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Understanding IBS-C Known as Constipation

Updated: Dec 11, 2022

What Are The Causes of Constipation in Women?

Understanding IBS-C AKA Constipation

As you can clearly see after reading the about me page I’ve suffered from many nutrition and wellness difficulties and one being chronic constipation. I created Spiced Life Conversation as a medium for my ministry to help humanity heal, for I believe that all diseases and conditions starts in the digestive system. Many people don't realize the gut and mood connection. A growing body of research indicates that the health of the gut and its resident microbes have a profound effect on mental health. Research also indicates factors that disrupt the gut microbiome may contribute to mental health disorders such as depression and anxiety. Learn more about how the gut microbiome is tied to mental and emotional health, and more importantly, what you can do to optimize the health of your gut microbiome to boost your mood, mental health, and prevent chronic constipation.

My goal is to educate and elevate my clients while helping them discover a higher level of wholeness, happiness and personal wellbeing by restoring their mind, body and spirit. I have a lot of tools in my tool kit from working as a behavior therapist and marriage and family counselor that I use when working with my clients. Whether its energy balancing, nutrition counseling, stress reduction, or mindset priming, I can help you to remove those blockages that keep you stuck in old, unhealthy patterns. I help you to understand you are where you are, and how you can get to where you want to be in your transition into your healthy lifestyle. However, the first step to behavior change is understanding what it is that need to be changed. I do this with the shadow work process. With that said I’m going to briefly explain what are the causes of constipation in women. But first I want to make it clear who is right for our services.

Who Do I Counsel?

When clients come to me for help for chronic constipation, skin eruption, anal fissure or emotional wellness, they usually have already investigated the problem and are interested in a holistic approach using food as medicine to restore their condition. But, not everyone is like this, some clients are referred by their physician to begin a healthy eating lifestyle to manage or prevent chronic constipation, skin eruption, anal fissure and emotional eating. Then there are those who are referred because the damage has already been done and surgery is required. When this happens clients see me for a pre and post opt surgery care plan. Then they can choose to purchase the 90-day transition program to work with me for 90-days to learn how to transition into a healthy whole food lifestyle. Or they can choose the 30 day self pace E-course where they follow the guide and complete the transition on their own with e-mail messenger support. Most times after anal fissure surgery physicians recommend the 90-day plan, but its the client choice whether or not to move forward and restore their health. Every client situation is different. Mindset about healthy eating (healthy conscious), financial issues (ability to afford nutrition counseling), willingness to change (ready to take action needed to change eating style and behavior), dealing with trauma and life issues it all boils down to the clients readiness to learn how to eat healthier, get organized and apply the change to their lifestyle.

So who are my digestive clients?

  • Those who are seeking to begin a healthy eating lifestyle.

  • Those who are seeking to manage or prevent chronic constipation, skin eruption, anal fissure and emotional eating through a healthy lifestyle.

  • Those who required anal fissure surgery or any surgery and need to prevent or manage constipation.

During my time working as a nutritionist I learned that one of the most common problems that no one wants to talk about is constipation, but knowledge about constipation prevention are often simple and bring quick relief. While this isn’t always something you want to discuss I would like to to have a conversation about it because it’s a serious issues if left ignored, just about everyone has experienced it at one time or another so there is nothing to be ashamed of by talking about it.

What is IBS?

Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhea, constipation, or both. With IBS, you have these symptoms without any visible signs of damage or disease in your digestive tract.

IBS is a functional gastrointestinal (GI) disorder. Functional GI disorders, which doctors now call disorders of gut-brain interactions, are related to problems with how your brain and your gut work together. These problems can cause your gut to be more sensitive and change how the muscles in your bowel contract. If your gut is more sensitive, you may feel more abdominal pain and bloating. Changes in how the muscles in your bowel contract lead to diarrhea, constipation, or both.

Does IBS have another name?

In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.

Are there different types of IBS?

Three types of IBS are based on different patterns of changes in your bowel movements or abnormal bowel movements. Sometimes, it is important for your doctor to know which type of IBS you have. Some medicines work only for some types of IBS or make other types worse. Your doctor might diagnose IBS even if your bowel movement pattern does not fit one particular type.

