I’ve been meaning to write this post for awhile, and today a friend was asking me for this kind of information, and I decided to just get this post up for everyone’s benefit. My purpose of this post is to provide some non-medical suggestions for lifestyle, supplements, diet and exercise to boost gastrointestinal (GI) health.
This is all coming from my personal experience of recovering from colon cancer surgery. I will be talking about myself, because that’s what I know, but I’m doing so in hopes that some of it may resonate with you. Because most of us, at various times, are not happy with how our GI systems are working. You do not have to have anything seriously wrong with your system to benefit from some tips and tricks in this post.
Lots of caveats: I’m not a doctor; this is not medical advice. Some or none of it may be useful for you. Most of what I’m going to be talking about is dealing with common symptoms such as constipation, diarrhea, bloating, etc., and I want to caution you to not just treat symptoms. Occasional bouts of these things is normal, but chronic issues have a root cause. Go to a doctor and try to figure out the reason behind your symptoms. Many things that cause GI issues need to be treated, and the sooner the better. Don’t just treat symptoms at home if you don’t know the cause.
That said – now, I’m going to talk with you about how to treat symptoms at home. This is to supplement your doctor’s directives – little details that your doctor may not have first hand experience with, or time to discuss in detail with each patient.
I’m going to start with a discussion about diet, then talk about probiotics and supplements, then finish up with an exercise.
First of all, I would suggest figuring out how long it generally takes for any given food item to get all the way through your GI system. This is going to vary, of course, person to person, and depending on whether you’re blocked up or running loose. But in general it’s useful to know how you trend. You will be trying to correlate symptoms with recent food and supplements, and being able to estimate lag time is useful. Gut transit time is generally 24 – 72 hours depending on the person and the food and other conditions. The best way to tell is eat something you don’t digest well (like corn) and see how long it takes to come back out the other side.
Now let’s start with a basic – water. Of course you’ll want to drink plenty of water. But I have a brief caveat about staying hydrated. If you get migraines, or live in a dry climate, or exercise a lot, make sure you supplement your water with electrolytes. I don’t use as strong of a dose as the package says, and I don’t use electrolytes every time I drink a glass of water, but I do use electrolytes daily. Otherwise I get migraines. I have literally brought on migraines by drinking too much water without enough electrolytes. Don’t be afraid of salt if you get migraines.
Also, be alert to your water source. We have good water in the US, and I don’t want to sound crazy, but some people are sensitive to some things that other people aren’t sensitive to. For example, for some unknown reason, Albuquerque water upsets my stomach. I do fine with Albuquerque water after it’s been filtered, so when we lived there, we installed a filter in our kitchen so I could drink the tap water.
At restaurants when I lived in Albuquerque, I needed to either bring bottled water or buy bottled water or soda at the restaurant. Remember that soda fountain drinks use local water. I also had to bring my own water and drinks to work, and make my own coffee. That was not a hardship, because after all, who likes office coffee?
Luckily, Tucson water works perfectly fine for me, although we still installed a filter in the kitchen. If your stomach is randomly going off for no apparent reason, you might consider switching to bottled or filtered water for a few days and see if it makes any difference. It’s not likely to be the water, but it’s easy enough to test.
Next, learn to notice what you’ve eaten prior to changes in your GI system. We all know about beans, beans, the magical fruit (the more you eat the more you toot.) But beans aren’t the only thing that commonly causes reactions.
For example, cheese. Hard, aged cheeses like cheddar, parmesan and swiss, can be constipating. These cheeses can be useful if you’re running loose, but limit them if you’re blocking up. Soft cheeses like cottage cheese can be an issue for a different reason. They have higher levels of lactose than hard cheeses. Lactose intolerance can develop as we age, so just because you didn’t used to have it, doesn’t mean you don’t now. For a good test, don’t eat any cheese (hard or soft) or dairy product for a few days and see what happens.
If you eat meat, pay attention to what it does to your system. Red meat can be constipating for some people, but for me, it has the opposite effect. I find that I can only eat meat if it’s very thoroughly cooked. That means I can’t eat a nice medium-rare steak. I can eat stews, posole, and other slow cooked meats. I can eat roasted chicken but I need to overcook it until it’s falling off the bone.
Cooking often helps digestibility, although I personally cannot eat cooked fruit. I especially cannot eat fruit cooked in any kind of muffin, scone, bread, etc. No raisin muffins for me! I can’t eat dried fruit either. I can only eat fresh fruit. This is a change for me – I used to eat a lot of dried fruit. Most of the changes in my gut are due to surgery, but aging changes our guts too.
Another thing I used to be able to eat but can no longer eat is raw cruciferous vegetables (cabbage, kale, broccoli, cauliflower; you can google the list). I have commonly heard the complaint that now that our GI systems are compromised, how can we eat healthily? I am an advocate of buying frozen vegetables – I find them easier to digest than fresh. And they say nowadays that our fresh vegetables sit for so long in warehouses that frozen vegetables are often a more nutritious choice anyway. I am lucky that I can eat salads because I enjoy them, but I do so in moderation.
