EP.169/ Symptom Management Supplements for the Endo Belly
Do you suffer with the endo belly? Is it accompanied by bloating, diarrhea, constipation or abdominal cramping?
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Whilst I’m all about getting to the root cause and find out WHY you’re suffering with the endo belly (not to mention, healing the root cause) I also understand the need for short-term symptom relief whilst we’re on that journey.
Today’s podcast episode offers just that. I am sharing the most effective supplement options that help to relieve endo belly flares in the moment. These are the tools and strategies we use in our SIBO training with Dr. Siebecker, but are safe if you don’t have SIBO but do suffer with IBS symptoms.
You will find all the dose references in the show notes, but remember - as a health coach I cannot prescribe you a treatment protocol, this is education only and the aim is for you to take this information away to discuss your options with your doctor.
Full credit to my tutor Dr. Allison Siebecker for teaching and providing us with these strategy relief tools!
Activated Charcoal
So first up we’re starting with activated charcoal, which is great for:
Diarrhea
Abdominal pain (not pelvic pain)
Gas
Acid reflux
It works by absorbing gases, which reduces pressure in the gut that can lead to cramping and of course, reduces bloating. It’s also absorbs fluid, so reduces diarrhea too.
The doses are:
Up to 1000mg, every 1-3 hours for diarrhea.
Up to 1000mg, every 2-6 hours for bloating/gas/abdominal pain.
Up to 1000mg 30 mins before a meal and one hour after for endo belly ‘trigger’ foods. Now what I mean by this, is if you have to eat something that you know is probably going to make you bloat or gassy, or swell you up, but you’re a bit stuck for choices, say you’re at a family thing or wedding, or you’re on holiday, then you could use charcoal. I don’t advise you just use it for every meal so you can eat whatever you want, because you’ll end up very constipated because it absorbs fluid, but I have found it very helpful on holiday and at weddings.
Up to 500mg every 2-3 hours for acid reflux.
So, some things to consider when taking charcoal:
Do not consume more than 4000mg per day.
It can cause constipation, so reduce the dose if constipation occurs or use with magnesium citrate (which you’ll learn about shortly) or stool softeners, and I’ve listed some natural stool softeners in the handout. If you do use magnesium citrate to avoid any constipation, take it an hour after the charcoal or before bed.
Your bowel movements may look dark after charcoal - don’t worry, it just stains everything!
Absorbs everything, so take it 30 minutes before meals/supplements/meds and/or one hour after.
Some research has showed that in it can cause vomiting if accidentally inhaled, so if you struggle with small airways or swallowing, be cautious with this. I also personally prefer using capsules, as I have tried using the powder stirred in water and have accidentally inhaled it myself one or two times!
Ginger
Next up is my absolute favourite, and that’s ginger.
Ginger is effective for:
Nausea/vomiting
Gas
Bloating
Fullness/food won’t go down
Abdominal pain
Ginger is a prokinetic, which means it stimulates the MMC and gut motility, so it moves gas down and out of the small intestine. This therefore helps with gas, bloating, pressure, and abdominal pain, and it helps food to go down as well if you’re feeling like you’re not digesting your food properly. And I’ve mentioned, it’s a great tool for nausea and vomiting.
The doses are:
1000mg an 1-2 hours after meals or at bedtime for nausea/bloating/gas/vomiting/ab. pain.
1000mg 30 mins before meals to aid with appetite if nauseas.
So, some things to consider when taking ginger are:
Do not consume more than 2000 mg per day.
It can cause something called ginger burn, which feels like heat or acid reflux is the oesophagus or stomach. If that occurs, take less, stand up and move around so it starts to go down (as ginger burn often happens when lying down or reclining in many of my clients) and sip on lots of water.
In people with interstitial cystitis, as it’s a spice, it might cause some irritation, but this tends to vary from person to person.
Finally, fresh ginger root is usually not as effective as dried ginger root powder, so we’re going for a 1000 mg in the form of capsules.
Peppermint
Peppermint can be used for:
Abdominal pain
Bloating
General IBS symptoms (there’s LOTS of research on peppermint for IBS)
Indigestion
Pain with bowel movements (which I know many of you suffer with)
Peppermint relaxes the smooth muscle of the intestines, so helps significantly with cramping and abdominal pain, and helps to ease the transition of gas. It’s also been shown to be 67% effective for reducing severe IBS symptoms, pretty impressive stuff!
So, the doses are:
Use peppermint tea/or tincture (follow label dose) for pain or sensations higher up in the abdomen (this is because peppermint generally works locally, so if you feel symptoms around the stomach area, the peppermint tea or tincture will be able to affect that area because it’s not sealed up in a pill, whereas the pills are coated and are designed to not be released until they exit the stomach).
Label dose of triple coated tablets for mid to lower abdominal symptoms, as needed or daily. Research has shown that pain and symptoms improve significantly with long-term use with peppermint oil.
Can also apply peppermint essential oil to abdomen. Follow label instructions as some oils require diluting in a base oil. A quick tip here, is you can use Be You patches, which I share on my podcast, over the abdomen, to ease spasms. You can keep those on for 12 hours and you can wear them daily.