Many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days.

IBS with constipation (IBS-C)

With IBS-C, on days when you have at least one abnormal bowel movement

more than a quarter of your stools are hard or lumpy and less than a quarter of your stools are loose or watery

IBS with diarrhea (IBS-D)

In IBS-D, on days when you have at least one abnormal bowel movement

more than a quarter of your stools are loose or watery and less than a quarter of your stools are hard or lumpy

IBS with mixed bowel habits (IBS-M)

In IBS-M, on days when you have at least one abnormal bowel movement

more than a quarter of your stools are hard or lumpy and more than a quarter of your stools are loose or watery

How common is IBS?

Studies suggest that about 12 percent of people in the United States have IBS.1

Who is more likely to develop IBS?

Women are up to two times more likely than men to develop IBS.1 People younger than age 50 are more likely to develop IBS than people older than age 50.2

Factors that can increase your chance of having IBS include:

Having a family member with IBS

A history of stressful or difficult life events, such as abuse, in childhood Having a severe infection in your digestive tract Woman talking with a health care professional in a doctor’s office. Women are two times more likely than men to develop IBS. What other health problems do people with IBS have?

People with IBS often have other health problems, including1

Certain conditions that involve chronic pain, such as fibromyalgia , chronic fatigue syndrome and chronic pelvic pain

Certain digestive diseases, such as dyspepsia and gastroesophageal reflux disease Certain mental disorders, such as anxiety , depression , and somatic symptom disorder

The brain and the gut are closely linked

Mental illness is quite common in the United States. Current statistics indicate that one in six American adults has a mental illness such as depression or anxiety. The conventional medical approach to treating mental health disorders is heavily focused on medication and views the brain as an entity distinct from the rest of the body. However, an emerging body of evidence demonstrates that the function of the brain is intrinsically linked to the health of the gut and that mental health problems may, in fact, stem from imbalances in the gut microbiome.

In animal studies, mice with lower levels of beneficial Lactobacilli have been found to be less resilient in stressful situations and more prone to depression. In humans, it has been found that depressed patients have significantly altered gut microbiomes compared to healthy controls, with a preponderance of pathogenic bacteria and lower levels of beneficial bacteria. Patients with bipolar disorder and obsessive-compulsive disorder also demonstrate significant alterations in their gut microbiomes which may adversely impact mental health. This research suggests that the balance of bacteria in the gut significantly impacts mental function.

In my private practice we focus on IBS-C also know as constipation...

If you’re a woman and suffering from slow digestion, you may wonder what causes constipation in women. There are actually several things that can cause this problem and more women than men seem to be afflicted with it, I say this due to 80% of my clients are women although I do have a couple of truck drivers who come to see me for constipation.

Hormonal Change Diet Lack of Exercise Medication Eating Disorder Pregnancy and Postpartum Low Carb Dieting Aging Stress or disruption in daily schedule

What is Constipation?

Before we get into the causes lets take a look at what constipation is and how we can know whether or not we have the symptoms to even be concerned with causes and treatment of constipation. Most people experience constipation at some point in their lives, but what is constipation? You may think you’re constipated for just a day or two, but true constipation lasts much longer and is more serious. For me, I only eliminated waste once every two weeks.

Constipation is more than just not being able to go the bathroom for a couple of days. To be considered a true medical or health problem, it needs to be a chronic problem that causes you to experience some symptoms.

Normal Digestion 101

I like to explain to my clients the digestion process and how it works, in order for them to have a clear vision of why they are experiencing what they are experiencing. When your digestive system is functioning properly, you probably don’t think too much about it. Normally when you eat, food is broken down from the time you start chewing until it reaches the large intestine.

Your body produces digestive enzymes that start to break down food in your mouth. As it moves through your esophagus and stomach, the food becomes liquefied which makes it possible for your body to absorb the nutrients in it.

In your small intestine, your body actually absorbs all of the good stuff from your food including protein, carbohydrates, and fats. It also absorbs vitamins and minerals through the walls of the small intestine. And once all the nutrients that can be absorbed have been removed, you’re left with water and waste.

