This week hear about Sian's IBS success story. She had slow transit constipation (methane dominant SIBO) and was struggling with a vegan diet based on convenience food.
Over 3 months together Sian managed to turn her diet around from fast food focus to a healthy vegan diet.
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When I went healthy, it was really bad.
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:That is what my client, Sian, said to me.
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:She was suffering with daily
bloating and pretty bad constipation.
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:She was only going to the toilet
every three days and really
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:straining to get anything out.
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:She was just sick of having
such a sluggish digestion and
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:wanted to eat a more varied diet.
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:I pull out these kind of case
studies to show how Sian turned
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:things around, as hopefully it will
inspire you if you also have IBS.
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:On this week's episode of the
Inside Knowledge podcast, I'll be
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:sharing Sian's story and how she
managed to get more regular bowel
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:movements and enjoy her food again.
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:Welcome to episode 58
of the Inside Knowledge.
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:I'm Anna Mappson.
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:Choosing case studies to share
with you is always really good.
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:It gives me a chance to reflect
a little bit on What's gone well
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:and actually how my practice
might have changed over the years.
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:And also I know from speaking to
people that you enjoy listening to
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:these case study episodes as well.
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:I often have people contact me saying,
Oh, I heard this story that you and I
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:think storytelling is really powerful.
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:So hopefully you will get
something out of today.
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:It's going to be about SIBO,
about constipation and bloating.
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:So if any of those are your
problems, then listen up.
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:Um, now also just to reiterate that,
Obviously I do change some details about
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:all of my case study people so that
you won't be able to tell who it is.
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:I will change their name, obviously,
but I will also change a few other
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:details like their job or anything
that is relevant, because I wouldn't
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:want anybody to be identified.
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:So let's meet Sian.
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:So Sian was relatively young in terms
of people I normally work with, she
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:was in her mid twenties and she had
had an episode of food poisoning ten
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:years ago when she was a teenager.
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:Then, apart from that food poisoning
episode, she had no problems for a
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:little while, but then over the years
her constipation got worse and worse and
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:worse and the bloating was unbearable.
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:She was passing a bowel movement every
two to three days and it was type 1 or
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:2, on the Bristol stool chart, is very
small, hard, pebbly poos, or large, big
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:ones, which required a lot of straining.
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:She was also eating a, Relatively
processed, sort of unhealthy
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:version of a vegan diet.
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:And I say that just, that's
how she described it to me.
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:And like I said in the introduction,
when she felt she ate a healthy
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:vegan diet, that's when her digestive
symptoms got 100 percent worse.
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:She had a goal in mind to try and lose
some weight, and in order to do that,
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:she was fasting, and missing breakfast
most days, so like intermittent fasting,
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:where she was just eating two meals a day.
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:The meals were a lot of vegan
fast foods, or vegan ready meals.
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:So she was having a lot of vegan
sausages, vegan sort of pizzas, burgers.
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:for breakfast, if she did eat it, it
would be rice krispies, and a lot of
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:vegan biscuits and that sort of thing.
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:She didn't enjoy cooking, she really
didn't enjoy making food and just
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:wanted things to be better, but didn't
really want to have to engage in the
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:cooking process, which is fine, not
everybody likes being in the kitchen.
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:Before she came to me, She'd already had a
SIBO breath test, and she'd had a private
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:stool test, and this was with a company
online, so she'd done the tests and then
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:got a quick online consultation from
the company that did the tests for her.
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:But they didn't really leave her
with a treatment plan that she felt
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:she could follow, or didn't really
give her anything that would help.
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:Her SIBO breath test showed that she
had high methane producing microbes,
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:especially in the large intestine,
as the methane went up quite a
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:lot as it hit the large intestine.
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:Uh, if you don't know what I'm talking
about, do listen to my previous
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:episodes on SIBO, episodes 11 and
12, where I explain a bit more.
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:What that is and what all the
testing involves, so you can
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:go back and listen to that.
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:But just to know that when you have
methane producing microbes in your
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:gut, then you're gonna slow down your
digestion because methane affects
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:the nervous system of the gut and
just slows down the movement of food.
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:So It is important to get on top of that.
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:So because she didn't get
anywhere with her previous online
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:nutrition support, she did take
her SIBO test to a private doctor.
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:Then she got prescribed some
antibiotics to address the SIBO.
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:As soon as she took the antibiotics,
which was rifaximin and neomycin, she
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:felt really awful and was unable to
finish the course of the treatment.
