Thursday, 14 November 2013

A Day in the Life - What a Gut Healing Diet Looks Like

Aka what the heck can I eat!?

Seems like so far in this blog I've written about what's wrong with my tummy and what I can't eat! But after the initial information onslaught, eating a gut healing diet isn't all doom and gloom. I thought to demonstrate my point I'd share my daily eating habits, tips, tricks and essential pantry items. 

All my meals are interchangeable and I eat lunch and dinner stuff for breakfast (which took a while to get used to) and when I snack it’s still based around what looks like a balanced meal.

I currently avoid nightshades, fruits, vegetables high in FODMAPS, eggs, chocolate and am trying my very best to avoid coffee! I eat this way due to having leaky gut which I've mentioned here. Recently I’ve also dropped starches (even though I'm a BIG fan of sweet potatoes) because of SIBO which I've written about here. I don’t use weird flours, eat paleo treat foods or expensive pre-packaged meals. I keep it real and simple.

I’ve been eating paleo for about 6 years on and off and pretty consistently the last 2 years prior to arriving at this point. I’m an ex vegetarian, vegan and raw fooder over a period of 10+ years, this diet was never right for me and is why I’ve chosen to continue on my new primal based path, making ethical food choices along the way.    

These are the foods I currently base my diet around:

Fats – Coconut oil, ghee (homemade), duck fat, olive oil (if I could find a good source of lard or tallow I’d use them too).
Proteins – Chicken: drumsticks, thighs, maryland, tenderloins, mince, breast. Beef: fillets, rounds, steaks, mince. Lamb: cutlets, leg steaks, mince. Pork; is it bad that I only like bacon!? Free range and natural of course. Fish and seafood. I try and get my protein grass fed, pasture raised, free range or wild caught as much as possible.
Vegetables  Carrots, spinach, silverbeet, asian greens, zucchini, green beans, cucumber, lettuce and occasionally broccoli and pumpkin.
Herbs Dillweed, oregano, chives, basil, fresh coriander, thyme, rosemary, sage, marjoram, bay leaves, parsley, tarragon and saffron.
Seasonings Cinnamon, turmeric, ginger, sea salt, lemon juice, apple cider vinegar and very occasionally coconut aminos and 100% natural fish sauce.
Misc - Bone broth, occasional high quality coconut water, herbal tea, fermented cod liver oil, L-Glutamine, probiotics, vitamin C powder and magnesium. 


Things I'd like to add to my diet are organ meats, fermented vegetables, gelatine, sardines, kombucha and potentially homemade keifer and yogurt when my stomach settles a bit. Things I'd eat if I didn’t react to them would be homemade coconut milk, coconut flakes, homemade mayonnaise and olives. If you don’t have trouble with small intestinal bacteria overgrowth you could add sweet potato, bananas, blueberries and oranges in moderation. You could also add other vegetables if you aren't sensitive to FODMAPS                                

Meal Ideas Proteins:
Meatloaf
Meat Patties (made from any kind of mince)
Baked Fish
Pan Fried Fish

Shrimp Stir-fry
Chicken/Vegetable Soup
Chicken/Vegetable Stew
Beef Stew
Lamb Stew
Lamb Cutlets, Pan Fried
Baked Chicken Drumsticks
Baked Chicken Thighs
Chicken Stir-fry
Beef Strip Stir-Fry
Beef Steak, Pan Fried
Leg of Lamb, Roasted
Whole Roasted Chicken

Meal Ideas Vegetables:
Roasted Carrot Wedges
Carrot Mash
Carrot/Ginger Soup
Roasted Zucchini Rounds
Sautéed Zucchini ribbons
Steamed Green Beans
Sautéed Spinach
Steamed Broccoli
Steamed Pumpkin
Roasted Pumpkin
Pumpkin Mash
Pumpkin Soup
Basic Salad

