Gut Health Update: Colon Cleanse + My First Endoscopy

Disclaimer: This post is my personal experience and is NOT intended as medical advice in any way. I am not a doctor, so please consult with a medical professional if you have any concerns about your overall health and take what I say with a grain of salt!

I’ve been on quite the journey since my last gut health update – and wow, what a journey it’s been. I’ve seen two different gastroenterologists, embarked on a colon cleanse and even had my small intestine biopsied to test for celiac disease. (Yes, that again.)

I’d be lying if I said that having my stomach pinched, poked and prodded by doctors and scopes all the time wasn’t stressful. But, I don’t regret it at all. Because of what I’ve survived this year, we’ve discovered that I almost certainly have IBS, relieving my worries that my gut health issues could be due to something more sinister than a spastic colon.

Since relocating to Cleveland, I’ve been receiving the bulk of my care at North Shore Gastroenterology under Dr. Mohamed Naem. Dr. Naem has done more for my colon health in one month than all of my previous doctors put together – but that doesn’t mean that my big move hasn’t been littered with challenges for my gut and mental health alike.

Below, I write about undergoing a colon cleanse, getting my first endoscopy and all the treatments, medications and procedures that led me to this point. Most importantly, I write about how they made me feel – because as we IBS patients know, our emotions are half the battle when it comes to our gut.

Before the Big Move

Back in Boston, I finally got into a gastroenterologist’s office at Boston Medical Center. I was impressed with the quality of care I received, but disappointed that my testing failed to reveal answers to what might be making me sick.

At that point. I had already been to an emergency room in Erie, PA while visiting with my boyfriend on winter break. I also visited an NP in Cleveland, Cheryl Brinley, who ordered a CT scan that failed to reveal anything (though we did discover a severe vitamin D deficiency that could be contributing to my low mood through the winter months).

My doctors at BMC ordered a fecal calprotectin test as an alternative to doing a colonoscopy, since it is essentially just as accurate and far less invasive than a scope. The test required me to provide a stool sample to the lab, who analyzed it for markers of inflammation.

This measurement told them with some certainty that I did NOT have IBD. Regardless, I still felt doubtful. My doctors took my symptoms seriously, but my results certainly did not alleviate my anxieties about my gut health. So, when I came to Cleveland, I decided to get in with a gastroenterologist ASAP – not only to establish care in my new city, but also to hopefully find some answers once-and-for-all.

The Colon Cleanse

Upon visiting Dr. Naem for the first time, he immediately suspected IBS-C – the C standing for “constipation type.” Despite the fact that I’d suffered from diarrhea in the past, my doctor suggested that this may have been “overflow diarrhea” from an underlying problem of constipation.

I finally had my answers – but what was a girl to do about them? According to Dr. Naem, it was time to flush out my colon and start over with an empty gut. And that meant laxatives. Lots and lots of laxatives.

For the cleanse, I purchased a bottle of magnesium citrate, which I’d been instructed to drink alongside two Dulcolax tablets to help flush out my colon. It only took about 90 minutes before I began to experience the symptoms of these laxatives.

The results lasted about 48 hours before my gut finally began to calm down and return to normal. But, arguably, my colon has been at its most “regular” since before I suffered from IBS at all.

After the cleanse, my doctor instructed me to begin mixing a capful of Miralax into a drink – my morning coffee, he suggested, though I’ve since begun to drink it with Gatorade so as not to ruin the sacred experience of coffee – each and every day. This practice has maintained the results of my colon cleanse for the past 2-3 weeks, and produced a radical difference in the quality and frequency of my bowel movements.

As I understand it, colon cleansing is a controversial topic in the medical field. While I don’t recommend you perform a colon cleanse without first talking to a qualified professional, I can certainly attest that my colon cleanse worked wonders for my IBS.

Frustrated gastro patients will try anything once – and for all the evidence behind the low FODMAP diet, this simple bowel regimen worked much better for me!

My First Endoscopy

Only, there was a catch: thanks to a twist of events in my gut health journey, I could no longer rule out celiac disease, despite previous tests that showed my IgA and IgG antibodies were normal.

My mom’s doctor began to suspect celiac disease in her, leading me to seek out the advice of a gastroenterologist as to whether I should be worried about my own gut health. Initial test results did not show evidence of celiac, but they did show that I was at high genetic risk, which could only mean one thing: my diagnosis (or lack thereof) must be confirmed via upper endoscopy.

Needless to say, I was terrified. Who wouldn’t be afraid of gagging in front of your doctor – or worse, experiencing the awkward discomfort of having a tube placed in your esophagus? In my case, I was most afraid of undergoing anesthesia, which I’d never done before – and, quite frankly, never expected to need to, outside of the standard wisdom tooth removal all my friends had undergone as teenagers.

To make matters worse, my endoscopy was scheduled far in advance, giving me plenty of time to worry prior to the procedure. The night before, I watched tons of YouTube videos to prepare myself for what to expect. I also could not eat for eight hours and could not drink for four hours prior to the scope.

When I arrived at the hospital, it took about an hour after my scheduled appointment time before the nurse called my name. Once she did, however, the procedure moved quickly. As usual, they took my height, weight, blood pressure and pulse. Then, they had me change into a gown and lie down on a bed.

As they placed IV fluids in my arm, I was so anxious that I began to quiver in fear – but the two nurses by my bedside did an extraordinary job talking me down and reassuring me that the process would be simple and painless.Then, it was go-time: the nurses wheeled my bed into the endoscopy room.

There, I got to quickly wave hello to my doctor and meet the NP who would be handling the anesthetic before being asked to roll onto my left side for the procedure. I barely remember anything past the NP inserting the anesthetic into my IV and the nurses asking me to bite down on a mouthpiece that would be used to insert the tube down my throat.

The next thing I knew, I had woken up in the recovery room with my boyfriend waiting by my bedside. Dr. Naem came to tell us that he had not found evidence of celiac and was 99% certain I did not have it – though technically, we had to wait for the biopsy results before we could be sure. (In fact, just yesterday, I received my results confirming I definitely do NOT have celiac disease!)

