A diagnosis of rheumatoid arthritis and Sjogren’s when she was 22 years old sent Cristina Montoya into a deep depression. But medication, meditation and dietary changes helped her retake control

In 2004 I was training to be a dietitian in Colombia, where I’m originally from. I was working at a hospital in Medellin, and the elevator was not working so we had to go up and down the stairs many times a day for three weeks. One day both of my knees starting hurting and I thought it was because of the up and down movement. But a month later, I had terrible headaches and all my fingers started to look like sausages. It was frustrating because I was a young researcher at my university and had a lot of typing to do. Every hit on the keyboard was painful.
The pain spread everywhere, my shoulders, knees, heels, ankles and hands. I was diagnosed with rheumatoid arthritis and Sjogren’s syndrome in January 2005 when I was just 22 years old. After my diagnosis, I went into a deep depression. I felt as though my world had fallen apart and saw no light at the end of the tunnel.

I had met a lovely man on the internet a couple of years before, and to my surprise he did not give up on me when he found out about my diagnosis. In fact, he persevered and came to meet me in Colombia in 2005. Our first face-to-face meeting was quite dramatic as the day he arrived I was hospitalised due to a rheumatoid arthritis complication.

True love exists and having Sameer’s support made the disease a little bit more bearable. We decided to get married and I moved to Canada and changed my qualification so I could practise as a registered dietitian in my new home. The stress of relocating (to a country with extreme weather patterns), a new language, getting married and trying to change my qualification put me under immense pressure.

I had always experienced bowel irregularities for no real reason and stress and sudden changes in my life seemed to trigger the symptoms. At that time, my gastrointestinal problems flared up to their maximum level, with severe abdominal pain, excessive bloating, gas and diarrhoea. I lived on supplements and crackers for several months as I could not tolerate any solids. I went through all kinds of tests with no outstanding findings. My gastroenterologist finally diagnosed me with IBS.

I took anti-acid medications, anti-depressants and made slight changes to my dietary habits which did little to improve my symptoms. Looking back, it’s hard to believe that for many years I ignored all my IBS symptoms, especially as I am a dietitian!

But six months after moving to Canada, the rheumatologist prescribed Humira which completely changed my life. I was able to function somewhat normally in terms of my rheumatoid arthritis, although my IBS continued to be a real problem.

Then last year I was offered a workshop on mindfulness-based chronic pain management at the hospital where I work. The workshop consisted of 10 sessions of guided meditation and I found it wonderful for my rheumatoid arthritis and IBS symptoms.

I finally began to use my knowledge as a dietitian on my own body and initiated a low-FODMAP diet (see below).

The low-FODMAP diet approach – and exercise – is proving to be successful in minimising my IBS symptoms. But diet cannot work alone if the person is experiencing stressful life situations; the mind-body connection is extremely important in managing IBS too. This combined strategy has not only alleviated my IBS symptoms but the overall pain from arthritis too.

My advice to anyone diagnosed with rheumatoid arthritis, Sjogren’s and even IBS is to never give up. Knowledge is power and the right combination of treatment and lifestyle choices is out there for everyone. Just keep looking for it.

To read more about Cristina, visit her website: www.soothingfoodsensations.ca.
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What are FODMAPs?

FODMAP is a much-needed acronym for: “Fermentable Oligo-, Di-, Mono-saccharides And Polyols.
FODMAPs are short chain carbohydrates that are poorly absorbed in the small intestine. These carbohydrates are commonly found in the modern western diet. They contain poorly absorbed sugars that are either fermented, which generates gas and bloating (including onions, beans, lentils, sprouts, artichoke and in some people wheat) or retain fluid (such as stone fruits, apples, beetroot) and may cause diarrhoea.
Some research is beginning to build to support the theory that a low-FODMAP diet can help reduce the symptoms of IBS but no long-term studies have been done. So make sure that you speak to your GP and/or a dietitian before trying it to ensure you don’t miss out on any key nutritional groups.

What can I eat on a low-FODMAP diet?

Most people with IBS suffer from food intolerance, not food allergy. Foods that contain poorly absorbed sugars (FODMAPs) can be eaten but in restricted quantities, but the following foods can be tolerated in moderate quantities by people on a low FODMAP diet:

• Vegetables: aubergine, bamboo shoots, bell peppers, carrots, courgette, corn, cucumbers, leafy greens, lettuce, potatoes, pumpkin, squash and yams.
• Fruits: bananas, berries (not blackberries or boysenberries), cantaloupe, grapes, grapefruit, honeydew, kiwifruit, kumquat, lemon, lime, mandarin, orange, passion fruit, pawpaw, pineapple, rhubarb, tangerine and tomatoes.
• Protein: beef, chicken, canned tuna, eggs, fish, lamb, nuts (not cashews or pistachios), pork, seeds, shellfish and turkey.
• Dairy: lactose-free dairy or half-and-half products, almond milk and rice milk.
• Grains: corn, oats, potato, quinoa, rice, tapioca, and gluten free options.

Back-up

• IBS support in the UK, contact the IBS Network: www.theibsnetwork.org or tel 0114 272 3253.
• IBS support in the US, contact the International Foundation for Functional Gastrointestinal Disorders: www.aboutibs.org or tel (888) 964 2001.

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