endometriosis nutrition

Easing Endometriosis Pain and Inflammation with Nutrition

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Inflammation is the body’s natural and essential reaction to injury, infection or disease that causes tissue redness, swelling, and the unpleasant sensations of heat and pain. While uncomfortable, inflammation is a crucial first step of the healing process, so it is very beneficial when in control relative to a short term injury or illness. The problem is that many of us are stuck in a prolonged inflammatory state and this protective function spins out of control, like a fire raging in the body. New research is consistently linking countless chronic diseases, conditions, degeneration, and even depression with chronic, low level, systemic inflammation. One of the most fundamental ways we can reduce this excessive inflammation back down to a healthy level is by changing the way we choose to eat.

The Modern Diet Induces Inflammation

Processed, inflammatory and nutritionally-void foods have become the staple of the standard North American diet. Some of the most common offenders are sugar and processed grains such as bread, pasta, crackers and baked goods. Certain oils, including the oils that have been heavily marketed as being “good” for us, such as highly processed oils high in omega 6, such as corn, canola, safflower and cottonseed seed oils are potent inflammatory triggers when consumed in excess. The delicate balance of omega 6 to omega 3 is exceedingly important in regulating inflammation. Of course trans fats like margarine and shortening are the unhealthiest fats of all and should be strictly avoided.  If a food doesn’t grow in nature, chances are it is fueling inflammation and could potentially be making symptoms worse.

Conversely, fresh, whole, unprocessed foods tend to calm inflammation down.  Abundant fresh produce like fresh dark leafy greens, berries, pomegranates, broccoli, and avocados are fabulous anti-inflammatory foods. Flavorful spices like ginger, garlic, turmeric, and good fats rich in omega 3, like wild salmon, raw nuts and seeds such as walnuts, chia, hemp and pumpkin seeds are also often helpful. The essential fatty acid EPA, which is a metabolite of omega 3, is particularly adept at reducing inflammation. EPA is found in foods like wild cold water oily fish like salmon, herring, or sardines and some types of microalgae.

Endometriosis and Inflammation

How does this relate to endometriosis? Endometriosis lesions are like little inflammation factories, pumping out inflammatory cytokines like tumor necrosis factor and interleukins that can cause debilitating pain and scar tissue. The foods we eat contain the building blocks with the potential to fuel both inflammatory and anti-inflammatory states. The everyday food choices we make can help shift the balance to calm down the metaphorical fire, whereas eating the wrong foods will tip the scale against us and throw gas onto the flames. Why would we choose to keep eating foods that just make us feel sick, miserable and make an already bad situation even worse?

Where to Begin

The first step in transitioning to an anti-inflammatory diet is to find a nutritionist or naturopathic doctor who is experienced in women’s health and pelvic pain to design a balanced nutrition program that works for you as an individual. There is so much more to dietary therapy than simply avoiding a generic list of foods. In addition, more often than not there are “forbidden” foods that are well tolerated and “allowable” foods that trigger pain and other symptoms, so it must be personalized rather than a one size fits all approach. An experienced professional will create your specific, individual plan and guide you through the process while ensuring you get all of the essential nutrition you need.

Of course everyone is different, but there are three main components that I typically start with when working with a pelvic pain client. One: eliminate inflammatory foods. Two: eliminate food sensitivities, which are very common among endometriosis patients and three: eliminate endocrine disruptors. From there we determine what each person can tolerate and we further fine tune to address additional factors like interstitial cystitis, painful bladder syndrome, and pain syndromes which also can improve symptomatically with dietary therapy.

How Long Does it Take?

How long does it take to start feeling better?  It depends on the person. Some people can start feeling better within a week or so while for others it can take longer. Personally, I started noticing results in my own endometriosis pain within a month of making targeted dietary changes. If all of one’s dietary pain triggers have been eliminated, one should be feeling a difference within three to six months.

We all have to eat, so it only makes sense to start eating in a way that is going to help us feel our best.

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This post was published originally on Hormones Matter on January 6, 2015. 

Endometriosis in Canada

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At 13 years old, the pain was sudden and intense; unlike anything I had ever experienced before. Bleeding followed three days after the onset of pain.  The ripping pain through my abdomen left me shaking, grey, vomiting and fainting on a predictable basis.  Every month it was the same story, crumpled into an incapacitated heap on the bathroom floor.  Over the counter pain medications offered no benefit.  I also developed a weak resistance to infection with suspiciously cyclical flare ups of throat infections, severe fatigue and viral illnesses.  I knew something was very wrong from the start, although the medical establishment did not believe me.

