My gut history (IBS, SIBO + more!) - Part III

The incredible thing about our bodies is that they adapt and change over time (in fact every 7 years you are a completely different human on a cellular level - WOW!). In addition to changes in our bodies, our circumstances (physical environment, stress, family and home situations, etc) are also always changing. So especially when it comes to gut health, and especially for those with more sensitive systems, what works and makes us feel good in one moment may not work a few months or years later.

In this third post of my gut health history series, I’m sharing where I’m at right now with my gut and gut healing. As I shared in the first post in this series, my symptoms began to worsen the last year, and so I’ve made it my priority to focus on what these symptoms are telling me.

In case you missed it, check out the first two posts in my gut history series here:

My Gut History (IBS, SIBO + MORE!) - Part 1 - How it all Started + Symptoms

My Gut History (IBS, SIBO + MORE!) - Part 2 - What I’ve Tried in the Past

Quite a bit of this post will talk about SIBO, or Small Intestinal Bacterial Overgrowth. SIBO is HOT right now in the digestive health world - people are being diagnosed left and right. Like with gluten intolerance or IBS, I’m not sure if the increase in diagnoses is because there’s more information available about this condition, or if it’s become the new catch all condition, but many many people are dealing with similar symptoms and protocols.

Side note: I’m not 100% sure that I have or had SIBO. I’ll talk about this more below but most all digestive disorders are tough to clearly diagnose AND often issues overlap. IBS can cause SIBO, SIBO can cause IBS. A food allergy can manifest as a skin condition, as can a parasite, or straight up anxiety.

Please do not let the nuances and complexity of the gut and your symptoms deter you from moving forward. Please do not let “failed” treatments rob you of hope. Instead I encourage you to take each step of your healing process in stride, each protocol or supplement regime or test an opportunity to gather more information from which you can build a stronger, happier, more balanced foundation.

As always, I share not as a doctor or medical professional, but as a human having a human experience in hope that what I write may provide you with a spark of insight or inspiration or hope that supports your own healing process. Please read my full disclaimer here.

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WHAT IS SIBO?

Small intestinal bacterial overgrowth (SIBO) is defined as the presence of excessive bacteria in the small intestine.

Bacteria in our bodies is not a bad thing; in fact, there are more bacterial cells in your body than human cells (there are roughly 40 trillion bacterial cells in your body and only 30 trillion human cells). Your microbiome (the community of bacteria that live inside and on our bodies) plays a crucial role in many bodily functions including digestion and nutrient absorption, immunity, metabolism and brain health.

Most of the bacteria in your digestive tract is located in the large intestine (also called your colon). This is where these bugs assist in the final stages of the digestive process. With SIBO, too much bacteria has found it’s way into the small intestine, where it neither has a place nor a function.

SIBO SYMPTOMS

Symptoms of SIBO include:

  • Abdominal bloating**

  • Abdominal pain and cramps**

  • Constipation, diarrhea or both**

  • Gas (belching and flatulence)**

  • Heartburn and/or acid reflux**

  • Nausea**

  • Food sensitivities**

  • Headaches**

  • Joint pain

  • Fatigue**

  • Eczema, rosacea or skin rashes**

  • Anxiety and depression**

  • Malabsorption / nutrient deficiency (especially iron or B12 deficiencies)

  • Weight Loss**

**All symptoms I’ve experienced as shared in the first post of this series

The main symptoms of SIBO are those of IBS (Irritable Bowel Syndrome), which is why more and more people who were told they have IBS and there’s not too much they can do about it are now being diagnosed with SIBO (which can be a good thing, since with SIBO there are more treatment options).

SIBO is also related to many other disorders such as leaky gut, Crohn’s, ulcerative colitis, Hashimoto’s and more, both as an underlying cause or as the effect of the pre-existing disease - which can make treating it complicated, individualized and nuanced.

For a full list of symptoms and associated conditions, click here.

WHAT CAUSES SIBO?

Sure, diet can trigger SIBO symptoms to flare, but the underlying cause of this condition often is not just a result of the food you’re eating.

One cause of SIBO is low stomach acid. We’ve been taught to think that stomach acid is bad, and it is in excess, BUT acid plays an important role in both the digestion of food and how our body rids itself of harmful bugs and pathogens. Regular or frequent use of antacids can result in reduced stomach acid, which means it’s harder for your body to digest your food, and that you’re more susceptible to harmful invaders.

Another cause of SIBO is a dysfunction in the migrating motor complex (MMC).


What is the migrating motor complex? The MMC are waves of electrical activity that sweep through the intestines in a regular cycle during fasting. These motor complexes trigger peristaltic waves, which facilitate transportation of indigestible substances such as bone, fiber, and foreign bodies from the stomach, through the small intestine, past the ileocecal sphincter, and into the colon.

The MMC occurs every 45–180 minutes during the interdigestive phase (i.e., between meals) and is responsible for the rumbling experienced when hungry. It also serves to transport bacteria from the small intestine to the large intestine and to inhibit the migration of colonic bacteria into the terminal ileum. [Wikipedia]

In other words, your MMC is responsible for "housekeeping" in your gut - it sweeps residual undigested material and toxins through the digestive tube so that they’re properly eliminated.

