Gut
Disclaimer. This web site is for research and educational purposes only. The information given in this site is not intended to replace a therapeutic practitioner relationship.
When it comes to CFS and FMS the gastrointestinal or GI tract is a major area of concern. Almost all sufferers of these conditions are given the label of having irritable bowel syndrome or IBS, which basically means bloating, indigestion and alternating diarrhoea and constipation 'of no specific cause'.
The Vital Role of the GI Tract
When it comes to CFS and FMS, the gastrointestinal (GI) system is critically important to evaluate and optimise. In evaluating the GI system, the following areas should be considered:
1. Digestion: chewing, stomach activity, pancreatic activity, bile salts, small intestinal function.
2. Microbiome: Any parasites? Any dysbiosis? Yeast overgrowth?
3. Food sensitivities: Genetic and acquired.
4. The state of the liver.
5. Nutritional deficiencies: protein, essential fats, minerals, vitamins.
6. Eating habits: times and size of meals, snacking, fasting, bedtime and rise time
7. Other factors that may be impacting gut function: stress, past surgery, exercise, water consumption, potential gut irritants (caffeine, alcohol), heavy metal toxicity, thyroid function.
Considering these seven areas in more detail:
1. Digestion.
What is the state of your teeth? Do you chew your food well? Both fat and carbohydrate digestion begin in the mouth. The importance of proper chewing is underestimated.
Family history is important when it comes to digestion. Is there any family history of pernicious anaemia, inflammatory bowel disease, coeliac disease or pancreatitis?
Do we need to rule out the stomach bug called Helicobacter pylori?
Some medications can interfere with digestion. Drugs designed to reduce the acidity of the stomach (antacid family, ranitidine family, omeprazole family) can potentially interfere with the quality of digestion. Some cases of heart burn are actually caused by too low stomach acid instead of too high. In such cases using apple cidar vinegar about half an hour before meals can bring relief, rather than using a drug to further suppress acid levels.
Sometimes it is necessary to use supplements of digestive enzymes or betaine hydrochloride (hydrochloric acid). This can be especially important in those who are already undernourished because undernourished persons are not likely to have the optimal levels of amino acids needed to construct the enzymes that are used to digest food. Paw paw seeds are high in the protein digesting enzyme papain. You can freeze them and then take some out to chew with meals. I have found them quite useful for stomach digestion issues.
Pancreatic function may also need to be augmented with enzyme supplements. Inflammation of the pancreas due to any reason should be checked for and treated. Malnutrition itself can lead to pancreatic inflammation. Alcohol is another common cause. High dose vitamin C may sometimes help with pancreatic inflammation. Severe cases need hospital intervention.
If fat digestion is inadequate the stools may be greasy or fat may even float on the water of the toilet pan. Flatulence may also be problematic. Bile salts are essential to fat digestion as they are needed to emulsify the fat. Their production can sometimes be stimulated by taking certain herbs about half an hour before meals. Gentian is one example. Attention to general liver health is important in promoting optimum bile salt activity.
Small intestinal function. Glutamine is an amino acid. It is used as a fuel by the cells that line the small intestine and can be a good tonic to promote there health. Gluten can be a big enemy of these cells that line the small intestine. It is often worthwhile doing a trial for four weeks off wheat or all gluten if you have significant bloating, loose stools or indigestion.
2. Microbiome.
In Australia we can now get a stool PCR parasite and pathogenic bacterial test done on Medicare when requested by a doctor. If you do have one of these parasites or pathogens then eradication therapy should be undertaken if at all possible. Sometimes other family members need checking too as you may get reinfected if they also are a carrier.
