Most of us at some point in our lives experience uncomfortable GI symptoms including bloating, gas or diarrhea, but it’s a topic we tend to shy away from talking about, even with our doctors. Renowned gastroenterologist, Dr. Roshini Raj and dietitian Julie Dubois joined me for an interview recently to discuss the importance of talking about your GI symptoms with your doctor, especially if you’re suffering frequently as this could be a sign of an underlying GI condition, including EPI (Exocrine pancreatic insufficiency). Dr. Raj and Julie also discussed what EPI is, the most common symptoms of the disease and the importance of keeping a food journal.
Candace Rose: Dr. Raj, Why should people make improving digestive health one of their top New Year’s resolutions and stick to it?
Dr. Roshini Raj: “Well, we’re learning more about how the digestive tract is really the cornerstone for our overall well being and health. If you’re not feeling well in your tummy, chances are you’re not feeling great in general. Many people ignore GI symptoms, things like bloating, gas or diarrhea because maybe they’ve had them occasionally in the past, they don’t think too much of it or they’re just simply too embarrassed to bring it up with their doctor, but this is a mistake. If the symptoms are happening frequently or affecting your life, they could be a sign of an underlying GI condition, one of which is EPI or Exocrine pancreatic insufficiency, which is what Julie has experienced. You really want to talk to your doctor to get to the bottom of what’s going on and get the correct diagnosis.”
Candace Rose: Why is it so important to schedule an appointment with our doctor before making major changes to diet or activity?
Dr. Roshini Raj: “Well, when we start to eliminate foods on our own because maybe our friend did it or it’s a new fad or we think there’s a certain food that’s causing us to stress, when you do that on your own before speaking with your doctor, you may affect the accuracy of certain tests that they may want to do, so you may affect their ability to really diagnose you properly. Before making those changes talk to your doctor about how you’re feeling, why you want to make those changes and see if it’s a good idea. Check with them first.
Same thing with exercising – if you’re not used to exercising, you’re trying something totally new that’s maybe working on a different part of your body, different muscles, you may want to check with your doctor first to make sure you’re not putting yourself at risk for any kind of injury.”
Candace Rose: Why are people sometimes reluctant to visit their doctor with digestive problems?
Dr. Roshini Raj: “You know, I think we’re raised as young women or girls and men as well to not discuss certain topics in public, it’s not considered polite talking about your bathroom habits and things like that, so it’s easy to get embarrassed and not want to bring it up. Your doctor has heard it all before, there’s nothing you’re going to say that’s going to shock him or her, so make sure you get over that embarrassment and really give them the information they need to help you. We’re not mind readers, we can’t help you the best way we can unless we have all the information.”
Candace Rose: Julie, How are you prioritizing your digestive health in the new year?
Julie Dubois: “There’s a few things that I’m focusing on, one of which is keeping a food journal, so keeping not only what I’m eating and maybe the calories that are in it, but I’m actually focusing on my digestive health and symptoms that might be associated with certain foods that I eat, so I can then take that to my doctor and discuss it with him and see if there’s any changes I need to make to my food intake. Additionally, I’m trying to exercise more frequently, keep my stress levels down because there’s a very big connection between your stress levels and your digestive health and that really does make an impact on my digestive health, personally. Additionally, getting enough sleep which is really hard for some of us, especially if we keep a busy schedule. It’s something that I find that if I don’t get enough sleep then my GI symptoms become worse.”
Candace Rose: Dr. Raj, What is EPI?
Dr. Roshini Raj: “EPI stands for Exocrine pancreatic insufficiency and it’s a condition where your pancreas is not producing adequate amounts of pancreatic enzymes, digestive enzymes that help you digest your food. So as you can imagine, if you’re not digesting food well, you may experience diarrhea, bloating, gas, pain, and sometimes unexplained weight loss.”
Candace Rose: Who could have EPI and what are the most common symptoms associated with it?
Dr. Roshini Raj: “It can occur with anyone male, female. It is associated with certain conditions of the pancreas like pancreatitis for example, which is inflammation of the pancreas. The symptoms unfortunately are common GI symptoms that can be symptoms of something else, which makes the diagnosis kind of hard to do on your own, but they include bloating, diarrhea, gas, abdominal pain after eating and weight loss.”
Candace Rose: Julie, When were you first diagnosed with EPI?
Julie Dubois: “I was diagnosed back in 2011, I experienced pretty much every single one of those symptoms that Dr. Raj described and it got to a point where I was having to schedule bathroom breaks around my ballet classes for example. It really was affecting my lifestyle, and what I could do on a daily basis, and so having that conversation with my doctor, putting any embarrassment aside and telling him what was really going on was really important to getting diagnosed and get the right treatment.”
Candace Rose: Julie, How does having EPI impact you as a dietitian and personal trainer today?
Julie Dubois: “It actually makes me do a lot of the things that I tell my clients to do, like keeping a food journal and exercising regularly and getting enough sleep just to make sure that all those lifestyle things aren’t affecting me even more than what I already have with EPI.”
Candace Rose: Dr. Raj, What steps can people take for better control of their digestive health?
Dr. Roshini Raj: “Well, if we’re talking about EPI in particular, they can go to IdentifyEPI.com because it has a lot of the symptoms that we’re discussing. For overall GI health, Julie mentioned a couple of them – managing your stress is extremely important, getting enough sleep is also great for overall health, but digestive health in particular.
Keeping a food journal is a great way to kind of take stock on how you’re feeling and what particular foods may be affecting your digestion. It’s good information to bring to your doctor, but you don’t want to cut out or eliminate any foods on your own. Speak to your doctor first because it could affect the testing later on and ultimately the diagnosis that you need to have.
Also, when you’re talking about digestive health or overall health goals, you want to be realistic and set yourself some achievable goals. You don’t want to set the bar so high that you’re kind of doomed to fail and you get discouraged.
You also want to be patient. When you’re talking about health, this is a long term situation, don’t expect immediate results or if you’re not feeling well, to feel better immediately. It’s a journey with your doctor, it’s a partnership and you want to manage your expectations in terms of that and also give yourself some concrete small steps to achieve that goal, and maybe getting more sleep and exercising more than you already do – all of those things can really help.”
Candace Rose: Where can we go for more information?
Dr. Roshini Raj: “You can go to IdentifyEPI.com.”