Get this: the most common cause of low MMC function is food poisoning. When harmful bacteria enter the small intestine they release a toxin that kills the immune cells that trigger your MMC. Symptoms of this may take weeks or months to show up, which is why doctors don’t always link symptoms to SIBO or the food poisoning.

The second cause of MMC dysfunction is structural - a kinking of the intestines, a stricture (narrowing) from abdominal surgeries (hernia, C-section, appendectomy, endometriosis, etc) or other organs pressing on the intestines. Think of your intestines like a garden hose - if the hose gets kinked, folded or pressured, waste cannot flow freely through.

Additionally, while I have NOT found solid research on this, I believe another cause of of MMC dysfunction can be prolonged use of laxatives or fiber supplements. Why? If you’re FORCING yourself to go (either through the use of these medications, or by excessive pushing in the bathroom), you’re not allowing the MMC or your digestive muscles to do their jobs. Eating disorders such as anorexia and bulimia can also result in low MMC function, known by some as “lazy bowel syndrome.”

When I learned this, a LOT of things clicked into place: my first major belly issues happened after I had eaten a questionable egg salad sandwich during a time in my life when my system was likely extra sensitive (freshman year of college). And after that I did tend to get constipated and relied on laxatives and supplements to go #2. I rarely allowed my belly to relax, and I didn’t trust it to do it’s job.

Finally, as mentioned above, SIBO can be linked to many other disorders. It’s still unclear in many cases whether it’s the cause or effect, but if you’ve suffered from IBS, leaky gut or hormonal imbalances such as Hashimoto’s, they may be connected to MMC dysfunction.

TESTING FOR SIBO

SIBO diagnoses have increased in the last few years - this apparent increase in prevalence may have occurred because readily available diagnostic tests have improved our ability to diagnose SIBO.

The main test for SIBO is a breath test that you can do from the comfort of your own home over a 2 or 3 hour period. You fast overnight and then drink a sugar solution (either glucose or lactulose). The test measures the levels of hydrogen and methane (gas!!) in your breath as the sugar solution makes its way through various parts of your intestines.

The SIBO breath test kit

The SIBO breath test kit

Two things to note about testing:

  1. There is no definitive consensus about what constitutes a positive result, so your diagnoses may depend on your doctor and which test you take. Glucose can only provide information on the first two to three feet of the intestines, because after that it’s absorbed into the body. Lactulose is the safer bet if you want to test for bacteria beyond that point, but can provide less clear results.

  2. False negatives are possible. There can be another bacteria in your gut that eats the hydrogen and methane gas, so gas levels will not show up as elevated even if in fact they are.

This is what happened when I took the test: my hydrogen and methane levels were not elevated enough to clearly conclude that I had SIBO. But my doc and I decided to move forward with SIBO treatment because of my history and symptoms, and the fact that if SIBO was in fact the case, we would need to treat that before addressing any other issues.

TREATING SIBO

Digestive issues are complicated. There is SO much we don’t understand, and SO much more than simple science. I say that not to discourage you, but rather to empower you. If you’ve been diagnosed with SIBO this may just be step one in your healing journey - I know it is for me. Use this as an opportunity to learn more about your body and yourself, to truly examine your habits, but know that one round of antibiotics, or herbal antibiotics, may not be the cure all.

While a SIBO diagnosis and treatment plan may provide physical and emotional relief, this is rarely the only issue and there’s rarely a one-size-fits-all healing protocol

With treating SIBO, you have options. First, I recommend working with a practitioner (a doctor or naturopath) that you’re comfortable with and trust. I DO NOT recommend going at this alone - it’s important to have a professional who’s dealt with many cases and can see things in your tests and symptoms that you may not.

Additionally, I encourage you to go with your gut. If you’re not feeling great about taking antibiotics, find someone who will support you through a herbal protocol. And if your doc is pushing the herbal route but you’d rather just go at it with drugs, do that.

When I shared on social media that I was taking the antibiotic route (versus herbal) I got some push back. Why would someone like me who promotes holistic health and healing choose medication over herbs? Aren’t I so against antibiotics since they kill the good bacteria in your gut?

This was a personal decision and ultimately my body and heart knew that I needed to go this route. It’s also what my doctor suggested, especially given my history and the long term nature of my symptoms, and I trust her. There is a time and place for Western medicine, and even though I’d prefer natural solutions 99% percent of the time, for ME this felt like a situation where I wanted to use the power of stronger drugs.

While SIBO protocols vary, my doctor (Dr. Aliza Cicerone, ND FABNO, amazing human and founder of Spark Health) recommended her unique 4 phase protocol for me:

  • Phase 1: Treat SIBO. This is when you’ll be actively killing the overgrowth of bugs through an antibiotic or herbal antimicrobial. Most often there are no dietary restrictions during this time, with the exception of foods that may interact with the drugs or herbs you’re taking.

  • Phase 2: Restricted diet. During this phase you’ll be on a restricted food protocol and likely an extensive supplement routine. The purpose of this phase is to continue to starve off any bacteria overgrowth while also supporting your digestive processes.

  • Phase 3: Re-introduce and re-build. During this phase you’ll start adding restricted foods back in. The purpose is 1) to start to re-build the good bacteria in your gut through the introduction of new foods and 2) observe if there are any foods that trigger your symptoms. You’ll likely re-test for SIBO before starting this phase - if it hasn’t improved, you may go through another round of phase 1 and phase 2.