For the hour after the procedure, I felt a little woozy. David took me to get a milkshake, which I eagerly devoured. After that, I lost my appetite for most of the afternoon. About two hours later, the numbing anesthetic wore off and my throat began to kill. Luckily, the pain only lasted about a day. But, overall, the procedure was quick, relatively painless and more than worth it to relieve my anxiety and definitively rule out a diagnosis of celiac disease.

Gut Health Products + Resources

As usual, I’ll end this post on a positive note by sharing some of the products that helped me get through this stage of my gut health journey. Once again, I’ll share links so you can purchase some of the staples that saved my life (metaphorically, of course) during my experience with IBS!

  • Suja Digestive Wellness Shot. ($50 for 15, Suja Juice) When I recommend this shot, I do not recommend it for the taste! The shot contains a spicy burst of cayenne pepper, so it burns the whole way down (and trust me when I say, cayenne and pineapple juice make a horrible combination). That being said, these shots got my digestive system M-O-V-I-N-G! When your gut goes stagnant and you need to kick-start your metabolism again, I highly recommend these shots as a quick fix for your gut health woes. Just treat them like medicine, rather than a drink, and you’ll be fine. (My tip: they’re called shots for a reason – so pinch your nose and suck it up, buttercup! The faster you can throw it down, the easier the recovery.)
  • Robyn Youkilis’s Guide to Magical Digestion. (Free with Email) I’m not one for impractical, woo-woo wellness tips – but when a gut health practitioner shares evidence-based advice, I find it best to listen! Robyn’s free guide is full of common-sense tips you may not have thought of (for example, when’s the last time you paid attention to how thoroughly you’re chewing?). Robyn shares a delicious recipe for an aloe vera shot for soothing an angry, inflamed digestive tract. (And, for my fellow ED recovery warriors, I especially love that she points out that “I’m bloated” is often used as a synonym for “I feel fat,” expressing discomfort with our bodies rather than physical pain.)
  • The FODMAP Friendly Kitchen by Emma Hatcher. ($20, Amazon) I discovered this delicious cookbook of low-FODMAP recipes at my local library. Since I recently quit being vegan (post on that later), I appreciated the reintroduction to the vast variety of things one can enjoy on an IBS-friendly diet! My favorite recipe? Polenta with Burst Tomatoes and Mozzarella, which reminds me of my childhood spent frying polenta with my Polish-Italian Mom and Grandma. Mmm, mmm, mmm!
  • Rao’s Homemade Sensitive Formula Marinara Sauce. ($9, Rao’s) I finally splurged for the $9 jar of marinara that everyone with IBS has been talking about – and man, was it worth it. Quick, easy meals are hard to come by when you typically can’t eat anything that comes out of a box. Luckily, Rao’s Sensitive Formula is made without onion or garlic: two of the worst offenders when it comes to sneaky high-FODMAP ingredients! Mix it into some gluten-free pasta with parmesan or spread on a gluten-free pizza crust for a simple dish your whole family will appreciate.
  • Nature’s Fusions advanCBD Tincture in Mixed Berry. ($40, Nature’s Fusions) Before accepting my new job, I was a brand ambassador for Nature’s Fusions – and I can honestly say that their mixed berry flavored CBD tincture is 100% pure, THC-free and delicious! Though I take CBD for my anxiety, those of us with IBS know that the two often go hand-in-hand. In the event that your stress causes an IBS flareup, a couple drops of this edible CBD tincture will help your racing mind calm down naturally.

Can You Go Vegan in Eating Disorder Recovery?

I am more than five years into eating disorder recovery – so you can imagine how scary it was when I thought to myself the other day, “Maybe I’ll just go vegan again.”

To provide some background, I have been eating on the low FODMAP diet for IBS for the past several months. I’ve discovered a (genuine, medical) lactose and gluten intolerance that already makes it difficult for me to sustain my eating disorder recovery. And I recently started being vegetarian again after six months of eating whatever I wanted without question. So, when I recently ran out of lactase pills and thought “Hmmm, maybe I’ll just stop eating animal products altogether,” it brought my day to a screeching halt.

Surely, a radical statement that calls for cutting out entire food groups deserves some curious self-examination on my part. But does it warrant saying I’ve “relapsed” and seeking treatment for my eating disorder once again?

I did some research – for my own sake, and for my future clients’ – to find out what the answer was. Unsurprisingly, I found that there isn’t really a textbook, one-size-fits-all approach to going vegan in ED recovery.

Based on what I’ve read as well as my own experiences, here’s my take on going vegan in eating disorder recovery. I hope this helps you find peace in your own decision “to be or not to be” vegan – whatever that choice may be!

My Story

black and white dairy cow on green grasses during daytimeI first tried going vegan my senior year of high school, after watching the documentary Cowspiracy with my best friend and learning what a profound impact raising livestock has on our environment.  Before that, I had been vegetarian for six years, beginning when I was thirteen.

At those points in my life, my choice not to eat meat or animal products had nothing to do with my eating disorder. When I was fifteen, I adhered to a strict diet in an attempt to get down to my “goal weight” of 105 lbs. I cycled between orthorexic periods of restriction and “cheat days” where I would binge until my stomach hurt.

But I never questioned my decision to eat meat or not to eat meat: my love for animals was a part of who I was, and I thought my decision to be vegetarian/vegan said a lot about who I was.

In college, I quit the vegan diet, only to start it again my second semester of freshman year. My decision to go vegan the second time was deeply linked to my lactose intolerance and my GI symptoms, which you can read more about in my health update here.

You see, I also developed IBS sometime in high school, around the same time that I was dealing with my eating disorder and my decision to be vegetarian/vegan. However, my symptoms would not become intolerable until earlier this year, my third and final year of college, when I would finally see a GI doctor and get diagnosed.

After keeping a food diary, I discovered that a lot of my stomach issues were tied to my decision to start eating meat again as a second-year college student. So, I became vegetarian again, occasionally breaking with that choice at restaurants or family dinners, and found that it helped my IBS symptoms tremendously.