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:She just only took it for a few days and
then, felt very sick, her stomach was
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:very unsettled and she had pains and the
bloating was worse and she just didn't
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:want to carry on and also she didn't have
any follow up with the doctor to check
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:back in with her so she just stopped
taking them and then didn't know where to
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:go from there so that is how we started.
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:Sian came to me because she wanted
somebody to walk her through what to
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:eat and also how to do it so she'd
had Testing done, and an online
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:consultation that wasn't very helpful.
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:She'd then been to a functional
doctor and had antibiotics prescribed,
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:but had a horrible reaction and
didn't then trust to take them
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:or trust what he had recommended.
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:Because there was no follow
up, she felt on her own.
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:So she wanted somebody Who
would speak to her each week?
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:And so that is what we did and
that is how I work with people
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:in my three month gut reset.
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:I speak to clients weekly
for six weeks and then it's
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:fortnightly for the last few weeks.
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:So you get nine half hour calls with me
throughout the three months and during
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:that time that is when you can really
explore what's going on and I can push you
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:a little bit more to make some changes.
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:So I started off with Sian suggesting
that she goes through her basic checks,
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:what I would call the constipation
basics, and these weren't changing
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:anything about her food as yet.
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:So I wanted to see what would happen with
her constipation if she just ate three
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:meals a day, because at the moment when
she started she was skipping breakfast and
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:then would go to work and then just have
lunch and dinner and they were, like I
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:said, mostly fast food type vegan meals.
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:quite low in fibre and vegetables
because she felt that they were her
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:biggest triggers for the bloating.
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:I also encouraged her to start
drinking more water and to
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:actually start tracking it.
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:So getting up, drinking a bit of water
first thing in the morning, having a
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:little bit of water when she went for
her break at lunch in the morning, like
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:trying to use some Key points in the day
to hang the water hat on so you say right
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:every time I go to the toilet I'm gonna
have a little glass of water or every time
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:I Go and have a meal I'm gonna make sure
I've had some water in the preceding hour
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:before that just things like that just
to really try and Get drinking water a
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:habit because if your stools are hard And,
pellety, you may be not drinking enough
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:water because the longer it's sitting
in your digestive tract, the more water
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:is being absorbed, and that is where
you can end up with really hard stools.
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:So, it's not the only thing that would
cause constipation, but it's one of
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:the basics to just cross off the list.
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:So, eating three meals a day,
because every time you eat,
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:it kickstarts constipation.
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:The gastrocolic reflex, which
is going to push food through
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:your gut, and you want that.
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:Then making sure there's water there,
so that fibre that you do have can, um,
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:draw water in and create a softer stool.
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:And then the other basic that she
started on was mindful eating.
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:So really chewing her food
properly, sitting at the table.
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:This was quite a challenge for
her, and she found sitting at the
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:table on her own really difficult.
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:She lived with her mum and dad,
but they had different sort of work
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:schedules, so she often ate on her
own, and would just make herself
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:really quick meals in the kitchen, but
really struggle to sit and eat without
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:distraction or in front of the TV.
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:So we came up with a compromise of
listening to her favourite podcast
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:and trying to fix something funny,
something where she could sit up
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:right at the table, but still, get
a little bit of concentration on
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:chewing and digestion and food.
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:Sian really wanted to lose some
weight as well as part of this, and
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:although weight loss wasn't a focus
of our work, I explained to her that
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:her diet was very low in protein.
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:Because she was eating a vegan diet,
it was mostly carbohydrates that she
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:was eating, and so we talked about
how Vegan proteins and what sort
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:of things she could look out for.
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:For example, tofu and beans
and pulses in small amounts.
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:And then also vegan alternatives like
veggie burgers and things which she
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:was already eating quite a few of.
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:But I really wanted her to experiment a
bit with tofu and she wasn't mad keen on
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:it, but she did give it a go and introduce
things like Scramble tofu, for example,
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:in the mornings instead of scrambled eggs.
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:The thing about eating a vegan diet that
is low in protein is that you generally
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:tend to be very high in carbohydrates
and particularly, in this case, it was
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:very high in wheat because a lot of
things she had were wheat based proteins.
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:or there was a lot of just
carbohydrates like pasta.
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:because that was a lot of the bulk
of what she was filling up on.
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:When you eat a lot of wheat, like to that
extent, it can be difficult to digest
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:and can, when you're already constipated,
cause a lot more bloating because it's
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:slowly going through the large intestine
and your gut bacteria are going to ferment
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:those fructan molecules that are in the
wheat and cause a lot more bloating.
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:So adjusting the balance and
eating more diversity is helpful.
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:The other thing that I thought would
help with weight loss was increasing
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:the amount of movement that she did.
