Intestinal Dysmotility Diet - Link Please

[futurehope]

I may have some gut dysmotility, but not severe enough to cause serious problems:it's a nuisance. I have small intestine bacterial overgrowth which kind of points me in the direction of dysmotility as a cause.

So, for the people who know, I was curious as to the diet that can be followed for this? Or, a link please.

Thanks in advance.

[juliegee]

Sorry, I don't have a link. I'll sum it up: low fat, low fiber. WHITE rice, bread, pasta, pureed fruits (baby food), mushy overcooked veggies, lean meats (chicken, fish turkey.) Many have luck with a non-dairy diet.

Your SIBo's certainly point to dysmotility. Are you taking a daily probiotic? That helps. Culturelle is great. I take it daily.

Feel better-

Julie

[futurehope]

Julie,

I appreciate your answer.

Yes, I had been taking Probiotic Acidophilus (bought at GNC) 2X/day for a very long time and I was doing "okay". I switched about 1 1/2 weeks ago to Align 1X/day, and have been constipated and had hard stools since. I do not know what I'll do.

I asked about the diet because.......

whenever I get on my "healthy food" kick (like right now), and include whole grain pastas, raw veggies, or raw salad, I seem to have problems...more than my usual. I get very gassy and seem to have problems digesting. Also, I cannot take in much milk products and no liquid milk at all. Milk products give me a stomach ache. Interesting, almost any fat makes my stomach go into more spasms, including the "healthy" olive oil or canola oil which I've been using on my lunch salads lately.

So, the diet you mentioned seems to exactly fit what I have already found out on my own.

My only problem now is, I've been on 3 fibercons/day to "help" my bowels, but I am beginning to think this is not the correct thing to do with motility problems. Also, I may have to go back to my original probiotics, or the Culturelle like you suggest. The Align is creating new problems for me.

How do people who eat rather blandly, without the "healthy fiber", get their guts to "move"? I'd really love to know. I was always told that the additional fiber would "help" my bowel problems. If the bowel has problems with motility, I am assuming the additional fiber could get things "bottled up"? Thanks in advance.

P.S. Any good ideas for lunches for people with motility problem, the easier to prepare the better? TIA

[sue1234]

Futurehope,

The only thing that works for me is a big glass of iced tea every morning. I can't handle coffee with the extra caffeine, but tea works for me. Of course, I have my days where nothing works. I just started this week adding in ALOT more vegetables, like beans, cooked veggies, etc. and, yea, it's giving me gas, but also bulking up my stool(TMI!).

On another note, I saw in your tag line that you have low blood volume. I believe I do, but don't know how to find out. How did you get tested?

[futurehope]

Sue,

Your answer can be found in this thread:

http://dinet.ipbhost.com/index.php?showtop...hl=blood+volume

Also, my POTS doctor, at my request, submitted a request for a blood volume study. I did mine at Washington Hospital Center in D.C. It is done by the nuclear medicine department. Relatively easy to have this set up.

It's interesting to know that I am usually on "the low" side, as opposed to being "normal". My results were: mildly hypovolemic.

Thank you for the "tea" idea. I cannot tolerate coffee for sure.

[janiedelite]

Here's a link to a thread on small bowel dysmotility: http://dinet.ipbhost.com/index.php?showtop...;hl=dysmotility

It is so frustrating because I have a set of foods that I cook for my husband (whole grains, veggies, good stuff) and then another set of foods for myself (white flour, bland, not very healthy stuff). A lunch I can tolerate and that really helps my POTS is Campbells chicken noodle soup. Nice and salty plus easy to digest.

[juliegee]

Yikes! You are doing EVERYTHING wrong & paying the price The worst thing is the fibercon! They can be dangerous to us folks with slow motility. They actually swell up and block the rest of the food from moving. Your tummy must be so swollen- I've been there. I can really feel for you. My bowels have stopped moving too, even with the culturelle. If you think the acidiphilus was helping there, by all means switch back. I take 2-3 doses of Miralax every evening. It doesn't act like a laxative, it just makes me normal. Once I have a little coffee or a banana in the AM, I feel the morning urge and my tummy's flat again. The miralax takes a few days to start working.

