Foul gas and bloating - any advice on cause or solution?

[bttory]

Sorry for the gross topic, but I'm not sure who else to ask. I have almost non-stop bloating (very uncomfortable), and very foul smelling gas (most potent and frequent after I eat, but present at all times). It is REALLY foul smelling, and strong. I am in recovery: diagnosed in February, went on Entocourt (9 mg), reduced the watery BM but was still having multiple BMs a day (and still had bloating). So, I listened to everyone's advice here and started the recovery diet. I went down to 1 to 2 more solid BMs a day, and as a result reduced my Entocourt to 6mg (I'm still on it), but still have the bloating and the gas. I'm not sure what else to do.

For anyone that has the time to give their insight, this is what I eat:

BREAKFAST
ground turkey
steamed winter squash
(shake with hydrolyzed collagen and 1/4 banana, only if I workout, as post workout shake)
decaf coffee (sometimes with coconut oil)
vitamin d
magnesium
vitamin k7 (not soy derived; I take it because I get none of it from my diet)
B12 (sublingual; I take it roughly every other day)

LUNCH
ground turkey (occasionally salmon)
steamed winter squash
banana
1 desiccated liver capsule (I take it for the B vitamins)

DINNER
ground turkey
steamed winter squash
cream of rice (with olive oil on it)

NIGHT SNACK
sweet potato (steamed)
magnesium
and sometimes one or more of the following (if hungry): more ground turkey, Oskri coconut bar, and/or banana

Any thoughts on what may be causing my issue, and what I can do? FYI, the bloating was there before and after each of the supplements and collagen. So I don't think those could be the issue, but I'm interested in your thoughts if you think I'm wrong.

Also, I had a breath test (before I was diagnosed with LC) and it was "positive." I went on antibiotics; it helped with the smelly gas but not the bloating. Many months later I had the test again and it was negative. I know little about SIBO but wonder if that could be at play, too.

Sorry for the novel. I'm distraught; the gas is so bad it is difficult to be at work. Thanks for any and all help. You all are the best.

[bttory]

I should've mentioned that I'm still on Entocourt (6mg) and have been continuously since February. I sometimes wonder if I need to go back to 9mg, but I really don't want to take that step backwards, especially given how long I've been on it. Thanks again.

[Rosie]

What strikes me here is all the ground turkey, for breakfast, lunch and dinner. Almost all ground turkey brands (and many other ground meats) now contain rosemary extract, which we recently discovered is extracted with soy oil. If you are sensitive to soy, that may be the culprit. Even if the label doesn't specifically say rosemary extract, but something more vague, like "natural flavors", it probably is either rosemary extract or perhaps another extract that very well could contain soy. I know that when I accidentally get soy, I have a lot of nasty gas.

You might try finding a butcher that will freshly grind turkey for you without any additives. Also check some of the organic food stores to see if they carry pure ground turkey, perhaps frozen, or have them grind some for you.

I really feel for your distress, and hope my suggestion, or someone else's, will help you find relief.

Rosie

[Gabes-Apg]

in line with Rosie's reply - i dont think there is one major thing causing the gas, moreso there is a few small things that are all contributing to the issue

- ground turkey as only protein - it would be good to try a protein where the animal is 'grass fed'
(and the risk of soy in the natural flavours)

- steamed winter squash - have you tried other vegetables?

- entocort, the fact that you are having solid BM's but having the gas - the digestion is slow/not ideal. consider reducing the dosage a bit more to see if this improves the gas situation

- liver capsule - a quick read via google search i saw multiple comments that this product can cause gas. (some comments mention " they have a tendency to cause some pretty horrific gas, a considerable volume")


if it was me - i would stop the liver capsule first - and see if the gas issue resolves, if not then work through the other suggestions one by one.

[tex]

Well, bloating and foul-smelling gas are classic symptoms of MC and food sensitivities in general. But I don't see anything wrong with your diet (other than the possibility that Rosie pointed out). Other than that, it looks lean, clean, and mean.

