5

votes

GI Tract Healing Strategy?

Answered on August 19, 2014
Created August 04, 2010 at 5:57 PM

I am interested in achieving maximal GI tract health, and I am concerned that I have been continually re-injuring the damage done by 20 years of SAD. I am wondering what the optimal strategy is for restoring gut health as fully as possible.

Background: For as long as I can remember, and continuing into eating paleo, I've had almost constant low-level diarrhea. I've also had bad gas, which has been partially but not fully alleviated. I was beginning to suspect hypochlorhydria, so I started supplementing my meals with Now Foods Super Enzymes. With the enzymes and strictly paleo foods (excluding nuts) I've eliminated the gas problems, but the diarrhea remains. (Also of note: low B vitamins on my recent lab work.)

Diet: I eat a high-fat diet, with high-protein on weight training days, and infrequent carb refeeds with tubers. Primarily meat and animal/coconut fat, fermented milk products, vegetables, occasional chocolate/nuts/fruit/tubers. One meal/day intermittent fasting on average, with substantial randomness. One of my major fat sources has been milkfat, including from heavy cream. I was formerly cheating with wheat occasionally, but I'm now firmly convinced I must remain gluten-free forever, and the last cheat was a few months ago (so I might still be healing). Unfortunately I have been drinking beer occasionally, so that could be another gluten source. Not all of my meat/milk products have been pastured.

So where do I begin, and then when do I reintroduce various foods?

I'm not a big supplement fan, but is there anything I should consider?

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on September 03, 2010
at 12:31 AM

Hey, thanks for checking in! I am actually just getting started now, I hit a rough financial patch and couldn't afford the proper foods for a time. I made my first ever bone broth the other day, and I am well stocked on grass-fed beef, so here we go!

52cae90a114ca8f0404948e2b7ccb7ef

(1595)

on September 01, 2010
at 11:06 PM

how's your gut doing, Will?

84666a86108dee8d11cbbc85b6382083

(2399)

on August 10, 2010
at 06:50 AM

From what I have read probiotics can supply 6-8 temporary gut residents which is like 1/20 or so of the whole gut flora.

52cae90a114ca8f0404948e2b7ccb7ef

(1595)

on August 09, 2010
at 12:55 PM

That our gut flora are fixed at birth doesn't make any sense to me, but I still think you should try a probiotic like the one I mentioned. It's got more than just acidophilus in it. It's Gr8! :-) BTW, low B-12 can cause low folate. Google "folate trap".

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 09, 2010
at 09:25 AM

B-12 was low, as well as folate (B-9). I don't recall ferritin offhand but I know it was within the reference range. Tried Acidophilus earlier without much effect, but I would be willing to try more probiotics. My understanding is that gut flora is relatively fixed at birth, so constant supplementation would be needed for any effect if at all... luckily I had a vaginal birth despite being 10 lbs 12 oz!

3864f9a2af09b1b447c7963058650a34

(3703)

on August 06, 2010
at 05:18 AM

If the B-vitamins do not correct themselves on their own, you might find some benefit with Betaine HCl -- it's a B12 derivative and helps with digestion esp if you think you are low in hydrochloric digestive acid. My trainer JJ at xfit added some to each meal and now his hair is growing like wild fire. He suspects he is actually absorbing more nutrients now both water- and fat-soluble. Biotin and pantothenic acid (e.g. 'Pantene' for hair, get it?) are all B-vitamins which are important for growth, reproduction, repair. Robb Wolf has discussed betaine too (but I guess I missed that podcast).

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 09:06 PM

I just meant, it seems that the digestive enzymes are helping to correct for something, whether it might be low stomach acid, pancreatic function, or something in the gut. If I keep up with the treatment, I won't necessarily tell when the underlying problem is resolved.

