I apologise for this interruption for your regularly scheduled endo posts. There is a bake-off at work on Thursday for RUOK Day and I’ve been bitten by the Nailed It bug, so I’m using my after-work hours and new energy (thanks Zoladex!) to create like a mad thing. I’m trying to create a Golden Gaytime vegan frozen cheesecake worthy of Rainbow Nourishments (whose BEAUTIFUL e-book is well worth the $20!). Trouble is, her Golden Gaytime cake is a jealously guarded secret so I’m improvising based on several of her other recipes. This could be a disaster.
To add to the pressure, my work bestie has decided to make this into a personal challenge about who is the better baker. I love her but I must defeat her.
For that reason, I spent last night starting the process and will use tonight to do the bulk of the work, which will take hours. I won’t be able to write an actual useful post as a result. However, tomorrow night I will post the result of my labours (and the battle) as well as explain a bit more about RUOK Day. On Friday we will return to something a little more on topic.
Ah, IBS! The fun, the joy, the explosive diarrhoea! Aren’t you just quivering in excitement?
IBS, or Irritable Bowel Syndrome, is the medical term for “something is wrong with your digestive system but we aren’t really sure what.” It is not to be confused with IBD, or Inflammatory Bowel Disease, which is both more easily diagnosable because there are clear physical markers, and far more serious.
That’s not to say that IBS isn’t hellishly annoying and painful – it’s just unlikely to be fatal. What it will likely do is cause massive swelling, keep you on the hop between diarrhoea and constipation, possibly put some mucus in your poop, and make you unable to eat a wide variety of foods without horrific pain. Also, nausea. For no reason.
Doctors have never been able to nail down a cause of it and it seems like it has really become an umbrella term for digestive systems that are a bit delicate, sensitive, and easily upset. I apparently have it, but I also have a completely normal result for colonoscopies, endoscopies, and whatever-other-method-of-sticking-tubes-down-your-throat-and-up-your bottom-oscopies they can think of. For me, and for many in my position, the bowel difficulties are caused by endometriosis growing on or near the intestine, and doctors happily cover it with this wonderfully useful catch-all phrase – IBS.
Dealing with IBS
So, what to do if there is something like this going on in your piping? The first and best way it to look at changing your diet. I recommend the Low FODMAP diet, which I have discussed here, because it allows you to figure out what your main triggers are. Bear in mind, however, that it may not solve all your problems. I still manage to have plenty of stomach upsets even avoiding my trigger foods. What it will do is make sure that you aren’t suffering more than necessary by putting foods that will irritate your bowel straight into it.
In terms of dealing with the symptoms, I’ve discussed relief from constipation and bloating here. To my intense annoyance, there really isn’t much you can do about diarrhoea except ride it out. You can eat foods that you know will constipate you but then you have the risk that everything will swing the other way, and, let’s face it, most of what will constipate you is not healthy. If you are in serious pain and popping codeine for relief, you’ll probably find that swings you round into constipation territory too.
If you find that your poop is so liquid that you are suffering from faecal incontinence (i.e. you can’t hold it in or you don’t notice that little bits are slipping out), I recommend a good, thick panty liner such as the Tena brand. Designed specifically for incontinence rather than periods, they are long, thick and hold stacks of liquid. Importantly, they also hold in smells. They will hold the little brown demons off your clothes until you can get to a toilet. Keep a spare pair of clean undies and a pad in your bag as well (I’d recommend carrying those at all times with endo anyway). It may be embarrassing for you to buy and carry big old incontinence pads, but trust me, it is more embarrassing to poo your pants in public.
If you do suffer from faecal incontinence because of IBS, or for any other reason, you should not feel guilty or bad or embarrassed. I say this knowing that the few times it has happened to me I wanted to die of humiliation and no one even knew about it. It feels icky and you feel like a child who can’t even control their own bodily functions, but plenty of adults suffer from it and it is not something you can help or control. You are not gross or weak or pathetic – you are suffering from a disease and it is not your fault.
If you suffer from nausea, there are prescription medications like maxalon that can help deal with it. However, some of these can interact very badly with pain medications, so double-check before you dive in using them. Try ginger tablets or ginger chews to keep the sensation at bay, and double up with peppermint or lemon and ginger tea (peppermint reduces colon pain and lemon and ginger settles the stomach).
