The Gut Health Podcast
The Gut Health Podcast explores the scientific connection between the gut, food, mood, microbes and well-being. Kate Scarlata is a world-renowned GI dietitian and Dr. Megan Riehl is a prominent GI psychologist at the University of Michigan and both are the co-authors of Mind Your Gut: The Science-based, Whole-body Guide to Living Well with IBS. Their unique lens with which they approach holistic conversations with leading experts in the field of gastroenterology will appeal to the millions of individuals impacted by gut health.
As leaders in their field, Kate and Megan dynamically plow through the common myths surrounding gut health and share evidence-backed information on navigating medical management, nutrition, behavioral interventions and more for those living with or without a GI condition.
The Gut Health Podcast is where science, expertise, and two enthusiastic advocates for wellness come together to help you live your best life.
Learn more about Kate and Megan at www.katescarlata.com and www.drriehl.com
Instagram: @Theguthealthpodcast
The Gut Health Podcast
Part 3 of the IBS-C series: Finding Your Path: A Personal Journey to Constipation Relief with Erin Judge, RD
What if you could navigate the complexities of IBS without falling into restrictive habits or feeling overwhelmed? Join us for an insightful conversation with Erin Judge, a registered dietitian nutritionist as she shares her compelling journey from childhood challenges with IBS-C to becoming an advocate for patient-centered care. Erin opens up about her early experiences with gastrointestinal issues, exacerbated by a Giardia infection painting a vivid picture of the emotional and physical hurdles she faced living with the complexities of IBS, in a time in which, IBS research and treatment modalities were limited.
Erin's story is a testament to resilience and the important ways resources for IBS management have evolved over the last decade. She reflects on how understanding balanced nutrition, avoiding restrictive habits and adopting an enriched lifestyle have been key to her management strategies.
Listeners will gain valuable insights into practical strategies for constipation relief, emphasizing the gut-brain connection's role in managing symptoms. Erin discusses the significance of lifestyle adjustments, such as movement, adequate hydration, supportive dietary changes, and stress regulation, offering a toolkit to empower individuals facing similar challenges. By sharing her knowledge and experiences, Erin aims to foster hope and confidence, encouraging a guilt-free approach to health and wellness for those living with IBS.
Learn more about Kate and Dr. Riehl:
Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast
Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.
The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.
This podcast has been sponsored by Ardelix, or a healthcare provider, you are in the right place. The Gut Health Podcast will empower you with a fascinating scientific connection between your brain, food and the gut. Come join us. We welcome you.
Dr. Megan Riehl:Welcome to the Gut Health Podcast, where we talk about all things related to your gut and well-being. We are your hosts. I'm Dr Megan Riehl, a GI health psychologist.
Kate Scarlata MPH, RD:Hi, and I'm Kate Scarlatta, a GI dietitian, so today's episode is part three of a three-part series that we have on irritable bowel syndrome, specifically IBS-C or constipation predominance IBS. This is our last part three of the series, and we've really covered a wide range of topics related to this diagnosis.
Dr. Megan Riehl:Yes, last but not least, a very, very important piece of the story with IBS. Today, with our guest, who is Erin Judge, I'm going to tell you a little bit about her, with the topic of IBS being very near and dear to us. It's a subject matter of our book, Mind your Gut, but also one that Erin speaks very eloquently on as a registered dietitian and nutritionist. She's also a certified personal trainer and founder of Gutivate, a virtual nutrition counseling practice for digestive disorders and gastrointestinal conditions. Erin's wealth of expertise is in providing medical nutrition therapy for functional gut disorders with a patient-centered focus. She is proud of her work in education and advocacy for the IBS patient community through social media, as well as her work in providing resources for dieticians in the GI field. In addition to the important work that Erin does in her GI practice, she's also an individual living with IBS-C. So for today's topic Finding your Path A Personal Journey to Constipation Relief. We are so delighted to have you today, erin, to highlight your resilience and share your insights, so welcome.
Erin Judge RD:Thank you so much for having me. I'm excited to be here. I admire you both and so I'm very excited to be able to chat and talk about this topic that, you are correct, I love very dearly.
Dr. Megan Riehl:Yes, yes. Well, there's lots of challenges and solutions, and so we're going to dive in there's lots of challenges and solutions, and so we're going to dive in.
