Some general questions about IBS
#339811 - 12/21/08 05:38 PM
|
|
|
|
|
|
Hi Everybody, I'm new here. I've read the material on the site, and have a few questions. This is turning out to be a very long read, so I would really appreciate anybody who answers any of my questions
First I'll give some background
My name is Matt, and Im 16. Since freshman year of high school, Ive always had some GI troubles. I would often have constipation, and occasionally have very painful cramps followed by diarrhea. I never went to the doctor until it got worse a few months ago, when I was diagnosed with IBS.
Since then its been on and off bad or good. I am concerned that I am losing weight (and I am already very lean), because my stomach will feel unsettled so I will not eat as much. I also eliminated fatty foods like peanut butter and chocolate from my diet. I am afraid of having diarrhea in a public situation, which is the reason why I will often be cautious when eating
I talked to my doctor about some of the material "Eating for IBS," and he dismissed it as BS. He said, basically, that the only dietary modification I should make is to eat more fiber. I asked him about fatty foods and other food to avoid, and he said there is only anecdotal evidence to support these claims. So, basically, is there any scientific proof of the information on this site?
My next question regards warding off diarrhea. For as long as I can remember, I have had episodes of (very) painful cramps followed by diarrhea after I have been constipated. In my mind it seems like its my body's way of eliminating waste that couldnt be eliminated before.
I started eating a diet high in fiber, and dates, oatmeal, and raisins have been particularly effective in reducing my constipation. However, I have been getting diarrhea after being completely regular, which has never happened to me before.
I also almost never get diarrhea soon after having it, but for the first time ever this week, Ive had it two times within a few days.
So, my question is, I am learning how to deal with constipation, but my main concern is my occasional diarrhea. How can I prevent that?
I know people are going to answer the last question by saying 'do not eat trigger foods.' How can I determine what is a trigger food for me? For example, I may get diarrhea after having a bland meal that does not seem like a trigger. How long ago should I look back when determining what triggers problems for me?
OK, final question. I have never liked dairy, and basically eat no dairy at all. I also remember it always not agreeing with me. Anyway, my mom is concerned that I don't have sufficient calcium in my diet. Is this a problem? How will it impact my diarrhea/constipation?
Thanks
Print
Remind Me
Notify Moderator
|
|
|
Your doctor must just be a family doc and not a GI specialist. Did you know doctors receive about a day of digestive training in all of medical school? My GI doc loved the EFI plan! But all most doctors can do is say 'eat more fiber' without telling you anything about how it works. So basically do what works, not what your uninformed doctor tells you.
There are definite reasons behind the recommendations here. You have already discovered that dairy is really hard to digest. So to handle IBS the best we can we avoid anything that is probably problematic. Not too complicated.
Your doctor should know that fat is a definite common cause for digestive problems, and not just for people with no gallbladder.
Ok so you have IBS-A (alternating), which is what I have. It is the most tricky because of that swinging back and forth. Like you say, you get into cycles of C for a few days causing D to get rid of waste and then the D makes you C- I've been there! A good soluble fiber supplement will help you be regular which also helps with D. And avoiding trigger foods and buffering hard to digest insoluble fiber will help you avoid D. I have no C or D if I don't mess up (take my acacia, drink enough and avoid triggers). If I eat a trigger, especially fatty dairy, I usually have D in 10 minutes. That said, the digestive upsets don't always come right away and that is why it is difficult for a person on their own to figure out their problem foods. You may feel normal after some foods but they could be causing a future reaction. Try out the diet with your mom's help (her cooking will have to be right on) and you won't have to worry about D.
You can get enough calcium from the milk alternatives- they have the same amount added. If you don't do the rice and soy milks then just take a calcium/magnesium pill once a day to be safe. Other foods have calcium too.
To gain weight you just want to be munching all the time. Pretzels and other snacky but low fat foods are great. Focus on the simple carb type foods until you stabilize. There are lots of options. Just ask questions here for more advice on diet.
I appreciate your excellent writing for a teenager. You must be smart.
--------------------
IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
Print
Remind Me
Notify Moderator
|
|
|
Welcome mcem.
I'm not knowledgeable enough on the diet to offer any advice (but Little Minnie seems to have answered some good basic points) BUT I will tell you that I'm familiar with your uncomfortable feeling about being out and worrying about getting diarrhea.
This is an excellent place to get advice and share thoughts about IBS and I hope your stay here will be fruitful for you.