Finally, of course, consider what can be done to deal with the root cause, if you know what it is. If it is endometriosis, talk to your surgeon about whether there is any point attacking it surgically. There may not be. Like with endo anywhere else, removing it is no guarantee that it won’t just go back. Further, the intestine is such a delicate area that some surgeons prefer just to do a straight-up bowel resection than attempt to remove it, especially if it is small or deeply embedded. Either way, bowel surgery is risky, so you want to be fairly certain that there will be a tangible benefit before going in. It may be that sufficient medication can reduce the endo growth on the bowel enough to provide you relief from symptoms.
Of course, it may not, and IBS may become yet another unfortunate part of your reality when living with endometriosis. What fun, eh?
Do you suffer from bowel-related complications for your endo? Have you been officially diagnosed? What’s your best method of relieving the symptoms? Let me know in the comments.
My apologies for posting nothing yesterday. I’ve had a particularly bad flare-up over the past few weeks and trying to get back to work was taking all my energy. It was quite painful to sit up and type, and I don’t have a laptop, so skipping a day became necessary for survival.
Today, I want to talk about back pain. Some side-effects of endo are embarassing, annoying and/or painful, but few are as truly debilitating as backache. It can paralyse you. It can make every single little movement send shocks of agony through limbs, lungs and pelvis. It can render walking absolutely impossible and standing up straight a delirium dream.
I already have spinal problems to start with. I split and bulged a disc in my lower back when I was 18 in an embarrassing series of incidents involving a back-bend, the splits, and a sneeze whilst buck nude in the shower. My mother, as per usual, was the hero of the story. The split and the bulge have long since normalised but I felt ongoing pain there for years. During my endo flare-up in May, I experienced such horrific lower back pain once more that I was genuinely concerned I had torn every disc I possessed for a while. Walking was incredibly painful. Even shifting position on the couch required a lot of bracing myself mentally. It was very close to as bad as when I first hurt myself, when I was paralysed for a day (unfortunately still naked but for a towel having been rescued from the shower. If you are going to injure your back, I recommend doing it clothed).
Doctors were less than helpful about that, including an emergency department doctor who insisted I must have done some sort of injury to my back despite me clearly not having done so, and despite the back pain moving in lock-step with the severity of my endo pain. The only thing that was even coming close to reducing the pain was Mersyndol Forte (a prescription-only combined painkiller and muscle relaxant), which of course meant impaired cognitive function, fatigue and lots of constipation. My surgeon later confirmed that yes, endo can and does cause backache because it can fiddle with your back nerves.
But enough of my whinging. What should you do when your back starts acting up because of endo? (Please note that whilst some of these tips may apply to a genuine back injury, not all of them will. If you have actually injured your back, hie thee to a physician). As usual, I am not a doctor and this is not medical advice; this is stuff that I have found through experience has really helped me. My first tip would always be to see a doctor to ensure that there isn’t actually an injury there.
1) Apply heat
Get yourself some of those glorious Deep Heat patches and wack them on the sore bits.
The back pain size is really big and will comfortably cover most of the sore bits. If you need to, wear several to cover all the pain. I would recommend keeping a few of these in the medicine cabinet at all times.
The heat penetrates the muscles around the spine and I find it helps keep them a bit more relaxed, which in turn reduces the pain a little. Stiff, tense muscles bunching up to protect the perceived injury makes it all worse.
2) Find a comfortable position and stay there
If you can, push yourself through prepping a couple of meals, fill up a large water bottle, put them all within arms reach of the stop you intend to lie, and then collapse there. I would advise finding a bed or couch as close to a toilet as possible. Have devices charged and remotes within reach.
3) IF the pain allows it, do some gentle stretching
If every single movement is agony, don’t do this. However, if it is a deep but bearable ache, move your back gently. A very gentle cobra position, cat/cow pose, and some gentle side-stretches will help prevent the muscles locking up and may even give some relief.
