Get My GI Tract in Shape
March 11, 2015 9:52 AM   Subscribe

So, lady in her late 30s and over the past year or so I have been having weird GI things going on. Some appear to be related to the menstrual cycle, others are just out of nowhere. I think my gut is out of whack and need help getting it back into shape.

A few of them are:

- constant feeling of fullness
- bloating
- constipation
- gas
- outright lack of hunger
- major munchies
- general stomach blah

For a while, the bloating was specifically associated with my menstrual cycle, but now it just seems to be constant.

I've been drinking more water, taking some probiotics (Florastor) and some stool softeners but nothing seems to be really get it back to that normal feeling. So, I think it's time to get more serious about my nutrition to get my gut back into shape.

Any suggestions on foods, supplements (natural), practices?
posted by tafetta, darling! to Health & Fitness (19 answers total) 8 users marked this as a favorite
Use a nutritional tracker like to track what you're actually consuming per day for a couple weeks, and take symptom notes. Whether you try to tackle this yourself or end up at a doctor or dietician's office, you'll need to have this information about what your actual dietary day is like.

I had these symptoms before I found out I had a thyroid condition, by the way, which can only be confirmed with blood tests.
posted by blue suede stockings at 9:56 AM on March 11, 2015 [1 favorite]

I suggest seeing a physician - I don't think you should try to diagnose or treat yourself without a medical evaluation first. Drinking more water and probiotics are unlikely to hurt, and you could try diet suggestions for IBS (or just adding more fiber to your diet, which should help with constipation), but IBS is a diagnosis of exclusion, which means that other diagnoses need to be ruled out first. A diet diary is a great idea from blue suede stockings.
posted by treehorn+bunny at 10:02 AM on March 11, 2015 [5 favorites]

Also, I suggest discussing it with a physician before you start supplements, as well. "Natural" means nothing in terms of whether something is healthy - it's just marketing mumbo jumbo. Cyanide, arsenic, digitalis, belladonna, mercury, and botulinum toxin are just a few examples of substances in the natural world that can kill or seriously harm you, and supplements, unlike prescribed medications, are not regulated by the FDA so you're getting unknown and less precise amounts of any active ingredients in the supplement, and there may be things in the supplement that aren't what you want to be taking (i.e. contaminants or unlisted ingredients).
posted by treehorn+bunny at 10:07 AM on March 11, 2015 [5 favorites]

Not to be all Doom-y (and it is probably nothing serious), but I think the first stop for a woman of your age with those symptoms should be an OBGYN to rule out serious issues such as ovarian cancer which presents as you describe.
posted by girl flaneur at 10:10 AM on March 11, 2015 [3 favorites]

Re: possibility of ovarian cancer at the OP's age, the average age at diagnosis is 57.

I would start at a primary care physician, since most of the symptoms are gastrointestinal, and that is outside the realm of an OB/GYN specialist's purview.
posted by treehorn+bunny at 10:13 AM on March 11, 2015 [2 favorites]

I will nth exploring this with a physician, but also mention that these symptoms are very consistent with SIBO. A common dietary modification to address the bloating is the low FODMAPs diet described here. It won't hurt you to try the diet in the meantime (as long as you continue to maintain adequate nutrition -- don't cut out foods without replacing them with other foods).
posted by telegraph at 10:15 AM on March 11, 2015

I'd definitely go to the doctor. Start with your primary who will probably refer to you to a GI specialist.

Also instead of taking a stool softener I'd recommend a bulk laxative like Citrucel if you're going to take anything.
posted by radioamy at 10:23 AM on March 11, 2015

I would try eliminating dairy - milk, cheese, yogurt - for a week or 2. Chinese, Thai, etc., tend to be non-dairy, if you go out to eat. Eliminating dairy fixed my gas, bloating, digestive woes, and after a couple years, I realized I just plain felt better. Taking lactase (Lactaid is the brand name) helps some, but I feel better with no dairy.

Fermented foods, like sauerkraut and kimchi are recommended as natural probiotics, along with spinach/kale/chard, and fresh veg. in general.

