Putting the debate to rest: IBD fatigue isn’t your “normal” type of tired

I was putting away the dishes after dinner when I paused, exhaled, and said to my husband, “Whew. I just got a major wave of fatigue.” He said, “Yeah, I feel tired right now, too.” This isn’t the first time a healthy, able-bodied person has responded this way—and I know everyone with a chronic illness can relate. I kind of laughed and tried to explain why chronic illness fatigue wasn’t the same as feeling tired, but I was coming up short for words and having difficulty explaining the difference. My husband, Bobby, genuinely wanted to know why I thought my fatigue was different than his and how I knew it was. I said I used to be healthy. I used to not have a chronic illness. I know what tired felt like then and what fatigue feels like now.

Articulating pain with IBD and fatigue can be so challenging—even though it’s something that is so much a part of our day-to-day experience. Unless you live it and it’s your reality, it’s difficult to put the experience into words.

I called upon the IBD family on Twitter and Instagram to see how they describe their own personal fatigue. Here are some of the responses:

“Imagine your car being on empty and you put $5 worth of gas in the tank until you’re running on fumes. Then you put $5 worth of gas again, and you continue this process for months at a time…while sometimes running out of gas completely multiple times along the way.”

“Having to run a consistent marathon without stopping while carrying a toddler in the front and a backpack with a week’s worth of supplies on your back…in flats.”

“Mentally feeling like you have the energy to do simple tasks, but your body physically won’t let you. Knowing I need to walk 100 feet to get in my work building and having to give myself a pep talk to do it because I’m not sure I’ll make it without having to sit down.”

“You’re tired from being tired. You are just over everything and the day drags on and on. A nap doesn’t help because you “waste” your day, but the truth is you can’t even take a shower because the thought is way too much energy.”

“Like you’re walking with ankle and wrist weights on 24/7. There are days I feel like I’m walking through a fog so dense in my head I can touch it.”

“When I think of chronic fatigue for me it means faking being well. When getting out of bed or getting a shower is an accomplishment or needing to rest after taking a shower. No matter how much sleep you get you still wake up tired. Chronic illness fatigue is physical, mental, and emotional exhaustion.”

“Trying to motivate yourself when you’re fatigued and having brain fog is how I imagine swimming in syrup or molasses would be.”

“It’s the feeling of exhaustion, hopelessness, and loss. You’re beaten down from managing your condition and the various negative side effects that come with it on top of trying to function in whatever role you’re trying to play on a daily basis (for me: wife, mother, employee, and friend). It’s trying to make the most out of life but knowing you’re limited. It’s mourning the person you once were and want to be at that time. It’s physically, mentally, and emotionally draining.”

“I explained the fatigue to my students that just thinking about lifting my legs to walk or the mechanics of moving my limbs is exhausting…let alone the act of doing it. Everything feels heavy.”

 “Down to the bone, exhaustion in my core, something that is impossible to push through.”

“I like it’s like first trimester fatigue! But, with no end in sight and nothing hopeful to show for the symptoms like a baby!”

“Like your body is made of bricks. Your mind knows you need to get up and do something—change over the laundry, send an email, but your mind cannot make your body move.”

“Living in a constant state of exhaustion. No amount of sleep or rest seems to shake it.”

“For me…I would describe chronic illness fatigue as KNOWING your car has no more fuel and having to get out and push it home yourself.”

“Heaviness in my body. Just surviving, not thriving. Frustrating because I want to do more things but can’t always.”

“Being tired as soon as you wake up, until you go to bed. Never fully feeling rested. Planning naps throughout a day. Heavy eyes. Mood swing when beyond exhausted.”

“Like constantly living under 10x gravity.”

“Like someone pulled the plug out.”

“Like moving through the mud. It can also creep up on you when you least expect it, sort of like this year’s global pandemic—all encompassing and has no sympathy.”

“Like I’m wearing 100 pounds worth of sandbags that don’t go away even when I get lots of sleep.”

“Waking up and still being tired. No amount of coffee can fix this tired.”

Stop the comparison game

After reading these descriptions, my hope is that the next time you try and compare your fatigue or tiredness to someone with a chronic illness you pause and be selective of your words. Of course, everyone is entitled to be and feel tired, but it’s not an even playing field energy-wise when you’re a healthy, able-bodied person. Coffee, naps, and sleeping in help most of the population feel energized and re-charged, but fatigue with chronic illness is often untouchable. A full night’s rest can still leave you feeling exhausted. A coffee may have no impact. A nap may cause the fatigue to be even more pronounced. As an IBD mom, it can be frustrating to hear someone without a chronic illness try and diminish my personal struggles by equating them to theirs when there is truly no comparison.

Why IBD Forces You to Take Off the Rose-Colored Glasses and See Clearly

I remember the first time I put glasses on in fourth grade and no longer saw the world unclearly. I can still recall the first time I wore contacts sophomore year of high school and experienced how crisp life is supposed to look. Prior to glasses and corrective lenses, I thought my vision was how everyone else saw. I recently came across a discussion on Twitter by Jessica Caron (ChronicallyJess) about how you would describe your IBD journey at the beginning—in one word. One woman, Emily Morgan (@EmMorgan27) replied with the word blurry.

That response got me thinking. It’s spot on for so many reasons. Take yourself back in time to the first week you were diagnosed with Crohn’s or ulcerative colitis and the clarity you’ve gained and continue to gain with each year that passes.

When I was diagnosed with Crohn’s in July 2005 at age 21, I remember sitting almost stoically in my hospital bed because I was so overwhelmed by not only what the next day or week would bring, but the next hour. All my plans, all my goals, all my dreams that were once crystal clear became incredibly hazy. The thought of thinking beyond that moment almost made me feel dizzy with dread.

What does this new world of chronic illness look like?

What would be possible with IBD? Who am I now? How has my identity shifted? Where do I go from here? What will my friends think? What will future employers think? What’s it like to be on medication for the rest of my life? Will anyone ever love me? The list goes on. The vision that I had the first 21 years of my life was forever tainted.

But as the years rolled by, I came to realize the rose-colored glasses I wore prior to diagnosis didn’t give me that clear of a reality about not only my own life, but those around me. Prior to Crohn’s I just expected everything to go my way. Prior to Crohn’s I felt invincible. Prior to Crohn’s I didn’t think twice about my health and what a gift it was.

Now life is anything but blurry

Looking back over the past 15 years, my vision of life with Crohn’s is anything but blurry. As I grew older and more mature, this disease of mine made me see the world clearer than I had ever before. The darkest days have led me to the brightest, shining moments. Nothing is taken for granted. Nothing is expected, but rather overly appreciated. This disease forced me to see the strength inside myself and the resilience that I never knew existed. This disease has demanded a lot out of me and still does, but it’s enabled me to discover a newfound gratitude for life’s simplicities and provided me with superhero strength vision of who is genuinely in my life, and who is not.