Switch your diet up. Forget a typical "healthy" diet- it's not healthy for YOU. You can still eat heathfully with lots of mushy fruits and vegs and lean protein. Forget whole grain. White, white, white bread, pasta & rice! You may get to a point where you can tolerate a salad here or there. I instinctively know when I can handle food like that...I like the bagged sweet butter lettuce. It's really tender. But, I think you ned to wait until you can try to tolerate that. A great lunch would be a sandwich- sliced turkey or chicken on soft white bread, or tuna or chicken salad made with low fat mayo. I think eggs any time of day are great too. How about a few slices of cooked chicken (no skin) with mashed potatoes and gravy, with some well cooked veggies- yummy!

The non-dairy thing is really important. Rice Dream or any Soy Milk is a great alternative. We regularly mix fresh or frozen fruits, ice, "milk" and blend for a healthy smoothie. We use smart balance as a butter substitute.

Feel better-

Julie

[Maxine]

Another problem is when folks who have slow gut motility take proton pump inhibitors (PPIs) (AKA nexium), as these block the natural gastric juices which help in the motility process. I'm wondering if you can take something else to help with the reflux you get which very well could be secondary to the slow motility. I get this on OCCASION, but I only take an antacid for it. They have found this in the elderly who take PPIs-------------the small intestinal bacterial overgrowth. I wish I could find the study. I'll look for it.

I only tried a PPI once, and it wreaked havoc on my digestive system AND my ANS, so I took this as a warning not to take it again. My gastric motility is normal, but my small intestines are kind of a mess due to a very large 5 cm diverticulum. I also have excessive diverticuli in colon. My husband took nexium, but recently switched to prilosec generic brand. It's free on our plan, and the naxium was $60 for a 90 day supply, and his doc said it's the same thing.

I think PPIs should not be given to people with slow gastric motility, and another class of drugs be given to keep reflux down when needed. I only get mild reflux when I'm way backed up---------but when plumbing is working----(even fair) this isn't a problem. Some docs like to sell the old "acid refux" problem to thier patients so they can get thier cut from the pharmaceutical companies. They prescribe PPIs like candy----------they are over prescribed way too much to people with other digestive issues that doctors are too lazy or ignorant to investigate--(i.e.----> gall bladder disease, slow gastric motility), and sometimes people end up worse off. Just my opinion.... I'm a little passionate about this------------- My mother ended up on PPIs, and the root cause of her digestion problems were never found. One day she ended up in ER, and they had to use a gastric tube, and everything started to go backwards because she was so full of it that she wasn't digesting anything. They found skins from a plumb she ate 2 weeks previous-------------

My husband has true acid reflux, so they have worked out well for him. He doesn't have any other digestive problems other then possibly needing his gall bladder removed at some point---(runs in his family) his stomach gets more sour when his GB acts up. No doubt backed up acid needs to be taken care of, but docs need to investigate other options for people with slow gastric motility. Obviously you don't want to risk potential esophageal complications. ACID REFLUX can be secondary to other problems, and the docs should not assume this problem is primary.

http://www.springerlink.com/content/p42335p25l00k36h/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1726985/

This is from wikipedia;

"Certain patients are more predisposed to the development of bacterial overgrowth because of certain risk factors. These factors can be grouped into three categories: (1) disordered motility or movement of the small bowel or anatomical changes that lead to stasis, (2) disorders in the immune system and (3) conditions that cause more bacteria from the colon to enter the small bowel.[1]

Problems with motility may either be diffuse, or localized to particular areas. Diseases like scleroderma[6] and possibly celiac disease[7] cause diffuse slowing of the bowel, leading to increased bacterial concentrations. More commonly, the small bowel may have anatomical problems, such as out-pouchings known as diverticula that can cause bacteria to accumulate.[8] After surgery involving the stomach and duodenum (most commonly with Billroth II antrectomy), a blind loop may be formed, leading to stasis of flow of intestinal contents. This can cause overgrowth, and is termed blind loop syndrome.[9]

