A Gut Check

For years now, I have had stomach issues. It’s not the most glamourous thing to talk or write about, but I think it’s important to share because it sheds light on things that others may not be aware of and may be helpful and, it may end up explaining why some of my runs/races haven’t gone so well (and why I often need a pitstop).

When I say stomach issues, I mean the following- upset stomach/bowel movements on average 3-6 times a day, heartburn, acid reflux, bloating, pain and gas. Sounds terrible, but I got used to it and just figured it was me. My family pushed me for years to see a gastroenterologist but I put it off out of laziness and fear of what they would say. I LOVE food. I’m not a picky eater. I love to try fabulous restaurants and I love to cook. I didn’t want to give up either of these.

I went completely unprocessed during lent last year and I thought it would solve everything. And while I lost weight, and ate “clean” I still had stomach problems. I decided when I was training for NYCM to seek out a nutritionists’ help. I found Marni through my friend, Katie. I really wanted to work on my stomach issues and make sure I was eating enough at the right time to stay fueled. Marni was perfect for this- she’s an amazing triathlete and I highly recommend her for sports nutrition. I was able to stay full and fueled and my stomach was better while running (I ate very bland pre run), but it wasn’t necessarily better day-to-day.

I made an appointment back in July with a gastro, but couldn’t actually get an appointment until November, after the marathon. Dr. Yanda asked me tons of questions and he suggested we do a blood test to test for celiac and depending on what that showed, a colonoscopy if needed. The blood test was negative, but showed possible signs of colitis so we scheduled the colonoscopy.

IT sucked. Not the colonoscopy itself, but the prep. My colon came back fine- no colitis- but they did find a polyp. It was pre-cancerous but came back fine and now I will just have to go back every 3 years. So, what was my doctor’s plan? The low FODMAP diet for IBS. WHAT. IS. A. FODMAP (I will get to that in second).IMG_9722I bought the book that was recommended, read it over the holidays and quickly realized that it was a bit more complicated to figure out on my own. Marni was honest with me and said this wasn’t her specialty and suggested I find someone in Atlanta. So with a little research, I contacted Jenny, from Balance Fitness and Nutrition. She’s a runner and knows all about FODMAP and LEAP (another type of elimination/food intolerance test) and we met last week to go over the can have/can’t have/do’s/don’ts.

So, here’s the lowdown. This is all information from Patsy Catsos‘- the medical nutrition therapist and FODMAP expert.

FODMAP- this is an acronym for a particular group of carbohydrates in your food (Fermentable Oligo-Di-and Mono-Saccarides and Polyols). FODMAPs include certain natural sugars in foods such as milk, fruit, honey, and high fructose corn syrup. Some FODMAPs are certain types of fiber in foods such as wheat, rye, onions, garlic, and beans, inulin, and chicory root.

To sum it up- these things can wreak havoc on your gut. It can mean gas, upset stomach, foods not properly moving through the intestines which leads to bloating and diarrhea. TMI, but welcome to my world.

On this diet, you should limit the amount of FODMAPs you have in a certain amount of time (per meal, every 2-3 hours) to ease the symptoms. In order to test what FODMAPs you are sensitive to, you have to do an elimination diet and then return the FODMAPs to your diet in a systematic way to observe symptoms.

The list of foods is extensive and I was really overwhelmed when I first did my research. Basically, all of my favorite fruits and vegetables, the ones I usually combine and DEFINITELY have more than 1/2 a cup of per meal were on the list (see full list here). I lived off of brussel sprouts, asparagus and broccoli. I’m pretty sure my diet consisted of garlic and onion, and this to me, meant no cooking and recipes. Do you know how hard it is to cook without garlic and onion!?!? Cooking is one of my favorite things to do and I feared losing it.  You can sense a freak out. Jenny calmed my anxieties and explained it well, told me the elimination stage was only for 2 weeks and even gave me a cookbook.IMG_0079It’s easiest to explain the diet as no gluten (not all gluten free products work though because they may have other high FODMAP ingredients), no lactose, and certain fruits and veggies on a list that I now live by and carry with me everywhere I go.IMG_0078I can do anything for 2 weeks. I kinda started the diet a few days before I met with Jenny, and officially on Thursday (still had gum and wasn’t counting quantities). There has been IMMEDIATE relief from doing this but it is HARD.

The 2 hardest things so far:

1. Finding the time to prep all my food, reading all the labels and finding foods to eat when out and about.

I literally couldn’t eat a single thing at an event I went to Thursday night. Each dish was healthy, but had one or two ingredients I couldn’t eat. I came home and had eggs and grits for dinner. We went out for an early birthday dinner for Rich on Saturday at my favorite steakhouse and I could only have a plain salad, plain steak, and plain spinach. Not nearly as exciting as what I would normally eat, but much more healthy and I was in no pain the next day.

2. Measuring out my food and not mixing certain foods together. Measure a 1/2 cup of strawberries they next time you want them or only eat 1/2 of a banana. Or 2 cups of popcorn, or 1/2 a cup of sweet potato, or 1 1/2 tablespoons of maple syrup. You get the idea. This is my life right now. 

I’m currently tracking everything in an app on my phone, what I eat and when, when I go to the bathroom (did you know there are six types of poop!?!), how much I sleep, how I feel, etc. The only somewhat rough morning I had was Saturday, but it was nothing like it usually is.photo (3)The best thing about it all right now? How much better I have felt. It’s insane. Very little pains, gas, and runs to the bathroom. I’ve actually enjoyed trying a few new recipes (pancakes, meatballs, and a quinoa salad to name a few) and have been pleasantly surprised at how flavorful the foods are.