It’s gotten to the point where I don’t even know if I would have been the same adult if I never got Crohn’s. My IBD is not my identity, it’s only a part of who I am. Now I credit not only my contacts, but my Crohn’s, for improving my vision.

“So, You Have an Ostomy”: Recommendations for Dating, Intimacy, Naming Your Stoma, and Dressing—Part 3

Dating with IBD can be daunting. Add an ostomy to the mix and that stress is amplified ten-fold. In Part 3 of “So, You Have An Ostomy” hear from several ostomates about navigating relationships, intimacy, discovering what clothing and undergarments work best, and why some choose to name their stoma and others don’t.

Before we get started, here are links to:

Part 1: Coping with the Complexity

Part 2: Tips for Travel, Diet, and Bag Changes

Dating and finding the one with an ostomy

Brian Greenburg, 37, of New York was diagnosed with Crohn’s at age 11. He has a permanent ostomy and “Ken Butt”. As a married man, he reflects on what it was like to be part of the dating scene.

“The best piece of advice I was given about dating is that my ostomy won’t keep me from meeting the “right one”, it will keep me from trying to be with the “wrong one”.

Read that again. It’s powerful and so, so true for anyone with a chronic illness. Brian advises it’s best to talk confidently about your ostomy and not to shy away from communicating with your partner.

London Harrah, 29, of California, was diagnosed with ulcerative colitis two years ago. From the get-go, his gastroenterologist told him there was a possibility he was going to need an ostomy. At first, London was completely against the idea. His disease didn’t give him any other choice and he ended up with an ileostomy.

“I was having 20 bowel movements a day and throwing up at least one time a day and I was losing a lot of blood. I mentally and physically got to the point where I could not take it anymore and after countless visits to the doctor and attempts at different medicines, I told them that I wanted to proceed with the surgery. I had basically given up on any and all expectations on what I wanted my life to be and had accepted that I just needed to feel better.”

London recalls making his first post about his ileostomy on social media and expecting that no women would be interested in him because of it. He was single when he had the surgery and had accepted he was going to be alone the rest of his life.

“Over time I gained more and more confidence and ended up testing the waters with talking to women. I soon was able to figure out that, if anything, having this surgery just assisted me in weeding out the bad apples. There are a lot of people out there who see beyond the surface of someone and will accept you for the person you are.”

London is currently in a new relationship and just got past the peak of explaining everything about his ileostomy in detail with his girlfriend. He says he feels a lot better knowing she accepts him completely.

Jordan Ditty says she was worried going into surgery not how it would impact her marriage, but moreso that her ostomy not only affects her life, but her husband’s as well.

“Going through surgery, seeing my stoma, sharing the frustrations and wins, naming my stoma together…it all brought us closer. If you ask my husband, he will tell you it did not impact him at all, he was happy that I was no longer in pain and we were able to live.”

As far as intimacy goes, Jordan says she was nervous, but that her ostomy did not affect a single thing.

“I personally always empty right before we do anything then just fold it up, so it is not flapping around between us. There are also many options out today for ostomies, crotchless lingerie that keeps your bag in place if you don’t want your partner seeing it, high waisted options, belts, etc. Find what makes you comfortable, just remember you are still you, beautiful as ever because you are finally healthy!”

Andrew Battifarano is a 26-year-old in New York, as far at the dating scene in the Big Apple, he says he’s usually open about his ostomy and finds it’s beneficial for both sides. Andrew says most people are super accepting and appreciate his honesty.

“There are those who are grossed out and don’t want to deal with someone who has an ostomy. It’s good to know who wants to be in your life and will accept you no matter what early in the process rather than later. I think everyone has their own methods, but I stand by being forthright early on so you can tell a potential partner what it is and hopefully educate them a little bit.”

Payge Duerre met her boyfriend after she had an ostomy. She says he saw her bag in a photo on her Tinder profile and stalked her ostomy Instagram before they met in person.

“He had actually said that my ostomy was a small part of what drew him to me, he could only imagine how I was living, and he wanted to take care of me like no one else did. It did not impact being intimate at all. We both think scars are more beautiful than untouched skin. And it has helped my intimacy. Not having that pain and sickness wearing me down all the time, or not worrying about using the bathroom in the middle of being sexy has helped me.”

Richard Harris, 39, of the United Kingdom was diagnosed with ulcerative colitis when he was 23. He says his girlfriend at the time of diagnosis and his first surgery is now his wife and the mother of their two boys.

“We’ve really been through it all together. She visited me in hospital when I was sick and had lost more than 3 stone (40-plus pounds!), so I think she saw it as a life or death thing too. Post-surgical recovery, intimacy took a while, but we got there in the end. The Coloplast Senusra Mio has a handy fold up feature with some Velcro to tuck the bag away which I tend to do.”

Tim Albert’s girlfriend has been by his side through it all, too.

“Initially I was concerned she wouldn’t want to deal with the struggles an ostomy brings, but she has proven time and time again that she has my back with this. For me, it wasn’t easy to be intimate, simply because I didn’t have the core strength. I physically couldn’t perform like my old self, and that was a tough pill to swallow. With time, I got stronger and that aspect of our relationship became fun again.”

Lindsay Dickerson says her ostomy did not impact her husband at all.

“He assured me multiple times that I am just as attractive, and it does not take away his sexual drive for me (just being blunt). However, as confident as I was with showing my bag off for others everywhere else, the bedroom was a different story. Finding lingerie that is “accessible” to your significant other but covers up the bag has helped me with confidence. Switching brands helped also – Hollister was super loud, and you always heard it during sexy time. The Coloplast Mio makes no noise.”

Byrd Vihlen says her husband is very information oriented and learned the ostomy terms before she did from reading an informational packet provided by the hospital.

“He helped me empty my bag, with no hesitation, for several days after surgery when I was unable do it. It was truly a sign of unconditional love. If your significant other cannot accept that you need an ostomy bag, their love is conditional.”

To name a stoma or not to name a stoma

Of all the ostomates I spoke with—it was a mixed bag (no pun intended!) when it came to those who choose or chose to name their stoma and those who do not. Each person’s reasoning and explanation made a lot of sense.  

Tina Aswani Omprakash said her husband named her stoma “Snuffleupagus” in the hospital after surgery since it resembled the snout of the Sesame Street character. She also calls him “Bebu” which is a loving term that means “baby” in Hindi.

Sahara Fleetwood-Beresford’s experience is unique in that she has gone back and forth through her journey.

“I did not name my first one. I named my second one because I read it could help with acceptance of it. It DID make it easier to talk about to people. I do still consider my current stoma to have the same name, but I don’t often refer to it by name anymore. I usually just say “my stoma” because I felt like referring to it by name almost made me think of it like a sperate entity, when it’s not. Porta didn’t shit in the shower – I shit in the shower! Porta is not farting – I am farting. You get the idea.”