--------------------
Saul (IBS - D)
Print
Remind Me
Notify Moderator
|
|
|
Wow, this couldn't have been stated any better! Great Job!
As Little Minnie said, please please ask questions! That's the only way to learn. It's like school, you don't know until you ask, and no question is a dumb question.
--------------------
IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
Print
Remind Me
Notify Moderator
|
|
|
Hi Matt
It is a pleasure to meet you and welcome to the board.
I will try to answer each of your questions in detail. First I have a couple of questions for you. Was your IBS diagnosed by a specialist or was that your GP's diagnosis? Did they do any tests, if yes, what tests did they do?
There is plenty of scientific evidence supporting the claims that some foods can make IBS symptoms worse. For example, the National Institute of Health has a lot of information on digestive disorders such as IBS. They take about triggers. Also, if you are looking for some information on triggers to take your doctor here is a recent article written for doctors about IBS and diet. It talks about triggers such thing as fatty foods, alcohol, foods/beverages containing caffeine, high fructose fruits and whole grains. If you need more articles on IBS triggers to take to your doctor I would be happy to give you more links to good reference information for physicians and health professionals.
I use to alternate between constipation and diarrhea. Now, if and when I have a problem it will usually be diarrhea. However, I found three things helped me the most. First, I eat only low fat foods. Second, I making sure I eat the right kind of fiber. There are two kinds of fiber - soluble and insoluble fiber. I found that if I ate foods containing more soluble fiber than insoluble fiber the constipation cleared up and the diarrhea was less frequent. However, you do need some insoluble fiber but dates and raisins could be a problem. White rice, potatoes and pasta are a good source of soluble fiber. Also, they have lots of carbohydrate calories which may help control your weight loss too. Third, for some people fruits that have a lot of the sugar fructose, such as apples, pears, mangoes and melons can cause some people with IBS problems. Again when I restricted my consumption of these fruits and other foods high in fructose such as honey and high fructose corn syrup my symptoms settled down. I tend to eat berries, oranges and bananas. The problem with fructose and other sugars for people with IBS is talked about in the article on diet and IBS for physicians.
It takes foods about 30-60 hours from the time it enters you mouth until it leaves your body. The length of time depends on a lot of factors. IBS is a problem associated with the large bowel or colon which is the last part of intestine. Some triggers can cause problems as soon as they enter the large bowel which is usually 2-6 hours after you eat. Others foods can cause problems later in the bowel. If you are keeping a food journal you may want to consider foods that you ate up to 3-4 days earlier.
If you find dairy is a problem then you definitely want to stay way from it. There are lots of good source of calcium. The National Institute of Health has a web page with a good table giving a variety of sources of calcium.
If you have any questions post them here. You will get a lot of advice and support. 
--------------------
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
|
|
|
Thanks for the advice Little Minnie and Syl
Like my first post, this post is turning out to be epicly-long
First off, responding to Syl's question
I was first diagnosed by my pediatrician. I then saw a specialist (I was lucky- there were no appointments open for 2 months but I got in on a cancellation), who tested for coeliac and a few other diseases, all which came out negative. The specialist seemed to be concerned about testing before talking about IBS, and since I never made a follow up appointment, I was never given any expert advice.
Second, I don't think I was clear on my calcium question. I'm asking if I should be getting calcium because right now I have very little in my diet. I know calcium is supposed to prevent diarrhea/cause constipation
My main concern right now is how to determine which foods will cause bad reactions for me. Since Ive gotten IBS, I think I've improved my mind-body connection.
I have been judging foods based on how I feel after eating them. Some foods I am surprised to learn are 'bad' for IBS, like sources of insoluble fiber (I've never felt bad after eating whole wheat, but maybe it just takes time for the reaction to happen?), and as Syl mentioned, high fructose fruits like apples.
I guess I am just not aware of what foods are good or bad, especially if I don't feel the effects right after ingesting them. Right now, my stomach feels very unsettled, and has been for the last two days, and I cannot think of what I might have ate to cause it. So, I guess I will list foods and ask if they are generally good for IBS.
Apple sauce (I often eat this and cherriors when my stomach feels unsettled- am I making a mistake?)
Apples
Graham crackers
Wheat bread (I know you guys say that insoluble fiber is bad (in large doses), but I never feel bad after eating wheat. Maybe its a delayed onset?)
Rice
Bananas (but aren't these bad for constipation?)