Doctor after doctor dismissed my symptoms.  “This is normal.  Get used to it.”  “You’re too sensitive.”  “It can’t possibly be that bad, you are being over dramatic.”  “You have penis envy.”  “You are a hypochondriac; it’s all in your head.” Futile doctor visit after futile doctor visit, I was caught in an unrelenting cycle of illness on a monthly basis.  I missed a great deal of high school due to illness and this unrelenting pain with seemingly no explanation.

Following high school graduation I moved to a major city to pursue my education.  I was very fortunate to find a new family doctor who did take my symptoms seriously and referred me to one of the country’s leading experts of the highly suspected disease.  Several months later, after laparoscopic excision with biopsy the diagnosis was certain: endometriosis.  I was 20 years old.

After my surgery I did improve for a while.  With continuous birth control pills and copious NSAIDs I was semi-functional; however it got to the point where I knew another surgery was imminent.  I had my second laparoscopy with a different doctor in Calgary AB eighteen months following my first surgery.  Immediately after surgery I developed a new severe stabbing pain in the lower right quadrant that never went away.  I later found out this doctor had lied to me and had actually performed a laparoscopic fulguration of endometriosis rather than the consented to excision procedure despite my very clear wishes that anything other than excision was not to be performed under any circumstances.  This doctor continued to lie to me the remainder of time I was under her care.  This kind of patient treatment and the complete disregard for patient consent is deemed to be perfectly acceptable and ethical by the Peter Lougheed Hospital and Alberta Health Services.

During this time as my pain was relentless I started learning everything I possibly could about diet and alternative treatments.  Although my vegetarian diet has always been quite healthy I found that certain foods absolutely triggered pain and inflammation.  As sick as I have been, certain foods make my symptoms a thousand times worse.  Dietary therapy and acupuncture were absolutely critical in my functioning in daily life for the next several years (as they continue to be) and inspired me to pursue an education and career in nutrition.  I personally and professionally believe an integrative approach to endometriosis (expert excision surgery, dietary therapy, pelvic floor physical therapy, acupuncture etc) is essential in the optimal treatment of endometriosis.

In the summer of 2008 I suddenly became very sick with fever, nausea and a sudden mysterious painful lump in my abdomen.  It was deep in the muscle just to the right of my navel and felt like a burning marble embedded in my tissue.  Upon seeking medical care, I was sent directly to the emergency room at Vancouver General Hospital for urgent testing.  After an eventful evening in the ER, they ruled out appendicitis and other emergent conditions and sent me home for the night to return for more testing the following day.  My ultrasound could have been a scene from the pregnant man episode from Grey’s Anatomy.  After my initial scan, doctor after doctor came in, followed by residents and students “just to take a look.”  It turned out I had what was believed to be (and later confirmed) an extremely rare abdominal wall endometrioma.

Several months later I had a repeat laparoscopy and mini laparotomy to remove the abdominal wall endometrioma with my initial surgeon.  I improved for a little while, although my stabbing lower right quadrant pain that started after my second surgery persisted relentlessly.  About a year and a half following this surgery I suddenly developed severe nausea and fevers again, along with other inflammatory symptoms that always seem to accompany my endo.  Around this time I also developed stomach ulcers and gastritis from years of taking NSAID medications daily like TicTacs and now can no longer use these medications.  After a couple of years of my worsening symptoms not being taken seriously by numerous specialists across the city with no treatment offers other than hormones (which I am not interested in due to their serious side effects and questionable efficacy) and various stomach medications I decided to look elsewhere for effective treatment to completely excise all of the endo once and for all.

I consulted with three global endometriosis excision specialists, all based in the United States.  All of whom opined that my endometriosis had not been completed excised and diagnosed additional problems that had been missed completely by my leading Canadian specialists. Despite my worsening symptoms, recurrence of the abdominal wall endometrioma and new symptoms suggestive of sciatic endometriosis the doctors here and Health Insurance BC refuse to admit that my rare and complicated case requires a level of expertise that exceeds the present capacities of the Canadian medical system.   They would rather pay considerably more to continue ineffective care here than cover likely curative surgery in the United States.  My case has remained ignored by the BC Ministry of Health despite having caught the attention of the Vancouver Sun in February 2013.  It doesn’t make sense on any level: fiscally, medically or ethically and begs the question does ego matter more than patient care in the province of British Columbia and in Canada as a whole?