However, I still struggled with my lactose intolerance. Lactase pills helped with the maldigestion and symptoms I experienced when eating dairy products, but they were expensive and made me feel limited in my food choices. I felt like if I went somewhere without my Lactaid, I wasn’t “allowed” to have dairy.

And that’s when the thought popped into my head: “What if I just went vegan again?” I’d save the hassle of buying Lactaid pills every month – and feel like my avoidance of dairy was my “choice,” rather than a product of my IBS. Which is exactly how I ended up starting a vegan diet again – and exactly how I wound up writing this article!

The Facts

As I mentioned previously, I was honestly a little bit frightened when I found myself considering a vegan diet again. After all, I was already worried that eating low FODMAP was causing me to fall into restrictive eating patterns – and I didn’t want veganism to be a “sign” that I was relapsing.

So, to make sure what I was doing was safe, healthy and, above all, right for me, I embarked on a little bit of research about being vegan in eating disorder recovery. In that process, I found that as with anything else, there are both pros and cons to going vegan in eating disorder recovery. Namely….

Pros

  • When done right, veganism is a moral and ethical lifestyle choice, NOT a fad diet. Almost 3x the number of people who go vegan for “health reasons” go vegan for moral concerns about animal rights, according to a global survey conducted in 2019. And it’s no wonder, given the dire living conditions of livestock raised for slaughter in the meat industry!
  • An additional 10% do it for the environment, according to the same survey – which makes sense when you think about it. If you’re passionate about the environment, a vegan diet offers reduced land and water consumption and a smaller carbon footprint. In fact, one medical study shows the vegan diet’s environmental impact is 40-80% smaller than a traditional, omnivorous diet.
  • “Vegan” is NOT a synonym for “healthy” or “low-fat” or “low-calorie.” Duncan Hynes chocolate frosting, Oreo cookies, Fruit by the Foot, Lays Original potato chips, Sour Patch Kids and Ritz crackers are all vegan foods, but not exactly nutritious. Thus, you can still challenge yourself with “fear foods” by seeking out vegan versions of your favorite junk foods or “accidentally vegan” products you already love.
  • For those of us whose eating disorders have been linked to eating vegan in the past, embarking on a vegan diet again, under the advisement of a therapist, can be a way of shunning false “comforts” and ceasing to correlate veganism with your ED. With a little soul searching and a lot of hard work, you can break your mental association between a vegan diet and a restrictive eating pattern, so that veganism is no longer viewed solely as a means of controlling your weight.

Cons

  • Being vegetarian or vegan is a socially acceptable reason to turn down “fear foods.” Alternatively, openly choosing to starve oneself may raise concern from friends and relatives. There is some evidence to show that some people with EDs may adopt vegetarian or vegan labels as a way to avoid certain foods offered to them in social situations.
  • There is a community of researchers who think vegetarian and vegan diets may “mask” ED behaviors, though it is hard to say if they are objectively “right.” One study found that self-reported vegetarianism in college-aged women is a marker for restrictive eating behaviors.
  • The vegan community can be triggering for people recovering from EDs. Jordan Younger, author of Breaking Vegan (who is vegan again, by the way), puts it perfectly when she calls it “vegan bullying, elitism and judgment” as well as “radicalism.” If you “slip up” or leave the lifestyle for any reason, the PETA worshipers will always be there, ready to chew your ass out.
  • It’s difficult to gain weight on a vegan diet, which tends to be high in carbs and low in protein in fat – which is why I DO NOT endorse a vegan diet for anyone who is underweight, in residential treatment or hospitalized for an eating disorder. In those initial steps of recovery, your focus needs to be on your physical state. You can worry about saving the animals when YOUR life is saved!
  • Many residential treatment programs will not allow you to maintain a vegetarian or vegan diet, so it may be difficult to find a professional who will work with your restrictions. Usually, this is not because your vegetarianism or veganism causes an eating disorder, per say, but because the restrictive nature of a vegetarian or vegan diet may be triggering for some of the other individuals utilizing that program. Still other patients may ask why your restricted eating patterns are tolerated, but theirs are not – thus hindering their own recovery process while in treatment.

My Advice

adult golden retriever taking a bathAfter hours of research, my conclusion about whether or not you can go vegan in eating disorder recovery is….it depends. “On what?” you might be thinking. Well, I’m no doctor – but here’s my take on when you should (and shouldn’t) consider a vegan lifestyle in ED recovery:

  • DO have a clear reason for going vegan. If you’re feeling a strong urge to go vegan, but can’t clearly articulate your reasons for doing so, it might be fueled by an unconscious ED mindset. Alternatively, if you have a clear reason for going vegan that isn’t motivated by weight or body image control – for example, ethical concerns for animals or the environment – focusing on that goal will prevent you from spiraling out of control and into a restrictive eating pattern.
  • DON’T go vegan if you’re not in remission, or if you’ve had a recent relapse. Unfortunately, the opinion of many experts is that you should not embark on a restrictive eating pattern until you have been stable in your recovery for many months, or even years.
  • DO allow yourself flexibility on a vegan diet. In my opinion, there’s nothing worse for ED recovery than hard-and-fast food rules. That’s why many recovery warriors turned vegans shy away from the “vegan” label, and instead choose to call themselves “plant-based” or “vegan-ish.” In other words, I believe that if you’re craving a Wendy’s Baconater, the healthiest option for your mental state is to eat the damn Baconater and move on with your life – and your vegan diet – the next day!
  • DON’T engage with radical veganism. Basically, stay away from animal rights marches, PETA events and the comments section of literally any vegan YouTube video or social media post ever. There is a small, yet significant subset of the vegan community dedicated to tearing apart anyone who questions or “cheats on” their vegan lifestyle. As someone in ED recovery, you may be more vulnerable to this type of radical language – so instead of training yourself not to fall for it, I say just avoid the “vegan shaming” altogether. After all, most people who love animals or care about the environment aren’t willing to go vegan – so you’re already making more of an effort than most by eating vegan 80-90% of the time! (And vegan or not, you certainly don’t deserve to be cyberbullied.)
  • DO keep a food and mood journal like this one, at least for the first few weeks of your vegan transition. Keep a careful watch on how selecting vegan foods affects your mindset. If you begin to notice old thoughts or behaviors cropping up as you transition to a vegan diet, it may be a sign that you’re not at a good point in your recovery to go vegan, or that going vegan may be too triggering for you to undertake at this point in time.
  • DON’T go vegan without telling your doctor or therapist. Finally, you should always make your healthcare team aware of any choices you decide to make in your diet – especially if you are in recovery. Your therapist and doctor can both help you decide if a vegan diet is right for you at this point in your ED treatment. Plus, they can hold you accountable by paying attention to your thought patterns and weight respectively, in order to alert you if they feel your vegan diet may be triggering a relapse.

