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  • Need help re. my visit to the gastro

    I'm a Primal newbie, 8 weeks into the plan and have been suffering IBS-type (gastro-intestinal issues- gas, bloating, diarrhea, stomach pain) right around when I started the plan. I'd been on the Slow Carb diet from Jan. until I started Primal about mid-May. The main difference is that I cut out legumes and ramped up my vegetable intake- lots of broccoli, spinach, cauliflower, artichokes, mushrooms, salads 3-4 times a day to make up for the legumes and added a little dairy (Greek yogurt 3-4 x/week) and some fruit (berries 4-5x /week). I've done some research and my most educated guess is that I upset the balance of stomach flora, and that the fiber intake was too much. I've been following a low FODMAP diet for the past 3 weeks, and last week was good, but I'm very limited in what I can eat, I've been surviving on chicken soup with sweet potatoes or carrots, eggs, steak, hamburgers, and an occasional PB pumpkin muffin.

    I went to the gastro today, and she was very uninterested in my diet, FODMAP, PB. She thinks that fiber is causing my issues and did rule out hernia, gallstones, and thinks stomach/colon cancers are very unlikely based on my symptoms. She mentioned stomach bacteria and thinks I have new "bad" bacteria that she wants to kill off. She prescribed a 10 day course of the antibiotic Xifaxan (rifamaxin) and a 30 day course of probiotics (Florastor). I've always heard of people developing stomach issues after antibiotics, I've never heard of taking antibiotics to kill off the bad stuff and using probiotics to restock the good stuff. I can't even tell from the sample's label what kind of probiotics are in Florastor. I'm going to research it before I take anything, but does anyone have any insights into this treatment plan? Any help, opinions, links, would be appreciated.

    On a side note, she was very dismissive of me, talked over me when I tried to answer her questions or talk to her about my diet or FODMAP. At one point she even called me "combative" when I asked her questions about how the antibiotic would kill off just the "bad" bacteria, and where sources of gluten would come from in my diet (she suggested a blood test for Celiac's, which I am doing). This sucks, I have a feeling that this is how my dealings with the medical profession are going to be from now on since I found PB. The GI told me that she would "never" tell any of her patients to cut out grains or dairy since they contains "so, so many good things".

  • #2
    have been suffering IBS-type (gastro-intestinal issues- gas, bloating, diarrhea, stomach pain) right around when I started the plan.
    Very common on those that switch from high-carb CW to primal. It should go away, if not... read on.

    The main difference is that I cut out legumes and ramped up my vegetable intake- lots of broccoli, spinach, cauliflower, artichokes, mushrooms, salads 3-4 times a day
    Cooked or cooked?
    Cooked is best if you've got gastric problems. If you cook them and still have problems, drastically reduce broccoli and cauliflower, and add more leafy greens (assuming you can have those on FODMAP? My IBS-D was cured 100% with Primal, I haven't tried FODMAP, but I might look into it)

    I went to the gastro today, and she was very uninterested in my diet.
    Red flag, find another gastro.

    I've always heard of people developing stomach issues after antibiotics
    Right.
    Instead, you might want to have fermented foods. Be a lot more strict about eliminating flours and sugars.

    ..she even called me "combative" when I asked her questions
    Red flag, fire her.

    where sources of gluten would come from in my diet
    Why does she want you on gluten? Just because everyone's supposed to eat them? Do you feel healthier without grains? If so, that should be reason enough to keep them out of your diet, and she should accept that.

    (she suggested a blood test for Celiac's, which I am doing).
    The truth is, many people have trouble with gluten whether or not they are Celiac.

    This sucks, I have a feeling that this is how my dealings with the medical profession are going to be from now on since I found PB. The GI told me that she would "never" tell any of her patients to cut out grains or dairy since they contains "so, so many good things".
    So? Don't tell them what you eat. There's nothing wrong with eating only "meat, fish, eggs, vegetables, fruit", and if a "doctor" is stupid enough to say there is, s/he deserves to be kicked on the chin.
    Last edited by abstractpersona; 07-14-2011, 11:55 AM.
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    • #3
      Also, what kind/brand of greek yogurt do you eat?

      Strained/greek yogurt is not supposed to have lactose, but some brands do have lactose. If you're not sure, remove it from your diet to see if your IBS gets better.
      My smartphone makes me about $100 per month
      Updating my journal again after a 2 year break.

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      • #4
        Forget the dr.

        IBS is catch-all for "don't know."

