Plus, More Tips for Coping at the Office
BY ELIZABETH MILLARD
As the human resources director for Family Destinations Guide, a website that offers kid-friendly vacation ideas, Bonnie Whitfield always makes sure employees feel comfortable disclosing their medical conditions so the company can provide accommodations. For Whitfield, it’s not just professional—it’s personal, because she has inflammatory bowel disease (IBD).
“Since I have IBD myself, and I’ve been through a few flare-ups at work,
I know what it’s like to be in that situation,” she says. Employees are often trying to navigate not just the symptoms of a chronic illness, but also anxiety over questions like: Should I tell my employer and coworkers? Will people feel like they can’t count on me? What if I’m embarrassed to talk about it?
These are all common concerns, says Whitfield, and unfortunately, worrying about such issues can actually put you at higher risk for an IBD flare that could affect your work.
IBD encompasses two conditions—Crohn’s disease and ulcerative colitis—that are characterized by inflammation of the gastrointestinal tract, leading to symptoms like diarrhea, abdominal cramping, fatigue, and sudden weight loss. Treatment options help many people go into remission so their condition becomes a non-issue, but even on medication, symptoms may return in a flare-up that can range from mild to debilitating and might last days or weeks. The unpredictability of the disease is another source of potential anxiety when considering how it will affect work performance, Whitfield says.
“Sometimes, pushing yourself can make your flare worse,” she adds. “Having a plan in place beforehand can go a long way toward keeping you productive while still taking care of yourself. It’s important to remember that being sick shouldn’t mean you can’t be an effective employee.” Here are some tips to consider when balancing your health and your workplace, even if your IBD is in remission right now.
Let your employer know—and put it in writing.
Although the symptoms of IBD—like frequent trips to the bathroom, gassiness,
and bloating—can feel embarrassing, it’s important to recognize you have a
chronic illness and that it should be handled as such, Whitfield advises.
She suggests telling your direct supervisor and HR director not just about your condition, but also what you need in terms of accommodation and why that will help you function better in the workplace. For example, many people with IBD benefit from having an office or cubicle closer to the bathroom, which can shorten the amount of time spent going back and forth during a flare.
Also, simply being closer might reduce worry about the issue, and in itself that could
tamp down some symptoms. Having to use a wheelchair may also come into play, since side effects used to treat ulcerative colitis can lead to mobility challenges, so letting an employer know that could be a possibility—and ensuring you have access to all the areas you need—is crucial for planning ahead.
There may be multiple doctor visits as well, especially when flares are more dominant, and treatment could include options like surgery in the future. Preparing an employer for that possibility should be part of the conversation about your condition.
Whitfield says putting information like this into writing is the best approach, since it provides the most clarity about what you need. Plus, it ensures that all parties are receiving the same information. “Explain how IBD affects your work performance and how you can still do your job effectively while keeping up with treatment regimens and any other responsibilities required by the company, such as working overtime,” she adds.
“The more specific you can be about what accommodations would help keep you healthy and productive, the better equipped your employer will be to develop a plan that works for both of you.” Another benefit to writing it down: It may feel easier than saying everything in a meeting, particularly with multiple people or those you don’t know well.
For instance, when Los Angeles-based Span Chen was working as a cashier, every day felt like a battle due to pain and the inability to leave a line of customers. Treatment helped reduce flare-ups, but also led to more fatigue. He felt hesitant to bring up his struggles.
“What helped was writing a letter to my boss explaining what was going on, and that
I needed to take time off in order to heal fully,” says Chen. “Because I wrote it down,
I didn’t forget key points, like saying that being able to have more time away from
work would allow me to return to full health.”
Read More: How to Maintain Your Social Life When You Have IBD
Establishing some code words and contingency plans.
Even just having a key phrase can be useful, says Cassie Mahon, who leads client
meetings for her employer in Columbia, Missouri. She informed her boss about her IBD &
together they formulated a plan of action about what to do if Mahon had to leave suddenly.
“If I say that it’s time for a short break, she understands what’s going on and
we don’t have to tell everyone else in the room what’s happening,” she says,
adding that sometimes her boss will step in to continue a presentation if necessary.
That might seem like a minor tweak to the process, but Mahon says it provides much-needed reassurance that her work can continue with minimal disruption.
Stick to your routine.