What are your thoughts on adopting a vegan diet in eating disorder recovery? Tweet me your thoughts @cozycounselor!

Gut Health Update + My Favorite Products for Gastrointestinal Flareups!

Disclaimer: This post is my personal experience and is NOT intended as medical advice in any way. I am not a doctor, so please consult with a medical professional if you have any concerns about your overall health and take what I say with a grain of salt!

When I started this blog, this was not the kind of post I imagined writing at all. Because I wanted it to be a professional blog, I did not have a mind to share anything personal about my health journey, beyond what I’ve experienced as a mental health and eating disorder patient.

But that all changed when, as I like to joke with my friends and David, my colon started trying to kill me. As with most things in life, I couldn’t predict that this was going to happen to me. I never thought I would feel so sick on such a regular basis, or that I would ever identify with the chronic illness and #spoonielife crowd.

Yet, here we are….and this post is all about how I got there. In a matter of several short months, I’ve gone from being a typical twenty-something who loves sipping rose and binge-watching Game of Thrones to an occasional invalid with the joint pain of a 70-year-old woman. (Yikes.)

So, how did this happen? Let’s start from the beginning. Oh, and warning: if you’re squeamish, skip the poop talk and scroll right to the bottom, where I list my favorite products for promoting gut health and soothing chronic pain!

Before College….

I have always known my gut was more, er, temperamental than most other kids’ my age. The first time I had to take laxatives, I was twelve or thirteen. I had to miss school because I felt so shitty (literally and figuratively, LOL). I remember this vividly – because the next day, I pulled myself together to go to a model U.N. conference at Bentley University.

Another time, I came down with terrible diarrhea that eventually turned into a black, tarry stool. In retrospect, that would have been grounds enough for concern….but being young, I waited for it to sort itself out, and eventually, it did.

The next time I felt like, well, shit, I was in high school and came down with the worst diarrhea I’d ever had in my life. Eventually, there was nothing left to pass but a thin, grayish-white mucus and bits of undigested food. It went away in a couple of days, so I stayed home to rest and chalked it up to food poisoning.

Early College….

After that, my digestive system seemed to miraculously heal until I was a freshman in college. I was eighteen when I saw blood in my stool for the first time. Immediately, I called my parents, who picked me up from college and drove me home to see my primary care doctor. (It might be a good time to mention that my parents only live 45 minutes away from my university.)

In an awkward experience I’ll never forget, the doctor inserted a gloved finger up my butt and told me I had an anal fissure. I asked what I should do and she replied bluntly, “Keep your stool soft.” So, I asked her what I should do if it happened again. She merely repeated, “Keep your stool soft.” I could tell I wasn’t welcome to ask any further questions, so I went home with a sigh of relief and vowed to start drinking more water. If only that had solved all my problems….

And Now….

I’ve experienced gut health problems left and right throughout the past three years of college, but over the past few months, my problems really started to rear their ugly head. For many people with chronic illnesses, our DNA predisposes us to the illness, but environmental stress activates the gene – so given the traumatic experience of cutting contact with my dad this summer and living through the Kavanaugh hearings as a sexual assault survivor in the fall, it’s no surprise that this year has been my worst one yet.

About two or three months ago, I saw my doctor for abdominal pain and chronic constipation, alternated with bouts of diarrhea. Since I noticed my symptoms were linked to gluten and lactose intolerance, my doctor tested my IgA and IgG antibodies to determine if I had celiac disease. As it turns out, I didn’t – so I was given a rough diagnosis of IBS instead, and told to modify my diet and come back if I still experienced symptoms.

Shortly after, I began working with a nutritionist named Liz at the Boston University Sargent Nutrition Center. All BU students get one free appointment, and if you have a GI condition or food allergy you can get up to five free sessions; insurance is needed for any sessions thereafter. If you go to BU, I highly recommend taking advantage of this service! My nutritionist has helped me overcome problematic attitudes and identify trigger foods as I started the low FODMAP diet.

However, despite my AMAZING experience with the Sargent Nutrition Center, not even the low FODMAP diet could stop my symptoms from worsening. Eventually, my stomach cramps got so bad that I was missing classes to stay in bed all day at least once a week. My appetite decreased, I was chronically constipated, eating too much food or overly-sweet foods made me nauseous and I even debated going to the ER at one point because the pain was so bad.

All these symptoms, combined with the presence of blood and mucus in my stool – an alarm symptom that isn’t typically seen with IBS, though it’s not impossible if you have an anal fissure or hemorrhoids – led me to schedule an appointment with a GI doctor in Boston. Since Crohn’s disease runs in my family (my mom’s uncle has it), I was concerned my severe symptoms might mean more than mere IBS.

In the meantime, I visited my student health center, where they ran more tests that, according to my doctor, came back normal (though this hasn’t necessarily matched up with the research I’ve done independently); however, I am still waiting for them to run a fecal occult blood test since I haven’t returned my sample yet. (Below, I’ll go into more detail about all the medical tests I’ve had thus far, for anyone who is curious or suspects they may have a GI condition and wants to follow my journey.)

Despite this, I continue to feel “ill” even though my sickness isn’t showing up on tests. I’m fatigued no matter how much sleep I get, my joints hurt, I can only eat small portions of food at a time and I still suffer abdominal pain and altered bowel habits, sometimes with blood or mucus in my stool.

