Bad GI issues. Should I halt treatment?

Hi Manzanita2 -

Sigh...GPs... with their ignorance about Lyme AND GI health... they're not much help.

Generally, my answer to your question is YES. yes, yes, yes. Always work out GI issues first, since nearly all our treatment is taken orally--if we can't absorb it because of GI problems or damage, it's a lot of wasted time and money.

Your case might be a little different. I agree that you really might have picked up a bug during traveling. If your ONLY weird GI sx is diarrhea, then you might be better off staying on the tx but trouble-shooting for the diarrhea. If you have other GI problems and now you have diarrhea, too, then I would stop everything and deal with only the GI.

Stay as hydrated as you possibly can. There are anti-parasite herbs you can buy at the health food store - one I would try is "SCRAM" by Healthforce - it is 100% Pure (Zero Pesticides, Non- GMO, Non-Irradiated) and contains:
Cloves
Black Walnut Hull
Wormwood Herb
Milk Thistle Seed Extract
Wasabi Extract
Enzymes (protease, amylase, cellulase, lipase)

So it has a better chance of hitting something without knowing exactly what it is.

I would read up on treating parasites so that you will know what to expect--you could have some seriously strange bowel movements at first, you might need to treat past specific life cycle periods, and other specifics. If this doesn't work, move on to something else. Don't try too much too quickly (like I did) because treating all this can be hard on the body.

If you don't have some success with something within a week---I would get more aggressive and call your LLMD for an emergency appt--you should not let "chronic diarrhea" go too long. Obviously, the diarrhea is your body's natural process of eliminating something that shouldn't be there but dehydration can be dangerous.

Also, I would try switching your diet to only liquids - healthy soups and pureed veggies (no roughage, nothing that requires a lot of digestive process like animal meats, no dairy and no sugar or grains)... really dumb down the diet. And this is key: eat only in very small but frequent portions. Keep a pitcher/bowl of soup in the fridge and drink maybe 1/4 cup every 2 hours or so.

This might help the overreaction from your GI and help you absorb more nutrients.

Others will be along to offer more suggestions... stay hydrated! Hope you find some relief.

-p

OK...

Well... after reading your follow-up post I think it is CRITICAL that you heal your gut first. HOW to do that is the difficult question and it can be a process. But it can be a life-changer if you do it the right way and give it the time it needs.

I would halt the anti-parasite tx for now as well as all other antimicrobials AND support. Focus only on GI.

Unfortunately, even gastroenterologists can be clueless about GI health. It's astonishing. Plus, medical curriculum usually includes only a couple of hours of nutrition in the first year of school. GI health is ALL about nutrition, and if you can't be digesting it, you can't be having it. And how in the world is our GI supposed to be functioning optimally w/out proper nutrition or the ability to properly absorb what we are taking to support it or treat issues?

OK - rant over.

MONTH 1
During this first month take copious notes every day about what you're eating, when, how and how you feel. You're kind of doing a modified "elimination diet". Generally, people do elimination diets to figure out what foods they react to but you're doing it primarily to maintain nutrition while you simplify the digestive process to allow your GI to heal. While critical at the beginning, this is a very restrictive diet and you wouldn't want to maintain it long-term.

Keeping good notes is key because you might also be dealing with leaky gut and there might be specific foods to avoid until your GI is completely healed. There might also be foods that cause other triggers and this should become a little easier to identify when diet is simplified and you take good notes.

Diet
I would really, really dumb down the diet first, as suggested. Unless there are specific veggies you are allergic or sensitive to, I would resort to eating only liquid/pureed veggies for at least a month. There are some very health veggies that can create histamine issues but without knowing you have that--I wouldn't worry about it right now.

As crazy as it sounds, organic baby food is a great option. Your portions need to be small so the tiny jars are perfect - less food to go bad. It's also a bit expensive but that's my easy and simple go-to when I need to streamline my diet and don't have the energy to make my own baby food. It won't be forever - make it easy on yourself.

Avoid fruits for now. Add to the veggies the best, most nutritious bone broths (chicken, turkey, beef, veggie are all good) - home made is GOLD!