Kate Scarlata MPH, RD:I know I think of so many GI dieticians that have gone into this field, often because we haven't had really satisfactory care along our own journey or we're hoping to learn a little bit more to make this journey a little bit easier for others that are walking our path. So, with someone that lives with a GI condition post-surgery, I know that you have your own personal journey and experience and we'd love you to share that, erin, starting from the early days of a diagnosis to where you are now.
Erin Judge RD:Absolutely so. My story is not unlike a lot of people in our community, but it is also very different than a lot of adults I typically see. So my story with IBS did start in childhood and my diagnosis came around fourth grade. Whatever age that was, a lot of it, as you'll probably figure out from my own story, has been a bit blocked out in my memory, but I remember getting a diagnosis after three full years of kind of going back and forth to specialists having many different tests run, and it all started with what we found to be a Giardia infection that I had around like kindergarten, first grade. I don't know how they found it much later but it makes sense with my history, but I was someone who was constantly getting sick. I would have the stomach virus over and over and over again and you know it was on multiple rounds of antibiotics throughout those years. In first grade my dad was diagnosed with a chronic illness that we did not believe would be he would live very long and so he went through experimental like drugs at that time within and out of the hospital. So you have this child that was bombarded with a gut infection, chronic antibiotics, again constantly getting sick.
Erin Judge RD:I grew up in what we would consider to be a food desert in rural South Arkansas. Most of my food intake was bread and cheese. I did not eat a lot of vegetables and fruits and those things, especially when I was often sick and then was hit with this family childhood trauma adverse event that was really hard to process as a young child. So I held a lot of anxiety in my body, held a lot of stress in my body and I kind of grew up in a space where we just didn't talk about it if we were struggling, right. I'm now almost 33 years old, so I know a lot of people who grew up even at the same time that I did. That was before we had access to social media and information, but we also grew up where we didn't discuss hard things and especially when it came to health as a kid. I didn't learn a single thing about health as a young child in school and from my family, and we didn't have access to those resources. And so I found myself over those years, you know, going from getting you know stomach viruses off and on so getting the Z-Pak every time for some reason, you know, just going through the cycle of all these different infections and gut issues, to then that settling a little bit but it turned into these more significant flares. So I found that I would have, you know, accidents at school which now I believe to be kind of that overflow diarrhea Like I was so backed up and full of stool. You know I would constantly have like smearing, you know, in my underwear and need to change and was really overwhelmed and stressed about that. Again, I was in second, third grade.
Erin Judge RD:I was a very young child where this was not expected. I would get in trouble for it because my family believed it to be more behavioral and I would also find myself in the flares of so severe pain that I would be crying on the bathroom floor in the middle of the night and my mom would always think, okay, you have gallstones, you have pancreatitis, like something is seriously wrong because you're in significant pain. So she would end up taking me to the hospital, which was an hour and a half away, the children's hospital. So we would drive to the hospital, get the initial test. It wasn't anything more than constipation. I would come home, have to do suppositories and enemas and all these extreme measures and that was my life for three to four years before I finally got a little bit more testing and they ruled out as much as they could and decided that I had IBS and that was kind of all we were given at that time. I remember going off from that point and I got the like little Metamucil cookie things which were so gross.
Speaker 4:Why would you ever give a?
Erin Judge RD:child, these little biscuit things like I can't even look at them now. I have such an adverse effect from those. But I was sent home with those and Gatorade when needed, which I don't understand, and then the suppositories are in them as I needed them. That was kind of all that I was given and thankfully I transitioned into middle school. I started playing sports. I became a little bit more, maybe involved in my health. Not consciously or with a lot of effort. I did become aware of my body. I was going through puberty so there were things maybe I was doing that.
Erin Judge RD:I wasn't intentionally trying to improve my constipation, but I did improve the flares just by moving my body more and doing a few different things, and I also learned how to kind of control and mask a lot of the flares and the symptoms I was having. So they turned into not having accidents that's called, thankfully. But I did learn how to not be away from home too much. Before football games everyone came to my house so I would have the comfort of my bathroom in my home, in my comfort zone. If I was too full, or cheerleading camp and all these different environments where I would get so severely constipated, I would just eat a little less or skip a meal and I would wear looser clothes or always make sure my cheerleading uniform was a little big enough in case I was bloated. And I didn wear looser clothes or always make sure like my cheerleading uniform was like a little big enough, like in case I was bloated and I didn't know what I was doing. But looking back on it, I was learning how to live with it.