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:She was not going to the gym or doing
any walking or anything because the
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:bloating had been bad and she just felt
really sluggish with the constipation.
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:She felt slow, like everything was
heavy and hurting and she would just
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:felt very full in her stomach and
hadn't wanted to do any movement.
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:But I was explaining that if you can get.
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:Your gut moving through some gentle
walking every day, maybe going to the
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:gym and doing a little bit of exercise.
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:That would not only help with the weight
loss, but also would help with digestion.
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:So we agreed on a, you know, a
gentle pattern of reintroduction
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:of some movement, as well as
increasing her vegan protein sources.
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:For supplements, I advised her to start
taking magnesium oxide, which is not a
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:very well absorbed form of magnesium.
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:This can draw water into the large
intestine and create a softer stool.
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:So it makes things mushier,
easier to pass and just helps to
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:speed things along a little bit.
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:So she started taking a
couple of those at night.
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:There were some other supplements that I
suggested that she take that would start
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:to reduce the methane producing microbes.
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:So remember, methane gas producing bugs
will slow down your transit time and
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:we needed to speed it up because often
the bloating is down to constipation.
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:When you're full of stool that can't come
out, not only does gas get trapped and
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:feels much more painful but It's really
hard to keep things moving, so we need to
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:speed things up and try and get the whole
digestive tract operating as it should.
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:I wanted to see what happened if
we reduced down methane producing
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:bugs using allicin, which is
a garlic extract, and oregano.
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:She was really, really nervous about
taking these because of the bad reaction
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:that she'd had to the antibiotics.
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:These kind of antimicrobials supplements
can have a similar effect, to be honest.
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:They are as effective in some studies
as taking antibiotics, although they
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:are much slower working, so you will
have to take them for six to eight
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:weeks instead of just two weeks.
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:So she did very gently start taking
them, but it was a very slow process.
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:In fact, The first few weeks she didn't
buy the supplements and I kept saying, How
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:are you feeling about the supplements now?
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:And then she would say, Oh, okay.
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:Yeah, I'll get them next week.
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:I'll get them next week.
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:And then she actually got them,
she didn't want to take them.
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:So there was more than just, um, not
being sure about the supplements,
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:whether they're effective, but it
was like a fear of bringing back that
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:same experience with the antibiotics,
which was so understandable, she'd
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:had a really horrible time of it.
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:Eventually, we did managed to talk
through how to take them and doing it
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:in such a gentle way and she started
to take these supplements which
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:reduce the methane producing microbes.
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:After one month she was having a poo
every other day and it was more formed,
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:it was not as pebbly and it was easier
to pass, so still straining a bit, and
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:she still had a sense of like incomplete
evacuation, but the stools were more
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:formed and easier to pass than before.
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:So this was really encouraging,
and she could see, okay, actually
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:maybe it is working, maybe there
is something to all of this, and we
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:carried on increasing up vegetables.
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:At the beginning, she was starting to have
raw salads, so she really wanted to eat a
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:healthy vegan diet, but found that eating
lots of salads made her feel very bloated.
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:So I explained that sometimes raw food is
more difficult to digest than cooked food.
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:So we increased vegetables, That started
off in the low FODMAP vegetables.
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:So really trying to bulk out things that
felt safe and eat them in a cooked way
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:to try and increase low FODMAP fiber.
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:Now this actually helped and then
she was able to experiment with some
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:higher FODMAP foods like raisins.
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:And she started taking little boxes of
raisins to work with her, which would
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:really help her get looser, softer stools.
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:I also really encouraged her to eat fruit.
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:She was very nervous about this
because she felt fruit was too sugary
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:and it might stop her losing weight.
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:And so I explained again that actually
increasing the amount of fruit wouldn't
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:really have an impact on her energy
intake because fruit is quite low calorie
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:and And the rest of her diet was vegan.
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:It wasn't like she was
eating a lot of fatty foods.
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:Adding in some fruit was going
to add in essential antioxidants,
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:fiber as well, which is critical
for a good, healthy bowel movement.
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:And just really upping that diversity
that would help her with better stools.
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:When we were two months in, she was still
only going to the toilet every other
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:day, but the poos were a lot fluffier.
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:less straining, a lot easier to pass,
and she'd managed to start at the gym.
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:So she started going back to the
gym and she was really loving it.
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:She was really enjoying moving her body
and being able to get into the stuff
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:that she'd wanted to do for a long time.
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:She felt like It was really sort of
engaging back with her body after
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:feeling like everything's broken,
nothing's working, it's all terrible.
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:Actually to feel like, yeah, I'm building
some muscle, like I'm getting stronger.
