Introducing: Stephanie Bird, Nutrition & Food Science, Gut Thinker, and Mission Statement

Stephanie Bird - Gut ThinkingI thought I’d update some info about myself, in case you’ve stumbled across this blog on a random journey through the internet. I contribute information infrequently, and also post on Facebook on the Gut Thinking group. I am currently back in school, completing a degree in Nutrition and Food Science, Dietetics, and am in the process of starting my job search, as I plan on starting a career as a food technologist in June, 2013.

Please find my career portfolio (in progress) online here. 

My mission: To compassionately help people with a variety of health concerns find better living through diet changes and supportive strategies including recipes and sharing of knowledge, with a dash of humor if it helps. 

Gut is my co-pilot. Most people know what it’s like to have a “gut feeling.” We work on instinct to make decisions based on what we know to be true

I have spent my life trying to get my diet right because I discovered along the way that what I eat definitely impacts how I feel that day, up to several days after. Sure, I’d heard the whole “you are what you eat” bit growing up, but I hadn’t realized until my late 20s how literal that message is.

For me, that meant the things I was eating weren’t adding up to a healthy-feeling me. In order to change that, I have been on a quest since 1999 to figure out what types of food make me feel good without feeling bored or punished.

This also meant I had to do a lot of research on my own, as I discovered that even most of the health professionals I talked with weren’t aware of the various problems people suffered as a result of eating foods not suited for their best health. Sure, doctors and dietitians knew that if you were diagnosed with celiac disease, you needed to avoid gluten. If they knew about interstitial cystitis, they may have found some of their patients/clients respond well to a low-acid diet. And to those fortunate enough to have a food allergy they tested positively for, as opposed to a food intolerance or other adverse food reaction, then they knew to recommend a diet without that food in it, and could prescribe antihistamines or other treatments to ease symptoms.

However, functional conditions such as dysphasia (difficulty swallowing) or IBS (irritable bowel syndrome) aren’t as cut and dried. Dysphasia could be related to eosinophilic esophagitis which is related to allergy (back to not knowing again!) and IBS could be triggered by food or just be the way the gastrointestinal tract misfires.

I have had a fairly restricted diet for the last 13 years and have been challenging that since May of 2012 in order to intensify reactions so that testing will be more conclusive about my condition(s). I have personal experience with sensitivities to many different foods, including gluten and nightshades, as well as seasonal allergies.

I have been studying Nutrition and Food Science, with emphasis in Dietetics, so I can ultimately work with media, researchers, and food companies to help develop and provide information to others who have health issues they may not realize are related to their diets. The didactic program I am enrolled in is at California State University at Chico, and I have also studied sciences at Huntington College of Health Sciences of Knoxville, TN; California State University at Sacramento; and University of California at Santa Cruz. I am currently certified in ServSafe and HACCP (Hazard Analysis & Critical Control Points).

See my LinkedIn profile for more information.

Eggs is Enough – a pseudoallergy

bird's custard - egg freeI’m going to have to revise my list of foods I avoid on this blog. Since this last summer’s food challenge, I have been able to reincorporate a few foods but have discovered that I have an aversion to eggs. Since eggs seem to trigger symptoms of eosinophilic esophagitis (EoE) in me, the reaction I’m having is likely an allergy.

But I am intrigued by a bit I read on Wikipedia about eggs and allergy, stating that some people have pseudoallergy to eggs. Since they are histamine-containing foods, they can trigger an allergy-like reaction in sensitive people without actually firing up the IgE allergy immune reaction. As a result, some people who are sensitive to eggs can still eat them in baked goods as they are distributed enough that they don’t trigger the reaction.

I also read that many EoE triggers are from IgG or so-called “slow allergies” which makes it harder for people to determine the trigger. I’m not sure why this would necessarily be the case, but eosinophils are the result of an immune reaction and once triggered in tissue (as opposed to flowing in the blood) they are “active” for some 8-12 days. This could explain why food reactions in some people last a couple of weeks.

I am still trying to learn more about this disease and how it is related to other conditions. I recently joined APFED’s online community so I could learn more from other people with eosinophilic disorders. Hoping to meet more people with practical experience with this condition that I have likely had for my entire adult life.

Interesting detail I learned from the Wikipedia page: Bird’s Custard was invented by Alfred Bird, as his wife, Elizabeth, was allergic to eggs. As my family name is Bird, we’ve always joked about this treat. Maybe it’s a “Bird” thing!