It's important to keep it as clean as possible, organic is best, so that you aren't reacting to chemicals, which can be confusing and can cause harm that you can't heal from if you're continuing to eat them. And any animal product really, really needs to be organic. 80% of the antibiotics sold in the US are used in animal product production so most meat products come from animals given HIGH doses of abx and other drugs because of the living conditions of production processes... it will be too difficult to heal the gut if you continue to feed it chemicals that it may be reacting to to cause the sx. You really have to dumb this down to figure it all out. Although all-organic all-nonGMO is critical right now (and healthier in the long run) it doesn't have to be a 'forever' thing if you're concerned about cost.

Again, keep the portions very small and frequent. I wouldn't go to bed hungry - eat right before bed if you like but keep it a small portion.

For this first month I'd steer clear of all grains, sugars, dairy, animal meat, legumes and roughage (salads) for now. Let your digestive tract really calm and slow down, which will make digestion less of an overwhelming and dramatic process, strain your immune system less, and with less noise/inflammation and less to manage, your sx might also calm down or at least provide more clarity to help you understand better what is causing what and what.

Y/F overgrowth
If you know you have a yeast/fungal overgrowth problem (which MANY people do, and it causes all of the typical GERD, SIBO, gastroperesis, gastritis, symptoms yet MDs have no clue how to interpret y/f symptoms... then I would immediately also start taking an antifungal. With GI issues as significant as yours, you should skip the natural antifungals and try Rx - Nystatin is best. I strongly recommend reading the y/f info in this thread to help you understand your sx and how to treat... you may have a y/f issue and not know it or this info can help you rule out y/f. Testing is not always reliable. It's a lot of reading - sorry

Y/FO post in the "New to Lyme?" thread:
www.healingwell.com/community/default.aspx?f=30&m=1606610&g=3644275#m3644275

If you know for sure you do not have y/f issues, I would also incorporate very bland foods but again, organic, non-GMO at very low portions. If you're not sure if you have y/f but don't have serious symptoms, I would still stay away from white foods (rice, potatoes). Brown rice, sweet potatoes are good energy foods to incorporate after the first couple of weeks.

Mold
Another thing that can cause GI disruption is mold so if you do have a significant mold issue, the binder you choose should probably be pure cholestyramine. If not, I wouldn't worry about the mold until your GI is a little healthier.

Parasites
Same goes for parasites. You'll want to eliminate them in order to really health the gut and eliminate the GI sx but let the gut do a little healing first.

Detox
I would also be sure to include a gentle GI binder (activated charcoal, bentonite clay, cholestyramine). Make sure you stay regular but the binder might help eliminate what your body is creating the diarrhea to eliminate. Some people have increased diarrhea with binders but I think if you start very slowly with low doses and work up to optimal doses, you might be able to find the right dose that helps the diarrhea.

Week 2 -
Healing
You might also try incorporating things like aloe vera juice (organic, filleted).

Supplementation
digestive enzymes, probiotics... but always always start with very low doses and only one at a time. Give them a day or two before increasing or adding anything new. Always high quality and don't bother with probiotics unless it's live, fresh (refrigerated) and have high numbers of strains (Garden of Life is one brand that has at least 34 strains). Probiotics can be tricky and cause more problems than they solve so be wary of this - start very slowly.


MONTH 2:
(or sooner if you're not making progress but give it at least 2 wks)
Re-evaluate... if you're making progress, try incorporating more foods slowly but choosing those foods will depend on how you reacted in that first month of restrictions.

If you're not feeling too weak and your sx have improved, maybe stick with the original restrictions if the diet is going OK. If you really need to expand diet, that's OK too.

If you're making significant progress with gut healing, you can certainly start very slowly, one at a time, at low doses, reincorporating the support protocol (detoxing, and other support). Start with detoxing first and go slowly.

Week 6
With good GI progress I would start VERY SLOWLY incorporating anti-parasite protocol. Increase detoxing as you go.

MONTH 3:
I would continue the restrictive diet with minor additions if you're making some progress, but not a lot. If you're making good progress, I'd broaden your diet but continue to eliminate all sugars except fruit, processed foods, and grains and dairy (you might need to keep these eliminations for the first year - or reduce them to once every 2 wks or something like that - you can play around with it).