Jordan Ditty and her husband named her stoma “Norman”.

“We call him Norman when he is being difficult and Norm when he is being good. I thought it was silly at first to name him, but after a few weeks of being home with it, we came up with a name. It normalized it, made it easy to throw into a conversation, my friends and family all refer to my stoma as Norman.”

For those who haven’t chosen to name their stoma, the consensus was that it’s “just a part of them and not separate.”

Clothing preferences

  • Ostomy Secrets Underwear for Men—supportive and comfortable
  • Ostomy Secrets Wraps for Women—helps keep everything secure
  • High waisted tights, leggings, skirts, dresses, and jeans
  • American Eagle jeans
  • KanCan pants—with their stretch to allow the bag to grow
  • Vanilla Blush Hernia Support Vest for strength exercises
  • LuLu Commission Pants (for Men)
  • Aerie leggings and underwear for security and flexibility with an ostomy
Gaylyn Henderson modeling for Aerie as a proud ostomate.

Natasha Weinstein recommends discussing ostomy accessories with your care team.

“Would you do better with an ostomy belt? Are you active? Do you like to run, hike, bike, swim? You can still do these things! I am a runner and started running because of the Crohn’s and Colitis Foundation’s Team Challenge program and continued running despite my Crohn’s. Having an ostomy has made it easier for me to run since I am less worried about when I’ll need a bathroom next. Like more extreme sports? On my 27th birthday Ziggy stoma (yes I named mine and I recommend you do too – it helps with acceptance and I have all my friends referring to him as Ziggy), well Ziggy and I jumped out of an airplane! IT WAS A BLAST! What I promise is you can truly do anything you set your mind to, and your new ostomy will be along for the ride.”

Stay tuned Wednesday (September 30) for the final piece in the Lights, Camera, Crohn’s “So, You Have An Ostomy” series. A look at the perspective gained, advice for caretakers and family members, and incredible stories of ostomate perseverance that are sure to inspire.

“So, You Have an Ostomy”: Tips for Travel, Diet, and Bag Changes—Part 2

Navigating life with an ostomy takes patience and persistence. The adjustment is not only emotionally and mentally taxing for many, but the physical day-to-day takes some getting used to as well. In Part 2 of “So, You Have An Ostomy,” I interviewed ostomates about everything from diet, to bag changes, and how best to pack when you’re away from home. It’s my hope that by hearing these words of wisdom, that you’ll feel better equipped and more at ease should you need to make these lifestyle changes for yourself.

Discovering Your “New” Diet with an Ostomy

After ostomy surgery, it’s recommended to stick to a low residue diet for about six-eight weeks. Once you reach that point in recovery, work with your surgeon and GI dietitian to reintroduce foods one by one to see how you tolerate them. Hydration is key every single day. When you are outdoors or more active, you will want to make sure you hydrate before, during, and after, not only with water, but having some sodium and sugar in your system for better absorption. This can either be a homemade mixture, powders (ex. DripDrop, Liquid I.V.), or premade drinks (ex. Pedialyte, Metamucil Water, or Gatorade). Ultimately, you want to keep a pudding consistency of output.

If you’re eating high fiber foods like nuts and raw veggies and fruits, ensure you are chewing well, eating a bit slower, and drinking water throughout the meal, as these foods are harder to breakdown.

Sahara Fleetwood-Beresford, 32, of the United Kingdom, was diagnosed with ulcerative colitis at age 19. Since then, she’s had three stomas. When it comes to diet with an ostomy, it’s very much trial and error, like it is with IBD. For many, marshmallows, unsweetened applesauce, and peanut butter are the ‘go-to’s’ to thicken output, but unfortunately those don’t do the trick for Sahara.

“My main piece of advice is not to be afraid of trying things. If you chew thoroughly, that minimizes the risk of blockages. Your stoma will be settling in for up to twelve months, so if something doesn’t agree with you in the beginning, try it again later. My diet is healthy now, thanks to my stoma. I can eat all of the fruits and vegetables that I couldn’t eat before due to pain caused by strictures.”

Karin Thum, 42, of Florida, battles not only Crohn’s disease, but Spina Bifida. She says an ostomy isn’t as bad as it seems and that in time, you’ll find it’s the best thing you could have done for your health and your quality of life. When it comes to her top dietary hack she says, “I’m a salad girl. I learned from my doctor to use scissors to cut up lettuce so that it’s easier to digest. This way I don’t have to give up eating salad completely and can enjoy one of my favorite foods in moderation.”

For Andrew Battifarano, 26, of New York, he noticed he has higher output after having a sugary drink, like soda. Steering clear of these has helped his bag from filling up so quickly.

“At the same time, I try and have as much water I can tolerate. You can easily get dehydrated without even realizing it (I have and it’s not fun), so staying on top of that is super important. And eating less at night, or having smaller meals spread out will make you have less output when you’re sleeping, which might help prevent any leaks and also let you sleep longer without having to get up during the night.”

Tim Albert, 32, of Wisconsin, received his ostomy this past November. If he ever feels dehydrated, he swears by DripDrop ORS. He says if he drinks 16 ounces of water with DripDrop he starts feeling better in 30 minutes.

“As far as output, I’ve learned to think of things the same way a diabetic might manage their blood sugar. If I eat something that will water down my output, I need to counter it with something that will thicken it. Foods are going to be different for each person, but for me, I am able to thicken things up with apple sauce. I like to buy the little pouches; they are great for on the go.”

Sarah Byrd Vihlen, 33, of Georgia was initially diagnosed with ulcerative colitis in January 2014, but has since been switched to Crohn’s. She underwent subtotal-colectomy surgery right after bringing her two-year-old daughter, Penelope, into the world via c-section. Talk about a rockstar IBD mom. When it comes to diet, she says it’s very much like what you’re told with IBD.

“I typically avoid anything with large seeds or nuts, and if I do eat them, I chew thoroughly, the same with fruits and vegetables that have skin. I still do not eat popcorn. Since getting an ostomy I have been able to eat a wider variety of foods than before, but I have heard mushrooms are dangerous and I miss eating them a lot. To thicken output I eat marshmallows, rice, potatoes, and bananas.”

Some foods are known to increase output and gas. Carbonation drinks, chewing gum, and even something as simple as using a straw, can increase your gas ingestion which will need to be expelled. The challenge is, what may increase one person’s output, may not for someone else or vice versa.

Oh, The Places You Will Go…With an Ostomy

Once it’s “safe” to travel post-pandemic (can you even imagine?!), there’s a lot to keep in mind when you’re packing your bags and you have a bag. The first rule of thumb—be overly prepared and always carry-on your supplies in case your suitcase gets lost. Ostomy supplies are needed to be temperature controlled; they are permitted to go through TSA as carry-on.

Be proactive and if you need to cut your wafer, try to cut some before you travel, and pack your favorite scissors in your checked baggage. The consensus among all ostomates I spoke with—pack extra of everything. You don’t know if you’ll have a defective appliance or have any issues arise while you’re away from home.

