Gut feelings
December 23, 2019 8:18 AM   Subscribe

Something is quite wrong with the way I digest food. Very gross details inside.

I've suspected for a while that something is amiss with the way I digest food. I'd say it's been going on for more than a year.

The patient

54, white female. I've been exposed to the Lyme bug but if I'm symptomatic, it's not clear.

I'm currently travelling through South America (Argentina & Chile, not the Amazon), but this started before I arrived here.

I have binge eating disorder, but I'm in treatment for it and please don't worry about triggering me in your responses. I want to get this taken care of.

Symptoms
  • Occasional extreme intolerance to dairy, especially milk. I came close to being incontinent in public just now within about 45 minutes of two cafés con leche. To say the least, this isn't sustainable.
  • Many undigested particles in my poop. Chia seeds? Might as well not even eat them, they're not getting processed at all.
  • My hair looks like I'm malnourished: limp, sad, thin. I've always had fine, thin hair, but it always looks bad now unless I blow-dry it. I'm perimenopausal, which doesn't help.
  • Rosacea acne, which comes out in force when I change my dietary pattern. The zits hurt and they're large. A low dose of doxycycline clears them up quickly, but I prefer to use benzoyl peroxide on them.
  • Recovery from any kind of exercise can take a few days sometimes; my muscles get super sore and stay that way for a while. This also is sporadic.
  • Sphincter strength (urinal/anal) is sad. Hence the risk of incontinence. Related? Who knows. Kegels aren't helping, unless doing them several times a day instead of once or twice would make a difference.
Antibiotic usage

Bad stomach bug last year, most likely from fresh vegetables, while I was visiting Macchu Picchu in Peru. I took antibiotics for it and have taken antibiotics this year for strep throat.

Diet

As I said above, I have been travelling for the last few months, and my diet has swung widely between keto level of carbs and wayyyyyy too many carbs.

I'm trying to keep the carbs on the downlow right now, and I'm focusing on healthy fats, fruits, and veg. I'm in the land of beef, dairy, and pork (Argentina) but I try to get some chicken, eggs, and fish in there when I can.

I will not eat soy except for an occasional serving of tofu. I cannot do a vegetarian diet at all: I've tried many times and I wind up in a metaphoric pile on my floor. I would definitely consider swapping out some of the animal protein for black beans and such, though.

Self-help

As a low-harm, possibly high-impact first step, I'm going to try to get a good probiotic, the kind that requires refrigeration. Wish me luck, they're not easy to find outside the global North.

Halp me

If this rings a bell to anyone, please let me know.
posted by Sheydem-tants to Health & Fitness (15 answers total) 2 users marked this as a favorite
 
I don’t know about your other concerns but I do know that pooping out entire seeds, like chia, flax, raspberry, sesame or even corn kernels, is totally 1000% normal.

Many seeds are evolved specifically for animals to eat the fruit and poop out the seed elsewhere, so the seed can sprout and grow a new plant in a different place. Raccoon and bear scat (poop) are so full of undigested, still-fertile seeds that their turds look like fancy granola bars!

So that, at least is no cause for concern, and it’s still worth eating the seeds because they are a great source of fibre. If you want even more nutritional benefit from them (like if you want to be able to access the oils inside of the flax seeds), you can crack their outer layer by buzzing in a blender before ingesting.
posted by nouvelle-personne at 8:26 AM on December 23, 2019 [16 favorites]


You should definitely see a physician about this.

I will make one suggestion—have you tried lactase supplements while consuming dairy for the lactose intolerance?
posted by grouse at 8:36 AM on December 23, 2019 [3 favorites]


If dairy is causing a lot of intestinal distress, try avoiding it or consuming it with a lactase pill. I’ve needed this more as I’ve gotten older.