The best test that I know of for good and bad bacteria is the Faecal Microbial Analysis performed by Bioscreen in Melbourne, Australia. Severe dysbiosis can really muck up the immune system and in my opinion, can even lead to false positives on serology for some stealth bugs, for example on the Lyme IgM Western Blot test. You will really need to pay attention to getting a good quality probiotic. There are many of these supplements that are just a waste of time and money. Some of the most useful that I have used are “Prescript Assist”, “Five-Lac”, “Three-Lac” and some of the Metagenics products. I have some patients who have undergone a faecal microbial transplant (FMT). One patient of mine had a dramatic improvement following FMT with clearing of pretty much all their “lyme symptoms”.
Yeast overgrowth is best dealt with using a strict diet and natural anti-yeast herbs and supplements. Some of the most useful I am familiar with are oregano oil and coconut oil. Olive leaf can be helpful too.
3. Food Sensitivities.
The area of food sensitivities is fraught with challenges. One of the biggest ones is the worry-stomach connection: If you think a food is going to hurt you when you eat it then you are quite likely to get a reaction. It is a kind of self-fulfilling prophecy. So you have to be somewhat careful with tests. If you never had a problem with apples, for example, and the test says “apples are a problem” you might find yourself henceforth having problems with apples because you believe, based on the test that you ought to have problems. It is amazing what confidence we put into tests. Another problem with food sensitivities I call “The Disappearing Diet”. This starts by excluding certain foods and eating lots of the ones that you don't have issues with. But the problem with this is that the more often and the greater amount of a food that you eat, the more likely you are to get sensitive too it. So more foods are added to the every increasing list of reactive items. Until you are only on two or three foods, which you eat lots of and very often. In addition to the above two challenges, it is also true that food sensitivities can wax and wane depending on your general health. They can also change so that two food sensitivity panels done a few weeks apart can be quite different.
Having said the above, there are five foods that are well established as being generally reactive and common causes of food sensitivity. It is often worthwhile doing a trial off these one at a time to see if there is any difference. If you do improve then they are likely to be a long term issue. But they may still not be a permanent issue. You may be able to tolerate small amounts every now and then. These five foods are gluten (particularly wheat), dairy, soy, chicken eggs and corn.
For general food sensitivity problems, in my opinion the most important thing to help reduce them is to get rid of gut parasites and optimise the microbiome. Anything that reduces leaky gut is likely to reduce food sensitivities. I believe that leaky gut can be caused by stress, wheat, parasites, certain medications (like anti-inflammatories, oral contraceptives and steroids) and heavy metal toxicity.
4. The Liver
The role of the liver in digestion and assimilation is easily underestimated. The liver manufactures bile salts which are essential for the proper digestion of fats. The liver receives all the nutrients absorbed by the small intestine and processes them. If the small intestine is compromised and toxic substances are absorbed, then the liver has the job of trying to detoxify these poisons. In my experience with CFS and FMS patients it has often been evident that the liver is struggling with its load of work and is not properly able to remove toxins which then go on to produce symptoms. Thus, remedies that can take the pressure off the liver are likely to help patients feel better.
Some of the best treatments for the liver are external applications. Poultices or compresses. A poultice is a wrapped up application of a remedial substance to the skin. For example, one of the best options for absorbing toxins through the skin is the use of a charcoal and ground linseed poultice. Activated charcoal is mixed in with a binding agent, such as ground linseed or any natural mixture of a porridge-like nature. This mixture is then placed in a thin cloth and applied to the skin over the liver and wrapped in something fairly watertight, like plastic food wrap. Then some fairly tight clothing or a bandage is worn over this. With charcoal, you can leave the poultice on for 12 hours. With some other poultices, such as potato, you need to change the application more often, like every 4-6 hours. Compresses are made by applying a liquid to a cloth which is then applied over the affected area and wrapped in a similar manner to a poultice. The main compress used over the liver is a castor oil compress. Medicinal clay is another application over the liver that can be very beneficial. The problem with poultices and compresses is that they are time and energy consuming, which is not helpful for those who are chronically sick. For this reason, sometimes the best way to use these methods is to purchase stick-on ready made 'detox patches' or go where someone can do the poultices for you.