I will see my gastro on Monday the 19th and then meet with Jenny again on the 21st. Jenny will evaluate my food log and then help me reintroduce the foods back into my diet to see which ones are triggers and what I will need to avoid for good.

So, there it is, all out on the table. I truly had no idea that certain foods could really make this much of a difference on my quality of life. I’m excited to finish the process in a few weeks, really see how much my gut has changed and see how this could effect my training.

Any questions for me? Have you ever had to do an elimination diet? Have you heard of FODMAPs? Do you have food sensitivities? If so, what food(s) have you had to give up? 

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  • Wow. Sounds like this FODMAP thing nailed it for you. I’ve never heard of this. What a pain to eliminate so many things but you’re doing great with it and most importantly, you’re feeling good! With my hypothyroid, I need to avoid soy, which is pretty much in everything processed. Good reason to avoid!

  • Oh, man. That’s a lot of changes. I would also talk to your doctor about adding in a source of lactobacillus to help rebuild your probably low normal flora levels. Hopefully you continue to feel well and are able to make and eat foods you enjoy.

  • I’m sorry you have all this trouble. Good for you for taking care of you. I had similar issues and went to a Dr and was told IBS. I felt that doctors tell you that if they can’t find anything else. It really didn’t help me at all and I just knew as much as before. At that time I was super stressed at work and life in general. Luckily things changed, I got married and pregnant and quit my job and since then, I feel soo much better! I sometimes feel a little off but nothing compared to before. I think it’s great you do the elimination diet, but also try to look into the mental aspect. Stress can be a big factor as well.

  • Wow, this is a lot to go through! But it sounds as though you found something that is working and found good people to work with. I’m sure it helps that you are seeing positive results, but I can’t imagine how hard it must be. I’m like you – I love food and love to go out to eat and cook at home and would have a hard time eliminating things. Glad you’ll be able to add some of the foods back in and are feeling better!

  • I am so proud of you for tackling this. I did this last summer, as you know, and while brutal at first, I am SO, SO glad and am running and feeling a million times better. Not the GI stuff (though I did actually have that for runs), but the constant hives. Once you get through elimination, you will find you can introduce some things back in, just in small doses. Like you, I was eating super cleanly and still having issues. I follow FODMAP the day before hard runs and my histamine diet 90% of the time. Re-learning how to shop and cook is the hardest park. But I’m so glad it’s working!!

  • I know people who have done GAPS, FODMAPs, etc. – it sounds tough, especially at the beginning, but if you feel better then it can make a world of difference. Then it becomes worth it, even if it is a giant pain in the ass. You may want to check out Practical Paleo (even if you’re not paleo) since I think that cookbook has FODMAPs adjustments.

    I’ve been suffering from a lot of intestinal distress and stomach pain and I’m wondering if it’s time to see my doc and get a referral as well. I basically feel perpetually bloated and I wake up with stomach pains and gas all the time. Part of it is what I’ve been eating, so I’m just getting started with my second Whole30 to see if that will help with processed/fast food and take it from there.

    Good luck and glad to hear you’re feeling much better! Do you find that the new diet has affected your pre- and post-run fueling significantly, or your training itself?

  • Whoa! Thanks so much for sharing. I have been experiencing diarrhea since mid-November. My GP ran stool culture, negative. Next, GET an appointment with GI specialist….blood work and more stool cultures. Next, GET an appointment for colonoscopy which will be end of January. When I run FAST, my system blows up afterwards. Spent entire post-race in ladies room, thank goodness it was at a park with a restroom facility vs. porta-john. In middle of OTF workout, system blew out on me. I’m afraid of going back. I’ve ceased track workouts because there is not a restroom facility available for use. It’s cramping my lifestyle! So glad you are on the road to finding answers even though it’s not an easy path.

  • I’m proud of you for being so dedicated to finding out what works and what will make you feel better. This is a really hard diet, especially for social outings, and you are doing amazing. Keep it up. It is painful now but when you find out what is causing this the results will be great. Looking forward to continuing to hear about this journey, even the pooping part. LOL #unladylike

  • I’ve been experiencing higher than normal bloating / gas/ horrible cramps over the last month as well. I was thinking about seeking out a specialist, but since this came on suddenly vs. this being a constant I started looking at my diet. Inulin was the #1 thing for me that i felt almost immediate relief when i cut out or took 3 beano prior to eating… but who wants to walk around with a bottle of beano everywhere they go??
    I hope you’re able to nail down your triggers so you won’t have to be as restrictive!

  • You know I share some of your poop issues so I’m excited to see how this is helping you! Gives me hope one day I’ll be able to race without spending at least 3-4 minutes in a porta potty. 😉
    I’ve been GF and soy-free for years and it was so hard at first but it does get easier and as you’ve already seen the benefits far outweigh the inconveniences.
    Cheers to healthy guts!! xoxo

  • Weird. I had the exact same problems and same results from a colonoscopy. My stomach went from bad to worse the first Full marathon I trained for. And with a history of Colitis in my family- sister and mom have it. I knew I had to go to the Dr. He found a pre-cancerous polyp in my colon as well. I’m so glad I read this because other than a repeat to be 5 years later, that was ALL I was told. I still have issues, though they weren’t as bad as they were while hard-core training. I will look into finding a new Gastro in ATL. I’d love to talk to yours! (My friend read you blog and told me I should read this one… I see why!) I know figuring out what my trigger foods would help me too. Thanks for sharing this.

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