So I wonder about the Entocort. Those symptoms are listed as common gastrointestinal side effects of Entocort in the Healthcare Professional section at the following link:

Gastrointestinal

Very common (10% or more): Nausea (up to 13%); abdominal pain (21%)
Common (1% to 10%): Viral gastroenteritis, upper abdominal pain, flatulence, abdominal distension, constipation, dyspepsia, vomiting, diarrhea, sore/irritated throat, dry mouth, bad taste, rectal disorder, rectal hemorrhage, ulcerative colitis, burning in the rectum or pain
Frequency not reported: Anus disorder, enteritis, epigastric pain, gastrointestinal fistula, glossitis, hemorrhoids, intestinal obstruction, tongue edema, tooth disorder
Postmarketing reports: Pancreatitis[Ref]

Entocort EC Side Effects

If your diet is working, you should be in remission by now. The Entocort may be causing those symptoms. If I were in that situation, and changing turkey or switching to lamb or venison or some other wild game, and trying the suggestions that Gabes made didn't do the trick, I would try slowly weaning off the Entocort to see if those symptoms slowly fade away.

Tex

[CathyMe.]

I will add to the discussion that I had to stop eating sweet potato as they caused me major discomfort. You might try skipping that to see if it helps.

[bttory]

What strikes me here is all the ground turkey, for breakfast, lunch and dinner. Almost all ground turkey brands (and many other ground meats) now contain rosemary extract, which we recently discovered is extracted with soy oil. If you are sensitive to soy, that may be the culprit. Even if the label doesn't specifically say rosemary extract, but something more vague, like "natural flavors", it probably is either rosemary extract or perhaps another extract that very well could contain soy. I know that when I accidentally get soy, I have a lot of nasty gas.

You might try finding a butcher that will freshly grind turkey for you without any additives. Also check some of the organic food stores to see if they carry pure ground turkey, perhaps frozen, or have them grind some for you.

I really feel for your distress, and hope my suggestion, or someone else's, will help you find relief.

Rosie

Hi Rosie,

Thanks for your input. Very good advice - I wasn't aware of the issues with ground turkey. I avoid soy, but I didn't know that even small amounts like that could have an effect. I'll look into what I've been eating and make a change if need be. Thanks for taking the time to offer your advice; I really appreciate it.

[bttory]

in line with Rosie's reply - i dont think there is one major thing causing the gas, moreso there is a few small things that are all contributing to the issue

- ground turkey as only protein - it would be good to try a protein where the animal is 'grass fed'
(and the risk of soy in the natural flavours)

- steamed winter squash - have you tried other vegetables?

- entocort, the fact that you are having solid BM's but having the gas - the digestion is slow/not ideal. consider reducing the dosage a bit more to see if this improves the gas situation

- liver capsule - a quick read via google search i saw multiple comments that this product can cause gas. (some comments mention " they have a tendency to cause some pretty horrific gas, a considerable volume")


if it was me - i would stop the liver capsule first - and see if the gas issue resolves, if not then work through the other suggestions one by one.

Hi Gabes,

Very good advice, thank you. To answer your questions:

- I've tried other vegetables before I went on the "recovery diet," and that is when I had troubles. And, because I'm still on 6mg of entocort, I'm afraid of adding new food. I had hoped to wean myself off entocort before trying new vegetables. Do you think that is a wise approach?

- I desperately want to get off entocort. My plan was to eat the "recovery diet" for as long as it takes, and slowly wean off. I tried going to 3mg (from 6mg) once every 4 days, but on the days I only take 3mg, I have extreme bloating and pain, and after 2 weeks of trying, I had a 1 day relapse of watery BM. So I'm afraid to wean from 6mg to 3mg without getting some of my current problems resolved. Maybe that is the wrong approach, however?

- excellent advice on the liver capsule. I'll stop taking them and see if it makes a difference.

As always, I appreciate your wisdom. Thanks.

[bttory]

Well, bloating and foul-smelling gas are classic symptoms of MC and food sensitivities in general. But I don't see anything wrong with your diet (other than the possibility that Rosie pointed out). Other than that, it looks lean, clean, and mean.