Natasha Weinstein always considers how long she is traveling and how she is getting to her destination. She says, “I always pack for up to 3 changes a day. If I am flying, I pack a bit more, as air travel seems to affect my adhesive. I seem to do better with car travel. If I am being exposed to extreme temperatures or my itinerary is more active, I take that into account. I do everything I can to alleviate any possible stress about supplies, so I can enjoy my vacation.”

Double and triple check to ensure you have all your supplies and bag changes packed before you head out the door. An ostomy isn’t like a regular prescription; it can be impossible to find when you’re in another city and you’re simply out of luck at that point. Many of the ostomates I talked with recommend organizing your supplies in a travel toiletries holder.

For additional travel—both domestic and international—with an ostomy, check out this helpful article by ostomate, Tina Aswani Omprakash.

Ch-Ch-Ch-Changesss…the ins and outs of changing your ostomy bag

How long a bag will last varies depending on a few different factors: activity level, weather, bathing, sleeping, etc.There isn’t a one size fits all for bags, it takes a while to figure out which appliance and ‘accessories’ work best for you, that can also change over time, even after you think you have found the right one. Skin allergies are common. It’s best to get free samples from several different companies and try them out. Deodorizing & lubricating drops are also helpful.

For any new ostomates, if insurance/payment allows, it’s recommended to have an ostomy home care nurse help you through any trouble shooting with changing your bag at home.

“I don’t know what I would have done without my ostomy nurse, she was an absolute angel. She would come weekly and was able to talk me through problems I was having and give me several new tips. If that’s not available, several people on social media have videos posted. Organizing your supplies is important too so you know your inventory levels and don’t run out. I have a small stocked caddy in my bathroom ready in case I need to do a middle of the night bag change,” says Byrd.

Byrd typically changes her bag every four days, but has gone longer on occasion. Morning bag changes seem to work best for her (before she eats anything) otherwise she says you can wind up with a mess.

Lindsay Dickerson, age 30, of Georgia, was diagnosed with colonic inertia, gastroparesis (digestive tract paralysis) at the age of 17. When it comes to changing her ostomy, she says it’s key to lay out all your supplies prior to making your first move.

“Know you have everything there, so you don’t have to run to your supply closet and risk a spill. I use a grocery bag and tuck it into my waistband to collect any output and trash.  When I used the Hollister brand, I had a thousand supplies that went into a bag change. Now that I’ve switched to the Sensura Mio Convex 2-click appliance, I need the wafer, a bag, and skin-tac that helps the bag stay on longer. My Hollister (which I used for 3 ½ years) lasted two days; my Coloplast Sensura Mio lasts at least 5 days.”

Lindsay recommends always having a water bottle with you when you empty. Since output can be sludgy and hard to empty, it enables you to rinse your bag with some water after you’ve dumped it. She says this tip will change your life!

Michel Johnson, 56, of Tennessee, had a temporary ostomy for nine months. He recalls changing his bag every three to four days. At first, he said he would relive the trauma every time he had to change or empty it, but then his perspective shifted.

“I realized my ostomy saved my life. Rather than moping around, I brought a music speaker in the bathroom and created a dance playlist for my bag changes. I looked forward to it! I danced and sang while I changed my bag. Doing this completely reframed how I looked at this process.”

Several ostomates also mentioned showering bag free and what a wonderful feeling it is to not have anything attached to your body. Just remember to keep soaps and shampoos with perfume and moisturizers away from your stoma and peristomal skin, as they can cause irritation.

Jordan Ditty, 27, of California, was diagnosed with Crohn’s at age 11. When it comes to changing her bag in public, she recommends hitting up Starbucks, as they usually have single bathrooms. If you need to change your bag in public, she says it’s also helpful to use the stall with the changing table so you can lay out all your supplies. Jordan always keeps disinfectant wipes in her bag along with extra paper towels to make sure she’s able to clean the surface area and stoma well.

“You can also sample different companies supplies for free. Email them with what you are wanting to try, and they will send you 2-3 of them as well as others so you are able to find what works best for you. In the past year and a half, I have changed my pouching system at least five times if not more to find what works for my skin, activity level, daily life, and stoma.”

Overall, the recommendation—expect the unexpected. You can’t control what the stoma does, so when it’s not cooperating, try your best to go with the flow (literally and figuratively!). And don’t wait too long to change a bag. If your skin is burning underneath, it’s probably leaking, change it. If you think the adhesive is coming off your wafer and may not last sleeping through the night, change it. Overestimate the time you will need and please give yourself grace upon grace.

Stay tuned for Part 3 of “So, You Have An Ostomy…” Monday (September 28th) we’ll cover disclosing you have an ostomy on a date, intimacy, styles of clothing and underwear that work best and the unique names some IBD warriors have for their stomas.

In case you missed it, click here to read Part 1 of “So, You Have an Ostomy”—The Complexity of Coping, which focuses on what it’s like to find out you need an ostomy, the complexity of coping, and adjusting to your new normal.

“So, You Have an Ostomy”: The Complexity of Coping —Part 1

When you think of ostomy, what comes to mind? As someone whose had Crohn’s for more than 15 years, but never been an ostomate, it’s something that has loomed over my head since diagnosis. I’ve always wondered if I would ultimately end up with a bag and what that would mean for my life. I know I’m not alone in those worries and curiosities. Which is why I’m kicking off a 4-part series on Lights, Camera, Crohn’s— “So, You Have An Ostomy.” Over the course of these articles you will hear from more than 20 ostomates from around the world.

Today—we’ll focus on what it’s like to find out you need an ostomy, the complexity of coping, and adjusting to your new normal.

What it’s like to wake up from ostomy surgery

Blake Halpern, 39, of Texas, was diagnosed with ulcerative colitis in November 2004. By April 2005 he had a temporary ileostomy. After four weeks of being hospitalized on full bowel rest, it was determined he would need his colon removed. Blake says he was so worn out and emotionally drained, he felt like a shell of his former self. He was anxious to have the surgery and get his life back on track.

 “The ostomy is so shocking. It seems like something out of a Sci-Fi movie.  My small intestine poking through my abdomen emptying my waste into a bag?? That’s crazy. But it gave me some semblance of my life back. I was able to get out of the hospital, slowly start eating again and reclaiming my life.”

Alison Rothbaum, 41, of Ohio, was diagnosed with Crohn’s disease in 1994 at age 15. She says prior to her ostomy surgery, she went into a very dark mind space that she wasn’t prepared for.

“I woke without a pivotal organ. I woke with a new prosthetic device attached to me. I ached in my belly and in my heart. I needed to mourn the loss of the organ. It’s hard to describe unless you’ve experienced it. I refused to look at myself from the top to bottom in the bathroom mirror for a week. I didn’t want to see what the new body looked like, even though I had already begun to learn how to change my ostomy while lying in my bed.”