Erin Judge RD:Not well, because I also would find myself in that significant pain where I would sneak away to lay on a bathroom floor and pass gas or maybe go home for a little bit to maybe have a bowel movement or manual evacuation, like there were so many things I kind of learned to do to try to survive and get through it. And it was finally. Whenever I went to college and high school again, things got a little bit better. I was moving more, I was eating some fiber. You know I was doing things I wasn't necessarily treating IBS for, but now I know I was at least helping and supporting my gut and the constipation and I was getting older. But in college I found that I really struggled because I didn't have my comfort bathroom. I was in a dorm room, another life transition.
Erin Judge RD:I cried on my way to college and so many people will relate to this, but I was going from a town of 1,000 people to what would be considered to be a big city in Arkansas, the University of Arkansas, our biggest university, and that alone was a huge change. I was going to be living in a dorm, I was stripped away from all my friends and I was really involved in my high school. I did well in school and I was stripped away from all my friends and I was really involved in my high school. I did well in school and I was going into like a pre-med and kind of AP. I got out of that really quickly, but the more advanced classes I was going into that, and the thing that I cried in the car on my way to college over was being in a public bathroom. That's what I was the most afraid of was how am I going to poop in a public bathroom on my floor? And what I did was all the girls on my floor were in sororities. They went out on Thursday, friday nights. That's whenever I could poop. That's whenever I would have that space to myself and I felt comfortable. That's whenever I would, you know, have that space to myself and I felt comfortable. That's how I lived my entire freshman year of college and thankfully, I learned pre-med was not for me. I found dietetics and, you know, found nutrition and it was a great change. In my nutrition classes we had one lesson on it was like our GI lesson for M&T and there was a five minute part of that lecture that was about IBS and it was the first time since. So this is sophomore year of college, since I was in fourth grade and diagnosed with IBS, actually talked about IBS and explained, you know, the things that we could do and you know it was low FODMAP diet. I'm pretty sure that was all that they said. That's all we really had at the time. This is 2012, I think, and so brief lecture, everyone just moved on and I was thinking about I'm like wow. I remember like I was told that this was something that I had. This connects a lot with me.
Erin Judge RD:And then I started going down the path, which then was kind of messy, tried doing everything on my own. I went to the doctors like I need to be tested for celiac disease, I need to be tested for lactose intolerance. I was trying to figure it out. I was like none of this was rolled out for me. I need to make sure, and you know the test came back as negative. But I was like, okay, well, I guess I have IBS, like that makes sense.
Erin Judge RD:And so I started doing all of these different things in a not so healthy way, because I was literally just reading a textbook that had maybe a chapter worth of information and just getting as much, like trying to grab, like what is anyone saying about this? What can I try? I was trying to be healthy, you know, as nutrition students often do, and I found myself very restricted. I had a lot of rules. I definitely didn't go about it the best way, but after many years of trying to figure it out and reading the research and becoming a dietitian and working with patients and just seeing a little bit more I guess, depth of information that was available, I kind of figured it out for myself and got to the point where I didn't have flares anymore and I learned how to prevent the trapped gas pain compared to hiding away to like go to the car and try to pass it, you know secretly away to like go to the car and try to pass it, you know secretly. And so now I find myself.
Erin Judge RD:I still have IBS and I always say that. I think it would be unfair to me to say I healed my gut and I'm perfect. I don't have painful flares. But I'm also very intentional every day with the things that I do and how I live my life to prevent that, because I lean towards constipation still live my life to prevent that, because I lean towards constipation still. But now I get to also help other people and patients across the spectrum of IBS and functional GI disorders deal with some of those symptoms. But also, how do you healthfully take care of your gut and put all the pieces together as you as a whole person in a way that's actually going to be supportive across the board and not restrictive or isolating or all of those things? So very long winded way to share my story. But if you are familiar with my work at all, it makes sense where I come from personally because I've kind of woven that into my communication and what I like to do now as a dietitian.
Dr. Megan Riehl:I mean, first of all, thank you for your openness and vulnerability and really highlighting how everyone's journey to IBS is different, that you know there are ways we can look at environment and genetics and you know a post-infection and familial stress and life change and all of those people with IBS will have a variety of potential factors that can lead to their diagnosis. And you beautifully and vulnerably share your journey there and arriving at being a helper at somebody that has taken what they've learned. Is there something that, when you think back, would have been helpful to have known back then, and maybe even highlighting where the research has gone, even in? You know I'm a bit older than you, so in that couple of years since you've been in college and then when you were a little one, it is wild to think of how much more research we have.