  • Phase 4: Maintenance. Ultimately the goal is to get you to a place of “I can live here.” Through the reintroduction phase it may become clear that there are other issues at play that need to be explored (food intolerances, hormone imbalances, etc).

SIBO is a chronic condition. If symptoms comes back, it’s not an indication that the treatment plan didn’t work, but instead that the root cause was not dealt with properly, or there wasn’t an appropriate maintenance plan.

MY PERSONAL SIBO HEALING PROTOCOL

As I write this, I’m just over 3 months into my SIBO healing protocol. What I’ve found is that while the medications, supplements and dietary shifts are essential to me feeling better, the lifestyle changes and healing practices have been just as essential.

Before we get into those practices and healers, I want to share an outline of the protocol I’ve been on. This is NOT a recommendation for you to follow this protocol. I purposefully have not included dosages. As I mentioned previously, I strongly encourage you to work with a professional (someone with extensive SIBO experience - I’ve linked my doc below!) and together craft a plan that works for your body.

  • Phase 1 - Treat SIBO - As stated above, my doctor and I decided to go with traditional antibiotics. During this phase I was on two antibiotics to kill off the bacteria overgrowth (Rifaximin and Metronidazole), along with Naltrexone which supports gut motility. No diet modifications at this point except no alcohol because it can interact with the drugs. I started to take my supplements during this period including support for fat, starch and protein digestion; vitamin D and an energy support blend.

  • Phase 2: Restricted diet - After the course of antibiotics, I started the restricted diet phase of my healing. I had a very specific foods list and everything had to be cooked (and homemade to ensure no restricted foods were included). My list included a handful of fruits and vegetables (but again, everything had to be cooked), all proteins (except a few high mercury fish) and a few fats/oils. It was similar to a low FODMAP plan except a bit stricter, with no grains or dairy and everything had to be cooked. I could have tahini and winter squash which basically saved me during this phase, which ended up lasting for 45 days (we originally planned for 30 days but I wanted to go a bit longer since my symptoms weren’t improving as much as I would have liked). This was definitely a challenge, especially since I traveled during this time, but it wasn’t THAT hard. I stuck with basically the same supplement plan except I was taken off the energy support blend, and added in an additional enzyme support and gut lining repair support in between meals. I also continued the Naltrexone

  • Phase 3: Re-introduce and re-build - This is the phase I’m currently in! My foods list has expanded so I’m gradually adding back in specific foods (one at a time!) and monitoring my symptoms. I’m also allowed to have raw foods, which I am SO happy about since it’s the middle of summer here in NYC. My supplements will shift some during this phase - the plan is to scale back some of the digestion support (ideally we want my body to do this all on it’s own)! The energy blend supplement comes back in thought, which I’m glad about because I felt it helped in Phase 1. If all goes well with food re-introduction, I will start adding in a probiotic in a few weeks to start to re-build my gut bacteria.

My first time taking antibiotics in over 10 years

My first time taking antibiotics in over 10 years

Throughout all of the phases, I’ve been working on specific lifestyle changes and with certain healing modalities to support my gut healing. All of these practices were recommended by my doctor, and every single appointment she has checked in with my, gently reminding me that stress reduction and being kind to myself is just a crucial part of the process as the foods and drugs.

  • Stress reduction

  • Allowing 3-4 hours between meals

  • Mindful eating (ie chewing and being present with food)

  • Quality SLEEP! Especially during the antibiotic phase

  • Daily low intensity exercise (walking, hiking, yoga, light runs, stretching or rebounding)

  • Sauna and salt baths

  • Manual therapy (at some point I will write a whole post on this because I feel it has been SO supportive to my healing process)

  • Acupuncture

  • Lots of therapy, sessions with my own coaches and long talks with good friends

What next?

One of the most frequent questions I’ve gotten over the past few months is “So how are you feeling??”

That is the million dollar question, isn’t it?

Am I feeling better than I was 3 months ago? Definitely.

Am I feeling totally healed? No.

As I mentioned above, I do believe SIBO and SIBO healing is just one step in my process. I’m grateful for this experience, for the fact that I do have the time and resources to commit to such an intense protocol, and for all the things I learned and re-learned along the way.

My doctor and I decided NOT to re-test for SIBO at the end of Phase 2, mainly because I am still experiencing symptoms and I did start with a negative test. We’ll be exploring other avenues, including a stool test and a food intolerance test, after a few weeks of re-introducing foods.

I know that this isn’t a quick fix. That my gut issues run deeper than that, and that it’s going to take time and patience to feel REALLY better.

But I’m #hereforit. Ultimately our guts are our guides, and if something isn’t right down there, there’s often more than just food that needs to change.

I’m doing what I can now, taking the steps I can with my body, my work and my life. Bigger change is coming, and deep in my heart I know that these changes are going to be so good for my gut.

When life gives you a challenging diet, make  MUFFINS !

When life gives you a challenging diet, make MUFFINS!

As always, THANK YOU for reading, for being a part of this journey and for cheering me on all along the way! If SIBO is something you’re dealing with or you’re curious in learning more about this condition, I suggest checking out the articles and resources I’ve linked below.



And finally, a HUGE thank you to my team of healers and support over the last few months. I definitely wouldn’t have made it this far without you!

Dr. Cicerone and the Spark Health team (SIBO and gut specialist!)