Although IBD might not be predictable, your work schedule still can be, if you have the option of being flexible about location. That means making sure you’re able to work from home occasionally and that there’s a plan in place for those days, including having a home office setup and access to online company resources.
“Stay true to your usual routine as much as possible, which can help take some of the stress out of an IBD flare,” Whitfield says. “This can keep your life feeling normal while also giving your body time to recover.” Of course, not everyone has the option of working from home, but if it’s a possibility for you and can alleviate some of the worry around being in the office, it’s helpful to incorporate at-home time when you can.
If it’s not possible, Whitfield says that creating a more flexible work schedule could be another beneficial strategy. For instance, if being around so many coworkers makes you anxious about flares, you might swap one weekday for working on a weekend day so you’re in the office with fewer people.
Keep supplies on hand.
Another part of preparation is knowing what you need so you have items at the ready,
no matter what. For Boston-based Keyla Caba, being anywhere that’s not home can be difficult with her IBD, particularly because she wears an ileostomy pouch—a special bag that collects waste from the colon—which must be emptied regularly.
After years of fretting over the distance between her desk and restroom, she decided to make it a priority to make her experience more comfortable and address her fears about not making it to the bathroom in time.
That has meant always having spare clothes at the office, as well as some sort of deodorizing spray, and a sign she would hang on her desk to let colleagues know
she was having a flare and needed extra time away.
“This was the start of how I transformed the office bathroom into a peaceful experience
for myself, and relieved my restroom anxiety,” Caba says. “Knowing I have what I need
on hand can reduce my fears about flares.”
Know your rights.
Even if company management and HR are happy to accommodate your needs
as someone with IBD, it’s still essential to know your rights as an employee, says
Kia Roberts, principal and founder of Brooklyn, New York-based Triangle Investigations, which handles assessments of workplace misconduct. For example, she recently worked on a harassment case for a person with Crohn’s disease who wasn’t given accommodations by her manager.
“Most workplaces today understand the importance of not discriminating against employees based on protected characteristics like race, sexuality, gender, and ethnicity, but many employers do not understand the importance of having a policy on how employees with health issues should be treated within the workplace,” says Roberts.
“If an employee feels they are being singled out for different treatment based on their health issues, that could represent discrimination on the part of the employer.”
Another important aspect of your rights: If your IBD is disabled, it’s protected under the Americans with Disabilities Act, which means your employer must make reasonable accommodations. You may also be covered under the Family and Medical Leave Act, which entitles eligible employees to take unpaid, job-protected leave for medical reasons—up to 12 weeks of leave within a 12-month time period.
Focus on gut-healthy lifestyle habits.
Part of being more productive at work comes from what you do outside of the office, and that means implementing the right lifestyle behaviors, according to Dr. Ashkan Farhadi,
a gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif. In addition to making sure you follow treatment protocols like medication you may be prescribed, you can lower risk of flares by focusing on gut health, he says.
“Diet will, of course, play a major role in your IBD management, but equally important are other habits that improve your gut microbiome,” Farhadi says. “The three most prominent are sleep, stress reduction, and exercise, because if you get those on track along with your diet, it can significantly reduce the frequency and severity of flares.”
For example, there’s a strong association between sleep difficulties and gut function, which can lead to more than just daytime sleepiness or flares at work. A 2018 study in the journal Frontiers in Psychiatry found that insomnia has been linked to poor immune function, difficulty absorbing certain nutrients, and depression.
Read More: These Environmental Factors Increase the Risk of IBD
Staying aware of potential overwhelm.
Stress is another big challenge when it comes to avoiding flares,
adds Dr. Rudolph Bedford, a gastroenterologist at Providence Saint John’s
Health Center in Santa Monica, Calif.
“Chronic stress has a ripple effect on your gut microbiome, which means it can impair your gastrointestinal system and keep it from functioning well,” he says. “When you have IBD, that means it could make your flares more intense, or could cause flares even if they’ve been well managed in the past.”
A significant part of better stress control comes from evaluating all aspects of your everyday activity, and that includes work. If you’re feeling frazzled, that’s another conversation to start with your supervisor and HR.
“When someone has a chronic illness like IBD, remember that it should be a team effort
in terms of management,” Whitfield says. “The more that people around you understand
what’s going on, the more it will benefit you, your company, and your coworkers.”