For Tina Aswani Omprakash, 36, of New York, needing an ostomy struck a major chord for not only her, but her family. She recalls how her dad hated his ostomy while he was alive and used to rip it off when he was in a coma in the hospital. Because of that, her mom had a significant amount of PTSD from his experiences and was against Tina receiving one. Her cultural society also told her that no one would marry her or accept her if she was an ostomate.

“I held off for as long as I could, but I started thinking that an ostomy wouldn’t be as bad as everyone was saying. I knew I needed to listen to my heart and to my doctors. My gut feeling (as flawed as my gut may be) was right. My ostomy had become my baby so to speak and I grieved for months if not years for the life it had given be back. Don’t let society sway your thinking. Seek counseling and ask all the questions you can to your surgeon and Wound, Ostomy, and Continence Nurse (WOCN) before the operation so you can feel a bit more at ease.”

Tina recommends connecting with fellow ostomate online over social media and through blogs. She says an ostomy doesn’t have to be a life sentence, but rather a life-saving force.

Adjusting to the new normal

Renee Welch, 34, of Toronto, Ontario was diagnosed with Crohn’s when she was nine years old. Getting an ostomy was a life or death decision for her. She knew the life she was currently living wasn’t what she was destined for and ultimately the choice was out of her hands.

“The hardest part of having an ostomy was recovery. It’s a long process that is not progressive. Mine took three months until I was able to feel like myself and even after that my energy was not the same until six months down the road. Recovery is something you can try to mentally prepare for, but you never know.”

Natasha Weinstein, 28, of Connecticut was diagnosed with Crohn’s at age 11. She can still remember feeling that tug on her skin and not knowing if the bag was going to randomly fall off. Eight years later, she’s still impressed with how strong the adhesive is! One of her main struggles was adjusting to her new self-image.

“No longer would I have a “flat” right side when I looked in the mirror, in fact I was always going to have this device protruding and as a college student and a young adult that’s a lot to adjust to.”

Payge Duerre, 21, of Iowa, was diagnosed with ulcerative colitis in 2003 at age 5. Her advice—not to think of your entire life as the first couple months after surgery.

“The first couple months can be shitty. More pain, more recovery, less muscle, new foods, new clothes. The entirety of ostomate life is not like that. My first three months post op were spent relearning life. But now I’m two years post op. I’ve already re-taught my body, but I’m always constantly learning new tips or tricks from other ostomates to make life easy.”

Advice for those who need an ostomy

Ashley Clark, 27, of British Columbia, was diagnosed with Crohn’s when she was 19. Her main piece of advice, “If you’re at a point where you are contemplating ostomy surgery, get it sooner rather than later. Waiting until getting my ostomy was a matter of life or death is one of my biggest regrets. It took me so much longer to recover because I let myself get so sick before I would agree to it. Looking back, I think, wow my life is so much better now, if only I had known it would be and agreed sooner.”

Tionna Forchion, 32, of New Jersey, was diagnosed with Crohn’s when she was 13 years old. She ended up getting an emergency colostomy after a bowel obstruction, so she wasn’t able to mentally prepare for the everything that came her way. Tionna says she was angry at first and cried for days, but as time passed so did her acceptance for how having a bag saved her life.

“My advice for anyone on the verge of getting a bag or needing one is that there is life after getting an ostomy. So many times, people say they don’t want a bag because they assume there will be so many things they can no longer do and that is so false. You can still travel, swim, go to college, have kids, get married and do everything a person without a bag can do.”

Gaylyn Henderson, 36, of Atlanta, Georgia, was diagnosed with Crohn’s at age 14 and has a permanent ileostomy. She says at times with chronic illness you can’t help but wonder if there is anyone out there who really understands what you’re going through, but that there is.

“You need to meet them, and you need to seek them out to know that what you are feeling is not unusual. The feelings you have are very real and it’s not out of the ordinary to be feeling that way. You are not crazy, your life is. There is an importance to building a fellowship of those that can relate to what you are going through. It is imperative to know you are not alone. You may not go through the exact same circumstances, you may not have the same diagnosis, but chances are you have similar experiences and can relate more than you realize. You need to know that what you are going through you will get through.”

Stay tuned for Part 2 of “So, You Have An Ostomy…”, Wednesday (September 23rd) we’ll cover diet recommendations, how to pack when you’re traveling, and how best to change your bag.

Navigating IBD and IVF During a Pandemic WITH A Toddler

When I asked 34-year-old Amanda Osowski how she’s juggling Crohn’s disease, motherhood, and IVF during the pandemic, she said “with caution.” And rightfully so! These times are complicated and overwhelming for everyone. Add some chronic illnesses and trying to maintain your health, sanity, and emotions while doing all that and trying to get pregnant with a second child through IVF, and I’m amazed she found the time and energy to write this guest post! I’ll let her take it away.

Here we are, more than 7 months into a global pandemic, still wondering if and when life may “resume as normal”. To be honest, in my house, life has in some ways paused and in other ways accelerated since the March quarantines began. As an IBD patient on Remicade (an immunosuppressant medication to manage my Crohn’s disease), I have chosen from the beginning to adhere strictly to social distancing, mask wearing, unnecessary exposure and other risk reducing options. 

This also meant that my job, my income, and my ability to support others has transitioned from mainly in-person to entirely virtual. The silver lining of this is that I’m able to work with clients all over the world. Balancing that alongside parenthood, and IBD during a pandemic requires a good bit of patience, strategic thinking, and deliberate planning.  

Gearing up for Baby #2 Through IVF 

My husband and I were diagnosed with Unexplained Infertility in 2017 while trying to conceive our first child. After several failed treatments, we had one successful round of IVF in which I became pregnant with our daughter in the fall of 2018. As soon as she was born, we knew we wanted to have another baby close in age – both for our family planning goals and in hopes that I would be able to maintain my Crohn’s remission status long enough to complete another pregnancy. 

While we began trying naturally as soon as we were ready, we knew that the recommendation for fertility treatment was to wait until 12 months passed after delivering our daughter. I desperately hoped that we’d get lucky before then, and that we’d end up with natural conception, rather than going through the physical, emotional, and financial journey of another cycle of IVF. I also knew that I wanted another baby, and that would happen however it was meant to. 

How the pandemic has impacted fertility treatments

We were scheduled to begin fertility testing in March 2020, with treatment starting in April. As I’m sure you guessed, that was immediately halted with the closing of most fertility offices and the pausing of all new treatment cycles with the influx of COVID-19 cases and concerns. Having my treatment (and my timeline) be paused indefinitely with the continuing anxiety and stress of the pandemic caused my IBD symptoms to increase – something that then caused me more anxiety and stress about its impact on my IVF plan if and when I was able to reschedule treatment. 