Delia Ahouandjinou (Manual Therapy NYC)

Christine Nichols (Alchemical Acupuncture)

The Studio NYC

Megan Bruneau

My gut history (IBS, SIBO + more!) - Part II

The purpose of sharing everything I’m sharing today is not to tell you what to do or present you with the perfect formula for feeling better (I still haven’t figured that out yet!). Rather I hope this post will provide you with options and inspiration for foods, supplements, healing modalities and lifestyle choices that may help your symptoms improve.

In this blog post I’m going to share the things I have tried in the past to heal my gut and relieve my IBS (+ SIBO) symptoms.

In case you missed it, check out the first post in my gut history series here:

My Gut History (IBS, SIBO + MORE!) - Part 1 - How it all Started + Symptoms

With everything that I share here on my blog and on social media, I encourage you to follow your curiosity and intuition. Do you feel something light up in your belly reading about acupuncture and essential oils? Or perhaps hearing about the low FODMAP diet piques your interest? Try that!

While there are some proven strategies (low FODMAP being one of them, more on that below), for the most part what works well for one person is slightly (or more than slightly) different from what works for another. This is called bio-individuality and because of this, experimentation is the best way to find what I call your “feel good formula” - the combination of food and other strategies that allow you to feel your best.

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FOOD + DIETARY STRATEGIES

As I started writing out this list I realized just how many food approaches I’ve taken over the years (it’s a LOT!). Many of these approaches did provide me with relief for a period of time.

  • Vegan/ Vegetarian - My first attempt to manage my IBS symptoms through my diet was by reducing, and then eliminating meat and animal products. This was almost 10 years ago - at the time pretty much all health bloggers were vegetarian or vegan and so it felt like the right path to follow. While it surely helped some to become more conscious of my food choices, over time this became a diet I was following because I thought I “should” instead of what my body was telling me.

  • High Carb - Low Fat - When vegetarianism and veganism started to fail me (my belly issues weren’t fully resolved… which I now know was more about job and life stress… and I gain a bit of weight), I fell into an internet hole all around the high carb low fat vegan diet. Individuals who follow this diet eat mostly raw fruit and vegetables, with very little else. It seemed super attractive to me at the time: I could drink smoothies made with bananas and coconut water, eat 5 mangoes for lunch and enjoy a big ass salad for dinner. I think the most enticing thing was the feeling that I didn’t have to limit myself. In college I fell into a cycle of calorie counting and even though I moved away from that, the restriction mentality was still on my mind (eat less = feel better). For a little while I felt great on this diet (I’ve since learned that my body does well with simple meals and fewer foods combined together). The problem was that it didn’t mesh well with my corporate, city life, especially during colder months or when I wanted to be social. So I pretty quickly gave it up and went back to my more traditional vegan diet filled with grains, beans, nuts and seeds.

  • Paleo / Whole30 - Fast forward to 2.5 years ago… I was getting ALL the signs from my body that I needed to eat meat again. I had added back in fish and eggs a little while after the HCLF experiment and while it was helping with my gut and energy levels, I found my body asking for more. I decided to do a Whole30 in January of 2017 as a way to reset after the holidays. It was an awesome experience and I definitely recommend the program for anyone looking for a super sane, whole foods based reset. Since then, my diet mostly models a paleo diet, with the occasional gluten free goodie or grain here or there.

  • Ketogenic - When keto first starting getting popular I of course had to try it out, for experimentation sake ;) Keto is HIGH fat and usually heavy on animal proteins (so pretty much the opposite of my HCLF experiments). This is one diet that really did NOT work for me. I had a ton of indigestion - fat can be tough to digest, especially if you have a weaker constitution - and felt more anxious than usual. The one thing I learned from this approach is that it helped me stop snacking and allowing myself more time between meals (another thing I’ve learned my belly likes - space to digest!).

  • Low FODMAP - A few times over the years I have tried to follow a low FODMAP approach. FODMAP stands for fermentable oligo-, di-, mono-saccharides and polyols. These are the scientific terms used to classify groups of carbohydrates that are notorious for triggering digestive symptoms like bloating, gas and stomach pain. This diet is the ONLY diet scientifically proven to reduce IBS systems. When I’ve done it, it’s definitely helped reduce my symptoms, but, like so many of the approaches I’ve tried, it didn’t help SO much that I’ve been motivated to stick with it long term. I do know many many people who this approach has provided much relief to, so absolutely worth trying out.

  • Celery Juice / Medical Medium - A relatively newer trend, drinking celery juice on an empty stomach and eating a diet rich in plant based superfoods is an approach made popular by Anthony Williams, aka the Medical Medium. I tried drinking celery juice first thing in the AM for a few weeks and my symptoms (specifically bloating) did improve. Honestly I fell out of this because it was such a commitment. Celery juice is something I’d like to add back in after I’m through the first phase of the gut healing diet I’m on currently.

  • Elimination diet - Elimination diets are very popular in the digestive health world as they allow you to experiment on yourself and determine if common allergens and irritants are causing your issues. I’ve done many rounds myself - my first I eliminated gluten, dairy and sugar, and more recently I’ve played with eliminating other common trouble foods like eggs, nightshades, nuts and grains. I highly, highly recommend an elimination diet for anyone struggling with belly woes -it’s such an empowering way to figure out if there are certain foods triggering your symptoms. I’ve supported MANY clients through this process - I definitely suggest working with someone to help keep you on track and to have space to reflect on your experience. Contact me if you’d like to chat about how I can support you during this process. 

