Today, we're diving into a fascinating case study from my Gut reset program. If you've ever wondered what it's like to work with me, this episode will give you a behind-the-scenes look at the transformative journey of one of my clients, Tony.

Tony's Journey

Tony approached me with severe nightly pain caused by bile acid reflux, compounded by a missing gallbladder. His restrictive diet, coupled with constipation and gastric dumping, had led to weight loss and low energy levels.

• The Gut Reset Approach: Importance of a strong client-nutritionist relationship. Learn how a gradual introduction of foods, strategic education on digestion, and personalized dietary changes played a pivotal role in Tony's progress.
• Gradual Dietary Changes: Hear what he started eating, and how
• Supplements for Support: Learn about the supplements that complemented Tony's journey, from magnesium powder to butyrate and probiotics.
• Celebrating Milestones: Winning with a normal bowel movement after four years!
• Beyond Diet: Explore unique elements of Tony's journey.
• The importance of client motivation, ongoing support, and the success of my three-month gut reset program.

Relevant episodes

• Ep 1 - Normal digestion

Work with me

• Group Gut Reset - https://www.goodnessme-nutrition.com/group-course-ibsc/
• 1:1 Gut Reset - https://www.goodnessme-nutrition.com/consultations/

Ready for your gut reset? 🌍 I work with clients worldwide, providing remote consultations and a wealth of educational resources.

Have you ever wondered what it

might be like to work with me?

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I'm going to go through some mini

case studies of some of my clients

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to show you exactly what it's like.

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to be part of my GRIP gut reset.

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Hopefully it will give you an idea of the

types of solutions I provide for people.

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The types of people who actually reach

out and want to work with a nutritionist

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for their IBS or other gut health issues.

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As well as key supplements I've

used, the exact things I've helped

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them reintroduce with their diet.

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And specifically, how they

have found the process.

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So what kind of reactions did they

have to the suggestions that I made?

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And what kind of results

were they able to achieve?

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I hope this will give you a good

insight into how I work with people.

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Welcome to episode 32

of the Inside Knowledge.

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I'm Anna Mapson.

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I'd like to introduce you to Tony.

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Tony, I worked with this year, and

his big problem when we started

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working together was severe pain every

single night that was coming from a

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bile acid build up during the night.

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He had bile acid reflux, so that's where

the bile that we produce to help us

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emulsify fats was backing up into his

stomach and causing him a lot of pain.

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The reason it was dripping out

is he didn't have a gallbladder.

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He'd had it removed about 30 years prior.

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And it was really affecting his sleep,

really bad pain he was getting, and he

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also had issues around constipation.

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So he was passing one bowel movement

every day, but he was really struggling.

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He also felt that he had some

problems with gastric dumping.

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So this is where your stomach is emptying

too quickly into the small intestine.

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All of these problems together had led him

to have a really, really restrictive diet.

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So not only was he waking up several

times throughout the night, He was

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also on such a small selection of

foods, so his energy levels were

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really low, he'd lost a lot of weight.

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He was extremely low in mood and just felt

like things had hit a real crisis point.

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He was only eating eight different foods,

and actually one of those foods was...

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and fruit juice.

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So it was a really reduced

amount of different things and

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eating those on repeat every day.

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But with a sense of hopelessness,

there was a sense that he was not

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going to survive this Health condition.

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He really felt like things had got

so bad that he was just wasting away,

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and he didn't know where to turn to.

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Obviously, he'd been to

his doctors lots of times.

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He'd really been back and forth, to

his different healthcare providers, and

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they had run lots of different tests,

they had given him some medication

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to help excrete the bile out of

the body, and that was helping

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to an extent, but not really.

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The reason that Tony said he wanted

to work with me is that he knew from

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our first discovery call where we went

through his issues that I had a good

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understanding of his health conditions,

of Diet and food and what things can do

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and by that I just understood what the

medication was I Knew a lot about the

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different medical terms that he was using

and I was able to challenge him a little

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bit on Different diet things that he

may have heard online or read about that

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Actually, I thought weren't helpful.

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So he knew that we were gonna have a good

working relationship and that we would be

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able to be on the same page about things.

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So I think that's what really helped

him is that discovery call, just

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feeling like actually I can learn

from you and I want to work with you.

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And I have to say he is one of the

most committed people I've ever

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worked with in terms of taking

everything on and really going for it.

