Support for Constipation & Motility

Supporting gastrointestinal motility and bowel regularity are core features of a comprehensive treatment protocol for SIBO and IBS-C.

I've been hard at work behind the scenes at my day job (Product Development Manager at Moss Nutrition) developing two new products to address these needs and I am thrilled to announce that both are now officially launched!

MMC Select™ is a prokinetic formula designed to help promote gut motility by supporting healthy function of the migrating motor complex (MMC)—the "cleansing wave" that sweeps food, bacteria and debris out of the stomach and small intestine towards the colon. As we've discussed before on Sexy Sibo, the MMC is active between meals when the digestive system is at rest, which is why practicing "meal spacing" is so important for SIBO! MMC Select™ contains a careful selection of evidence-based ingredients for motility support: organic prokinetic ginger root, a premium concentrated DGL deglycyrrhizinated licorice extract researched for motility support, 5-HTP + P-5-P to help increase gut serotonin levels, absorption-optimized anti-inflammatory curcumin phytosome and alkalinizing potassium, a traditional prokinetic nutrient.

Colon Select™ is designed to help provide safe, gentle relief from occasional constipation with meaningful levels of researched and traditional ingredients. This formula features:

• Magnesium in two forms: ascorbate (vitamin C) and hydroxide
• Triphala, the revered Ayurvedic triple herb combination for enhancing bowel tone & function
• Aloe ferox extract (Cape Aloe) in the clinically relevant potency for helping to promote elimination: minimum 18% aloin content
• A blend of 5 time-honored botanicals to help stimulate complete and comfortable bowel movements: Marshmallow, Ginger, Sweet Fennel, Barberry Bark & Turkey Rhubarb Root.

Click on the product names above to visit the Moss Nutrition website and read more about these fabulous SIBO-specific products. I am so happy to be able to offer them to the world, and to my patients and clients in particular! (If you are a new patient or client, contact me for details about ordering.)

Yours in joyful service,
Diana🌀

Fiber & Constipation: The Dirty Truth?

Since 19th century health nut Sylvester Graham (the “prophet of bran bread”) began espousing the nutritional and moral superiority of whole vs refined grains, Fiber has assumed a central role in medical lore as essential for healthy digestion and elimination.

Today, whenever issues of constipation come up, one of the first questions you get asked is "Are you eating enough fiber?" Ironically, often, the answer is "Yes!" Many people suffering from irregularity eat extremely high fiber diets. (As a former raw foodist, I myself was an excellent example of this unfortunate phenomenon.) In such cases, adding more fiber is rarely a solution. On the contrary, experience leads many people with bloating symptoms to develop a near mortal fear of fiber (think of the incredible expanding psyllium seed, and other "bulking" agents that threaten to blow your intestines up to monstrous proportions).

At any rate, in response to anecdotal evidence challenging the value of fiber for bowel health, investigators have begun asking: What if fiber isn't the constipation cure-all it's promoted to be? Research designed to answer this question, ended up with remarkable results, as evidenced by the following title:

Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms.

[Ho K-S, et al. World J Gastroenterol. 2012 Sep 7; 18(33): 4593–4596]

Here's the scoop on what went down.

Sixty-three constipated adults between the ages of 20 and 80 (median age 47) were enrolled in the study referenced above. All subjects went on a 2-week fiber-free diet. Afterwards, if they had found the fiberless plan to be beneficial in terms of constipation relief (which all of them did), they were asked to remain on as low a fiber diet as possible.

Six months later, a follow-up was performed. 41 of the patients had remained on a no fiber diet, 16 on a reduced fiber diet, and 6 had resumed their high fiber diet for religious or personal reasons. And guess what? Those in the first two groups reported significant improvement in their symptoms, while the few who went back to a high fiber diet remained as constipated as ever.

A classic "zero-fiber" meal: Roast Chicken

Patients on the zero fiber diet got the best results, improving from an average of 3.75 days between bowel movements (sound familiar?) to just 1 day (the dream!) Results for the 16 low-fiber dieters were mixed, but most people in that group also started having daily poops.

To read the entire study, click here. Below are some of my favorite quotes from the paper:

"This study has confirmed that the previous strongly-held belief that the application of dietary fiber to help constipation is but a myth."

"Constipation is often mistaken by the layman as the state of not passing stool, with the subsequent false notion that making more feces will allow easier defecation. In truth, constipation refers to the difficulty in evacuating a rectum packed with feces, and easier defecation cannot possibly be affected by increasing dietary fiber which increases bulky feces."

"It is well known that increasing dietary fiber increases fecal bulk and volume. Therefore in patients where there is already difficulty in expelling large fecal boluses through the anal sphincter, it is illogical to actually expect that bigger or more feces will ameliorate this problem. More and bulkier fecal matter can only aggravate the difficulty by making the stools even bigger and bulkier. Several reviews and a meta-analysis had already shown that dietary fiber does not improve constipation in patients with irritable bowel diseases."

