Digestion and Regularity, GERD and Ammonia Breath | THRR172

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Shitty question: digestion and regularity

Jonathan writes:

Hey Robb and Nikki,

Long time listener, first time caller. Have been listening on and off since the paleo solution days with Greg Everett. (six listeners can't be wrong!)

Quick back story (that you can cut if this is too much but maybe helpful context), about a year ago I had a bout of food poisoning and developed a weird aversion/anxiety around eating for a few months after. I got through it with meditation and cognitive behavioral therapy and completed the Nerva hypnotherapy course recently (which was pretty nice). I think a lot of ibs symptoms that I developed came from anxiety, panic, hypervigilance and fixation and have mostly subsided as I worked in it.

However, I still have problems with Regularity. I'll have a few days of slow digestion and some heartburn, bloating, and gas then a few days of everything coming out with some moderate to severe "get your ass to the bathroom quick!" mixed in, then back to slow... You get the picture. It's like things get backed up then all move at once, rinse and repeat.

Went to a gi doc and he was pretty not helpful - tested for celiac (I don't have it) and IBD (I don't have it) and then told me to, like, ya know, drink Metamucil and maybe, if I wanted, follow a low fodmap diet, or whatever man... Oh, and stop drinking kombucha. Good luck! I also did a Viome test and it told me my overall gut health was good but digestion scores were poor and have some very vague dietary recommendations, though I haven't tried their probiotic yet.

Anyway, with the testing behind me I went down the path of looking back at diet and driving myself insane, it's just so hard to pick through the noise

Fiber is good! No fiber is not necessary!

Eat yogurt! No actually, dairy is bad!

Take Probiotics! No, Probiotics don't matter, take prebiotics instead!

It's probably Sibo bro! But you can easily check for that so....

And on and on it goes.

OK, so my actual question is: Are there any general dietary or lifestyle non-negotiables you would reccomend to help with digestion and regularity? What are the food or diet boxes to tic. Maybe there are even some supplements or other potential things like zone 2 cardio, abdominal massage, cold showers... Anything.

I'm pretty healthy otherwise with my exercise being wendler powerlifting and rucking, but don't follow a super strict diet. I do now super enzymes before the first bite of lunch and dinner and take Probiotics on and off along with some fermented foods. I try to drink a lot of water but fiber drinks tend to give me some stomach upset.

Appreciate you taking the time to read this. Thanks for any help you can give!

GERD, ammonia breath, and macros

Nancy writes:

Hi Robb and Nikki:

Been one of your 6 listeners since the Paleo Solution Podcast days and first just want to thank you both for the wealth of knowledge you continue to share... your curiosity, smarts, humility and sanity have been a godsend, especially over the last 3 years.

Okay, here goes... I'm having two troubling issues and am wondering if they're related:

1. I've had what I'm pretty sure is undiagnosed GERD for about the last 3 years, but a recent overindulgence at a cookout sent it over the top. I don't feel so much heart-BURN as bloating (in the stomach, not abdomen), along with a dry cough (mostly at night), a globus sensation in my throat, the feeling of post-nasal drip, and even fluid on the middle ear when things really flare up. Oh, and the first symptom I ever noticed was after an emergency appendectomy when I discovered my tooth enamel was being corroded... coincidence?

To mitigate symptoms since this recent flare-up, I've been sleeping propped up at a 45-degree angle, chewing my food into oblivion, walking after meals, practicing diaphragmatic breathing and hoping like hell to get a handle on this (without meds) before it destroys my esophagus. (Tried pickle juice, ACV and ginger... very modest effects, at best, but tasty!)

2. No one has had the balls to tell me this, but I'm pretty sure my breath smells like urine. I constantly smell it on the rim of my drinking glass, and no, I'm not drinking pee. Also did the lick-the-wrist test and got the same smell. The internet wants to convince me I have chronic kidney failure but my kidneys appear to be working fine... no pee issues at all other than smelling it where I shouldn't.

For context: I'm a 56-year-old, post-menopausal female, 5-ft 8, 150-lb mesomorph, active daily (yoga and hiking), in good shape, strong immune system, don't smoke or drink (other than a glass of white wine once a week), have regular, near-perfect poops, and eat fairly clean (whole foods plus olive oil, butter, the occasional white basmati rice and super dark chocolate), with a long, never-fully consummated flirtation with keto... hey, fat is flavor, what're ya gonna do?

I also, pretty naturally, tend to stick with a 16:8 fasting-feeding window, skipping breakfast most days.

I'm wondering if (despite getting a decent amount of vegetable-, fruit-, and rice-based carbs) my high fat intake and the IF might have generated enough ketones to make my breath smell pee-ish, or if that's almost always a sign of too much protein. Thing is, I don't typically get more than 40-50g of animal protein a day (e.g., 2 or 3 eggs for lunch and a 6-oz. slab of salmon for dinner) and as a post-menopausal woman, feel my protein intake is already low.

My hunch is that the pee breath and GERD are related, but I'm not clear as to how. I'm wondering — if I AM getting enough fat to be in ketosis, could the fat in my diet be causing the GERD? Or is it more likely that I'm not actually in ketosis but that the GERD is causing the pee breath? (And do you think the appendix surgery could have caused the GERD, what with things getting shoved around in there willy-nilly?)

Apologies for the long-winded question-palooza... totally understand if this is too long for the podcast, but if you ARE able to offer any insights, they would be very much appreciated. Thanks again for all you do!

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