Learning more about eosinophilic esophagitis

apfed logoI’ve been having throat issues this fall, not sure if it’s something I’m eating or if it’s some kind of airborne allergies. Either way, it feels like someone has tied a drawstring in my throat and is pulling the strings. It’s tight in my throat and my shoulders and travels up to my ears. I’ve also been having some heartburn.

I started budesonide therapy, mixing one .5mg vial in with about four teaspoons of stevia that I get from Trader Joe’s. But it’s inconsistent and a pain to make, so I was looking around for another idea and got to reading the APFED.org (American Partnership for Eosinophilic Disorders) site. They have a support board which I’ve only dipped a toe in, but already learned that some people take budesonide with applesauce. I’m psyched! I need to try it like that – I’ll bet it is much more tolerable that way.

Looking forward to learning more!

How do you take meds for Eosinophilic Esophagitis?

splenda sucraloseI was diagnosed with Eosinophilic Esophagitis (EoE) this summer, which is an allergic condition involving difficulty swallowing and narrowing of the esophagus due to the presence of eosinophils in the esophageal tissue. Ordinarily, these inflammatory lymphocytes would not be present in the tissue of the esophagus, however some people with food allergies may develop this condition. It has ties to asthma, which is another condition where eosinophils collect where they’re not supposed to be.

There is no officially approved medication for treating EoE but many studies have shown improvement for those swallowing a viscous solution of corticosteriods, which are used for asthma treatment, though modified so they will coat the throat instead of heading down into the lungs. My doctor prescribed me the most commonly used one, budesonide 0.5mg, which are in the form used in a nebulizer for asthma. Everything I’ve read online in case studies shows that this form is mixed with 5 packets of sucralose sweetener and then swallowed, with nothing else taken by mouth for 30 minutes after.

Success rates or abatement of symptoms is very good, up in the 80% range in the studies I read, so I’m confident in trying this method. But I’m not sure about making this viscous solution, as I can’t see how the ampule of budesonide (it contains 2ml of fluid) could mix with 5 packets of sucralose (aka Splenda) and make a swallowable concoction. I also don’t like the taste of Splenda, so I’m wondering if there’s another sweetener or substance I can mix this with to try it out.

Basically, I’m afraid I’ll end up with a mouthful of bitter stuff and a numb tongue, as I did when I tried to dry-swallow a standard inhaler. So I’m wondering if anyone else has any suggestions or has tried a similar treatment? Do you have any pointers?

PS: just found this video on YouTube showing a mom preparing the viscous budesonide for her son. It looks like a “snowball” (as she calls it) which is very different from how I interpreted it from instructions. Thank you, YouTube!

Back to gluten-free, and a few other things

no burgerSix months later, it looks like my strict diet is resurfacing.

Actually, my diet has been getting corralled for weeks now, and then last month I caught some flu-virus and was sick for nearly three weeks, and eating lost its appeal. That was the first time in years that I got sick like that, where I just couldn’t shake it off, but reminded me of back before I stopped eating gluten when I used to get virus after virus. I would be well for a couple of days and get flattened by the next thing going around. It wasn’t pretty.

I decided mid-virus to go back to my former restricted diet, keeping only a few things that didn’t seem to be bothering me too much. But I ate some food this last weekend that really screwed me up for a couple of days, which is uncomfortable but also excellent motivation for sticking to my diet.

Here’s my current list of restrictions that I’m going to stick to as best I can, though it’s not as easy as it used to be since I had gotten accustomed to eating some of them the last few months:

  • Gluten/gliadin grains (wheat, barley*, and rye*)
  • Oats (so-called “gluten-free” or not, both make me feel like I’ve been punched in the gut)
  • Nightshades (tomatoes, peppers, potatoes, eggplant*, kava kava*, tobacco*)
  • Eggs (unless baked into something)

*Items I didn’t try during my food challenge, but had previously reacted poorly to them so will avoid now.

I don’t feel the need yet to be as strict as I used to be, for example I seem to be able to get away with some potato starch/flour in my gluten-free baked goods, and some french fries, though I’m not sure how long that will last as those items were the last to go in my nightshade-avoidance diet.

