This post contains affiliate links from which I may make a commission for purchases at no extra cost to you. This post was updated on 10/30/2020 with new information on how to support acetylcholine production.
In the wake of my post-COVID-19 recovery complications that has started a sweeping storm of neurological symptoms, I thought it would do me and my readers some good to concentrate on something that has gone right in my health; the improvement of my gastrointestinal symptoms from delayed gastric emptying, aka gastroparesis, and irritable bowel syndrome.
After going through a number of Gastroenterologists and a wide range of tests and retests, they could never detect the source of my many gastric symptoms. I was constantly bloated and nauseated. I suffered almost daily from heart burn. I felt full after only a few bites of food and sometimes vomited completely undigested food after several hours. My bowels were even worse. I rapidly fluctuated between diarrhea and constipation and my bowels ached and burned frequently.
Two years ago, I laid out a bunch of possible remedies for the improvement of these symptoms. Today, I’m going to outline what I’ve done since to take back control of my digestive system, allowing me to eat just about anything my heart desires, within moderation, of course.
Before we get started, it’s important to note that while your symptoms may match mine, we might see different results using the same tactics. It’s also important to stress that it took me a full two years to see radical improvement, not only because I added on treatments slowly (mostly as I discovered them), but also because it takes time for the digestive system to heal and adjust. While some of the things I discuss offered instant relief of certain symptoms, this is not a guide to instantaneous relief and improvement. It’s a journey that takes time, patience and above all, persistence.
It can also get expensive, but I figure in the long run it’s saved me money, too. I was quickly headed toward expensive surgeries and a gastric pacemaker or feeding tube of some kind, which would have had severe consequences for my quality of life. To me, there was no contest between cost and what I had to gain. In the end, it’s a personal choice we have to make by weighing all the options.
The following were instrumental to my healing:
- The Low FODMAP Diet
- The Histamine Diet
- The right Probiotic
- A low FODMAP daily fiber supplement
- Discontinuation of drugs which can affect motility, such as ibuprophen and opioids
- Drinking aloe juice nightly
- Evaluating medications for their effects on gut motility and when necessary, changing or adding medications and supplements that heal the vagus nerve and aid digestion
Let’s address each of these topics in more detail!
Following the Diets
The low FODMAP and Histamine diets were instrumental. When the digestive system no longer works right, your stomach’s ability to digest high fiber, high FODMAP (sugary foods) becomes compromised. These foods no longer get broken down easily and thus cause a slow down in digestion. This slow down means that food sits longer in the digestive tract and begin to ferment.
This fermentation causes the nausea, heartburn and constipation we know so well. It also causes inflammation and I strongly suspect it greatly influences histamine intolerance, aka mast cell activation syndrome. Fermenting foods produce histamine and overload our systems with it. I don’t have any hard evidence of this, but it just makes sense.
If your digestive system is filled with fermenting foods, how could it not contribute to an overflowing histamine bucket? While I don’t have the research to back it up, it just plain old makes sense. And if histamine becomes part of the problem, the histamine diet is definitely something that should be incorporated to a natural treatment plan for these conditions.
While much of the literature points to these diets as being short term, the truth of the matter is that if you have long-term problems and haven’t managed to address the source, you’ll need to follow these diets for some time.
For me, two years later, I’m still following them, but I’ve been able to incorporate many more foods than I used to without any symptoms and there are few things I can’t eat with some careful planning. Still, it’s important to remain vigilant and monitor your diet. Once you are able to eat the things you love again, moderation is still key. To get started with these diets and learn what they’re all about, see these articles:
- FODMAP Diet Trials and Tribulations and How to Get Started
- MCADs and The Low Histamine Diet
- Diets & Recipes
Probiotics and Fiber Supplements
I can’t stress enough how important it is to a healthy working stomach that enough fiber be consumed. Fiber gives our stool bulk, helps prevent both diarrhea and constipation and generally works to keep our systems moving along at the right pace. Unfortunately, if your digestive system is no longer digesting FODMAPs well, it’s no longer getting the fiber it needs either.
Most fiber supplements are very high in FODMAPs and not appropriate for people with IBS and gastroparesis. Boy do I wish I’d learned this decades ago. I was only complicating matters by taking products like Benefiber and Metamucil, which are fine for healthy bellies, but can aggravate low motility.
Instead, you need a low FODMAP fiber and the only one I know out on the market today is guar gum powder, aka sun fiber. There are several brands and I encourage you to shop around, but my go to favorite is Healthy Origins Natural Healthy Fiber, which is non-GMO and generally more affordable than other brands. It needs to be started off slowly. Here are my recommendations for taking sun fiber.
Also instrumental is a good reliable probiotic. It took me years of trial and error, research and discussion in groups before I finally figured out which benefited me most. It turns out there are certain probiotics that work especially well to clean up histamine and bifidobacterium is a heavy hitter when it comes to controlling histamine and correcting an imbalance of intestinal flora. I take Life Extension’s Bifido GI Balance every morning. I’ve been taking it for over a year now and have seen improvements in both my motility and my histamine levels.
Consuming Aloe Nightly
I’ve written extensively on this, so I don’t want to go into a lot of detail. I stayed on Aloe for approximately 8 months, taking 4-6 ounces of Lakewood Organic Pure Aloe Vera Gel a night and saw a reduction in all of my gastric symptoms overall. At 8 months, I decided to go off of Aloe to see if I noticed a difference, and my stomach finally remained stable. However when I tried to go off of it at 4 months, I suffered a return of symptoms.