Disorders of the immune system can cause bacterial overgrowth. Chronic pancreatitis, or inflammation of the pancreas can cause bacterial overgrowth through mechanisms linked to this.[10] The use of immunosuppressant medications to treat other conditions can cause this, as evidenced from animal models.[11] Other causes include inherited immunodeficiency conditions, such as combined variable immunodeficiency, IgA deficiency, and hypogammaglobulinemia.[12]

Finally, abnormal connections between the bacteria-rich colon and the small bowel can increase the bacterial load in the small bowel. Patients with Crohn's disease or other diseases of the ileum may require surgery that removes the ileo-cecal valve connecting the small and large bowel; this leads to an increased reflux of bacteria into the small bowel.[13] After bariatric surgery for obesity, connections between the stomach and the ileum can be formed, which may increase bacterial load in the small bowel.[14] Proton pump inhibitor medications that decrease acid in the stomach cause bacterial overgrowth by a similar mechanism, as they prevent the anti-bacterial effects of acid in the stomach. The clinical significance of this in causing symptoms is unclear.[15][16]

[edit] Diagnosis"

Maxine :0)

[futurehope]

I'm trying real hard to remember, but......

A while ago, pre-POTS, my gastroenterologist ran a test to see how quickly "something" went from my stomach through to my bowels. I cannot remember much, but the fact is, at that time, I was moving food through QUICKLY.

I do not know if I was on the PPI at the time. I also have no idea whether this test would give the same result NOW that I have POTS?

I will discuss motility issues and the ongoing ingestion of a PPI with my doctor.

Because of my taking a PPI, I know for a fact that I "pick up" stomach bugs more easily because I do not have the acid level to kill them off.

I'm pretty sure the doctor "knows" I do have reflux because he has been down my esophagus a few times (I've lost track of how many times he's looked.), unless he's just says I have acid reflux because saw my inflammed esophagus and deduced it?

At this point, if I stop PPI, I go into reverse, and the acid really hurts me. I had to stop them once for something and it was not easy. I do take raniditine 150mg/at night. It tends to depress me, as does Pepcid, so I am not an easy case by any means. I also have a moderate hiatal hernia.

At this point, I would love to have a gastro doctor who specialized in motility issues. I don't think we have one in Baltimore?!

[bruc]

If your susceptible to SIBO due to dymotility then why would you thrown in probiotics ie any bacteria which will just

sit in the small bowel and ferment, in my case, adding fuel for the SIBO to grow?

[sue1234]

OMG, Bruc, that is so me! I thought I was the only person in the world that looked at probiotics as poison! For 10 years I have been trying to take them and all they do is make my bloating horrible. It finally dawned on me a few months ago that that is what's happening--the bacteria are setting up way too early because of the slow gut.

[mwise]

I agree with Mack's Mom with the low fat/low fiber diet. I am on that for a diagnosis of Gastroparesis and Diverticulitis. I also have GERD. If you could tolerate high fiber foods, this will help with getting your bowels moving again.

My suggestions are to see a GI specialist(s) who will refer you to a Dietician to help find the right caloric and fluid intake. My GI doctors are at Cleveland Clinic. They have me on Domperidone 20mg before meals & at bedtime (I get it from Canada) for motility & nausea. They also had me taking Miralax 1 capful 2-3 xday along with a Ducolax suppository for constipation. They referred me to a Dietician who put me on a low fiber/low fat diet along with drinking 2-3 liters of fluids a day and night. She gave me a list of foods-similar to Mack's Mom's suggestions that I am able to eat. I also purchased the book Calorie Fat & Carbohydrate Counter by the Calorie King. Great little book especially for eating out. He has a web-site: www.calorieking.com

My Neurologist has me on Mestinon, which he says also helps with motility. Between the Domperidone & Mestinon, it really is helping with motility and took away my nausea. No more bloating and full feeling. I do take a probiotic 1xday-Advantage and have had no problems with it. I buy it on-line.

It took about 2 weeks with the Miralax & Ducolax suppository getting my bowels working with 2-3 bowel movements of soft stool a day. I still go 2-3xday of soft stool with even the urge to go. No more bearing down and feeling like I was going to pass out from going. I am only using the Miralax 1xmth without the suppository.

