The patient: “Patrice,” a 55-year-old massage therapist.
Why she came to see me: Patrice appeared to be the epitome of health when she stepped into my office for the first time. Radiant and fit, it was clear she treated herself with tremendous care. Right off the bat, however, she told me that she’d spent the last month battling digestive distress that had ranged from mild to severe. Gas, constipation, bloating, and diarrhea had come to rule her days—so much so her symptoms determined her wardrobe while her ability to maintain her list of massage clients was starting to wane. She wanted to get to the bottom of her intestinal issues, and to address them without the use of pharmaceuticals.
How I evaluated her: I began my assessment as I always do: With a long and in-depth discussion about Patrice’s medical and personal history.
A former civil rights attorney in Chicago, Patrice had recently moved to Hawaii after giving up her high-stress job and a marriage that had stopped working over a decade earlier. Shortly after landing in the islands, she decided to revamp her life from the inside out—and from the outside in. In addition to switching to a less taxing and traumatic field of work (but one that was no less meaningful), she’d begun to take care of herself in ways she’d never before attempted. She quit smoking with the help of an acupuncturist, gave up the nightly bourbon she once used to relax after long days in court, and took up tai chi, Reiki, and meditation. “A month ago,” she said, “I’d never felt healthier or happier.”
In the last four weeks, however, her newfound vitality had been compromised by a slew of digestive issues. This made “zero sense” to her, as she put it: Six months earlier, she’d become a vegetarian, and five weeks earlier she’d given up gluten and dairy after reading about the potential benefits of a gluten- and dairy-free diet. And yet, almost immediately after eating a meal or snack, she felt besieged with bloating, which was then followed by gas, constipation, or diarrhea. Ten to 12 times in the last five weeks she’d also experienced soft tissue and joint pain. Her new primary care physician in the islands had diagnosed her with irritable bowel syndrome and prescribed her with Lubiprostone (Amitiza) to help her pass the painful stools that often arrived when she was constipated. She’d tried the medication once but ultimately decided against it. In her new life, she was aiming to be as natural and chemical-free as possible. Moreover, she was determined to solve the mystery behind the sudden onslaught of her symptoms.
To get to the root of her problem, I conducted a full physical exam, as well as a food and chemical sensitivity blood test.
What my evaluation revealed: While Patrice’s physical exam underscored the fantastic health I believed her to be in, her food and chemical sensitivity test revealed an allergy that many may have never heard of: Guar gum. (She also tested positive for gluten and dairy allergies, confirming that Patrice had done the right thing in removing those foods from her diet prior to meeting with me).
Patrice’s immediate response? “I don’t even chew gum!” I empathized. Like several other gums—xanthan gum, acacia gum (also called gum Arabic), and locust bean gum (or carob bean gum)—guar gum is often a hidden ingredient, not only in processed foods but also in an increasing number of “natural” foods and personal care products. In particular, baked gluten-free foods often rely on guar gum to stabilize, emulsify, and thicken their products. Yogurt (including dairy-free yogurt), almond milk, soup, vegan protein powders—even the non-dairy Coconut Bliss ice cream Patrice loved—also frequently contain this additive (or another gum). Guar gum is derived from the Indian cluster bean, which sounds wholesome enough; it’s also sometimes used to treat irritable bowel syndrome. (Take it from Live Science, which reported in 2013, “In hydrofracking, guar gum is used to thicken water, which allows it to move grains of sand underground more effectively than water alone would. In the human digestive system, it does something similar: the gum can function as a laxative by forming a bulky gel that moves the intestines along.”) This may benefit some; for others, however, it can lead to a cornucopia of digestive complications.
Why? Because guar gum is a type of soluble fiber, it can result in the benefits—and side effects—of fiber itself. Meaning, on one hand, it may organically support ideal cholesterol levels, help one feel sated longer, and naturally encourage stable blood sugar levels. (Indeed, given its capacity to promote a sense of fullness, as well as the laxative effect it can have, guar gum was used in weight-loss medications until the FDA banned its inclusion in weight-loss pills in 1992.) On the other hand—particularly if one is unaccustomed to consuming fiber, or has an allergy to guar gum—the additive can cause a range of gastrointestinal problems, including gas, nausea, abdominal pain, constipation, and diarrhea—the very symptoms Patrice was experiencing. In extreme cases, high doses of guar gum may also result in small bowel obstruction, pulmonary embolism, esophageal tear, and even death. Lastly, guar gum, in rare cases, can engender the soft tissue and joint pain from which Patrice was suffering.
How I addressed her problem: The excellent thing about Patrice’s diagnosis was that it was simple to treat—and, to her delight, we were able to do so naturally.
First, I asked Patrice to toss (or give away) any foods in her kitchen that contained dietary gums. (While she did not test to having an allergy to other gums, data reveals that xanthan gum can exacerbate digestive issues, while carrageenan—a gum derived from seaweed and used in the likes of soy milk and salad dressing—can cause inflammation and lead to IBS and ulcerations. Meanwhile, locust bean gum, which is from carob, may cause increased flatulence, and gellan gum has been linked to intestinal abnormalities.) Out went the brand of coconut milk she typically used in her coffee, as well as the gluten-free bread she typically used to make toast. In their place, I suggested she reach for foods that did not come in a package—fruits, vegetables, seeds, and nuts—and to only purchase and consume packaged foods, such as crackers, that did not use gums.
I then suggested she start rebuilding the healthy bacteria in her gut through a mix of probiotic and prebiotic foods. For the former, I suggested sauerkraut and kimchi, both of which could be added to salads or sandwiches; for the latter, I urged her to fill her plate with foods that would act as “fertilizer” for the probiotics in her gut (such as bananas, asparagus, and sweet potatoes).
To be on the safe side, I also encouraged Patrice to take a look at the ingredients in her personal care products—lotions, cosmetics—and even paper products. (Guar gum is more ubiquitous than one might think!)
Finally, I asked Patrice to consider adding cardio and yoga to her daily wellness practice. While tai chi has a wealth of benefits, the gut—literally—needs a work out Even a gentle walk after a meal would help alleviate Patrice’s symptoms.
The patient’s progress: Four weeks later, Patrice returned to my office with terrific news: Her digestive issues had gone from agonizing to significantly reduced. In fact, most days her GI system was “right on track.” She had stopped grazing on gluten-free muffins and crackers and had become smitten with Brazil and macadamia nuts. And while reading label after label had proved “a tad tiresome” at first, she’d found a few quality products that didn’t use gums (such as Anita’s coconut yogurt). What’s more, the yoga practice and daily swimming she’d woven into her schedule had immersed her even deeper into her new, wholesome, island lifestyle. “I have,” she said, “at last arrived.”
Click here to buy Dr. Laurie Steelsmith’s books, Natural Choices for Women’s Health, Great Sex, Naturally and Growing Younger Every Day: The Three Essential Steps for Creating Youthful Hormone Balance at Any Age.