I’m still eating corn on a fairly regular basis at this point without obvious reaction, and I haven’t had a problem with shellfish, though I’ve only had shrimp, scallops, snow crab, and calamari. I’m looking to trying some crab as the focus of a meal to see how that does with me. I haven’t had much citrus, so am not sure if I should be avoiding it or not. Being able to keep some items from my former forbidden list, at least for now, makes me feel better about it.

It’s been an interesting ride, this major food challenge. Before I started it, I thought it would kill me, or at the least, I’d be really very sick the whole time. But it wasn’t that bad and I actually had a hard time stopping once I got started. I have been feeling better though since I cut back on the other foods, and even lost some weight. Hopefully, I’ll be able to trim off the rest of that which I gained since this crazy “eat-everything” diet began last May!

To-Do List: GF Recipes I Want To Try

lemon wedding cookiesI’ve been finding myself tired of my “eat everything” diet, mainly because eating some things make me feel queasy or congested during the day, and I would also like to get rid of the bloating that developed since I started it. So I thought I’d share some links of a couple of recipes I’ve found recently that I plan on trying when I get a chance:

I also want to try this bread – it sounds delicious!

I’ve tried one Julian Bakery bread that was made of sprouted beans and was low carb that looked like a tall muffin and had a sourdough taste but whole grain texture. Their coconut bread looks light and fluffy, like it’d be good for sandwiches, possibly even untoasted. Has anyone else tried it?

Endoscopy Results In: However….

Blastocystis hominis

Four forms of Blastocystis hominis

My new gastroenterologist is a nice guy. However, he is known for keeping his patients waiting. The day I was to get my results, I got a call saying he was in emergency surgery and my appointment would be delayed an hour and a half. Not wanting to wait to find out my results, I said I’d still like to see him that day, if possible. Those 90 minutes stretched into 4.5 hours, but I finally got to see him. I’m glad I waited.

I had remembered being told I had a peptic ulcer during my endoscopy, so I wasn’t surprised when he told me about it. In fact, he nearly stated it with glee: “You have an ULCER!” Well! Good times for me! I had been wondering about the cause as I do take ibuprofen from time to time and NSAIDs are known for causing ulcers in some people. Also, some food allergic individuals develop ulcers in response to the allergen, and as my 6 week food challenge where I was eating everything from my forbidden food list would have given my stomach the opportunity to form an ulcer, I figured this was also a possibility. I wasn’t expecting a Helicobacter pylori infection to be the cause as I’d recently had a blood test given by my allergist, come back negative. But, according to biopsies of the ulcer and stomach tissue, H. pylori it was.

Biopsies of my villi for celiac disease came back negative, though the pathology report did indicate some inflammation of the tissue. That could be the result of H. pylori as well, since it also causes duodenal ulcers. Visible inflammation was seen in my esophagus, which is a sign of acid reflux.

My doctor was pretty tired (I didn’t get into the appointment until just past 9pm) so I pressed him for more information. Turns out I also have eosinophilic esophagitis (EoE) as the biopsies of my esophagus contained moderate amounts of eosinophils, which is an allergic reaction to food. And from the lab tests I’d had run the week before, my intestines appear to be hosting a “moderate” amount of protozoan parasites, known as Blastocystis hominis, which appeared in all three samples given. While Mayo Clinic gives this diagnosis short shrift, many other sites, from research to conspiracy theory, indicate some connection between this parasite and conditions such as IBS.

Now you can see why I was glad I waited around. Our current plan is to treat the ulcer first by eradicating the H. pylori. As my insurance doesn’t cover name-brand medications, my doctor was nice enough to give me samples of Pylera, which is a combination antibiotic therapy for H. pylori. Had I paid out-of-pocket, it would have cost me over $600 so I was happy to receive the freebies. He also gave me some Nexium to take along with it, as a proton pump inhibitor is required additionally for the therapy, though Prilosec is more commonly used.

Our current plan is to treat the ulcer, then for me to try and find out what foods I am allergic to (back to the allergist now that I’m on the allergy-provoking diet?) and then, if all else fails, treat the parasite. Unfortunately, from what I’ve read, Blastocystis is hard to eradicate, and once gone, the symptoms may persist. So I’m not optimistic about that one. But I’ve heard that clearing up H. pylori may help out with reactions.

So cross your fingers that I survive the antibiotics. They’re a bit of a tough pill to swallow: 3 pills 4x a day, plus 2 Nexiums for 2 weeks. I don’t seem to be having as bad of side-effects as other report, and am on day 5 at this point.

I’ll let you know!