The low fat/low fiber diet is great. I eat small meals of a variety of foods. Giant Eagle, Wal Mart, Trader Joes to name a few have allot of low (reduced) fat and fat free products. Read the labels.

The Counter book helps when going out to eat. I just recently took my daughters (identical twins) for their 16th birthday to Red Lobster. Resturants can be very accommodating if you just ask. I brought my own light "I can't believe it's butter" and fat free sour cream to the resturant. They melted my butter so I could have it for my Lobster tail, substituted saltine crackers for their biscuits and used my butter & sour cream for the baked potato along with steamed broccoli. Their Lobster & Shrimp was lowest in fat content. It was great being out eating again.

Stonyfield Products are organic. They have great smoothies and yogurt products. This helped me with getting 5 lbs on when I wasn't able to eat. Avoid Ensure or Boost-the Dietician shared too much high fat content. Danimals Smoothies by Dannon are also good for calories. I do drink 1% or fat free milk. Cream of wheat cereal was recommended by the Dietician along with making Carnation Instant Breakfast inbetween meals. I also eat low fat/fat free puddings and ice cream. Steamed vegetables are easy to digest. Apple/fruit sauces and canned fruits are also fat free. I am lucky I have no problems with carbs LOL.

Good Luck and feel free to email me if you want specifics with foods being low fat/fat free and fluids.

[juliegee]

bruc-

Can I call you Bruce? I definitely believe that probiotics help especially in folks with slow motility. The way that I understand it, the small bowel is FULL of bacteria at all times. What's important is the balance of good to bad bacteria. Probiotics are the good bacteria. Bad bacteria comes from the food that sits there rotting because our GI tracts are moving too slowly.

Balancing the bacteria by itself will not get the food to move. If you have a dysmotility, you should consider using a GI prokinetic and/or Miralax. The combination of a helpful diet, properly moving food along, AND balancing the bacteria is key.

My son's docs at Johns Hopkins swear by this regimen. Prior to taking 2 culturelle a day, my son had regular SIBO's. He now only gets them occasionally.

Julie

[bruc]

Im already on Nulytely which is Miralax plus electrolytes.

No other pro-kinetic works other than antibiotics.

From my readings; bacteria, good or bad, are not part of the digestive process in the small bowel.

The small bowel operates in an acidic environment. As bacteria accumulates, the alkaline nature of the bacteria disrupts this environment.

As toxins are produced the bowels ability to cleanse and protect itself is reduced allowing for further bacterial overgrowth.

Eradication of this overgrowth is key to regaining this function. In dysmotility the cleansing waves are inadequate. Due to this inadequacy, good bacteria can accumulate and overgrow just like the bad. Balancing the good with the bad does tend to reduce the amount of toxins being produced so there will be improvement but the bacteria still produce gas, bloating. Some relief but not solving the problem. Small intestine isnt designed to work this way. You need too eradicate all bacteria.

My GI specialist has advised me not to take probiotics, wont help.

But my philosophy is; if it working for you then go with it.

[Guest tearose]

Here is a link explaining how positively probiotics effect the good intestinal bacteria.

http://www.crohns.net/Miva/education/whatprobiotics.shtml

[Sunfish]

i'll try to make it back to chime in re: discussion, but for now here are some links that may prove helpful:

here are a variety of "gastroparesis diets" from various sources to perhaps give you some ideas:

http://www.healthsystem.virginia.edu/inter...sisDietTips.pdf

http://www.healthsystem.virginia.edu/inter...ARESIS-DIET.pdf

http://www.acg.gi.org/patients/gihealth/pd...stroparesis.pdf

http://www.gicare.co...ted/edtgs08.htm

http://www.g-pact.org/diet.htm

they vary greatly in terms of detail & i apologize if any are now "dead" (as i copied & pasted from an old post). i'll check them & remove/ change any bad ones over the weekend but after being up all night last night w/ my cat prior to him needing emergent surgery today i am simply WAY too wiped at the moment.

hope this helps,

melissa