66 yo F chronic vulvodynia, diarrhoea, stomach pain, low mood, restricted diet

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Welcome! Forums 66 yo F chronic vulvodynia, diarrhoea, stomach pain, low mood, restricted diet

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    • #842
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      Hi, I’d be grateful for some input on a lovely client I have been seeing for several months now.

      She came to me regarding her gut as she has gradually become intolerant to more and more things over the past few years. She even arrived with spreadsheets about her history and which foods she can/cannot tolerate.

      She has suffered vulvodynia for 20+ years but the digestive issues began in 2014 when GP informed her of high cholesterol and suggested low fat diet. This resulted in 2 stone weight loss, extreme fatigue, onset of loose bowels and left sided tummy pain and things haven’t been right since. She has had some improvement when removing certain foods over time but symptoms have always returned, leading to removal of more and more foods. Her diet has been limited for past two years to a lot of processed beige foods, plain chicken and a few vegetables. Gluten and dairy free.

      We ran a stool test, which showed very low beneficial bacteria (not surprising due to antibiotic use and low fibre) and high level of infection with ‘Aeromonas boiler veronii’.

      She now has a lot of fear around what she consumes (supplements and food) and we have had to take things very slowly, many things have triggered pain/loose bowels but she has now been on Optibac Everyday Extra double dose for 2+ months and we introduced berberine a few weeks ago, which she feels she is tolerating well although her vulvodynia has flared up. Tried collagen powder to help up protein but she didn’t feel she could cope with this mentally and physically.

      She feels empty and although remaining as positive as possible, is struggling to see a way forward. I am concerned about her lack of nutrition and that we are not really progressing enough. She has added courgette and blueberries successfully but this has taken months. I’d be grateful for any advice, this is my first time working with a client that has had an extremely restricted diet for such a long time. Many thanks.

       

      Posted by Kristie Becker 12.03.18

    • #843
      Christine Bailey
      Moderator

      Dear Kristie,

      Many thanks for your question about your client with a number of digestive symptoms, vulvodynia and limited diet. You mentioned she has high levels of Aeromonas spp. These have been associated with changes in bowel including diarrhoea.

      Vila et al. Aeromonas spp. and Traveler’s Diarrhea: Clinical Features and Antimicrobial Resistance CDC Volume 9, Number 5—May 2003  https://tinyurl.com/y9tdkkgc

       

      It is therefore likely that this imbalance in her gut is contributing to many of her symptoms. I would suggest oregano oil which I find effective for many bacterial infections. Supporting her innate immune system is also recommended with nutrients such as vitamin A and D and Saccharomyces boulardii.

      Imbalances in the gut flora can also affect the health of the gut lining and immune modulation and this in turn could be influencing her reactions to various foods. Therefore in addition to removing the pathogens I would support the health of the gut lining and lower inflammation.

      Vulvodynia, also known as burning vulva syndrome, is characterised by sensory abnormalities of the vulva and the surrounding tissue, such as an unpleasant burning and itching sensation, or a painful response to a stimulus that is not usually painful such as sexual intercourse or the touch of a cotton swab. Organic vulvodynia is often treatable once a cause has been established. Idiopathic vulvodynia, which consists of vulvar dysesthesia or vestibulodynia vulvar vestibulitis syndrome, often exists in conjunction with organic vulvodynia.  Several treatment methods exist for idiopathic vulvodynia and most may be used in conjunction with each other. Treatment options that are less invasive are often tried first, including hygienic and dietary changes, surface electromyographic biofeedback, and medications. The onset of vulvar pain may be associated with episodes of yeast infection, infection by genital herpes virus, trauma such as childbirth, or certain therapeutic procedures on the vulva, including cryosurgery including cryosurgery or laser surgery, or may occur spontaneously.

      The most common cause of vulvar pain is chronic vaginal microbial infections by fungi, protozoans, or bacteria.  Other causes could include active infections with genital herpes virus or human papillomavirus, infection of Bartholin’s or Skenes glands, atrophic vaginitis associated with peri or post menopausal oestrogen decline, and Behet’s disease, allergic or irritant reactions (perfumes, dyes, or steroids). Frequently co-occurring disorders such as interstitial cystitis, urethral syndromes, irritable bowel syndrome, subclinical hypothyroidism, and fibromyalgia may also play a role. It may be that the current microbial infections are contributing to the condition. I would also consider whether you suspect she has a viral infection as well. The advanced viral screen by Regenerus is a pertinent test to consider.

      As it is considered to be an inflammatory condition you may find that anti-inflammatory nutrients may be helpful. I would also consider a low allergen diet. Solomons hypothesised that the burning sensation of dysesthetic vulvodynia were a result of oxalic acid in the urine irritating the vulvar tissues. He advocated restricting foods with high oxalate content, such as peanuts and chocolate, and taking calcium citrate to reduce vulvar burning sensations. However, the results have been variable.

      Glazer HI. Long term follow-up of dysesthetic vulvodynia patients after completion of successful treatment by surface electromyography assisted pelvic floor muscle .rehabilitation. J Reprod Med 2000; 45:798-801. https://tinyurl.com/ycgwkf9f

      Clinical Management of Vulvodynia Oct 24, 2011 Reviews in Gynaecologial Practice, September 2002, Volume 2, Issues1-2, https://tinyurl.com/yd86hp99

       

      Your client may also wish to consider topical / vaginal natural treatments in the meantime – applying a tampon soaked in natural yogurt with added probiotic powder can be helpful. Wear natural fibres such as cotton, linen, or silk. Avoid wearing tight pants, pantyhose, tights, or leggings, using feminine deodorant or scented tampons or pads, sitting around in wet clothing, especially bathing suits and sitting in hot tubs or taking frequent hot tub baths.

      Acupuncture may help vulvodynia sufferers by switching off overactive malfunctioning pain fibres (delta fibres). A clinical study reported that of 12 patients refractory to traditional treatments, 9 (75%) reported some pain relief with acupuncture, two self-reported absence of pain following a five-week treatment

      Powell J, Wojnarowska F. Acupuncture for vulvodynia. J R Soc Med 1999; 92: 579-581. https://tinyurl.com/y85kmxyv

       

      With regards to her limited diet I would encourage your client to keep foods rotated as much as possible. Avoid eating the same foods each day and if you are concerned about nutritional sufficiency I would include a liquid multi at this time. If protein levels are low then consider an amino acid formula and you may find collagen powder easy to tolerate.

       

      SUGGESTED SUPPLEMENTS

      The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.

      Anti-microbial support

      ADP Oregano (BRC) – take 2-3 with each meal – https://tinyurl.com/hdjg9c5

      Innate immune support

      Saccharomyces boulardii (ARG) – take 1 twice daily (but away from the ADP Oregano) – http://tinyurl.com/z27sdwn

      Vitamin D3 Complete (ARG) – take 1 daily – http://tinyurl.com/jqx3ttt

      Lower inflammation and gut healing

      Arthred Collagen Powder (ARG) – take 1tbsp three times daily – https://tinyurl.com/j2arfe4

      Phospholipid colostrum (ARG) – take 1tbsp three times a day – https://tinyurl.com/zwty66b

      Immune modulation

      Lactobacillus Culturelle GG (ARG) – take 1 twice daily (but away from the ADP Oregano, & with the S.B.) –  https://tinyurl.com/zonwo4a

      Free Aminos (ARG) – take 2 twice daily

       

      I hope this helps with your client

      Christine

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