Sic transit gloria abdominis

It’s been three weeks since I last moaned online about my guts. A few things have occurred, and some experimentation and learning have transpired. Read on if you want to know more.

What do I know?

The colon transit study (markers ingested 21-23 July, X-ray on 25 July) ‘confirmed slow bowel transit with a significant number of shapes within the left colon by day 5 and faecal loading noted’, according to the GI specialist. This fits with my ongoing symptoms of central abdominal bloating, constipation. It doesn’t explain, at least to me, the pains in my legs and feet – these were severe a week or so ago, but have reduced in frequency and intensity since then.

I also know that travel is difficult just now. Elly and I went to Ocean Terminal last night to see Star Trek Beyond The bus there and taxi back gave rise to severe abdominal pain. However, we both enjoyed the film, despite The Register having described it as a ‘steaming pile of tribble-dung’. More importantly, my partner and I were out enjoying ourselves, not doing Bruce-medical things, for the first time in ages. Seeing Elly happy was more important and fulfilling for me than almost any amount of pain.

What do I suspect?

It is possible – but not yet proven – that certain foods are exacerbating abdominal (and maybe other) pain. For example, I ate a lot of rye bread and peanut butter – one of my comfort foods – in the week after the colon transit study. Abdominal pains were severe, as were leg pains. They reduced markedly the day after I stopped eating rye bread. A few days later, I ate a hummus sandwich. Within 30 minutes, my guts were in uproar. Peanut butter on rice-cakes does not appear to cause extra issues. So wheat and rye flour are likely to be agonists, despite testing negative for gluten allergy a month or so ago. It’s not clear-cut – I had some couscous on Monday and didn’t suffer noticeably more than usual, even though couscous is made of flour. Still I’ll avoid bread for the time being.

My GP mentioned that if I have irritable bowel syndrome, lentils and onions are very bad news. The FODMAP food list concurs. However, it’s not proven that I have IBS because this is a group of abdominal issues without obvious cause (wikipedia). How do you prove something that can’t be observed?

So I’m experimenting to find out what sets me off. Apples seem to be bad news (today’s finding). Channa dahl without onion didn’t affect me on Monday, so I’ll next try making the same curry with onion. Then I can try the same recipe with different varieties of lentil. This might lead to more pain but it will also lead to knowledge.

What’s next?

I am to have a hydrogen and methane breath test, to provide information about the digestion of carbohydrates such as lactose and fructose, and to detect abnormal growth of bacteria within the small bowel. I don’t see the point of testing for lactose intolerance because I’m vegan, and so won’t frequently ingest lactose!

I’m also to have a gastric emptying test, to ‘exclude concurrent gastroparesis’ (partial paralysis of my stomach [wikipedia]). I don’t quite understand this – if the lower parts of my digestive system are blocked, won’t these automatically slow stomach throughput?

What do I fear?

That I will not be able to return to normal work in October, and that the condition will go on   indefinitely, sapping my satisfaction with life. Objectively, I don’t know that I won’t recover. I need to feel that I’m earning my place by doing useful stuff, and to enjoy myself via academic success, being silly, learning and using new skills and going out on the bike. I am achieving some things at home – I’ve just about fixed our lounge door today, for example – and I need to learn to give myself credit for this.

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