        Most people just do the elimination routine. Stop eating things one at a time until you figure it out. I don't think much of the gut flora theory.

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        • #5
          No advice, but I sympathise. The same thing happened to me today at an appointment for allergy testing. The dietician talked over me, wasnt interested in the diet, and told me to get 50% of my calories from 'starchy carbs and grains'. Sucks!

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          • #6
            Originally posted by spincycle View Post
            She mentioned stomach bacteria and thinks I have new "bad" bacteria that she wants to kill off. She prescribed a 10 day course of the antibiotic Xifaxan (rifamaxin) and a 30 day course of probiotics (Florastor).
            I wouldn't take it. Rifamaxin is being touted by Pimental as a "wonder cure" for IBS, but even if it helps it's only temporary. Doctors (mostly) just prescribe. Google Dr. Pimental, the drug, SIBO, efficacy, etc . . . The PB will do more good. You likely won't have to stay on FODMAP forever, just until you can get your gut bacteria under control. Read through this blog as well. Cooling Inflammation All antibiotics will do is give you a temporary decrease in the overgrowth of bacteria but it will come back, most likely worse. You may have fructose malabsorption as well, I do, in which case you'll likely have to cut way back, most likely for life, but not nearly as severely as FODMAP.
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            • #7
              Find a new doc. This one obviously doesn't know what she's talking about.
              Primal eating in a nutshell: If you are hungry, eat Primal food until you are satisfied (not stuffed). Then stop. Wait until you're hungry again. Repeat.

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              • #8
                OK, past my bedtime, but I just reread what you wrote. You went to the doctor for gut issues that only just started when you started PB? In that case, completely ignore everything that the doctor told you. She's useless. Less than useless, I'd say dangerous. A change in diet will almost always cause digestive upset in the beginning. Usually you just have to ease off on the gas producing foods and slowly increase their intake. You don't need antibiotics and they will most likely screw up your guts even worse. Probiotics aren't very useful as they don't contain the diversity needed to repopulate your gut after so much is wiped out from the AB's. What then happens is that there's a good chance that you will end up with some kind of overgrowth.
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                • #9
                  Thank you, wise, Primal people. You've confirmed what I thought. Half of me is still stuck in CW, I will admit to fondling the samples of antibiotics she wants to start me on and thinking how great it would be if they worked, magic pills are so much easier than an elimination diet ;-) I am definitely not going to go back to her.

                  Another question then- right now I am literally surviving on very few foods. Proteins are fine (chicken, beef, fish, eggs). I eat chicken soup with sweet potato or carrots 2-3 times a day, bananas, and the proteins I mentioned. These are the foods I've found that don't cause GI distress. So for the past 10 days, a typical day looks like this:

                  Breakfast: Bowl of chicken soup with sweet potatoes or carrots
                  Lunch: Bowl of same chicken soup with a side of beef or fish
                  Snack: Banana
                  Dinner: 2 fried eggs

                  I've tried to add small amounts of other foods (tomatoes, eggplant, yogurt, red bell peppers) with no success. I'm going to try spinach in the soup today. How long can I continue with this limited diet? I'm concerned about not getting the nutrients that I need. Should I be taking supplements? I've gotta say, aside from the GI distress, I've been feeling great- alert, energetic, happy- even on this limited diet.

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                  • #10
                    A bit of GI distress won't hurt you, as long as it isn't extreme. It may be uncomfortable, but it will pass. (heh) From the looks of how you were eating when you first started the PB you introduced A LOT of veggies, many of them notorious gas/distress producing. Too much too soon will freak your guts out.

                    Do you have access to a farmer's market with fresh organic veggies? If so, then I would get some leafy greens and fresh herbs. Even better if you can grow your own herbs, and just rinse off the dirt, trying to leave the naturally occurring bacteria. This will be much more beneficial for you than store bought probiotics. Change one of your daily meals to a salad with the greens and herbs. You want a variety of foods because your gut flora will adapt to what you eat. The bacteria we need to digest the foods we eat are actually found on the foods we eat but the SAD processes foods so thoroughly, simplifies our foods to the point that our gut flora shifts to a simplified one. It takes time and a little discomfort to get our guts to a healthier state. Some people eat fermented foods as well, but I find that most are just too extreme for my guts, due to healing from FM and gluten intolerance.
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                    • #11
                      Originally posted by abstractpersona View Post
                      Strained/greek yogurt is not supposed to have lactose, but some brands do have lactose. If you're not sure, remove it from your diet to see if your IBS gets better.
                      All brands of Greek yogurt I've found are very rich in lactose. They're just regular yogurt that has had the whey strained out to make them thick. The only way to remove lactose is to ferment the yogurt for 24-36hrs (instead of the usual standard 4-8hrs), which makes a *very* tart yogurt. One taste and you know that's not the case with storebought yogurt of any kind I've ever tried (and I've had many many wonderful specialty brands), and one look at the carb count will confirm it.



