resistant starch
#360417 - 08/18/10 07:06 AM
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I realise, through searching the message boards, that there have been a number of posts relating to resistant starch. The overall theme of these posts suggest that resistant starch is a positive for people with IBS, as it acts like soluble fibre and soothes the GI tract. The majority of evidence supports the argument that resistant starch is beneficial for healthy individuals (non-ibs), however the advice from the National institute for clinical excellence (NICE) suggests that ibs patients limit their intake of resistant starches.
As I understand it, resistant starches are foods that are incompletely digested, and could, therefore be considered the third form of fibre. They enter the bowel where they are fermented and produce gas. This gas that would usually cause no pain/discomfort for healthy individuals, can and often does, in part due to the hypersensitivity of the gut in ibs patients, cause pain, discomfort and bloating.
I just wanted to gauge people's opinion on this topic and if they've had any luck restricting/increasing the levels of resistant starch in their diets. Resistant starches are predominantly found in pulses, whole grains, nuts and seeds, bran, cooked and cooled potatoes/corn/rice, processed foods and dried pasta.
Best wishes
S
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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Resistant starches belong to a class of fiber called functional fibers. They are indigestible carbohydrates. Total fiber in a diet was redefined a few years ago to be the sum of the amount of dietary fiber (SF + IF) plus the amount of functional fiber. You can find a discussion of it in this posting
For the past few years I have making sure that I have plenty of foods glutenous rice and oatmeal in my diet which are high in resistant starches. This ensures that I am getting a considerable amount of functional fiber with soluble fiber properties. Many of the foods on the EFI soluble fiber list are high in resistant starches. As a soluble fiber they tend to be beneficial for many individuals with IBS.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Thanks for writing. I understand the logic behind consuming RS for healthy (non-ibs) individuals, however my argument would be, if the RS is not digested in the small intestine, but is instead fermented by bacteria in the large intestine, the gas produced in the fermentation process is likely to cause problems for individuals with ibs. For example, the addition of RS to foods stuffs, for its reported prebiotic effect, can be problematic for some ibsers and the FODMAP dietary approach recommends avoiding these products. Extrapolating from this recommendation, this approach would presumably also recommend limiting the amount of RS in the diet, in order to combat the effects of bloating and distension resulting from the fermentation of the RS.
The article on RS you reference is published in 2005, while the NICE guidelines and FODMAP book/research papers were both published in 2009, and specifically with managing ibs symptoms in mind. I understand the logic of consuming soluble fibre, and that now seems to be an almost universal first-line approach to combating ibs, and that the foods you mention, rice and oatmeal are high in soluble fibre. However, letting the rice cool, or processed flour (pasta/bread), the staples of the EFI contain reasonable amounts of RS, and for the reasons outlined above, are potentially problematic for ibsers.
Having said all that, a good proportion of my diet, (an amalgamation of the FODMAP/EFI guidelines) is comprised of SF and RS. I wonder if reducing the RS in my diet would reduce my distension and bloating.
Kind regards
Sx
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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Bloating and distention is also caused by the fermentation of other indigestible foods such as the IF, sugars and other carbohydrates. I suspect that in order to make a significant difference to the bloating and distention resulting from fermentation one would have to remove most if not all fermentable foods. This would be unhealthy because besides producing gases fermentation produces a variety of valuable byproducts such as short-chained fatty acids ( SCFA ) that the body uses in a variety of beneficial ways. One of the benefits of prebiotics is to increase the production of SCFA through fermentation. It is sort of catch 22.
I have not noticed that RS causes much bloating and gas. On the other hand, insoluble fiber particularly from cereal grains and malabsorbed sugars are a big problem. 
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Yes,
Raffinose, fructose and whole grains cause me major problems too. Perhaps surprisingly, giving my malabsorption of specific carbohydrates, sugars and fibres, I'm more prone to IBS-C than IBS-D. How do you do with wheat (not whole grain) given your fructose malabsorption, and have you tried spelt? The most recent paper by Gibson et al suggests spelt as an alternative to wheat on the FODMAP diet. Personally I was a little surprised by this, given spelt is a distant relative of wheat, and according to the USDA, contains more fibre per 100g.
Thanks again,
Sx
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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I have little problem with wheat as long as I keep my consumption around two thin slices of bread each day.
I have not tried spelt. However, Gibsons etal recommendation that it may be better than wheat is a bit surprising given the fact that some research literature indicates that the content of certain fructans is high in spelt compared to wheat. However, it is possible that these fructans aren't short chained and therefore less of a FODMAP problem.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Do you know which foods are low in resistant starch and FODMAPs friendly? I feel like there's nothing I can eat anymore except for cooked oatmeal ... !
I seem to be so sensitive to anything gas-forming (bloating and associated discomfort and pain are my main symptoms).
I'm pretty sure resistant starch is a trigger for me (fine with fresh cooked potatoes but not re-heated for example). I've kept a detailed symptom diary and reducing FODMAPs also seems to help.
If I could cook fresh rice/potato/oatmeal for every meal I guess I'd be ok but that doesn't really work when Im out during the day at university or hospital on placement...
If you can give me any tips I'd be so grateful!
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Hello,
I'm afraid I don't have a simple solution. I often cook more than I need and reheat the leftovers the following day. For example, reheated rice/potatoes don't seem to be a trigger for me. Perhaps, instead of a hot/reheated meal try taking sandwiches, made from wheat/gluten free bread, if that would be more convenient, or make a batch of soup (although again reheating issues). Other soluble fibre, low FODMAP foods that I base meals around include: rice noodles, Quinona, polenta, oats, rice, potatoes, sweet potatoes, root vegetables and rice/corn pasta.
Are you positive it is the resistant starch? If you're following a low fibre/FODMAP diet then the majority of the symptoms that are troubling you (bloating and discomfort) should gradually subside. How long have you been following the diet? What about fibre supplements, are you taking any? Also, are your bowel movements predominantly constipated/diarrhoea?
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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Oatmeal has a lot of resistant starch. There is no more resistant starch in reheated potatoes that there is in freshly cooked hot potatoes. The resistant starch is formed when the potatoes, rice etc are cooked and then left to cool. Reheating destroys the resistant starch.
You might look at the Cambridge University Hospitals low fiber diet including low resistant starch in this post
For a fairly comprehensive FODMAP list have a look at the first two links in my signature. And below is a link to a simple overview prepared by the IFFGID - International Foundation for Functional Gastrointestinal Disorders. Look towards the middle of the newsletter
IFFGID newletter
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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It's mainly C, occasionally D but even then it's very mild so I wouldn't say I really had alternating IBS, it seems to be a gas thing because if I pass gas (I know this is a bit too much info!) then I tend to be a lot better.
I've been trying to stick to low FODMAPs for quite a few weeks now, just the odd spot of milk in my tea or a wheat cracker now and then but nothing much that could be a problem. I'm not sure it's resistant starch that also causes me problems .. it's so difficult to tell .. I've never managed to eliminate enough stuff to keep completely symptom free, it seems I would have to eat nothing at all for that :-S
I have been really ill after eating cold rice that I've taken as a packed lunch before, but I wasn't aware that re-heating things like that would get rid of the resistant starch so that's good to know. It would make sense that RS is a problem for me because it acts like insoluble fibre doesn't it? and I am very bad with anything high in that, especially pulses. I had read in scientific journal articles that oatmeal was low in resistant starch... I tolerate it very well with rice milk.
Thank you for your replies and the links, I will read immediately!
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