Your gut is endangered. And that’s not a good thing for your health—
or the health of the rest of the world. © Getty Images
The Human Microbiome Is Going Extinct, Scientists Say.
The End Will Be Devastating. Story by Tim Newcomb.
Researchers say the human microbiome that lives in your gut is now endangered.
The loss of bacteria and microorganisms reduces your chance at a healthy life.
You’re the one killing off your own microbiome. The human microbiome is endangered.
And that’s not a good thing for your health—or the health of the rest of the world.
A new documentary, The Invisible Extinction, highlights how the human microbiome—also known as the bacteria and microorganisms living within the human body, most prevalent in the gut—is on the verge of extinct. And it’s all your fault.
The Invisible Extinction Movie: The Quest to Save the Microbiome!
There’s a war raging in our bodies, and the casualties are the bacteria that live in our gut. These bacteria, known as the microbiome, are crucial for our health, but factors like antibiotics, C-sections, and processed foods are threatening their survival. In the new documentary film “The Invisible Extinction,” doctors Martin Blaser and Gloria Dominguez-Bello embark on a mission to save the microbiome.
These tiny organisms help us digest food, make vitamins, and protect us from illness. They can be found all over the body, but most reside in the gut. People with a more diverse microbiome tend to be healthier. Researchers have used poop (yes, you read that right!) to study the microbiome and its connection to diseases like inflammatory bowel disease, multiple sclerosis, liver disease, diabetes, and autism.
Antibiotics can be harmful to the microbiome because they can kill off both good and bad bacteria. To keep our microbiomes happy and healthy, it’s important to eat a varied diet, avoid unnecessary antibiotics, and consider vaginal delivery over C-sections.
In a discussion with People, two researchers behind the doc, Martin Glaser and Gloria Dominguez-Bello, say the human microbiome is essential for us to digest food, make vitamins, and train our immune systems. “When we eat,” Blaser tells People, “we are nourishing both our human cells and also our microbial cells.”
The slow death of the human microbiome is thanks to our modern way of life. We use antibiotics to kill off bad bacteria. But antibiotics kill off plenty of the good stuff, too. Blaser says the more antibiotics given to a child, the more likely they are to develop a range of illnesses. Blaser adds that the Centers for Disease Control and Prevention
(CDC) estimates about one-third of antibiotic prescriptions are unnecessary,
leading to the overuse.
Then there’s the highly processed, chemical-laden food that’s wreaking havoc on our gut health. “The single most important component of the diet to feed the microbiome is fiber,” Dominguez-Bello says. These fibers feed your microbiome, while processed food removes the fiber, posing a negative result for your microbiome.
The researchers want better options for the antibiotic issue, both with improved testing to see if a bacterial infection is really in play, and by developing new antibiotics that don’t have the “collateral damage that is killing every bacterium inside.”
“We are making a complete mess of biodiversity, including microbes,” Dominguez-Bello says. “Microbes are essential in every ecosystem, not only in humans or animals or plants, but also in the oceans. The whole thing is linked together by the impact of human activities. We need to preserve microbes because they really modulate functions of Earth. They modulate the climate. They modulate everything. They modulate our own gene expression.”
The human microbiome is a big deal. Let’s not kill it.
https://www.theinvisibleextinction.com/
How Fasting Can—and Can’t—Improve Gut Health
BY MARKHAM HEID
What is fasting and how does it work. – Bing video
If you spend a lot of time online, you may have noticed that parts of the internet have caught fasting fever. Online message boards are awash in posts touting the benefits of time-restricted eating and other intermittent-fasting approaches that involve going without caloric foods or drinks for an extended period of time—anywhere from 12 hrs.
to several days.
These online testimonials have helped popularize intermittent fasting, and they
often feature two common-sense rationalizations: One, that human beings evolved in environments where food was scarce and meals occurred sporadically; and two, that the relatively recent shift to near round-the-clock eating has been disastrous for our intestinal and metabolic health.
Mining the internet for accurate information, especially when it comes to dieting, can feel like panning for gold. You’ve got to sift through a lot of junk to find anything valuable. But this is one case where nuggets may be easy to find. A lot of the published peer-reviewed research on intermittent fasting makes the same claims you’ll find on those Reddit message boards.
