Lee was visiting from down south when she came to my office. She was 56 at the time, about 25 lbs. overweight and complaining of colitis with bad gas, bowel movement urgency, and loose stools to the point where she was afraid to do much traveling, which she had really enjoyed in the past. In addition to seeing me, she went to a top gastroenterologist in New York City. She was otherwise in excellent health except for some arthritis that bothered her mostly at night.
The doctor gave Lee a colonoscopy which was basically normal, diagnosed her with irritable bowel and sent her on her way. Her diet was high in sugar and fat, and low in vegetables, protein and fiber.
I recommended reducing Lee’s consumption of meat and dairy, which are pro-inflammatory (contributing to her gut inflammation and arthritis), and eliminating alcohol, wheat and sugar, which tend to be gut irritants, for four weeks.
The meal plan that I provided was high in fiber consisting of whole grains (other than wheat), legumes, vegetables, fruits, nuts and seeds as well as quality protein and lots of purified water to help push the fiber through her digestive tract. Wheat was withdrawn initially because it can cause irritation to the digestive track and is the grain that many people are most sensitive to. It might seem odd to the reader to recommend fiber when there are loose stools, but sometimes this is the result of not enough bulk to create a healthy bowel movement. In addition, Lee started on an acidophilus/bifidobacteria supplement to build healthy gut flora and reduce bacterial overgrowth, and peppermint-ginger tablets to help with the daily symptoms of gas and bloating. I asked her to record what she ate and how she was feeling and gave her a stool collection kit.
The specialty lab that I use looks for things like how much good bacteria are available, whether proper digestion and absorption are taking place based on certain markers, and if any bad bacteria, pathological yeast, or parasites are causing a problem. Information about this lab is also in the resource section or on my website.
When Lee and I did a phone follow-up several weeks later she informed me that her gas and bloating were much improved and her bowel urgency was somewhat better although she still had loose stools.
According to the test results, Lee had elevated levels of cholesterol in her stool which may reflect fat malabsorption, too much dietary cholesterol, fiber insufficiency or intestinal inflammation. With the changes she already made in her diet, I thought these problems would resolve without further treatment. She had decreased levels of short-chain fatty acids, which are crucial for the health of the intestine and serve as fuel for the cells and the rest of the body. Insufficient amounts may reflect not enough healthy flora, a diet low in fiber or not enough butyrate which provides energy for colon cells. Meat and vegetable fibers were seen in the stool, direct indicators of malabsorption due to hydrochloric acid or pepsin insufficiency (digestive enzymes). Lastly, she had zero good bacteria (lactobacillus and bifidobacteria) and high levels of possible pathological bacteria and yeast overgrowth.
This lab reports what is wrong and how to fix it using prescriptive and natural substances. In Lee’s case, the herbs uva-ursi* and garlic were recommended to kill the bacteria and yeast. In addition, I recommended a digestive enzyme to help her body break down fats, protein, and starches more effectively. In many cases as people age, their levels of digestive enzymes decline, making it more difficult to digest everyday meals. Lastly, I suggested Lee follow a yeast-free diet for one month. The major elements of a yeast-free diet are to cut out the foods that make yeast grow like sugar, alcohol, fermented foods and refined carbohydrates that quickly turn to sugar. Instead the foods to eat are high in protein, essential fats and fiber. A natural by-product of this diet is to lose weight, which Lee did.
- Meat, Fish, Chicken, Eggs
- Fresh Nuts (not peanuts or pistachios which are moldy)
- Fresh Fruit – two per day because of high sugar content (peeled, no moldy fruit like melon, grapes or berries).
- Grains: brown rice, buckwheat, corn, wheat, millet, quinoa, spelt, oats, rye
- Lots of water, green, white and red teas
- Oils: flax, olive, canola or walnut
Foods to Avoid:
- Sugar and all things that mean sugar i.e. honey, corn & maple syrup
- Fermented foods and foods with vinegar such as condiments (ketchup, mayo, soy sauce, mustard, salad dressings)
- Yeasty foods (alcohol, bread, bagels)
- Commercial juices
After I had worked with Lee on and off for a period of four years she had total improvement of her symptoms. She also lost weight, was able to travel to Europe, play tennis and eat an occasional food off of her diet without any trouble. When she went back to her old eating habits, the symptoms would flare up again. This is a common problem that I see with many of my patients and have also experienced myself.
Sometimes a patient will say, “Why do I have to be on such a restrictive diet and take my supplements when my husband can eat whatever he wants?” The answer is that we all have different constitutions. Some of us have such sensitive guts and digestion that we must eat a certain way for our whole life if we want to stay healthy, be energetic, and feel good on a daily basis. That may mean giving up sugar, alcohol, and caffeine for good. I know from first-hand experience that this isn’t easy, but when I or my patients feel sick after going back to a poor diet, most of us agree that it is worth it. Of course some of my patients tell me in the beginning that they will never give up sugar, caffeine, alcohol or chocolate, so we work around this and have them change what they are willing to change. Although they might not have as dramatic results as those who follow all of my recommendations, they will still be moving in the right direction. What fun is life anyway without a few small vices? As my colleague J.J. Virgin tells her patients, use the three-bite rule on foods that you can’t give up.
Have three bites and then throw them away. That way you will never feel deprived.
Lee’s Makeover: Before
Problem: Irritable bowel, candida, poor diet Lee had irritable bowel that was ruining her life. She had severe bowel urgency that made it difficult for her to leave the house and do the things she enjoyed.
Diet: Lee’s diet was a common Southern diet high in fat and fried foods. She also ate prepared and convenience foods and had a fair amount of sugar and alcohol. She ate little quality protein and few vegetables.
Supplements: Lee was not taking any supplements when she first came to see me.
Exercise: Lee loved to play tennis and tried to play 3 times a week when she was feeling well.
Stress Mgt. & Self-Care: Lee had no formal program to relieve stress, which is usually high in patients with irritable bowel.
Lee’s Makeover: After
Problem: Irritable bowel, candida, poor diet After several tests we found Lee to have candida and other bowel abnormalities. After changing her diet and helping with these problems, she regained normal bowel function and was able to travel and play tennis again.
Diet: I recommended that Lee reduce her meat, dairy, sugar and alcohol consumption that was contributing to her gut inflammation and arthritis. The meal plan that I recommended was high in fiber, quality protein and lots of water. Wheat was originally withdrawn from her diet but was able to be added back in small quantities once her digestive tract was healed.
Supplements: Lee followed the 4 R program with many nutrients rotated in and out until her symptoms resolved. She was then on a maintenance program that included probiotics, a multi, fish oil, glucosomine, and vitamin E.
Exercise: Once Lee felt better, she was able to go back to her regular tennis program, which improved her energy and stress level.
Stress Mgt. & Self-Care: Lee learned relaxation exercises and how to calm herself down if she suspected a flare-up of her symptoms. Deep breathing and going back to her original food plan always seemed to work.