We are all different; we all have different family
traditions in daily living and our dietary patterns. Different shaped bodies
have different intake needs, and different bowel habits. There are those of us
who have exercised regularly all our lives and try to keep our bodies in shape
– whatever our physical problems, and there are many people who have never
needed to seek out exercise – their bodies are just in a natural balance.
There is one truth I know, and that is we all feel
more comfortable when we have emptied our bowels. Doesn’t matter if we are once
a day types, or once a week types. For those of us with Transverse Myelitis,
there is another truth, and that is that from time to time we all have problems
keeping regular. Some of us have naturally sluggish bowels apparently made
worse by TM, some of us have erratic bowels, or recurrent diarrhoea. Either way
we are likely from time to time to get ourselves in a mess and maybe embarrass
ourselves in public. I am not necessarily talking about the first few days and
weeks after we are attacked by this damned disease, as I described (chapter 3
in my book on recovery: ‘Taking Charge; a journey of recovery’ now available on Amazon Kindle (you need the whole title to find it !!). Rather my focus is on after we have reached a steady state of some sort of recovery.
I thought I might share some things I have
discovered. My hope is that it will help those of you who are a bit shy, or
intensely private, to discuss your own experience to help others. The basis of
this article is to make changes as ‘naturally’ as we can, and avoid having to
take artificial laxatives from the pharmacy. In fact I will not be talking
about those at all.
So, my natural habit, all my life, is to go twice
a week. Now I have reached a steady state, I am sort of back to this pattern.
The problem is that (in semi-retirement) I work in a private practice 2 days a
week (Wednesdays and Thursdays), and that is fairly intense, with back to back
clients – not much time for personal needs. But what seems to have happened is
that the ‘twice a week’ happens on the days I work! All very awkward... I want
to change the pattern, and have been struggling to work out how.
The first thing to say is that, despite body shape
and lifelong habits, my bowel habit (like everyone else’s) depends on my
intake. If I go with my childhood preferences of high calorie, low residue
foods, then I get ‘blocked up’. Being married to a dietitian, I have learned
that, (in order to avoid later diabetes) it is advisable to eat what are called
low glycaemic index foods. That is foods that release their sugars into the
body slowly over time. As an example, if I eat potato in a meal, then the
starch is broken down into some sugars slowly over time. Conversely, if I drink
a can of high sugar fizzy soft drink, then I get a sugar hit – a rapid rise in
my blood sugars, which challenges my pancreas to produce insulin, to reduce the
blood sugar rapidly. Then I feel I need another sugar hit.
OK, the interesting thing is that the can of soft
drink does not contribute much (if anything) to my bowel regularity. Potatoes,
on the other hand, like many starchy vegetables, provide the bulk to my stool
that we all need. A wide range of other foods help to keep us regular. Fruits
and vegetables are never totally digested, and leave behind cellulose and other
things that provide bulk. Meat fibres tend not to be totally digested, and meat
also contains fats that may pass through to the large bowel.
If your bowel is a bit slow, look at your own
diet, and see whether the addition of foods that leave residue could be part of
the answer. My own diet includes two serves of bread with lots of salad
(lettuce, celery, tomatoes, etc) and some tasty filler (cheese, ham, sardines or
paté, etc) for lunch most days, with a piece of fruit (a pear or apple). Our
evening meal always has at least three vegetables in season, in addition to a
main item.
There are some other things I have found by trial
and error. Dried fruits (apricots, figs, cranberries), are tasty, and leave a
residue which can induce a bit of bowel movement. I have practiced enough now
to know exactly how much I can eat of these on a regular basis to avoid
looseness and diarrhoea.
Kellog’s make a cereal which is known as
‘Guardian’ in Australia (no, I don’t have any shares or other conflict of
interest). It contains a fibre called ‘psyllium’, which stays in the bowel,
provides bulk and provokes some bowel movement; very useful. Several members of
my family have a habit of using this as part of their cereal serve every morning,
and swear it keeps them regular. I think it tastes a bit like cardboard, but
when I am a bit glued up, I succumb and have some over several mornings, and it
does help. Each of you will be different, and will use something like this on a
more or less regular basis, to suit your own bowel pattern. My preference is to
have a bowl of porridge with honey and some cooked dried fruits on a couple of
strategic mornings each week to provoke a bowel movement over the weekend or on
a Monday (to avoid the problem of my clinical practice days).
There are some foods almost guaranteed to provoke
a bowel movement if you are a bit blocked. One well known one is a good curry.
Very much your choice... Baked Beans have a reputation for provoking a bowel
movement. Again, very much your own choice...
I am somewhat lactose intolerant. Part of my story
from hospital is that I love yoghurt. I never gave it a second thought, just
ordered yoghurt each morning for breakfast. In retrospect, that was stupid,
because I could have ordered lactose free yoghurt, and not had such a glorious
story to tell. LOL. However, I use lactose free milk on morning cereal, and
that avoids a problem. If I am glued up, I can have a bowl of ice cream on one
or two nights after dinner. Ice cream contains lactose, so 36-48 hours later, I
usually get a result.
Many people are using so-called probiotics to
provide them with a regular ‘natural’ bowel rhythm. I know it works for many.
Personally, I get a similar result to when I use ice cream, so I have not found
it helpful.
The bottom line here, is that whatever your level
of damage from TM, I want you to think through your diet, and look to make some
deliberate changes to improve bowel function, and thence your sense of
wellbeing.
I don’t want you guys to think I am obsessed with
my bowels. However, it is crucial to work out how many times a week you want to
go to the toilet to feel comfortable, well, and happy with your body. My personal
obsession is to ensure I go to the toilet on any other days than a Wednesday
and Thursday. We seem to be managing fairly well.