There are many herbs and nutrients that can assist the liver. This is because the liver needs lots of nutrients to work properly. Amino acids, vitamins, minerals and other substances can all be helpful but knowing exactly which ones can be an issue. For this reason, purchasing a ready-made 'liver tonic' is often a good choice. However, if you have a practitioner skilled in liver problems, getting specific advise is likely to be even better. They may be able to organise a 'Functional Liver Detoxification Profile" to better assess what is going on. If you use some tablet or powder for the liver and find that on using it you feel worse, then this product probably is not for you and may be making the job of the liver harder or interacting with something else you are using.
Coffee enemas have been used widely as a means of detoxing the liver. I have had many patients report excellent results from using these enemas. However, it is invasive and does have its risks. For this reason, my personal preference is using external applications while keeping the bowels working well by taking things by mouth. Patients who do have really massive constipation issues or faecal impaction will however usually benefit from the use of enemas or a colonic irrigation in order to get things moving. Such procedures should be done by properly trained personal.
5. Nutritional deficiencies
A fairly common deficiency state is called Type II Malnutrition. In this state protein, magnesium and zinc are all deficient. These three nutrients are sympathetic to one another. If, for example, magnesium is low, then zinc and protein will drop in order to match. So in order to treat Type II Malnutrition you need to give bioavailable forms of all three: protein, magnesium and zinc. If you are having problems keeping one of these three at a normal level in your system, it may be because one of the other two are low.
Iron deficiency complicates many areas of health and is definitely something that those with CFS and FMS won't to avoid. Vitamin C taken with meals in the form of lemon juice or a supplement will greatly assist in the absorption of iron from meals. You do not have to eat lots of red meat in order to have normal iron. If you are a lady with heavy periods then this is very important to address if it is contributing to iron deficiency. Heavy and irregular periods may be due to thyroid problems and low iron itself can ironically be a cause of heavy periods. Finding an oral iron supplement that does not upset the gut can be a problem for many. Liquid forms or capsules with liquid in them are often kinder on the stomach. A natural food very high in iron is a mixture of kelp powder, molasses and organic lemon (rind and all). One dessert spoon twice a day. This has far more iron in than the highest meat source. But it does also contain a very large amount of iodine which potentially can upset thyroid function in susceptible people. Sometimes an iron infusion or iron injections are needed to get things out of the danger zone.
Water is a nutrient. It is the most abundant one in the human body. Partial dehydration can cause many of the symptoms of CFS or FMS, especially brain fog, fatigue, headache, muscle ache and constipation. Try and make sure that the drinking water you use is as free of contaminants as possible. Usually filtered tap water or bought water is best. Straight tap water is usually a problem. Aluminium in tap water can, in my experience, add to fatigue problems by building up in the systems of some people.
Lack of essential fatty acids can aggravate inflammation. If you are going to use fish oil supplements, please use high grade products that guarantee freedom from heavy metal contamination.
6. Eating habits
I have found that eating late, large evening meals promotes weight gain, sleep and mood disturbance and blood sugar problems. Often having a large meal at night leads to a very low appetite for food at breakfast time, the very time when your body needs fuel to organise good blood sugar levels for the day. If you want to lose weight I recommend moving food earlier in the day – less dinner and more breakfast.
There are exceptions, but in most cases I recommend two or three meals a day with only water or herbal teas between. If eating of meals and snacks is too close together then delayed gastric emptying and fermentation may result.
Fasting can be beneficial for your health, but you do need to be careful. I would recommend first discussing this with a health practitioner familiar with fasting before trying it. Diabetics or those on medication, especially epileptics are likely best to avoid fasting or get specialist advise. I don't believe in fasting pregnant ladies or young children except in exceptional circumstances, which would normally mean some illness that requires hospitalisation. For those who are trying it, then one simple method is just to miss the evening meal or to have juice instead. This will give you a fast from lunchtime through to the next breakfast, which is approximately 18 hours. Fasting can give the gastrointestinal system assistance in healing and also assist in detoxification. Make sure you keep up your fluids when fasting, but don't overdo your water intake either. Four litres of water is a bit much over 12-18 hours for many people. Too much water can drop your blood sodium (salt) levels which is not good.