Another thing to consider if you’re traveling a lot is that it may take your body some time to acclimate to a new environment. I tend to need to eat gently for a day or so and have enjoyed travel a lot more since I figured this out.
posted by tchemgrrl at 8:41 AM on December 23, 2019 [1 favorite]


I'll be watching this closely because a lot of what you have going on, is me as well. The difference is my digestion issues have been going on for about 15 years now. I've had all kinds of tests, tried quite a few diets (glutten free, paleo, whole 30) nothing helped until I looked into FODMAPs and eating low FODMAP. Eating low FODMAP clears up everything that troubles me about 70% of the time. I believe the other 30 % of the time is a mix of not actually eating as low FODMAP as I think I am, and hormones from Perimenopause. Your entire condition sounds so similar to mine that I think its probably worth your while to read up on FODMAPS. I use an app put out by Monash University to keep track of the foods I can and can't eat, its not perfect but it has helped enormously. If you have questions or want more details than I put down publicly here, memail me.
posted by WalkerWestridge at 8:43 AM on December 23, 2019 [6 favorites]


I don't know, none of this sounds that serious to me. Looking at these items one by one: Have you obtained and tried Lactaid when you might be exposed to milk or milk products? Lactose intolerance can increase with age, and what you describe is certainly one of the things that can happen when you're lactose intolerant. If Lactaid makes a difference, then that might be it. The differences in your hair sound more like what happens to me when I'm in a different climate or there are different water properties than I'm used to—have you tried different products, or more or less of your current products, to see if it makes a difference? Seeds going straight through, that's going to happen. Rosacea can also be triggered by stress, such as the stress of travel; I know someone who has it and is going through a stressful period right now and has super flaking skin all over their face. It can probably also be triggered by hormone changes, though it doesn't look like there's a lot of good data available on that (as with many things hormone-related). Hormone changes can also strongly influence the tonic contraction of sphincters, and what you describe is common among older women. Oh, and antibiotic use can definitely disrupt digestion in a sustained way.

To me, it sounds like you might be a bit anxious during your travel and hyperaware of what your body is doing or how it might be changing, and that may well also be the commonality between a lot of these things (and your noticing them). I would chalk the rest up to age and hormone changes.
posted by limeonaire at 8:44 AM on December 23, 2019 [7 favorites]


While I have no expertise other than general layman, I'd suggest the following: travel introduces your body to whole new biomes it's never been exposed to before, so that's definitely a potential factor. And, when you get back to whatever your home base is, I'd recommend making an appointment with a gastroenterologist. This isn't the kind of generalized thing where the answer lies in the wisdom of the commons.
posted by WCityMike at 8:45 AM on December 23, 2019 [6 favorites]


I am having most of these same issues, though not incapacitating I guess, and just kinda assuming it's the menopause and aging being a general bummer. If you can find somewhere to get real certified pelvic floor therapy, it will help with those issues, but that struggle is common. Nobody digests hard seeds. Travel is hell on your microbiome, though that's no reason to stop traveling.

I do have to watch dairy, especially because of the rosacea, but I also have to be brutally rigid in my skincare too if I want to keep flares at bay. I have to be especially careful about touching my face with...really anything but my hands plus a little silicone wash pad I found at a dollar store, and I can get away with micellar water wipes but I need to rinse after. Terry-style towels, brushes, washcloths (most of the time) will make me flare.

You might consider, as much as it sucks, first going off liquid dairy (keeping active culture yogurt, cheese, and butter) or using a lactase inhibitor, try that for a couple weeks. See what happens. If the only time you drink milk is in coffee, it could be the coffee, that might be the next thing to eliminate. I don't remember if South America has a strong fermented food culture, if you can get your hands on fermented pickles or cabbage it could help with gut cultures.
posted by Lyn Never at 9:00 AM on December 23, 2019 [4 favorites]


I'd suggest being exposed to new foods & bacterias while travelling is throwing things off or making any underlying problems worse. I'd be extra careful to avoid tap water, salads or fruit etc that might have been washed in the tap water, even if you aren't getting OMG sick from the water, you are still exposing your system to new bacteria. If you are lactose intolerant, you are going to need lactaid & to avoid dairy. Also kegels, according to my doctor, need to be done more than once or twice a day. At least, 3 sets of 10 -15 a day, more is better.