Emotionally, this has been the hardest part: I can feel that something is wrong, and I just want someone to see me for the way I feel instead of downplaying my symptoms. Right now, I’m just impatient to see the specialist, but since they can’t get me in until February, that seems to be a long-time coming. If my symptoms get worse in the meantime, where I have severe pain or lose lots of blood, I have been instructed to visit the ER – but hopefully, it won’t come to that!

Medical Testing So Far

As I mentioned before, I suspect I may have some form of IBD, such as Crohn’s disease, which runs in my family. Unfortunately, these illnesses – like many “invisible” chronic illnesses – are difficult to diagnose and identify. Additionally, depending on the source, different numbers are considered “normal” in some tests.

So, in case you are on a similar journey as me or are simply curious about the path toward diagnosis, I’m chronicling my health history as well as any tests I’ve had. So far, I’ve had the following tests:

  • IgA and IgG antibodies: tests for celiac disease.
  • Complete blood count (CBC): gives an overview of red and white blood cells.
  • Metabolic panel: reports electrolytes to give a picture of kidney and liver function.
  • ESR/SED rate: measures how long it takes red blood cells to settle at the bottom of a test tube, to detect inflammation.

None of these tests revealed any abnormalities; however, my doctor says this does not mean I do not have IBD. In many cases, imaging is the most reliable way to determine if you have it.

Last But Not Least….My Favorite Products!

Now that I’ve given you a long – but informative, I hope! – health update, I promised I’d share with you some of the products that have helped me deal with this difficult time in my life. I’ll also share links so you can purchase these products for yourself if you are struggling and interested!

  • Abercrombie & Fitch jogger sweatpants. When you’re as bloated and crampy as I have been recently, the last thing you want to do is squeeze into your skinny jeans. These sweatpants are so soft and comfy – I swear, I’ve worn them every day for the past two weeks! (Don’t worry, I’ve washed them.)
  • Hooty & Friends microwavable heating pad. I purchased this owl-shaped heating pad at a TJ Maxx in my hometown back in high school, and it’s been a staple in dealing with pain ever since. I like using this on my stomach to help with stomach cramps and painful bloating, but it’s also useful for joint pain.
  • BKR water bottle. When dealing with constipation, staying hydrated is key. My BKR bottle is the cutest way to stay hydrated on the go – plus, the kit I purchased comes with a handy brush and replacement bottles for easy cleaning.
  • Cara app. Not technically a product since it’s free to use, but the Cara app has been my go-to for tracking every symptom. The app is specifically designed for people with IBS or IBD to track symptoms, stress and food. It even correlates things like the number of steps you take, how stressed you are and what you ate to your symptoms, so you can easily uncover ways to improve them.
  • Up4 Probiotic. I’ve tried a lot of probiotics over the years, but I bought Up4 probiotics after taking the SmartGut test (more on that next!) of my microbiome. I noticed I was low on bifidobacterium, so I looked for a probiotic that contains bifidobacterium and lactobacillus, which are two strains important for your gut health. I like this probiotic more than any other I’ve tried precisely because it is a no-bullshit product that only contains simple ingredients: two strains of bacteria and vegetable cellulose capsules.
  • SmartGut by Ubiome. If you have IBS, IBD or various gut health symptoms, you might be eligible for the SmartGut test by Ubiome. This company makes simple at-home tests of your microbiome and can detect both pathogens associated with infectious diarrhea and strains connected to food intolerances, IBS, IBD and other medical conditions. As a result, I’ve found out that I’m intolerant to lactose and gluten and that I am extremely low in the strain bifidobacterium, which confers many positive health benefits. The best part? My insurance completely covers it through Ubiome’s patient assistance program, designed for people with low-incomes. They send me a test every two weeks, entirely for free, that allows me to monitor my microbiome and how it changes over time. This is truly the medicine of the future, people!

The Surprising Connection Between Digestion and Mental Health

IBS is almost as common as anxiety – making it unsurprising that the two conditions are linked. Could rebalancing your gut be the answer to your mental health challenges? Read on to find out.

Recently, after years of on-again, off-again constipation, bloating and acid reflux, I finally received a diagnosis for my elusive digestive problems: Irritable Bowel Syndrome (IBS). When I found out, it was like everything I’d always known suddenly fell into place. After all, I’ve had anxiety and intestinal flareups all my life – but I never thought to connect the two until I got my diagnosis.

One in five adults in the United States has IBS, making it almost as common as anxiety. However, many people don’t think to connect their digestive symptoms to the stress and anxiety they experience on a daily basis. Since I discovered the connection between the two, I’ve been doing everything I can to learn how improving my digestive health can help improve my mental health. From books to journal articles to magazine columns, I will read anything if it has those two magical words – “gut” and “brain” – in the title.

I’ve also recently started the low FODMAP diet to heal my body from my IBS. In the process, I’ve strangely noticed that my anxiety doesn’t seem as bad as it used to be. Considering that most of our serotonin is produced in our gut, this makes total and complete sense from a scientific perspective. Yet as an aspiring mental health professional, I find it completely shocking that I went so long without anyone drawing a connection between my gastrointestinal symptoms and my anxiety.

Part of the issue was, admittedly, my reluctance to seek help; after all, constipation and bloating are hardly glamorous issues. It used to be that I’d rather talk about NASCAR than discuss my bowel habits (which, coming from me, is really saying something!). But I had also never heard of IBS until I was in college, even though I’d had these symptoms for far longer.

This paragraph might be TMI for some, but I remember once, in high school, during the stress of the school play, I suffered from such bad constipation that I had to take laxatives (and a day off school) to recover. After that, I was drinking Milk of Magnesia at least once a month to relieve the pain.

When I got older and developed orthorexic behavior, it was all I could do not to obsess over the constant bloating in my lower abdomen. No matter how many minutes I planked or what I cut out of my diet, I could never achieve those perfectly flat abs like I saw on all the Instagram stars and YouTube icons I idolized so much.