Then you mix and match with the herbs and fats to create meals:
- Chicken meatloaf with spinach and coconut oil roasted zucchini rounds with dillweed
- Beef patties made with 3 herbs served with green beans drizzled with olive oil
- Sea salt and thyme pan fried lamb cutlets with duck fat roasted carrot chips
- Lemon baked salmon with ghee mashed pumpkin
- Pan fried white fish with steamed broccoli drizzled with olive oil
- Chicken thigh stir-fry with turmeric, spinach and zucchini
- Pan fried steak with zucchini ribbons and steamed pumpkin
- Tuna Salad with lettuce, cucumber and chives with olive oil and apple cider vinegar
- Chicken Salad with lettuce, cucumber and chives plus homemade mayonnaise
- Baked chicken drumsticks sprinkled with sage served with ghee mashed carrot
- Beef stir-fry with asian greens and green beans
- Roast chicken with roast pumpkin and sautéed chard

You get the idea - Protein + Vegetable + Fat = Every Meal. I eat my vegetables well cooked and as you can see from my examples, usually limit ingredients to about 5 per meal (yes, the examples above are as easy as they sound).


It's essential for me to eat 3 meals a day all with enough protein and fat to keep my hunger at bay and energy steady. As soon as I stray from that I notice a massive increase in cravings and this way of eating starts to feel really hard. If I eat regularly with all the right nutrients, have 1-3 cups of bone both and 1-2 cups of herbal tea a day it seems 'easy' and I feel balanced. At the start smaller meals more often were helpful and I also needed probiotics as well as digestive enzymes to help restore my gut. After my vegetarian shenanigans, then doing low fat treaty paleo, I had to get my tummy used to eating real food at every meal.     

If I need to snack its bone broth, soup, left over patties or meat loaf or I just have a small meal… I won’t lie though, it’s taken me about a year to let go of the 'why me' mentality and make this way of eating feel natural and unrestricted. I’m also at a point where eating otherwise causes me discomfort and flare ups of symptoms… so that’s extra motivation to stay on track.

Tips to make it work:

Pantry watchkeep all treats out of the house, if a partner or flatmate brings something you just can’t resist into the house ask them to kindly eat it within 24 hours (for example my boyfriend and raw chocolate).
Fully stocked – make sure you always have good food in the fridge and left overs for emergency hunger attacks.
Plan ahead – I try to have an idea of what my next 3-4 meals are, all the time and have the ingredients on hand or know when I can get to the store and exactly what I need to buy when I get there.
Cook once, eat twicewhenever I do anything in the fry pan I double up, some for breakfast some for lunch for example… this is a great technique if you need to have food “on the go”. Also, just great to put the second batch aside for a left over meal to have in the fridge.
Batch cook – Whenever I have the oven on I throw in some meat loaf or meat patties for snacks and quick breakfasts.

Stress management, rest and relaxation, movement, connecting with friends and nourishing myself are also essential components. I try to get enough of these daily to stay truly nourished. I've learnt the hard way that no matter how well you eat, if you’re a stress junkie too paranoid to leave the house, too busy to get fresh air or wander along the beach or take the time to chill on the couch with a book or even some bad television... You’ll never get to a full state of wellness.  So now my diet’s pretty much dialed in, these things are my focus. 

Wednesday, 6 November 2013

Update: Gut Infections and Resistant Bugs



Aka not as easy as I thought! 

Well, the last several weeks have been fun (she says with excessive sarcasm). The old saying "from bad to worse" applies after a few more weeks on the couch due to daily fatigue, foggy head and nausea. My stomach has been misbehaving no matter how well I treat it as my system slowly but surely begins to react to pretty much anything that touches my mouth. I'll admit though, due to frustration and finances, I haven't been as attentive to taking probiotics and enzymes that I know help... But sometimes it's nice to take a break to get a realistic picture of the true state of your health. I've been popping pills, taking supplements and doing alternative therapies for 14 years now - when all that stopped working I was forced to get to the root cause. It's been a shit fight (excuse the term) but it had to happen eventually, and 12 months on, it certainly doesn't happen overnight!