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 05:27 PM

Thanks for the great handout, that will come in handy. I've used Mg citrate in the past, but I didn't see any difference at the time. For what it's worth, the labs showed excellent liver, TSH and testosterone. The B vitamins surprised me, but I know that malabsorption can result from gut damage.

9d43f6873107e17ca4d1a5055aa7a2ad

on August 05, 2010
at 05:09 PM

PLUs= plus. Oops. Haha. I don't think digestive enzymes would cause gas, but it depends on the kind.

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 04:55 PM

Your diarrhea point is well taken, I will try that. The gas has largely resolved already with the addition of the digestive enzymes. Would you recommend that I stop taking them for the time being, so I know when the gas stops during the all-meat phase? (What are PLUs?) Do you think I could re-introduce pastured butter during the CI protocol?

62ed65f3596aa2f62fa1d58a0c09f8c3

(20807)

on August 05, 2010
at 04:00 AM

Ah yes, the super bland diet of bananas, applesauce and pumpkin is a very very good thing to try. That sucker has helped a lot of my family and friends to get out of serious intestinal problems. Before paleo, I did it with white rice as well and it still worked. Some people also allow boiled chicken with no skin and no spices. Something about the super bland and easy to digest diet that just gives the intestines some time to rest and recover. If ever I have intestinal probs again, this is the first thing I will try, but hopefully on paleo now, I will be more protected.

93f44e8673d3ea2294cce085ebc96e13

(10502)

on August 05, 2010
at 12:00 AM

@Will -- you may want to explore Pimental's approach of killing off dysbiotic bacteria by starving them of nutrients. And then seeding your GI tract, or setting the stage for for symbiotes.

4145b36f1488224964edac6258b75aff

(7821)

on August 04, 2010
at 07:25 PM

I did exactly this for a year. I ate cheese, eggs, bacon and heavy cream the whole time as well. I've got Crohn's and it seems to have gone into medicationless remission. The important note here is that the first 3-4 months were tumultuous in terms of diarrhea and digestion. I lost about 10lbs (did not have it to lose) until things stabilized in months 5-6. Since then, I've been doing great, with only the usual episodic diarrhea in response to excessive fat intake or accidentally drinking the water in India.

1a8020e101199de55c1b3b726f342321

(1973)

on August 04, 2010
at 06:44 PM

Begin by reading Ayers, the discussions after each post are the best part. http://coolinginflammation.blogspot.com/

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 04, 2010
at 06:28 PM

Didn't get Vit D checked. I don't get much sun, but for a period of time I religiously supplemented with 10k IU/day, now take 10k IU periodically. No antibiotics in a year or two.

84666a86108dee8d11cbbc85b6382083

(2399)

on August 04, 2010
at 06:21 PM

Vitamin D levels ? Any antibiotics usage (in the past) ?

84666a86108dee8d11cbbc85b6382083

(2399)

on August 04, 2010
at 06:17 PM

Aha, I see about diarrhea.

84666a86108dee8d11cbbc85b6382083

(2399)

on August 04, 2010
at 06:15 PM

Vitamin D levels, bowel movements/constipation/stools shape (Bristol Chart) and antibiotic usage ? :)

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6 Answers

3
9d43f6873107e17ca4d1a5055aa7a2ad

on August 04, 2010
at 09:41 PM

The first thing I would do is try to stop the diarrhea completely. When I was occasionally eating gluten I was having problems with diarrhea, but what works for me in a diet of just bananas, applesauce, and mashed pumpkin until you get at least one diarrhea-free day. Then switch to all-meat/eggs PLUs good bone stock and l-lysine..and do that until you have at least three gas-free days. Then start following the Cooling Inflammation protocol of Dr. Ayers- paleo diet (no cheats) + probiotic supplement + "good" fiber. This gentle, then fiber-less, then rebuilding approach has worked for me. I was diagnosed with IBS. I know people with IBD have to often do these stages for much longer and that different things work for different people though.