Celery Juice.JPG

Supplementation

As I mentioned in this post, for the most part I’ve approached my symptoms from a more holistic way - preferring diet, lifestyle and supplement tweaks over traditional medication. Here are some of the supplements I’ve taken over the years to relieve my IBS symptoms.

These supplements have all proved beneficial for me over the years - I don’t take all of them all the time but rather bring specific remedies in during periods where I feel like my body needs a bit more help.

  • Insoluble fiber - In college I used laxatives which NEVER felt good (guys, laxatives are NOT meant to be taken regularly), but soon after I switched to using a more natural insoluble fiber supplement. Insolube fiber promotes the movement of material through your digestive system and increases stool bulk, so it can be of benefit to those who struggle with constipation or irregular poops.

  • Probiotics - I cannot tell you how many people have messaged me (when I post about digestive woes) “Well have you tried a probiotic??” Yes. I’ve been taking probiotics for YEARS. And while this supplement has certainly helped, it’s not the magic pill for me (spoiler alert: there usually isn’t JUST ONE THING). A quality probiotic helps support the balance of good bacteria in your gut and can be beneficial even if you don’t struggle with gut issues. Note: If you have SIBO or think you have SIBO, taking a probiotic is not going to be helpful since you have a bacterial overgrowth. More on SIBO specifics supplements in the next post of this series!

  • Magnesium - Bloating, cramping and diarrhea can all be caused by inappropriate spasms of the muscles in the gut. Magnesium helps to relax these muscles which can significantly improve these symptoms.

  • Digestive enzymes - In addition to being a physical process, digestion is also a chemical process. During digestion, the body breaks down food, extracting the energy and nutrients it needs. An important part of this process are enzymes that start the breakdown process. Taking a digestive enzyme before meals (especially heavy or larger meals) can give the body the boost it needs to properly break down food.

  • DGL - Another pre-meal favorite supplement of mine is DGL (deglycyrrhizinated licorice). Licorice is soothing to the digestive tract and can be especially helpful with relieving acid reflux and indigestion.

  • Aloe Vera juice - Like DGL, aloe vera is calming and soothing for your digestive tract - you can think of it calming any internal “sunburn” (ie inflammation) in your gut. You can add a splash to your water or smoothies, or mix with juice and take it like a shot.

  • Herbal remedies - In the past I’ve worked with acupuncturists who have provided herbal remedies to help relieve symptoms. Many of these remedies are focused on the other organs and glands (specifically adrenals and hormone balance) and not the gut itself, but as you may know everything in the body is connected.

These supplements and more are all linked on my “Favorite Products” page

These supplements and more are all linked on my “Favorite Products” page

healing modalities

The root of most digestive issues (especially IBS) is stress and inflammation. The healing modalities listed below all work to reduce stress, calm inflammation and ultimately allow the body to function more optimally.

Some of these modalities focus more on the physical body, some are more for the mind. More and more research is showing how intricate the mind body connection truly is - you can’t simply heal the gut by taking a series of supplements. There must be an energetic or emotional component to healing as well.

  • Yoga, meditation + breathwork - I first found my way to yoga to balance out years of distance running, and I was quickly hooked on more than just the physical benefits. Over the years I’ve done all sorts of practices, right now a combination of vinyasa and Katonah yoga feel really good in my body, ideally in the morning before caffeine or food. The movement from any sort of exercise, but especially yoga, is super helpful to promote gut motility.

  • Acupuncture - I started going to acupuncture right after my initial anxious stomach diagnosis. My body responds well to this healing modality and so it’s something I keep in my regular routine. Many folks with digestive issues find that the relaxation and release from acupuncture is immensely supportive in managing symptoms.

  • Bodywork - Similar to yoga and acupuncture, bodywork (massage, myofascial release, manual therapy, etc) helps promote movement in the body. Bodywork specifically tends to work with the tissues and fascia.

  • Energy work (mainly UHP) - And now we move into the more energetic and emotional healing techniques. The main form of energy work that I work with is Universal Health Principles (which you can read more about here and here). I am a UHP practitioner so I do sessions on myself but also try to receive regular sessions from other certified practitioners.

  • Therapy - I’ve been in therapy for the last 2.5 years and it’s definitely been a HUGE part of my healing process. I’ve learned so much about myself, and have had so many insights around how my physical and emotional health are connected. Plus, it’s been an essential way for me to start to acknowledge and release what’s been weighing on me.

  • Stress management - My flare ups almost ALWAYS happen after an intense or stressful period, and so learning how to appropriately manage and release stress has been so key for me (and for almost ALL of my clients, friends and family who suffer from similar digestive issues). All of the above help me manage my stress, but other things I do include nightly journaling, time in nature, quality time with friends, essential oils, exercise of all forms, deep meditations and time offline.

  • Mindful eating - HOW you eat is just as important as WHAT you eat. If you are stressed or distracted, your body isn’t going to be able to properly digest and process your food. Slow down, be present with your meal and chew your food - it sounds simple but it truly is a challenge in today’s hyper connected world.