So I wonder about the Entocort. Those symptoms are listed as common gastrointestinal side effects of Entocort in the Healthcare Professional section at the following link:

Gastrointestinal

Very common (10% or more): Nausea (up to 13%); abdominal pain (21%)
Common (1% to 10%): Viral gastroenteritis, upper abdominal pain, flatulence, abdominal distension, constipation, dyspepsia, vomiting, diarrhea, sore/irritated throat, dry mouth, bad taste, rectal disorder, rectal hemorrhage, ulcerative colitis, burning in the rectum or pain
Frequency not reported: Anus disorder, enteritis, epigastric pain, gastrointestinal fistula, glossitis, hemorrhoids, intestinal obstruction, tongue edema, tooth disorder
Postmarketing reports: Pancreatitis[Ref]

Entocort EC Side Effects

If your diet is working, you should be in remission by now. The Entocort may be causing those symptoms. If I were in that situation, and changing turkey or switching to lamb or venison or some other wild game, and trying the suggestions that Gabes made didn't do the trick, I would try slowly weaning off the Entocort to see if those symptoms slowly fade away.

Tex

Hi Tex. Great advice as always, thanks. As mentioned in my response to Gabes, I would love to get off entocort, and have tried by going from 6mg to 3mg once every 4 days. On the days that I take 3mg, I have extreme bloating and looser stools. Then, after about 2 weeks of doing it, I had a relapse the day after going to 3mg. So I'm in a hard spot - if the entocort is causing the gas and bloating, I'd like to reduce it, but if I do, I seem to go into a relapse (or at least worse conditions). Do you think it is best to go forward with the phased reduction of entocort (e.g., 3mg every 4 days, and then eventually 6mg every 3 days, etc.), despite the increase bloating (and risk of relapse) to help my body get used to less entocort?

Another point in your email gave me pause: you said that if my diet was working, I should be in remission by now. I thought that some people had to stay on the "recovery diet" for a year, maybe more, to reach remission (even on entocort)? Or do I have it wrong, and with a diet I should be able to wean off entocort in a short amount of time, and then the diet (without the entocort) is the "recovery" that takes a year or so? Sorry for the many questions, but I want to make sure I get this right.

Finally, I would love to be able to have wild game (instead of turkey). I'm not a hunter (although I'm thinking of becoming one so I can get a deer each year and have that meat through the year - I live in NH, where nabbing a deer is very possible). Other than hunting, do you have any other ideas on where to buy wild game? There is meat shop that sells "game" near me, but I get the sense the animals are domesticated (e.g., antelope, bison, etc.), even if they are considered "game," and for that reason, they are probably fed a questionable diet.

Thanks so much for all of our help. You all have gotten me so far in my recover, and really, I couldn't have done this without you. I hope you all understand that you have affected another person (and I suspected many others) in a profoundly positive way. I am so grateful for all of you.

[bttory]

I will add to the discussion that I had to stop eating sweet potato as they caused me major discomfort. You might try skipping that to see if it helps.

Another great point - thank you. I'll keep that on my list of foods to try eliminating, to see if there is a difference. Thanks for taking the time to write!

[tex]

Do you think it is best to go forward with the phased reduction of entocort (e.g., 3mg every 4 days, and then eventually 6mg every 3 days, etc.), despite the increase bloating (and risk of relapse) to help my body get used to less entocort?

I would try the other suggestions first because every time you have a setback, it reverses some of the healing.

Another point in your email gave me pause: you said that if my diet was working, I should be in remission by now. I thought that some people had to stay on the "recovery diet" for a year, maybe more, to reach remission (even on entocort)? Or do I have it wrong, and with a diet I should be able to wean off entocort in a short amount of time, and then the diet (without the entocort) is the "recovery" that takes a year or so? Sorry for the many questions, but I want to make sure I get this right.

I noticed that you joined 10 months ago, so I assumed that you began making diet changes soon after that. Yes, there are always exceptions to every rule, but most people are able to see significant improvements in the 6–12 month time frame after they get their diet in order. "Tough" cases don't meet that time frame. "Tough" cases can be due to extreme sensitivities and/or other complications that may have to be resolved first (such as other AI issues that dominate the immune system), or they can be cases where the diet is cross-contaminated.

We always hope that it's the latter. It can be difficult to track down cross-contamination problems sometimes, but once the problem is found, the solution is usually obvious and relatively easy to handle. That's not the case with the other categories of tough cases. In some of the tough cases, budesonide is a continuing necessity (eventually at very low doses) in order to maintain remission. But before we consider viewing your case as a candidate for the "extreme sensitivity" or "other complications" category, we need to be absolutely sure that we aren't overlooking something in your diet (or your environment) that is perpetuating your symptoms. There's always a reason for everything that happens.