To learn more about why I believe it works, see Why Aloe is for Spoonies. Since I also started supplementing my acetylcholine production, I think it also contributed to why I no longer needed the aloe. Now I only use the aloe to treat occasional stomach upset.
There are many over the counter and prescription drugs which can affect motility and gut flora. Antibiotics can obviously wreak havoc by killing off intestinal bacteria colonies and causing imbalance. Others can increase certain types of bacteria, while others yet can slow down motility. If you have GI issues such as gastroparesis, IBD or IBS, it’s important to explore the effects of drugs on motility and whenever possible, select an alternative. When it’s not possible and the drug is necessary, then selecting the right probiotic can be helpful.
Drugs that are known to affect motility and gut flora the most based on clinical testing are PPI’s, which are designed to decrease the production of stomach acids. Unfortunately, they also increase fatty acid production and increase upper GI tract bacteria. Other drugs that can impact gut flora include metformin, laxatives and SSRI’s which are very popular for treating depression, anxiety, bipolar disorder and many other mental health conditions. Drugs that can slow motility and cause constipation include (ironically) H2 acid reducers containing calcium or aluminum, SSRI’s, Anti-psychotics, opioids, blood pressure medications, anticonvulsants, anticholinergics, calcium channel blockers, diuretics and iron supplements.
Obviously not every drug which may interfere with the gut can be discontinued or refused. Many of these drugs are essential for certain conditions, but it’s good to know what you’re up against and have other things in your protocol to help combat these issues.
For me, an H2 acid reducer works better than PPI in regards to motility and the reduction of heart burn, but since both can interfere in its own way, you may find just the opposite. However, one of the reasons I chose an H2 over a PPI is the H2’s ability to reduce histamine levels. You may find a PPI more effective based on the root of your issues and your own physiology.
I also figured out pretty early on that I can’t tolerate the ingredients in most laxatives, just like I can’t do any fiber but low FODMAP hydrolyzed guar gum. Once I figured out they caused swelling and only compounded my inflammation issues, I started using a sea salt water cleanses anytime I couldn’t produce a bowel movement for 3 days. Trust me, waiting longer only makes things less pleasant. You can learn more about the do’s and don’ts of salt water cleansing here.
One of the most important things to help get a sluggish tummy going again is to improve the health of your vagus nerve. I achieved improvement by helping the body to produce acetylcholine naturally, a substance which many people with these conditions are deficient in. Acetylcholine helps our nerves to communicate properly. The best way to support acetylcholine production is to take the building blocks that will allow your body to make your own. To achieve this, taking acetyl-l-carnitine, thiamine and huperzine A.
Since I started taking it almost a year ago, it’s increased the regularity of my bowel movements, helped normalize my hunger signals and much of the sensation that I lost in my lower abdomen has come back. I can now tell when I need to go and my muscles function better, which means much less straining on the toilet.
These things happened slowly over time, but the end result has been quite powerful, up to and including the disappearance of most of my symptoms related to dysautonomia.
It may be hard to believe that changing my diet, evaluating my meds and adding some supplements could affect such radical change. I can hardly believe it despite experiencing it myself. But I know it works and some of the women I have worked with one on one or in my group have also turned around terrible gastric pain and chronic constipation utilizing some of the same tactics. Current medicine standards and practices work pretty hard to convince us that all our health solutions will come from surgeries or medications, but for some of us, these options only worsen our symptoms.
After embracing all of the tactics above, I cannot say that my digestive system is completely healed or that I can eat anything I want without reservation, but then again, who can? Eating poorly catches up to all of us eventually. However, I can eat most FODMAP ingredients in moderation and don’t need to watch my histamine intake as much as I used to.
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So long as I keep my diet reasonable, I experience no heartburn, I have healthy, normally formed bowel movements on a fairly regular schedule, rarely ever experience nausea and only experience a slow down to my motility when I’ve gone overboard with what I eat. I’m also fairly certain the only time I’ve vomited over the last year was when I had COVID-19, and I can enjoy a lot of foods I could no longer tolerate.
In fact, since my husband and I have both been experiencing some pretty gnarly fatigue/PEM and neurological symptoms since we had COVID, we began testing some frozen foods and boxed meals, not to mention eating out more and we both see fewer gastric issues than we used to experience. We can’t eat like this every single day, but it sure does come in handy when we’re just too worn out to go the extra mile on the much more wholesome home-cooked meal. In moderation, I can even have chocolate, pizza, fermented foods, hard dairy, most fruits, non-cruciferous vegetables and even a bit of garlic and onion if we don’t do it too often.
Have your own gut health protocol? Let us know what works for you in the comments! Thanks for checking out our recommendations. If you learned something from it, please be sure to give it a like and a share.
Resources and Further Reading
- Common Medications Linked to Changes in Gut Microbiome. Healio Gastroenterology. 23 Oct 2019. Accessed 19 May 2020.
- Medications That Can Affect Colonic Function. International Foundation for Gastrointestinal Disorders. 2 Oct 2019. Access 19 May 2020.
- What is Gastroparesis? Curtis, Michelle. The Zebra Pit. 18 Aug 2018.
- Natural Treatments for Gastroparesis Curtis, Michelle. The Zebra Pit. 17 Aug 2018.
- Natural Treatments for Gastroparesis Part Two Curtis, Michelle. The Zebra Pit. 19 Aug 2018.
- Gastrointestinal Symptoms in EDS Curtis, Michelle. The Zebra Pit. 27 Oct 2017.