After an exceptionally long few months, my doctor’s office re-connected with me about getting my appointments scheduled. My IBD while not flaring, was not perfectly calm either, and that’s such an important part to me about preparing for pregnancy, so we gave it a little more time. FINALLY, this month (September), I began the treatment protocol I should’ve started five months earlier. Our daughter Brooklyn just turned 16 months old.

Today you’ll find me managing IVF medication injections around business calls, my Remicade infusion schedule, chasing a toddler and being stuck inside my home around the clock. It’s HARD, and exhausting, but it’s the only way I know how to make my hopes come true. 

Tips for handling IBD + IVF

  1. Communication with your partner is critical. From parenting responsibilities to COVID-19 precautions to childcare to work stressors to fertility treatment planning and execution – there is an entire machine full of decisions and emotions that are part of every single day, and not being on the same page as your partner can have devastating effects. My recommendation: schedule time once a week on your calendar after bedtime to talk. Keep a list running during the week of things to add to the conversation. Ask all your questions to each other then, when you can focus and talk and connect. You’re a team, and it’s important in this season to work together. 
  1. Mental health is just as important as physical health. When managing IBD + ANYTHING, let alone motherhood, and a pandemic, and fertility treatment, taking time to check in with your mental health and care for yourself is imperative. Each of these things come with so many feelings, and burying them all will only make it harder to deal (& keep your IBD in check!) I personally recommend working with a counselor, taking time to journal or meditate or center yourself, and ensure you’re checking in with your own needs regularly. 
  1. Social Media Strategy – During the pandemic, I think we’ve all admitted to more screen time than usual. I know firsthand that the amount of pregnancy announcements, gender reveals, new baby births & seeing families with multiple kiddos can cause feelings of guilt, frustration, jealousy, anger, etc. Social media can make things feel extra difficult for those struggling to get pregnant, undergoing fertility treatments AND managing something like IBD. Here’s what I recommend. The beauty of social media is that we can choose what we do and don’t see while we scroll. This is a perfect time to click “hide” or “unfollow” on any hashtags or accounts that make you feel sad or icky. That’s not to say you don’t love your neighbor/friend/co-worker, but in my opinion you also don’t have to constantly watch their highlight reel. On the flipside, utilize social media to connect with your TRIBE. Whether that’s other IBD and IVF warriors, others struggling with infertility, etc – there’s so much more space for online communities now than there ever has been before. If you’re having difficulty finding and connecting with others, please DM me and I’m happy to make some suggestions! Also, please know that whatever you’re feeling during this experience and this season is so valid, and you’re not alone!  
  1. Give yourself grace. There will be days when you feel inadequate – as a parent, as a spouse, as a patient – these moments don’t define you. You’re juggling so much, it’s so important to know that you’re doing the best you can, even if that looks different than it used to or different than you’d like it to. 

If my story resonated with you, or you’d like to connect, please reach out! You can find me on Instagram personally as @amanda.osowski and professionally as @heartfeltbeginnings.  

Why this public bathroom triggers me: Tactics for coping with the mental health aspect of IBD

I paid for my groceries and casually pushed my cart full of food through the automatic door when I saw it. The bathroom where I experienced one of my scariest and most painful moments. The bathroom I had to run into after pulling over on my way home from work because I was in such debilitating pain, I couldn’t handle sitting upright in my car to make it the extra five minutes home. The bathroom where I lost all feeling in my arms and legs and where my fingers locked into painful contortions. I couldn’t even hold my phone to call my boyfriend (now husband) to tell him we needed to go to the hospital. The bathroom where I unknowingly happened to call my mom after accidentally hitting “Recent Calls” with my elbow. All she heard on the other line when she answered was me screaming. She didn’t know if I was getting raped, she didn’t know what the hell was going on and she was in a different state. God was watching out for me because she was able to call Bobby and let him know I needed help and I needed help fast.

He rushed to the grocery store and whisked me out of the bathroom and straight to the hospital where I found out I had a bowel obstruction.

I’ve been going to this same grocery store for nearly seven years. It’s been nearly six years since that dramatic experience occurred. But even now, five years into remission, I always go out the other doors because seeing that bathroom is a trigger. A trigger to one of my lowest points in my patient journey with Crohn’s disease. A trigger that caused my IBD to act up right in that moment this past week.

I was forced to go out of the grocery store that way as part of COVID-19 safety procedures to keep all incoming traffic through one set of doors and all outgoing traffic to another.

Coping with psychological triggers

When those of us in the IBD community hear the word “trigger”, food usually comes to mind. We casually say “oh that’s a trigger food for me”, but we often don’t pay much attention to the physical triggers in our lives that can exacerbate our symptoms—such as locations like that grocery store bathroom, relationships with certain friends and family members, the pressure of being enough and doing enough in comparison to our peers, the list goes on.

I interviewed Dr. Tiffany Taft, PsyD, MIS, a Research Assistant Professor at Northwestern University Feinberg School of Medicine, and a fellow IBD warrior to get some clarity on this subject and to learn more about what steps we can make right now to protect our mental health and prepare for the unknown.

NH: As chronic illness patients–how can we best navigate triggers that instigate a stress response? (Other than avoidance)

Dr. Taft: “While avoidance feels like the safest option when it comes to situations that trigger our stress response, it simply kicks the can down the road in terms of the effects these situations have on our bodies. People living with chronic illness may collect multiple situations that trigger the stress response – doctor’s offices, hospitals, certain tests or treatments, making avoidance very risky if it means not managing the illness and staying healthy.

Try the “Exposure Hierarchy” exercise: Dr. Taft recommends making a list of activities or situations that are stressful, ranking them from the least stressful to the most stressful and picking 10 things. Rate those 10 things from 10 to 100 (100 being the worst). After making the list, she has patients start with number 10 and practice that task several times over the course of a week.

Before that, though, she teaches relaxation strategies such as deep breathing and grounding to help when the anxiety goes up. She says, “With repeated exposures to the feared situations and working through the anxiety, each time we do activity 10 again, it will feel easier and confidence grows. Once the patient is ready, they repeat with 20, 30, etc. until we get to the dreaded 100 which will actually feel less scary because of all the other work we did before.”

**NOTE** If you feel you have symptoms of Post-Traumatic Stress Disorder (PTSD) which include vivid nightmares, flashbacks, and feeling on high alert most of the time, you should seek treatment with a trauma therapist. The good news is research on treatments for PTSD show they are just as effective when delivered via tele-medicine.

NH: Can you explain (in layman’s terms) what goes on when we’re “triggered”?

Dr. Taft: “Triggered is setting off our body’s fight-flight-freeze response, and results in a cascade of physical sensations and emotions. The most common ones are muscle tension, sweating, shallow breathing, and heart racing. Unfortunately, this response can also trigger our guts to start acting up because of the brain-gut connection. It’s a completely normal process but when you have IBD it can trigger symptoms. Your thoughts may be all over the place and littered with “what if’s” and “I can’ts”. Your mind may revisit the worst aspects of past experiences or come up with even more catastrophic possibilities in the future.”