7. Other factors
The brain-gut connection is very strong. You need to relax when it comes to eating. Digestion is one of those things that you do better when you are relaxed and not thinking about it. Eating socially, with other people, is often helpful in getting your mind of yourself and in relaxing.
Past surgery on or around the gastrointestinal system may affect your ability to digest certain foods. You will need to discuss this with a doctor familiar with the surgery performed. Having the gall bladder removed may sometimes reduce your tolerance to fatty meals.
Light, relaxing exercise after a meal should be beneficial to digestion. But avoid violent or extreme exercise shortly before or after a meal as this may reduce the digestive powers of your system.
Avoid drinking large amounts of cold water or juice at meals as this will reduce the digestive powers of your system. The stomach will need to warm up the gastric juices and concentrate them by removing water before optimal digestion can occur.
Sometimes caffeine or alcohol can contribute to an irritable gut and lead to diarrhoea or bloating.
Heavy metal poisoning can lead to a mysterious stomach or abdominal pain that doctors not familiar with chronic poisoning find difficult to explain.
Low thyroid function can slow the digestion and result in constipation. Over active thyroid function can cause diarrhoea.
Mutations or polymorphisms can affect the liver's ability to detoxify drugs or toxic substances. If you notice that you are particularly sensitive to medications then you may have an issue here and extra liver support may be helpful. Pyrroles are another issue. They are a substance that can build up in the system of some people resulting in symptoms of fatigue and mental disturbance. There is a urine test to check for this problem (the best one I have used so far is called 'Mauve Factor'). If you have pyrroluria then zinc and P5P supplements may be helpful.
Weight management and food go together, of course. This is often a big area of challenge for those with CFS and fibromyalgia due to their reduced energy expenditure. Those interested in exploring weight loss options could contact my wife, Lorna Bird, who is a certified health coach with a special interest in helping people achieve realistic weight loss goals. Her email is lornahealthcoach@gmail.com
The Vital Role of the GI Tract
When it comes to CFS and FMS, the gastrointestinal (GI) system is critically important to evaluate and optimise. In evaluating the GI system, the following areas should be considered:
1. Digestion: chewing, stomach activity, pancreatic activity, bile salts, small intestinal function.
2. Microbiome: Any parasites? Any dysbiosis? Yeast overgrowth?
3. Food sensitivities: Genetic and acquired.
4. The state of the liver.
5. Nutritional deficiencies: protein, essential fats, minerals, vitamins.
6. Eating habits: times and size of meals, snacking, fasting, bedtime and rise time
7. Other factors that may be impacting gut function: stress, past surgery, exercise, water consumption, potential gut irritants (caffeine, alcohol), heavy metal toxicity, thyroid function.
Considering these seven areas in more detail:
1. Digestion.
What is the state of your teeth? Do you chew your food well? Both fat and carbohydrate digestion begin in the mouth. The importance of proper chewing is underestimated.
Family history is important when it comes to digestion. Is there any family history of pernicious anaemia, inflammatory bowel disease, coeliac disease or pancreatitis?
Do we need to rule out the stomach bug called Helicobacter pylori?
Some medications can interfere with digestion. Drugs designed to reduce the acidity of the stomach (antacid family, ranitidine family, omeprazole family) can potentially interfere with the quality of digestion. Some cases of heart burn are actually caused by too low stomach acid instead of too high. In such cases using apple cidar vinegar about half an hour before meals can bring relief, rather than using a drug to further suppress acid levels.
Sometimes it is necessary to use supplements of digestive enzymes or betaine hydrochloride (hydrochloric acid). This can be especially important in those who are already undernourished because undernourished persons are not likely to have the optimal levels of amino acids needed to construct the enzymes that are used to digest food. Paw paw seeds are high in the protein digesting enzyme papain. You can freeze them and then take some out to chew with meals. I have found them quite useful for stomach digestion issues.
