If you are working on recovering from disordered eating and experiencing digestive issues, you are not alone. In fact, most people recovering from an eating disorder have to endure mild to severe discomfort while eating, due to the changes in the digestive system while restriction and other eating disorder behaviors are present.
Why do digestive issues happen?
Your digestive tract gets deconditioned. Food restriction, bingeing, and purging cause the muscles lining the entire digestive tract from the esophagus to the anus to become deconditioned. The muscles “shrink”, causing food to empty very slowly. Food can literally sit in the stomach or intestinal tract for hours, causing gas, bloating, and pain. This is why I often hear my clients say it feels like their stomachs have “shrunk”, which is why they can only eat small amounts of food at a time and feel like they’ve eaten enough.
If you’ve lost weight because of your eating disorder, you’ve likely also lost muscle strength. The muscles that support your abdominal cavity are weakened and not yet strong enough to “hold” your stomach in. This can make bloating occur more easily, and your belly may distend more visibly when gas, liquids, and food are traveling through your intestinal tract. It can also cause symptoms like constipation, difficulty passing stool, or difficulty holding stool in, because the muscles of the pelvic floor are affected. Excessive exercise can also affect the muscles of the pelvic floor.
Purging can disrupt your digestive system as well. Repeated vomiting damages the esophageal sphincter (the “door” where your esophagus empties into your stomach that keeps the food from coming back up your esophagus) and can cause GERD (acid-reflux). Laxative abuse interferes with digestion, decreasing the function of your colon and making it difficult to have regular bowel movements.
Your gut microbiome changes. Your gut microbiome – the microorganisms that live in your intestinal tract and help you digest your food – changes during periods of restriction. This means foods that your body tolerated just fine before your eating disorder developed, may be difficult to digest and contribute to symptoms like bloating, gas, acid reflux, and indigestion. These uncomfortable symptoms may, understandably, lead you to continue to avoid those foods.
Tips for dealing with digestive discomfort
When it comes to recovering from an eating disorder, there is no substitute for food as your medicine. Here are some tips for dealing with digestive discomfort.
Eat regularly.
Eating meals and snacks about every 2-3 hours means your stomach can empty out regularly and you won’t have to sit with as large a volume of food in your stomach compared to eating less frequent and larger meals.
Because the healthy bacteria in your gut are reduced, extra gas is produced as bacteria “ferments” this partially digested food still sitting in your digestive tract. Continue eating at regular intervals – even when you are bloated and full from your last meal – as this is the best treatment for gas, pain, and bloating.
Work with your registered dietitian to determine the use of nutrients such as fiber, fluids, fats, and protein, as depending on your symptoms you may need more of less of these nutrients.
Soothe the belly pain.
Laying on your left side after meals can reduce the feeling of fullness. Use hot water bottles, heating pads, or warm compresses on your abdomen to provide relief.
Reduce or halt consumption of sugar-free gum, mints, and excessive quantities or fruits and vegetables. Sorbitol, fructose, and natural sugars found in sugar-free gum and mints may also contribute to bloating.
Speak with your dietitian about use of over-the-counter digestive enzymes, such as Lactaid and Beano.
Speak with your doctor about medication such as MiraLAX, probiotics, simethicone (Gas-X), and other medications that may be helpful depending on your symptoms.
Peppermint oil (sold in capsules) and mint tea appear to have relieving effects for pain and cramping. It seems to help calm muscle contractions in the stomach and intestines. This is not appropriate if you are having acid reflux, so check with your dietitian if you’re unsure. Iberogast® is an herbal liquid product that can also relieve digestive woes.
Get support.
Working with your therapist to address anxiety and other emotional distress that comes up as you experience digestive discomfort is key. Lean on your treatment team, and anyone else in your life who supports your recovery.
Gentle yoga and mindful meditation have been very effective at reducing stress and anxiety related to recovery, which in turn, can help calm your digestive system.
During the first year or two of recovery from an eating disorder, gastrointestinal problems are very normal and to be expected; recovery times time and patience, lots of support and hard work. Remember, you are not alone and recovery is absolutely possible!
You do not have to do it alone! If you need help, contact Rebecca by clicking here.
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