NH: As people with IBD–I know many of us are nervous about flaring and needing to be hospitalized all alone during this pandemic, while being at greater risk for getting COVID. Do you have any advice on how to cope/mentally deal with that worry/concern?

Dr. Taft: “Facing a flare and hospitalization was stressful in the “before times” so facing this during COVID19 is an extra level of stress. While we have video chat, it does not replace the comfort of physical closeness and touch we would get from supports who could be in the hospital with us. The good news is hospitals have figured out COVID quite well and the odds of contracting it while hospitalized for IBD are lower than they were at the start of the pandemic.”

If you’re facing hospitalization, think about your resilience in these circumstances. There were probably times you felt like you couldn’t handle it, or it was never going to end or get better, but here you are today reading these words. You made it through. It may not have been pretty, it was probably incredibly hard. Anxiety has a great ability to negate our memories of how much we’ve navigated in the past.

Feeling anxious? Do this: Write down the ways you coped before, what worked and what maybe didn’t. Evaluate your thoughts about being hospitalized. Are they accurate? Are they helpful? What are some alternatives that could help you feel less anxious? If that doesn’t work, sit with the anxiety, and try some deep breathing to calm your nervous system. The sensations will likely pass and then you can retry evaluating your thinking when you aren’t feeling so keyed up.

NH: What advice do you have for people during these already complicated and challenging times when it comes to managing mental health?

Dr. Taft: “This is truly a unique time in that we are all in this COVID19 boat together. We all came into the pandemic with our own life challenges, and those probably haven’t gone away and even may have been made worse. We’re coping with a lot of information, new rules every other day, grim statistics, and people bickering over who’s right or wrong. I’ve told every patient I see to turn off the news. Get out of the comments on social media when people are arguing the same points over and over.”

Steps you can take in your day-to-day: Dr. Taft advises not to spend more than 15 minutes a day on the news, so you can stay informed but not get into the weeds. Take social media breaks, especially if your feed is full of the same tired arguments. Focus your attention on meaningful activities that align with your values. Those are what will bring you some stress relief. And those are unique to you, so no list on the internet of how to cope with COVID is going to solve everything. Sometimes these lists make us feel worse because we’re not doing most of the recommendations. Be as kind to yourself as you would be to your best friend or a beloved family member. Nobody has it figured out right now even though some people like to say they do.

Self-care isn’t selfish: Using my birthday as a re-set button

One of my friends recently said I need to start doing more for me, that once I fill my own cup that energy and that fulfillment will spill onto others, without making me feel depleted and like I’m constantly in survival mode. As an IBD mom of two, who has lived with Crohn’s for more than 15 years, these challenging times we’re living in have forced us all to pause and refocus on what’s important and what we need to do to get by.

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Today is my 37th birthday. Sounds a lot older than I feel, but chronic illness has a way of forcing you to grow up and mature well beyond your years. Between the pandemic, mom life, and my advocacy work, there hasn’t been much time for a breather. I feel as though I’ve been coasting for awhile. Coasting through the day to day. Coasting through remission. Coasting just to make it through.

I don’t want to coast anymore

If you’re feeling the same, please follow my lead and that of others, who have recognized they’re ready to do more to improve their quality of life.

I want to stop being such a “yes” person.

I want to stop making excuses.

I want to stop waking up when my kids call out for me and instead start my day with a cup of coffee outside on the patio or a workout, followed by a shower, while the house is calm and quiet.

I want to stop not asking for help.

I want to stop staying up so late binge watching TV or scrolling through my phone.

I want to stop going months on end without a night out with my husband (we’re going on a date tonight for the first time in over six months!) IMG-7109

I want to stop working seven days a week and being at everyone’s beckon call and instead set aside days where I’m offline and able to live in the moment.

I want to start prioritizing my health, my well-being, my marriage, my friendships, who I am outside of being a mom and a person with chronic illness, because while that’s a lot of me—it’s not all of me.

Finding the ‘Joie de vivre’

Let’s face it, this coronavirus nightmare isn’t ending anytime soon. Much like a chronic illness diagnosis—there is no end in sight. We all rise to that challenge day after day, and don’t think twice. I fear if I don’t start spending more time for myself, I may put my remission in jeopardy and that scares me, big time, because when you’re a mom and a wife, your flares impact a lot more than just you. IMG-5066 (1)

I look at this 37th year with a lot of hope and a lot of possibility. I’m eternally grateful for the life I have and the family and friends I have around me, near and far. Recognizing there’s a need for change is similar to the importance of being proactive in managing your illness and doing all the things you can to set yourself up for success—whether it’s seeing countless specialists for medical care and preventative screenings, taking medication, getting blood draws and scopes, etc.…I look at this form of self-care as just as important in managing my Crohn’s and giving myself the best shot of staying out of the hospital and flare-free. IMG-6382

Cheers to the next 365 days and beyond! Thank you for following my journey and for your support through the years. This blog is like one of my babies and being able to speak to you through it is one of the most cathartic aspects of my patient journey. If you’re feeling like you’re in a bit of a rut or a funk, remember self-care is not selfish. Now I just need to practice what I preach.

Finding your voice with Crohn’s: How music helps Anna Tope cope

Songwriting has been a coping outlet for 22-year-old Anna Tope, for as long as she can remember. When she was diagnosed with Crohn’s disease in June 2019, she worried if her aspirations of sharing music with the world would be silenced. COVID-19 hit during her final semester at York College of Pennsylvania. She looked forward to and worked hard for her senior recital all four years. The event was scheduled for March 13th, right when the world started to shut down. IMG_6972

Luckily, the music faculty were able to work things out and held the recital before campus had to be cleared out. Anna gave the best performance she ever had. The whole audience was on their feet, followed by a huge line of people waiting to greet her afterwards. The moment was a dream come true. Check out her recital performance here.

The song inspired by Crohn’s

“My favorite part was being able to end my recital with a song that I wrote about my Crohn’s Disease journey called “Renewed.” This is a song that has moved people to tears, and people have told me how much the song has impacted them, especially during the pandemic,” said Anna.

Anna wrote “Renewed” in January 2020, while sitting at a Barnes & Noble. Click here to listen to the song.

She says quarantine has enabled her to focus more on creating music and writing.

“My songwriting is essentially reflecting through some of the hardest times of my life, such as my illness/diagnosis, but also showing how my hardships have been so eye opening and influential,” says Anna.

Finding joy through the suffering

Anna’s main goal with her music is to bring joy and hope to those suffering from chronic illness. The unpredictability of Crohn’s often leaves Anna feeling worried about whether IBD is going to rob her of her musical dreams, but not only that—like many of us, she worries about her future. Two of her biggest fears are finding love and being able to have kids one day. Ann is incredibly grateful for her amazing support system and how her friends and family have rallied around her since diagnosis.image0 (1)

She wants to use her voice, energy, and the broken parts of her experience to bring comfort to those who feel alone.