Katonah Yoga.JPG

In the next post (which may be the final post in this series for now!) I’ll share more specifically where I’m at RIGHT NOW. As many of you know I’ve been working with a doctor and nutritionist doing a very strict SIBO protocol, which I’ll share more about in that post. Feel free to message me with your specific questions or leave them as comments below.

If you yourself have struggled with digestive issues (IBS, SIBO or otherwise), I’d love to hear from you - what has been the most helpful healing approach for your body?

Leave a comment below and share with us all!

My gut history (IBS, SIBO + more!) - Part I

It’s funny - my health and wellness journey began with my own gut issues, but over the last year or so I stopped sharing as much about digestive health, and focused more on general wellness, mindfulness and even have started coaching more around living a fulfilling life (ie career and life coaching).

It’s not that I don’t enjoy talking and teaching on gut health - I do! But I think on a subconscious level as my own symptoms started to come back and worsen, I began to become less confident in my ability to coach around something I clearly hadn’t figured out for myself.

Recently I started sharing more of my own journey (including the foods and healing modalities I’m trying along the way) and the response has been incredible. I get messages on Instagram every day from individuals saying how grateful they are for the recipes and tips I’ve been sharing, as well as words of encouragement.


Lesson for all my coaches READING THIS POST: You don’t have to have mastered, healed or fixed all of your own stuff before you can be of service to others.

The more I shared, the more questions came my way about my history and symptoms, what I’ve tried in the past, what’s worked and what hasn’t. I also had a lovely reader ask (via the community survey I sent out earlier this month!) that I put all my gut healing tips and recipes together in one place.

SO… I’m doing just that.

In a series of blog posts over the next few weeks I’m going to be sharing all about my gut health history and journey thus far.

If there’s something you have a specific question on or would like to see covered in this series, please shoot me a message and I’ll do my best to address it here!

Today we’ll start with how it all began… when and how my digestive issues first came up, and the symptoms I’ve experienced along the way.

IBS SIBO history - Emily Nachazel.png

How it all started

I always say I’ve had digestive issues my entire adult life, which is true - I can pinpoint the day during my freshman year of college when my symptoms started. Some of you have heard the story, some of you haven’t so I will share it below but there are some other facts I want to bring into this post that may have a part to play in my digestive health history:

  • I was a super sensitive kid with picky taste. I was the one who always got her feelings hurt, who went home crying more often than the others. I also remember being a little picky about my food - not liking specific foods and eating my meals in a specific way (I didn’t want my food categories to touch and would eat one at a time).

  • In high school I contracted mono (yup, the kissing disease). This is also when I remember being more aware of my body and my weight. I had always been normal sized, not super skinny but average - then I lost a lot of weight running cross country as a freshman, and subsequently gained a bunch back when I was sidelined from sports because of mono.

  • High school (my sophomore year) is also when my friends and I started drinking alcohol. We drank anything we could get our hands on, often a combination of spirits siphoned from our parents’ liquor cabinets. This obviously continued into college where alcohol was WAY more available and a big part of undergrad life.

It was during my second semester of college that I had my first intense belly ache (which I’ve since coined l my “stomach attacks”). It had been a stressful semester, I was carrying a full course load and had joined a sorority, so I was partying more than usual. My motto was “work hard, play hard” - I definitely didn’t drink and go out as much as some of my friends, but still it was A LOT. I was also running and working out more. I had gained some weight my first semester (beer and unlimited ice cream at the cafeteria will do that to you) and wanted to lose it.

My mom was visiting and we went to the downtown mall for lunch (I went to college in Charlottesville and this was an outdoor mall with lots of cute shops and nice restaurants, a quick drive or bus ride off campus). We stopped into a deli and I ordered an egg salad sandwich - something a little strange for me as it’s nothing something I would usually get out (I was never a big fan of mayo). I ate it and then my mom dropped me back at my dorm to do a little work before we’d meet up again for dinner.

Back at my dorm I started to feel awful. I was having these intense pains in my stomach, unlike anything I’d ever experienced before - I curled up under my rainbow sheets on my XL twin bed and called my mom crying, not sure what was happening. It was so bad she almost took me to the hospital, but after a little time (and some Tums and Saltine crackers) the pain started to subside.

College = too much fun ;)

College = too much fun ;)

MY FIRST ATTEMPT AT GETTING HELP

I don’t remember having more of those intense belly aches throughout college, but I also chilled out a bit after freshman year. I do remember feeling like my stomach was sensitive, and I was particular about what I ate (healthy food, I cooked a lot even then!).

It wasn’t always easy for me to go to the bathroom (especially the more specific I got with my food and workout routine) and college is when I first experimented with using laxatives to help my body be more regular.

Fast forward to after graduation when I entered the “real world” as an auditor at a Big 4 Public Accounting Firm. I loved my job, but after my first year it became more and more stressful. Not necessarily because of the work, but because I was a high performer and I took on a lot, and didn’t always know how to ask for help when I was over committed.

I started running a LOT more consistently (ie every day). I got more and more healthy (and also more and more extreme) with my diet, eventually becoming vegetarian and then vegan. I swapped the laxatives for “more natural” fiber supplements.

But despite all I was doing for my body and for my health, I regularly felt bloated and constipated, and pretty soon my stomach attacks started coming back.

I finally decided to see a gastroenterologist at the urging of my mother. He did a routine examine and tested me for the major digestive distress culprits at the time: gluten and lactose intolerance, and I believe Celiac’s as well. Everything came out negative.