As a sophomore in high school, I was so bloated that I cried trying on my prom dress and, feeling how tight it was, convinced myself that I was “too fat” to go at all. This led to a downward spiral of orthorexia, bulimia and anxiety, which – knowing what I know now – obviously exacerbated the problem. (Eventually, I exchanged the dress for a different size and went, you would never know from the pictures just how damaged my body image, or my gut, truly was.)

For so long, I convinced myself there was something wrong with me or the way my body was built. Then, I spent several long years recovering from my poor body image, anxiety and depression, and realized the problem wasn’t in my weight, but in my gut.

Developing intolerances to lactose and gluten was the last straw: I finally sought help from my doctor, who told me I – like 1 in 5 Americans – most likely had IBS. Suddenly, it all made sense why I always looked three months pregnant in photos, or why my bowel habits were so irregular, fluctuating from nonexistent one week to gas and diarrhea the next. Soon, I also learned that there was a connection between IBS, stress and anxiety, which validated what I had always known: anxiety is a physical disorder, just as much as a mental one.

If this sounds like you or someone you know – or if you’re simply interested in improving your overall gut health – I highly encourage you to read on for tips and tricks on healing your gut for mental health! (As always, I am not a doctor, and you should consult with your GP before making any drastic changes to your health regime.) Below, I’ll share some of the wisdom I’ve learned throughout my journey with IBS, the diet that works for me and some tips and tricks I’ve been meaning to try for giving your gut a much-needed boost.

Gut Health for Dummies

A well-functioning digestive system is one of the cornerstones of good overall health. Because it’s where most of the body’s serotonin is produced, it especially has strong ties to our mental health – a phenomenon doctors and medical researchers like to call the “gut-brain axis.”

But which organs are we talking about when we say the word “gut?” More importantly, how can we tell whether our gut health is good or bad? (While you’d think it would be obvious, many signs of poor gut health are much subtler than pain or erratic bowel movements!) Well, for the purposes of this article, I will use the term “gut” to refer both to your GI tract and to the diverse microbiome that calls it home.

The GI tract is the system of organs that runs from your esophagus down to your anus – in other words, the path your food travels through as it is being broken down by your body. This starts with the esophagus, followed by the stomach, small intestine, large intestine and rectum (your “bowels”). Your anus is the point of exit for any excess waste that hasn’t been used by the end of this process. (See below for a detailed diagram of the GI tract.)

digestion

Within this “gut” of ours, each of us carries as many as 2 kg of friendly bacteria – or what we like to call your “gut microbiome.” We each have a unique breakdown of species populating our gut, which results in small differences between individuals; for example, food intolerances like mine are strongly linked to a lack of “helper” bacteria that break down lactose or gluten.

The composition of your gut is affected by your genetics, as well as environmental factors like whether you were delivered vaginally, whether you were breastfed and whether you played outside often as a child. All these experiences expose us to different kinds of friendly bacteria, which continue to populate our gut and affect our bodies as we grow up.

Unfortunately, it’s difficult to change your microbiome – but you can do it both by creating a positive environment for healthy bacteria to thrive in and by reintroducing positive flora to your gut. In mild cases of gut dysbiosis (a fancy term for “imbalance”), this might mean taking a probiotic or upping your intake of fermented foods; in serious cases, such as IBD or chronic infection, treatment could even include a fecal matter transplant, which transfers bacteria from a healthy person’s gut to your own.

When people speak of “healing” your gut, this is generally what they mean. Not only do you want to minimize the inflammatory conditions in your gut, making it easier for healthy bacteria to thrive there, but you also want to introduce bacteria to your body and give it the opportunity to grow. So, feel free to pass this wisdom on to the moms in your life: a little dirt can actually be a good thing – at least as far as your gut is concerned!

So You Think You Have IBS…

“Yes!” you scream at your computer, knowing full well that I can’t really hear you. “That sounds just like me. I must have IBS, too!” Now, you’re probably wondering “So, what next?” Well, after making an appointment with your doctor to confirm the diagnosis (and rule out any more serious gastrointestinal conditions, such as Crohn’s, ulcerative colitis or celiac disease), there are a couple of steps you can take to help yourself heal faster.

The Low FODMAP Diet

The number one dietary change recommended for IBS patients is cutting out something called “FODMAPs.” FODMAP stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols” – but if you’ve been on this diet before, you know it pretty much stands for “I can’t eat anything that isn’t sold for $10 at Whole Foods.”

I say this because on the low FODMAP diet, you can only have a limited number of fruits and vegetables, gluten-free grain products, lactose-free dairy products and most kinds of meat and fish. Eating gluten-free isn’t exactly great for one’s wallet – but then again, you can’t really put a price on the bliss you feel from not having to spend half your life in-and-out of bathroom stalls anymore.

Below, I’ve copied the chart I use to know which foods I can and can’t have on the low FODMAP diet. While you’re getting used to the diet, I highly recommend you print it out and post it on your fridge (or somewhere else in your kitchen) for easy reference!

fodmaps

Source: Monash FODMAP

 

On the go, the app called “The Low Fodmap Diet for IBS” only costs $0.99, and provides a simple searchable database of foods and their FODMAP contents, complete with a rating of Low, Medium or High FODMAP next to each food.

Finally, there are tons of bloggers who have posted delicious low FODMAP recipes on Pinterest – I especially love Fun Without FODMAPs – which makes Pinterest an amazing resource to bookmark for meal planning for IBS.

If you’re new to the low FODMAP diet, DO NOT PANIC! Though it looks restrictive at first, there are still so many delicious foods you can eat sans FODMAPs – not to mention that it really, truly does help reset your digestive system, banish bloat and get you “regular” again (if you know what I mean).

Still don’t believe me? Here are some typical snacks and meals I will eat in a day on the low FODMAP diet. (I think I eat pretty normally still!)

