It's been a roller coaster ride since I started eating paleo back in November of last year. Mostly down. The good part is that I've lost weight. The bad part is that I've had some sort of GI issue since January.
I just wrote about this last week:
Last week I thought the reason for my recent stomach pains was that I've been re-introducing occasional wheat into my diet since late March. I had a few weekends the past few months with severe pain in my stomach. While I did notice some severe pain occasionally it was usually a mild discomfort on my right side...about 6 inches to the right of my belly button. During this "re-introduction to wheat" period, I did have more regular bowel movements. Less constipation. Less diarrhea. Things appeared to look normal..but the stomach/side pain was annoying.
Saw a GI doc last week. Took a blood test to see if I may have celiac (which there was a definitive test if the blood test came back positive). Of course my blood was normal, so no celiac.
Came to the conclusion that maybe eating occasional wheat/rice/corn was causing my the abdominal pain. So for the last week I've been strict paleo...even cutting out dairy which I did not consume much anyway.
Stomach pain is pretty much gone..and definitely no severe pain. But now its like flip a coin whether I will be constipated of have diarrhea. This is what I was experiencing off and on Jan - March. I usually feel fine all day until I get home from work. From there its either a normal bowel movement or constipation...then diarrhea at night. After dinner, it sounds and feels like a volcano or thunderstorm going on in my digestive system. I hear rumbling...gurgling..I can feeling liquids sloshing around..and then diarrhea.
I'm trying to determine if I need to completely eliminate dairy, coffee, alcohol, etc.
My GI doc last week just encouraged me to take a fiber supplement daily and I have a follow up in September. From there it will probably be more tests ($$$$$$$) and potentially drugs. I have no confidence anything will be resolved soon.
I know this is diet related somehow. I just need to play health detective to determine what the root cause is.
Here is a list of what I consume (not everything):
Eggs, cheese/half&half, ghee/butter/coconut oil, pickles/kimchi/sauerkraut/kombucha, coffee/water/booze, grass and grain fed beef/chicken/pork/fish, fruit/steamed veggies, avocados, dark chocolate, honey
Multi-vitamin, Omega 3 supplement, pro-biotic, Vitamin D
I have not tried fermented grains, haven't had nuts in weeks, and do not eat too many starchy veggies.
Sorry for the rant! I'm completely stumped and frustrated. Any thoughts would be appreciated.
I would try cutting out the cream (lactose), chocolate (lactose and sugar), and honey (and sugary booze like wine, beer, mixers etc opt for straight transparent spirits instead, like whiskey, tequila or vodka)
Basically everything with sugars in them. (Which probably includes some of your fermented too. You might want to trial a period without them as well as well as without the probiotic, not everyone responds well to probiotics)
Even with major digestive issues you can usually handle two sugars 1) glucose 2) fructose if its in small amounts (ie small portions of lower sugar fruits consumed on there own). This is because glucose is quick absorbed (no digestion), and fructose is also quick, but only under a certain threshold.
Just make sure if you eliminate loads of stuff that you replace the foods so you get good nutrition. Almond milk makes an okay replacement for milk, and its got just as much calcium (for example).
If you get results doing that, check out the sugar and starch content of everything you eat, and read up on fodmaps.
If not, its probably not bacteria. Then I suppose maybe its a food allergy or something else.
But with my digestive issues, your diet would give me total hell, hence my advice.
GI questions are almost always confusing and cause as many headaches as stomachaches, so to speak.
My first question back to you is this: you've had GI issues "since January" -- what happened in January? This seems like a very sudden start to GI issues, and if you've not had them before, you might look for what changed at that time.
A few bullet points to consider, but far from a complete answer:
There are things in your diet that are well known to cause constipation. I know it sounds counter-intuitive, but alcohol, coffee, and dairy are three of these things. I would do an elimination of one of these for 2-4 weeks to see if any of them are causing the problem.
Did they check for appendicitis? This is often localized at first in the area you describe. Gall stones can also cause similar pain.
Just because the doctor says your celiac tests are "normal" doesn't necessarily mean you don't have a wheat sensitivity that can cause the problems you describe. The only way to know for sure is through an elimination of wheat/gluten/gliadin. And it sounds like when you re-introduced it, the pain came back. It can take 1-3 months to completely rid your body of gluten too.
I highly recommend following up with Jordan and Steve's site at SCDLifestyle.com. They have excellent first-hand knowledge and expert research on the kinds of issues you're dealing with.
Good luck on the journey!
I'm kind of in your boat. I've lately been trying a new more potent Probiotic "Biokult" and a bit more fermented foods. It's been a bit promising we'll see how it goes.
Have you try to have LESS fiber? It might be feeding the "bad" bacteria in your gut. I've been trying to do a lower carb paleo while my gut flora recoup.
I have had a lot of digestive distress as well, becoming considerable worse about 5 months into paleo. I used to be able to eat a wide variety of foods, but now I've been having problems digesting starches and dairy.
I don't know if this has anything to do with eating "cleaner", but it seems ridiculous to me that I have more problems now than before I began this dietary misadventure. I don't plan on giving up or going back, since I am almost 100% certain that I have a major gluten intolerance.
What has helped me tremendously has been realising that vegetable fiber is quite hard on me. When I first started paleo I was gorging down tons of lightly cooked veggies all the while wondering why I was so constipated. I think paleo puts a lot of stress on the digestive system, because it involves quite a drastic change in the type of fiber consumed.