During a very teary session with the GP last week, I found out that not only did the aggressive antibiotic treatment I put myself (and my boyfriend) through not kill the tummy bugs, it turns out the chronic infections and stress have given me a case of adrenal fatigue (low DHEA levels and low hormones in blood tests). This would explain why my gut is still a minefield and why my energy went from average/managing, to low/non existent almost overnight. I tried the super low carb thing to starve the bugs in hopes to relieve symptoms and I didn't react well. I'd still wake up feeling like there was a basketball in my stomach and after every meal it still felt like someone was slowly blowing up a ballon inside of me - not to mention the increasing deep, daily fatigue that I couldn't shake. When I asked for antibiotics for SIBO that came up positive in breath tests he brushed me off and said it wasn't important. Didn't even look at the test results I'd placed on his desk. I was so upset as I know that SIBO is, and has been, a massive cause of many of my symptoms. 

So I scuffled away with more tests to do, people to call and people to see. I was greatful to get a referral for a colonoscopy and endoscopy through the private system (public was going to take me 3 more months to see anyone). But the whole appointment was extremely deflating. I called the GI office Monday morning after my appointment through tears, and the lady said she could get me in on Wednesday and I had to start prepping now. I hung up slightly bewildered but thankful that answers were closer. 

Fast forward through 2 days of not eating, drinking picoprep and staying very close to the toilet... The wait at the clinic was painful to say the least but after 7 hours I was out and awake and had a piece of paper in my hand clearing me of any major inflammatory bowel diseases like crohns or colitis, no major structural damage like diverticulousis and a very healthy looking intestinal tract (is it too gross to post a picture!?) Biopsies were taken for H Pylori, Celiac, Bacterial Infection and for some weird bump in my esophagus to make sure it was benign (it was). I was a bit spaced out for the next few days but I'd overheard in the waiting area that the anaesthesiologist, "likes to make sure they're out deep enough because you never know how long the procedure will take and you don't want them waking up or remembering anything". This provided me with a weird mix of terror and relief - waking up during a medical procedure is my worst nightmare! But would explain why it took me a good few days to recover.

I woke up late yesterday to a missed call and a voicemail from the Gastroenterologist, mumbling something about its strange and staphylococcus aureus and duodenum and antibiotics. I consulted Dr Google as my Gastro was not reachable - freaked out a bit at first (as you do), Golden Staph!? In my intestine!? WTF? But then stumbled across this article (which is one of the best in terms of what it is and how to treat it) which informed me that staphylococcus aureus is present in 13% of SIBO cases: http://ndnr.com/gastrointestinal/small-intestine-bacterial-overgrowth-2/ (you'll have to copy paste this link).

So pretty much the antibiotics the GP didn't want to discuss, or the condition I told him I had (small intestinal bacterial overgrowth), is exactly what needs to be treated. I know one person can't know it all, but it made me so upset because for the last several years so many doctors and naturopaths have made me doubt myself with comments like: it's just depression, IBS, sleep more, eat more fibre, do you drink enough water? And: when you stop working nightshift everything will change, it's just stress, do laxatives work? And on and on... I'd almost started to believe it was in my head, maybe I was just depressed and I'd feel this heavy fog and no energy forever (if that was the case I sadly didn't want to stick around to find out what that life looked like!)

Moral of the story is, if you're unwell, trust it. One medical practitioner will not have all the answers and these life sentences we're handed out in the form of pills and short term symptom relievers aren't the answer. It'll take a lot of research and probably some cash, but don't stop till you get to the bottom of it. Don't trust what you're told and never, ever let anyone with a degree or letters after their name make you feel bad about yourself or like its 'all in you our head' or that there are no other options. Trust yourself - you know best xx


Tuesday, 5 November 2013

Testing for Digestive Health, Parasites, Leaky Gut and SIBO – Links and Costs

Just thought I’d do a follow up post to extract the info from the last three blogs where I’ve mentioned testing as it seems to be the most FAQ at this point :-)

The first test I got was the GIFX stool test through:
I did it in Australia through:
This company also does this testing and I think Metametrix is linked with them now:
The Naturopath I did my consults with was Shannon Buford at:
I now see Dr Dane Pervan here in Perth:
To find your own practitioner simply send an email to Diagnostic Insight in Australia or New Zealand or Metametrix in the US.