Here are my views on meat from wild game:

For the most part, ranchers who raise venison tend to specialize in species such as red deer or fallow deer. But some also offer native deer species (whitetail deer, mule deer, elk, etc.) The deer typically range over large acreages and get their nutritional needs from the land. During the winter, or during other severe conditions, such as droughts, storms, etc., the rancher will feed hay. But this is naturally-grown forage, and wild deer typically sneak into feeding areas and eat hay with cattle on most cattle ranches, anyway. If it's available, most ranchers will feed alfalfa hay, because it supplies all the protein that the deer need. In some cases (some areas) if alfalfa hay, or alfalfa cubes, are not available, they may have to feed conventional commercial range cubes, which would almost surely include soy protein. But anything is better than letting the herd starve.

I would venture to guess that most deer ranchers would choose to follow organic production practices, because with deer, it's not that difficult to do, due to the fact that deer are relatively self-sufficient anyway, compared with cattle. Most deer ranchers have websites these days, where you can find the answer to any questions about how the deer are raised. And even when there is no website, the meat should be appropriately labeled in the supermarket.

Bison are another matter. It's good, nutritious meat. However, if you are sensitive to beef cattle, then you may react to bison meat, as well. The problem is that back about 140–150 years ago the government promoted a program to exterminate the bison herds in order to force the native American Indians onto reservations. The bison herds became so depleted and scattered that many individual bison roamed the country searching for other bison, and ended up joining herds of domestic cattle. Bison are genetically capable of crossbreeding with cattle, and as a result, I would be surprised if you could find a bison anywhere on the North American continent that does not carry DNA from domestic cattle.

And also as a result of the limited bison gene pool, bison ranchers find it very beneficial to occasionally crossbreed their bison with cattle in order to enhance their genetics. When the population of a species becomes small enough, inbreeding is a major problem because it amplifies any genetic defects, causing each generation to become less robust and more prone to disease. After many generations, unless their DNA is improved by "healthier" genes, they tend to become stunted and disease-ridden.

Antelope would be safe, but there probably is a very limited supply of antelope meat available because they don't adapt well to ranch production methods. That said, Broken Arrow Ranch is one example of a vendor that offers antelope, along with other wild species.

Note that only government inspected wild game can be legally sold (either federal or qualifying state inspection). For example, venison from deer taken for recreational purposes can be donated (by following the rules set up by the state in which the animal was harvested), but it cannot be sold. The game ranches that specialize in wild meat have official inspectors on site during harvesting and processing.

I hope that some of this is helpful.

Tex

[Gabes-Apg]

I am aware from one of our other NH members that there is a butcher in that area that sells grass fed lamb

agree with the points made by Tex, if your current foods were your 'safe foods' then you should have a good level of remission by now.
something in your eating plan /supplement plan is causing inflammation.

[bttory]

Do you think it is best to go forward with the phased reduction of entocort (e.g., 3mg every 4 days, and then eventually 6mg every 3 days, etc.), despite the increase bloating (and risk of relapse) to help my body get used to less entocort?

I would try the other suggestions first because every time you have a setback, it reverses some of the healing.

Another point in your email gave me pause: you said that if my diet was working, I should be in remission by now. I thought that some people had to stay on the "recovery diet" for a year, maybe more, to reach remission (even on entocort)? Or do I have it wrong, and with a diet I should be able to wean off entocort in a short amount of time, and then the diet (without the entocort) is the "recovery" that takes a year or so? Sorry for the many questions, but I want to make sure I get this right.

I noticed that you joined 10 months ago, so I assumed that you began making diet changes soon after that. Yes, there are always exceptions to every rule, but most people are able to see significant improvements in the 6–12 month time frame after they get their diet in order. "Tough" cases don't meet that time frame. "Tough" cases can be due to extreme sensitivities and/or other complications that may have to be resolved first (such as other AI issues that dominate the immune system), or they can be cases where the diet is cross-contaminated.

