Brand New To This: Severity Question
#343871 - 03/30/09 09:59 PM
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Hello! First of all I would like to say I have found the information on this site well presented and though I haven't begun implementing it I can see that it has helped many people.
I have been "preliminarily" diagnosed with IBS. That is to say, I am still being tested, but I have had an unstable digestive environment for about a month now. I am an unusual candidate as I am a male and almost 30. From what I hear it appears most IBS sufferers are female and have it from a younger age.
I guess my main question is this: Just six months ago I drank Rockstar energy drinks loaded with artificial sweetener and caffeine with no ill effect whatsoever. Now on your site I am being told I cannot even drink green tea (which is a huge letdown as I just recently got really into the history and culture of tea) which has about 10% the caffeine in a cup of coffee, and less than 5% of the Rockstars I used to drink. Also, up until my diagnosis I would eat Promax Protein bars, loaded with sugar, whey protein, fat, etc. as my staple food. I had at least one nearly every day and some weekend days when I had no food and was too lazy to shop I would subsist on them and eat 4-5 a day - with NO ill effect. That was four weeks ago. In fact, before my diagnosis but after my stomach problems started (which I believe was caused by a stomach bug but who knows) I continued to eat them and though of course I had problems, they weren't exacerbated by the bars, and I have been without them for two weeks now and am no better off than before.
In summary: how is is possible for my system to so radically change in such a short period of time, where just recently I could eat pretty much anything with no more ill effect than a normal person, and all of a sudden my digestive system can now no longer function unless I adopt the draconian (and I say this with love, I am well aware of the amount of work put into the diet and how many lives it has improved, but one must admit compared to eating everything it's kind of strict) diet plan laid out here. I know the experts here are not doctors and scientists, but frankly I feel I may get a more sensible answer here because of that.
Finally, my assumption is that IBS, like anything, is a condition of degrees. My further assumption is that the active participants on this board likely have it leaning to the more severe side. This may be just wishful thinking, but is it possible that many with IBS may benefit from this diet but could survive, aside from the occasional binge/stress fueled "flare up", without negative effect by going off the track a little bit?
Thank you so much for your help and I wish all of you the best!
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First of all, I drink green tea without any problems. I prefer rooibos tea, but that is another story.
Second, I was able to eat crap my whole childhood without any problems at all. I got sick after having a severe food poisoning. That triggered IBS for me (I have been properly examined so I know that it is IBS that I have). My doctor told me that it was quite common that IBS would occur after food poisoning or a bad stomach flu.
Third, I think you have to find out for your self what you can and cannot tolerate. But you should wait until your doctor gives you his final word, so that you know it is IBS without a doubt. If it indeed is IBS then I believe you will have great benefit from this site and Heathers books. I always have her advise in the back of my head when I make any food-related desicions. Hope this helps 
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Thank you for the prompt reply. I guess it really can happen just like that - however, that makes me wonder why it can't go away just like that as well. I guess life just isn't fair that way.
I also enjoy rooibos, but I was concerned about it being a trigger since it correlated (I know correlation \= causation) with a gassy and painful episode.
Just now, after reading this board (and on an empty stomach since about 5 hours ago) I had a half avocado and some packaged tuna in water. I also had about 12-16 oz of peppermint tea (pure peppermint leaf purchased from a tea site, not a name brand blend or anything) and about 15-20 minutes after that I had some pretty bad abdominal pain. No gassiness, just pain. It was bad enough I couldn't concentrate on the phone. Now, that seems to be ok by the diet, was the tuna my mistake? It's not on the cheat sheet, but I thought fish was ok. Peppermint tea - at least THIS kind, seemed to make things worse, not better. In contrast, my last meal, at 5:00 PST, before I found this website, was a Fiber One fiber bar (I believe all insoluble, no soluable, plus oodles of sugar), a banana, and some trail mix with almonds, peanuts, raisins, peanut butter chips, and m&m's and after eating that I was fine. In fact, I felt normal until after this recent small meal. Can anyone suggest a reason? Could my previous bad meal have just taken 5 hours to effect me?
Thanks!
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Well I can say that all of what you ate sounds like triggers to me.