“Until recently, food availability has been unpredictable for humans,” wrote the authors of a 2021 review paper in the American Journal of Physiology. “Knowledge of early human evolution and data from recent studies of hunter-gatherer societies suggest humans evolved in environments with intermittent periods of food scarcity.”
They say that fasting regimens may provide a period of “gut rest” that could lead to several meaningful health benefits, including improved gut microbe diversity, gut barrier function, and immune function.
The past decade has witnessed an explosion in fasting-relatedid research. (According to Google Scholar, the last five years alone contain almost 150,000 articles that examine or mention fasting.) While that work has helped establish links between intermittent fasting and weight loss, as well as other benefits, it’s not yet clear when (or if) fasting can help fix a sick gut.
“I would still consider the evidence moderate,” says Dr. Emeran Mayer, a professor of medicine and founding director of the Goodman Luskin Microbiome Center at the University of California, Los Angeles. “[Fasting] looks like a prudent way to maintain metabolic health or reestablish metabolic health, but it’s not a miracle cure.
When it comes to gut conditions such as inflammatory bowel disease (IBD),
he says the research is either absent or inconclusive.
To his point, researchers have found that Ramadan fasting—a month-long religious period when people don’t eat or drink between sunrise and sunset—can substantially “remodel” the gut’s bacteria communities in helpful and healthy ways. However, among people with IBD, studies on Ramadan fasting have also found that a person’s gut symptoms may grow worse.
While it’s too early to tout fasting plans as a panacea for gut-related disorders, experts say there’s still reason to hope these approaches may emerge as a form of treatment. It’s clear that some radical, and perhaps radically beneficial, things happen when you give your body breaks from food.
How fasting could repair the gut.
For a series of recent studies, a team of researchers based in the Netherlands and China examined the effects of Ramadan-style intermittent fasting on the gut microbiome—the billions of bacteria that reside in the human gastrointestinal tract. (Ramadan comes up a lot in published research because it provides a real-world opportunity for experts to examine the effects of 12- or 16-hour fasts, which is what many popular intermittent fasting diets espouse.)
“We really wanted to know what intermittent fasting does to the body,” says Dr. Maikel Peppelenbosch, a member of that research team and a professor of gastroenterology at Erasmus University Medical Center in the Netherlands. “Generally, we’ve seen that intermittent fasting changes the microbiome very clearly, and we view some of the changes as beneficial. If you look at fasting in general, not only Ramadan, you see certain types of bacteria increasing.”
When Butyrate Levels are high cancer risk is low.
For example, he says that intermittent fasting pumps up the gut’s population of a family
of bacteria called Lachnospiraceae. “In the intestines, bacteria are constantly battling for ecological space,” he explains.
Unlike some other gut microorganisms, Lachnospiraceae can survive happily in an empty GI tract. “They can live off the slime the gut makes itself, so they can outcompete other bacteria in a fasting state.”
Lachnospiraceae produces a short-chain fatty acid called butyrate, which seems to be critically important for gut health. Butyrate sends anti-inflammatory signals to the immune system, which could help reduce pain and other symptoms of gut dysfunction.
Butyrate also improves the barrier function of the intestines,
Peppelenbosch says. This is, potentially, a very big deal.
Poor barrier function (sometimes referred to as “leaky gut”) is a hallmark of common
G.I. conditions, including inflammatory bowel disease. If intermittent fasting can turn down inflammation and also help normalize the walls of the GI tract, those changes may have major therapeutic implications.
Lachnospiraceae is only one of several types of helpful bacteria that research has linked to fasting plans. But at this point, there are still a lot of gaps in the science. Peppelenbosch says the guts of people with bowel disorders don’t seem to respond to fasting in exactly the same way as the guts of people without these health issues. “In ill people, we see the same changes to the microbiome, but it’s not as clear cut as in healthy volunteers,” he says. “So we are now actually trying to figure out what’s going on there.
”Healthy microbiome shifts aren’t the only possible benefits that researchers have linked to intermittent fasting. UCLA’s Mayer mentions a phenomenon called the migrating motor complex. “This is rarely mentioned in fasting articles today, but when I was a junior faculty it was one of the hottest discoveries in gastroenterology research,” he says. The migrating motor complex refers to recurrent cycles of powerful contractions that sweep the contents of the gut, including its bacteria, down into the colon.