Erin Judge RD:Even since I was in college, I've been a dietitian for it'll be 10 years this year officially as a dietitian, which is also hard to wrap my head around. But in the last 10 to 15 years the research has completely changed and you guys have been a part of that, and I mean even looking at where we are today. It's going to change even more in the next 10 years, which is really exciting, especially for patients, but also as a provider, and so, of course, I would love to know what we know now. Whenever I was a kid I think I actually have. I'll share it with you. I think that you guys would appreciate this, if I can actually find it I think a psychologist is who I met with after my diagnosis, very, very young.
Erin Judge RD:So I have this note. My mom saved it. She found it like in a drawer a few years ago, but I met with a psychologist or a psychiatrist somebody after we got my diagnosis, and this is the plan that I've received for my IBS, and it says Erin needs to do a toilet sit after snack, after dinner, in order to keep her privileges. Which advice. Not so bad the result? Maybe not. Erin will earn $1 for each accident free day and Erin will pay mom 50 cents each time she has an accident. And then Erin must continue cleaning up after an accident and washing out her own underwear, and that was my plan, that's horrendous.
Erin Judge RD:It's not great and I know I was maybe motivated differently as a child and I understand you know a little bit of where they may have been coming from. But the idea that I was told and I can see it in the way that I maybe lived my life after that I was told that this was all within my control, that it was completely behavioral, and this was really isolating to think like someone who's in fourth grade. This child, you know, is having these problems and it's completely within her control. And I was very smart, I had friends, I was very outgoing, I wasn't a very isolated kid. You wouldn't think that compared to some of the things I had gone through. So what I had wished that I had received at the time was a lot more practical day-to-day ideas and strategies that my family could have helped me implement.
Erin Judge RD:I wish I would have been taught how to eat a balanced diet, because I was not taught that at all and I wouldn't have wanted someone to say like, oh, you can't eat certain. You know I don't. I wouldn't have wanted that approach and I'm glad I never had that, but I would have loved to understand that probably eating just cheese nonstop was not helping me. Like what else could I have eaten that would have been tasty and good and would have supported me at the time. You know, fruits, how that would have impacted me. Was I drinking water? Probably not. I was probably drinking sodas and Gatorade and things like that, because that's what people drank in my school.
Erin Judge RD:Juice boxes, Juices yeah, Maybe milk at the time. So I would have loved to understand hey, this is actually going to be supportive in this way. Understanding the whole toilet sit thing, I wish someone would have taught me how to relax and breathe, not just force me on the toilet after meals, but taught my family what that actually would look like. I wish I would have understood the impact of movement, because movement for me has been such a key part of the way that I've managed my symptoms for the rest of my life.
Erin Judge RD:If I would have known that as a kid like go play more, go like run around and after that maybe, you know, make sure you're drinking water and go to the bathroom I probably would have been a much different place than I ended up being. And I don't think I needed a low FODMAP diet. I don't think I needed a list of supplements and maybe things that I would use as an adult. I don't think I needed that as a kid. But I would have appreciated some interventions that could have stuck with me and my family because I could have addressed that so much differently through middle school and high school.
Erin Judge RD:I maybe even avoided some of the disordered eating and that side of things, hopefully, because there was a lot that was tied there as well. So that's something I wish I would have gotten. And then even in college you know I did go to it was the campus doctor whenever I was like I have these issues, I've had them forever, can you test me for celiac disease? And even with them, you know I brought up, I got this IBS diagnosis whenever I was a kid and they kind of just stopped and said, oh well, that's what it is, that's what you're experiencing, and that was probably true.
Erin Judge RD:But even then it just felt like okay, it felt like the hard line of great, okay, providers are not going to help me. This is not something like medically that I can get support with. And if I could have just gotten maybe a referral or something at the time or a little education, you know, I wanted the bare minimum of just something. That would have been helpful, that would have likely made a lot of things easier for me or hopefully had gotten me to a place where I had symptom relief and even just understanding and confidence in what my body was going through at an earlier age. I mean, I wouldn't have missed out on so much or done all those kind of weird things that I did to try to cover it up.
Kate Scarlata MPH, RD:The avoidant behaviors.