It took me several doctors and two naturopaths to finally get to this, I had to ask specifically and find someone who did it as not everyone does. It cost me $385 but is extremely comprehensive testing for: inflammation, candida, helicobactor pylori, dysbiosis and roughly 15 different parasites. This did not cover the cost for initial and follow up consults which can be anywhere from $100-180. Or the treatment fees for herbals and prescription drugs.

Then I did a urine test for Leaky Gut/Intestinal Permeability, I choose to order it through a practitioner online:
Who used:
This company also does it:
As would Metametrix/Genova in the US mentioned above.

Many practitioners do this test, I found it hard to convince my naturopath to give one to me though (hence why I went online). His theory was (understandably) that if I have digestive issues and especially parasites, then it’s safe to assume I had leaky gut. Due to the dietary restrictions involved in healing leaky gut however I wanted to see it on paper to keep me motivated long term. I paid $140 but I think it’s usually around $90-120.

Then I did the breath tests as I wanted to confirm my suspicion of SIBO, small intestinal bacteria overgrowth (what's SIBO? Click here) and check if my reactions to some fruits and vegetables as well as dairy products were due to my gut dysfunction or actual malabsorption issues.

I went through:
Mainly because they deliver Australia wide and I wanted to do the tests at home.
Here is a company in the States that you can order the same tests through:

These tests aren’t cheap but for me they were important to do. You don’t have to do all of them but the minimum is two tests as one is a control test. The cost for me here in Australia was $475 as I did four of them (fructose, lactose, glucose for SIBO + control test). No other consult fees as I did it at home. Side note, the customer service at Stream Diagnostics was fast and thorough. 

If I was to start the journey again I would find a functional medicine specialist, I had to go through at least five practitioners before I found people that were on the same page as me. Dr Lauren Noel, Dr Amy Myers (both in the states) and Claire Yates at Indi Nature here in Perth are people at the top of my list and you can work with these ladies online. Functional Diagnostic Nutrition Practitioners are also great.

A quick note too, I don’t get any perks from sharing these links, it’s purely in the interest of sharing what’s helped me that I put this post together. Now go forth and test! 

Links:

Dr Lauren Noel
Dr Amy Myers
Claire Yates
Function Diagnostic Nutrition


Monday, 4 November 2013

SIBO + My Action Plan

Will the next diagnosis please step up *drumroll* it’s the complicated SIBO! Uh oh!

I’ve had my suspicions for a while now, and although I’ve spent the last year listening to podcasts and educating myself on health and nutrition, every time I heard the description of SIBO I’d turn the part of my brain off that was saying, “that’s probably you ya know Kristi”.  Why? Pretty much because I like carbs and the idea of going without sweet potato, pumpkin and occasional dark chocolate was too much to bear on my already restricted diet. But I’ve slowly gotten used to the idea that first I need to strip my diet right back, calm the inflammation pit that has become my digestive system, and start again.

When the results for the breath test came back positive for small intestinal bacteria overgrowth, I just kinda rolled my eyes and took a deep breath and reminded myself of something I’d read on The Paleo Mom's site that very same day, “It can be very frustrating and very discouraging, but I try and focus on the positive:  I now know how to eat for my health issues and even if it’s sometimes hard to comply, I am no longer roaming in the dark taking scads of prescription medications.  I am healing.” I have my first significant diagnosis, and now that I know what I’m up against, I’m doing my best to be grateful.

What is SIBO? The small intestine should be a sterile place, but when your digestive system is askew sometimes bacteria either from the stomach going down, or the colon backing up, gets in where it doesn’t belong. Once its gained entry it’s hard to control so flourishes in the untouchable environment. It causes all the symptoms related to IBS (which isn’t actually a diagnosis by the way, IBS is merely what you get labelled with if they can’t find anything else): gas, bloating, distension, cramps, pain and changes in bowel patterns. Along with this SIBO sufferers also experience:  nausea, acid reflux, malabsorption, leaky gut, food intolerances, joint pain, skin issues, headaches and cognitive dysfunction including depression and anxiety. Personally my main symptoms have been gut pain, cramping, chronic constipation, acne, joint pain, foggy head and depression. More recently I’ve been experiencing nausea, fatigue, insomnia, migraines, loss of appetite and weight loss.

