How I keep my digestive system happy with cystic fibrosis

If you have, or have heard of cystic fibrosis, you will likely know that digestive system management is pretty much a full time job.

With CF, you have to be aware of what you’re consuming in every meal, snack and drink. You have to be able to estimate (with some degree of accuracy) the amount of fat in each meal as a minimum. If you’re also diabetic, like me, you also need to estimate carbs. And if you’re health conscious, you’ll likely be keeping an eye on your protein intake too... And then you have to dose the correct amount of digestive enzymes, like Creon, as well as insulin to ensure that you digest that food.

But that’s not where it ends. Gut transit in CF is generally a lot more sluggish. This can lead to anything from bloating or constipation to bowel obstruction and a hospital admission.

It’s one of the many things in life where prevention is better than dealing with the symptoms - symptoms that are at least uncomfortable and at most agonisingly painful and lifestyle inhibiting.

Over the last couple of decades, there are a number of things that I have learned that can help me to keep my tummy happy and I felt like it’s about time that I share them.

Please keep in mind that these are the things that I pay extra attention to on top of a baseline healthy diet, medication adherence, good sleep and well-considered supplementation.

I stay super-hydrated

Keep a bottle or glass with you at all times

This is a big one. I always have a reusable water bottle with me everywhere that I go. And for every instance I have little tactics that I use to keep fluid intake high.

When I leave the house, taking a filled and reusable bottle of water is the first thing I grab with my purse and keys. On a long trip (like a flight or car journey) I might have 2 or 3 bottles with me. And they’re big ones. A minimum of 500ml, but I prefer my 750ml bottle or even a litre. I refill them as often as I can.

At home, I always have a water bottle or glass that I use throughout the day. I always have it beside me. Since I sat down to write this article, in the space of writing 376 words, I’ve drunk one 450ml glass full of the clear stuff.

During meetings where I know I’m going to be pretty much glued to my desk, I will prep with a bottle of water and at least one mug of tea. When I know I’m not going to be moving for a while - or might be a bit lazy to get up - I want as many fluids to hand as possible. I also always - out of habit - have a glass of water with meals. And when I work out, if a full bottle isn’t gone by the end, that’s pretty unusual.

Think about the different situations that you have in your day-to-day life and make plans for how you can make healthy drinks part of those scenarios with ease.

And, if you ever take supplements like Movicol (macrogol sachets) to help things along, drink extra water when you take it. I always try to mix a sachet in with a full pint of water if I need to take it.

My favourite water bottles include my Chilli’s bottle and I also have my eye on some of the beautiful, sustainable water bottle designs available through Wearth London

Drink warm tea

I used to chug blackcurrant squash by the pint several times a day.

That was until Waitrose discontinued the blackcurrant squash that had been my favourite beverage since childhood and only offered the sugar-free version which just felt like plastic chemicals on my taste buds. Coincidentally this also happened at the same time that I was diagnosed with CF-related diabetes. Perhaps that was a lucky escape from some seriously unmanageable hyperglycemia.

Anyway, around this phase in my life I started drinking fruit teas. A lot. I’m not a big black tea or coffee lover and am happy to stay that way. But I love to squeeze in flavourful fruit teas that may pack some health benefits too.

I find that drinking something warm (especially before I have my first meal of the day) can really help to soothe and gently start mobilising my gut before I start loading it with food. I also like to mix fruit teas into my day just for some variety and to keep my tummy and taste buds happy. Staying hydrated feels more sustainable that way.

My favourite teas are Pukka without a doubt. The three fennel tea, three licorice, blackcurrant beauty, elderberry and echinacea and night time tea are my go to rotation. I also love Pukka because their bags are unbleached and biodegradable so I can just pop them straight into the household compost. (I avoid brands like Twinings as they currently still have plastic in most of their fruit tea bags and I’m sure that does nothing good for my tummy or the planet.)

And, as a side note, I never drink high-sugar fruit juice, fizzy drinks or energy drinks.

