Need Advice...Lexapro and Diet questions
#370193 - 09/16/13 01:23 PM
|
|
|
|
|
|
SO, im completely confused about what is causing my IBS. I changed to a low dose of 5mg lexapro 8 weeks ago and slowly my IBS got worse but im also under a lot of stress with being unemployed and suffering from panic disorder. I know this site is a big proponent of refined carbs ie white flour, etc....but then i watched a video by Dr Mark Hyman(leading naturopathic dr) and he is like you need to go gluten free, lactose free, etc for 8+ weeks and then also take antibiotic and probiotics etc.....I was tested a few yrs back and im not celiac or lactose intolerant......whats the deal with gluten...everyone is like you have to go GLUTEN FREE? I tried it for 5 days and still felt crappy....plus its not healthy...many of the products have high sugar(i avoid) or sodium(i avoid)....are many people on this site gluten free and lactose free? When im not stressed it seems i can eat most things.....so isnt it more about emotions vs food? hate to deprive myself of evenmore food....i wonder how much of it would be placebo effect also.
Print
Remind Me
Notify Moderator
|
|
|
The cause of IBS is unknown and Dr. Mark Hyman's claim of a cure for IBS is misleading.
Your GP or GI doctor should have told you about some recent develops in IBS symptom management. A clinically tested elimination and re-introduction dietary approach called the FODMAP approach has been tested on very large numbers of IBS suffers with good results. Generally speaking there is a 70-80% improvement in symptoms.
Here are links to a clinical practice article for physician, a dietitian's explanation for the general public and two more useful resources
Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach
The FODMAPs Approach — Minimize Consumption of Fermentable Carbs to Manage Functional Gut Disorder Symptoms
Low FODMAP diet
Understanding FODMAPs
Also, one should remove/reduced common IBS triggers such as caffeine (coffee, tea, etc), high fat and high insoluble fiber (e.g whole grains or bran) foods, etc. Here is a link to more information
How to eat for IBS
--------------------
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
Print
Remind Me
Notify Moderator
|
|
|
THank you! But the FODMAPs suggests gluten free while heathers site is ok with white pasta, bread etc....this is where i get confused? Also, FODMAP is ok with coffee and heathers site is not...again, confusing, no? ALso, do any of these studies take into consideration SSRIs...i believe my IBS got triggered by lexapro...ALSO, what about the role of anxiety.....mine certainly triggers.....its complex, isnt it?
Print
Remind Me
Notify Moderator
|
|
|
gluten is a protein, FODMAPS are types of carbs. One type, fructans, is found in wheat, so people get confused. Plus, there is interesting research going on showing that people who test negative for "true" gluten intolerance nonetheless may have some form of gluten intolerance anyways.
I've no idea why some of the FODMAPS practitioners are so narrowly focused and are okay with known GI irritants like coffee just because they're FODMAPS free. To me this is appalling, so you'd have to ask them to explain that position. It's like okaying lard - which, come to think of it, some of them do.
Use your own common sense - if things are known to be hard on the gut (any gut, whether you have IBS or not) be cautious. FODMAPS aren't the only thing that can upset IBS, so if you use this approach tweak it as necessary. It's more the rule than the exception that IBS can take multiple treatment approaches (not just within diet, but across a broad spectrum including stress issues, supplements, prescription meds, sleep, exercise, etc.) , and that's okay.
And get tested for celiac, so you know if really do have a true gluten intolerance. If you don't, but all other dietary changes aren't working for you, try going gluten free to see if you're one of the folks who are currently mystifying GI researchers in this area with the non-celiac gluten intolerance. Lots of studies going on with this right now so keep checking the research - it's interesting!
Best,
H
--------------------
Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
Print
Remind Me
Notify Moderator
|
|
|
At the basis of the FODMAP elimination/re-introduction approach is the assumption that you have removed common IBS triggers such as caffeinated drinks, high fat foods, high insoluble fiber foods such as whole grains, etc. These are the common sense thing to remove even using the FODMAP approach.  The developers of the FODMAP approach were very clear about that (see third link in my signature) where they say
"If adherence was strict, attention may be needed to modify intake of resistant starch and insoluble and soluble fiber. Other dietary triggers such as food chemicals may need to be considered, as should potential factors such as caffeine, fat, meal size and regularity."
During the elimination phase it is recommend that you eat a gluten free diet. This is not because of the gluten but because the fructans in wheat can be a problem. The best way to eat 'wheat free' is to eat 'gluten free' -- the later automatically implies the former. After eight weeks you will re-introduce wheat into your diet and determine if you can or cannot handle fructans in wheat products. And if you can how much you can handle.
Heather's eating for IBS diet does not consider FODMAPs as this is a relatively new development that came about after she developed her guidelines which cover the basics very well. So it requires some juggling to use them both but it works well
There is no question that anxiety and stress can make IBS symptoms worse. However, they are not the cause of IBS just other triggers. SSRIs have been studied in clinical trials on individuals with IBS showing some success in some individuals. FODMAP have no effect on SSRIs 
The dietary approaches
--------------------
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
Print
Remind Me
Notify Moderator
|
|
|
i was just going by the sample menu in SYLs fodmaps link....it had gluten free and coffee for instance.....i think im ok with white bread and pasta.....but i eat wheat also......and lots of walnuts......usually i start to have lots of flatulence after dinner.....my guess is because i take the lexapro 1 hr before i eat.......since taking lexapro, my ibs has worsened.....it was pretty much under control before(with brief periods of relapse under stress, etc).....but the lex seems to be helping with panic...so its a tradeoff.......if i came off the lexapro, i think even with decaf coffee, wheat etc in my diet, my ibs would be ok.....so, i think the lexapro is the big culprit....but i think i will cut out my daily 1/2 cup decaf iced coffee.....and cut out whole wheat.....keep the white bread and white pasta.....and see how it goes.....i also react to apples pretty quickly....so thats out.....ive had lots of anal itching for the last 6 months......i do have hemorroids but perhaps this is also some yeast infection, although im male...so not sure that is common?
Print
Remind Me
Notify Moderator
|
|
|
and some (not all) of the US dietitians now using it. I've seen quite a few examples where dietitians are giving the okay to anything - and I do mean anything - as long as it has no FODMAPS.
Coffee, steak, you name it - they're not paying attention to IBS as a whole, they're just paying attention to FODMAPS. And it's confusing people to the point that I'm getting a lot of emails about it, and seeing frustrated patient posts on FODMAPS blogs.
- H
--------------------
Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
Print
Remind Me
Notify Moderator
|
|
|
that is why sometimes I wish you would update the EFI diet to accommodate the FODMAP approach. I am certain it would be a big hit as it would cover the basics in depth as well as introduce new principles
--------------------
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
Print
Remind Me
Notify Moderator
|
|
|
it's a struggle to keep up with writing the way I'd like because the manufacturing end of things has taken over my life.
You'd laugh if you saw the list taped to my desk of projects - so old now the ink has faded. FODMAPS is on there....
- H
--------------------
Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
Print
Remind Me
Notify Moderator
|
Great ....
#370230 - 09/19/13 04:48 AM
|
|
|
|
|
Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
|
|
|
If you need any FODMAP reference material I would be glad to send you want I have. As you may know I have an fairly extensive library on the topic. And the Monash researchers recently released a cellphone app for FODMAPs. This is one way they hope get around some of the misinformation and they can update it quickly.
--------------------
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
Print
Remind Me
Notify Moderator
|
Posts
