Self Care With A Chronic Illness

Though the average, healthy human body can survive about a month (30-40 days) without food(1), we can only survive a matter of days without water. Tap water in cities the world over is treated/cleaned so it is safe to drink, but ironically it often contains nasties such as heavy metals, added chemicals and can be contaminated with many different macromolecules which can make it unsafe. It can commonly contain microorganisms like bacteria and parasites, chemicals from industrial waste and crop spraying, improper disposal of pollutants and fertilisers from land runoff among others(2). Thus, it is important to have a water filter, whether it is attached to your kitchen tap or as a separate jug. Here are some review sites(3), (4), which rate the best filtered water jugs in the market this year. Even a basic, cheap filter is better than nothing.

There are many different factors which can impact and impair digestion. Here are a few - 

• Good posture. Having poor posture can cause a surprising amount of damage in the body. The human body simply isn’t adapted to sit hunched at a computer and looking down constantly at our phones. Being told to “Sit up straight” when we were younger, may be wiser advice than we realise as research has shown that body posture affects the function of the digestion and impacts absorption(5). It’s important to sit with a straight spine while eating, as this doesn’t constricted intestinal space and therefore undermine gut function(6). 
• Relax + slow down. Relaxation training is an integral component of behavioral therapies for managing chronic illness and is vital in the management of functional gastrointestinal (GI) disorders(7).
• Chewing. This first and crucial stage of digestion not only optimises digestion, but influences how much we eat and how often. The satiety and pleasure we get from our food decreases from the moment we take the first few bites of a meal. Called the "satiety cascade," this affects how much you eat during a meal and the amount of time between your next meal(8). 
• "Mindful eating."  Focus on the food you're eating, enjoy the aromas, savor every bite, eat slowly, and chew each mouthful thoroughly for maximum pleasure. Slow eating releases more flavors from food and extends the time the food lingers in your mouth. And because the food is in contact with your taste buds longer, it boosts your feelings of satiety. Mindful eating can help reduce the total amount you eat at any meal. For example, when you eat in front of the television, your attention is diverted from the food. That can result in "unconscious" overeating(8).

As the SIBO diet contains a lot of acidic digestive aids in the form of lemon and lime juice and ACV (Apple Cider Vinegar), to avoid acid erosion it is advised that you do the following(9) - 

• Eat digestive aids with meals. Instead of snacking throughout the day, save acidic foods for mealtimes. This will reduce their contact with your teeth and help neutralize the acid by eating it with other foods.
• Wash down with water. Sip water alongside or after the acidic food or drink to wash it out of your mouth. You can also simply rinse your mouth after eating an acidic meal - that will do the trick.
• Use a (metal) straw. If you drink acidic beverages, reduce their contact with your teeth by using a straw. 
• Wait before brushing. Acid softens your enamel, so brushing immediately after eating or drinking high-acid foods or drinks can actually cause damage to your teeth. Rinse your mouth out with water and wait for a good few hours before gently brushing your teeth. 

 “...nothing should be placed inside the ear to remove dirt and debris. This is dangerous and could cause hearing loss or a damaged ear canal or eardrum.”(10)

Many people aren't aware that the cotton buds/q tips sold in pharmacies actually push ear wax further down the canal, leading to potential infection, wax blockages and deafness. Our ears don’t actually need cleaning that often - the skin in your ear canal naturally grows in an outward, spiral pattern. As it sloughs off, ear wax goes with it. Most of the time the wax will loosen and fall out on its own while you are asleep. The outer ear or pinna benefits from a good cleaning every now and then. This can be accomplished with a little soap, water and a washcloth while you shower.

But when wax builds up too much, it can be beneficial to use olive oil ear wax drops or bicarbonate of soda ear drops - available from a chemist of pharmacy (you may have to ask at the counter as these products aren’t commonly stocked on shelves). This is the best and safest way to cleanse your ear canals and can help prevent infection.

There are risks attached to enemas so we recommend you read health articles such as this to understand them before jumping straight in. It’s important not to do enemas too often as they can interfere with the large intestinal microbiome. However, enemas are a highly useful tool while water fasting and to relieve symptoms of SIBO-C. We bought a medical-grade enema kit from Amazon which is super easy to use and there are many options to choose from online. Doing enemas once weekly has caused us no problems at all but we also water fast regularly and practice intermittent fasting daily to promote and improve gut function and motility - enemas alone are not enough.

A word of warning from Dr Chris Kresser - “...some studies show that a bowel lavage, colonic, or a laxative kind of thing, can lower or even eliminate methane production.  But I would be careful with that, because colonics, while they do wash out some of the bad gut flora, they also wash out a lot of the good gut flora.  They’re also pretty invasive.”(11)

Pooping - the great leveler. What goes in, has to come out and how people choose to poop is, believe it or not, a cultural decision. People adapt their “defecation postures” to suit the toilet types available to them. Though sit-down lavs have existed at least since Egyptian antiquity, for almost all of our history, the vast majority of Homo Sapiens defecated squatting in the open(12). We have evolved to ‘go’ while squatting with our knees close to our chest and thus in the “anorectal angle”, the intra-abdominal pressure rises, the bowel straightens, lengthens and movements pass more quickly, easily and without any need for force. The squat posture also beneficial for strengthening the thigh and pelvic floor muscles. Passing fecal matter with force can lead to serious internal damage and a host of severe health conditions(13). For those unable to squat due to physical restrictions or fatigue, you should place a bucket/stack of yellow pages etc by the loo to use as a substitute and free “squat potty”. “Elimination is love” people.