4) Avoid sitting for too long
When you sit, all the weight of your upper body presses down on your lower back. If you are going to sit for a long period of time, because you have to for work, for example, consider a medicine ball. That gentle bounce can help relieve the pressure on the lower back (although may case some muscle tightness in your upper back as you do have to work to keep good posture without the back of a chair to slouch against). This was one thing my sports medicine doctor was very keen on me doing after my back injury and it was less painful than an ordinary chair.
If you must sit and can’t have a medicine ball, consider whacking a cushion under your bottom and behind your lower back for lumbar support.
5) Consider a TENS machine
I know I’ve harped on about the glories of TENS machines before, but it is with good reason. They are so effective about cutting through pain. If you have one in your bag or to hand when pain strikes, slapping it on may just allow you sufficient relief to get yourself home or into a state of sufficient preparedness for a day-long hibernation.
6) Have a warm bath with muscle relaxants
This is assuming you can safely enter and exit a bath, of course.
When I say muscle relaxant, I’m not talking powerful prescription drugs, I’m talking epsom salts. They can help tense muscles release, particularly combined with the warm of the bath.
7) Drink herbal teas
Again, this is all aimed at relaxing. Chamomile in particular is known to relax the body.
8) Take your supplements
Vitamin D and magnesium both help reduce spasms and cramps and keep all your muscles functioning normally. Valerian is a particularly stinky relaxant that can also help aid sleep.
Speaking of sleep….
9) Gets lots of sleep
It’s the body’s natural healer, so they say. Also, when you sleep, you aren’t in pain, which is always nice.
10) Take anti-inflammatories (including food and supplements)
Be careful with ibuprofen to avoid stomach problems – don’t use it long-term or exceed recommended doses, but if you are ok with it definitely take some to reduce any swelling in your back. Smash down that turmeric tea, eat your leafy greens and fresh fruits, and keep up with your good fats (hello, avocados).
Those are my top ten tips for a sore back. What are yours? Have I missed anything? Have you experienced back ache with your endo? Let me know in the comments.
Yes, it’s your obligatory spot-the-vegan post. I’ve mentioned that I’m vegan before, I know, but today I want to explain why and how it gels with my endometriosis.
I’ve been vegan for just shy of four years, and was vegetarian for maybe two years before that. Veganism is a change that I would encourage everybody who possibly can to make. I know that not everyone can. For people will allergies or intolerances to common ingredients in fruits or vegetables, such as fructose, or someone with a thyroid problem exacerbated by certain plant foods, veganism may simply not provide the nutrients they need. Someone with an eating disorder may find that the limitations on their diet trigger a collapse back into incredibly restrictive, unhealthy meal management. Some people simply may not live in an area that allows them to obtain healthy vegan food. However, that leaves a vast number of people who can.
I have three main reasons for my veganism, and I’ll outline them below.
1) It is the healthiest diet for me
I’m not suggesting that a balanced omnivorous diet can never be healthy; quite the opposite. However, I have high cholesterol. Cholesterol levels are supposed to be a 5.5 to a 6.5 on the scale my doctor was measuring on. I was a 6.7 as an omnivore, and got up to 7.2 as a vegetarian (because I replaced my meat intake with cheese and eggs, which are both full of the stuff). As a vegan, my cholesterol is finally back down in a health range. A vegan diet is naturally cholesterol free, so that’s no longer an issue for me.
A plant-based diet also cuts out many of the things that are bad under both the endo diet and the low FODMAP diet (predominantly red meat and dairy), so it helps me manage my endo very easily from a diet perspective.
Finally, a vegan diet almost guarantees nice, regular bowel motions. Given that my bowel-endo can often result in constipation, this is a very good thing. Seriously, 1-3 times a day is quite normal for vegans. Try it. Your colon will be shocked.
2) It is the cleanest diet for the environment
Climate change remains a hot button issue today, with the vast majority of scientists agreeing that the climate is changing and that humans are a major contributor. It is estimated that livestock takes up about 18% of our emissions, according to a widely-cited 2006 study. Robert Goodland and Jeff Anhang estimate it actually accounts for around 50%. The Food and Agriculture Organisation of the United Nations also cites livestock as being responsible for massive amounts of deforestation, soil erosion and polluted run-off.
