Report From My Gut: Let's Talk Motility!

This blog entry is not for the faint of heart!

Time to talk "motility."   For people with GERD, gastroparesis, and other GI conditions, "not going" is not just uncomfortable -- it's a crisis.   One "slow" day can easily spiral into a few days, making my already challenged intestines and slow stomach even more cranky.   And, I have found that when I am constipated, nausea often follows.

This morning, I am on day three of feeling not my best.  

I do all the advised things.  I've done most of these in the last 24 hours:

• Eat plenty of vegetables and fruits (Veggie diet -- check!)
• Eat more fiber (that's ALL I seem to eat some days…)
• Take probiotics (done -- in the form of pickles and Puehr tea…)
• Exercise (stair-climbing daily, a few big walks each week, Tai Chi, stationary bike…)
• Drink more liquids (water, non-caffeinated tea, caffeinated tea, more water)
• Relax (trying!!  trying!!  trying!! but easier said than done when the clock is ticking and I need to leave the house for work -- bloated, again!)

Now it's less than 40 minutes to my departure time and I need to shower, get dressed, pack my lunch, and head out -- but who wants to schlep to work feeling like you've got an extra 29 pounds in your gut?  Gassy.  Crampy.  Psychologically bloated.   I don't like using public restrooms (who does?) and with "gut issues" it's just better dealing with things at home, trust me.

So, this remains an ongoing issue for me.  For months, I had somehow settled into a routine and constipation was occasional.  It is upsetting to be back in this situation, worrying where and when my next bowel movement will be!   If I "take too long" in the morning, that can prevent me from meeting my exercise goals -- a 45 minute walk before work, or my Tai Chi class.   It's a daily struggle.

One comfort:  If you are reading this and experience the same issues, you are not alone.  Constipation is one of the most common concerns, and one of the least discussed.  It may not be "life threatening" but it is definitely life-impacting.


WHAT OTHERS ARE SAYING -- LINKAGE 

A few interesting and helpful online resources:

Silent Struggles: The Ugly Truth about Gastroparesis and Constipation

Gastroparesis FAQ:  Constipation Causes & Remedies.  Video from Living With Gastroparesis blogger Crystal Saltrelli, Certified Health and Nutrition Counselor

Excellent graphics and information are included in this Constipation Fact Sheet by the Bladder and Bowel Foundation 

Australian Government Initiative: Looking After Your Bowel -- A Guide to Improving Bowel Function.  A whole government-issued document on the subject!  More good graphics here.

Food Diary: GERD Elimination Diet - October

I am recommitting myself to figuring out and better controlling my latest gut issues.  I think another GERD Elimination Diet week will benefit me.   So, here we go, another week without caffeine, chocolate, spice, oils.   I'm also interested in sharing a few improvements I've made -- more nuts throughout the day, for one thing.  Thank you for the advice!

At some point, I'd like to try a few weeks of a "Food Elimination Diet."  I am intrigued by a coworker who discovered her gluten reaction by a variation on the usual elimination diet -- she spent weeks eating one trigger food every day for a week and then avoiding that food, documenting if she felt different when she stopped eating it.   I'd like to try this approach, which seems more doable given my schedule, out of town guests, nutrition needs, etc.  (It can't hurt, right?)

FOOD DIARY

Breakfast

Mood: somewhat nervous about intestines/off and on constipation; going to doctor for follow up visit (non-GI related); otherwise fairly relaxed 

Symptoms: reflux/belching before eating; belching and some reflux after eating; bloated overal

1 Wheetabix square

1 C. Blue Diamond unsweetened vanilla almond milk

1 tsp bran

1/4 C. ground walnuts

handful of miniature grapes
1/2 C. apple cider (from the greenmarket)

1 C. lemon verbena tea

Snack
1 small oat-bran-apple muffin (from home)
1/2 C. mini-grapes

Lunch
Mood:  content, busy, hungry
Symptoms: belching, some reflux off and on

1 serving eggplant-chickpea-tomato casserole (from home)
1/2 whole wheat mini baguette from Au Bon Pain (I forgot my grain today!)