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So as an example of that, one

of the first things I wanted to

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do is try and get him eating.

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a variety of different foods.

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I wanted to increase the amount of fiber

that he was getting to help increase

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bowel movements and ease that sense

of constipation that he was getting.

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I also really wanted him to eat more

protein because I was really concerned

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that he was not able to sustain his

muscle mass and would eventually start

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to lose even more weight if he couldn't

increase his amount of calories.

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I started off by suggesting to him that

he would introduce green beans, so little

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thin green beans, and at such a gentle

way we would start off with one bean.

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On one day, the next day we

would increase it to two beans,

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and the next day to three beans.

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So that was my first suggestion, and

I said you don't need to do anything,

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just the first step is to go out,

buy the beans, and we will chat in

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a few days and see how it's gone.

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One of the examples of how I think he

was so committed is By the time I'd

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spoken to him, he had already bought

the beans and he'd already done day

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one and day two, and he was just on it.

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He was so keen to make some changes.

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And even though these were tiny

changes, he was really prepared to

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give it a go, despite the anxiety

and the worry that this would not

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work for him, that there would be a

further problem by following my advice.

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This is a really crucial

part of working with someone.

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So if you.

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Have a call with me or someone else,

another nutritionist, and you don't

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really get the sense that they know what

they're talking about, and that they have

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got examples of having done this before,

and , that you just don't believe what

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they're suggesting is going to be helpful.

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It's not going to work.

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You have to buy in to the process and

you have to buy in to the thought that

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this person is the right one for you.

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And it might not be the right one.

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Like, you can shop around and

find different nutritional

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therapists all over the world.

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People who are doing a similar job

to me but in a different style.

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You've got to find the

right person for you.

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The next thing that I really wanted him

to focus on was increasing his protein

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and this was where it didn't go so well.

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Um, I asked him to start taking some whey

powder because when people are sensitive

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to FODMAPs, that's the carbohydrate

element of lots of foods, lactose can be.

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something that people react to.

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It can make you bloated, it can give you

gas, it can cause diarrhoea, all kinds

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of things that people don't always get on

well with in terms of drinking cow's milk.

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However, I have had some really good

results with people taking whey protein,

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so that's the protein from dairy.

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and adding it to their food, or

adding it to a smoothie or something.

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The problem was, is that he wasn't

having anything that he could mix

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it with, so it was really difficult.

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So what he decided to do was buy some

milk and mix the whey protein with milk.

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This was terrible, and he started getting

a lot of gas, and even within one day, he

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just decided this was not going to work.

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So, what we did instead was move back

towards focusing on other types of

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protein, and he kept the whey protein

because it keeps for a long time, won't

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go off, and we started thinking about how

he could eat more eggs, because eggs were

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another protein he was prepared to try.

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So starting off with just one, then

having maybe two scrambled eggs, and

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then maybe moving on to an omelette.

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The next vegetable that he

increased was butternut squash.

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So once he'd got to three green beans, I

said keep it at that level for a few days,

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then we're going to start to aim for 80

grams, which is one portion of vegetables.

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So I wanted him to aim for 80

grams of the But once he'd got to

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say about 40 grams, we started to

reintroduce another vegetable, which

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in this case was butternut squash.

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And again, starting with really

small amounts, little cubes of

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mashed up soft boiled vegetables,

really easy to digest and just helped

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him to get a bit more confidence.

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That was just in the first sort of two

weeks, we just introduced those things.

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So green beans, the whey,

which went terribly, and then

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butternut squash and eggs.

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In this way, he's starting to increase

his fiber, starting to increase

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some protein containing foods.

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Now alongside all of this, there was

education really around Digestion and

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how long things take to move through

you, so I asked him to do a stool

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transit time to check how long food

was taking for him to eat, uh, and then

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how long he would see it in the toilet.

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This was really important because

he was feeling that some foods were

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giving him an immediate sense of

constipation or bad bowel movement.

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And I talked a lot about how long

food takes to move through us.

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If you want some details on

that, go and listen to episode

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one about normal digestion.

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But, effectively, you're looking

for like 24 hours, 36 hours

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for food to start coming out.

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That's normal.

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So something you literally just

eat is not going to cause you

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constipation or a hard stool the

next time that you go to the toilet.

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So it's kind of uncoupling that

sense of what you're eating,

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giving you an immediate problem.