And, yes, do see your doctor.
posted by theora55 at 10:24 AM on March 11, 2015 [1 favorite]

Re: possibility of ovarian cancer at the OP's age, the average age at diagnosis is 57.

I would start at a primary care physician, since most of the symptoms are gastrointestinal, and that is outside the realm of an OB/GYN specialist's purview.

As I said, it is very like *not* ovarian cancer, but according to the 2007 Consensus Statement, women with these symptoms should seek medical attention, "preferably [from] a gynecologist" (the words of the American Cancer Society, not mine):
posted by girl flaneur at 10:25 AM on March 11, 2015 [2 favorites]

I agree that it's best to see a doctor, but have you tried treating your symptoms with an over the counter acid reflux medicine or the like? Except for the munchies, those are all symptoms I get surrounding my acid reflux (which is not diagnosed by a doctor and which I really should see one for, by the way). Just for some symptom relief, try a Pepcid Complete tablet the next time you feel really crappy. If part of the issue is acid, you'll feel better within 30 minutes. And knowing whether it's at least partly acid will help you decide whether/how to change some habits.
posted by kitcat at 10:35 AM on March 11, 2015

While the suggestion to see a physician is an excellent one, I would also suggest giving Konsyl a try. One of my doctors suggested it as a way to exert some control over my ulcerative colitis, and I swear by it now. You have to ease into it a bit, as starting full strength will give you the bloating and gas you mention, but I would much rather see you taking a strong fiber supplement than taking stool softeners.

When he suggested Konsyl, I told him I was already taking fiber capsules. He said I would have to take 48 fiber caps a day to get the same benefit as a full dose of Konsyl.
posted by janey47 at 10:44 AM on March 11, 2015

I have a history of migraine so I located food triggers, one of them is some yeast products. I started checking them out, and among the things I noticed, is some rapid rise yeasts like in Papa Johns Pizza, or Digiorno, products, really mess with my gut and give me reflux. That is one GI trigger I came across. Some things long touted as stomachic herbs, like peppermint, do what they do by relaxing the sphincters at the top of the stomach and at the esophagus, and release air bubbles. This can also create reflux. The square stemmed spices oregano, thyme, rosemary do the same. Basil does not do this, so tomato sauces can be eaten without compromise. If you are taking antacids, they allow for bacterial overgrowth of some kinds because the natural acidity of the stomach regulates the gut ecosystem. If you take asthma meds, they also loosten these closures in the digestive tract, allowing for more exchange of air and fermentation. Too much fermentation? Take some raw apple cider vinegar in your salad dressing. The mother of vinegar culture gets after yeasts, that cause fermentation and gas. If you are using artificial sweeteners like xylitol, mannitol, then stop those, they set off the insulin reponse anywuay, but move big insoluble sugars to your lower gut and they change dynamics there. Artificial sweeteners are not benign.

I am serious about the different kinds of yeast in modern and old school products. In wine making, I can drink red wine if it is fermented with champagne yeast, but not with the typical. Torula yeast, used on smokehouse almonds will ground me for a day with headache, brewers yeast as a suppliment same thing. But I can have a pale beer, or eat bread made with non rapid rise yeast.

What I am saying here is that some food ingredients affect us in ways that are not as obvious as migraine. New gut dysfunction can be many seemingly innocuous factors, that add up. I hate food fads, with a passion, but if you look at pesticides, herbicides, artificial sweeterners, and junk ingredients added to increase profit, in combination with medications, and over the counter products, it is significant. I whole heartedly endorse eating more pricey old school pasta, as farmers have been encouraged to spray their wheat crops with roundup, eleven days before harvest, to facilitate harvest. I bought some Western Family linguini, and while cooking it, I could smell something like motor oil, I rinsed it after cooking and still the odor was there. Big food, big ag can be life changing, in among the complex factors of one's personal ecosystem. Eat food you make, lower she salt content somewhat. Read labels, if you need a magnifying glass and it takes more than a minute, find a product with less ingredients, ones you recognise as food.
posted by Oyéah at 10:48 AM on March 11, 2015 [1 favorite]

Your first stop should be your GP for some bloodwork (test for thyroid issues and celiac disease markers, specifically) and a gastroenterologist. It could be a whole bunch of things, but they will need to test you to make sure.