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Kate Scarlata MPH, RD:You needed someone to you know, empower you and not maybe punish you for something you had little control over.
Kate Scarlata MPH, RD:It breaks my heart to think that you had to.
Kate Scarlata MPH, RD:You know experience that when you know you had no control over what was going on and and someone thought you did, and that's unfortunate.
Kate Scarlata MPH, RD:But you can see, like I see in a lot of dietitians and other practitioners that have gone through hard things, they do weave that beautiful compassion through their practice, which you absolutely do, and just your willingness to be so open with pretty raw moments in your life is going to make a difference because a lot of people will be listening and that validation is powerful. It really is so powerful to know that you're not alone in maybe experiencing something. Maybe you feel like, oh, I should have said something or maybe I could have pushed harder for that test that they slammed the door down for, and sometimes we're just not in the right place with the right practitioners or it's just years before we had a lot to really offer and but you know, your story is just, is unbelievable and I know we'll, we'll make a difference in in people that are listening. It's really hard and beautiful at the same time to see where you, how far you've come.
Erin Judge RD:Yeah, I absolutely agree and I definitely don't blame practitioners at the time because, again, research wasn't there. My experience, if I was that age today, would have looked so different. It was also in a very we didn't have the resources right, and I think with internet and social media and that's why I'm so adamant about being on social media is that it does allow people in rural places where maybe you don't have the best teaching hospitals or like as much access to information. You don't have specialists that you can be referred to, even if you wanted to be, and you know now, with costs and all of that included, it does hinder people from getting the information they need, and so I'm very much recognized that and I know that it would have been different today or in a different place, but being able to provide that is really empowering.
Erin Judge RD:And one thing I always say to patients that I have to tell myself is that you know there are different factors that maybe could have been controlled in my life that would have prevented IBS right, there are factors that were environmental, that were choices that we as a family made for me at the time, but it is not my fault that I have IBS Right and someone who's making the same decisions I'm making on how they move their bodies, how they sleep, how they, you know, handle stress, what they put in their bodies. They could do the same thing as me, and they don't have IBS, but I do right. They could do quote unquote worse than me or better than me, and they may or may not have an illness or a condition. And so I always tell patients it's not your fault, you have IBS. Because you have IBS, your body does require different things. So my body needs more from me. It's maybe not as flexible as other bodies may be because I have the condition flexible as other bodies may be because I have the condition and so I do have to be really mindful and intentional and understand how things impact me and like be wise about that, right.
Erin Judge RD:But that doesn't mean that that's my fault and that I should feel guilty or shamed if I don't do it perfectly, because that doesn't mean that I'm bad or I'm wrong. It just means, okay, my body just needs a lot more from me because of this condition I have. That it's okay for me to be angry and upset that I have, because it is unfair in a way, but it wasn't my fault and that's okay and I think that's a really good part of the acceptance piece and then fighting to make sure we're getting answers and we're not just settling for, you know, severe symptoms or no results from treatments. You know the things that you guys have talked about as well, that sometimes it's not just IBS and we can't tell patients it is always just IBS. But it's also empowering to say you know, my body is struggling with something.
Erin Judge RD:It does have a condition. There is something going on that hinders the way that maybe I respond to certain things in my life. So I have to be intentional. I have to be aware I have to be more consistent than others in order to keep this in a place that's manageable for me. And that is okay. That's just my reality.
Kate Scarlata MPH, RD:And the whole guilt thing, because I do see a lot of patients sort of like, ah, like I shouldn't have, or, you know, bring that piece on. You do need to be a little more intentional. You have to do special practices, whether it's diaphragmatic, and that's guilt-free zone too right, you just jump back on the saddle and get yourself back in a good place. But I think the guilt piece does come through with a lot of the clients that I've seen throughout the years and I want that not to be removed from their experience, because no one's supposed to be perfect either. Even with an intentioned, beautiful plan that we put together, we all step off the plan sometimes, so don't feel bad about it if you do. If you're listening. I'd love to just transition into just a simple question here. Maybe, maybe not. How do you describe IBS to your patients that you work with? What is your elevator pitch for IBS? How do you describe that?