One of the big things you’ll want to do with your diet is introduce probiotics to your system in a daily, gentle manner. You can take probiotics in pill form, but I find the pills are very hard on my stomach. Instead, I look for probiotic forms of foods and learn how to comfortably add them to my diet. I say “comfortably” because many are an acquired taste. If you don’t like these foods, start with small amounts and mix them into other foods.
For example, I don’t drink kombucha by itself. I mix it 50-50 with orange juice; 1/2 cup kombucha and 1/2 cup orange juice every morning. It’s not a lot of kombucha, but my goal is to introduce probiotics into my system slowly and naturally throughout the day. My daughter buys a type of kombucha at a farmer’s market in the California Bay Area that is so delicious I could drink it straight all day, but I don’t live there. And also be aware – kombucha is often make from black tea and contains caffeine.
Here’s some of the probiotic foods currently in my refrigerator. (Haha, yeah, I fished that Trader Joe’s probiotic fizzy drink can out of the recycling bin so I could take the picture. The things I do for you!)
I will commonly eat probiotic yogurt in the morning, or I may put a small dab of probiotic cottage cheese on top of my scrambled eggs. Remember that heating your source of probiotics will likely kill the probiotics. So I usually put them on top of food that I’ve already cooked. A spoonful of probiotic sour cream can go on avocado, salads, sandwiches, meat, rice, vegetables, etc. A tiny bit of sauerkraut or fermented pickles or kimchi can liven up a salad even if you don’t think you like the sour/salty intensity of these foods. The key is to use small amounts, all throughout the day.
Plus, there are even non-sour foods with probiotics! Everyone likes granola, right? No? Then how about lemon & ginger tea?
I was skeptical about the probiotic tea, but apparently they’ve formulated a probiotic that can withstand the boiling water. Google it, see what you think. In general I don’t expect my probiotics to survive any kind of heating or cooking, but there are apparently exceptions.
Next, supplements. This part is critical for me. First of all, I like these digestive enzymes. I don’t know that this brand is any better than any other brand. I would suggest buying digestive enzymes of whatever brand you like.
Secondly, I swear by magnesium citrate and calcium citrate if you have issues with constipation. There are lots of products that will fix the problem faster, but there’s nothing else that I’ve found that I can take on a daily basis without disrupting my system. Everything stronger throws me into an oscillation back and forth between constipation and diarrhea. I call it my rollercoaster, and it’s not fun.
Not all magnesium is the same. Magnesium citrate has a very different impact on your gut than other forms of magnesium. If you look up on the internet under which kind of magnesium is “good for” your gut or “easy” on the gut, that won’t tell you anything, because it depends on your goal. If you’re using magnesium as a laxative, use magnesium citrate and pair it with calcium citrate. If you want to take magnesium and calcium but you’re running too loose, don’t take it in citrate form.
I take 300 mg magnesium (from 1350 mg magnesium citrate) which is 3/4 of the recommended dose of magnesium (1.5 pills instead of 2), and 375 mg calcium citrate, which is less than half the recommended dose (1.5 pills instead of 4 pills). It took me awhile to get the dosage right.
Plus, it depends on the situation. I occasionally take medicine for migraines that slows my GI down, so if take that medicine, then I also take a little extra mag-cal citrate. Your dosage will be different than mine, but my point is to be aware of how sensitive your system might be.
I buy tablets instead of caplets so I can cut them in half. I take between 1-2 of each of these supplements each evening, with one and a half pills of each being my best usual dose. I can’t imagine taking the entire recommended daily allowance. Note also that the recommended dosages listed are generally for a grown man. Your correct dosage may be different. My dosage is less than recommended, because the recommended dose would for sure give me diarrhea. But on the other hand, I absolutely do need to be taking these supplements daily or else I will for sure block up entirely. It’s finding that middle ground.
That’s how sensitive GI systems can be. You can imagine how the various laxatives sold in the pharmacy section of the grocery store impact sensitive systems like mine. All the laxative options, even when I cut the pills in half or quarters, are way, way too strong for my system. I overreact to everything and then the rollercoaster starts, careening back and forth between diarrhea and constipation extremes.
That’s why I’m writing this – for others who are like me. Because your doctor is not going to tell you this. In fact, if you complain of GI issues, they will probably prescribe medicines that are even more crazy-strong than the over-the-counter items.
If you are swinging back and forth between constipation and diarrhea, you are likely taking meds or supplements (or even just eating food) that is too strong for your system and you’ll want to moderate your intakes. Now, I understand it’s really hard to be moderate and not overdo it when you’re totally blocked up and have been for days and you just want to f*cking get that shit outta there. And you may need to just do that occasionally; take a lax and start all over again after you’re cleared out. But then go back and try again to find that moderate place where you don’t need the strong interventions.
