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Questions for my doctor regarding digestion?

Answered on September 12, 2014
Created February 18, 2011 at 3:42 AM

Last April I cut out HFCS and lost 15 pounds in two months, but stalled after that. I started paleo in September, but I still haven't had any significant weight loss. My weight fluctuates between 157 and 163, but otherwise it hasn't budged since June. I'm 5'2" and would love to be at a healthier weight.

It was brought to my attention that my once per week bowel movements should be daily. I can't remember when I started going only once a week (sometimes less often), but I know it's been almost a year at least. It was suggested that I see a doctor. I have an appointment tomorrow.

Are there any specific tests I should ask for? Any drugs I definitely don't want to take that she may recommend? I worry that she's going to want a quick fix and that a potential underlying problem could be ignored. I also worry that there may be an easy fix and she'll want to give unnecessary tests and drugs. I don't trust conventional wisdom, but I don't know how to fix this on my own.

A little background. I had my gallbladder taken out in '96 and my appendix out in '07. I am sensitive to gluten, dairy, fruit, nuts, tomatoes and starchy vegetables. I usually only eat meat, vegetables (cauliflower, broccoli, asparagus, spinach) and fat (coconut oil, olive oil and occasionally Kerrygold). I drink a few cups of coffee in the morning with minimal heavy whipping cream and over a gallon of water throughout the day???I'm usually that thirsty. I love eating this way and I feel great, apart from constantly being bloated and never losing inches in my waist.

I take Now Foods Super Enzymes with every meal and fish oil almost daily. I supplement with D3 and magnesium. I sleep 7-9 hours a night.

Any advice you have for my appointment tomorrow would be great! Any advice also on my inability to go to the bathroom would be appreciated too. Thank you!

Eea4c0f072bb5caa74c1fbe6dfab5f46

(942)

on February 26, 2011
at 03:01 PM

I agree that probiotics and sweet potatoes is the way to go. You can also try chia seed. And I would cut out the coffee! Might be one reason why you are so thirsty -- it dehydrates you. And you can also buy straight glucose. Have teas like yerba mate with cream instead.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on February 18, 2011
at 06:59 PM

So which carbs do you eat if you're not eating any starch or any sugar or any dairy (well I guess you have minimal dairy)? The carbohydrate in vegetables is not really available to you as glucose -- by the time it's in your bloodstream it is fat, actually, thanks to your gut bacteria. That's another thing the Jaminets talk about, but you can also find it in textbooks. ... Hope the experiment with the sweet potatoes goes well! If you post a comment back here to let us know what happens I'd be very interested to read it.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 02:23 PM

This is interesting. I hadn't even considered myself VLC. I actually tried for VLC for 4-5 weeks last year and logged all my food intake on fitday. I felt like crap the entire time and gained weight and decided it wasn't for me. Lots of people talk about this elusive ketosis that sheds the fat, but that doesn't happen for me. I hadn't considered adding glucose. I'll have to play around with sweet potatoes. (They'll suffice, correct?) I may be able to eat a couple a week to see if the glucose theory rings true for me too. Thanks Paul!

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:41 AM

@Olga Thanks for the suggestions! I will definitely try some of them.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:34 AM

I actually realized last week that I shouldn't be eating so much Kerrygold and very, very sadly cut back on it. That's good to know about the MCTs though.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:30 AM

I'll have to mention the thirst to my doctor then. Thanks. It's not that I drink because I feel overly thirsty, per se. It's more that my mouth gets dry if I'm not drinking that much. I work out, but there's no heavy sweating.

F9a0b72f38860d7601afd5a45bb53394

(3618)

on February 18, 2011
at 05:15 AM

You can eat medium chain triglycerides without too much trouble. Try cutting back on the butter and eating more coconut oil. (Normally I wouldn't recommend axing butter, but it contains long-chain triglycerides.) You don't need bile salts for the MCTs.

E46d4f7e35e46ee4e8211ab4bc852023

(1510)

on February 18, 2011
at 05:10 AM

Hmm, just realized that the eating more fat suggestion might not be appropriate for someone without a gallbladder. That could be a good thing to check with the doctor about.

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5 Answers

3
03db20f160e58814827ae5a05a5c8792

on February 19, 2011
at 01:53 PM

Hi kinetic,

with your symptoms and constipation you are really in trouble. Yes, most docs just say "Eat fiber". That is the worst thing you can do! It is like healing "alcoholic fatty liver" with high doses of tequila. Probiotics are the answer not psyllium.