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 04:55 PM

Your diarrhea point is well taken, I will try that. The gas has largely resolved already with the addition of the digestive enzymes. Would you recommend that I stop taking them for the time being, so I know when the gas stops during the all-meat phase? (What are PLUs?) Do you think I could re-introduce pastured butter during the CI protocol?

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 09:06 PM

I just meant, it seems that the digestive enzymes are helping to correct for something, whether it might be low stomach acid, pancreatic function, or something in the gut. If I keep up with the treatment, I won't necessarily tell when the underlying problem is resolved.

62ed65f3596aa2f62fa1d58a0c09f8c3

(20807)

on August 05, 2010
at 04:00 AM

Ah yes, the super bland diet of bananas, applesauce and pumpkin is a very very good thing to try. That sucker has helped a lot of my family and friends to get out of serious intestinal problems. Before paleo, I did it with white rice as well and it still worked. Some people also allow boiled chicken with no skin and no spices. Something about the super bland and easy to digest diet that just gives the intestines some time to rest and recover. If ever I have intestinal probs again, this is the first thing I will try, but hopefully on paleo now, I will be more protected.

9d43f6873107e17ca4d1a5055aa7a2ad

on August 05, 2010
at 05:09 PM

PLUs= plus. Oops. Haha. I don't think digestive enzymes would cause gas, but it depends on the kind.

3
84666a86108dee8d11cbbc85b6382083

(2399)

on August 04, 2010
at 06:25 PM

Via Art Ayers @ Cooling Inflammation

Recommendations for repairing damaged gut flora: probiotics, lactulose, pectin (apples), inulin (leeks, onions).

Also eat small amounts of many different kinds of raw vegetables with each meal (building diversity of the gut flora). Use plenty of herbs and spices.

If diarhhea is accompanied with constipation that might suggest dehydration.

Although reduction of some foods might help on the short run I believe it will be difficult to reestablish diverse gut flora with a non diverse diet.

I wish you all the best,

Ikco

3
F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 04, 2010
at 06:04 PM

First, I think I should start with an all-meat diet. Stick to pastured ruminants, wild game, wild-caught fish and bone broth. No eggs or any dairy during this step. Everything fresh, eaten raw or cooked with low heat methods. This seems to be the most eliminative diet I can think of.

I'm not entirely sure where to go from here, or how long to stay on this step.

Items to reintroduce (not in this order):

Pastured non-ruminants, eggs
Coconut oil, coconut products
Ghee, pastured butter, pastured cream
Fermented milk products
Vegetables (nightshades separately? maybe crucifers? anything else to consider?)
Herbs/spices
Starchy tubers
Nuts
Non-gluten alcohol
Canned food (coconut milk, wild-caught fish are so handy!)
High heat cooking

I don't think I need fruit ever again, and I'm better off without chocolate...

4145b36f1488224964edac6258b75aff

(7821)

on August 04, 2010
at 07:25 PM

I did exactly this for a year. I ate cheese, eggs, bacon and heavy cream the whole time as well. I've got Crohn's and it seems to have gone into medicationless remission. The important note here is that the first 3-4 months were tumultuous in terms of diarrhea and digestion. I lost about 10lbs (did not have it to lose) until things stabilized in months 5-6. Since then, I've been doing great, with only the usual episodic diarrhea in response to excessive fat intake or accidentally drinking the water in India.

2
3864f9a2af09b1b447c7963058650a34

(3703)

on August 05, 2010
at 05:04 PM

Hi Will,

Hopefully your diarrhea with resolve soon. The inability to form normal, dense, non-floating stools indicates a lot regarding gut dysbiosis. Loose stools also can occur from certain(cheap) magnesium supplements (oxide or citrate; malate and chelated are the best forms).

http://www.drjakefratkin.com/pdf/LeakyGutHandout.pdf

The above link is one of the best explanations on gut health and how to heal. All the above responses above ARE TOTALLY EXCELLENT TOO!