The basis of my diet consists of lots of white bread.After that I can eat pretty much anything.
My IBS started after the birth of my second son and always flares due to stress.Funny thing is...it hits me 6 months later.
My suggestion to you woul dbe to follow the diet now and see what happens.I would also take a probiotic like acidophilous or even activia yogurt.Your stomach bug could have altered the balance between good and bad bateria.
So the peppermint tea was probably ok but for me I can't drink it or reg tea.I drink Rooibos with no problems.
If you had a SF base in your stomach such as white bread,white rice,pasta or potato...the tuna and avacado may not have been such a pain.
The trail mix again would have killed me.Banana ok but lots of people can't do them on an empty stomach.
The fiber one bar I know nothing about but by the sounds of it , it may have glucose fructose as an ingredient?? That could also be a trigger.
It won't take you long to figure out your triggers if you try the base diet for a few days and introduce your reg favs slowly.
Yes IBS sucks but it isn't the end of the world.Somedays are good some are bad and here you will find all degrees of severity.Some of us have it at a managable level while others are still struggling.The support of others going through the same thing will likely help you plenty.
finish with the tests just to make sure but it really won't hurt for you to try eating the EFI diet.We all tweak it to suit our own comfort levels so you will find the right balance too.
Good luck and I hope that helps a bit.
Chris
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IBS-D since 1999...mostly stable..i do cheat too.Bad me.
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Welcome to the board,
Generally speaking IBS occurs in 5-10% of the population in most countries and it occurs about 1.5 more frequently in women than men. The frequency of onset is highest in the third and fourth decade of life, however it may occur at any age. In about 50-80% of the cases it is never officially diagnosed.
Many IBSers recall the day when the symptoms first occurred. I remember when it happened for me. IBS remission can occur but some small studies have shown that once diagnosed more than 55% of individuals still had IBS after 7 years. One study suggested that chronic ongoing life stress may precluded remission. IBS may also be precipitate by a GI infection. Post-infective IBS (PI-IBS)develops in 3–30% of individuals with bacterial gastroenteritis. About 65% of individuals with PI-IBS recover within 3-5 years.
You can read more about the etiology, epidemiology and management of IBS in the references below.
It is possible that the more aggressive one is in managing IBS symptoms from the onset the higher the likelihood of remission or that it will be less bothersome later in life. This is just a hypothesis since there are few if any studies to support this notion.
Good luck
Reference
Spiller, R., Q. Aziz, F. Creed, et.al, 2007: Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut, 56, 1770-1798.
Spiller, R Post Infectious Irritable Bowel Syndrome. The UNC Center for Functional GI & Motility Disorders
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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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My IBS, often, takes 1-2 days to flare up from something I ate or overeating. Sometimes, it's immediate like with eggs or oily food I'm in pain as soon as it's registered in my stomach. I ate at a Mexican restaurant for the first time not too long ago and ate the Spinach Enchiladas; they sounded like a good choice at the time, but after the first few bites, my colon started kicking me for putting oil in my body.
Anyway, you definitely need a soluble fiber base for almost every meal. Do you normally experience diarrhea or constipation? I am C, so a little more IF does me good, but those fiber bars, trail mix, avocados, and tuna in oil usually kill me. I can eat avocados if I have some kind of SF before hand, but avocados are very fatty (even though it is the good fat). I ALWAYS get tuna packed in water.
My suggestion, like the others said, wait for all the tests to rule out any other illness/disease, and then start this diet.
It will be hard to rule out foods at first, but you will be able to tell what triggers your symptoms the longer you are on it. and NEVER eat IF or high fat foods on an empty stomach!!!! I hope that helps!
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IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
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Hi there and welcome 
I have to be honest. Most people have figured out there triggers food-wise, but not I. Something that may or may not have bothered me one time, will be different the next time. There is no rhyme nor reason to it. 
However, I have been symptom free for about two months now, all since beginning the hypnosis CD's. So, that tells me, at least for me, mine is mostly stress related.
I have incorporated many items back into my diet with no problems at all. That was not always the case. I could never get a handle on what was affecting me and what was not, until I realized that food was not the issue for me.