I went vegetarian (mostly)

When I reduced my meat-consumption my tummy problems almost disappeared over night. After cutting out meat almost entirely for several months, I had some roast chicken during Sunday lunch with my parents and I could tell the difference immediately. I felt bloated, gassy and my gut transit time slowed right down for a couple of days. Even now, if I don’t have meat for a while and then add some chicken to a meal, I notice my tummy lags about 12 hours behind where it usually would.

I don’t tend to label myself and the way that I eat. Some days I might eat fully vegetarian. Some days I might eat fully vegan. Some weeks I might have one meal containing meat. Some weeks I might have a meal or two containing fish. I don’t think about it too much. I’m very fortunate that over many years I’ve honed the ability to eat intuitively. But one thing I do think about is how my gut reacts when I eat too much meat. It’s just slow. It’s uncomfortable.

Sure, eating vegan or vegetarian can have its downsides too. Eating a lot of beans, lentils and vegetables can lead to bloating and gas. But even when I have those symptoms, my bowels are still operating like clockwork.

I took notice of food intolerances

Over the years I have figured out that I don’t tolerate gluten exceptionally well. I’m not coeliac but I know that if I have too much gluten-containing foods, I will be incredibly bloated, lethargic and even nauseous.

Take notice of what foods affect you and how. Then, if you feel you need to, you can work with a professional to manage reducing these foods in a way that won’t be detrimental to your health.

I gave my tummy (and taste buds) a helping hand

As well as figuring out what you maybe need to reduce in your diet to get a healthier and happier tummy, there might be things that you can add in to help your case.

Some of my go-tos include, prunes and other unsweetened dried fruits (figs, apricots…), ground flaxseed and oats. And plantain! Nothing works quite like ripe, cooked plantain for a happy tummy in my opinion.

All of these foods are things that tend to help keep my gut moving well. An easy way to get these into your daily routine is to have morning porridge for breakfast and toss all of these ingredients in to make a sweet, delicious start to your day.

And if you’re also taking a CFTR modulator drug or any supplements that require fats to be properly absorbed, don’t forget to stir in a generous spoonful of peanut butter!

I started taking a morning walk

This has been a massive game changer for me. Get into the habit of taking a walk before breakfast. Take a bottle of water or your cup of tea with you and just start moving. My walks can vary from 5 minutes around the neighbourhood to a 30 minute walk while I listen to a podcast.

Moving my body before I start loading it with food in the morning makes my gut wake up and start moving too. Plus, it has the added benefit of helping me to better manage my blood sugar for the whole day! The WHOLE DAY.

If you can manage it, try taking another short walk before or after each other meal time too.

It’s pretty well-documented that walking can help with digestion and blood sugar management so it’s well worth giving it a go.

I get a variety of exercise

While walking should be a staple of most people’s days, adding in extra exercise will obviously come with another huge bundle of benefits.

For me, when it comes to having a healthy tummy, variety is key. I love weight training, but I also try to jog a couple of times a week, do some yoga and stretches and try to vary the positions that I’m in for both resistance training and yoga. Twists, forward folds, and things like plank and other core-focused movements (my Mindful Core programme is great for these!) really help me.

If you need help coming up with a workout programme or even just a plan for your week to help you schedule the variety that you need, get in touch with me for a chat.

I’m mindful of my hormones

Ladies, you might notice that before your period you are more bloated and prone to constipation. You might also notice that as soon as the first day of your period arrives, your gut habits tend to swing the other way and everything passes a little more easily.

This is because after ovulation, progesterone levels increase and can cause constipation. Then, they drop at the beginning of your period along with the release of prostaglandin that can cause diarrhea. It’s mostly to do with these hormones having a muscle relaxing or contracting effect.

There might not be a lot that you can do about it but using some other techniques (like the ones I’ve mentioned) more diligently during tricky times of the month might just take the edge off.

What works for you?!

Of course there are lots of other things that can affect our digestive health and some things that might work for me, may not work for you, and vice versa. But after taking this approach for several years, finally establishing a digestive system that operates on a more regular schedule, and sharing this approach with friends who have also benefit, I know that some of these things should be staples for everyone for generally better health and a happier, more comfortable and more confidence life.

If there’s something that works great for you, I’d love if you’d share! Comment below, tweet me @_nataliejohanna or drop me a comment/message on Instagram. Know that my email inbox is always open to you too. :)

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