Pancreatic function may also need to be augmented with enzyme supplements. Inflammation of the pancreas due to any reason should be checked for and treated. Malnutrition itself can lead to pancreatic inflammation. Alcohol is another common cause. High dose vitamin C may sometimes help with pancreatic inflammation. Severe cases need hospital intervention.
If fat digestion is inadequate the stools may be greasy or fat may even float on the water of the toilet pan. Flatulence may also be problematic. Bile salts are essential to fat digestion as they are needed to emulsify the fat. Their production can sometimes be stimulated by taking certain herbs about half an hour before meals. Gentian is one example. Attention to general liver health is important in promoting optimum bile salt activity.
Small intestinal function. Glutamine is an amino acid. It is used as a fuel by the cells that line the small intestine and can be a good tonic to promote there health. Gluten can be a big enemy of these cells that line the small intestine. It is often worthwhile doing a trial for four weeks off wheat or all gluten if you have significant bloating, loose stools or indigestion.
2. Microbiome.
In Australia we can now get a stool PCR parasite and pathogenic bacterial test done on Medicare when requested by a doctor. If you do have one of these parasites or pathogens then eradication therapy should be undertaken if at all possible. Sometimes other family members need checking too as you may get reinfected if they also are a carrier.
The best test that I know of for good and bad bacteria is the Faecal Microbial Analysis performed by Bioscreen in Melbourne, Australia. Severe dysbiosis can really muck up the immune system and in my opinion, can even lead to false positives on serology for some stealth bugs, for example on the Lyme IgM Western Blot test. You will really need to pay attention to getting a good quality probiotic. There are many of these supplements that are just a waste of time and money. Some of the most useful that I have used are “Prescript Assist”, “Five-Lac”, “Three-Lac” and some of the Metagenics products. I have some patients who have undergone a faecal microbial transplant (FMT). One patient of mine had a dramatic improvement following FMT with clearing of pretty much all their “lyme symptoms”.
Yeast overgrowth is best dealt with using a strict diet and natural anti-yeast herbs and supplements. Some of the most useful I am familiar with are oregano oil and coconut oil. Olive leaf can be helpful too.
3. Food Sensitivities.
The area of food sensitivities is fraught with challenges. One of the biggest ones is the worry-stomach connection: If you think a food is going to hurt you when you eat it then you are quite likely to get a reaction. It is a kind of self-fulfilling prophecy. So you have to be somewhat careful with tests. If you never had a problem with apples, for example, and the test says “apples are a problem” you might find yourself henceforth having problems with apples because you believe, based on the test that you ought to have problems. It is amazing what confidence we put into tests. Another problem with food sensitivities I call “The Disappearing Diet”. This starts by excluding certain foods and eating lots of the ones that you don't have issues with. But the problem with this is that the more often and the greater amount of a food that you eat, the more likely you are to get sensitive too it. So more foods are added to the every increasing list of reactive items. Until you are only on two or three foods, which you eat lots of and very often. In addition to the above two challenges, it is also true that food sensitivities can wax and wane depending on your general health. They can also change so that two food sensitivity panels done a few weeks apart can be quite different.
Having said the above, there are five foods that are well established as being generally reactive and common causes of food sensitivity. It is often worthwhile doing a trial off these one at a time to see if there is any difference. If you do improve then they are likely to be a long term issue. But they may still not be a permanent issue. You may be able to tolerate small amounts every now and then. These five foods are gluten (particularly wheat), dairy, soy, chicken eggs and corn.
For general food sensitivity problems, in my opinion the most important thing to help reduce them is to get rid of gut parasites and optimise the microbiome. Anything that reduces leaky gut is likely to reduce food sensitivities. I believe that leaky gut can be caused by stress, wheat, parasites, certain medications (like anti-inflammatories, oral contraceptives and steroids) and heavy metal toxicity.
