I think my history with healthcare probably sounds a lot like that of most people who have gotten to the point, like I have, where drinking Chinese herbs seems like a perfectly reasonable solution to my health issues—the kind of people who regularly throw around words like “naturopath” and “licorice root” and who think that laying in a “therapeutic” vibrating, noise-emitting bed weekly is worth a shot. I think most of my friends and family have been hearing me refuse conventional pain killers and topical steroids for so long that they forget I tried the whole doctor thing. For years. Like a lot of people I’ve stumbled across in the digestively challenged community, my (our) doctors didn’t listen to me (us). They suggested I try to avoid stress and chew more and sent me on my way with the names of over-the-counter laxatives and gas relief medications and referrals to therapists. Of course, sometimes I can't help but wonder if I didn’t stand up for myself like I should have. That maybe if I had pushed back a little harder, things wouldn’t have gotten to the point that they did. But at some point I just accepted that chronic constipation, severe bloating and abdominal pain were my normal.
That's not to say I didn't see gastroenterologists a few times (thanks again, Mom, for coming to the city multiple times to distract me while I was on a strict popsicle diet and get me home safely post-anesthesia!) but after colonoscopies and endoscopies came back normal and those doctors didn’t offer alternative solutions, I let it go. At the time, my symptoms were manageable. Whenever I ended the day with intense abdominal pain and a distended belly, I dealt with it by eating my fried egg dinner horizontally in bed until it passed on its own after a few episodes of Grey’s Anatomy. Maybe sometimes I had to leave work a little early and my commute home might suck once in a while, especially if I couldn’t get a seat on the train and had to stand doubled over in pain clinging to the subway pole, but that was just the way of my world. To this day, my worst GI symptoms always seem to save themselves until the end of the work day—I took plenty of time off from work for all of the colds and flus I was contracting before I changed my life for the more holistically oriented (of course, now it makes sense that with a gut so out of whack, my immune system would be too), but ironically, I can’t remember ever needing to take a sick day for my digestive issues.
I do remember being at a concert when I had an especially bad stomachache and just standing there, so I could finish seeing the show. I hobbled my way home—I think I even took a cab because I could barely walk—but whatever this was, it was not preventing me from living my life. Then there was that night I spent with a new boyfriend mostly on his bathroom floor instead of in his bed while he slept in the next room—he never suspected a thing. When I voted for Hillary, I was so bloated I could barely stand upright as I filled out my ballot, but I did what I had to do (and that one I certainly don’t regret). Being constipated for days at a time was just me! We’re all different! And my stomach only really hurt every few months or so, no big! The stressful periods and strange hormonal symptoms, "brain fog" and memory issues, anxiety, clumsiness to the point of injury, acid reflux, skin problems and consistent level of exhaustion that became my standard—all of it was totally "manageable."
The last time I remember feeling “normal” was when I traveled to London with my boyfriend and his family right after Christmas in 2015. I was able to eat whatever I wanted whenever I wanted, I could go to restaurants without researching the menu first or making complicated requests and changes once I get there, I didn't have to plan every meal in advance or obsess about food nearly constantly. In what I still sometimes think of as my past life, there were no diet diaries or food rotation spreadsheets, I didn't have to study the ingredients on every single food label, or make my own milk, yogurt or bread. In London, I had multiple English breakfasts, ate gluten ladened pastries most mornings, drank coffee AND black tea filled with conventional milk every day, and had plenty of beer and wine. It was a freedom I didn't know I had. But I also experienced constipation so bad during that trip that for the first time in my life it scared me. This should have been what a lot of SIBO folks call their “wake up call.” It wasn’t for me, not yet, but it was coming.
Soon after that trip, my every-couple-of-months pain quickly became monthly and then weekly. And that’s when I went to the gastroenterologist who would administer the (three hour) breath test that would finally diagnose me with a “severe” case of SIBO. Side note for those who haven’t already heard my spiel—SIBO is “small intestinal bacterial overgrowth,” meaning bacteria from the large intestine somehow ends up overflowing into the small intestine, usually because “gut motility” is impaired— i.e. the digestive system isn’t clearing itself out properly—resulting in that bacteria, which doesn’t belong there, eating your food, stealing a lot of your nutrients and emitting gas which causes bloating. For digestive problems a lot of the time, a diagnosis is half the battle. It was a relief after all those years to know what was going on with me, to know that it had a name, to know for sure that this was more than just stress. What I didn't know, and what that doctor did not make at all clear at the time, was how particularly difficult SIBO is to treat, how the type of SIBO I happened to have (methane) was the more complicated of the two options, how there is not even close to a standard way of treating it, that it can take years to do so, and that it s more often than not a chronic condition. At the time, the doctor who diagnosed me put me on a "six week" low FODMAP diet (more on that later), prescribed me a round of antibiotics and sent me home. The SIBO returned pretty much immediately once I was off the antibiotics, so I was put on another round, given another colonoscopy and endoscopy, which again, did not help or prove to be particularly enlightening. And that's about when I lost (most of) my faith in Western medicine and discovered a whole separate, very strange new world of holistic, naturopathic medicine, which is mostly what I will talk about on this blog.
And how did I end up this way? The short answer is, I don’t know. I think some people can trace their digestive issues back to specific health issues or experiences—Lyme disease, overuse of antibiotics, food poisoning, surgery, etc. I've had some degree of digestive distress my whole life—my mom tells me that even when I was a little kid, if I wasn't feeling well, it was usually because of something to do with my stomach—but it became intensified in the last few years. Being on hormonal birth control since I was 18 and the excessive drinking, cigarette smoking and maniacal level of socializing that came with being a single twenty-something in New York City probably did not help what was likely already a susceptible gut. The fact that I was born via Cesarean section, that I used topical steroids for most of my young life to treat my severe atopic eczema, that I took Advil whenever I had the slightest headache and for all of those hangovers, that I was given a couple of rounds of antibiotics for my multiple oral surgeries all could have added up. The constipation I've suffered from for years alone could have led to this. (If there's anything to be learned from my experience, it's this—longterm constipation is never normal and should be addressed!) And I will say, as much as I regret all those doctors who told me that my stomach problems were nothing more than stress, I do believe completely that stress can make a "manageable" health problem much much worse. And if stress is a major contributing factor to developing a condition like SIBO, perhaps I know exactly why I got SIBO when I did. But that's definitely a post for a different day.