I would be careful about incorporating grains unless you can verify that they are organic, non-GMO and unprocessed. Sometimes it's easier to eliminate. Gluten-free is not always safe because generally, foods that have grains need a gluten binder so another binder is substituted that can be just as problematic.

Only after you've fully incorporated your detoxing and your GI has made a lot of improvement, would I restart antimicrobials.

Of course, as you go along you may need to tweak all of this - and the time frames might not work for you... customize it however you think might help.

And let us know how things go!

-p

Post Edited (Pirouette) : 9/10/2017 1:13:39 PM (GMT-6)

You're welcome, of course.

Leaky gut
I have found the stool tests used for the food panel fairly accurate - it basically looks for immune reactions to foods in the blood stream so it finds antibodies. Generally, people with food sensitivities have leaky gut, which is caused by damage to the mucosal lining of the intestines (often caused by yeast/fungus that literally drills holes into the lining). Undigested food particles, fecal matter, toxins and other things can seep through this damage and then enters the blood stream where the immune system comes upon it and reacts to this "foreign" body that shouldn't be in the blood stream.

Next thing you know, the immune system is creating these antibodies to nearly everything you eat, and an overactive immune response can also trigger countless GI symptoms like yours. And herein lies the confusion--you can be eating all the right foods but still have leaky gut from damage and the response isn't necessarily always to stop eating ALL those foods (except problematic foods like dairy, sugar, grains, legumes), which is what MDs will tell you to do.

Stop the leaks
The key is to repair the damage ASAP to stop the leaks. And to do that, you follow the kind of restrictions in my email above and go all-liquid, etc... Once you stop the leaks by repairing the damage you can hone your diet based on what other sensitivities might be going on (like the histamine issues I mentioned) or foods that might trigger other GI stress. Or hopefully, just broaden your menu. During treatment, it will always be important to eliminate sugars and processed foods. Which categories of foods work best for you might end up being trial-and-error because we are all very different and few diets work for everyone.

Some food panels can provide more info than that--just depends on what you get.

Yeast/fungus
Unfortunately, the tests used to find yeasts are not always reliable. Candida is the most common strain but there are others and the tests don't always find yeast - regardless of the strain. Insurance companies might require them in order to cover meds. I like the stool tests because they often tell you what antifungals (natural and Rx) are susceptible to the yeast/fungal strains it finds.

The BEST indicator of yeast/fungal overgrowth is symptoms so I would review the list of sx in that long thread I referenced and see what rings a bell. SOME of the sx can also be caused by Lyme & Co, which is yet another reason it is very important to eliminate y/f overgrowth so that it's easier to understand how well your Lyme & Co tx is working.

Adrenals
I'm not sure if coffee is OK for you. I lean towards 'OK' as long as you don't have acid reflux from it or obvious jittery or anxious reactions, etc. One main reason to avoid caffeine is if your adrenals are not healthy. Your adrenals are part of the HPA (hypothalamus, pituitary, adrenal) axis and function as part of the endocrine system. If you are under stress it's your adrenal function that triggers your neurotransmitters to issue a surge of adrenaline and cortisol and other chemicals and adrenals that help you through a crisis by increasing acuity and endurance and awareness, etc.

However, after the crisis your stress level should be reduced so that all these systems can return to a normal state. The problem with today's stressful lives, exacerbated by not great health (particularly GI problems), complicated by our Lyme & Co infections, aggravated further by the drain on our bodies from the treatment... our stress levels remain VERY elevated for long periods of times. For many of us--years.

Our bodies were not designed to function like this for long periods of time and systems WILL break down: the prolonged presence of these heightened functions and surges does damage, wears us down, overtaxes our immune response, changes our ability to digest properly, creates confusion in other systems and imbalances with hormones and problems detoxing, etc. It's a mess and it can be very difficult to unravel.

Adrenal levels can take a VERY long time to rebalance. Mine never responded to supplementation but did respond to a year of not working... I think most people are not that extreme.

Part of the problem is that our Lyme & Co conditions involve three different types of stress - our illness and treatment causes physiological stress, living busy and stressful lives in stressful environments full of stress bombarding us from all directions causes physical stress, and EVERYTHING causes psychological stress.

Your adrenals are like a reservoir and each time it needs to deal with a stressful event it taps into the reservoir to get you through it. Normally, inbetween stressful "events" it has time to slowly replenish. Just like filling a real reservoir requires a long time waiting for water concentrations to build up in weather patterns that can then dump rain into the reservoir.