Erin Judge RD:I would say I don't have the best elevator pitch. I probably say too many words most often, but I do describe it as it's a functional GI disorder that impacts how your body responds to different things in your environment. That's how I typically will phrase it. And then we might get into the weeds of because your gut brain connection is altered or there's some miscommunication with IBS that impacts how stress impacts your body. That impacts how different sensations in your body may result in pain because of this disorder. And then the same with because you may have increased levels of intestinal permeability. You may have an altered gut microbiome.
Erin Judge RD:There may be some immune activation going on, maybe the role of mast cells, like there's a lot that could be happening in complexities and that may impact how your gut motility is going. You know day to day and how you're pooping every day. That may impact how you respond to certain foods or food intolerances that you notice. That may impact why when you get sick you are thrown off and things seem to spiral a lot differently than other people. So that's typically how I will explain it, to try to pull together some of the more the research we have. That's maybe a little mysterious to some patients, but bring it back to like a practical place of, okay, here's why you feel the way you feel, as much as you know, we can know and understand. And then we can come back to that as we put interventions in place to say, okay, we're targeting gut brain connection here, we're targeting this sensation, we're targeting the gut microbiome here, we're looking at the immune system here. Like, those are some of the ways we can kind of pull it together. Yeah, it's complicated.
Dr. Megan Riehl:Yeah, it's complicated, and I love what you started the interview with today, just saying you're not trying to cure IBS. That is not an option. But what we can do is improve the severity of your symptoms and improve your quality of life, improve your confidence, get you back doing things that maybe you had been avoiding and hiding and keeping in, and when we think about constipation, there's so much keeping in and tension and literally holding in the beep, and so we have to instill this level of hope with the treatment plan. And you certainly have, like, walked the walk. You've really kind of talked a lot today about moving your body and some of the lifestyle strategies that you find helpful. Tell us a little bit more about that. Like, what are the strategies that you find to be so helpful?
Erin Judge RD:Yeah, so with constipation. I do love working with patients with constipation, so I say there's so many tools at our disposal, there's so many things that could potentially help, which is exciting because there's creativity involved, like patients who are high achieving, people who are working really intense jobs versus the mother that's home with five kids, and versus the student versus the person that's retired. You know we have so many different strategies we can use in different scenarios, so some of my favorites. Movement is definitely one of them, and I love exercise and fitness in that world. But the everyday movement is often neglected and that's what I tend to focus on the most is how are you walking throughout the day, like, can we get your steps up, can we get your blood flowing through the day, not just in one exercise, and that seems to really help. I love I always call it toilet time how we adjust toileting technique and how you sit on the toilet, adjusting posture, teaching patients how to relax and leading them towards those diaphragmatic videos where they know how to breathe properly. I think that can be so empowering. Patients don't learn that often. From a diet perspective, obviously there's so many options there as well. Fiber is my favorite thing increased. As a GI dietitian, I personally love increasing fiber more slowly and I like using kiwi as we can. I'm a big fan of flaxseed. I probably prescribe flaxseed a lot more than I prescribe kiwi or some of those other kind of constipation remedies, just because I find it easy for patients to obtain, and so I'm a big fan of ground flaxseed, one of the two tablespoons a day. Proper hydration and even looking at you know, increasing water again throughout the day. I think with gut motility, sometimes we forget to teach patients that the gut needs to move consistently, and so it's not just about on paper what you're checking off and doing, but are you doing it throughout and is it spreading out? So it's fiber spreading out. Are you eating consistent meals and actually feeding your body throughout the day? Are you moving throughout the day? Are you hydrating throughout the day? Do I have a study to back it up? No, but I think it makes sense right, when you understand how the gut functions and how our body functions, like you have to keep feeding the body and doing those things. Same with relaxation and the stress side of things. You can't just do a meditation in the morning and then have a stress-loaded day that you never take time to regulate and expect that meditation in the morning to solve all your problems. We have to keep regulating. So that's really big.
Erin Judge RD:I do love utilizing different kind of laxatives or laxative agents with patients with constipation, in addition to those other pieces. I always say it's sort of like retraining the bowels, you know, to work when they've been slow, and so using things like Miralox or magnesium or maybe the kiwi or things that are a little bit more intense, that can help clear stool out while building up fiber, I think that can be really empowering again to patients understanding I can clear the stool out while building up fiber. I think that can be really empowering again to patients understanding I can clear the poop out, I can add the fiber in my gut's. Moving with that, I'm also moving my body and I'm giving it, increasing my blood flow, keeping things soft with fruit and water. You know, understanding all those little pieces and knowing, okay, each step I'm taking is leading in the direction I'm trying to go and I'm sitting on the toilet, well, and I'm pooping, well, and all of that's happening. So I'd say those are probably the things that I would use the most.