Cold cuts (my school cafeteria has extremely limited choices for lunch. They have the disgusting daily lunch menu which I am certain would not be good for my IBS, and they have a place to make custom sandwiches. Most days this year, Ive eaten a chicken, with mayo and mustard, tomato, on a white roll)
Bagels
Raisins
Dates
Fruit juices (I mostly drink fruit juice, not milk, water, or soda- mostly grape, apple, and orange)
Kiwis
Cheerios
Tomato sauce (the last two times I had diarrhea were right after having pasta with red sauce, although in both instances my stomach felt unsettled beforehand. It had mushrooms, onions, paresely, garlic, and a little olive oil.)
Peanut Butter (according to the link syl gave, http://www.practicalgastro.com/pdf/July08/PG_July08SanjeeviArticle.pdf , peanut butter is a tolerable food. I used to eat tons of peanuts/peanut butter before I read not to eat fat for IBS.)
Avocados (like peanut butter, I used to eat these but have stopped because of very high fat content. I know that this is vegetable fat rather than animal fat- is there a difference? I read in a pamphlet about IBS at the gastroenterologist that both kinds of fat are bad, and avocados should be avoided)
On this topic, what is OK to eat if I feel unsettled? Since I was diagnosed with IBS, my main fear is getting diarrhea. I've restrained from eating a lot if I feel like I might have diarrhea. This does not go over well with my mother, who is afraid that I am not fulfilling my caloric and nutritional needs.
Last but not least, I'd like to talk about the mental aspects of IBS. I can remember for the last two years being constipated and having occasional episodes of diarrhea. Since I was diagnosed (my state had worsened, causing me to go to the doctor), it almost feels like I'm causing suffering by the knowledge of my condition, like some sort of evil placebo. In fact, my doctor (pediatrician, not specialist) advised me to 'not worry' about it.
If I know a food is supposed to be bad for me, I might believe I'm feeling bad after eating it (like indulging my sweet tooth). When this happens, I'm reminded of the massive amounts of fat I'd occasional eat even after being diagnosed with IBS. For example, between the period when I was diagnosed with IBS and learned to avoid certain foods, I pretty much ate an entire bag of M&Ms in a day and didn't feel a thing, or I might eat a ton of peanuts.
I'm an extremely thoughtful person, so I feel like I would be prone to hypochondriac-like reactions to foods. On the other hand, this would only apply to me feeling queasy or uncomfortable. When I actually do have an episode of diarrhea, as soon as I start to feel cramps and pain, it is completely inevitable, and feels completely out of my control.
Thanks,
Matt
Print
Remind Me
Notify Moderator
|
|
|
I'm really impressed by your grasp of it all.
First, calcium. You don't have to take a suppplement if you are eating some things with calcium. If you don't think you are getting enough, a supplement should have calcium and magnesium in it to balance the effects (cal- C, mag-D) and you shouldn't have to worry about it (they always have both). You probably shouldn't take the supplement to control symptoms, but a pill with both should not worsen symptoms. Hope that makes sense.
I really understand what you are saying in your last paragraph. I can remember eating alfredo sauce and crab legs and always getting sick right after, BUT in general, I never had drastic reactions to foods. I loved cheese and other dairy when younger and I never noticed anything to make me think it was bothering me. Now I can see it. So was I ok with it then? Nope, I just ate it so often I couldn't see what caused problems. My body chose when to react but it didn't do it 100% of the time.
On the other hand, having stress or mental or emotional factors to IBS is common. I don't feel that the worry about eating a certain food will cause more of a reaction than eating a trigger food unknowingly-- for the most part .
You may have no problems with wheat or fructose. Those are common digestive issues but not 100% for IBS-ers. The fiber in fruit (versus pop or juice) slows the fructose and makes it more tolerable. So cut out fruit juices and tomato sauces/juices for now. They are touchy to the gut- you can add back in later. Otherwise I think your diet is good, as long as, you are eating the insoluble fiber only with soluble fiber and as long as you are eating fattier things like PB with fat free things like bananas. The more low fat calories you eat the more fat can be digested. What that means is when you eat nuts or other things with fat make sure to up the calories for that meal or snack. That is how to do it. Don't eat fat or insoluble fiber alone.
I would recommend the break the cycle diet to get yourself on track. I have a good feeling that you will be able to control your symptoms well. Try not to stress or worry. Peppermint caps might help you stave off any gut reactions.