Breakfast

  • Two eggs, fried in grassfed butter, with salt and pepper
  • Udi’s gluten-free white bread, toasted, with grassfed butter (and sometimes a low FODMAP strawberry jam)
  • Lactose-free yogurt – I love the one by Green Valley Creamery!
  • Cheerios (which are now 100% gluten-free! Woohoo!) with Lactaid milk and sliced strawberries or raspberries

Lunch/Dinner

  • Turkey and lettuce on Udi’s gluten-free white bread with a side of grapes
  • Quinoa with tomatoes, bell peppers, cucumbers and feta cheese, drizzled with a little bit of EVOO
  • Brown rice spaghetti with grassfed butter and parmesan cheese
  • Amy’s gluten-free macaroni and cheese (with two lactase pills to aid my digestion)
  • Bob’s Red Mill gluten-free pizza crust with sliced tomatoes, fresh mozzarella and fresh basil

Snacks

  • Dunkin’ caramel iced coffee with cream only
  • Gluten-free cookies (Trader Joe’s has delicious ones!) with a glass of vanilla almond milk (or coffee!)
  • Bob’s Red Mill oatmeal with Justin’s almond butter and sliced strawberries or raspberries
  • Gluten-free crackers (I like Back to Nature or Crunchmaster) with brie or cheddar
  • Lactose-free yogurt with sliced strawberries or raspberries
  • Annie’s gluten-free “bunny grahams” in cocoa and vanilla
  • Banana with Justin’s almond butter packet
  • Fun Without FODMAPs’s low-FODMAP chocolate chip pumpkin bread
  • Bobo’s oatmeal bars

Tips for Overall Gut Health

Besides changing your diet to reflect your diagnosis, there are many other steps you can take to improve your gut health that aren’t related to what you eat. Believe it or not, many of the habits we take part in every day have consequences for our overall gut health. Here are some small adjustments you can make to start a more gut-friendly routine for your body!

  • Take a probiotic. Experts recommend taking 10 billion CFUs of a probiotic containing Lactobacillus and/or Bifidobacterium. (If you have lactose or gluten-intolerance like I do, Bifidobacterium deficiency may be to blame!) A high number of CFUs (“Colony-Forming Units”) is key, since many bacteria will die before you take them. My roommate stores hers in the fridge – no clue if this helps or not, but I’m on board with it. I recommend up4’s Adult Probiotic Supplement, which contains both strains and is more affordable than many probiotics on the market.
  • Dry brush. I love dry-brushing for stimulating circulation and digestion. Using a dry brush, brush your skin upwards with firm motions toward your heart. This gets your blood pumping and all those toxins moving down and out, stimulating healthy digestion!
  • Drink bone broth. Collagen, the protein found in bone broth that makes it so darn good for you, has gotten a lot of buzz lately. Drinking this warm beverage will not only keep you toasty on chilly winter days, but also help soothe and heal your intestines from the inside-out.
  • Chug more water. If you suffer from constipation-type IBS like I do, you’ll probably hear lots of people say “Eat more fiber!” However, eating more fiber doesn’t help unless you’re also drinking the appropriate amount of water. On the other hand, if you’re dehydrated, your stools will have less bulk, be harder to pass and may even lead to painful, bleeding anal fissures (which, I know from experience, can cause quite the health scare!).
  • Test your microbiome. The SmartGut test by uBiome is covered by most insurances, and will tell you what bacterial species your gut is most abundant in – and lacking. Its findings have implications for food intolerances like lactose and gluten, and can also identify species linked to Crohn’s disease, ulcerative colitis, IBS and more.

 

 

Eating Right for E.D. Recovery: A Crash Course in Intuitive Eating

Eating disorder recovery presents many challenges to patients struggling with anorexia, bulimia, binge-eating disorder and orthorexia. Here’s one method of learning to eat normally again – it’s called intuitive eating, and it will teach you to eat only when you’re hungry and stop when you’re full.

I have always been interested in nutrition – not as a career choice, but as a personal hobby of mine. Maybe I’m just a nerd, but I’ve always loved reading about different vitamins, minerals and supplements that help nourish your body and mind. I actually enjoy learning about how different foods affect my body, what the benefits of healthy substitutes are and why moderation is key to eating a balanced diet. In this sense, my fetish for nutritional science has served my body and mind well.

My interest in nutrition is also a double-edged sword. You probably saw this coming, but as a teenage girl growing up in a high school where cliques and gossip prevailed, I developed many unhealthy eating habits that I would now describe as disordered. More specifically, I suffered from a pattern of orthorexic, anorexic and binge-eating behavior: counting calories, being afraid to eat “the wrong” foods and eating sweets to the point of sickness on my “cheat” days because I just wasn’t used to allowing myself to give into my cravings.

I’ll never forget the day I tried on my junior prom dress in front of the mirror and started crying because it fit more snugly than when I’d bought it a year before. I was already trying to recover from my disordered eating patterns, trying to rid foods of mental labels like “good” and “bad” – and though it was a step in the right direction, I didn’t realize that weight gain was inevitable when recovering from disordered eating. I was uncomfortable in my new body and, more importantly, uncomfortable with myself.

Knowing what I know now about mental illness and my genetic predisposition to anorexia, I realize that I was most likely struggling with an eating disorder at that time in my life. Like many young women, I didn’t seek help because 1. I was afraid of what my parents would think, 2. didn’t feel comfortable opening up to them and 3. thought I could handle my illness on my own. Luckily, though I was struggling in secret, I found the book Eat What You Love, Love What You Eat, which introduced me to intuitive eating for the first time in my life.

This book was a complete game-changer in my recovery from disordered eating. I completely credit intuitive eating with gifting me a better relationship with food, my body and myself. And now, I want to share that gift with you – not just because it helped me with disordered eating, but also because it allowed me the freedom to enjoy my life sans guilt, sans dieting.

Because I no longer have to plan my meals down to the minutiae, or check menus ahead of time to make sure they have something I’m “allowed” to eat, I have the flexibility to go to parties, eat out with my friends and enjoy traditional meals while traveling abroad without fear of consequence.

To me, eating has become a daily ritual I actually enjoy. Not only is it something I do to nourish and fuel my body, but it’s also fun to try new foods! (Since then, I’ve eaten paella in Spain, enjoyed gourmet chocolate in Switzerland and even tried lobster for the first time – meals that would have been unthinkable to me way back when!) And I want you to be able to enjoy food, and your life, the same way – because it truly is a precious gift to be able to share those dishes and moments with the people you love.