Erin Judge RD:I recommend abdominal massage. I have patients who do that, and then sometimes we do have to think outside of the box and we get a little bit more nitpicky about maybe adjusting the texture of foods or playing with. Are you three meals per day spread out, kind of person, or do you benefit from five meals per day? Is that more beneficial? Maybe we use things like different teas, maybe supplements can fit in, but usually we like to start with those basics and that typically, when done well and done consistently, I find really works for patients before needing all the sexy things that are really complicated and can be hard to maintain over time.
Dr. Megan Riehl:If you haven't heard our episode with Dr Justin Brandler in this series, he gets into the nitty gritty of medications and prescriptions in a very digestible way. So we encourage you to check that out. And I'll say, if you follow Erin on social media, you can see her living her life traveling, going to concerts, eating out and a lot of different strategies that you have woven into your life. And it's not that it doesn't take effort and planning and thought, but it's amazing to see you living your life, a full, busy, active life, and really implementing so many different strategies that really hit across the board, from moving your body to being relaxed, to putting your legs up on the wall to stretch out. You know all the things. It's very helpful, very helpful to see, absolutely.
Erin Judge RD:I think again you have to think of the whole person, especially with IBS, gi, any area of health, but again GI often that's missing is the whole person matters, you know. Feeding the body what it needs, that really does matter. But also having a good relationship with food also does matter. Right Moving your body also matters. Knowing where your limits are also matters. Sleeping matters, social time matters. Moderating alcohol intake, that matters, you know there's so many things that actually do really matter.
Erin Judge RD:And I think sometimes we get into that black and white thinking that either isolate somebody where they're like, well, I can't do anything because it's outside of my little bubble, that doesn't work, because then we're missing out on the social or missing out on the quality of life or what's life for if you're not doing anything that you enjoy right? Or I think people tend to focus just on one thing and then they don't want to recognize the sleep or the stress or those other pieces. And so it's really to me, I find it. I often say I wish I didn't have IBS, I wish I lived a different life, I wish I was doing some other job. If I'm honest, I do, I wish I never had gotten IBS. That would have been wonderful. At the same time, I'm really thankful that, because I've had IBS for the majority of my life, it has forced me to truly take care of myself. It's forced me to not in a way that's like a slap on the wrist, because I've worked really hard to understand the power of my own choices and think about those in terms of what I want in my life and what matters to me and knowing that they're improving my life. But at the same time I can't binge drink on the weekend and I can't. I'll end up in a lot of pain and I don't want that for myself.
Erin Judge RD:So I have to be more intentional about how I'm relaxing my body, what I put on my plate metaphorically the overall plate, but also the physical plate. I just have to be mindful and aware of that and that's how I found a lot of freedom in my life that I have. But it does come with really intentional choices, priorities, some sacrifice, but I weigh out what matters. I accept I know how to take care of myself if things fall apart. You know that took a lot of work.
Erin Judge RD:It takes a lot of effort, but to me it's worth it, because I do get to experience all of those things, and patients do have that option, and it's going to look different for every person because there's a lot of different ways IBS affects somebody and what they need may be completely different than me. Their barriers may look different than mine, what they're willing to accept in their life and how they feel is going to look different than me, but it is still very empowering to know that, being intentional, a little intuition, a lot of intentionality, you can see the results that you want and you can do the things in your life that you want. It's very much possible. So I'm always happy to share that and be really honest, even about where it is a struggle, because it's not perfect, but it is very much possible.
Kate Scarlata MPH, RD:Well, on that note, Erin, that was just so amazing, so beautiful I don't even know how to say just. It was a beautiful, eloquent discussion about your patient journey and how you help others with their individual journey with IBS. So it's beautiful. Thank you for coming on. We really appreciate your time and, to all our listeners, we hope that you comment, like and share the Gut Health Podcast. Your support means the world friends, thanks so much.
Dr. Megan Riehl:Thank you for joining us as we grow this gut health community. We hope you enjoyed this episode and don't forget to subscribe, rate and leave us a comment. You can also follow us on social media at the Gut Health Podcast, where we'd love for you to share your thoughts, questions and experiences. Thanks for tuning in, friends.