Our seas are also being rapidly overfished, with the heartbreaking problem of bycatch persisting in gill net, purse-seine, long-line and trawling methods. Sharks, dolphins and sea turtles are all victims of circumstance. Aquaculture is no better, with 1 tonne of farmed salmon taking the equivalent of 3-4 tonnes of wild-caught to feed.
Yes, plant-based agriculture still costs land, but if we are using it all to feed humans instead of billions of livestock each year, that will be a far more efficient use of it, and it will take less space overall. People like to say that overplanting soy is destroying the Amazon. It is, but who eats most of the soy? Cows, not vegans.
3) It is the kindest diet to animals
Yes, yes, I know that mice will sometimes get caught up in combine harvesters and eat pesticides, etc. However, as I said, the majority of plants are already being grown to feed to livestock, so that is happening anyway. By adopting a vegan lifestyle, you not only reduce the incidents of that, you avoid the animals that are being fed this mouse-bloodied plant matter from being killed as well.
This, I think, is the strongest point. As mentioned, you can eat a healthy non-vegan diet. You can fish and hunt sustainably to eat meat without relying on farming. You can raise your own chickens in a sustainable way. But the animals and their deaths are the core of veganism. You cannot eat meat without animals dying. You cannot use animal byproducts without taking something that is theirs.
To me, it doesn’t matter whether an animal is treated well in its life if it is going to be slaughtered a fraction of the way through it. This article outlines why “humane” raising and slaughter is not an ethically sustainable position far better than I ever could, and I’d encourage everyone to read it.
I arrived at veganism through the animal branch, and my reasons boiled down to essentially these two things:-
I do not believe that unnecessary harm is ethical. It is not necessary for me to eat animal products to survive. Therefore, harming animals is unnecessary. Therefore, it is unethical.
It would be incredibly selfish of me to take away an animal’s life – everything it has – for a couple of minutes of taste. I cannot think of a more selfish thing I could do. Even for things that could potentially be taken without harming the animal, such as eggs – I don’t need them, so why would I take something that isn’t mine? If chickens were humans we’d call it theft.
Things like dairy and eggs, that by their nature involve the exploitation of the female reproductive system, also don’t sit well with my position as a feminist. As a person with a grasp on logic, I also don’t love the weird disconnect between our treatment of domestic animals and livestock. The underlying attitude is just overwhelmingly one of entitlement towards the bodies of others. It’s an attitude I hate between humans, and I don’t like it any better between humans and non-humans.
These are my reasons at their most basic. For me it is a decision I don’t regret – I am still sometimes overwhelmed with sadness at the cruelty against animals in this world, and this is one way my battered old body can protest against it and not contribute to it.
Unfortunately, there are bad actors in the vegan community. There are those who thing animals are gods and humans are mud and will actively stamp on humans to help animals. There are those who don’t care about racism, ableism, sexism or classism, etc, either in their vegan advocacy or in their lives in general. There are those who think I must be veganning wrong because it hasn’t cured my endo, so I need to eat raw organic food only, or something. Like feminism, I strongly believe veganism must be intersectional. There is no point in fighting one sort of oppression if you don’t care about others – and after all, humans are animals too.
Are there any vegans amongst my readers? What were your reasons? Has your diet assisted your endo at all? Let me know in the comments.
Before you read any further, make sure you’ve read the title. Diet can assist to manage symptoms of endometriosis. It’s not a cure. If anyone tells you that eating a certain way will cure you, roll your eyeballs as hard as you can. Raw vegans of a clean-living bent are the worst for doing this, and I say this as a die-hard vegan myself.
Now, not everybody will experience flare-ups from the same foods. Some endo-sufferes can eat anything and not have a single issue. Others only have to look at a trigger food (food that triggers a bad reaction) to feel like they’re about to die.
Broadly speaking, there are two main diets that people with endo tend to adopt to manage symptoms. Those who suffer mostly from uterus pain will probably opt for the Endometriosis Diet. Those who have more difficulty with their gut may prefer the Low FODMAP Diet. I’ve tried both, and experienced more relief from the FODMAP diet because I have trigger foods that aren’t excluded by the Endometriosis Diet (namely onion and garlic). This is because of the endometriosis on my bowel, which is severely irritated by trigger foods.
The Endometriosis Diet
The Endometriosis Diet is a little more simple than the low FODMAP diet. It is basically made up of foods you should avoid and foods you should eat lots of.