Also as someone that is a little ahead of you in her menopause journey. Progesterone changes can effect your digestive system, think period poops & pre period constipation on a bigger scale.
posted by wwax at 9:07 AM on December 23, 2019 [2 favorites]


Not to thread-sit, but wow, yeah, period poops, I didn't even think about that even though I know it's a thing. Excellent thoughts, everyone.
posted by Sheydem-tants at 10:00 AM on December 23, 2019


My spouse has some similar issues and, while we don't have a confirmed answer yet, he has found more consistent relief following a low-FODMAP diet that is also low carb (though not fully keto). I will say that your description of your hair, skin, and energy level seem to point to something autoimmune (including potentially celiac) so if you have the ability to see a specialist who can test for autoimmune issues (and allergies in general), that might yield very useful information for you.
posted by devinemissk at 10:33 AM on December 23, 2019 [1 favorite]


Two cafe con leches in a row would have me running for the bathroom too and I have none of the other issues you mention. Coffee can be a laxative.

Travel + perimenopause + age-related lactose intolerance seems likely to blame for most of it. I'd try some good probiotics to make up for the rounds of antibiotics you've had too.
posted by peanut_mcgillicuty at 10:42 AM on December 23, 2019 [3 favorites]


I agree that travel (and coffee! and hormones!) are potential culprits, as is the lactose. After a 17-week stint of antibiotics a couple years ago, it took me several months to rebuild my gut biome to the point that my digestion is now normalish.

Probiotics are great, but they're transitory. They can help with short-term digestion but don't really feed the bacteria that you actually need to take up residence for long-term digestive comfort.

Look into adding - slowly! - fermented foods and resistant starch into your diet. Fermented foods will help reintroduce some of what the antibiotics killed. Pickles, kombucha, kimchee, miso, whatever - just make sure it's truly fermented and served cold, nothing that's been canned or shelved where the bacteria have died off. Resistant starch - found in white beans, lentils, whole grains, etc - resist being digested in your gut, so they feed the resident good bacteria. Cooked and cooled (and reheated) potatoes, rice, and oats are particularly full of resistant starches - something about cooking them and letting them cool preserves the levels of resistant starch vs eating them freshly cooked. Overnight oats (raw, soaked in yogurt or a milk of your choice, maybe non-dairy in your case) are also great for this. If you're traveling but have access to a kitchen, that can make for an easy breakfast.

Make sure to go slowly with any of this - too much change at once can make things worse in the short term.
posted by writermcwriterson at 11:25 AM on December 23, 2019 [8 favorites]


Though I’m a decade younger, like you I’m perimenopausal. I also have trouble absorbing nutrients because of stomach issues. As a result my iron levels are low (I’m on a supplement). When my iron was low and I didn’t realize it, my hair was awful, so I recommend you get your iron levels checked to rule that out.
posted by hurdy gurdy girl at 12:21 AM on December 24, 2019 [1 favorite]


It could be a non-functioning gall bladder. Chest/back pain and the inability to digest fat (about half an hour after a fatty meal) are indicators.
posted by kjs4 at 6:14 AM on December 25, 2019


Follow-up a few weeks later:

In late December I took my TRX suspension trainer out of its box and started working with it again for 15-30 minutes every other day. The incontinence I alluded to in the post is all but gone. Completely unexpected result. I had NO idea how much pelvic floor health is related to core strength, but apparently it is, bigtime.

Along with better core strength has come lessened fatigue and greater mental clarity.

I'm still having occasional problems with dairy... just did, earlier this afternoon. But it's not the horror show it was. Staying with "better" coffee places helps and eventually I'll be back in the US where I'll be able to get light cream again.
posted by Sheydem-tants at 12:47 PM on January 22, 2020 [3 favorites]


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