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:I'm a bit more active and sort of growing
into that person that she wanted to be.
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:Now, remember I said she had been
fasting, so skipping breakfast?
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:Interestingly, about two months
in, she really noticed that on the
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:days that she thought, actually, I
want to go back to losing weight,
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:I'm going to start fasting again.
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:Those were the days when she
struggled to go to the toilet.
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:If she went and had breakfast every
day, then she normally went to the
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:toilet within 30 minutes, and then
the rest of that day, felt better.
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:She felt less bloated, less painful,
and she could move around a lot freer.
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:Um, in her job she did quite a
bit of walking and so she was
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:able to move a lot more freely.
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:That just made a big difference
actually noticing when you
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:start to see some changes.
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:And then things go back to how they were.
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:Then you're like, oh, I remember.
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:This is how it used to be.
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:This is what I used to have
to deal with all the time.
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:So it was really great, in a way, that
she had those days when she noticed the
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:change and the difference because then
she could see, Oh, actually it is working.
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:It does make sense.
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:And it reinforces what it is you're
doing and why you're doing it.
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:This doesn't mean it was easy.
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:One of the things she struggled with
a lot was eating in the morning.
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:And just because I said she did breakfast
doesn't mean, uh, She found it easy to do.
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:So she did feel a little bit nauseous
and she was getting up relatively
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:early for her breakfast as well.
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:So we talked about, you know, is there
a way she could eat when she got to
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:work, get there a bit earlier and
go to the staff room and eat there?
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:Or is there a way she could do that?
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:get everything else ready and then
eat just before leaving the house.
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:But then there was like an added
complication of, Oh, well, will I
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:need the toilet on my journey to work?
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:It is hard to change your routine and
hard to change your body, especially when
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:you have got timed deadlines that rely
on you leaving the house at certain times
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:or attending work at by a certain time.
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:This is really challenging when your
digestion's all over the place, but.
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:I felt so proud of her for really
sticking with it and trying a lot of
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:these things, but like I said, she
did do it relatively slowly in her own
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:time because she was so nervous about
the consequences of changing her diet.
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:The other thing I provide all my clients
with is access to the Gut Reset video
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:portal, and in there is a whole series
of videos, each one's quite short.
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:there's a specific section on
constipation, including things about
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:creating a morning routine, how to sit on
the toilet more effectively, um, thinking
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:about what to eat for constipation, so
it's all really laid out topic by topic.
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:So my clients can access the bit that
they need to learn, but she actually
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:found watching these videos and then
returning to them a few months later
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:was sometimes also helpful because she
didn't always take it in on the first
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:time and was sort of skimming them.
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:And then we would chat about it in
the one to one sessions and realize,
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:actually, maybe go back and have
another look at that video and
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:see if there's anything else that
you might be able to find useful.
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:At the end of three months, her bowel
movements were practically normal.
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:She was going four to five times a
week, so almost every day, but she
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:would still miss a day, They were
type 4 on the Bristol Stool Chart,
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:which is a normal stool, easy to
pass, and this was just fantastic.
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:Like, she was not getting as bloated
as she was, she still did fine.
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:Some meals, particularly, like
a vegan burger in a bun, might
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:have increased her bloating.
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:bloating.
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:But I think that's relatively normal
and a lot of people will get that.
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:But she was just eating so much more
and throughout this process she'd
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:learned to cook for herself, learned
how to make some simple foods that
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:could be batch cooked and saved and
like packed away or frozen so that
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:she could eat them later in the week.
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:Because when you've got to cook for
yourself all the time it is quite boring
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:and sometimes you don't really have the
energy or the desire to make a fancy meal.
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:Trying to make some batch
cooked foods is really helpful
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:in those kind of situations.
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:If listening to this story has made you
think you would like some one to one help
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:to really target better interventions
to get your digestive system working
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:as it should and get you eating a broad
range of foods again, then you can email
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:me about applying to work in my three
month gut reset with me, where we get
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:lots of time together to talk through
your issues and what you need help with.
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:You can email me on
info@goodnessme-nutrition.Com
315
:or book a call via my website.
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:I offer a 30 minute free call for
anyone who's interested in working
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:with me just to check if we're a good
fit and you want to work with me and I
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:think I can help you with your issues.
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:So we'll leave it there for
this week, back next week
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:with another podcast episode.
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:If you've got any suggested topics
or things that you'd like me to
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:cover, then please do get in touch
as well via my email address, or
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:you can reach me on social media.
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:I'm on Instagram, @goodnessme_nutrition.
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:Thanks for listening to this
episode of the inside knowledge,
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:better digestion for everyone.