“It’s this 90-minute recurring contractile wave that swoops down the intestine, and its strength is comparable to a nutcracker,” he says. Essentially, this motor complex behaves like a street-cleaning crew tidying up after a parade. It ensures the gut is cleared out and cleaned up in between meals, via 90-minute repeating cycles that fasting allows to become more frequent. It also helps rebalance the gut’s microbial populations so that more of them are residing in the colon and lower regions of the GI tract. “But it’s stopped the minute you take a bite—it turns off immediately,” he says.
Mayer says that modern eating habits—so-called “grazing,” or eating steadily throughout the day—leave little time for the migrating motor complex to do its thing. “This function has been relegated to the time when we sleep, but even this has been disrupted because a lot of people wake up in the middle of the night and snack on something,” he says. “So those longer periods of time when we’re-cleanse and rebalance our gut so that we have normal distributions of bacteria and normal population densities—that has been severely disturbed by these lifestyle changes.
”Ideally, Mayer says people could (for the most part) adhere to the kind of time-restricted eating program that allows a full 12-to-14 hours each day for the motor complex to work. “If you don’t snack, this motor complex would happen between meals, and you’d also get this 12- to 14-hour window at night where the digestive system was empty,” he explains.
In other words, sticking to three meals a day and avoiding between-meal bites (or nighttime snacks) could be sufficient. But again, it’s not clear whether this sort of eating schedule can undo gut damage or treat existing dysfunction.
Read More: The Truth About Fasting and Type 2 Diabetes
More potential benefits.
Another possible perk of fasting involves a biological process called “autophagy.”
During autophagy, old or damaged cells die and are cleared away by the body.
Some researchers have called it a helpful housekeeping mechanism, it occurs
naturally when the body goes without energy (calories) for an extended
period of time.
There’s been some expert speculation, based mostly on evidence in lab and animal studies, that autophagy could help strengthen the gut or counteract the types of barrier problems seen in people with IBD. But these improvements have not yet been demonstrated in real-world clinical trials involving people.
Meanwhile, some experts have found that fasting may help recalibrate the gut’s metabolic rhythms in helpful ways. “By changing the timing of the diet, this will indeed change activity of the microbiome, and that may have downstream impacts on health,”
says Dr. Eran Elinav, principal investigator of the Host-Microbiome Interaction Research Group at the Weizmann Institute of Science in Israel.
Some of Elinav’s work, including an influential 2016 paper in the journal Cell, has shown that the gut microbiome undergoes day-night shifts that are influenced by a person’s eating schedule, and that lead to changing patterns of metabolite production, gene expression, and other significant elements of gut health. “If you change the timing of diet, you can flip the circadian activity of the microbiome,” he says. This is likely to have health implications, though what those are, precisely, remains murky.
Read More: What We Know About Leaky Gut Syndrome
Fasting isn’t going anywhere.
It’s clear that when you eat, including how often you eat, matters to the health of your gut. But the devil’s in the details. At this point, it’s not clear how intermittent fasting can be used to help people with gut-related disorders or metabolic diseases.
“For a condition like IBD, it’s important to differentiate between what you do during a flare and what you do to prevent the next flare,” Mayer points out. The research on people observing Ramadan suggests that, at least during a flare, fasting may make a person’s IBD symptoms worse. Figuring out whether fasting could also lead to longer-term improvements is just one of many questions that needs to be answered.
While plenty of unknowns remain, experts say that common approaches to fasting appear to be safe for most people. Time-restricted eating, for example, involves cramming all your day’s calories into a single six-to-eight-hour eating window. Even among people with metabolic diseases such as Type 2 diabetes, research suggests that this form of fasting is safe, provided a person is not taking blood-glucose medications.
That said, there simply isn’t much work on intermittent fasting as a treatment
for gut problems. Also, there is very little research on more extreme forms of fasting,
such as plans that involve going without calories for several days at a stretch.
These diets may turn out to be therapeutic, but they could also turn out to be dangerous.
If you’re considering any of these approaches, talk with your health care provider first.
“We really need much better studies to compare all the different fasting protocols,”
says Peppelenbosch. “But generally speaking, increasing the space between calorie consumption is a good thing for you. The body is not made to be eaten all day.”
Top Doctor: If You Eat Oatmeal Every Day, This Is What Happens BY GUNDRY MD – Search (bing.com)