We always hope that it's the latter. It can be difficult to track down cross-contamination problems sometimes, but once the problem is found, the solution is usually obvious and relatively easy to handle. That's not the case with the other categories of tough cases. In some of the tough cases, budesonide is a continuing necessity (eventually at very low doses) in order to maintain remission. But before we consider viewing your case as a candidate for the "extreme sensitivity" or "other complications" category, we need to be absolutely sure that we aren't overlooking something in your diet (or your environment) that is perpetuating your symptoms. There's always a reason for everything that happens.

Here are my views on meat from wild game:

For the most part, ranchers who raise venison tend to specialize in species such as red deer or fallow deer. But some also offer native deer species (whitetail deer, mule deer, elk, etc.) The deer typically range over large acreages and get their nutritional needs from the land. During the winter, or during other severe conditions, such as droughts, storms, etc., the rancher will feed hay. But this is naturally-grown forage, and wild deer typically sneak into feeding areas and eat hay with cattle on most cattle ranches, anyway. If it's available, most ranchers will feed alfalfa hay, because it supplies all the protein that the deer need. In some cases (some areas) if alfalfa hay, or alfalfa cubes, are not available, they may have to feed conventional commercial range cubes, which would almost surely include soy protein. But anything is better than letting the herd starve.

I would venture to guess that most deer ranchers would choose to follow organic production practices, because with deer, it's not that difficult to do, due to the fact that deer are relatively self-sufficient anyway, compared with cattle. Most deer ranchers have websites these days, where you can find the answer to any questions about how the deer are raised. And even when there is no website, the meat should be appropriately labeled in the supermarket.

Bison are another matter. It's good, nutritious meat. However, if you are sensitive to beef cattle, then you may react to bison meat, as well. The problem is that back about 140–150 years ago the government promoted a program to exterminate the bison herds in order to force the native American Indians onto reservations. The bison herds became so depleted and scattered that many individual bison roamed the country searching for other bison, and ended up joining herds of domestic cattle. Bison are genetically capable of crossbreeding with cattle, and as a result, I would be surprised if you could find a bison anywhere on the North American continent that does not carry DNA from domestic cattle.

And also as a result of the limited bison gene pool, bison ranchers find it very beneficial to occasionally crossbreed their bison with cattle in order to enhance their genetics. When the population of a species becomes small enough, inbreeding is a major problem because it amplifies any genetic defects, causing each generation to become less robust and more prone to disease. After many generations, unless their DNA is improved by "healthier" genes, they tend to become stunted and disease-ridden.

Antelope would be safe, but there probably is a very limited supply of antelope meat available because they don't adapt well to ranch production methods. That said, Broken Arrow Ranch is one example of a vendor that offers antelope, along with other wild species.

Note that only government inspected wild game can be legally sold (either federal or qualifying state inspection). For example, venison from deer taken for recreational purposes can be donated (by following the rules set up by the state in which the animal was harvested), but it cannot be sold. The game ranches that specialize in wild meat have official inspectors on site during harvesting and processing.

I hope that some of this is helpful.

Tex

Great advice, thanks for such a thoughtful response. I can't tell you how much I appreciate it. I'll work on "fixing" parts of my diet (starting with the liver capsules and the turkey meat), and see where that leads me. If I work through those issues and don't get anywhere, I may come back to you all for advice.

A few other things to consider in my case:

(1) months before my LC started to show up, I had a neurological attack of some sort. Numbness in my face, heaviness, weakness, and odd sensations in my left arm and left leg. Extreme headache and stiffness in my neck, some coordination issues, even some mid cognitive issues (hard to get words out, some times). That lasted many months, but later tapered off. I did all the test for multiple sclerosis (MRI, spinal tap, etc.). All came back clear except I had small white matter lesions on my brain (shown by the MRI). None were typical of multiple sclerosis. None were "active," which would've been the case had I been experiencing a MS flare up. I had 2 other MRIs (6 months apart). No changes. The docs have said they don't know what was going on, and now I'm not being followed.

