Yes, the last several days have been a bit of a roller coaster. Gut seems fine... gut explodes... gut seems fine... gut explodes...
The diarrhea episodes are generally short, and completely different than what I was experiencing after the appendectomy but before I started taking Immodium. And I don't know if they're being caused by the switch to a meat-based diet, or by one or more of the foods that I'm eating, or by something else.
One possible culprit is spinach. Spinach -- and leafy greens in general -- is sort of a mixed bag: lots of nutrients and fiber, but also a high quantity of oxalic acid, which binds with some of the nutrients and decreases their bioavailability. And the oxalic acid itself might be a problem. Some people have problems with leafy greens, so, for a while, I'm going to lay off the spinach. I may re-introduce it in a week if things have settled down to see if problems recur.
Another possible culprit seems to be water. Yes, water. I made a joke about it in an earlier post, but honestly, drinking a lot of water -- something that happens out here in the desert quite frequently, especially when I'm riding my bike or knocking down walls -- really seems to play havoc with my intestinal tract. I'm feeling like I have to be just as careful with how much water I drink and when I drink it as I do with what foods I'm eating. If the quantity of water that I'm drinking really is having a negative impact, it seems as though there are a number of different possibilities as to why, based on things I've read over the past few days.
If what I've read is accurate, 80%-90% of ingested fluids are absorbed in the small intestine. Whatever's left is supposed to be absorbed by the colon. Based on the results of last year's colonoscopy, I'm not inclined to believe that there's anything wrong with my colon's ability to absorb liquids in general. So could it be that my small intestine isn't doing a good enough job of absorbing fluids, thereby sending too much to my colon, and that's causing a problem because it does fine absorbing a normal amount of fluid but it can't handle the excess volume?
Well, maybe so. I found a celiac site where members were discussing a decreased ability of the small intestine to absorb water because the villi and microvilli in the small intestine had been damaged by celiac disease. While I don't have celiac disease according to a blood test from a year or two ago, I do think it's likely that the villi and/or microvilli in my small intestine have been damaged by decades of SIBO. So at this point I'm hoping that continuing on the Specific Carbohydrate Diet will allow my small intestine to heal, which will presumably decrease any symptoms I may have due to water intake.
There is another road that this search took me down that I found very interesting, though, at the moment, I'm still thinking it's an unlikely explanation for my water woes. The other day I decided to try to limit my water intake (not to dangerous levels, just to maybe 40 or 50 ounces) to see if it would help my gut. I was thirsty all day, yet my pee continued to be clear or near-clear. So I Googled a bunch of different phrases related to thirst. Most of my searches resulted in many pages discussing diabetes; this was no surprise to me, as I've known since my mother was diagnosed with Type II Diabetes Mellitus that excessive thirst is a common symptom of this disease. I've had a glucose tolerance test and the results were completely normal, but that was some years ago, so it would probably be wise to get re-tested given genetics and all that. Still, I'm not overly concerned about the likelihood that I have diabetes mellitus.
What I learned after browsing a few pages, however, is that that there is another type of diabetes that is virtually unrelated to diabetes mellitus: diabetes insipidus. The main symptom? Excessive thirst despite drinking fluids, and the excretion of excessive amounts of diluted urine. This sounded intriguing. So I read up on it on the Mayo Clinic's website.
As I was reading, I was thinking (and I still think) that this is a stretch. I'm not always extremely thirsty, and it's not so much that I'm excreting a large amount of urine, it's just that it never seems to darken up much even when I'm exerting myself and not drinking much. But then I got to the "causes" page, and got suddenly alert when I read this:
"Certain drugs, such as lithium and demeclocycline (a tetracycline antibiotic), also can cause nephrogenic diabetes insipidus."
So I looked up democlocycline and found that it's marketed as... Declomycin.
Declomycin. That sweet, drinkable antibiotic that has become the bane of my existence. It turned my teeth gray. It most likely damaged my gut. And now I find out it may have damaged my kidneys, making them unable to respond properly to anti-diuretic hormone (ADH), also known as vasopressin.
Now, I still think this is a stretch. Given the results of my SIBO test combined with the results so far of eliminating all complex carbohydrates from my diet, I'm inclined to believe that a) I did, indeed, have SIBO, and b) a long-standing, low-grade SIBO situation damaged the structure of my small intestine, and c) that damage is what's responsible for any difficulty I may currently have absorbing water. But given my body's slightly weird response to water -- not just lately, but for many, many years -- and given the fact that Declomycin, a drug that I took a lot of way back when, may be implicated in a disease that alters your body's ability to deal with water normally, I have to raise an eyebrow.
I'm planning on finding a family practice or internal medicine doctor here in Tucson soon, just to establish a relationship with a local doctor. I'll probably schedule a full physical exam since I'm turning 50 this year, and I'll request a glucose tolerance test as well as one or more of the tests for diabetes insipidus. I don't expect positive results, but it won't hurt to check.
If nothing else, I learned some interesting stuff!
As far as the diet goes, a couple of new additions today: green beans and avocado. And in addition, I found a mustard that doesn't have any added sugar. So mustard is back on the menu! I found that mustard and avocado on my hamburger patty at lunch today made it about 300% better than the plain one I had last night.
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