My IBS was triggered by a very stressfull time in my life in 2007. Although, being C most of my life, I believe I have had IBS for a very long time, and the stressful time just flipped it to D. It seems for me, as long as I do the CD's, meditate, walk 45 minutes every day that I can, practice yoga, and follow a vegan diet, I have no symptoms whatsoever.
They took my mom to the hospital by ambo last Sunday night. I got the call @ 2AM. In a panic, I flew to the hospital, and basically spent the night there for 4 days straight. I figured my IBS would be out of control. But no, it wasn't. I continued my program, even though I was tired (and fatigue is a trigger for me, also), and I still had no symptoms whatsoever. So, go figure.
All I can tell you, is that everyone is sooooo different with this disorder. I personally think it is best to get a handle on it as soon as possible. After all, you are young, and you want to get control of it now, so that you can live a happy and pain-free life.
HTH
Lynn
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Thanks to everyone for the help. I am trying to begin following the diet even if I don't have IBS (but at this point, with many of the more serious stuff ruled out, what else can make your digestive system not function for five weeks?)
I have a follow up question. First, to answer the question of one of the repliers, this all began five weeks ago with the onset of D. However, it was nothing special, I have unannounced D about once or twice a year, and it basically clears up the next day - I always thought I just ate something undercooked or whatnot. This time seemed to be heading in that direction, too. I had a normal weekend after the D (it began on a Thurs) and felt fine until Tue of the next week when the D came back for just that day, and mostly reduced. Since then I have exhibited numerous problems including, most commonly, undefined abdominal pain, gas, bloating, nausea (more at the beginning - first two weeks - not so much now) and alternating between loose and C, but no technical D since the outset. My belief is, since the week following the D was super stressful at work, that I may have had a bug and that combined with the stress developed me into IBS or whatever I have now.
Until last night I had never heard of this diet. Both my GP and GI told me to not change my diet except to add Metamucil and my GI gave me a 7 day sample of Align. I cannot directly attribute the waxing and waning of my symptoms with "trigger" foods (e.g. I ate high sugar high whey chocolate protein bar and symptoms didn't worsen, or I would consume things that more closely approximated the diet (bananas and applesauce for two straight days) and that didn't noticeably improve them.)
I also reported side effects that didn't seem IBS'y, like waking up in the middle of the night with the shivers once which lasted a half hour but I wasn't cold. Waking up another night with out of control muscle spasms in my midsection, and a couple nights of not being able to sleep, but neither Dr. seemed particularly concerned (my GI asked me to come back in a MONTH.)
So, whatever I have, it's not being taken seriously by my doctors (or they just don't care), but both have made me take blood and stool tests (the GI results haven't come back yet, the GP's said I was fine - he was more concerned about my triglycerides and asked me to take fish oil) and pretty much ended it there.
So, there's my backstory. As per my first note, prior to 4/5 weeks ago, I could eat a whole chocolate cake or pizza if I wanted to with no ill effect. I guess first of all, since this forum is filled with actual helpful IBS patients, is to ask: Do my symptoms sound like yours? You aren't doctors, but do you agree that barring something more serious like Chrons (which my first tests said no) that what I am describing sounds like your IBS? It's more pain, discomfort, urgency (like I feel like I am going to have D, I freak out, but surprise, I don't) based than actual C and D most of the time.
Finally, (and I thank you for reading this far) today I tried the diet created on this website. I have a busy job with little time to shop so I just worked with what I had. Breakfast was applesauce and pretzels, and I felt great all morning, no problem. I was pretty geeked out on this diet and really happy. Then I got a taco salad for lunch which I modified to remove the non-diet ingredients (cheese, sauce, taco chips) and only ate the sourdough roll (first) then the chicken (it was lean white chicken, not fried or fatty), half an avocado, and a few black beans. However, only about 1/3 into it I had a terrible feeling in my stomach, I actually felt a little (very minor) dizzy, and I notice my stress response turned on, my head got hot and sweaty, I felt very uncomfortable. I didn't eat anything else all day since then, yet my stomach has remained tight and uncomfortable feeling. However, this has not yet led to D or anything like that.
Does that sound right? I really tried to adhere to the recommendations. Is it something that could have been brought on by things I ate in previous days, but just putting food in my mouth today triggered?
