So you’ve been struggling with chronic loose stool for awhile and despite taking Imodium and trying the meds your doctors has provided you, it’s not resolving. I know this problem all too well, as this was my journey for many years before I acquired the knowledge and tools to help myself. I also know the humiliation, suffering, and self-esteem hits that come with this particular health struggle - whether you have no diagnosis, you’ve been told you have IBS-D or colitis.
While most people start with over the counter drugs like Imodium and potentially a symptom-reducing med their doctor might offer, these solutions often don’t work well and the suffering continues. Eventually, if you are like me at the beginning of my struggle, you fall into a routine of taking some combination of meds and supplements to trial and error keeping the symptoms in check, despite struggling with frustrating and embarrassing flare-ups. You probably honestly aren’t even sure if what you are taking is actually helping, but have read or been told to take these things, so you do.
In this article, I want to offer you my top 3 tips to help manage your chronic loose stool more effectively on your own and help you identify the 1-2 supplements that will likely have the biggest impact on your symptoms. This is meant to be a short DIY beginners guide that, at a minimum, should help you somewhat, and at best, may give you a workable solution for life (how about that!).
Tip #1 Get the gluten out!
If there is one aspect of your diet to focus on, it is gluten and removing all of it. This includes all wheat and wheat component proteins, including gluten. Why is gluten so important to get out? For two reasons. One: those prone to chronic loose stool, IBS-D and colitis are far more likely to have genes that make them more sensitive and intolerant to gluten than the rest of the population. Research has actually shown this to be the case (https://pubmed.ncbi.nlm.nih.gov/29160841/ and https://pubmed.ncbi.nlm.nih.gov/32558265/). Two: even healthy people who eat gluten regularly still have a significant and prolonged zonulin response to the gluten every time they get exposure. Dr. Tom O’Bryan is a leader in the field of gluten research and explains this in the following article: https://thedr.com/about-leaky-gut/. What this means is that the body produces a substance in the gut called zonulin to help regulate the openings between the cells of the gut lining, which helps the body let out the substances that need to get out of the gut, while also keeping things in the gut that should stay in. When too much zonulin gets trigged by gluten consumption, it leads to a situation of more opening between those gut cells than is ideal, which can also create opportunities for food particles to “leak” out into the bloodstream and activate the immune system because they shouldn’t be there. This is essentially the process of “leaky gut” and is often thought to be at play in most autoimmune conditions. We want to avoid all foods that provoke that kind of leaky gut response, which is, first and foremost, gluten. Make sure to read all labels of any packaged foods you purchase at the grocery store. I go so far as to recommend to my clients to only purchase items that are specifically labeled “gluten-free,” just to be sure. If you are purchasing whole foods such as produce, cuts of meat, nuts, seeds, beans, and legumes, you are likely just fine as gluten should not be showing up in those foods. With any grains you regularly eat, please do an online search to verify that they do not contain gluten. Also, realize that any gray area packaged foods that contain spices, seasonings, sauces, etc. that are not specifically labeled gluten free can still have gluten via one of those added ingredients. And, if you eat out on a regular basis, I highly recommend you search for a local restaurant that offers a gluten-free menu and separate fryer for gluten-free fries. There will likely still be some cross contamination in a gluten-free menu type restaurant setting, but the exposure will be much lower than eating out at a conventional restaurant. Noticing the benefits from gluten avoidance can take some time, up to 3-6 months in certain cases, which is the average lifespan of the IgG antibodies that are often produced in individuals with gluten intolerance, long-term dietary exposure, and immune activation. Also, if your case is complex, you may need to do more than just eliminate gluten to notice improvement. This was the case with me. I still highly encourage you to remain as gluten-free as possible as you are recovering your gut health, even if you don’t notice direct improvement. I assure you, there is likely an extra contributing inflammatory stress to your health struggle just by eating gluten.
Tip #2 Support your stomach and pancreas.
These are the organs first in line to work on the food you consume and we want to make sure they are digesting well to lessen the burden on the intestines further down the track. Most people struggling with chronic loose stool, IBS-D, and colitis have symptoms that express in the small or large intestines, but that doesn’t mean the dysfunction starts there! In nutrition therapy, we say digestion is a “north to south” process and you need to start at the northern most end with your support for any support further south to be effective. Two very safe and basic ways to support your stomach and pancreas are: including apple cider vinegar or fresh lemon juice before a meal and making sure you take a high strength comprehensive pancreatic enzyme. You want to support robust stomach acid production and supplement your pancreas’ ability to produce enzymes because many people struggling with chronic loose stool do not make enough stomach acid and often have a low elastase value on stool testing. Elastase is reflection of pancreatic enzyme status, and if the value is low, you are likely underproducing pancreatic enzymes. Stomach acid and enzymes are both needed in good amounts to properly break down your food and make sure your intestines are not burdened with the additional job of handling maldigested food from the stomach and pancreas above. Maldigested food traveling through the intestines in and of itself, sets up a ripe environment for chronic loose stool due to a number of reasons. We want to help your body naturally correct these shortages of digestive fluids. Apple cider vinegar and lemon juice both have properties that naturally encourage your stomach to produce more stomach acid, and are safe to use at home on a daily basis. I recommend starting with 1 T of either apple cider vinegar or lemon juice in a 1/2 glass of room temperature water 15-20 minutes before a meal to start signaling the stomach to ramp up its acid production. Then, at the end of your meal, I recommend taking 2 high quality enzyme supplements to support pancreatic function. To order the high quality, high strength pancreatic enzyme I recommend to my clients, please click the following link to access my online dispensary and create an account: https://bit.ly/3sqaWMq
Tip #3 If you try probiotics, start with a high quality spore-based probiotic first.
I want to warn you that many of my clients simply cannot tolerate any probiotics in the beginning because their guts are so dysfunctional and reactive. So we often need to work on supporting deeper layers of gut dysfunction and addressing any hidden infections first, before introducing probiotics. However, as a DIY approach, I do encourage you to try a high quality spore based probiotic and see how that goes. The reason I recommend spore based probiotics is that they tend to migrate all the way to the colon (where the majority of your bacteria should live) and are less likely to contribute to overgrowth of bacteria in the small intestine. This is a condition called Small Intestinal Bacteria Overgrowth (SIBO), that is understood to go hand-in-hand with upwards of 75% of all IBS-D and IBD conditions. I won’t go into SIBO in this post, but understand that it’s a tricky condition to resolve and taking probiotic supplements can often make the symptoms worse - especially poor quality probiotics or the lacto-bacillus probiotic blends, which are commonly found at Walgreens and your local nutrition store. You want to avoid these and find a 100% spore based probiotic instead. The brand I love to start with is Megasporebiotic by Microbiome Labs. This particular blend of spore based probiotics was originally harvested from a healthy human gut and has been extensively studied in multiple chronic health conditions, including IBS, and has shown measurable improvement in reconditioning the gut and improving the symptoms of diarrhea, bloating, and constipation. This is a strong probiotic though, and if you choose to try this one, I recommend opening up the capsule and adding 1/2 capsule to a protein shake or applesauce every other day for one week. Up your dosage to 1/2 capsule per day for week 2. Increase to 1 capsule a day for week 3, and finally go up to and settle at 2 caps per day for week 4 and beyond. Sometimes very sensitive and reactive guts need to go even lower and slower to start. Megaspore is only available through credentialed health care providers. If you decide to try Megaspore, you can purchase it from my online dispensary here: https://bit.ly/3qakfNA
Please email me at courtney@courtneycowie.com if you have trouble setting up an online order account obtain either a high quality enzyme or probiotic supplement.
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