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We also had a lot of conversations

about what is constipated,

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what does that actually mean.

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If you're going to the toilet every day

and the stools are relatively soft, and

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you're having sufficient amount of stool

come out of you, that's not constipated.

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And yet, some people feel that they

haven't got rid of everything, and there's

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this sense of incomplete evacuation.

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That is really common.

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Now it doesn't necessarily mean

that you're constipated and

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that you need laxatives or that

you need to change your diet.

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It could just be needing to eat

more food because sometimes we

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need more bulk to move along.

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A lot of things are getting absorbed

through the gut and so sometimes

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you need to add more fibre in, in

order to get a more bulky stool.

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And that is actually what

happened in this case.

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So the more...

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food he ate like by the time he got

through a month or a month and a half

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that actually he was getting a really

good stool and it was happening because

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he was eating more fiber, more bulk

that could be passed through the gut.

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Tony also introduced potatoes.

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These were good foods for him

because we could cook them in a

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variety of ways and led him to eat

a bit more of an interesting diet.

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Also kiwi fruit because I stressed

about how it was a good way, low

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FODMAP way, to increase stools

and move away from constipation.

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But he also introduced a whole range

of proteins including beef, salmon,

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chicken and even nuts as well.

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And some days he ended up

going two to three times a day.

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This was in about a month into

our journey of working together.

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I also really wanted him to

focus on flavour giving food.

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So things like green herbs,

like parsley, coriander, mint.

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These are really great additions to

boost the flavour profile of your meals

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and make them a bit more desirable.

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When you've had a history of

eating the same food again and

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again, it just gets so boring.

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And so naturally you don't.

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Really feel much of an appetite.

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So in order to stimulate your appetite

to be able to eat more It's good to

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increase flavors things like ginger,

citrus fruits These can all be really

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helpful in small doses to begin with

till you feel confident with the flavor

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And then you can just go wild with those

things like green leafy herbs Because

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they're actually really good for you as

well and can contain things like iron and

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magnesium Going back to the protein, Tony

really had a sense that when he ate too

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much protein, his stomach just shut down.

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He felt like things did not move

through his gut for a really long time.

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He felt too full eating a

small amount of protein.

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So when we've introduced these things like

beef and the salmon, at first he was just

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eating a really small amount once a day.

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Obviously, I knew that this is not

enough protein to keep him going.

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However, he was prepared to keep going

with it and just stay at, for example,

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three days, eating one amount of beef for

three days in a row, just at lunchtime.

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After that period, once he felt

like that was being okay and

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tolerated, he was able to eat.

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Protein twice a day, for example,

having eggs in the morning, having

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the chicken at lunch and then even

moving on to having three amounts

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of protein throughout the day.

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As his confidence grew, we also introduced

snacks in between meals, and these were

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additional ways to eat foods that he just

quite fancied eating, that he actually

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just ate for enjoyment, but also to

try to up the nutrient content and up

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the calorie content because he really

didn't want to lose any more weight.

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So this feeling that protein was bad for

him that was closing down his system and

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shutting things down was actually really

key to address because without that level

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of protein I didn't feel like he was going

to get enough energy and enough strength

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to start and start feeling better overall.

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We need a lot of fats, proteins, carbs.

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Like we need the balance of all of these

things to have a good, healthy response

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and be able to create neurotransmitters

that help us feel happier.

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And just feeling like we've got

energy to want to go out for a walk.

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We need nutrients for all of these things.

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Basically feeling like you're having

a good life rather than just existing.

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And so trying to get

all of those different.

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Balance of nutrients in was really

important in order to make it

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feel like life isn't just about

this condition or the problems.

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Actually, he felt like the more

he ate, his appetite came back.

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So.

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He ended up saying, I've got

a huge appetite this week.

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About two months into working together,

and he had not felt hungry for so long.

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One of the best points for me in

this was that he said he once had

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a normal bowel movement and it was

the first he'd had in four years.

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And he was really happy and we had a

little mini celebration about that.

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Because this is a real turning point.

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And it felt...

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to him like a normal bowel movement

and I really attribute this to eating

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more food and eating a bigger variety

of foods because it was enabling

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him to have a better bowel movement

but also enabling him to feel more

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energy, feel a bit more positive.

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One of the final areas he introduced

was The really high FODMAP foods,

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including onions, garlic, and also wheat.