In the large intestine the water is removed from the waste of your food and begins to solidify into what we call feces. As food passes through the large intestine more and more water is removed until you have a bowel movement to release it from the body.

Symptoms of Constipation

When you have problems with constipation, it can cause some painful and even embarrassing symptoms. You’ll want to pay attention to your body to determine if you’re experiencing constipation symptoms. Symptoms are your body’s way of telling you that something is wrong.

Symptoms include:

Not going to the bathroom regularly Abdominal Pain Pain during bowel movements Swelling in your abdomen Vomiting Straining to go to the bathroom

After a bowel movement, you still feel like you need to go

The most common symptoms of constipation is not going to the bathroom regularly. If you have healthy digestion you should be having daily bowel movements at least 1-5 times daily. But if you don’t have at least one each day, you can be sure that you’re showing signs of constipation. If you’re skipping days between bowel movements, like I was by eliminating waste only once every two weeks this is a signal that your digestive system is moving too slowly. Many people have constipation that causes them to only have one or two bowel movements in a week. If you think about how often you eat, you can see that your body isn’t properly processing your food if you’re going to the bathroom that infrequently.

Now let’s take a look at each symptoms individually.

Abdominal Pain

When your digestive system gets backed up, it can cause abdominal pain to occur. Your pain may be a result of intestines that are too packed with feces to be comfortable.

Abdominal pain can also come from cramping when your body tries to move the waste through your body. In either case, you may experience discomfort and pain in your abdomen when you’re having difficulty with regular digestion.

Pain During Bowel Movements

Pain while going to the bathroom is also a sign of constipation. Your stools may become very hard and even very large making it painful when they leave the rectum. You may even experience anal tearing called fissures as a result of constipation. In my twenties after suffering from constipation the result from straining and me eliminating waste only once every two weeks cause a tear above my anal which lead to anal fissure surgery.

Fissures can also cause bleeding that you’ll notice when wiping and can even cause you to see blood in the toilet or your underwear. This is usually bright red blood and isn’t harmful, but if you see blood it’s a good idea to see healthcare provider to rule out something more serious. When I saw blood I did nothing. I thought it was from hard stool. But after having severe pained and bleeding I got it checked out and the Gastroenterologist confirmed the anal tearing.

Swelling in Your Abdomen

You may also experience swelling in your abdomen when you’re constipated. You may feel bloated or that your belly is actually hard to the touch. This is because of impacted waste. As your digestion slows down but you keep eating, your intestines become filled with waste.

You may even notice a slight weight gain or that your clothes don’t fit comfortably when you’re constipated. Again, this is your body’s way of letting you know there’s a problem that needs to be corrected.


You might not think of vomiting as a symptom of constipation, but it can be a result of it. When you eat food, but it can’t pass through your intestines easily this can cause a system backup. When food can’t pass normally, your body gets rid of it through vomiting.

Vomiting doesn’t occur unless your constipation has been going on for some time. This is one of the more severe constipation symptoms and indicates that you have a serious case of constipation that needs immediate treatment.

Often this type of constipation results from having a bowel obstruction, though that’s not always the case. Obviously there are other causes of vomiting, but if you’re vomiting and experiencing additional signs of constipation it’s important to seek treatment.

Straining to Go to the Bathroom

You may be able to have a bowel movement, but if you’re constipated it can cause you to strain and push when you go to the restroom. In normal digestion and bowel movements, this isn’t necessary.

Your body has involuntary muscles that will naturally help you to evacuate your bowels. But if your feces is very hard or impacted those voluntary muscles aren’t enough. If you feel like you have to bear down or push to go to the bathroom you’re probably experiencing constipation.

Still Feel Like You Need to Go

Even after a bowel movement, you may feel like you need to go again immediately. This is called incomplete evacuation. You’re having a bowel movement, but because of constipation you’re not able to get all of the waste out of the body.

A System Slowed Down

According to Arnold Wald, MD, MACG constipation is one of the most frequent gastrointestinal complaints in the USA and Western countries. There are at least 2.5 million doctor visits for constipation in the USA each year, and hundreds of millions of dollars are spent on laxatives yearly. So we are not the only ones who has a slow system.