The gastroenterologist told me I had IBS (Irritable prescribed me anti-anxiety medication and sent me on my way.

I was 22 at the time. I didn’t think I was anxious (I was). I knew some people who were on anti-anxiety meds and I thought “That isn’t me.”

And it’s true - I’ve learned since then that my anxiety manifests more inwardly (literally IN my organs), versus the frenetic restlessness and lack of focus I saw in others. But at the time I refused to take the drugs and instead decided that I would get to the bottom of whatever was causing my pain on my own.

This interaction also left me with a bad taste in my mouth with Western medicine - it would be almost 10 years before I saw another doctor for my gut health symptoms again.

The more I had stomach issues, the healthier I tried to be. Yes I’m cutting the fat off chicken breasts here

The more I had stomach issues, the healthier I tried to be. Yes I’m cutting the fat off chicken breasts here

MY SYMPTOMS

Over the years, my symptoms have ranged, but here’s a summary of what I’ve experienced. I’m also defining some terms below so that you can start to asses if symptoms you’re experiencing are worth further exploration. For example, I’ve had clients that didn’t realize going to the bathroom only 1x every 3 days wasn’t normal until speaking with me, and after some shifts in their diet and routine they were able to have daily BMs (bowel movements!) and feel so much better.

  • Pain in abdominal area - As described above, these “stomach attacks” have been a recurring issue for me. Sometimes I’ll have them as often as every day, or every week, sometimes I’ll go weeks or months without having an issue. Usually it feels like sharp, pain on the left side of my abdomen, combined with a sour feeling in my insides and extreme bloating.

  • Bloating - Bloating is something I’ve dealt with regularly also. This is an interesting symptom to look at because it’s cause can be so many things from eating too quickly, to food intolerances to body image issues (yep, disordered body image can totally result in bloating, or thinking you’re bloated all the time). We’ll dive more into the why of bloating and specific tools to decrease bloat in another post, but for now I simply want to share that this is something I’ve experienced regularly for the last 10+ years. And it sucks because no matter what the rest of you feels like, when your belly is bloated you feel uncomfortable and unattractive.

  • Constipation - Constipation is defined as “a condition in which there is difficulty in emptying the bowels.” This can mean you go for days without a bowel movement, but you can also be constipated even if you’re pooping every day but you don’t feel like your bowels are fully emptying. Back in college and my earlier 20s, I experienced a lot of traditional constipation. I dealt with this by using laxatives, fiber supplements and drinking a lot of coffee, which helped in the short term but I believe this also contributed to my longer term issues. This is improved now, but there are still a lot of time where I go but it doesn’t feel complete.

  • Diarrhea - Diarrhea is loose, watery stools, and professionals will say you have diarrhea if you have loose stools three or more times in one day. I usually have a bout of loose stools before one of my stomach attacks.

  • Rashes - This has been the least frequent of my symptoms, but quite a few times I’ve broken out in strange, hives-like rashes on my back, neck and face. Often (but not always) the skin will reflect what’s going on inside our bodies so rashes, breakouts and acne can be a symptom of gut issues.

  • Chest and back pain - I’ve had my share of chest and back pain over the years, more recently it’s been mostly in my back on the lower left side. There are a few explanations for this pain: Gastroesophageal reflux disease (GERD), caused by stomach acid splashing up into the esophagus, can cause a burning sensation or a tightness under the sternum. In addition, gas occasionally produces intense pain that makes the entire abdomen feel full and tender. This pain can radiate to the back, causing back pain and bloating. Other GI issues can also cause muscle pain. This can happen after straining to have a bowel movement or repeatedly vomiting.

  • Weight loss, and weight gain - My weight has fluctuated quite a bit over the years. As I mentioned earlier, I’ve always been “normal” sized - not super skinny but not heavy by any means either. When I first started having digestive issues, I lost a lost of weight and got to a place where I was very, very thin. More recently I’ve gained quite a bit. Both sides of the scale don’t feel good, I’d love to be at a more balanced place with my physical weight and I know this will happen naturally when my gut is also balanced. Weight fluctuations can absolutely be linked to digestive issues for so many reasons - your appetite can increase or decrease depending on other symptoms. In addition, if your microbiome (the billions of bacteria that live in and on your body, especially in your digestive system) is out of whack, this can result in unhealthy weight gain and/or loss.

  • Anxiety, depression and disordered body image - Alright here’s where we go a little deeper, and where I share some things I haven’t shared very publicly before: over the years I’ve struggled with a disordered body image (especially with my belly), anxiety and depression. Our brains and our guts are intricately connected - there’s so much research being done proving that our guts are in fact our “second brains” and play a huge role in so much more than digestion. The state of our bellies impacts how we feel (energy and emotions) - we get butterflies in our stomach before going on stage or when chatting with someone we have a crush on, we know that sinking feeling in our bellies when we’re about to hear bad news, and it’s like our insides are tied in knots when we have a tough decision to make. On an energetic level, our guts are the center of our beings. It’s where our third chakra is located, and this is the chakra that connects to self confidence and our personal radiance (the third chakra is called manipura which translates to ‘bright jewel’). Sometimes physical digestive issues can be the result of emotional issues such as anxiety, depression and feeling meh in your body, and sometimes it’s the other way around. I’ll be sharing more about the energetic and emotional side of the gut and how I’m working to heal myself on that level, but for now I want you to know that these “symptoms” can in fact be linked back to the gut.