You should avoid:
Unfermented soy (soy milk or cheese – tofu, tempeh, miso, soy sauce etc are fine because they have been fermented)
Yoghurts that lack live cultures
You should eat lots of:
Fruit and vegetables generally
It’s important to note that for the endometriosis diet, it is recommended not to eat the skin of fruits and veggies. This is because of the risk of absorbing pesticides, that would put an extra load on already strained internal organs.
The aim of this diet is to eliminate anything that contains lots of hormones or has inflammatory properties, as these can all trigger endo flare-ups. It’s very compatible with a vegan diet. It’s obviously spectacularly healthy.
I didn’t have too much luck with this diet. Eliminating sugar is really hard – fighting the pain and getting through a difficult day takes a heck of a lot of self-control, so I don’t have too much left in the tank to battle sugar cravings as well. Thankfully, I find that, as long as I don’t binge sugar, it doesn’t have an effect (sugar binges absolutely do, though).
I can’t comment on what effect red meat, eggs or dairy might have on my endo, as I was vegan for quite a while prior to my diagnosis.
Alcohol is a trigger, so I have to be careful with that, although I do find it is drink-dependant. I had a very small glass of whiskey (neat) the night before last, and I have been in nasty pain ever since. It’s about a six as I’m writing this. However, I’ve had a cosmopolitan or a gin-based cocktail before and been fine. Either way, I definitely can’t drink a lot, and I should definitely avoid alcohol entirely if I have something big coming up. Like trying to get to work on a Monday.
I can handle a couple of cups of caffeinated tea (green or black), but coffee makes me sick. I think that’s more the gastritis than the endo, though. I don’t seem to have a problem with soy milk, either.
Unfortunately, many of the foods that the endo diet encourages are massive triggers for me – garlic and apples both leave me in big pain, apricots play havoc with my bowels, and cauliflower has results that are no fun for anyone, me least of all.
The Low FODMAP Diet
Unlike the Endometriosis Diet, in which you just stop eating bad things, the FODMAP diet has two stages. First, you eliminate all high FODMAP foods for six weeks. Then, you slowly introduce FODMAP foods back in to see what you can handle and in what quantities.
FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Fermentable is stuff that needs to be broken down by the large intestine, and everything else is a sugar. It gets very sciencey, and people who suffer really serious bowel-issues get incredibly technical about it. I just have IBS because of the endo, and tolerate many foods just fine.
This excellent table from Monash University is a really good breakdown of good and bad foods, although it obviously isn’t exhaustive.
As you can see, this diet is also compatible with a vegan diet, and I’d recommend the facebook group “Low FODMAP Vegans” for support and ideas. There’s also a fabulous recipe book called Low-FODMAP and Vegan: What to Eat When You Can’t Eat Anything, which is full of some really tasty recipes. I particularly like the tempeh bacon.
What I really like about this diet is how flexible it is. You can really nail down what specifically causes you problems and in what portions. For instance, I am fine with a bit of gluten (a bowl of cereal, a small sandwich, a slice of cake). However, if I were to try and eat one of those massive sandwiches they make in restaurants with bread slices two hands thick, and then follow it up with a baked doughnut, that amount of gluten would have me reeling in pain. I’m also far more gluten-intolerant during a flare-up. I also used to be far less tolerant than I am now, but have slowly built it back up. That being said, I do limit my gluten intake.
Having said all that, it’s not gluten itself that is the issue in the low FODMAP diet, it’s a particular type of sugar in gluten. Baker’s Delight sells a great low FODMAP bread that isn’t gluten free but it perfectly fine for me. However, many people who need the diet can’t handle gluten at all, so listen to your body.
In the end, I’ve managed to narrow my trigger foods down to the following:
If I eat these things, I will be in pain. Avoiding them doesn’t guarantee that I’ll be pain free, but it does mean I won’t have extra pain.
I would strongly encourage anyone with endometriosis to seriously consider trying either of these two diets. Give either one of them six weeks and see how you go. Worst case scenario, you’ve eaten a boring and restrictive diet for six weeks. Best case, you’ll figure out how to make your diet work for your endometriosis.
Have you already tried one or both of these diets? What works best for you?