--------------------
IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
Print
Remind Me
Notify Moderator
|
Avocados
#339892 - 12/23/08 06:58 AM
|
|
|
|
|
Kappy
Reged: 10/09/08
Posts: 852
Loc: Mississippi
|
|
|
You say not to eat Avocados, but I find that Avocados are an excellent source of SF and they are good for you in many different ways. Most of the fat contained in Avocados is Monunsaturated fat, which is a good kind of fat. They are also on the Safe List of SF foods. Go to this web page and see all of the nutritional benefits of avocados. The website breaks down the avocado's minerals and nutrients. Yes there is alot of fat, but eaten in moderation, you should be ok with Avocados. I love them myself! 
--------------------
IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
Print
Remind Me
Notify Moderator
|
|
|
Hi Matt
Thank you for the information about your tests. It might be worth while some time making a follow-up appointment to talk with the specialist just to see what he has to say.
At your age you need to get about 1.3 grams of calcium per day. You should be able to get this from your diet. For example, a cup of calcium fortified orange juice which is also low in fructose or fortified soy milk contains about 0.35 grams of calcium. A small can of sardines contains about 0.3 grams, a bowl of oatmeal about 0.1 grams and 1 tablespoon of black strap molasses about 0.2 grams. There are lots of high calcium foods you can put in your diet to ensure you get an adequate amount of calcium.
The mind-body connection is the general interaction that takes place between the gut (mouth, stomach and intestines) which is sometimes called the second brain and the brain in your head. Compared to your brain your gut is the second most complicated organ in your body. IBS is thought be a result of problems with the way the brain interprets information it is getting from the gut and/or the way the gut sends information to the brain. Here is an interesting article that gives a good overview description of the mind-gut connection.
Some trigger foods may cause problems almost immediately while others can take hours or a day or two. In some people with IBS simply the act of eating - not the food - can cause IBS symptoms. It is quite difficult to tell which foods are causing problems. For example, your body is not capable of digesting soluble or insoluble fiber. Insoluble fiber in whole wheat bread is not digested in your stomach or small intestine. However, in the large intestine live billions and billions of more than 500 different kinds of bacteria. Some of these bacteria are capable of fermenting (another kind of digestion) undigestable food. These bacteria break down some of the insoluble fiber into things your body can absorb and some gases. The gases can cause feelings of fullness, bloating and gas. Similarly, in some people fructose is not digested until it reaches the bowel again where the bacteria break it down which again may cause IBS symptoms including diarrhea, constipation, gas and cramps.
Here are a few comments about you diet that you may want to consider. White bread or sourdough bread is fine but you may want to remove whole grain bread for a few weeks and see if that helps. Cold cuts contain preservatives. And it is a good idea not to eat red meat but things like chicken, salmon and tuna are fine. Try removing juices and other foods that contain grape, apple or pear juices. These juices are high in fructose. It may be okay to eat apples, applesauce and dates but this you will have to determine by trial and error. Kiwi is great! Raisins are dried grapes so you may want to stay away from them for awhile. You might check the ingredients list on the graham crackers and bagels to see if they contain high fructose corn syrup. If they do then look for a brand that does not contain it. Your sweet tooth may be tempting you to eat too much fructose which is the sweetness known sugar
Even though peanut butter and avocados are high in fat by themselves when you eat them with something else the total fat in the whole meal may be fine. The objective is to ensure the total fat in a meal contributes about 25% of the total calories. A simple rule to use is 1 gram of fat has about 9 calories and 1 gram of carbohydrate has about 4 calories. Now, consider a peanut butter and jelly sandwich with 1 tablespoon of peanut butter and 1 tablespoon of jelly. The peanut butter has about 70 calories, the jelly about 50 calories and two slices of white bread about 200 calories. The total calories is approximately 320 calories. The peanut butter accounts for 22% of the total calories which is less than 25% of the total calories for the sandwich. Similarly, you could figure out a meal that has 1/4 to 1/2 of an avocado but contributes less than 25% of the total calories. I hope you math is good because you need it to manage IBS
Matt, keep asking questions. I sure you will eventually figure out how to manage your 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
|
|
|
All I can say is that I wish I had a resource like this back when I was in high school - I was a senior when I first started getting symptoms. I had to learn so much over the years by trial and error, then finally found Heather's book which confirmed my own suspicions and helped me fine tune the things I hadn't quite figured out.
Things still aren't perfect, but I have much more hope than I used to!
--------------------
IBS-A and GERD since 1983
Low FODMAP since 2012
Print
Remind Me
Notify Moderator
|
|
Posts