For many different reasons, the digestive system can get slowed down. When this happens too much water is removed from solid waste making it hard and difficult to evacuate from your body. Over time this problem can be considered constipation.

When you’re constipated, your stools may become hard and difficult to pass from your body. You may skip days between bowel movements or only go once or twice a week. You may also find that you have to strain during bowel movements.

If you’re constipated, you may also feel like you haven’t been able to get all of your feces to leave your body after going to the bathroom. Wald explains that constipation is often thought of as a decrease in frequency of stools and many people believe they are constipated if they do not have a bowel movement each day. This is not correct, as many persons have as few as three bowel movements each week and are healthy. For many people, constipation means too much straining with bowel movements, passage of small hard stools or a sense that they have not completely emptied their bowels. The American College of Gastroenterology defines constipation based upon symptoms including unsatisfactory defecation with either infrequent stools, difficult stool passage or both. Any recent change in bowel habits, if persistent, may be cause for concern.

Therefore, in order to be considered the true definition of constipation, you have to experience at least two of these problems for a period of at least three months.

So while you might have an occasional day when you miss a bowel movement or feel that you’re straining, you really don’t have a problem that needs treatment unless it becomes a chronic problem for you.

It’s important to pay attention to your body so that you know if you have a problem that lasts for a long enough period of time to seek treatment. The good news is that if you have constipation, there are many ways it can be treated naturally and medically to give relief.

So while you might have an occasional day when you miss a bowel movement or feel that you’re straining, you really don’t have a problem that needs treatment unless it becomes a chronic problem for you. It’s important to pay attention to your body so that you know if you have a problem that lasts for a long enough period of time to seek treatment. The good news is that if you have constipation, there are many ways it can be treated naturally and medically to give relief.

How do gut bacteria influence mental health? The human gut contains trillions of bacteria and a special set of nerve cells called the enteric nervous system. Together, the microbes and nerves comprise the body’s nervous system. There are two potential mechanisms by which gut bacteria interact with the enteric nervous system, thereby influencing the function of the “nervous system” and mental health:

Pathogenic gut bacteria, which predominate when the microbiome is imbalanced, produce metabolites that promote an inflammatory immune response and increase the activity of the sympathetic nervous system. The sympathetic nervous system is the branch of the central nervous system responsible for the “fight or flight” response. Activation of this response produces anxiety. Conversely, beneficial gut bacteria, such as Lactobacilli and Bifidobacteria, produce compounds that suppress inflammation and the sympathetic nervous system reaction.

Certain gut bacteria produce neurotransmitters, such as serotonin, that communicate with the brain via the vagus nerve, which connects the enteric nervous system of the gut to the brain. Bacterial imbalances in the gut may alter neurotransmitter levels and disrupt mental health.

Strategies for balancing the microbiome and improving mental health To improve mental health, it is crucial that we establish a healthy gut microbiome. Here are some strategies for balancing your gut microbiome and promoting optimal mental health.

Eat a whole foods nutrient-dense diet Studies show that traditional, whole foods are superior for mental health. One of the reasons why a whole foods diet may benefit mental health is because this type of diet contains a special type of fiber, prebiotic fiber, that feeds beneficial gut bacteria. Prebiotic fiber is found in foods such as asparagus, garlic, onions, leeks, apples, and legumes. Consuming fermented foods such as sauerkraut and kimchi may also benefit mood by supplying the gut with live, probiotic bacteria. When gut bacteria are well-fed and happy, they help create a happy, healthy you!

Try a probiotic supplement Research indicates that probiotics may act as natural antidepressants by producing metabolites that suppress inflammation and the sympathetic nervous system response. In animal models of psychological stress, supplementation with Bifidobacterium infantis, Lactobacillus helveticus, and Lactobacillus rhamnosus has been found to reduce anxiety and depressive behaviors. Several human trials have also found a significant benefit of probiotic supplementation on parameters of mental health. In one study, supplementation with a multispecies probiotic containing Lactobacilliand Bifidobacteria reduced self-reported sad mood and negative thoughts in adults. In another human study, supplementation with Bifidobacterium longum led to reduced stress and improved memory. These findings suggest that taking a multispecies probiotic containing Lactobacilli and Bifidobacteria may be one way to significantly improve mental health!

