EP.295/ How to optimise digestion for less endo belly
Today we’re doing another clip from my course, Live and Thrive with Endo 2.0 as I am still getting over covid and what has turned out to be several of the most stressful days I’ve ever experienced (more on that another time).
During the past couple of days, I’ve not had access to the internet and so I wasn’t able to share that the course doors were closing for enrolment or even actually close the doors, so if you want to sigh up, you still can. I’m likely going to leave the doors open until Sunday or Monday, so just for a few more days.
Today’s lesson is all about first line therapies for optimising digestion, this is one lesson of three and this one is mainly about how you’re eating and what you’re eating. If you have a lot of bloating and endo belly, I would really pay attention to the sections on chewing, mindful eating and boosting stomach acid, digestive enzymes and bile and work on those first.
If you’re curious about the course, you can learn more at www.theendobellycoach.com/live-thrive-with-endo or just go to the link in my show notes here.
How to Approach Endo Belly/Gut Healing
Before we go into this, I want to talk about how to approach endo belly healing because this is a big topic and I want to help you to avoid overwhelm.
For most of us with endo, gut healing is likely going to take time because there’s usually a few things going on like SIBO and adhesions. But, for some people, certain issues like leaky gut, can heal within weeks or months and for many, these first line therapies will make a noticeable difference on gut health.
So, these therapies I discuss in this module can be implemented across a couple of months - three is usually a good time frame, but often we’ll need to do more extensive treatment which will take longer, like candida eradication or SIBO healing. But regardless of those conditions, these basic foundational therapies I’ll share in this module can be done by everyone (there’s a few tweaks that can be made to tailor and personalise) and though three months is a good time frame, take all of this at a pace that feels right for you. If you want to make one change per month and spend a year on healing your gut, do it!
If you ever feel overwhelmed on your gut healing process, slow down, go back to basics and take it step by step. This isn’t a race; this is about long-term healing and long-term healing can only be achieved if it’s something we can continue to commit to and it’s not stressing us out to do.
If you feel overwhelmed at any point in this module, just know that I’m here to provide all the information - that’s my role here, so yes, there is a lot, but that doesn’t mean that you have to do it all or do it exactly the way I’ve said! Make sure this fits you every step of the way.
Stress and Gut Healing
So, we’re starting with stress first because what I’ve noticed with clients is that pretty much all of them are living with chronic stress or some kind of unresolved trauma, and it actually affects their healing and how they feel about healing. So much so that I now consider it, for our community at least, as really something to be addressed as early as possible into the healing process, even before the direct gut healing protocols in some cases.
In this lesson, I want to give you a foundation on how stress affects the gut and some simple strategies to start rewiring the brain’s response to stress and to improve the gut-brain connection.
If you feel overwhelmed, anxious, or stressed on an everyday basis or you’re worried about healing your endo belly, then I would start here and actually spend some time putting in place some support strategies for your stress. Depending on what’s going on for you, you might do better spending a couple of months working on this before you even think about starting to directly work on the gut.
So, our digestion is affected by the parasympathetic nervous system and the sympathetic nervous system. We covered the nervous system in Module 4, but let’s do a quick recap.
The sympathetic nervous system is the system in the body known for the ‘flight or fight’ response which is our stress response. When we’re ill, stressed, injured, threatened in any way whether it’s from an underlying infection or condition or just too many emails, this is the response that’s triggered. This is our survival response which pumps out adrenaline and cortisol, and directs blood, oxygen and glucose to the brain, heart and lungs so we can prepare to run or fight.
In contrast, the parasympathetic nervous system is the system in the body known for the ‘rest and digest’ response. It is the system that activates when we’re asleep or resting and is responsible for digestion and repair in the body. When this system isn’t on, we can’t digest food or heal.
Because the flight or fight response is essential to our survival, when this is on, the ‘rest and digest response’ is turned off. Energy is directed away from non-essential functions in the body like digestion, reproduction and healing. Effectively, stress from rushing, over-exercising, worrying, anxiety, over-working, inflammation, chronic pain, etc. shuts down the digestion process and as a result, depletes stomach acid, digestive enzymes and digestive juices and causes IBS reactions.