(2) when my LC came on at its worst (Feb of this year, just before diagnosis) I had irregular blood tests and symmetrical lesions on my hands. Very odd, and they caught the doctor's attention. Blood tests had low iron binding capacity, high SGOT and SGPT (abnormal liver function), low white blood cell count, high red blood cell distribution, high mean platelet volume, abnormal ANA, high levels of eosinophil levels, high basophil levels, and high creatinine levels. Doctors didn't know what to make of it, but were concerned. Those abnormal tests went to normal, and the rash went away, a couple of months after I started on entocort. My doctor was puzzled, but attributed all the odd results and rash to my body being overactive due to the LC.

(3) I have celiac disease but am VERY careful to avoid cross contamination.

I know you all have lives to live and don't expect you to study my case! But if anything jumps out at you, or gives you some insight on what I might be dealing with, I appreciate the insight. I worry that I'm dealing with a bigger issue (MS, lupus, sarcoidosis, etc.) that may be preventing my LC remission (and causing my other issues).

I am blessed to have your insight - thanks.

[Gabes-Apg]

the symptoms you mention in point 1 - can be caused by deficiencies in key nutrients like magnesium, Vit D3, B group vitamins, and methylation cycle issues.
good quality magnesium supplementation/application of magnesium oil and active B's which we have already talked about will go long to resolve these issues

rash activity is the immune system struggling - Vit D3 and magnesium is a key aspect to this.
also - Vit C and zinc are key nutrients for the immune system.

as was discussed above, many people here get good remission and can expand their eating plan after 12 months. For some of us where there are other issues happening, this may not be the case. I am 7 years post Dx this week and due to my combo of health issues, nutrient imbalances etc I have not been able to expand my eating plan beyond the stage 2 type plan. I have been eating the same 5-6 vegetables and safe proteins for 7 years.
cie la vie - it is what it is for me... it is the only way i can keep inflammation levels down and have the energy and wellness to work.

[tex]

Interesting. Your issues are somewhat similar to mine.

Here are my thoughts/comments on your points.

1. One August morning in 2009 I got up and started to get dressed. I noticed that my right hand was numb, and didn't seem to be interested in waking up. Then I noticed that the numbness was moving up my forearm. Then I noticed that the right side of my face was becoming numb. That's when I took an aspirin, finished dressing, and headed to the ER. But my right leg was OK. The ER staff couldn't find anything wrong (my troponin enzyme level was normal), but they couldn't rule out a TIA, so that was the diagnosis. I had a second one about 9 months later that began about 10 or 11 at night while I was taking a shower. Same symptoms. I debated whether to go to the ER, and finally decided to go to see if they could run any tests that might show something interesting.

After the first TIA-like event I went to see a neurologist who ran all sorts of tests, including a brain mri, which showed some cortical shrinkage, but nothing remarkable. My scans also showed the white lesions, but no bleeding. But the neurologist noticed my gait and balances issues, and promptly diagnosed me with Parkinson's. At his suggestion, I began to take Metanx, which is a prescription blend of the active forms of vitamins B-6, B-9, and B-12. This helped with my balance issues and my reflexes (at the appointment, I had no reflexes below my knees, and little to no feeling in my feet). I decided that the symptoms were due to neurological damage caused by years of untreated gluten sensitivity. But the neurologist refused to recognize that gluten sensitivity could cause neurological damage (even though proof had existed in the medical literature for at least 6 or 7 years at the time).

Gluten sensitivity as a neurological illness

At the second TIA-like event, I stayed overnight in the hospital for the tests to be run the next morning and while I was waiting, the head of the neurology department came by with one of her students. They could no longer find any basis for a Parkinson's diagnosis, so they undiagnosed me. I still take Metanx, because whenever I have tried to do without it for more than a couple of weeks, my neurological symptoms (balance, gait, coordination, etc.) become noticeable worse.

These days I believe that the TIA-like events were probably due to a combination of gluten-associated neurological damage, and a chronic magnesium deficiency.

2. Basophils and eosinophils are associated with allergic reactions. These readings, together with the rash, suggest mast cell activation disorder (MCAD). Low white cell counts are often associated with viral infections. Vitamin D deficiency is associated with high MPV. High creatinine levels are often associated with a magnesium deficiency. Been there, done that. But looking at all these test results, there probably were several things going on, and one thing often affects another, despite the standard practice of doctors to always look at each issue as an independent event.

Mean Platelet Volume and Vitamin D Level

3. Is there by any chance a bag of wheat flour anywhere in your house?

Tex