Nilsa calls it gastritis: a cramping pain in her stomach accompanied by bloating when she eats beans. Gastritis tends to be a catch-all term for digestive issues here. I buy coconuts from Nilsa. I used to buy peanuts from her too, but my own complications with “gastritis” have put an end to that. I don’t recall exactly how Nilsa and I became friends. Relationships with the women in the market tend to form over time. Community has an effortless way of establishing itself. I always stop by Nilsa’s stall now to check in, to ask about her son Paulo and what she happens to be cooking for lunch that day. Today she cooks kale leaves with coconut milk and peanut flour, a classic and probably the most delicious Mozambican (African?) dish. That’s how the conversation turned to gastritis. I stopped consuming peanuts because they make my stomach bloat. Sometimes I’ll even vomit. I stopped consuming beans. I stopped consuming dairy. I stopped consuming caffeine, grains, nightshade vegetables, and any foods that contain high levels of FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols). I’m currently adhering to combination of two diets: a Paleo Autoimmune Protocol and a Low-FODMAP diet. The former seeks to limit any contact with inflammatory foods from our modern diet while the latter seeks to limit consumption of FODMAPs, specific carbohydrates in a variety of foods that, in certain people, pass through the small intestine undigested and generate Inflammatory Bowel Symptoms.
Why such a dietary shift? Because the Giardia took a toll on my digestive system. Giardia is a parasite of the protozoan variety that makes its home in the small intestines of individuals who happen to consume food contaminated by the cysts that allow Giardia to survive for long times outside the body. It spreads through poop: I have Giardia, I poop out cysts containing the parasite, the cysts survive for an extended period of time in a body of water (river, lake, stream, etc.), then you unwittingly consume some of that water, most likely used to rinse off your salad, and seven to ten days later you experience symptoms: bloating, cramping, weight loss and noxious farts imbued with a sulfuric hue. I had Giardia from November until February. I might well still have it. Add to that a separate bacterial infection in my colon in December plus over a year on antibiotics for malaria prophylaxis, and the result is a severely inflamed, severely disturbed gut. I did an extensive round of Metronidazole in February to kill the parasite, but Giardia has a pesky habit of hanging around. I’ll be submitting more stool samples in the coming weeks to verify that it has actually left the building. In the meantime, constant dietary vigilance dominates my days and Irritable Bowel symptoms dominate my body. Now that I have eliminated most of the problem foods, I tend to follow a somewhat regular schedule: three to four days of constipation (no poop whatsoever) followed by two days or so of diarrhea. Rinse and repeat (but look out for protozoa).
The weird part: the process of dietary rehabilitation intrigues me. The limitations are frustrating, yes – specifically no onions or garlic (oligosaccharides) – but once you learn to effectively navigate the market based on how your body reacts to certain foods, the process becomes simple. And just like the effortless formation of community, all your body needs is time. Or at least that is my hope – a strict diet in the short-term and a balanced diet in the long-term. What intrigues me is the relationship between what I put into my body and how it reacts. I have become a puzzle to solve. And in the process, it has become painfully apparent to me that we are what we eat (so don’t eat somebody else’s poop).