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I talked a lot about the prebiotic

qualities of these foods, like they

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are really good for your gut bacteria,

and how grains as well, like whole

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grains, including wheat, rice,

these can be very beneficial foods

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for supporting your gut bacteria.

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With this client, I didn't use many.

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supplements.

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One of the things I suggested

that he would do would be start

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taking some magnesium powder.

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And this was specifically at the

beginning when I had really understood

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that he was feeling constipated and

he also had a high degree of anxiety.

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So we used magnesium citrate powder.

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The reason I like using a powder

with people is because you can

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titrate it up and down, you can

increase the dose, and you can make

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very small doses if you prefer.

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So powder is really good in that sense,

particularly when people are nervous

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about taking different supplements.

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I also suggested that he start taking

butyrate, which is a short chain fatty

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acid produced by your gut bacteria.

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But if you don't have many good bacteria

in the gut, then sometimes it can be a

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way to accelerate progress by changing

the environment of the gut by actually

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putting this short chain fatty acid in.

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There's three types of short chain fatty

acids that our good gut bacteria make.

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Butyrate is one of them.

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The other ones are acetate and proponiate.

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These are anti Inflammatory.

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They are fuel for the colon cells and

they can actually move around the body

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and have an anti inflammatory effect.

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But specifically in the gut, they

really help to change the environment

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of the gut and so sometimes taking a

butyrate supplement may be helpful.

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It's not important for everybody

and the best way to get that

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is through food and fibre.

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But at the beginning when he wasn't

really eating much fibre, I thought that

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this might help accelerate his changes.

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And towards the end of working

together, we talked about

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introducing some probiotics as well.

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He was keen to do that, but I wouldn't

have thought it was essential.

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It was just another like additional

future proofing to try and really

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keep, keep things working as they were.

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One of the really nice things

that we ended on was him saying

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this is better than I ever

thought it could be for myself.

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Like, I can really see myself

getting better now and that sense

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of hope was really moving for me.

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I have to say, I really enjoyed working

with this person because he was so engaged

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in the suggestions that I gave him.

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Another thing that was slightly different

that I hadn't done before was encouraged

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him to use An iQuoro device, so this

is like a little plastic device you

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put in your mouth and bite down on

it and it tries to help you tone the

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muscles in your throat and your neck

and can be quite helpful for people

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with various issues around swallowing,

sometimes like if dysphagia where you

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can't swallow very well or you have

silent reflux, it's just about helping

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coordinate the muscles of your throat,

your esophagus and, and The tongue

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as well, and strengthening those up.

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The thing about this device

is that it only really works

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if you continue to do it.

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It's a bit like weight training.

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It's not like a once and

done and you've done it.

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It's like you have to keep going

and keep those muscles working.

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But if it allows you to eat better

and get the sense that your diet is

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improving, I think it's worth doing

some of those things sometimes in

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order to sustain the improvements.

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And that's the other thing about when

I say people are really motivated.

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When you are in such a bad place and you

can see some signs of improvement, of

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course you're going to be more motivated.

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There are other people who I've worked

with who, it takes a long while for them

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to start to see changes and they don't

feel as motivated, and I really get that.

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If you're not seeing progress,

it feels just all like an uphill

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struggle, whereas in this case...

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It was pretty quick, I have to say,

and rapidly saw some improvements

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in the way that he was feeling.

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So, I hope there's been something from

that that you can take that's useful

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for your situation, your digestion.

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If you're interested in working with

me, I work with people specifically

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over three months in my gut reset.

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Check out the show notes for links

to my website where you can find

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out a bit more about how I work.

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I work with you wherever you are in the

world, as long as the time differences

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work and we can align our schedules to

talk during my working hours, then I'm

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happy to work with you wherever you are.

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And I also have a whole

range of education.

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That is given as part of the Gut Reset in

videos and things that are pre recorded

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that you can do in your own time.

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So you can learn about gut health, about

diet and healthy nutrition, as well

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as getting the regular coaching calls.

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Because I speak to people each week and

I think for me that's a big part of why I

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see this transformation or why I see this

Process being effective is that I really

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get to know people and what will work.

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And I think that's where people make

the biggest improvements is because

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if things aren't working it's only

another few days until we speak again

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and we can really problem solve and

work out what would be better for you.

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What could you start, stop,

change to actually get the

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improvements that you need.

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Right, I will leave it

there for next week.