I think my SIBO is a mixture of poor bacteria colonisation as a kid, being a super stressy type A personality, having anorexia and overusing laxatives in my teens, being a vegetarian for many years and disrupting my stomach acid production… During that time I was also eating a lot of grains and nuts, which are actually are not great for the digestive system. My diet was also high carbs and low fat which SIBO just luuurrrvvess. Working night shift and neglecting sleep. I’ve also taken numerous drugs to deal with symptoms over the years which just added to the mayhem!

I’ve read about the GAPS diet as well as the specific carbohydrate diet for healing major stomach issues, but a few things didn’t resonate with me: they both include dairy, of which I’m not a fan as well as eggs, which I can’t tolerate. They both encourage a small amount of juicing, which doesn’t feel right for me these days. Later they also include nuts, which are not great for leaky gut and personally cause me pain. They are also both very precise and regimented whereas I like to have some amount of creative flexibility in the kitchen. So when I came across Aglaée Jacobs' book Digestive Health with Real Food I was super excited.


Her book explained the elimination diet, safe foods, how to mix them together to make a meal as well as how to reintroduce foods when the time came – I had ultimate flexibility on a crazy rigid plan. I came across her cheat sheet and this is what I follow now SIBO Cheat Sheet I’ve also enrolled in her Real Food Challenge to give myself a boost off the starting line.

Next month I’ll be seeing my favourite GP in the whole wide world to chat about drugs to help with the infection, I’ve listened to a lot of podcasts in which Alison Siebecker  has mentioned antibiotic protocol using rifaximin and neomycin followed with erythromycin to make sure the bacteria doesn’t repopulate (also mentioned in the Digestive Health with Real Food book). I’m hopeful that this, plus my new Aglaée inspired starch restrictions on the autoimmune protocolwill be enough to ride myself of most of my symptoms. 

Hooray for being on the TOP of the mountain looking down!

Links:
  

Sunday, 3 November 2013

Blastocystis, H.Pylori, Candida and Leaky Gut

When bad bugs happen to good people! Take a deep breath, it’s a long one.

Blastocystis Hominis is a parasite that infects the human digestive tract. While many carriers remain asymptomatic, it’s becoming more well known as a common cause of IBS. The Centre for Digestive Diseases in Sydney lists these symptoms as an indication of possible infection: “diarrhoea/constipation, mushy stools, abdominal discomfort, bloating, gas and pain. Other symptoms may include nausea, vomiting, headaches, dizziness, weight-loss, chronic fatigue, depression, low-grade fever, bloody stools and anal itching”.

Up until not so long ago this parasite was actually considered a yeast - so was overlooked in terms of the symptoms it causes. It’s still controversial as to whether treatment is necessary due to so many people having the parasite but presenting no symptoms. It can be tricky to find a doctor in the know and willing to help as there’s still ongoing research being done. I was lucky enough to find the magical Dr Dane Pervan.

For those of us who do choose to seek treatment, a 3 pronged antibiotic approach is required and it can be tricky to get rid of. It’s a tiny cyst like parasite that likes to burrow into the walls of the intestine, so not as easy to get rid of as other parasites that just float around (eewww). Below is a picture of my antibiotic arsenal – 3 different types 3 times per day, I also have 3 nilstat in my hand as I was treating candida at the same time. I will warn you, this was not fun…


Infection usually occurs through eating contaminated food, drinking infested water or dealing with animals. You don’t necessarily have to have travel to a third world country either. The best way to get tested is through a complete stool analysis that includes DNA testing. Any other stool test is close to hopeless (trust me; I went through 3 tests with normal doctors that showed nothing before I forked out the cash for one of these babies). They’re expensive but the overview you get on the state of your insides is WELL worth it.

Helicobactor Pylori affects over 30% of the world’s population. It’s a bacteria that hangs out in the lining of the stomach and is known to cause stomach ulcers. Carriers again can be asymptomatic but the symptoms associated with infection include: heartburn, indigestion, nausea, vomiting and loss of appetite. In my personal experience it also affects stomach acid production hence impairing digestion. Testing can be done via: gastroscopy, urea breath test, blood test or the stool test listed above. For me, the stool test was most successful as I’d gotten 2 negative results in the breath tests prior to stool testing.

