Letter to Dr. Ahlan

Hi Dr. Jason!
Thank you for replying to Kim Vinet's note on Facebook.
When I started writing this, I did not expect it to be such a saga, so I'll start at the end of the story:
For the past 5 years, I have been experiencing diarrhea and bleeding hemorrhoids. 
I am 46. From what I remember, family meals were always pretty hearty and nutritious. I started making my own meals when I was 12. The following is a bit of history of what's been going in and coming out of my body over the past 34 years. 
Some relative consistencies:
- I've always been active in team and individual sports as well as weight lifting & cardio at the gym.
- I ride bikes. A lot. I commute to work every day, train indoors and usually get in at least one big ride a week in the warmer months. All of my saddles have pressure relief channels.
- I do not stretch nearly as much as I should and am rather inflexible.
- I started drinking at age 14 and maintain a high consumption, averaging 4-5 measures a day.
- Most of my life, I have had little interest in sweets.
- For 95% of my adult life I have enjoyed a very regular morning elimination routine with Type 3-4 Bristol Scale Stools.
HISTORY
 
1987 - 1991 Playing and training for hockey, my weight increased from 150 to 230 pounds. My diet was indiscriminate, eating everything I could get my hands on. Experimented with Creatine and Ephedrine.

1991 - 1996 I stopped playing hockey in University, but kept eating and became a habitual drinker. By 1993, my weight had increased to 235, but I had lost significant muscle mass and replaced it with body fat. In 1994 I started backcountry skiing and rock climbing and shifted my focus back to diet and fitness. Discovered coffee and re-introduced Ephedrine until I developed heart irregularities.
1995 Harsh bout of Mono kept me in bed and on fluids for 3 months.

1997 Competed University, started working full-time and living on my own. Discovered The Zone by Dr. Barry Sears and it became my gospel. Never again did I consume carbs without fat & protein. I remained active with mountain sports, gym training and squash. Weight stabilized at 195.
 
Some time around here, I suffered Salmonella,
 
1997 - 2003 Diet became relatively standardized, Eggs on Toast, Oatmeal with yogurt & granola, raw cabbage, raw veggies, grilled meats and cottage cheese. I did the Wild Rose Cleanse twice and achieved the prescribed results.
 
2000 visited Dominican Republic and got Dengue Fever.
 
Some time around here, I suffered E-Coli.
 
2003 Visited Ayurvedic Naturopath, who categorized me as Pitta. As such, she recommended that I avoid dairy, soften all vegetables and eat less meat, getting more plant proteins (bias?). Some time around then, I did the controversial liver-kidney cleanse with unbelievable results!
 
2003 - 2013 No memorable issues. Always looking for healthy snacks, corn chips and nuts became a major portion of my caloric intake.
 
2013 Still very active (gym, outdoor sports, yoga) and healthy food focussed. Developed skin condition, best guessed to be perioral dermatitis, possibly a result of leaky gut and went full paleo. Dermatitis vanished immediately. Weight dropped 30# from 195 to 165 in 30 days. Discovered the blissful state of Ketosis and was amazed by the amount of energy I had during long endurance efforts.
 
2014 Relaxed my paleoness to 80%, allowing the off hamburger or pizza on special occasions. 
 
2015 Met my current wife and reduced paleoness to 50%, celebrating our time together with food. Mexican became a common cuisine, with lots of corn and nightshade consumption.
 
2016 Started experiencing diarrhea and bleeding hemorrhoids. GP sent me to a gastrointestinal specialist. Celiac Test, Endoscopy and Biopsy provided no indication of illness/disease.
 
2016 - present I am maintaining about an 80% Paleo diet. I am still experiencing diarrhea and bleeding hemorrhoids. My typical day is:
 
BREAKFAST
- 2 Moka Pot (unfiltered) coffees with MCT oil, vollagen & raw honey
- 2 fried eggs with guacamole and hot sauce
- Cup of frozen berries (blueberry, cherry, blackberry) with tablespoon of pumpkin seeds
 
LUNCH
- Cup of roast chicken
- Cup of steamed carrots
- Cup of steamed mushrooms
- Olive oil, lemon juice, coconut aminos, ginger
 
DINNER
- Usually meat, leafy greens and white rice or sweet potato with lots of garlic, onion & chili, but this is where I cheat most often with hamburgers, pizza, tacos, ramen, pho, shawarma, indian, pasta, etc.
 
SNACKS
- Nuts, rice chips, corn chips, sweet potato chips, popcorn, dark chocolate
- My go-to fuel for biking & skiing is the Larabar. Trying homemade rice cakes for the first time today.
 
I supplement with Genuine Health Fermented Whole Body Nutrition with Greens, Fish Oil, Vitamin D, Vitamin B Complex and Tumeric. I experimented with Maca and Ashwagandha, but did not notice any positive effect - possibly a negative one from the ashwagandha. I've recently started taking Ener-C while training on the bike.
 
We cook in bacon fat, butter, olive oil, avocado oil and coconut oil. 
 
Cheese does not seem to hurt my stomach, but it does seem to give me a bad complexion. 
 
We do not eat much packaged foods, but there is a strong correlation between packaged food and my guts feeling terrible. Is it the vegetable oils? the fibre, the corn? Last week I had terrible indigestion after eating a Juicy Jumbo. I wasn't surprised when I read the label and found that there's as much corn syrup and corn starch as there is meat.
 
I am not on any pharmaceuticals and try to avoid over-the-counter meds and NSAIDs. Usually around this time of year, I need to take Reactine to manage my fierce grass allergies. 
 
I convection vape and ingest cannabis oil in very small doses once or twice a month. My alcohol consumption is 80% red wine, 15% beer (pilsner and lager - hops make me sleepy and faint), 5% other (prosecco, tequila, vodka, bourbon).
 
I am a strong sleeper, despite my constantly sore hips. I usually go to be around 10:00 and often awake without my alarm between 5:30-6:00 with great energy. 
 
My resting heart rate is in the mid 50s and I top out in the high 170s. My blood pressure is usually great and while my LDLs are on the high side of acceptable, my doctor says he's happy as my HDLs are "off the charts".
My Paleo journey began with the assumption that phytates and phytic acid were causing leaky gut. I am now starting to wonder if I might be sensitive to fibre or something completely different....
Where do we go from here?
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