Who Do I Listen To?
As I prepare for yet another GI visit, where I expect to get barraged with the usual conflicting recommendations, I am bracing myself for absolute confusion.
The past few weeks I’ve been feeling worse than usual, stomach wise. Never knowing what foods would make me feel bad, and which ones would make me feel worse, sometimes I have to choose between two impossibles: feeling like shit and like extra bad shit.
I made outstanding strides between 2016-2018, which catapulted me into an almost-unrecognizable healthy state. However, as life would have it, the end of 2018 grabbed me by the throat and dragged me back… waaaaay back.
Not only did I stop menstruating, but life stresses brought on a recurrence of SIBO—the bacteria in my large intestines moved up to the small intestines where it’s not supposed to be, creating an overgrowth, causing frequent pain and bloating.
Since this wasn’t my first rodeo, I went straight to restricting my diet (even more so than usual). I’ve been on a low-FODMAP diet for years now, which already restricts many fruits, vegetables and grains, but now I needed to eliminate more.
I can’t deny that I felt better, bloating wise, however, I was miserable with the strict lifestyle adjustments that were needed in order to keep up this limiting way of eating. Not to mention, I constantly felt like I was missing out.
I suppose it would have all been worth it, had these restrictions healed me, however, this was not the case. A year and a half later, I have never quite overcome the constant, low-grade bloating and pain. Mostly it’s become part of the furniture, but these past few weeks have been especially rough. Tired of taking supplements and refusing fruit while hoping for the best, I decided it was time to see a specialist.
But even doctors can’t agree on a solid treatment plan. What is it about IBS and SIBO that leaves everyone so befuddled? Treatment has always been a series of, “Let’s throw this at the wall and see if it sticks!”
What’s worse is that each practitioner is SURE that THEIR suggestion is THE ONE to go by. All you can do is close your eyes and throw a dart.
When it comes to treating SIBO, there are some theories that say restricting diet to very low-fiber foods is effective for symptom management, as it starves out the bacteria. Others believe you should intentionally feed the bacteria with fiber-rich foods, so they are easier to target with antibiotics. The real problem with SIBO is that, aside from not knowing the best way to remove the overgrowth of bacteria, it can recur over and over again. Even if you manage to kill off the bacteria in your small intestines, what’s to prevent more bacteria from moving up from your large intestine again?
When I ask doctors this, many have given me a shoulder shrug in response, as if to say, “Beats me!”
But the question that seems to be the most mysterious riddle for everyone is, ”What should I eat?”
This has been plaguing me for years, long before the SIBO hit. Keeping in mind that I was already on a low-FODMAP diet for IBS, limiting certain fruits, dairy, grains, and veggies, here are just some pieces of advice I’ve had to sift through:
“Dairy is terrible for you, avoid it. Oh, but you’re not menstruating? You need to eat fatty cheese!”
“Oh, but not too fatty! You don’t have a gallbladder, so avoid fatty foods.”
“Don’t eat too much meat. Eat mostly veggies. Oh, you have SIBO? Then stick to leafy greens only!”
“You need grains for energy. Oh, but grains can be inflammatory, so limit grains!”
“Processed flour is terrible for you. Oh, but you have IBS? Okay, then you should stick with refined carbs and avoid the whole grains.”
At one point I was told the only fruits I could eat were lemons and limes. WHAT? Who eats lemons and limes?! When it comes to food, there’s just no end to what could possibly be a trigger.
Lectins (proteins that bind to carbohydrates) are found in beans, some vegetables, and whole grains. They can aggravate IBS. Could those be at fault?
And what about resistant starches, like potatoes and unripe bananas? They have prebiotics which are healthy. But, per the name, you guessed it, being resistant makes them difficult to digest. But dare I eat a banana that is too ripe, the excess sugar can trigger symptoms as well!
And then there are nightshades, a classification of veggies that only grow at night, like tomatoes, potatoes, peppers, and eggplant. Those have been known to irritate some people.
And just when I thought I had a handle on everything that could possibly be harmful, and finally whittled down my diet to plain grilled chicken and lettuce, my Eastern medicine practitioner advised me against eating anything cold. So that means no salads. DAMN IT!
So, what does this leave? And who do I listen to? And how do I make the time to prepare foods in these perfect scenarios—not too hard, not too soft, not too cold, not too this, but don’t forget that, watch out for these, make sure you’re getting plenty of that!
And the confusion doesn’t stop at food.
It seems like every time I go to the doctor, they have a confident suggestion for how I should be working out: Build arm strength to release tension in your body, do ab workouts so your stomach muscles aren’t so weak, do more yoga stretches, do strength training for your bones, do cardio for energy. What in the hell?!
And of course, there is mindset, one of the most important aspects of any healing process. But before I can cultivate a healthy mindset, I have to sift through all the conflicting messages about what a healthy mindset even is!
Is it more productive to have clear goals and focus on them regularly? Or, is it better to ask the universe for what you want but then let go of the attachment to the outcome?
Is it better to accept where you are in life, exactly as things are and not fight against it? Or, would accepting where you are be repeating the same negative story about yourself?
Should you sit with all your feelings, especially the painful ones? I know that’s important, but what about just focusing on the positive?
All this is enough to make you want to rip your hair out. Which leads me to another question: Is it better to be bald or.... Just kidding! No more questions, please!
What we’re all looking for are answers.
I have no good answers to any of these questions, no idea what’s right to eat, what’s wrong to think, and how to proceed. I do, however, want to say to all of you out there experiencing similar confusion and frustration, I FEEL YOU. The struggle is very real.
Were I to have an answer, it might sound something like this:
Just do the best you can—that’s a healing modality that will always be applicable, whether you can tolerate beans or not, whether 30 minutes of cardio is your sugar-free jam or you prefer yoga. Just know there are many people out there who are grappling with these same issues, asking the same questions, and hoping for clarity and relief.
Here’s hoping my upcoming GI visit will shed some light on this dimly-lit forest of confusion, but if not, I have to remind myself: When you don’t know what to do, just do the best you can.