The fiber Scam is insane. Konstantin Monastyrsky explains why. Mark Sisson mentioned him in an interview und recommended his book "The Fiber Menace"

http://www.gutsense.org/fibermenace/about_fm.html

You don't have to buy the book. You find everything you need on his website:

Gut Sense: Constipation And Irregularity. How to Reverse and Prevent Constipation and Irregularity in Children and Adults

http://www.gutsense.org/gutsense/about_gs.html

Here you find everything to ask your doctor the right questions and solve your problems

His you tube Videos give you a first impression

http://www.youtube.com/user/GutSense#g/u

A great lecture about how to heal your gut flora and what are the causes for damaged gut flora in the first place gives Dr. Natasha Campbell McBride here:

http://vimeo.com/10507542

For your food allergies or sensitivities read Dr. Campbell's article here:

http://www.gaps.me/preview/?page_id=344

Here is a comment from Mark Sisson's blog from a reader who found help for her kids from Monastyrsky's advise:

"I just completed research into this matter 2 weeks ago, as my 1 year old twins have been constipated since birth. Doctors told me that screaming and rectally bleeding while having a bowel movement once a week could be ???normal??? for someone, while going as many as 4 times a day could be ???normal??? for someone else. I knew this wasn???t true.

After trying all their useless recommendations of adding fiber, drinking water and fruit juice, I finally came across a website called http://www.gutsense.org. This guy (a Ukrainian nutritionist named KONSTANTIN MONASTYRSKY) is the world???s biggest expert on poo and he agrees with this post, Mark.

He has a book called The Fiber Menace and takes it one step further saying that relying on fiber in order to help IBS or to have a bowel movement is actually detrimental and can lead to longterm major problems. People loading up on fiber in their 20s and 30s are going to pay for it big time in their 50s and 60s. According to Monastyrsky, the biggest cause of constipation is disbacteriosis, when the good bacteria in your gut aren???t thriving or plentiful enough. So, I bought some Kefir and added it to my kid???s food. WITHIN ONE DAY, 13 months of constipation was gone and they have been having perfect, regular, soft BMs everyday since. This guy also sells supplement packs, but he discloses the ingredients in them.

He says a couple of weird things I don???t agree with but for the most part, his advice falls inline with a primal lifestyle and his website is worth a read. "

Source: http://www.marksdailyapple.com/fiber/

Campbell Bio

http://www.gaps.me/preview/?page_id=35

Monastyrsky Bio

http://www.fibermenace.com/author/author.html

2
47a42b6be94caf700fce9509e38bb6a4

(9647)

on February 18, 2011
at 06:53 AM

I just noticed that you're not eating any glucose. Fiber is one solution offered for constipation, eating more fat is another. But glucose can do the trick also. I can see that there are other reasons why you're eating VLC, but the infrequent bowel movements might be one result of it. Another result can be dry eyes and mouth. I've experienced this myself, but it was also discussed recently in the Jaminets' series on "The Dangers of Zero-Carb Diets." Most relevant to you is the second post. Here's an excerpt:

Another common symptom of very low carb diets is constipation. This is often attributed to lack of fiber, but I am skeptical. I will get to the various possible causes of constipation in a future post, but for now I???ll just point out that a deficiency of gastrointestinal mucus would create a dry colon and cause constipation.

What connects a zero-carb diet to dry eyes, dry mouth, dry airways, and dry gastrointestinal tract?

Tears, saliva, and mucus of the sinuses, airways, and gastrointestinal tract are all comprised substantially of glycoproteins called mucins. Mucins are primarily composed of sugar; they typically have a number of large sugar chains bound to a protein backbone.

These posts were certainly controversial, and we in fact had a discussion of them here on paleohacks (this thread). But whether you accept the Jaminets' more dire predictions or not, a lot of people think there's something to the constipation connection.

And you have the mouth dryness, which the Jaminets also mention. This happened to me for a while, as I mentioned above. And it was just as you described it in your comment to Eva: my mouth felt really dry, but I wasn't thirsty. Eating some potato now and then made it go away.

I don't know if this matches up with your history as far as the infrequent bowel movements, but it should be something to think about, if you haven't thought about it already. If you agree that glucose could be the problem and you can't eat starch, then if you want to experiment you'll have to find some other way to get it into your body.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on February 18, 2011
at 06:59 PM

So which carbs do you eat if you're not eating any starch or any sugar or any dairy (well I guess you have minimal dairy)? The carbohydrate in vegetables is not really available to you as glucose -- by the time it's in your bloodstream it is fat, actually, thanks to your gut bacteria. That's another thing the Jaminets talk about, but you can also find it in textbooks. ... Hope the experiment with the sweet potatoes goes well! If you post a comment back here to let us know what happens I'd be very interested to read it.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 02:23 PM

This is interesting. I hadn't even considered myself VLC. I actually tried for VLC for 4-5 weeks last year and logged all my food intake on fitday. I felt like crap the entire time and gained weight and decided it wasn't for me. Lots of people talk about this elusive ketosis that sheds the fat, but that doesn't happen for me. I hadn't considered adding glucose. I'll have to play around with sweet potatoes. (They'll suffice, correct?) I may be able to eat a couple a week to see if the glucose theory rings true for me too. Thanks Paul!