I am still locked in a battle with Health Insurance BC and my doctors trying to advocate for the level of expertise I know I need.  Trying to decide if I should just have yet another palliative laparoscopic excision in Canada and submit to a lifetime of pain, suffering and surgery or take my fight to the next level so they will hopefully finally realize that covering optimal care is in the best interest of all involved – myself, physicians, politicians and the tax payers.  So for now I stick with green juice.  As much as I want to believe that the future for other women and girls with endometriosis in Canada is going to be better than it has been for me I remain unconvinced.  The politics and attitudes lag far behind the science.  This is why it is so important for empowered and educated patients and health professionals to speak up and make our voices heard.  Without our united voices nothing will ever change.

 

Eating and Endometriosis: My Story

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I have suffered from endometriosis for as long as I can remember. I am sharing my story so that others may learn from my experiences, and be encouraged to share their own. By sharing our stories, our voices can make a difference in the lives of other women struggling with hormonal issues.

This is my story about food, an eating disorder and my battle with endometriosis.

For as long as I can remember, food has always been a big part of my life–and often a challenging part. When I was a baby, I started to have severe reflux from infant formula and Pablum, a precooked infant food made from wheat, oats and corn. Was my reaction an early indicator of a food intolerance?

I remember the food we ate growing up because it was the same thing every week. Chicken sprinkled with salt, pepper and garlic powder or meatloaf with mashed potatoes some green string beans. Another day we’d have spaghetti with ground beef or hamburgers with brown beans and a nice glass of cold milk. I would always have seconds. On rarer occasions, we would have cabbage rolls, liver, chef Boyardee ravioli, Kraft Macaroni and cheese or Campbell’s Tomato soup with grilled cheese.

For breakfast we would have corn flakes, rice puffs or toast with cinnamon spread. I remember having Jell-O, candy and popcorn but for the most part we ate healthier than other families.

When I was in middle school I would get home starving and would heat up some ravioli or whatever was on hand. Most of the time I would be too full to eat dinner, but I would still have to eat.

In High school for the most part I didn’t eat. I would be in a hurry to catch the bus so I wouldn’t eat breakfast or bring a lunch because I had to make it. By the time I got home I would eat Kraft dinner then go back out. I weighted only around 100-110 lbs. I was a very active teenager, and sometimes forgot to eat. If I was on my period, I lost my appetite for a week and if I did have a bowel movement the pains were so intense.

I started to have a love/hate relationship with food.

After high school, I continued to struggle with my eating patterns.  I had a friend who kept saying she was fat and she was a size 0. I have never been a size 0 and all I could think was ” if she is fat then what am I?”

I began to starve myself.  Living in a constant state of hunger went on for around 7 years and then turned to binging and purging, the classic cycle of bulimia.  I continued to purge up until 2009 when I realized that I needed to stop. I was able to stop purging, but I continued to binge.  It was a vicious cycle.

I was also in pain from the Endometriosis rectally. I had generalized pelvic pain as well.  I remember being nauseated and seeing stars all the time as well as blacking out.

In 2002 I became pregnant and started to eat 3 times a day while gaining over 70lbs but I wanted to make sure she was healthy and after I gave birth to my daughter I wanted to make sure she ate the best food possible. I became interested in avoiding processed foods for myself and my baby.  When my daughter was 6 months old, I started making homemade pureed foods such as spinach, peas, carrots, applesauce and sweet potatoes.

My friend was a vegetarian and she introduced me to a whole new way of eating. She made me see how important food is encouraged me to focus on healthier foods like fish and quinoa.

My focus on eating whole foods changed my life.

I eventually decided to experiment with going gluten-free. I was on and off for so many years because it was really hard for me to do. In Nov 2010 I saw a naturopathic doctor who told me I had food intolerances to Wheat, Spelt and Dairy and that I was not fully absorbing any nutrients vitamins or minerals. She also said that I had Candida in my large and small bowel. She put me on a Gluten free and dairy free diet as well as many supplements. I succeeded in following the diet  for 3 months then was put on Amitriptyline for the Endometriosis. The make me crave every single bad food out there. I felt really upset that I didn’t have the willpower to walk away. My cravings grew in intensity.

Even just eliminating gluten for 3 months, the Chronic Dermatitis on my toes went away for the first time in 3yrs and has not returned. Also all of my painful perineum fissures went away for awhile. Unfortunately they have since returned.

I have now embarked on a new Journey that started Nov 1st 2012 and I have been gluten and dairy free. I plan on continuing and not giving up. I mentally feel better but I still struggle with stomach pain.

There is so much confusion and conflicting information about diets to follow. It is difficult to learn what is actually best for my body.

I know that I experience positive changes when I maintain awareness of how foods affect my digestion and mood.

I am devoted to continuing to learn which foods to avoid and to nourish my body to alleviate my endometriosis symptoms.

What affects have eating and dietary changes had on your endometriosis symptoms? Share your story.

To read more about my struggles with endometriosis, click here.