"The role of dietary fiber in constipation is analogous to cars in traffic congestion. The only way to alleviate slow traffic would be to decrease the number of cars and to evacuate the remaining cars quickly. Should we add more cars, the congestion would only be worsened. Similarly, in patients with idiopathic constipation and a colon packed with feces, reduction in dietary fiber would reduce fecal bulk and volume and make evacuation of the smaller and thinner feces easier. Adding dietary fiber would only add to the bulk and volume and thus make evacuation even more difficult."

  

All this is GREAT news for those of us C types following a SIBO-safe diet! (Since fiber is the Great Fermenter, there is very little of it in a good SIBO protocol.) However, everyone has a different body, and a different response to food. I get terrible bloating from whole grains, but do find that a little "bulk" can sometimes push a stool through. However, I always try to keep it in the realm of the less-fermentable starchy vegetables (carrots, winter squash), sometimes Jasmine rice, and occasionally, Lundberg rice cakes.

What's your experience been with fiber and constipation. I'd love to hear about it in the comments below!


NOTE: Thanks to Dr. Norm Robillard for pointing me in the direction of this groundbreaking study. To learn about Dr. Robillard's work, visit his digestivehealthinstitute.com.

 

C difficile

A beautiful place to go.

I’m feeling frustrated this morning. Despite my dedicated AM hydration practice, my nightly magnesium supplements, my SIBO-specific diet and everything else, I am still C.

Backed up. Constipated.

For years I have been playing around with different strategies, different supplements and different herbs to help get me going. It’s not the funnest game in the world, but I seem to be stuck with it. Haha—no pun intended.

Back in my 20’s, I drank 8 ounces of lemon water every morning but that didn’t do jack. I tried it hot, cold and room temperature. No go. Coffee and a cigarette were more likely to induce a poop during that bygone era, but I don’t smoke anymore so that option’s out.  (As for coffee alone, in case you’re wondering: nada mucho.)

Another thing I’d do back in the day but only when things got serious (I once went BM-less for TEN DAYS, and I don’t mean half naked) was to make senna tea with real senna leaves that I crumbled into a teapot and covered with boiling water to steep for 20 minutes. That potent brew was highly effective in emptying my colon within 6-12 hours of drinking but the griping sensation (feeling of your entire insides coming out while doubled over with intense cramps) generally knocked me out for an entire day. Yuck.

Another in-a-pinch solution through the years (one upon which I still rely) has been to do an enema—the real kind, featuring a red rubber bag connected to a tube with a clamp and a plastic nozzle at the end. When done properly, a real enema offers tremendous relief. But it’s often followed, for me anyway, by knife-sharp stomach pains later that day and/or the next. The prospect of stabbing pain is a deterrent. Just saying.

And then, there is the encapsulated laxative category. Ah yes, laxative pills: The holy grail or the devil incarnate, depending on your perspective.

Personally, I've somewhat guiltily indulged in natural, stimulant laxative supplements from time to time but only in strict moderation, largely because I’ve been terrified of—God forbid— “becoming dependent on laxatives”. Laxative dependency is often framed as one of the worst things that can happen to you, ever, in your whole entire life. Because why? Because if you become dependent on laxatives, you won’t be able to go to the bathroom on your own anymore.

Um…HEL-LO. Go on my own? Anymore? What magic universe are we talking about here?

I mean, it would be REAL nice if I could go on my own on a daily basis. Find the true solution, the final answer, and become honestly, dependably regular. Sure. But this C business started when I was fifteen. We’re talking FORTY FUCKING YEARS.

At this point, I really have to wonder what would be so horrible about being “dependent” on laxatives? If Armageddon happens and I can’t buy my Colon Clean* at the coop anymore, I’ll deal with it then. Short of that, I really don’t care anymore! I can’t stand being backed up. I hate feeling bloated. IBS sucks. And SIBO is no barrel of laughs, either.

-------------INTERMISSION-------------

Okay. Done venting. Feel better now. Just needed to get that out, lol. Thanks for listening.

xo Diana

P.S. Don’t worry, I’m not giving up. There are still a few things I haven’t tried. Iberogast for one. I bought it a while ago, but I didn’t really give it a fair trial. 20 drops at bedtime. Maybe I’ll start tonight…

*Colon Clean is a great product by the way. They only sell it at River Valley Market and it really works. One or two caps at bedtime and (usually) voila!

Here’s what’s in it, per capsule:

Cascara sagrada bark     225 mg

Yellow Dock root               75 mg

Triphala                             50 mg

Oregon Grape root            25 mg

Licorice root                       25 mg

Gentian root                       25 mg

Ginger root                         25 mg