Digestive Issues In Recovery

I was recently doing an audit of my past clients, going through the records for each client I’ve worked with over the last couple of years. I wanted to see what were the most pressing symptoms they highlighted when we first started together.

Interestingly, there was a collection of 8-10 symptoms that accounted for nearly everything I work on with clients.

One of these symptoms was digestive issues. And more specifically, bloating and slow transit time.

Now, this wasn’t particularly surprising. The clients I work with are typically dieters who’ve had a history of restriction. Or they are somewhere on the disordered eating and eating disorder spectrum.

Poor digestion goes hand in hand with this kind of eating.

So what I want to do today is hone in on some of the specific reasons why this happens.

I also should mention that many of these symptoms arise when someone is in the process of recovery. So once they are eating more food or reintroducing previously banned foods, problems can actually get worse (at least temporarily).

Stress

When our body is under stress, digestion is not important.

During an acute, stressful event, the body pulls the blood away from your digestive and reproductive systems. It’s instead shuttled to your heart, brain, and big muscles groups. When the proverbial lion is chasing you, now is not the time to digest your food.

Under more chronic stress, a similar pattern also emerges. Your body focuses on functions and processes that are about short-term survival.

It costs energy to produce hydrochloric acid in the stomach or the digestive enzymes released from your pancreas and small intestine. These are seen as nice-to-have items that are about long-term health. So under stress, their production isn’t prioritised as highly by the body.

Lack of calories (whether currently or previously)

Under-eating could be thought of as a particular type of stress. Considering that food is turned into energy, certain functions have their resources reduced when it is in less supply than what their body needs.

If the body is trying to curb spending, digestion is one place that feels the cuts.

And this can have an impact even after someone starts eating more food again. You may be increasing what is now coming through the system, but to start with, a skeleton staff is handling this food.

Gastroparesis

One of the consequences that may arise is known as gastroparesis, which literally translated means “stomach paralysis”.

The stomach does its job of breaking down food through a combination of actions. Part of this is using chemical digestion, with substances like hydrochloric acid and pepsin breaking bonds in the food. And part of this is using physical digestion, where the stomach contracts and crushes food to break it apart.

With gastroparesis, the stomach is unable to contract properly.

Not only does this prevent proper digestion, but it also prevents food from being passed from the stomach to the small intestine, slowing the transit time of food. This is why gastroparesis is also referred to as delayed gastric emptying.

Symptoms that arise because of this are bloating, nausea, heartburn, and pain. But most common is the feeling of early satiety; where fullness is experienced shortly after commencing eating, even though only a small amount of food has been consumed.

Note: For some people, they have the opposite response: they introduce new foods and it causes a speeding up of the system and they are having urgent and loose stools. This is something I cover in this article. 

Enzymes, Villi, and Microvilli

Once food makes it past the stomach, other problems can still arise.

Digestion is only half the battle, the other half is absorption. Not only do you want to break down the food, but you also want to then be able to take this matter and absorb and utilise it.

The majority of absorption happens in the small intestine. You have finger-like projections that jut out of the small intestine. These are known as villi. And on these fingers, you have even smaller structures, known as microvilli.

The villi and microvilli are used to both digest and absorb your food. But like other parts of digestion, they are affected by stress and reduced energy, amongst other things.

When this happens, they atrophy. So no longer are they able to digest food and absorb it as they should, leading to bloating, slower transit time and missing out on much need nutrients from the food you’ve just consumed.

Difficult To Digest Food

Some foods are easy for the body to digest. Meaning that even when digestion is compromised, calories and nutrients from these foods are mostly able to get through (although symptoms will mostly still arise).

But then there are other foods that create a negative net effect. They use up energy as part of digestion but provide little in return. But added to this, they create the most obvious and painful symptoms.

Ironically, it’s often some of the foods that people think of as the “healthiest” that fall into this category. Salad leaves and green leafy vegetables are two such culprits.

Yes, on paper they are healthy and for many people they are fantastic. But for those with a compromised digestion, especially when recovering from restrictive eating practices, these are the foods that often lead to people being doubled over with pain and bloating.

Nocebo Effect

But digestion isn’t just about the physical capability of the various organs; it’s also impacted by our mind and our beliefs.

Most people are aware of the placebo effect. Where someone can be given a sugar pill or receive a sham surgery (they are opened up, but no surgery is actually performed) and because they believe it’s real, that they improve.

Bizarrely, placebos can even work when someone knows they are being given a placebo, provided they are told they may experience an effect.

The opposite of the placebo effect is the nocebo effect. So while the placebo causes positive changes, the nocebo effect causes negative changes.

An example would be receiving a sugar pill and being told that it’s a medication that comes with a list of negative side effects, and then experiencing those side effects.

The same thing can happen with food. If you fear certain foods or believe that you’re intolerant to them, these thoughts can be a self-fulfilling prophecy. Your mind creates these symptoms.

This doesn’t mean that these symptoms are “all in your head”. Digestion is impaired and you do, in fact, react to these foods. It’s just that this isn’t to do with something inherent in the food that you are reacting to, rather your body following the direction of your beliefs. 

Now, not all reactions are down to the nocebo effect. There are substances in food that can trigger a negative response regardless of what the mind believes. Some of these may even be permanent.

But it’s incredibly common for clients to start with a whole list of foods that they are sure they are intolerant to, only for these to disappear once they have done the work to repair both the physiological and the psychological.

Confounding Health Conditions

Often, digestive issues are a symptom of other health conditions.

The thyroid gland is a perfect example. It’s commonly referred to as the “master gland of metabolism” and through the action of various hormones that it creates, it impacts every system within the body.

In terms of digestion, the thyroid gland impacts on functions like enzyme production and transit time.

If this is the case, focusing on digestion may only get you so far because the digestive issues are a symptom, not the root cause. But by understanding where this problem is coming from and doing things that support thyroid health, the trickle-down effect is that digestion improves. 

Time, Patience, And Trust In The Recovery Process

None of these areas is a quick fix. In fact, symptoms can actually get worse in the beginning.

But this isn’t permanent. The body is incredible in its ability to heal. If you give it what it needs, it will do the rest.

Sorting Through The Confusion

As I mentioned at the start of this, digestive issues are one of the most common issues I work on with people. And I know how confusing it can be as it often feels like one step forward and two steps backwards.

If you suffer from digestive issues, whether it’s a stand-alone issue or just one in a long list of problems, I’d love to help.

I’m a leading expert and advocate for full recovery. I’ve been working with clients for over 15 years and understand what needs to happen to recover.

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