Note: I know you know this BUT I am NOT a doctor. On this blog I share my personal stories, and what has helped me and my clients over the years. If you think you have a serious condition - digestive, mental health, or otherwise - I encourage you to consult a trained professional. Please see my full disclaimer here.

Real life - me a few weeks ago, mega bloated before yoga.

Real life - me a few weeks ago, mega bloated before yoga.

WHAT TO DO

Whew! This post ended up being way longer than I expected, but I hope this provided you with some useful information about my history and symptoms.

Personally, it’s been helpful for me to hear others’ stories and symptoms as it 1) makes me feel less alone 2) dissipates some of the shame we feel around our bodies, especially with our bellies and bowel habits and 3) allows me to more clearly articulate what’s going on in my body. Like I shared about my client who wasn’t going to the bathroom, sometimes it takes hearing another’s story to realize what we’ve been experiencing is not normal, or there’s something we can do to improve our current situation.

In the next post in this series, I’ll be sharing more on what I’ve done over the years to manage my symptoms and get to the bottom of what’s going on with my gut.

Please feel free to message me your questions, or leave them below - as much as writing this series is to be therapeutic for me, I also want it to be interesting and useful for you!



Above all, whatever you’re going through, whatever you’re experiencing I want you to know you’re not alone and there IS HOPE. And even if there is no magic fix, no one diet or supplement that will wash away all of your digestive woes, you can and will feel better.

I believe in you. I believe in me. I believe in the power of our bodies and their desire to heal and function optimally. It may take time, and a lot of experimenting, but there is a better, brighter reality.

Why I'm not eating salads...

You are never going to guess what my acupuncturist told me NOT to eat.

SALADS.

Yup. I'm not supposed to be eating the "healthiest" food out there.

Let me explain...

I spent the last few weeks out in California. It was my little escape from NYC winter and it was lovely! I soaked up the sun, ate ALL the fresh produce and really made an effort to take care of myself (not drinking much caffeine or alcohol, sleeping plenty and exercising regularly).

So I was shocked when, at the end of my trip, I started to get sick.

I never get sick!!! What was going on?

I did EVERYTHING to fight off this illness. I ate ALL the immune boosting foods, I took my sickness-fighting supplements and I let myself rest.

I didn't get better. My head felt like it was under water, I was tired and achy and SO BLOATED. Not just my belly, but my whole body felt puffy. After a few days of this, I decided I needed some outside help so I got a recommendation for a local acupuncturist and booked an appointment.

I love going to acupuncture because I feel like it's a great mix of traditional and holistic medicine. The acupuncturist asked me a whole slew of questions (do you drink coffee? what are your stress levels? what's your diet like? do your hands get cold easily?) and he also took my pulse and looked at my nails and tongue (which supposedly show a LOT about your overall health).

His conclusion? I wasn't sick, but my body was working too hard trying to digest all the raw (and oh so lovely and beautiful) foods that I was eating. Because approximately 80% of our immune systems are located in our guts, when something is off with our digestion we can show signs of sickness, even if we haven't got a cold or flu.

So, the very next day I switched from salads to stir fry and soups and other cooked foods. And guess what? I pretty much IMMEDIATELY felt better.

I wanted to share this story for two reasons:

1) Sometimes we need to ask for help. I'm a health coach and very in tune with my body, but that doesn't mean I ALWAYS have the answers. Sometimes it's easier for an outsider to see the situation as it is and point something out that we ourselves have missed.

2) You don't have to eat salads to be healthy!! This is still one of the biggest health myths out there - that raw salads are the only way to beat belly bloat, feel super energized and be your healthiest self. While raw veggies are WONDERFUL, they are not the only option, nor the best option for everyone. In fact, if you struggle from digestive issues like IBS (like me) consuming more cooked foods may help you tremendously.

Here are a few ways to still get your VEG on sans salad:

  • Warm 'em up - Did you know that you can heat up salad greens? Some hold up better than others but you can do a quick saute with pretty much ANY green.
  • Add 'em in - Stir greens into your soups and stir frys. LOTS and lots and lots of them.
  • Get blendy! I'm a huge fan of blender soups like this one.


Click the photos for cooked food recipes!

Do you eat a lot of raw veggies or mostly cooked ones? Do you notice one or the other is more easily digested? I'd love to hear from you.

Spicy Citrus Tea

Tummy feeling off? Or just need something to bust through the after-dinner sweet cravings? This is the tea for you. The brightness of the citrus paired with the spiciness of the ginger and cayenne both calms belly discomfort AND sugar cravings. I like it as is, but feel free to add 1-2 tsp of raw local honey if it's a little too strong for you :)

Spicy Citrus Tea // vegan, gluten free, paleo, sugar free

Ingredients:

- 1/2 lemon, sliced

- 1/2 orange, sliced

- 1 inch knob of ginger, peeled and sliced

- generous pinch of cayenne (optional, but great for your digestion and immune system!)

Instructions:

  1. Add all ingredients to a small pot and cover with 2-3 cups of filtered water.
  2. Let simmer over medium high heat for about 10 minutes (you can let it go longer for a more concentrated flavor).
  3. Pour into a mug and ENJOY!