Eea4c0f072bb5caa74c1fbe6dfab5f46

(942)

on February 26, 2011
at 03:01 PM

I agree that probiotics and sweet potatoes is the way to go. You can also try chia seed. And I would cut out the coffee! Might be one reason why you are so thirsty -- it dehydrates you. And you can also buy straight glucose. Have teas like yerba mate with cream instead.

2
E46d4f7e35e46ee4e8211ab4bc852023

(1510)

on February 18, 2011
at 04:38 AM

I don't think that you're going to get too much more from your doctor than advice about eating more fiber and checking out the laxative aisle at your neighborhood pharmacy. At least, that's been my experience, and gastros don't offer too much more advice either. I did have the same once a week problem growing up and I can't quite pinpoint how I transformed it because I wasn't paying attention at the time, but I think all of the below factors helped. I think part of it is that your digestive tract needs to get used moving things along more quickly (although I have no scientific basis for this), which require your prompting at first.

  • drink more warm liquids. Hot tea with milk is great about sending a cue to your body that it's time to eliminate.

  • supplement Cal-Mag Citrate. You can take it instead of some or all the magnesium. It's very gentle and you won't see the difference until the next day.

  • eat more fat. For whatever, greasy foods are digested faster. Deep-fried foods work best for this, but even more coconut oil will help to.

  • exercise and stretch. It gets things moving, for whatever reason.

  • chew gum. For me, it sends a signal to my body that more food is coming and space needs to be made.

  • eat softer foods and stay away from foods you are sensitive too. For me, nuts and raw root veggies can be difficult to digest and take a lot longer. If there is any kind of seed involved, it's a disaster waiting to happen. Basically, if it comes out looking a lot like it went it, your body probably doesn't like it.

Fiber never really did work for me, which I found out after experimenting with psyllium husks. I don't think that eating more fiber is the answer here. Sure, the more food you eat of any kind, the more food mass is moving through you and has to come out, but that's not necessarily going to improve timing.

E46d4f7e35e46ee4e8211ab4bc852023

(1510)

on February 18, 2011
at 05:10 AM

Hmm, just realized that the eating more fat suggestion might not be appropriate for someone without a gallbladder. That could be a good thing to check with the doctor about.

F9a0b72f38860d7601afd5a45bb53394

(3618)

on February 18, 2011
at 05:15 AM

You can eat medium chain triglycerides without too much trouble. Try cutting back on the butter and eating more coconut oil. (Normally I wouldn't recommend axing butter, but it contains long-chain triglycerides.) You don't need bile salts for the MCTs.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:41 AM

@Olga Thanks for the suggestions! I will definitely try some of them.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:34 AM

I actually realized last week that I shouldn't be eating so much Kerrygold and very, very sadly cut back on it. That's good to know about the MCTs though.

1
62ed65f3596aa2f62fa1d58a0c09f8c3

(20807)

on February 18, 2011
at 05:07 AM

Wow, a gallon of water a day plus several cups of coffee because you are thirsty for that much. That seems like a lot unless you are exercising heavily or it is very hot out, causing you to sweat. I know people who choose to drink that much because they feel it is healthier but not any that feel the need to drink that much because they are thirsty. (assuming no heavy sweating). You should probably have blood sugar checked to make sure there are no issues with diabetes as this can cause excessive thirst. SLow bowel movement might be related to loss of gallbladder. If you had the gallbladder out but have had no major problems because of it, count yourself lucky. Anyway, might want to mention the thirst issue to the doctor. Doc will probably say reliably to 'eat more fiber' on the bowel movement thing, but heck, it might be worth a try. Studies suggest that is the one thing that fiber is sometimes (but not always) good for. Personally, I would try magnesium first though. Many people are magnesium deficient anyway so you might be able to kill two birds with one stone.

65660697ed243c7980725fd014eb00e0

(494)

on February 18, 2011
at 05:30 AM

I'll have to mention the thirst to my doctor then. Thanks. It's not that I drink because I feel overly thirsty, per se. It's more that my mouth gets dry if I'm not drinking that much. I work out, but there's no heavy sweating.

0
3c25fb1f34771839081abd48c1af1bf4

on February 20, 2011
at 04:20 AM

take more magnesium tablets. almost everyone with a low carb way of eating needs to. start with one additional and increase slowly until you get the result you need. good luck!

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