Rehab for the Gut

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They tried to make me go to rehab, I said, “No, no, no”

Amy Winehouse

Rehab for the digestive system?  If you’ve been sick for many years like most people who find this site, then it’s time to take your system to Rehab and stop crying ‘No, No No!’ 

You wouldn’t put your newborn baby in the garage exposed to noise, cold and toxic chemicals. Don’t do this to your new flora. Prepare a welcoming, nurturing home for it.  Don’t expect it to thrive if you haven’t got the basics covered.  Be prepared.  The last thing you want to inflict on your new flora is the ravages of trial and error while its trying to settle. 

If you are considering spending money on a FMT clinic or approaching and testing prospective donors, it is worth addressing as many perpetuating factors as possible before taking the plunge.  The exception is if you have C. Diff which is known to respond well to FMT in 93% of cases. 

We all want FMT to be a Silver Bullet but the reality is that many cyber-sufferers who discover this site are the unlucky portion of the population who are predisposed to bacterial imbalance in the gut known as ‘intestinal dysbiosis’.  All it takes is a trigger such as anti-biotics, anti-inflammatories or food poisoning to push us over the edge. Before you know it you’re on a google-a-thon looking for a fecal transplant. 

FMT is a significant tool in your Rehab toolbox – and it’s likely to do a better job of replenishing your intestinal flora than probiotics, prebiotics or fermented food. But to get the best out of it you also need to rule out other factors that may be perpetuating your dysbiosis. Digestion is a complex process and a holistic approach to recovery will be necessary for most.  

Unmasking Your Perpetuating Factors

So what’s does Rehab for the digestive system involve? Lots of people take our money suggesting that there is a linear roadmap to recovery.  In fact the journey is different for everyone.  I’ve spent the last year unravelling one clue only to be thrown another.  It’s been like watching a bad detective show on TV only it doesn’t end after an hour or a season – and you can’t turn it off.

The longer you’ve been sick, the longer the list of perpetuating factors you will be likely to accumulate. Dysbiosis is only one of these. Below is a checklist of Perpetuating Factors to consider as part of your decision to undergo FMT. Some are straightforward and can be addressed before FMT, the rest will depend on your symptoms, financial position, access to FMT and the urgency of your condition. The more that you investigate before FMT, the higher your chance of success.  Familiarise yourself with each so you know what to look for. 

This list will give you areas to research or discuss with your health practitioner. It is in no particular order of priority. 

  1. Diet (GAPSSCDPaleoBED PHD Elemental Diet or whatever works) 

  2. Nutrition

  3. Dysbiosis (FMT, pro-biotics, fermented foods) 

  4. SIBO

  5. Leaky gut

  6. Low/high stomach acid & digestive enzymes

  7. Allergies / Intolerances

  8. Liver overload

  9. Methylation / Histamine / Pyroluria

  10. Systemic inflammation / Autoimmune disease

  11. Low thyroid  / Hormones / Adrenals

  12. Stress   (don’t underestimate it)

After an initially fantastic result with FMT I’ve gone backwards because I made the mistake of thinking there was only one thing wrong with me. So I’ve spent the last year working my way through this list, assisted where possible by functional pathology testing through a practitioner who has a clue how to interpret the results.  The rest of the detective work I’ve done myself. It’s amazing what you can learn by reading the research and talking to others on a similar journey.

There’s a lot to say on each perpetuating factor but that’s beyond the scope of this post. Check out the links above for plain-english, brain-fog resistant information sources. There are other useful links in the Resources menu. 

A word on health practitioners

In my experience most practitioners don’t have a plan and prefer to fight fires as they occur. How well has that worked for you so far?  If your practitioner is unfamiliar with the perpetuating factors listed above, doesn’t know how to treat them or is unwilling to partner you in a Rehab plan, then it might be time to find another.  

You need a practitioner who knows more than you can read on the Internet. If you can’t find one locally then why not locate a Digestive Illness Coach who will consult by Skype or email and has been through this journey themselves?  You’re too sick to pay to sit in someone’s office humouring their ego as they tell you what you already know, or prescribe yet another round of broad spectrum anti-biotics that will make you feel better for a week, worse forever and contribute to the rise of super-bugs and degradation of the human microbe biome.

Take a good look at the service you’ve received from your practitioner and if you’re not happy, find a new one. You wouldn’t put up with indifference from a mechanic or politician, don’t put up with it from a health practitioner. 

DIY e-Patients

Some of us have ended up DIY e-Patients by default, rather than choice.  This could be due to financial constraints or simply because no one cares as much about your health as you do. Nowadays I have my own Rehab plan and seek the advice of a doctor and natural practitioner along the way. You’re the one that has to live in your body and suffer this illness, so you need to take charge and drive your recovery plan.

However remember that it’s prudent to consult as widely as possible.  Arrogance could be your downfall. It’s particularly important to ensure you have exhausted the usual gamut of mainstream medical testing: colonoscopy / endoscopy / ultrasound / bloodwork / fecal pathology. You don’t want to overlook the obvious. 

Preparing your Rehab plan

Preparing a plan is essential to give you a sense of control in circumstances where most likely you feel your health is in free-fall. It will take discipline and focus, but what other choice do you have? 

To prepare your Rehab plan, research those perpetuating factors on the above list that you feel might be a factor. Then prepare a plan that addresses each one in order of priority depending on your situation.

Your plan does NOT have to be a neatly presented grammatically correct PHD thesis (have you noticed how many people with gut problems are perfectionists?) Only you are going to read your plan so just prepare a one page list, with a priority number next to each factor and bullet points under each to trigger an action. Finally, decide where FMT fits in your plan. For some it will be at the top of the list, for others it will be lower down. 

Many of you will be familiar with the SMART goal acronym. To be meaningful a goal must be Specific, Measurable, Achievable, Realistic and Timebound.  ‘Get better soon’ does not qualify as a goal. The smallest journey starts with one step and setting small goals breaks your journey  into little steps to ensure that you move forward, rather than ending up in wishful thinking or collapsing from information overload. ‘Get better soon’ is the destination but you won’t arrive there without all the steps in between.

As with all plans yours must be sufficiently flexible to accommodate new developments and circumstances. If you’re not happy with your plan, change it. 

What if you’re too busy to prepare a Rehab plan? Then stop reading, turn off your computer and go for a walk. Enjoy your health while it lasts. Keep crying No, No, No!  Your Rehab plan will wait until you are sick enough to make the time.

Once you are committed to your plan, live it. Keep it on your phone or wherever you keep all your valued data.  Record daily your diet, treatment, symptoms and results. Review, interrogate and tweak your plan every morning before you get out of bed. Whatever you do, don’t give up. You future depends on it.

A chain is only as strong as its weakest link…

Proverb