. After half a dozen trips to the ER due to crippling nausea and pain, my gastroenterologist suggested I seek treatment at a university hospital that had better resources for my condition.

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My ex-boyfriend, Kyle, was my rock during this time. He rolled me around in a shopping cart to buy groceries when I was too weak to walk. He knew all my medications and helped me stay on track with them. He calmed me down during countless panic attacks, and he was by my side during every single doctor's appointment and ER visit. So after my gastroenterologist's suggestion, we made appointments at Johns Hopkins, Wake Forest, Mayo Clinic, Cleveland Clinic, and Medical University of South Carolina. I eventually decided to pursue treatment at Johns Hopkins.

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It took months to get an appointment with the Motility and Neurogastroenterology unit. I had been sick for almost five months, and I was in a very dark place. I spent my afternoons receiving IV fluids at my gastroenterologist's office, and I spent my nights fighting unbearable nausea and forcing myself to eat a few hundred calories. My entire life revolved around the fact that I was sick. I just wanted to get better. I wanted to live a normal life. I was physically and emotionally exhausted. So when I finally visited Johns Hopkins, I was desperate for help.

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I'm honestly amazed I was able to process anything from that first appointment. Not only was I malnourished and suffering from permanent brain fog, I was also covered in red, itchy hives from head to toe. I tried to taper off Mirtazapine way too quickly, and my body freaked out (I continued 15mg/day after that because I was too ill to deal with withdrawal symptoms). The basic gist of the appointment focused on a goal to figure out the root cause of my gastroparesis. My motility specialist referred me to a rheumatologist, a cardiologist, and a neurologist for a full physical because he wanted to figure out what was going on below the surface. After a year and a half, I had finally found a physician who wanted to dig deeper. I left that appointment feeling better than I had in months.

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My rheumatologist tested me for every autoimmune disease under the sun, but everything came back normal. My cardiologist discovered I have a heart murmur, but it wasn't a major concern. My neurologist, however, gave me another diagnosis that explained some of my health problems. The infamous tilt table test revealed that I have dysautonomia, specifically POTS (postural orthostatic tachycardia syndrome). This disease is widely misunderstood by medical professionals, but it basically means your heart rate and blood flow are totally out of whack. You know that scary feeling when you stand up too fast and you get lightheaded and your heart races? That's what POTS feels like all the time, except with nausea, headaches, fatigue, and heat intolerance piled on top. There's no cure for POTS, and treatment options are limited.

After I got these results, my motility specialist advised me to undergo a comprehensive GI transit study (which would analyze my digestive system from start to finish) at Johns Hopkins. I was tired of being poked and prodded, but I figured testing was the only way to get more answers. The results showed slight esophogeal dysmotility, which basically means the muscles in my esophagus don't always work properly. This explained why I often felt like food was stuck in my throat. 

After that visit to Johns Hopkins, I was supposed to do even more testing with my local gastroenterologist. It was endless. However, I suddenly started feeling....less miserable. In fact, I started feeling better. My nausea subsided, and I was able to eat more. It felt like a heavy weight had been lifted from my stomach. Does it sound like a miracle happened? Because that's how it felt. I've been trying to pinpoint a specific link for years, but there doesn't seem to be one. I hadn't yet made any major changes to my life or my diet that could've explained my improvement. I was dumbfounded...but ecstatic. Despite feeling significantly better, I still looked skeletal and sickly. My weight was dangerously low, and I still couldn't eat enough to gain. But I finally had a better quality of life, and I was filled with relief, gratitude, and joy.

2016

After I had been feeling good for a few months, Kyle and I jumped on the opportunity to travel. I still hadn't gained any weight back, but I had a brand new "now or never" attitude about life. We went to Los Angeles, San Diego, backpacked around Europe for six weeks and had the time of our lives. Over the next year, my health steadily improved...but I knew I needed to make some drastic changes to my lifestyle in order to gain weight and start feeling like myself again. I'll talk more about that in Part II.

Outlined below are the many prescription medications I tried while I was sick. And in just a few days, I'll publish the second part of my story.

MEDICATIONS

  • Domperidone: This prokinetic relieved my nausea and helped stimulate my digestion for years, but it's now linked to ventricular arrhythmia and cardiac death. Despite this, my doctor told me it's relatively safe in low doses. I still take the lowest dose possible from time to time, but only if I'm having a really bad stomach day.
  • Reglan: STAY AWAY FROM REGLAN. It's one of the only legal treatment options for gastroparesis, but it comes with a black box warning because it can cause tardive dyskinesa. I received IV Reglan in the hospital once, and it made me restless, jumpy, and anxious. I literally wanted to rip the IV out of my arm. 
  • Erythromycin: My gastroenterologist wanted me to try this antibiotic because it also stimulates motility, but I ended up in the hospital with an inflamed colon. 
  • Zofran/Phenergan/Compazine: None of these antiemetics helped my nausea. They each came with a variety of unpleasant side effects, too.
  • Sancuso Nausea Patch: This didn't help my nausea. It was also extremely expensive because it's typically used to treat cancer patients undergoing chemo.
  • Busiprone: My second opinion gastroenterologist thought I had functional dyspepsia, so he prescribed Busiprone to relax my digestive system. It only made me lightheaded and dizzy, which ended up with yet another ER visit.
  • Xanax/Ativan: Both of these prescriptions helped relieve my nausea, but they can only be used occasionally (and you have to pick one or the other). I can physically feel my stomach relax when I take them. They soothe epigastric pain and make it easier to eat.
  • Prednisone: I took this drug for a few weeks after itchy hives covered my face and throat and landed me in the ER. Some patients on prednisone experience an increased appetite and weight gain, so my doctors hoped it would have that effect on me. It didn't.
  • Mirtazapine: This truly was my miracle drug for about a year, but my body became immune to it. I still think it's worth a shot if you haven't tried it yet. However, withdrawal is no joke if you take it an extended period of time.
  • Marinol: Medical marijuana is a wonderful treatment option for many with digestive issues. Unfortunately, it didn't work for me.
  • Xifaxan: I took this SIBO antibiotic for just one day, and it made me sick as a dog. I was literally shaking, breaking out in cold sweats, and dry heaving for hours. This is typical of a die-off reaction (when the bacteria in your gut begins to starve and toxins are released), but I couldn't handle the nausea. I was already struggling to eat a few hundred calories each day, and any further weight loss would've resulted in a hospital admission and a feeding tube.

Do you sense a pattern here? Prescription medication rarely helped me. Most of the time, it only made things worse. Right before I started feeling better, I decided to adopt a more holistic approach to my health. After almost a decade on birth control, I stopped taking it. I threw out all my antiemetics, and I flushed various painkillers I had been given in the ER down the toilet. The only drug I kept taking (and only because I had to) was Mirtazapine. I also kept my Xanax prescription on hand for emergencies.

Stay tuned for Part II!