And of course, as you know now, stress also damages the gut lining and the microbiome.
So, we can throw all the supplements we want at our gut, but if we’re rushing our food or constantly stressed, our guts won’t heal, we probably won’t even absorb the supplements and the issues will continue.
Now, clearly, we can’t eliminate stress from our lives completely - we have to be realistic! But we can practice actively moving into ‘rest and digest’ and moving out of ‘flight or fight’ on a daily basis, so that our bodies learn to move into this state rather than staying stuck in a state of constant survival. The more we practice this, the stronger our ability to move into ‘rest and digest’ on a regular basis will become.
So, there are some practices and activities which have been proven to reduce cortisol levels and move us into the parasympathetic response. They include:
· Yoga
· Breathwork, even just a couple of minutes of slow breathing, especially with the exhale longer than the inhale. I’m going to share with you a couple of breathing strategies you might want to try in this lesson.
· Meditation
· Being in nature (walking in woodlands especially)
· Finding a support network (This is particularly relevant in people who have ovaries and a uterus. In research, females have been shown to be driven to connect with others by oxytocin during times of stress and it actually helps to buffer the damage of stress on the body. People born with testes do not have this drive and it’s now considered to be one of the reasons why the research is showing that women may live longer. I’m not sure how this would pan out if you were a transman taking testosterone however.)
· Optimised sleep - We know sleep deprivation raises cortisol levels so it’s really important that we work on getting 7.5 hours of sleep.
· Exercise (30 minutes, 3 times a week has been shown to be helpful here and can be done in 10-minute bursts)
So obviously those are a lot of options, and I don’t expect you to do them all in one go, so here are some tips for starting slowly and building them in if you have a busy lifestyle:
· Try 4-8 practice (breath in for 4, out for 8 for a few breaths) three times a day. You could do this at breakfast, lunch, and dinner. Or try one of the other breathing exercises I will show you in this lesson.
· Start with just one minute of meditation - build up to 10. I’ve linked to a couple of YouTube videos I like in the handout.
· Start with one small yoga session a week or begin your day with a 5–10-minute routine. Again, I’ve linked to a couple of YouTube videos I like in the handout.
· Try to get outside for a walk at least once a day, no matter how short. As I mentioned earlier, walking three times a day for 10 minutes has been shown to lower stress.
· Give yourself a 9-hour sleep window so you have more of a chance to get 8 hours sleep. If you have insomnia - meditate when you can’t sleep, as this has similar benefits on the brain as sleep.
Spotlight: Nerva/Hypnotherapy
So those are of course some fairly obvious go-to strategies that many of us can try, now what I will say is that consistency with any of those is what really gets results, but additionally, I do tend to see that our community need a bit more intensive support to calm their nervous system and repair the gut-brain connection. Sometimes this involves deeper trauma work, or neural retraining, which we’ll get to in a more advanced way in the second line therapy modules, but for now, I wanted to highlight a couple of methods that either I have seen work well or my tutors see work well .
Incredibly, time and time again, hypnotherapy is showing coming up in research as being highly effective for IBS and is being used more and more by SIBO specialists and gut health practitioners. It works by improving the gut-brain connection and essentially rewiring our gut-brain pathways via the vagus and it is often used in tough SIBO cases with incredible results.
To demonstrate this point, Monash University, who designed the Low FODMAP diet, have recently released an app that I use with almost all of my clients, called Nerva and in research, it’s been shown to be just as effective as the Low FODMAP diet! Which is just incredible as it means no food restriction, no negative effects on the microbiome because we’re restricting fibre and no triggering of eating issues. It is a six week course, and to be honest I’m not sure whether hypnotherapy would be classed as a second line therapy or a first, I think second because it’s not a simple change, but I wanted to bring it in earlier because if you don’t feel comfortable changing your diet yet, if that feels particularly triggering for you, this app may actually totally eradicate the need to do that.
Now Nerva does require full on commitment, you do have to do every day for six weeks to get the full effects, but the results are long lasting and really pretty extraordinary! In fact, 89% reported a calmer gut by the end of the six weeks.