Snack
1 banana
1/2 whole wheat mini baguette (the rest of it from lunch)

Dinner
Mood: Irritated, fatigued
Symptoms: No reflux but very bloated

2/3 C. Bird's Eye mixed vegetables
1 C. baked beans
2 Morningstar Farm sausage links (veggie)
2 slices rye toast
1 T. Earth Balance whipped spread

Snack
1 C. Breyer's ice cream (three flavor)

I went to bed feeling exhausted from a rigamarole of a day but slept throughout the night.  No GERD to wake me up.    [Note: By  morning, I woke up refreshed but again, about 5 minutes after waking and rummaging around the kitchen, I experienced a heavy feeling in my chest/stomach area -- what I think of as "reflux."   It is as if there is something "wet" inside my stomach.]

What Has Been Occupying My Time

I've been lax with the blog updates largely because I'm immersed in the Occupy Wall Street movement happening a short distance away from me.  What do you think, Cranky readers?

GERD-wise, I am doing okay -- a miracle since four days of sleep-deprivation  resulted in drinking a lot of caffeine and ingesting a lot of chocolate.  I've also been stuck eating a lot of late dinners.   No heartburn, no untoward belching, a bit of "food in throat" but even this is subsided.  I can't figure it out!

The only dietary change I have made over the past week is to include one-quarter cup of ground walnuts on my cereal, which has been Shredded Wheat.

Green Beans and Bees

Finally, on to the Union Square greenmarket!  It's been three weeks since I've been there -- and my psyche and stomach are feeling deprived.  I've loaded my grocery cart with three tote bags (one is a cooler-style bag) and two plastic containers in which to stash fragile things like peaches and tomatoes.  My journey to the greenmarket involves a lot of walking and a subway ride, so preparation is the difference between getting things home in one piece or finding all of your cherry tomatoes turned into a mash.

As I've been grumbling in the past posts, my diet this past week has been lacking fresh produce, let alone my beloved greenmarket produce.  Blame it on the hurricane, my schedule, family visits and a lot of eating out.   So, I cannot wait to get green beans, chard, kale, tomatoes, other leafy things, maybe cauliflower if they have it.

 Of note: I've had green or black tea every day this week, and any effects were modest.  Right now, I am drinking an oolong and admit I feel a minor "lump in throat" feeling.  If this is all I experience, I'm not concerned.  (Unless it's pathologically affecting my esophagus.  Then I have trouble.)

My GERD is minimal today.  I spent the past two days eating smaller portions -- back to the "two breakfasts" scheme -- and minimizing my dairy intake (just the nightly ice cream).

I've been sleeping hard and long, even with strange dreams, and have started a reading-before-bed routine to help me de-stress.  Reading before bed -- it's been a long time that I've done this, and I LOVE IT!  Right now I am in awe of Motel Art Improvement Service, a comic by Jason Little.  (Whom I met at a local comics convention and he drew my own personal Bee for me in the cover flap of my book!)

The Plan: GERD Elimination Diet

THE PLAN

Dr. C. suggested I try an "elimination diet" for GERD.  This means avoiding the following for 1-2 weeks and introducing them back in, to see what/if anything triggers GERD:

• Alcohol
• Spicy foods
• Chocolate
• Caffeine
• Mint
• Fatty foods

PROGNOSIS

Alcohol: Easy, as I am a teetotaler.

Spicy foods:  Also easy, as I am a spice wimp.

Chocolate: Problematic.   By 11:00 AM, I have usually had a square of dark chocolate.

Caffeine:  Tea is my life.  I have been experimenting with drinking caffeinated tea every other day.  For the elimination diet, I will have to cold turkey it for 1-2 weeks.

Mint: I can take or leave it.  This should not be a problem to avoid.

Fatty foods:  I will need to leave my olive oil at the kitchen door for the next few weeks.

OTHER ISSUES

I have been a vegetarian since the age of 12, and am striving to a vegan diet altogether.   This does not affect the GERD diet but if I also try a classic allergy elimination diet, things get complicated.

I am not supposed to recline until 2-3 hours after eating, but logistically, this is ridiculous.  By the time I get home, cook, and eat, it's already 8:00 PM.  That means going to bed at 11 PM but this is too late if I want to get up by 5:00 AM.   How do people manage?

Did I mention tea is my life?