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Dietitian not afraid to talk about poop

Niki Strealy aims to change lives through diet


STAFF PHOTOS: VERN UYETAKE - Niki Strealy, the Diarrhea Dietitian, poses with a plush poop and copy of her book, The Diarrhea Dietitian: Expert Advice, Practical Solutions, and Strategic Nutrition.

Niki Strealy’s nickname doesn’t roll off the tongue easily, and it may cause you to blush when you say it. She is known as the Diarrhea Dietitian; and, as a registered and licensed dietitian and nutritionist specializing in gastrointestinal problems, she wants to start a conversation about bowel movements.

“It was said best in a children’s book, ‘Everyone Poops.’ And let’s face it — everybody does,” the Lake Oswego resident said. “One in seven Americans suffer from Irritable Bowel Syndrome — IBS. It’s the second most common cause for absenteeism from work next to the common cold. I look forward to the day when it is socially acceptable to talk about IBS. It used to be unacceptable to talk about breast cancer, and now speaking about it is commonplace.”

Through her business Strategic Nutrition LLC, Strealy provides outpatient nutritional counseling for people with conditions such as gastroesophageal reflux disease (GERD), Crohn’s disease, ulcerative colitis, celiac disease, IBS, people who have had parts of their digestive system surgically removed, constipation and what she calls “garden variety” diarrhea — chronic diarrhea with no apparent cause.

“These people suffer in silence, with gas, bloating, constipation, diarrhea, abdominal discomfort,” she said. She knows firsthand about the suffering — she has had diarrhea most of her life.

“It started to get worse when I was in seventh grade,” she said. “I had my first barium enema at 13, then a small bowel follow-through and sigmoidoscopy at age 17. Since they never found anything ‘wrong,’ my doctor shrugged his shoulders and labeled me with irritable bowel syndrome, or IBS.”

Strealy visits clients in their homes, sharing with them information about how to change their diets to improve their intestinal health.

She said the digestive system has always fascinated her.

“I remember lovingly coloring my digestive diagrams in high school elective anatomy class,” she said. “In college, I initially majored in pre-med, then pharmacy, before finally graduating with a bachelor of science in nutrition and food management.” She completed her dietetic internship at Vanderbilt University Medical Center.

“In my internship I learned how to teach diabetic, renal, weight loss, weight gain, surgical and other diets to patients,” she said. “But no one taught me how to educate patients on what to eat for gastrointestinal problems. This surprised me — it just makes sense — the food you eat must go through the digestive system before it enters the body. So, it became my passion: To learn how to teach people to eat when their tummy doesn’t seem to work like everyone else’s.”

Strealy’s strategy to help clients is based on three components: scientific education based on anatomy, physiology and nutrition, her experience as a dietitian learning how food works in the body and her own personal issues with diarrhea over the years. Most recently she has been studying food allergies and intolerances, integrative and functional medicine and sports nutrition. She says many people are happy with learning how to manage their symptoms but she wants to discover the cause.

“There is an imbalance in your gut’s microbiome, but we don’t know what causes it,” she said. “We can restore balance to the gut and new medications are available that kill off the bad bugs in your gut.”

Foods, such as onions, garlic, wheat, milk and artificial sweeteners can cause intestinal distress.

Celiac disease is another common ailment; Strealy said it affects one in every 133 people.

“Celiac disease is an autoimmune disorder,” she said. “The body is attacking itself. It is different from gluten-intolerance, and if left untreated, can increase a person’s risk of cancer and other diseases.”

For the past 20 years, Strealy has been helping clients gain a new lease on life by changing their diets, and has seen many advances in intestinal health.

“In the next five to 10 years we will see even more solutions,” she said. “We just need to bring it out in the open and talk about it. ... After all these years of working with patients, there isn’t much I haven’t heard. One of my goals in life is to convince the world that it is OK to talk about bowels, diarrhea and gas.”

Strealy encourages people who suspect they have a gluten intolerance or celiac disease to get tested before they go long-term gluten free, and anyone experiencing intestinal symptoms should visit a digestive disorder specialist.

“Get a referral,” she said. “And keep knocking on doors until you find a solution.”

Strealy published “The Diarrhea Dietitian: Expert Advice, Practical Solutions and Strategic Nutrition” in 2013.

To learn more about Strealy and Strategic Nutrition, visit diarrheadietitian.com or visit her Facebook page.

Contact Barb Randall at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 503-636-1281 ext. 100.

Niki Strealy knows firsthand how people suffer in silence, as she has had diarrhea most of her life.

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