What is Intuitive Eating?

You probably won’t read about intuitive eating in your favorite beauty and lifestyle magazines. Instead, you’ll probably see headlines like “What to Eat for a Flat Tummy” or “The Ultimate Beach Body Diet.” Basically, intuitive (or sometimes “mindful”) eating is the complete antithesis to that style of dieting.

Instead, intuitive eating stresses being present in the moment, letting your intuition (hence “intuitive eating”) guide you toward the right foods and trusting your body to do what’s right for it. In other words, if you’re craving a giant Frappuccino and a blueberry scone, let yourself have the goddamn Starbucks! This is what we call normal eating, or returning back to the patterns of eating you had before society and the media taught you your body wasn’t good enough the way it is. This philosophy can be summed up in two basic principles of mindful eating: 1. eat when you’re hungry and 2. stop when you’re full.

Why People Don’t Eat Intuitively

Intuitive eaters choose to eat this way in part because intuitive eating is the “default” setting for the human body. Think of it this way: when you’re born, babies cry when they’re hungry. Then they drink milk until they’re full – and only until they’re full. Unlike many of us as adults, babies naturally know when to stop eating. So, why is it that a baby stops eating when it’s full, but I feel compelled to finish the entire pint of Ben and Jerry’s – no matter how hungry I actually am?

There are a couple important factors that play into satiety and fullness, and why we learn to continue eating even when we’re not hungry (or, in the case of anorexia, refuse to eat despite our body’s hunger cues):

  • Firstly, adults respond to media messaging that, through classical conditioning, basically teaches them to be hungry when advertising tells them to be hungry. In other words, anytime you see a Dunkin’ Donuts ad, you’re stomach is probably gonna growl – regardless of whether you ate a snack two hours ago or two minutes ago. (I used to be an ad major – I would know!)
  • Secondly, adults’ emotions are much more complex than babies’ – after all, you don’t see babies sobbing into a pizza box when they’ve just gotten dumped by their boyfriends. A baby’s life consists of eating, sleeping, crying and pooping, so of course they’re not going to have the same rich emotional lives that we do. However, as a result, they also don’t fall prey to the emotional eating habits that many of us develop as adults. Thanks to media messaging and cultural practices, we don’t eat just when we’re hungry anymore – we also eat when we’re happy, sad, bored or angry, too.
  • Last but not least, we in America eat some pretty sugary, unhealthy food. In fact, even foods we tend to assume are healthy often contain hidden sugars – and don’t even get me started on Sweet ‘n’ Low or Splenda. There’s pretty compelling evidence to show that sugars – and their substitutes – are everywhere. The thing is, the fact that sugar is everywhere makes us pretty much addicted – to the point where sweeter foods don’t actually make us full, and eating more sugar actually causes us to crave more and more sweets. And, as you can probably guess, that doesn’t exactly bode well for mindful eating.

Tips for Eating Intuitively

Thankfully, we can adopt specific skills to help us return to our roots as intuitive eaters. The problem is, now that we’ve learned these unhealthy habits, unlearning them is often frustratingly difficult! That’s where these tips come in: to make it easier for you to recover from disordered, emotional eating habits and start eating intuitively.

If you’re the kind of person (like me) who needs the rules spelled out for you before you dive into something like this, I go into further detail about the steps to intuitive eating below…

(Side note: if you’re interested in learning more about intuitive eating as a practice, I highly recommend this video by Becca Bristow – Becca is a YouTuber and Registered Dietitian whose channel is dedicated to healthy, intuitive eating. She’s also pregnant with her first child – congrats, Becca!)

  1. Eat when you’re hungry, stop when you’re full. As I mentioned previously, this is truly the core of any intuitive eating practice. At first glance, you’re probably going to think, “Pssh, this is easy – I’ve got this!” Once you start eating intuitively, however, you’ll realize just how deeply your emotional and media-driven hunger cues have impacted your relationship with food.
  2. Learn your personal hunger cues. Accordingly, the greatest challenge to the “eat when you’re hungry, stop when you’re full” mentality is learning to recognize what hunger actually is. This means something different for everyone: since hunger is biological (or, at least, the hunger we look to satisfy with intuitive eating is), your body gives off its own unique signs and symptoms when you need food. This can take the form of lightheadedness, stomachaches or growls, irritability, fatigue or even feeling more emotional than usual.
  3. Pay attention to emotional eating triggers. Likewise, also pay attention to times when you want to eat but don’t feel your biological hunger cues – these are what we call “emotional eating triggers,” and may include anything from a stressful day at work, to a Special K commercial, to downright boredom. Regardless, these are the times your body is tricking you into believing you’re hungry – and subsequently overeating – to compensate for some kind of emotion. And when you notice yourself reaching for a snack to satiate an emotional, rather than biological, hunger, I challenge you to reach for a coping strategy – like reading a favorite book, taking a hot bath or making yourself a steaming cup of coffee or tea – instead of the refrigerator handle. This is where progress is truly made toward intuitive eating!
  4. Don’t multitask during meals. This was the hardest intuitive eating practice for me to adopt, and is one I still struggle with every day. By definition, intuitive eating requires you to be fully present with your food – which means no Netflix-and-chill with your dinner, or munching on Cheez-Its while chilling in the library. When you’re busy, the idea of forfeiting an hour of your day to focus on food and food alone can be daunting, but it’s also incredibly important to pay full attention to your body and plate so you can be tuned in to your hunger cues and satiety.
  5. Last but not least, don’t ignore hunger cues. For those of us suffering from disordered eating – especially anorexia – learning to acknowledge and honor hunger cues, rather than ignoring them, is the fundamental baseline necessary for recovery. It can be difficult to rewire a brain that’s programmed to think of the calorie count and relative “good” or “badness” of the PB&J you’re about to eat, rather than your growling stomach or aching head. But I promise you, it is possible to recover from your eating disorder and achieve intuitive eating…and it all starts with the decision to listen to, and make peace with, your body – right here, right now.

 

Thinking of trying intuitive eating? Let us know how it goes in the comments below!