“IBD has impacted me in so many ways. It’s turned my life upside down, but at the same time it’s given me even more of a passion to sing and to help others.”

Use quarantine to your advantage

Living with a chronic illness in the middle of the pandemic is complicated and challenging, but Anna hopes others use this time to explore their talents and see beyond their IBD. IMG_6121

“Go write some songs or poetry. If you want to learn an instrument, now is the time! Go write that book you’ve been wanting to start. Do whatever brings you a feeling of accomplishment, joy, and comfort.”

The success of Anna’s senior recital pushed her to continue writing. At a time when many of us feel tapped energy wise—mentally, physically, and emotionally, try and find what motivates you outside of your illness. And like Anna, you’ll see, while IBD may change the course of the path you’re on and re-direct you for a bit, just because you have Crohn’s, doesn’t mean you can’t follow your dreams.

Connect with Anna

Instagram: @myvoice.myjourney

Facebook: Anna Tope Music

Twitter: @annatope_

YouTube: Music and Covers

 

 

Healing Holistically: 7 Helpful Tips from a Nutritionist with Crohn’s

When you’re diagnosed with IBD as a teenager, it’s safe to say, your disease plays a big role in your future. Brittany Duffy is a 24-year-old from Canada who is already a decade into her journey with Crohn’s disease. Her diagnosis inspired her to become a Registered Holistic Nutritionist.

This past March, Brittany had bowel resection surgery that also involved the removal of her appendix. She is currently medication free and choosing to support her body naturally through diet, stress management, and supplements. Surgery

Before we dig into this week’s article—I want to preface this by saying medication is not a failure. While diet and lifestyle alone work for some with IBD, it certainly doesn’t work for most. As someone who has been on medication for 15-plus years, I understand what it’s like to aspire to be med-free, but not be able to successfully make the transition without putting your health at risk. Please don’t go off your medication without first consulting with your gastroenterologist and care team. At the same time, even if you are on medication, your body, overall health, and well-being can benefit immensely by living a “clean” lifestyle.

When Brittany was first diagnosed in October 2010, she was put on Humira, which worked well to stop her flares. Unfortunately, the medication caused a host of other issues. She experienced anemia, muscle and joint pain, depression, anxiety, disrupted sleep-wake cycle, dry skin, brittle nails, hair loss, constant constipation, and uncomfortable abdominal pains. Sunny day

“I am so inspired by other IBD warriors, it reminds me that I’m not alone and to be grateful for the health I have. So many others have it much worse, so each day that is a good day I embrace and make the most of it,” said Brittany. “We never know when a flare will strike. There are tactics in my toolbox I have now to reduce gut inflammation, and I am passionate about sharing this information with others.”

7 tips for managing IBD holistically

  1. Stress management: It’s critical to manage your stress levels, because when the body is in a constant state of stress, simple functions like digestion, absorption, and elimination cannot occur, resulting as nutrient deficiencies, constipation, diarrhea, low energy, and whole-body inflammation. Stress turns off digestion and can trigger uncomfortable digestive symptoms, like gas and bloating, heart burn, acid reflux, constipation, or diarrhea. When we are stressed it can increase inflammation and reduce the chance of reaching remission. Some stress management practices include deep breathing when feeling overwhelmed, yoga or gentle movement, getting outside and being with nature, and also self-care (one activity a day that makes you calm – music, reading, calling a friend, journaling, physical exercise.)
  1. Choose local, fresh, quality foods: Fresh is best. If it doesn’t come from Mother Nature and you don’t understand the ingredient list, the body won’t either. The body recognizes real foods versus processed and boxed items. There are also beneficial enzymes, fiber, and antioxidants in fresh food that helps reduce inflammation and IBD flares.
  2. Avoid antibiotic and hormone fed meat, dairy, and eggs: Antibiotics and added hormones in our food can disrupt our gut bacteria balance and allow harmful bacteria to thrive, which may contribute to IBD symptoms and poor nutrient absorption. Our good bacteria help digest food and increases nutrient absorption, but if our gut bacteria balance has more harmful than good bacteria, our gut health will become affected.
  3. Practice mindful eating: Eating when rushed or in a hurry can delay digestion and may create symptoms of gas and bloating, diarrhea, or constipation. IBD often creates limited food choices due to food sensitivities or trigger foods, bowel blockages, scar tissue, high fiber foods, raw nuts and seeds or fruits and vegetables. If we create a stress-free eating environment it may help reduce digestive stress and allow our body’s a chance to break down “safe” foods easier, while also reducing the risk of triggering a flare or an inflamed gut. A stress-free eating environment includes sitting down while eating, away from stress and distractions, try to enjoy the food you’re eating, become of aware of how you feel while eating, and find pleasure in food. Take a few breaths and put utensils down in between bites to allow yourself time to eat. Eating should be an enjoyable routine, not something we rush through.
  1. Focus on anti-inflammatory foods that may help reduce IBD flares:

Healthy fats: avocado, hummus, coconut oil, coconut yogurt/milk, raw nut butter

Lean proteins: wild caught fish, chicken, turkey

Digestible fiber: sautéed spinach, carrots, zucchini, bell peppers, soaked or ground nuts and seeds, pineapple, strawberries, bananas, mango

Herbs and spices: cinnamon, cardamom, turmeric, fenugreek

Tea: ginger, peppermint, green, lemon, chamomile

  1. Understand Food combining: Certain foods digest at different rates, which may result as sugar and protein fermentation in the gut. Uncomfortable symptoms like gas, bloating, heart burn, constipation, diarrhea, and feeling tired can result when there is a compromised digestive system and poor food combinations. Try to eat foods that will digest the quickest first, like fruit, to avoid protein and fat fermentation in the gut. Try to avoid proteins and sugary/starchy carbohydrates together. Proteins and fats are okay with vegetables, but should be eaten separately from grains. The purpose of food combining is to improve healthy nutrient absorption and reduce bacterial overgrowths in the gut by reducing a food source, the sugars. Food combining does not have to be practiced several times a day, but it can help long term to reduce digestive stress, and improve overall gut health.
  2. Eat “Alive” foods: Quality probiotics, fermented food (raw and unpasteurized) like sauerkraut, kimchi, tempeh, coconut yogurt/kefir. These contain beneficial bacteria that supports healthy digestion, nutrient absorption, energy, and may help reduce inflammation.

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Now that Brittany is not on medication, she meets annually with her GI specialist to get blood work done once or twice a year. She also has a colonoscopy every three years. Her next scope is scheduled for October. If she recognizes any changes to her health, she contacts her physician or requests blood work. Since Brittany shifted her focus on diet, supplements, and lifestyle, she has improved nutrient absorption and reduced the inflammation in her body.

You can connect with Brittany Duffy, RHN on Instagram and Facebook: @digestionwithbrittany.