Limit antibiotic use Disruption to the gut microbiome by antibiotics may induce cognitive impairment and poor mental health by disturbing the balance of beneficial and pathogenic bacteria and the neuroactive substance they produce. To promote optimal mental health, it is best to be judicious with antibiotic use and only use them when necessary.

Reduce stress Psychological stress perpetuates a vicious cycle of poor mental health by lowering levels of beneficial bacteria in the gut that reduce inflammation and modulate the stress response. Stress-reduction practices such as yoga and meditation may benefit mental health by helping you maintain a balanced, gut microbiome.

Let’s Have A Conversation

If you are like most of my clients when you have this problem, it can be embarrassing to talk about constipation. However, you should know that this is a common problem and you’re not alone. When you have difficulty going to the bathroom it means that something isn’t quite right in your digestive system.

There are many simple causes and once you’re able to pinpoint the problem, you’ll be able to get relief. In very rare cases, constipation is a sign of something more serious that you need to discuss with a healthcare professional.

I like to inform people on the reality of constipation because by ignoring constipation like I did you can cause your symptoms to get worse and you can contribute to more serious problems with your digestive system that have long-term consequences. It’s important to make sure you’re in tune with your body and that you don’t let this problem go undiagnosed or untreated.

If you suspect that you’re constipated, it’s important to learn as much as you can so that you can get the right treatment as quickly as possible. It’s also important to understand the symptoms, possible causes, and treatment options that you have available to you.

A constipation cure could be as simple as increasing your intake of water or increasing or decreasing your intake of fiber (I know very confusion it all depends on your unique body and issues) or it might require you to make a larger lifestyle change. The point I’m trying to make here is prevention. I don’t want you to have to undergo anal fissure surgery like I once had to, trust me it’s not a good experience. You don’t have to suffer. My goal is to teach you how to become mindful of what your body is trying to tell you. When you pay attention to what your body is telling you, you can make informed choices about your digestive health.

There’s No Need to Suffer

If you’re suffering from constipation you should know that you’re not alone and you don’t have to live with the misery that accompanies it. People who suffers from constipation can feel uncomfortable and it can even make eating an uncomfortable activity.

But there’s no need for you to suffer with this problem when there are so many options available to you. The first step towards preventing it is understanding what constipation is. After which, it’s a good idea to learn more about the causes, symptoms, and treatment possibilities. I hope this information help you gain some clarity about your situation.

Final thoughts If you or someone you love has experienced depression, anxiety, or other mental health issues, know that it is not “all in your head;” in fact, much of the problem may lie in your gut! However, there is hope! By restoring balance to the gut microbiome using a whole foods diet, probiotics, and stress reduction techniques, it may be possible to improve your mood and create optimal mental health that lasts a lifetime. Have your doctor refer you to us today.

If you are ready to liberate yourself from chronic constipation please schedule a session today!

I can help you connect the dots between knowing what to eat and resources to help you restore your health.

Gaining relief from constipation is not achieved by dieting. Changing your lifestyle isn’t just a decision. Achieving lasting results is a process of change. As a nutritionist & life transition spiritual counselor I artistically merge together healthy eating, practicality and positive behavior change. Having overcame my own disordered eating, bloating weight gain, and struggle with chronic constipation, I will be an invaluable partner on your path to developing a healthy relationship with food, restoring your digestive health and transition into a healthier lifestyle.


Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Journal of the American Medical Association. 2015;313(9):949–958. [2]

Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology. 2016;150(6):1393–1407.

Arnold Wald, MD, MACG, University of Wisconsin School of Medicine and Public Health, Madison, WI – Published June 2004. Updated January 2010. Updated March 2016

The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center,

Mental Illness. National Institute of Mental Health. Updated November 2017. Accessed January 17, 2018. Deans E. Microbiome and mental health in the modern environment. J Physiol Anthropol. 2016; 36:1. Accessed January 17, 2018.

Marin IA, Goertz JE, Ren T, et al. Microbiota alteration is associated with the development of stress-induced despair behavior. Sci Reports. 2017; 7: 43859. Accessed January 17, 2018.