4. The Liver
The role of the liver in digestion and assimilation is easily underestimated. The liver manufactures bile salts which are essential for the proper digestion of fats. The liver receives all the nutrients absorbed by the small intestine and processes them. If the small intestine is compromised and toxic substances are absorbed, then the liver has the job of trying to detoxify these poisons. In my experience with CFS and FMS patients it has often been evident that the liver is struggling with its load of work and is not properly able to remove toxins which then go on to produce symptoms. Thus, remedies that can take the pressure off the liver are likely to help patients feel better.
Some of the best treatments for the liver are external applications. Poultices or compresses. A poultice is a wrapped up application of a remedial substance to the skin. For example, one of the best options for absorbing toxins through the skin is the use of a charcoal and ground linseed poultice. Activated charcoal is mixed in with a binding agent, such as ground linseed or any natural mixture of a porridge-like nature. This mixture is then placed in a thin cloth and applied to the skin over the liver and wrapped in something fairly watertight, like plastic food wrap. Then some fairly tight clothing or a bandage is worn over this. With charcoal, you can leave the poultice on for 12 hours. With some other poultices, such as potato, you need to change the application more often, like every 4-6 hours. Compresses are made by applying a liquid to a cloth which is then applied over the affected area and wrapped in a similar manner to a poultice. The main compress used over the liver is a castor oil compress. Medicinal clay is another application over the liver that can be very beneficial. The problem with poultices and compresses is that they are time and energy consuming, which is not helpful for those who are chronically sick. For this reason, sometimes the best way to use these methods is to purchase stick-on ready made 'detox patches' or go where someone can do the poultices for you.
There are many herbs and nutrients that can assist the liver. This is because the liver needs lots of nutrients to work properly. Amino acids, vitamins, minerals and other substances can all be helpful but knowing exactly which ones can be an issue. For this reason, purchasing a ready-made 'liver tonic' is often a good choice. However, if you have a practitioner skilled in liver problems, getting specific advise is likely to be even better. They may be able to organise a 'Functional Liver Detoxification Profile" to better assess what is going on. If you use some tablet or powder for the liver and find that on using it you feel worse, then this product probably is not for you and may be making the job of the liver harder or interacting with something else you are using.
Coffee enemas have been used widely as a means of detoxing the liver. I have had many patients report excellent results from using these enemas. However, it is invasive and does have its risks. For this reason, my personal preference is using external applications while keeping the bowels working well by taking things by mouth. Patients who do have really massive constipation issues or faecal impaction will however usually benefit from the use of enemas or a colonic irrigation in order to get things moving. Such procedures should be done by properly trained personal.
5. Nutritional deficiencies
A fairly common deficiency state is called Type II Malnutrition. In this state protein, magnesium and zinc are all deficient. These three nutrients are sympathetic to one another. If, for example, magnesium is low, then zinc and protein will drop in order to match. So in order to treat Type II Malnutrition you need to give bioavailable forms of all three: protein, magnesium and zinc. If you are having problems keeping one of these three at a normal level in your system, it may be because one of the other two are low.
Iron deficiency complicates many areas of health and is definitely something that those with CFS and FMS won't to avoid. Vitamin C taken with meals in the form of lemon juice or a supplement will greatly assist in the absorption of iron from meals. You do not have to eat lots of red meat in order to have normal iron. If you are a lady with heavy periods then this is very important to address if it is contributing to iron deficiency. Heavy and irregular periods may be due to thyroid problems and low iron itself can ironically be a cause of heavy periods. Finding an oral iron supplement that does not upset the gut can be a problem for many. Liquid forms or capsules with liquid in them are often kinder on the stomach. A natural food very high in iron is a mixture of kelp powder, molasses and organic lemon (rind and all). One dessert spoon twice a day. This has far more iron in than the highest meat source. But it does also contain a very large amount of iodine which potentially can upset thyroid function in susceptible people. Sometimes an iron infusion or iron injections are needed to get things out of the danger zone.
