Hi @R-S – nutrition can be very confusing because you can find valid pros and cons to absolutely everything. And that’s why context matters so much, and why prioritizing goals with the correct order matters more.

In your case, even though SIBO/IBS are a part of your overall symptom picture, what you need right now are soothing remedies for both the gut and nervous system in a form that you can tolerate and absorb.

Eventually, you’ll be able to lessen these therapies and focus on the fight – but not before you soothe and strengthen your body first. The order matters.

Hope that makes sense?

Hi @Vidu – if the bottle was kept in the fridge, you can probably still use it. But if it’s been out, then it’s best to throw it out unfortunately.

Have you gone through our Heartburn & Acid Reflux Resolution program to help you figure out/address the cause(s) and provide some rapid relief solutions?

Hi @yasminatassi – the fact that she’s still playful, without fever or vomiting, is a very good sign.

Since her stool is watery though, you’ll want to make sure that she doesn’t get dehydrated. So first prioritize hydration with plenty of fluids (water, diluted coconut water).

If she doesn’t have an appetite, consider giving her easy to digest foods instead like smoothies, cooked carrots, boiled potato, and plain foods like rice, mashed banana and fresh apple sauce. These will help firm up her stool. Also notice if the kefir is helping or worsening the situation since dairy might aggravate the situation.

In terms of probiotics, something with the Lactobacillus rhamnosus GG, Lactobacillus plantarum and S. Boulardii (or a combo of these) strains can help alleviate diarrhea. You can learn more in this lesson from the Gut Health Masterclass. For example Culturelle Kids has L. Rhamnosus GG and is available on Amazon.ae and arrives same day with Prime. Florastor Kids has S. Boulardii. I suggest you call local pharmacies and ask if they have probiotics with these strains if you prefer in-store.

A stool test isn’t really necessary at this point unless diarrhea persists beyond a couple of days or if she develops fever/vomiting or show signs of regression in her daily activities.

However, if you notice that something remains “off” after the diarrhea passes, then it might be worth exploring functional stool tests such as Tiny Health (although I’ve never used them) or the GI Map for microbiome mapping.

Hope her gut feels better soon.

@iryna_klevetenko – is there a particular area of focus so I can help you narrow it down a little? For example, marriage, trauma release, etc.

@yasminatassi kids go through different eating phases so it’s normal that your once super-eater becomes extremely picky as she gets older. I discuss these transitions briefly in my book UNJUNK.

I also discuss how some children develop sensitivities to the foods they crave most. And by eating them, it is a way of self-medicating that stress response in the body. Dairy for example releases casomorphins during digestion, which are opioid-like substances that produce the same “feel-good high” as opioid drugs (like heroin). If she’s developed a sensitivity to dairy, the immune system will create an inner “stress” response, and as a way to attenuate that stress, her body will crave those opioid-like substances found in both dairy and gluten.

I’m not saying that this is the case for your daughter, but it is definitely a possibility, especially if that’s all she wants to eat sometimes.

And given that dairy is often a culprit with loose stools, it might be worth trying an elimination challenge for at least 2 weeks to see if it helps, if the probiotics alone don’t help. You can look at replacing her beloved yogurt with coconut yogurt instead as a transitionary phase to see what shifts in her gut with the removal of dairy. The same with kefir; coconut kefir instead of cow milk.

I know it can be difficult with young ones, but you can tell her it’s an experiment and temporary to see if it helps her poop become solid again. You can show her pictures of the Bristol stool chart (Type 7 – liquid diarrhea) and explain what it should look like (Type 3-4). That might convince her to try if she resists the changes.

@R-S – if you’re tolerating ginger, you can also try some fennel too for additional anti-spasmodic support.

Artichoke is great for bile support, but won’t really help with spasms/cramps.

The goal of the “safe base” foods is to try and figure out what from that 3-day menu is causing a food sensitivity reaction. It’s fine to add in beef for variety if it’s something you’ve had in the past without issues. Same with dragon fruit and pumpkin seeds. If you’ve been having these in the past without issues, then you can keep eating them. But the idea is to keep the diet bland to minimize variables to help you isolate what might be the trigger when you add foods back in one at a time. Just keep monitoring with a food log.

Oh, and regarding the coconut milk. It’s unnecessary to have any other ingredient other than coconut milk. So please find another brand that offers pure coconut milk only – usually it’s only available in a can.

Hi @naslam1603 – sorry to hear about your mom. I’m assuming they’ve already finished the procedure? Were they able to remove the stone that was blocking the bile duct?

Please keep us posted on how she’s doing. Wishing her an effective recovery.

Hi @R-S – thanks for sharing your food log.

Question, is there a reason why you’re having the coconut oil + honey also in the mornings and afternoons? My suggestion was to have that before bed to help prevent a hypoglycemic reaction at night before rising. Just curious to know why you’re also taking it during the daytime.

If I compare your food journal from Sep 1-3 to this recent one, there are some new foods that you’ve introduced that could be culprits:

1. Eggs (on 4th and 5th). This wasn’t there Sep 1-3. Eggs are a common gut irritant/food sensitivity in alot of people, especially when “leaky gut” is already suspected.