So, some things to consider when taking peppermint are:
It can cause acid reflux in some people because it relaxes the muscles, it can open up the sphincter connecting the stomach and the oesophagus, so stomach acid can travel up. If this happens to you, try a pill that’s triple coated and designed to bypass the stomach.
For some people, peppermint can also cause nausea.
Magnesium
Magnesium citrate or oxide can be used for:
Constipation
These types of magnesium draw water into the colon, helping to create a bowel movement.
The dose is:
Up to 2000 mg at bedtime (two hours after food), daily or as needed until you have a bowel movement. However, 1000 mg is normally effective for many, but see what works for you.
So, some things to consider when taking magnesium citrate or oxide are:
You need to start slowly, beginning at 500 mg and building up until you find the dose that works for you. Generally, increasing your dose slightly each night should be a good pace, but keep in mind it can take a few nights to get to work, so don’t be too hasty.
Too much will cause abdominal cramping, bloating and diarrhea. If that occurs, reduce the dose back down until you get to a dose that creates a healthy bowel movement without watery stools or discomfort.
Food will reduce the effects, so keep in mind you need to take it two hours away from food.
And finally, you have to use either magnesium oxide or citrate, other forms of magnesium are not laxatives and will be absorbed in the body, rather than making their way down into the colon.
Partially Hydrolysed Guar Gum
PHGG be used for:
All IBS symptoms (multiple studies/reviews confirm this)
Constipation
Improving stool consistency
Diarrhea
Bloating/gas
Increasing beneficial bacteria
PHGG is a type of soluble, low FODMAP fibre, which is generally safe and well tolerated by even SIBO patients! It’s a longer term symptom management tool, whereas the others bring relief same day, this tends to need about a month to build up to the benefits. It helps to bulk up stools, making it effective for both constipation and diarrhea.
So, the dose is:
5-6 g daily, ideally dissolved in hot water on an empty stomach, for at least one month and likely ongoing for maintenance. Some people do put it with tea, coffee, smoothies or even porridge, but many of the labels suggest on an empty stomach.
Increase to full dose across one to two weeks, especially if SIBO positive, so start out lower, with say one gram, and then increase by a gram or half a gram a day.
So, some things to consider when taking partially hydrolysed guar gum are:
Ironically, in some people, likely people who have SIBO or extensive gut issues, it might cause bloating. So, give yourself a month or so on it and see how you respond. If it’s noticeably bad, reduce back down to a level you can tolerate or discontinue. Generally, it is thought to be SIBO safe, but we’re all different and SIBO is so individual, that we can’t guarantee it’ll be well tolerated by everyone.
And alongside that, it may cause some GI distress, so basically an irritation of your IBS symptoms and if you have SIBO and don’t respond well to it, it could worsen those. However, as I’ve mentioned, on the whole, it’s well tolerated.
Most Important Takeaway:
So, that wraps up this module, and I wanted to also let you know, there are multiple other options to help with symptoms, including more supplements and some at home remedies. I’ve linked to a handout in this slide by my tutor Dr. Allison Siebecker, which provides all of them. You don’t need to use them all, but I would recommend you have a read of it, so you know your options, and I also recommend trying some of the simple home remedies before buying expensive supplements!
But before we do any of that, remember, getting our foundations in place can make a huge difference to gut health - so start off with the first line therapies, before you start spot treating with lots of different supplements.
Show Notes
Charcoal
https://pubmed.ncbi.nlm.nih.gov/3717809/
https://pubmed.ncbi.nlm.nih.gov/3521259/
https://pubmed.ncbi.nlm.nih.gov/7015846/
https://pubmed.ncbi.nlm.nih.gov/3717809/
https://pubmed.ncbi.nlm.nih.gov/7949514/
https://pubmed.ncbi.nlm.nih.gov/12516788
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
Ginger
https://pubmed.ncbi.nlm.nih.gov/10442508/
https://pubmed.ncbi.nlm.nih.gov/16865831/
https://pubmed.ncbi.nlm.nih.gov/24390893/
https://pubmed.ncbi.nlm.nih.gov/17545109/
https://www.europeanreview.org/article/10145
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958926/
https://pubmed.ncbi.nlm.nih.gov/18403946/
https://pubmed.ncbi.nlm.nih.gov/25912592/
https://pubmed.ncbi.nlm.nih.gov/23612703/
https://pubmed.ncbi.nlm.nih.gov/30423929/
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
Peppermint
https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-018-2409-0
https://pubmed.ncbi.nlm.nih.gov/11207510/
https://pubmed.ncbi.nlm.nih.gov/24100754/
https://pubmed.ncbi.nlm.nih.gov/26319955/
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
Magnesium
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
PHGG
https://pubmed.ncbi.nlm.nih.gov/25843197/
http://ecite.utas.edu.au/121479
https://pubmed.ncbi.nlm.nih.gov/16413751
https://pubmed.ncbi.nlm.nih.gov/25519526/
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
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