So, here’s some graphs taken from one of the studies they used when researching their six-week hypnotherapy programme and as you can see, in most cases, hypnotherapy actually has more of an effect than the other options. I believe the slight difference is statistically insignificant, hence why it’s classed as ‘just as effective’ but still, incredible results.
And here’s a graph from Nerva directly, which is formulated from another studied, showing how their six-week programme compared to other traditionally IBS treatments and management options.
Address Adhesions and Pelvic Floor Dysfunction
Okay so we’ve already had a module on structural problems and hopefully, you are experiencing some improvements with your bowel health as a result, but let’s look at a couple of gut specific tools you can try to help you with these issues.
So, as I mentioned, you can begin improving your pelvic floor at home with simple daily stretches and exercises which will reduce tightness and start loosening adhesions. As you know, this course is designed for helping with the endo belly and gut health specifically, but this work will also really help with pain!
Movement helps to keep the fascia and muscles fluid and mobile, and keeps the gut moving, so is a good tool for constipation, gas, bloating and healthy gut motility.
I just wanted to highlight some movement options which will actually help manage the endo belly and gut health.
Exercise is incredibly important to help with normal gut motility as it can stimulate that movement and prevent things from becoming stagnant. It also helps with our stress response, so is yet another tool for helping with moving into rest and digest on a more regular basis.
One of my SIBO tutors, Dr Nirala Jacobi, is a fan of walking and rebounding (which is essentially jumping up and down or jogging on a small trampoline) for constipation and general healthy gut motility. Additionally, you can use specific yoga exercises to aid with bloating, constipation and overall digestion health and I’ve linked to a couple of great videos for this by FemFusion - all for free. I really encourage you to look through these because there are different options, not just for those with constipation either, but for those of us with gas or bloating.
Finally, I also wanted to mention constipation briefly.
If you suffer with constipation or painful bowel movements, consider how you’re sitting on the toilet. Straining and pushing can cause more inflammation, nerve sensitivity and pelvic floor tension.
So having your feet elevated, so you’re adopting more of a squat position (knees higher than pelvis) can help with easier movements and prevent further damage to the pelvic floor because you’re actually adopting the correct position that your body wants to naturally adopt in order to eliminate waste.
To demonstrate this, here’s a video from podcast guest and pelvic floor physiotherapist Nicole Cozean explaining why this is so important in more depth.
Now if you’re on a budget, you can just grab a stack of books or magazines and use them, or you can use something call the squatty potty, which is a stool that you rest your feet on whilst on the toilet. There are so many of these now, with varying prices, so check out the options that suit your budget. Even if you don’t have constipation, if you think you might have some pelvic floor issues, I do recommend using one of these at some point to support your pelvic floor healing.
So lastly, let’s talk about abdominal massage. Abdominal massage, in whatever form, is a key strategy we use in SIBO recovery because it can help break down the adhesions that are affecting gut motility, it also stimulates the MMC and helps to move waste, gas and bacteria along the digestive tract and it helps to activate the rest and digest response and supports the vagus nerve. Additionally, it’s also great for pelvic, period pain and fertility issues.
You can do abdominal massage whenever you like, but I see it as most effective in the evenings, because our migrating motor complex works best overnight whilst we sleep and doing the massage before bed can really get it going (I literally hear mine kick in when I do it, it sounds like hunger pangs). The more regularly you do it, the more your body will become used to switching into rest and digest and of course, your intestines will become looser and freer as you work on the adhesions, so if you can do it daily, amazing, but if not, a couple of times a week or even once a week will be great!
The two types of massage I use with clients are:
· Arvigo massage, which is designed for period pain, pelvic pain, gynae. problems like endometriosis and gut problems like constipation and bloating, and Tara will teach us all how to do this.
· There is also the I Love U massage, which is a free massage you can find on YouTube and is designed specifically for IBS problems like bloating, gas, constipation, etc.
Key Takeaway
So, to wrap up this session, I want to leave you with this key takeaway and reminder: how you feel affects how you heal.
If you’re feeling stressed about life with endo, about your gut, about your healing or just life in general, first begin with adding in practices that help to lower your stress response.
Once you’re feeling a bit calmer and more in control, then proceed forward with the next steps.
Need more help or want to learn how to work with me?
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