                      The OP mentioned adding eggplant, tomato, & bell peppers and having troubles. I don't know if this is your issue, but these are all nightshades, which some people can't do (I don't know what the symptoms of nightshade intolerance are, though).

                      Did you do dairy before going primal? If not, I'd start right there with the elimination diet.

                      Is the chicken broth homemade? If so, yay! great for your belly. Just add ferments and you've got a great recipe for improving digestion, along with removing problem foods until gut flora is well balanced. (And no, I don't think going primal threw off your balance.)
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                      • #12
                        I'm sorry but I disagree with most of what is posted here even though I'm rarely a fan of CW and am definitely in the "you know your body better than any doctor" camp.

                        You seem very vague on the most important question which is why did you book an appointment to go and see a gasto doctor in the first place ?

                        1 - If the answer is that you have had various problems that are gastro related over a long period of time hence you trying so many different diets then that is a whole different post to if the answer is that:

                        2 - You have always had great digestion and problems have only started occurring since you altered your eating to PB

                        So I don't think anyone can comment on this until we actually understand the issue, because imo if the answer is 2 then I don't really understand why you made the appointment - and I don't think anyone can fault a doctor who says that an eating plan is not agreeing with you if you have made an appointment to see them because the eating plan you are using is not.
                        1st June 11 to 30st Aug 11 - 36lb removed in 13 weeks
                        Messed about on and off for the rest of the year

                        June 2012 - Had the practice - now time to do it for real

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                        • #13
                          Some replies (sorry I haven't figured out how to add the original quotes yet):

                          I do have access to a Farmer's Market. Lettuces wreak havoc on my system, but I will search for spinach and watercress and herbs and see how that goes, thanks for the suggestion. I have read about the importance of "dirty" organic produce, I'll hunt for it today!

                          I did not do dairy before going Primal, I'd been on a Slow Carb diet (no dairy or fruits, but lots of legumes) since Jan. So the big changes when I went Primal were 1. Ramping up veggie intake to replace legumes, 2. Introducing Greek yogurt 3-4 times a week 3. Eating some fruits- berries, bananas. Also, I wasn't aware that Greek yogurt had lactose, but I haven't eaten any for the past 10-11 days anyways, as I've really restricted my diet to try to avoid GI symptoms.

                          My chicken broth is homemade sometimes, and sometimes not, depending on what's handy, but the soup is always homemade. Can you tell me more about ferments? Can I buy them, or do I make them?

                          Thanks for all the help, it's been frustrating; it seems the healthier I eat the worse my stomach feels. Never had these issue on a conventional diet, or the slow carb diet.

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                          • #14
                            The nightshade symptoms I have are pain in muscles and joints - much like the aches you get from the flu. I never had GI upset from them. Also, I add kale to my chicken soup along with carrots, onions and celery. Very good nutrition from boiling a chicken carcas along w/ 1-2TB apple cider vinegar (it helps leach out good stuff from the bones). I now use my crock pot out on my back deck and let it go over night. The broth is really rich and yummy. I would not take the antibiotics either as they will surely cause another problem somewhere for you. I don't think your diet is too limited either - in fact I'm sure it's better than most!

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                            • #15
                              Hmm forum just ate my longer post.

                              Booking an appointment with the gasto will have just confirmed to them what they believe that they already "know" - following a PB is bad for you and gives patients bad symptoms which will make it even less likely that they will listen with an open mind to their next patient on a Primal diet.

                              Anyway - If you're only getting symptoms since following a PB diet I would go back to your low carb Diet and see if the symptoms disappear - if they do then you have your answer - your body does not like something you're giving it eating primally. If they don't then there could be other problems which would have warranted a gasto appointment.

                              Once you know the answer to whether its the primal diet thats causing your symptoms then first try adding in something that you ate primally and not on the low carb diet - ie yoghurt and see if it cases the problems - rinse and repeat till you have the answer.
                              1st June 11 to 30st Aug 11 - 36lb removed in 13 weeks
                              Messed about on and off for the rest of the year

                              June 2012 - Had the practice - now time to do it for real

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