Naseribafrouei A, Hestad K, Avershina E, et al. Correlation between the human fecal microbiota and depression. Neurogastroenterol Motil. 2014; 26(8): 1155-1162. Accessed January 17, 2018. Evans SJ, Bassis CM, Hein R, et al. The gut microbiome composition associates with bipolar disorder and illness severity. J Psychiatr Res. 2017; 87: 23-29. Accessed January 17, 2018. Rees JC. Obsessive–compulsive disorder and gut microbiota dysregulation. Med Hypotheses. 2014; 82(2): 163-166. Accessed January 17, 2018. Bailey MT, Dowd SE, Galley JD, et al. Exposure to a social stressor alters the structure of the intestinal microbiota: implications for stressor-induced immunomodulation. Brain Behav Immun. 2011; 25(3): 397-407. Accessed January 17, 2018. Forsythe P, Bienenstock J, Kunze WA. Vagal pathways for microbiome-brain-gut axis communication. Adv Exp Med Biol. 2014; 817: 115-133. Accessed January 17, 2018. Rahe C, Unrath M, Berger K. Dietary patterns and the risk of depression in adults: a systematic review of observational studies. Eur J Nutr. 2014; 53(4): 997-1013. Accessed January 17, 2018. Desbonnet L, Garrett L, Clarke G, et al. Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression. Neuroscience. 2010; 170(4): 1179-1188. Accessed January 17, 2018. Ohland CL, Kish L, Bell H, et al. Effects of Lactobacillus helveticus on murine behavior are dependent on diet and genotype and correlate with alterations in the gut microbiome. Psychoneuroendocrinology. 2013; 38(9): 1738-1747. Accessed January 17, 2018. Bravo JA, Forsythe P, Chew MV, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci USA. 2011; 108(38): 16050-16055. Accessed January 17, 2018.

Steenbergen L, Sellaro R, van Hemert S, et al. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015; 48: 258-264. Accessed January 17, 2018.

Allen AP, Hutch W, Borre YE, et al. Bifidobacterium longum 1714 as a translational psychobiotic: modulation of stress, electrophysiology and neurocognition in healthy volunteers. Transl Psychiatry. 2016; 6(11): e939.!po=2.17391. Accessed January 17, 2018.

Frohlich EE, Farzi A, Mayerhofer R, et al. Cognitive impairment by antibiotic-induced gut dysbiosis: Analysis of gut microbiota-brain communication. Brain Behav Immun. 2016; 56: 140-155. Accessed January 17, 2018.

Help Developing A Plan For Self Care

Do you want help developing a self care plan that works for your own busy schedule? Do you want accountability implementing a self care plan? If you or someone you love is struggling to maintain optimal mental and emotional health, consider reaching out to Spiced Life Conversation Art Wellness Studio and Botanica. We are a Metro Atlanta, Conyers Georgia area. We are a coaching and counseling practice with empathetic, skilled counselors and recovery coaches who can help you set goals, develop a self care routine and move forward to build a more fulfilling life. Our team would be happy to work with you either just for a couple of sessions to develop and implement a Self Care plan or longer term to work toward overall better mental health within our membership site or other programs.

About The Author:

Dr. Nikki LeToya White MSEd-TL, Ph.D. RHN is the founder, director and a full time board certified trauma-informed nutritionist, folk herbalist, and wellness consultant at Spiced Life Conversation Art Wellness Studio and Botanica. She created Spiced Life Conversation, LLC

Art Wellness Studio and Botanica to provide the Metro Atlanta area with a counseling and coaching services where clients are carefully matched with the right program for healing abandonment and childhood emotional neglect trauma that cause codependency, emotional eating, financial stress, and imposter syndrome as it relates to fear of success and being abandon. We help you begin your emotional healing journey with ease. Recently, we have expanded to include online membership site so we now provide support to people living all over the world. All of our recovery coaches provide at least one evidence based treatment to assist in your recovery. Dr. White is a big proponent of self care and helping people live a fulfilling life! She has been in full remission with both codependency and emotional binge eating disorder since 2016. In live a life in recovery from sugar addiction. Loving her low sugar balance lifestyle.

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