Saturday, June 16, 2018

Tackling the Gut

Karlee Pinto, RD, LDN
Sometimes I think of the gastrointestinal (GI) tract as this large dance party. There is a lot going on. Everyone is spinning around on the dance floor. All different dance styles and music. Unique and individual wardrobes and personalities. So much is happening at once. The night is constantly evolving. OK, bear with me here…we don’t have a dance party in our bellies (although sometimes it may feel like it), but the GI tract is incredibly complex and intricate. It feels like we have been researching the GI system forever, yet we still have so far to go. But this is the true beauty of it. There is so much to learn and so many unknowns to discover.
            Because this system is so intricate and a hot topic to study right now, it receives a lot of attention, specifically when addressing food and its effect on the GI tract. Think about it. When you have an upset stomach, a lot of gas, or some abnormal bowel habits, often the first thing you think is “ohh…what did I eat today??” Certainly, some medically diagnosed conditions—such as an allergy or intolerance—relate specifically to a certain type of food. If you feel that you may have an allergy or intolerance, please consult your general practitioner. But in this post, I hope to provide you with a little more knowledge to help you understand just how complex this system is and how many factors impact our GI health.
            Often, when we are presented with some sort of GI issues, the immediate recommendation is an elimination diet. For those unfamiliar with elimination diets, here’s a brief overview. Individuals experiencing GI distress keep a detailed food log and deeply analyze and study the specific GI symptoms that they experience to try to link them to a specific food or food group. Depending upon the specific protocol, foods and food groups that are more common allergens and intolerances are strictly removed from the diet and then gradually added back, one by one to determine which ones could be causing the GI symptom. This may seem like a no-brainer protocol, however the restriction has the potential to be harmful and triggering to someone who has a history of dieting, an eating disorder, or disordered eating. There is a fine line between reasonable intention to take care for one’s own body and using elimination as a vehicle to manage other aspects of our well-being. Maybe it is that inner factor that thrives on controlling all aspects of the diet. Or maybe we are searching for stability in our live, so we seek this through our experiences with food. In these moments, we need to take a step back and take a look at the bigger picture. The sole focus may not necessarily be on food itself.
            Our digestive system is intricately connected to the nervous system. Our thoughts and feelings can transform into a very real, physical experience or sensation. Have you ever been super-stressed before an exam and your breakfast just didn’t sit too comfortably? Or you had a meal just prior to experiencing some unpredicted stressful situation and suddenly a wave of nausea hits? Our GI system is heavily impacted by emotions, such as stress, anxiety, fear, depression, and so forth. Surely, we could be having some other co-occurring physiological symptoms that exacerbate the feelings of GI distress and discomfort. However, add in some other strong emotions like anxiety and stress around eating, and you can see how we fueling the fire. Thoughts and emotions live in our bodies and deserve to be acknowledged while we try to understand and decipher this mind-gut connection.
            Gastroparesis is a fancy term that can be easily defined as delayed emptying of food from the stomach into the intestines. This process is caused by decreased stomach motility, or movement. In some cases, the vagus nerve, which controls the stomach muscles, is damaged. This interferes with your stomach’s ability to naturally contract and move food along the GI tract. Another possible determinant to gastroparesis could be a change in the gut microflora, which could be triggered by restricting specific foods or food groups. There could also be changes in the production of digestive enzymes. In simple terms, this variation could impact how certain foods are broken down and digested. Once restriction barriers are taken down and food is reintroduced back into one’s routine, some GI discomfort could potentially arise.
            So how do we begin to calm down this gastrointestinal dance party? How do we wind down and relieve some of this chaos? What follows are a few simple steps to help work through some of these GI issues:
Balance and Regularity
Our bodies love routine. In fact, our digestive tract prefers meals every 4 hours or so. Things may seem to pass along more smoothly when we honor our bodies’ natural rhythm. Make it a priority, and care for your body by eating balanced meals and snacks every few hours. Bring mindfulness and awareness to this need. Just as someone with the diagnosis of diabetes mellitus is more mindful of the impact of carbohydrates on their blood sugar, perhaps you may need to be more mindful of routine eating patterns to aid in the digestion process.
Stress Management
Work with members of your treatment team to develop skills and tools to tackle and manage stress. Remember, the nervous system feeds into the gut. A stressed-out mind can lead to a stressed-out gut. Consider how an emotion might be affecting your digestion just as you would question the impact of food.
The Squatty Potty
Well, I guess this is happening—I am indeed going there. Because of the body’s natural physiology, the rectum and anus are located at the end of the digestive tract. You have a muscle that sort of ropes around the rectum, kinks, and contains the stool so that you can go about our life. Using a squatty potty allows our knees to rise above our hips, mimicking a natural squat. The muscle that loops around the rectum loosens up, making it much easier to go to the bathroom.
Fibrous Foods
Are you eating a lot of raw produce or fiber-enhanced foods, such as protein bars or crackers? Highly fibrous produce can be taking a toll on our GI system as it may not have the capacity to digest all of this roughage. Allow your gut to relax. For ease of digestion, try to cook some of the produce that you believe may be triggering GI distress and see if this helps to alleviate gas and bloating.

            Most importantly, give this process time and grace. If you are experiencing GI distress and discomfort, let your treatment team know as each member can contribute something meaningful to help improve your digestive health. Allow them to provide you with that support and guidance while you patiently explore your own, individual digestion. 
Karlee is a staff nutritionist at The Awakening Center. To schedule an appointment, call 773.929.6262.