Paleo Diet and Paleolithic Diet Questions & Answers

Question

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I am a 27 year old female, relatively active (meaning I workout 3-4 times a week), and have been eating paleo for 6-7 months. Sometimes when I go to the bathroom, I feel a sharp pain and I find little traces of bright red on the toilet paper. There's also some drops in the toilet, too.

This used to happen often in my pre-paleo days, and then when I started paleo, it rarely happened. Now I notice it happens after a 'cheat' of grains or nuts. (I'm still trying to figure out exactly what it's related to)

When I asked my doctor about this previously he said it was a fissure, which is what I'm thinking it is now. I'm considering going to ask him again, but I'm curious what the paleo world thinks - last time my doctor told me to increase my grains and fiber...

So my guess is that while my gut was healing, I didn't have this problem. Now when I have grains/nuts I'm irritating my stomach/digestion again and it takes a while to heal after it's been affected.

I've been taking probiotics for a few months and just added enzymes a few days ago, hoping that would help!

Any ideas/recommendations/thoughts?

Update: I've been taking Mag Citrate for just over a week now and things are much 'nicer'. Dr B, you asked if I was itchy... I wasn't before, but now I am a bit. What does that mean? Any recommendations? Thanks!

edited Dec 9 2010 at 16:57

asked Nov 29 2010 at 14:14

Lauren
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have you had anxiety, depression, fatigue correlated with when you had blood regularly in the toilet? – Mark Jul 4 2011 at 15:23

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No, I wouldn't say I experienced any of those symptoms you mentioned. Maybe mild anxiety, but not depression or fatigue. Over the past few months I have realized I can attribute this problem to eating gluten (which I RARELY do now), or sometimes it happens a day or two before I get my period (and get a bit constipated, sorry for tmi). – Lauren Aug 1 2011 at 1:01

Dr. B · Accepted Answer · 2010-11-29 15:34:42Z UTC

Ok so we have ruled out anal sex as a risk factor! And no constipation?! The fact that you had the problem before starting the paleo diet (and it went away after starting) leads me to believe something is going on in your gut. Perhaps you have a gluten sensitivity since you say that when you have grains it causes the bleeding. Also, google "leaky gut syndrome". This is what grains (gluten) and phytates cause.

If I were you, I probably would not go to my doctor just yet. The fact that you can control your symptoms with diet leads me to believe it is controllable on your part. If it gets worse, or you have other symptoms then definitely go to your doctor.

So no straining when you go to the bathroom, right?!

Dr. B · Answer 2 · 2010-11-29 14:38:58Z UTC

Sounds like it could be hemmorhoids or anal fissures. The fact that the blood is bright red means it is most likley coming from the anus, rectum or sigmoid colon. A darker color, almost black tar like, indicates it is coming from the upper GI ( stomach, small intestine, etc.) Is there any pain associated with your bowel movements or do you have any pain or itchiness at all?

Do you have any other symptoms i.e. diarrhea, lack of appetite, nausea? Also, not to sounds crude, but anal intercourse is a huge risk factor for anal fissures as that significantly increases the chances of tearing of the anal lining.

So your doctor told you to increase your grain intake. Apparently he needs to learn the truth and not just succumb to what he hears!

David Csonka · Answer 3 · 2010-11-29 17:53:17Z UTC

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This is a great opportunity to try some real disciplined self-experimentation. You should try doing a very serious elimination diet to determine what the cause is.

Go pure paleo till the condition goes away. Then reintroduce one potential causative food for a week.

If condition is still good, remove that food and then introduce a different one.

Do this until you have exhausted the candidates or the blood reappears.

Keep a rock-solid food journal throughout.

answered Nov 29 2010 at 17:53

David Csonka
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	Do you think I should stop taking the enzymes so I can really see what's affecting me? – Lauren Nov 29 2010 at 18:45
	That would be the best way to really see what's going on. Though, if you were taking the enzymes before and after the blood showed up, it could be fine. You just have to be able to say with certainty that you never missed a dose of the enzymes. If you can't you should probably take them out as well. (If you want to be absolutely sure) – David Csonka Nov 30 2010 at 12:31

Olga · Answer 4 · 2010-11-30 00:37:11Z UTC

I had the same symptoms at 20, which were diagnosed as colitis. If you think you might have that, I would recommend that you immediately discontinue grains, nuts, starches, fruits, and vegetables, because fiber = pain. Then it's up to you how long you want to keep that stuff out and how you want to integrate it back in. For me, giving it up for 2 weeks is usually enough for healing and then I bring the veggies and nuts back in.

42 · Answer 5 · 2010-11-30 03:17:46Z UTC

If you had a fissure, you probably still do. They take ages to heal.

I think you just need to give it time and stop the cheats. All those years I thought fiber and psyllium were supposed to be good for me... grr.

For a good laugh, google "Bob the anal fissure".

Alan · Answer 6 · 2010-11-30 06:53:34Z UTC

I'd also suggest increasing your dietary fat intake. This will drastically soften and shrink the stool. Definitely agree to remove all grains and fibre too. I eat no fibre (meat and eggs) and have small soft stools that are very easy to pass, no effort at all.

asdf · Answer 7 · 2010-11-30 01:27:48Z UTC

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this is ulcerative colitis, i have this condition, went away with a couple of pills of Apriso (mesalamine)

answered Nov 30 2010 at 1:27

asdf
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	Downgraded because I really doubt you're a gastroenterologist and have examined this patient personally. – 42 Nov 30 2010 at 3:12
	Although his/her idea is worth staying on this page; just in case someone will benefit from the hint. – Lemon Mar 12 2011 at 20:12
	@42 - downgraded? what about all the other recommednations? asdf was just answering the question based on personal experience. – Jack Kronk Mar 22 2011 at 21:33

Hanna · Answer 8 · 2011-03-22 18:58:55Z UTC

This sounds like you have a gluten sensitivity. If this only occurred after you had grains, then that's definitely the cause of the bleeding. I have leaky gut and celiac sprue disease and once finally off all foods I couldn't eat, I bled a little, which I believe is a process that allowed my body to cleanse myself out and clear out the toxins within (this only happened twice and it was within the first month of discontinuing "bad" foods for me (dairy, grains, soy, corn). I think that you should stick to a paleo diet (the diet I'm on now) because it really has done wonders for me. Maybe think about taking probiotics too.

Heather · Answer 9 · 2011-03-22 19:23:38Z UTC

I had this happen for the first time a few months ago after a corn chip binge (bright blood, no straining). I'm pregnant, hence the binge :P plus pregnancy does funky things to your digestive tract if your diet isn't perfect. Now it recurs whenever I get way too much fiber, and I get hemmorhoids with just a teensy bit too much fiber. So, what works for me is to go very easy on the fiber and heavy on the fats to help things along. I also drink bone broth after an episode. Not sure if it helps, but it might, and it tastes good!

These were certified gluten-free chips, so I know the issue wasn't gluten. Maybe I'm sensitive to large amounts of corn. Well, probably everyone is sensitive to that amount of corn....

Blood in Stool?

9 Answers