It’s not 100% certain how it’s transmitted, but oral-fecal, oral-oral, poor hygiene and contaminated water seem to all be culprits. It’s also commonly known to be picked up during childhood – often passed on from an infected family member. To eradicate H. Pylori a combination of antibiotics and a stomach acid suppressor is prescribed. I was also given some herbs to take along with the H. Pylori eradication kit, Nexium HP7, pictured below that my doctor recommended.


Candida is another one of those things normal doctors don’t really jump up and down about. Because we all have candida in our system anyway – a lot of people brush it off when it comes back positive in a (stool) test. If you have an overgrowth though, it’s seriously worth looking at and treating, through diet and supplements with the optional addition of a drug called nilstat. There’s also a specific strand of probiotic called saccharomyces boulardii which is known for its yeast eating abilities, candida is a type of yeast. It pretty much opens up a fermentation factory in your gut.

When stomach acid is low and the balance of good to bad bacteria askew (dysbiosis), candida has the perfect place to thrive and quickly overpopulates - especially if you couple that with a diet high in sugar and processed foods. The list of symptoms is looooong and varied: depression, headaches, brain fog, sleep issues, anxiety, bloating, joint pain, constipation/diarrhoea, nail infections, eczema, acne, thrush, allergies, fatigue as well as intense sugar cravings as the yeast screams to be fed… Often candida does not just ‘happen’ so it’s important to figure out what allowed it to flourish, and eliminate that, to avoid it returning.

Leaky Gut is a big one, so I’ll try and nutshell it. Usually after things like the above go down in the gut the gut lining is affected. So much so that little gaps start to form in the gut lining. Considering we need that lining to keep things in, when things leak out it causes trouble. Food particles, waste, drugs and supplements can all cross over the barrier and leak into the blood stream. When this happens the body reacts by attacking – these particles are now foreign invaders which the body most get rid of! In short your body uses precious energy to attack things that shouldn’t have ended up in the blood stream to begin with.

If this goes on long enough you’ll start to experience a similar range of symptoms as those listed above for candida. Often the symptoms can start off subtle so they just go on ignored. From experience, if you feel like crap every day because of leaky gut, well, you kinda get used to it as your new norm. But long term ignorance causes a great stress on the immune system as it’s always ‘on’. The craziest thing about it – leaky gut left untreated, can lead to an autoimmune disease. The body becomes so confused attacking the particles that have crossed over your gut barrier into the blood stream that it starts to attack the body’s own cells. I know it sounds insane, but it’s a true story. Check it out here for more detail: What is Leaky Gut and how can it cause so many health issues?

Treating leaky gut is a long term commitment to diet and lifestyle changes such as: stress management, sleep quality, appropriate exercise and finding happiness in your daily life. Supplement support is encouraged as well as learning to take life easy. First you must treat the cause of it though so getting some tests done is of the utmost importance. No point under taking a healing journey only to be back at the start because you failed to eradicate parasites or had H. Pylori suppressing things or candida funking the place up. If you have any stomach issues, you can pretty much bet on the fact that you have leaky gut; if you do want to test however, a simple ‘drink a solution pee in a bag over 6 hours’ urine test can be done.

My condensed version of what I’m doing diet wise can be found over here: When JERFing isn’t enough (aka the autoimmune protocol) and The Paleo Mom has a great article here on: Repairing the Gut My biggest regret in this area is not educating myself earlier on or having the balls to tell my doctor what I thought was up and what tests I thought I needed. Not all practitioners do the stool testing either, so I had to find one that did and pretty much tell him that I refuse to come in unless I received a stool kit, and promptly. Luckily I found an understanding naturopath here in Perth, Shannon Buford at Cura Medicine who sent me home with a lab kit from Diagnostic Insights.

So pretty please, if any of this resonates with you or you've found yourself nodding at the symptoms listed, make the investment to get yourself tested… sooner rather than later.

Big Love xx