But if you're in a constant state of stress the reservoir is always draining--never filling. We're kind of the same in that it takes numerous, extended and specific types of downtime and de-stressing processes to rebuild our reserves.

You can read much more about how to support your parasympathetic nervous system online - lots of good articles. It's more than just getting a good night's sleep (which is also critical).

All that to say - coffee is an agitator and you might need to figure out whether or not you have an adrenal issue first. The best test is a 4- or 5- saliva sample 24-hr test, where you will spit into a vial every 4 or 5 hrs throughout one 24-hr period, plus one urine sample. Compare your results to your symptom experience and you can get a pretty good idea of whether or not your adrenals are being overtaxed, how, and the best way to recovery.

If you do have some adrenal fatigue and unless coffee specifically relaxes you (there are rare people who need coffee to sleep, for instance) I would suggest you avoid it until your adrenals are much healthier. Withdraw is hard but again, with all your GI problems, your body is struggling with so much and the less stress it is dealing with, the sooner your GI can heal and you can get back to your antimicrobial protocol, and the sooner you'll be done with tx and can get back to coffee. ;)

Hope that's helpful!

-p

I'm back with a couple questions.

For digestive enzymes can I use ACV or would it be better to use hcl or something else?

Cholestyramine is prescription only, isn't it?

What do you think about diatomaceous earth as a binder? I used it once for a parasite cleanse and felt it helped. It also had a somewhat constipating effect so maybe that part would be a benefit right now?

What do you think about L-glutamine? Should I try adding that at some point? I keep reading it helps heal the stomach lining.

I love your baby food idea! I'm going to get some for those days when I'm not up for cooking.

After many years dealing with yeast/fungal overgrowth, I treated it aggressively and successfully. But every now and then I'd still have some weird sx that I finally relized were associated with BIOFILMS. So I started on anti-biofilms and after crashing because I treated too much too fast, I made a LOT of progress with some remaining sx.

So that's where I would look to next if antifungals aren't helpful with your GI healing or if you think y/f isn't an issue.

I think probiotics can be taken any time - the last thing before bed is helpful because your digestion enters a unique function overnight and this gives it a lot of time to slowly go to work.

However, binders ALWAYS need really good buffers. For you, I would wait at least 2 hrs after eating or taking anything before you take a binder, and then wait 2 hrs after using the binder to eat or take anything. It's best to do binders twice a day and it's optimal to use them after you do antimicrobials (in order to move what you kill out of your body ASAP).

But since you're not going to do antimicrobials for awhile, it might be OK to do the binders just once a day. My schedule is so tough I don't have the time to do binders more than once because of the time buffers. But the best time would be in the evening, eat and do everything, wait 2 hrs, do the binder, wait 2 hrs then take your probiotic and go to bed.

-p

Thanks Pirouette. That answers my scheduling question, which is very helpful. I get so confused sometimes with the scheduling of all these herbs and supplements and meals. It will be nice to take a break from it all for a bit and just worry about probiotics and binders. I have some activated charcoal tablets and also DE powder so I guess I can start there.

I'll read some more on yeast in case it becomes a problem. My GI symptoms have been all over the map these last three years so I wouldn't be surprised at all if yeast issues popped up at some point.

RedEyedArab, thanks, I'll definitely look into liposomal colostrum. I haven't heard of it. I'm glad it helped you. That's awesome!

Evanston1, an "adrenal support" herbal complex I'm taking has some in it, yes. But I don't think it's a lot and I just started taking it a week ago. So that couldn't have been the cause all along but it may be why I feel especially bad this week.

I'm cutting out all herbs for now. I should be over the diarrhea before I ease that one back into my protocol. I'll keep an eye out for issues when I do. Thanks!

Floristor may also help

I developed real bad diarrhea from taking Augmentin (most likely caused by the Clav portion). Floristor helped control it and I eventually didn't need it anymore. Its a different form of probiotic (sachromyses bolardii) more like brewers yeast than typical multi-strain probiotics. You can even take it with ABX is you wanted, but I chose to take it same time as my VSL#3 2 ot 3 hrs away from ABX.