Water is a nutrient. It is the most abundant one in the human body. Partial dehydration can cause many of the symptoms of CFS or FMS, especially brain fog, fatigue, headache, muscle ache and constipation. Try and make sure that the drinking water you use is as free of contaminants as possible. Usually filtered tap water or bought water is best. Straight tap water is usually a problem. Aluminium in tap water can, in my experience, add to fatigue problems by building up in the systems of some people.
Lack of essential fatty acids can aggravate inflammation. If you are going to use fish oil supplements, please use high grade products that guarantee freedom from heavy metal contamination.
6. Eating habits
I have found that eating late, large evening meals promotes weight gain, sleep and mood disturbance and blood sugar problems. Often having a large meal at night leads to a very low appetite for food at breakfast time, the very time when your body needs fuel to organise good blood sugar levels for the day. If you want to lose weight I recommend moving food earlier in the day – less dinner and more breakfast.
There are exceptions, but in most cases I recommend two or three meals a day with only water or herbal teas between. If eating of meals and snacks is too close together then delayed gastric emptying and fermentation may result.
Fasting can be beneficial for your health, but you do need to be careful. I would recommend first discussing this with a health practitioner familiar with fasting before trying it. Diabetics or those on medication, especially epileptics are likely best to avoid fasting or get specialist advise. I don't believe in fasting pregnant ladies or young children except in exceptional circumstances, which would normally mean some illness that requires hospitalisation. For those who are trying it, then one simple method is just to miss the evening meal or to have juice instead. This will give you a fast from lunchtime through to the next breakfast, which is approximately 18 hours. Fasting can give the gastrointestinal system assistance in healing and also assist in detoxification. Make sure you keep up your fluids when fasting, but don't overdo your water intake either. Four litres of water is a bit much over 12-18 hours for many people. Too much water can drop your blood sodium (salt) levels which is not good.
7. Other factors
The brain-gut connection is very strong. You need to relax when it comes to eating. Digestion is one of those things that you do better when you are relaxed and not thinking about it. Eating socially, with other people, is often helpful in getting your mind of yourself and in relaxing.
Past surgery on or around the gastrointestinal system may affect your ability to digest certain foods. You will need to discuss this with a doctor familiar with the surgery performed. Having the gall bladder removed may sometimes reduce your tolerance to fatty meals.
Light, relaxing exercise after a meal should be beneficial to digestion. But avoid violent or extreme exercise shortly before or after a meal as this may reduce the digestive powers of your system.
Avoid drinking large amounts of cold water or juice at meals as this will reduce the digestive powers of your system. The stomach will need to warm up the gastric juices and concentrate them by removing water before optimal digestion can occur.
Sometimes caffeine or alcohol can contribute to an irritable gut and lead to diarrhoea or bloating.
Heavy metal poisoning can lead to a mysterious stomach or abdominal pain that doctors not familiar with chronic poisoning find difficult to explain.
Low thyroid function can slow the digestion and result in constipation. Over active thyroid function can cause diarrhoea.
Mutations or polymorphisms can affect the liver's ability to detoxify drugs or toxic substances. If you notice that you are particularly sensitive to medications then you may have an issue here and extra liver support may be helpful. Pyrroles are another issue. They are a substance that can build up in the system of some people resulting in symptoms of fatigue and mental disturbance. There is a urine test to check for this problem (the best one I have used so far is called 'Mauve Factor'). If you have pyrroluria then zinc and P5P supplements may be helpful.
Weight management and food go together, of course. This is often a big area of challenge for those with CFS and fibromyalgia due to their reduced energy expenditure. Those interested in exploring weight loss options could contact my wife, Lorna Bird, who is a certified health coach with a special interest in helping people achieve realistic weight loss goals. Her email is lornahealthcoach@gmail.com
Images and content © D. Bird 2017