If you ever asked me if I knew the difference between menstrual cramps or gas, I would have definitively said, “Yes.” With that opening line, you probably realize that this blog may come with a little TMI. I’m going to talk about my bowels more than you may care to know about. I’ll try to make the process at least mildly entertaining. But if you don’t have any menstrual or bowel trouble you’ve been trying to sort out, you can feel free to skip this one.
I’m familiar with gas pain. As a kid if you had gas pain in our house my mom would make you get up and move. She called it the chicken walk. You would make big, exaggerated movements and get your knees up really high, practically pulling one knee up toward one shoulder and then repeating on the other side as you strutted around the room. If you weren’t doubled over in pain from gas cramps it would have been hilarious. And it was always hilarious to the observer. It was also almost always effective. (Movement makes everything better.)
The first time Matt ever saw me do the chicken walk, he guffawed. “What is happening?” he wanted to know. He didn’t understand. He had never experienced gas pain. He couldn’t comprehend my motivator and willingness to make myself look like such a fool. He also has never had a bug bite last more than 24-hours, and he’s not temperature sensitive. Sometimes I wonder if he’s actually human.
In addition to gas, I’ve also had debilitating menstrual cramps. Not every month, thankfully, but when they were bad they could bring me to my knees. I’m just lucky that way. But based on having had gas pains and having had menstrual cramps I would have told you that I could definitely tell the difference between my bowels and my uterus. I was wrong.
My OBGYN’s Da Bomb:
While, I don’t know the timeline exactly (because I don’t keep Jeffersonian notes on my days), over a year ago at my last OBGYN appointment I mentioned that I was getting mild menstrual cramps all month long, not just right before my period. I was worried something might be wrong. I would never have described what I was feeling as gas. What I was feeling was always the sensation I get right before my period. Different from terrible cramping. Just mild discomfort that makes you remember your period is on its way. A roll-you-eyes kind of cramp.
To be thorough, my OBGYN did an internal ultrasound. That’s never fun, but now I know my ovaries and uterus are beautiful—her words, not mine. However, she told me that while all my lady parts were doing just fine, my colon was spasming. I don’t care who give you the news, you don’t want to hear you have a spasming colon. She suggested I go to a gastrointestinal doctor because lots of women confuse abdominal pain for menstrual cramps when it’s actually intestinal. In fact when I did a Google search for “menstrual cramps no…” period is the first thing to come pop up, followed shortly behind uterus and ovaries. So even when women no longer have all their original parts they still assume they are having menstrual cramps or they are trying to figure out why they might have cramps when they have nothing left to cramp.
Turns out what feels like cramping can actually be intestinal. Sometimes I’m shocked at how little I know my own body for someone whose career is, at least in part, about feeling and sensing her own body.
I’d spent months altering my diet, cutting out various foods that could be aggravating, searching for a possible food allergy all with minimal to no noticeable benefit. That’s when my GI doctor ran a hydrogen breathe test for SIBO. I wish she ran it first. It’s a three hour exam. After fasting, you drink a sugary beverage at the doctor’s office and then every 15-minutes for three hours you blow in a tube and they look for hydrogen or other gasses in your breath that shouldn’t be there in excessive quantities. You can’t sleep or exercise while testing. My test came back positive for SIBO.
What is SIBO?
SIBO (small intestinal bacterial overgrowth) means that the bacteria that normally live in your colon creep up into your small intestine. Since they don’t belong there, they can wreak havoc.
These were my symptoms. They aren’t all the symptoms associated with SIBO and they aren’t always caused by SIBO.
Bloating after eating
Diarrhea (I was in denial about this one in some ways)
Urgency to Use the Bathroom—like I couldn’t hold it and didn’t get much warning
Getting Full Fast
Treatment for SIBO is with antibiotics, which according to google, the tome of all knowledge, isn’t always effective. Meaning it can take a few treatments to finally work. But figuring out if you have something that even needs to be treated is the first step.
I think there were a variety of reasons it may have taken me a long time to get diagnosed with SIBO. First of all, my symptoms didn’t all come at once. A couple started and then a few others trickled in. I didn’t necessarily link all of them together. Also, SIBO may be more common than people once thought. So I’m not sure it’s every doctors ‘go-to’ problem.
In addition, I could explain all my symptoms away, or so I thought. Fatigue could be lack of sleep. Heartburn seemed like normal aging. Bloating must mean I’d developed a food allergy. That’s why I was willing to try all these different experiments with my diet. I’d developed a chicken aversion. The idea of eating most poultry was nauseating. And, in all my experiments with food, the only one that seemed to make a difference was cutting out raw veggies. I presume this is because SIBO can make it harder to digest food and raw veggies are hard to digest anyway. As I mentioned before, I thought my abdominal pain was actually menstrual cramps. Urgency to go was my last symptom to crop up, but it bothered me most of all because it literally put a cramp in my style. I detest using public restrooms, and I started to get nervous about when the urgency would arise. Could I be in the middle of teaching a class and need to excuse myself to go to the bathroom? Luckily, it never came to that.
I often joke that I’m an 80-year-old in a 36-year-old’s body. I like to be in bed by nine. I get up early. I’d happily eat dinner at early bird special time. Some of these symptoms just confirmed for me that I’m secretly an old lady at heart and now, apparently, I was one gastrointestinally too. I’m glad I have my mom because she always confirms for me that all my issues are not part of “normal aging.”
If I’m honest, time got in the way too. How many doctors can you go see? I wasn’t making time for any of those issues. Mostly, I just dealt with them. I was so hesitant to delve deeper into what was happening that when my OBGYN started scheduling an internal ultra sound, I almost said, “You know what, forget it. I’m okay.” When I went to the gastroc I downplayed all my symptoms. “I don’t have diarrhea,” I insisted. “I have soft stool”—a difference I still stand by. Then she reminded me that I’m not 80. I’m 36 and that’s abnormal and a change in my body.
I desperately didn’t want to have to do another personal stool collection at home and then drive it to the lab. I’d done so many of these. It never gets easier or more fun. It’s always mortifying. And the last time I’d delivered my sample at the lab, the guy collecting said, “Has anyone ever told you that you have beautiful eyes?” Then I handed him a bag of my own poo. You just don’t feel pretty when feces are around.
How do you get SIBO?
What sets SIBO off in the first place is not fully understood. It could be an issue with the nervous system or a muscular issue. Our bowels normally work without us thinking about it. So, if you’ve kept reading even though your bowels work fine, give them a little nod and some gratitude. Take a minute to appreciate all they do without skipping a beat. Around the time I got diagnosed with SIBO I was also diagnosed with Lyme disease, which can lead to SIBO. So for me, maybe my SIBO started when I got Lyme. Lyme affects the nervous system. It’s all related. But like most of our gut health, we still have a lot to learn.
I treated with antibiotics and my SIBO seemed to clear up entirely. It’s funny, you can kind of get used to discomfort or an abnormality that just becomes normal for you. It was so nice to feel better. I’d forgotten how good it feels to feel good.
I’m currently still being treated for Lyme Disease. It’s a long treatment of antibiotics, but as of now I’m quite happy to share that my gut feels pretty good. And I no longer have to make a mad dash to the throne.
Lucky me, here is another health issue. Read about costochondritis that might explain rib pain. Click here.
Tips for cramping (especially in the feet) when you exercise. Click here.
Prone to cramping? Click here to find out some possible reasons why.
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