By the way, if I do need an intervention, I usually just increase my magnesium & calcium citrates. But senna tea is also effective and less strong than the pharmacy meds. But it’s still too strong for me to use on a daily basis, and I can’t control the strength well enough (I can measure a 1/4 cup, but how strong was the tea?), and anyway, it causes bloating.
Speaking of bloating, let’s talk about fiber! Everybody promotes fiber. That’s because it can bulk up your stool, which can be helpful for both diarrhea and constipation. But fiber’s dirty little secret is farts. Farts, farts, farts! Fiber = farts! Now you may be saying, “Speak for yourself, Kristina, fiber works fine for me.” So if it does, that’s excellent. If fiber = fine, then eat your fiber foods and take your fiber gummies; that will definitely be useful for you. It’s good for the gut if you can tolerate it. I used to eat a raw cabbage salad with chopped pineapple and coconut flakes in the morning and a spinach and kale salad for lunch. And I didn’t have any farts! It’s amazing what I used to be able to do. Now I can’t eat anything remotely like that. That’s why I use magnesium citrate and calcium citrate instead of fiber to keep things moving.
Another thing to think about is the difference between motility and stool consistency. If you are getting constipated, is your stool too hard because you’re dehydrated? Or is it because your internal GI contractions aren’t strong enough? Or it could be even more complicated. Maybe you have nerve damage (like I do)? Or are you missing some of your colon (like I am)? Or is it for some other reason? Old age! Ha, I hear you, but be more specific if you can.
The root cause is likely a disease or injury, and the final outcome is your symptoms. But in between the root cause and your symptoms is the place I’m suggesting you think about. What exactly is going on in your gut, to the extent that you can guess?
It can be hard to know, but here is where your health history and ongoing medical testing comes into play. The more you know about the actual cause of your symptoms, the smarter you can be when treating symptoms. Some medicines make more fluid available during the stool forming process, others increase contraction strength – there different approaches. So the more you know about what’s going on in your own gut, the smarter you can be about how to help it.
Also don’t be afraid to try thing that seem gross. The less hang-ups we have about grossness, the better job we will do in taking care of our bodies. For example warm water enemas. Who wants to talk about that? I don’t actually do them myself because they are too harsh and cause that rebound rollercoaster I’ve talked about. But they are a tried and true, non-drug method that can be remarkably useful.
Also if your doctor recommends a fecal transplant, do it! I’ve heard they work super well. I didn’t need one, but if you do, don’t hesitate just because it sounds yucky. Our bodies are yucky sometimes. It’s ok. That’s how we’re made. Gloriously alive, wet, stinky, sloppy, messy, squishy, and unpredictable.
And lastly exercise! You should consult a physical therapist who is going to know a lot more than me, but let me tell you what I do. We can’t control our smooth muscle contractions of our internal organs. But we can sometimes help those processes with our skeletal muscles that are under our control.
For those women out there who know what a Kegel is, imagine a Kegel plus abdominals, and glutes, and everything from the waist to the knees. Lay flat (or stand). Start by breathing in. As you breathe in, let your belly expand, your diaphragm drop, your pelvis relax and drop. Everything is expanding and going outward to make room for your breath. Try pushing down slightly almost like you’re on the toilet (maybe use the toilet first before trying this, lol). Consider spreading your knees a bit and bear down slightly like you’re giving birth. But not nearly as extreme, of course, as that! All this opening and expansion and downward movement is what you do while breathing in. It’s a little counterintuitive, but remember you’re making as much space for your breath as possible.
Next, slowly breathe out for as long as you can, like you’re a singer holding a long note. While breathing out, bring everything in and up and tight. Belly in, diaphragm up, pelvic floor up, butt squeezing it in, hold it all in, bring it up and in as tight and as far as you can and leave no more room for any breath until your breath is all squeezed out. Keep squeezing! Imagine you’re sucking your poop right back up into your stomach! (I know, that visual was gross, hahaha, but hopefully useful, especially for all the guys who aren’t connecting with the Kegel analogy.)
Then relax and breathe in again and let it all go down and expand outward again, to allow for maximum room for your breath. Repeat a few times. Stop if you get dizzy and breathe normal for a bit, and try again later. I find it useful to do these a few times during the day, but I don’t do very many at a time.
This exercise will not only help you gain muscular strength but also help your brain-body connections in that region. My colorectal surgery did nerve damage which can interfere with my brain-body signaling (knowing when I need to go, and knowing how to go when I’m ready to go). For me, sometimes trying to poop is like trying to wiggle my ears – my brain doesn’t always quite know what to do to make it happen! Not everybody has nerve damage, but if you do, sometimes you can slowly improve that brain-body signaling by thoughtfully exercising the surrounding muscles – the ones that you can control. It seems to help the brain become re-aware of all the muscles.
I hope this was helpful. Good luck on your journey of being in a mortal body in this world. It is not always easy, but we are never alone.