I would consider the high value of: --more fiber if you are not allergic to metamucil/psyllium 1-2 tsp daily w/lots of water (psyllium is safe for both constipation and diarrhea) --cessation of all dairy (elimination diet -- then add back later in 2-4 wks) --gut vitamins and cofactors (vitamin D, omega-3, glutamine, B-vitamins activated low dose like Ultrabotanical or Jarrow's since you mentioned your lab was low, trace minerals)

Our gut (stomach and intestines) are the size of a TENNIS COURT. When it does not function properly, it screws the immune system and additionally nutrients are not absorbed or very minimally which subsequently affects all energetic pathways and organ function (esp liver, pancreas, gallbaldder, thyroid, adrenals, immunity, gonads, heart and brain).

Hope you better soon! -G

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 05, 2010
at 05:27 PM

Thanks for the great handout, that will come in handy. I've used Mg citrate in the past, but I didn't see any difference at the time. For what it's worth, the labs showed excellent liver, TSH and testosterone. The B vitamins surprised me, but I know that malabsorption can result from gut damage.

3864f9a2af09b1b447c7963058650a34

(3703)

on August 06, 2010
at 05:18 AM

If the B-vitamins do not correct themselves on their own, you might find some benefit with Betaine HCl -- it's a B12 derivative and helps with digestion esp if you think you are low in hydrochloric digestive acid. My trainer JJ at xfit added some to each meal and now his hair is growing like wild fire. He suspects he is actually absorbing more nutrients now both water- and fat-soluble. Biotin and pantothenic acid (e.g. 'Pantene' for hair, get it?) are all B-vitamins which are important for growth, reproduction, repair. Robb Wolf has discussed betaine too (but I guess I missed that podcast).

0
52cae90a114ca8f0404948e2b7ccb7ef

(1595)

on August 08, 2010
at 04:10 PM

You said "low B vitamins" and given your IBS, I'm assuming you mean B-12.

Low B-12 is serious, so yes, you need to fix your remaining gut issues so that you can absorb all the nutrients from your diet. B-12 absorption is especially difficult with IBS and/or hypochloridia. You may want to be tested for the cause of your B-12 if it persists once your IBS is abated.

Strict paleo is great but a good probiotic might really help you quickly. Try NOW Foods Gr8 Dophilus (under $10 from iHerb.com):

http://www.nowfoods.com/Products/ProductsAlphabetically/M010908.htm

And consider getting a B-12 shot from your doctor. Have your B-12 and ferritin levels checked again soon.

F8fa4b0809d3b74fcf0361c0d53b60c1

(911)

on August 09, 2010
at 09:25 AM

B-12 was low, as well as folate (B-9). I don't recall ferritin offhand but I know it was within the reference range. Tried Acidophilus earlier without much effect, but I would be willing to try more probiotics. My understanding is that gut flora is relatively fixed at birth, so constant supplementation would be needed for any effect if at all... luckily I had a vaginal birth despite being 10 lbs 12 oz!

52cae90a114ca8f0404948e2b7ccb7ef

(1595)

on August 09, 2010
at 12:55 PM

That our gut flora are fixed at birth doesn't make any sense to me, but I still think you should try a probiotic like the one I mentioned. It's got more than just acidophilus in it. It's Gr8! :-) BTW, low B-12 can cause low folate. Google "folate trap".

84666a86108dee8d11cbbc85b6382083

(2399)

on August 10, 2010
at 06:50 AM

From what I have read probiotics can supply 6-8 temporary gut residents which is like 1/20 or so of the whole gut flora.

0
D0a103cafaf4768c6dc69b1772a55877

on August 04, 2010
at 08:30 PM

Have you tried Barlean's Greens? http://www.barleans.com/greens.asp

Seriously- I had the same issue with diarrhea. Now totally gone. One of the trainers (who is a die hard paleo guy) suggested it to me. Drinking it tastes a little it like smelling a farm- but it works.

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