Recently I had cause to engage the services of a Nutritional Therapist or a Nutritionist for short. I wrote about this experience briefly in Going Gluten Free but I wanted to reflect on the whole experience here.

First things first, let me set the stage. For a number of years now I have been suffering from abdominal pain and poorly formed and frequent stools. When I first went to my local doctor, his answer was to take Nexium when the pain hits. Boom, you’re fixed! This was the extent of the wisdom dispensed to me from the doctor, when I said I don’t really want to be taking Nexium for the rest of my life and taking a pill does not really address the root cause, his answer was an incompetent “a lot of people take pills for their whole life”. I don’t buy this nor do I want this to be me. A lot of people get cancer and heart disease too, and I don’t want to be one of them either.

Through my own self-diagnosis, I narrowed down my root cause to be either food or stress related or most likely a bit of both. I figured I needed some professional help so I sought out the services of a Nutritionist. Nutritionists in Ireland are not a regulated entity, in the sense that anyone can call themselves a nutritionist and start seeing people and doling out advice. Either way, I found a suitably qualified practitioner and engaged their services.

The 1st stage of this process was to rule out any pathology issues through some blood testing (cost €80). The blood tests were done via a referral to another GP. Based on the consultation with this GP, I was referred to hospital for a colonoscopy (cost €1000) to detect any issues in the digestive tract.

The results from the blood tests showed high cholesterol levels (total = 6.0 and LDL = 3.5) but all other vitals were good. The results from the colonoscopy showed no major issues but some signs of diverticulosis, but nothing major to worry about. I also got a CT scan of my upper abdomen done, again the results indicated nothing to worry about here.

Ok so at this point there is no clear root cause identified from either blood tests, a colonoscopy or a CT scan. Pretty comprehensive eh? Total cost so far is about €1200 including nutritionist fees.

So I am back with the nutritionist and based on the recommendation from the hospital consultant to try a wheat and gluten-free diet, we agreed to try an elimination diet. This is a short-term eating plan that eliminates the most common troublesome foods like dairy, gluten, wheat, soy, and eggs as examples of foods to remove from your diet. I did this for a 3 week trial period and I guesstimate that I stuck to plan at least 80% of the time. I fell off the wagon at times on the soy (which I didn’t believe I had an issue with anyway) and the gluten (Weetabix) but I was pretty good overall, or so I thought. My nutritionist wanted 100% compliance to be able to accurately identify troublesome foods. So we tried elimination diet #2 for another 3 weeks. I guesstimate was compliance with the plan to be about 95% this time. Still not good enough and no further along the road to any real conclusions of the root cause.

Next step was to try a low fodmap diet. Fodmaps are small carbohydrates which exist mainly in dairy, legumes, and many fruits and vegetables. Given that I follow a mainly veggie based food diet, this was going to a real challenge to me. A low FODMAP diet is not designed to be permanent. It is highly restrictive for several weeks before foods are slowly reintroduced to determine what causes symptoms.

I had serious concerns about my ability to stick to a low fodmap diet for 8 weeks so I agreed with my nutritionist that this was basically the end of the road for us both here. The pain involved in a low fodmap elimination diet seemed greater to me than the pain I experience occasionally from stomach cramping.

So I’ve spent about €1500 in consultations and services and I am none the wiser, bar some piece of mind from the colonoscopy and the CT scan and an awareness that I need to address my cholesterol levels.

Upon reflection of this experience, I noticed that during all of these consultations, we rarely spoke of stress or stress management. Personally, I feel that stress is a major factor in my situation, and likely has more to do with the root cause than any food-related issues but we never addressed how I manage stress or how stressful my life is. Now I know I was seeing a nutritionist who is food focused but it seems silly to compartmentalize this to me. Stress influences your mood and your food choices and internal inflammation levels as a result.

Here’s to an awareness of the whole person, and not just focusing on one perspective.

Yours in health and happiness,

JP