2. Coconut milk + rice puff cereal on the 5th. Does your coconut milk have gums, oils, additives or stabilizers? Or is it pure coconut milk from a can? Rice puff cereal is obviously processed, even though it’s gluten-free, so that could be hard to tolerate if the gut lining is already sensitive.

3. Kale chips (on 4th and 5th). Kale (raw/dried forms) is high in insoluble fiber (the type that causes faster transit). The extra fiber can be irritating to an already inflamed gut, and that type of fiber can lead to faster transit (which can explain the greenish stool if the timing matches).

4. Potato (on 6th). Nightshades can sometimes aggravate some people.

5. Grapes (4th to 6th). This new fruit is very high in sugar which can quickly ferment in the gut. Depending on how many you had, this could also be a culprit for digestive discomfort.

Here’s how you can experiment to figure out which ones are causing you issues:

• Remove the newer foods (eggs, kale, coconut milk, rice puffs, grapes, potato) while keeping to the “safe base” of chicken, zucchini, carrots, cucumber, rice, slippery elm for for a few days.
• Once you’re back to steady-state, re-introduce one at a time after 3+ days to see if any symptoms return. Have a small portion earlier in the day and track symptoms (bowel changes, abdominal pain, anxiety, palpitations).

Here’s a reintroduction order you can try from what is likely “lowest risk” to “highest risk”:

1. Grapes – small amount only (3-4 pieces)

2. Potato (boiled, plain)

3. Egg (boiled, half first day) – very common sensitivity so observe carefully

4. Kale chips – lots of insoluble fiber

5. Coconut milk only – especially if your coconut milk has “other ingredients”

6. Rice puff cereal – test only if really desired to keep in your diet since it’s processed

Now in terms of rapid relief for anxiety/palpitations and the heightened nervous system state that some of these foods are likely causing, I’d suggest a few helpful hacks:

• Dunking face (up cheeks at least) in ice water in a bowl
• Box breathing – 4 breaths in, hold for 4, 4 breaths out. Can also do 8-8-8 or 4-4-8. Whatever works best for you.
• Humming/gargling/singing out loud
• Going outside and grounding in nature or walking by the beach

All of these help activate the parasympathetic system, which can help the body relax and “unfreeze” from that flight/flight state. I suspect the constipation is a result of the sympathetic dominance, so that should hopefully also get relieved once your body shifts to a more relaxed nervous system state.

And in terms of relieving the abdominal discomfort and cramps, did you try the Iberogast or digestive bitters or antispasmodic teas?

@iryna_klevetenko – here is another option. Dr. Katerine Lemay has been recommended in another group that I’m in. I don’t know her personally though, but worth investigating.

https://tmtcdubai.com/about-us/dubai-psychologists-team/dr-katerine-lemay-ph-d-c-psych/

They offer family mediation services as well.

@iryna_klevetenko – I believe I may have already shared this contact with you before, but I know the owner of Thrive Wellbeing Centre. They have a team of psychologists with diverse specializations that can help.

Please let me know if this is the type of clinic you’re looking for.

@Kkol you book on their websites:

https://integrativemgi.com/appointments/

https://drlindseyberkson.com/consult-re/

@Kkol fire those doctors and find her one who understands hormones! If she’s open to a virtual consultation, I highly highly recommend Dr. Felice Gersh and Dr. Lindsey Berkson – both were guest experts and I’ve linked their sessions with details on how to connect with them.

@Kkol – appreciate your loyalty and we value our founding members so much!

I guess we should make our “feedback” link more obvious. 🙂 It’s in the global footer of all of our pages.

Here’s the direct link if you’d like to provide constructive criticism or positive reviews : https://bbettermembership.com/feedback/

@Bahareh – the menopause transitions kit. It measures FSH to determine your stage of menopause transition, LH to see if you ovulate, E3G to measure estrogen, and PdG to measure progesterone. The kit comes with 20 wands each so you can pretty much test your whole cycle after your period. Isn’t that so cool? I was so excited when I found out about this company. I’m exploring others too.

@Kkol haha, thanks – that means a lot! B Better has always been mission-led first with a strong vision of becoming the “Mindvalley of functional medicine”. We’re still in the building phase (not quite profitable yet!), but what matters is showing up consistently for our members. I know with time, more and more people will find their way here too. If you feel compelled, we’d appreciate you spreading the word to friends and family too! That would help us so much. 🙂

Ok, I’m glad sleep apnea has been ruled out. I’m assuming a sleep study was done? If so, that’s a big checkbox marked off… if not, please pursue.

And yes, like I mentioned in my previous reply, cutting out sugar and quitting smoking are positive choices on your part. They absolutely affect lipids.

As for target ranges:

• ApoB: Ideally <80 mg/dL if higher risk, <100 if moderate risk
• LDL-C: Often <100 mg/dL, or <70 mg/dL in higher risk cases. “Too low” is less of a concern since your body still makes the cholesterol it needs

• Lp(a): This one is mostly genetic. Like I mentioned before, niacin (flushing form, under supervision) has been shown to help, and PCSK9 inhibitors can lower it too if that’s what you’re leaning towards.

So your goal of bringing LDL and ApoB into range is a good strategy, and like you said, if Lp(a) comes down too then even better. Between your diet/lifestyle changes, the right supplements, and some medical interventions if needed, you’re on the right track.