It's easy to become caught up in everything paleo-related - militant attitude towards following the paleolithic principles of whatever dietary guru one chooses to worship, Intermittent Fasting, general food-obsession/strict avoidance of neolithic agents of disease (and guilt-trips when one slips), etc. But over time, I have come to realise that stress plays a huge impact in overall health, and that it is much much better to relax a little and to take time off the internet to enjoy yourself.
If you already do this, good. Otherwise I'll advise you to cut down on the vegetables, consume more easily digestible fruit and enough protein and fat without overdoing it. Having a balance is important - too much protein or fat can cause problems, even though I know it's the generally accepted dietary stance around these parts. When and if you choose to have more vegetables, cook them thoroughly. Think stews and soups, NOT stir-fries. Treat your stomach gently. And listen to yourself and your body - it really does know what is best for you. Don't force down certain foods just because your diet tells you to.
FODMAPs, SIBO, IBS etc. all those are just symptoms of an underlying imbalance. And you don't have to suffer from all of them or become obsessive about finding a specific diagnosis to pinpoint your symptoms on. Sometimes all that does is create more stress.
Best of luck!
Not really an answer...just a few more observations.
I'm only having these issues Monday through Friday for some reason. At my apartment.
I'm only having the constipation/diarrhea issues in the evening (7pm - 11pm). The problems don't generally last 4 hours, just a time frame when these things occur.
Friday night/Saturday/Sunday I drank more alcohol and ate bad food (chips...oops). But my crazy digestive problems were not present. I did have the hangover (I don't really have severe hangovers) poop..hard to explain but a lot of movement but not diarrhea. And not constipation either. Saturday night I only had a few drinks (unlike Friday) and Sunday's I was generally fine. No severe pain and no constipation/diarrhea.
Cooked pork chops in coconut oil tonight (Monday) and I had a diarrhea after. Constipation before dinner.
Dill pickles (Bubbies Brand) seem to make my stomach make a lot of noise after eating.
Hardly any dairy the past week. No fruit.
Not sure if I can make any conclusions to any of this.
Colon cancer, dude. If your body is not meant to be eating gluten, knock it off, and figure out another way to poop. People who are gluten intolerant don't realize that cheating may very well take years off their lives. It sounds like you have a cranky, autoimmune-ish sort of gut like me and many others. Eat clean, eat your probiotics, sleep well, drink water, and if you have to, do a REAL elimination diet. None of this "it's been a week" stuff. A week is nothin', especially if you've got multiple variables going on. Do it the right way so that you can do it once. Do you have a good, modern, paleo friendly nutritionist in your area? Identify what your likely allergens/irritants are, cut them 110%, and then methodically reintroduce them.
Your explanation is just about identical to mine, with one major difference; I have been strict PALEO for 38 days, and I started it after a 15 day master cleanse. The master cleanse was 15 days of only water, lemon juice, cayenne pepper, and coconut nectar, no food or beverage at all.
Since starting, I have been eating only grass fed beef, sugar free, nitrate free bacon (not allot), fruit, veggies, lost of carrots, Steves Paleo Kits are a staple, as are the Paleo Crunch Bars. I eat sunflower seeds, raw, and unsalted, and spaghetti squash, as well as lots of water and some almonds.
My gut has been rumbling since almost day one, so I tried a pro-biotic, that just made the diarrhea more predictable. The pro-biotic was seaweed based, and organic, so not fillers, or non paleo ingredients.
I have not cheated one time, so zero wheat, zero dairy, zero cornstarch, or syrup, or any additives, only pure clean food, yet I feel like crap almost all the time.
I do feel it’s a balance thing, but cant figure out what it is. I have tried knocking out the almonds, the pro-biotic, and went days without tree nuts, yet its the same. For only 2 of the last 38 days, I had constipation, otherwise, I just plain feel like crap. It cant be this uncomfortable to be Paleo.
I read everywhere, every post, answer, theory and the like, yet no one really comes out and says, when you go on Paleo, you ........, so be aware. Maybe that statement does not exist, but I need some help bad.
I was doing fine on Paleo, I don't poop often but that's always been my body even on SAD then I are fresh cheese with butter and bam I got the runs gurgling and then away it goes (mostly water) first 45 min after consumption and again the next morning. I'd say it is the cheese. Cut it out. BTW: why drink booze? Cut that out as well and be healthier. Fruits are not needed, chocolate and honey should perhaps be regulated to cheat days alone? If you can't totally cut them out (I know woman and their strange chocolate addictions) thank goodness im a man and don't suffer from such weaknesses :)
Sometimes paleo can irritate underlying gut problems. Check out this website, and especially look in the left hand column, near bottom, for FODMAPS, IBS, SIBO, etc. Especially if you are doing everything 100% paleo perfect, and the problems get worse.
I had to tweak my diet, and the SIBO protocol worked best for me. No fruit for 30 days let my gut flora get back on track. No onions either - that's a big trigger food for me. I still tend to have a lot of diarrhea when I am strict paleo, but I attribute some of that to the actual fat loss, and the excess waste my body is excreting after metabolizing all that fat! I can't find anyone, anywhere, that says this, but it only makes sense. All that fat doesn't get "burned up." There has to be some waste from cell metabolism.
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