That said, I had all of your symptoms but with a bonus prize of constant heartburn, and eliminating gluten from my diet resolved them all. However, I wouldn't try an elimination diet yet without seeing the doctors for tests, because confirming celiac disease in particular requires you to still be eating the offending substance for the bloodwork to be even close to accurate.
posted by bedhead at 10:48 AM on March 11, 2015

Okay, yeah, I hate to be another one to lay this one you, but: when this happened to my best friend, it ended up being stage IV ovarian cancer. Yeah, it's most likely not at all what is causing your distress, but given that it is a possibility, no matter how remote, you owe it to yourself to have a round of tests at the doctor. Please.
posted by BlahLaLa at 11:05 AM on March 11, 2015 [2 favorites]

Response by poster: Should have mentioned that I have had blood work for both thyroid and Celiac and both came back negative.

I will also follow up with a doc but in the mean time, keep the recommendations coming.
posted by tafetta, darling! at 12:15 PM on March 11, 2015 [1 favorite]

If part of the issue is acid, you'll feel better within 30 minutes.

I just want to qualify this. If part of the issue is acid, at least some, not all of those symptoms should improve in short order. I mean the bloating and general stomach blah. Some people have trouble recognizing when they have acid reflux issues and if you are one, you might have to try something OTC to find out, is what I was driving at.

For constipation, which I get a lot and which exacerbates my acid reflux issues, I like milk of magnesia or mineral oil. But that's for when the constipation is moderate to severe. YMMV.
posted by kitcat at 2:19 PM on March 11, 2015

according to the 2007 Consensus Statement, women with these symptoms should seek medical attention, "preferably [from] a gynecologist".

To explain my point further, I absolutely agree, a gynecologist absolutely makes sense as a next stop after primary care, or perhaps even as an appointment to be made concurrently with primary care follow up. As a rule, though, I'd suggest to start with a general practitioner if symptoms are nonspecific and could be related to more than 1 system of the body. The problem with going to a specialist first is that they will usually only focus on the system that is their specialty, which can cause a delay in diagnosis if that system turns out not to be the culprit. A general practitioner can begin a workup for multiple systems and then make the most appropriate referral(s) after the initial workup has begun. I've just seen too many people get into trouble by trying to guess what's wrong with them and seeing multiple specialists before seeing a primary care physician, it turns out to be a waste of time and money if they guess wrong.
posted by treehorn+bunny at 5:42 PM on March 11, 2015 [2 favorites]

I'm noting that you said that some of your symptoms used to track with your menstrual cycle, but then became more chronic. Later 30s is not an uncommon time to enter perimenopause. During perimenopause, your estrogen and progesterone levels rise and fall much less predictably. People talk a lot about how that can make periods irregular, or more or less frequent, or heavier. Less commonly discussed is that for people with digestive problems like IBS, these can get a lot worse--especially if symptoms previously tracked the menstrual cycle.

If this is the case for you, knowing why won't solve your problems with symptoms, but at least it's good to know that there is a reason, and not a life-threatening one like ovarian cancer.
posted by DrMew at 6:50 PM on March 11, 2015

As someone who's suffered from IBS and GERD (among other things) for a long time, I totally endorse tracking your food intake for a while and seeing if certain foods trigger your symptoms. Read up on these from several sources and separate the wheat from the chaff. A lot of what's out there is anecdotal and outdated so be aware of what you're reading and check the dates and sources of what you're reading. Even some of the doctors I've been to have outdated ideas about IBS and GERD, but again, they are only human.

Not saying you have either IBS or GERD, but it's possible. Those are classic symptoms. They got worse when my thyroid went. Also, as an aside, I know you said you were checked for thyroid issues, and it was fine, and I want to say... get checked again. I was checked often as a matter of routine and my thyroid was always "within the normal range" until it wasn't. Now it's completely shot.

Then my whacky digestive system went totally nuts the moment I stepped into perimenopause, and walked right on into menopause. Yay! I'm still working on getting it back down to a manageable level. But keeping a food diary that you can share with your doctor -- don't do this alone -- can help.
posted by patheral at 11:26 AM on March 12, 2015

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