Thanks again! You are all so nice, and I can't imagine a source of information more useful than an internet forum filled with experienced people - even a doctor can't match that!
PS: SYL - I'm a logical kind of guy, and love numbers and science, so thank you so much especially for your statistics!
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Urgency was my biggest issue for awhile. I never knew what kind of surprise would greet me...usually nothing. 
Believe it or not, I have also had the shivers. I used to think I was coming down with a bug, but then I would get a bit nauseous and bloated, so I would get under some covers and the next day, I would be fine. I never quite understood that!
It sounds to me that you might have a bit of anxiety going on there. This can affect your gut and make you feel dizzy, and hot/sweaty. Have you ever suffered from panic/anxiety?
I hope you find your answers and let me say without a shadow of a doubt...doctors can be a#@$%. If you don't find your answer from one, find one who will listen to what you are saying. After all, you are paying for it, or at least the co-pays, deductibles, and premiums.
As I said in a previous email, sometimes there is no making sense of this disorder. You just have to make sense out of something that makes no sense. 
Take care
Lynn
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Yes, your symptoms do sound alot like mine. I am no longer very constipated, I usually have a bowel movement once a day or every two days. HOWEVER, I still get the bloating, gas, distention, horrible abdominal pain, urgency, dizziness, and nausea. I used to have a flat belly, but all the bloating has stretched it out so.
Yes, it could be possible that you have eaten something in the last few days that could cause this, and eating something today (or in the now) can trigger a flare up from what you have eaten previously. The avocado is very fatty, and the black beans are a caution with so much insoluble fiber (IF). If you want to eat avocados and beans, they really need to be either pureed (guacamole homemade) or cooked to a pulp (black beans) Most of the time, cooking veggies is the best way to protect the colon from freeking out. I love avocados and eat them sporadically, but sometimes, I just can't eat them.
Keep the diet up, I know it's boring, but you have a better chance of controlling your symptoms by following it for a long period of time. This doesn't just go away over night. You might also want to try more starches and not just bananas and apple sauce, some people can't handle bananas and apple sauce, so it might be a trigger for you.
The whey protein bars could definitely be a trigger. I know what you are saying about it didn't trigger anything, but if you ate it Sunday, it could be what caused a flare up on Monday or Tuesday. I used to eat Fiber One bran cereal, I loved it and ate it almost every morning. I didn't think it could possibly be a trigger, but when I stopped eating it, I definitely got somewhat better. There were still other triggers, but it was one of my main ones. It's full of IF.
I hope that helps!!! If you have any other questions, please ask!
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IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
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wow kappy you sound so smart. Hey I was wondering if you workout or think you need to lose weight. I know some people on this site talk about being underweight..but I need to get in shape and lose 20-30lbs to get to where I want to be,flat stomach and toned good. really want to get into home fitness.Have u read my post on the fitness and lifestyle board? anyway,do u have myspace?
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I'm sorry, I don't have Myspace. I used to, but I can't get on there at work (they blocked it) and I don't have the time after work!!
Thank you for the "smart" comment, I don't get that one too often!
I love to work out, i actually would like to lose about 10 more pounds, but I'm on a fairly new-to-me medicine, and it makes it really hard to get up in the mornings like I used to do. I used to get up at 4:30 or 5 and exercise for an hour before getting ready for work. Now, it's so hard to get up, I barely have time to get dressed. After work, I'm so exhausted it's hard to find time, but I know I have to start back exercising soon, especially with the wedding in 6 weeks! I enjoy the home exercising, too. I have a bunch of DVD's that I love to dance and workout too. I will check out your post on the fitness board.
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IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
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Let me get this straight: you never had digestive issues more than once a year or so at all, until a few weeks ago and now you possibly have IBS? I am not used to the idea of IBS coming on suddenly and really being IBS and not something else. I have had it pretty much my whole life. Anyway you have had it just a few weeks and wonder how you used to eat foods that are triggers without having symptoms then, is that right?
First you, and many others, don't have a clear idea of how IBS and the IBS diet work. The triggers are foods that most likely, odds are good, chances are, will cause digestive problems. They are known to cause gut reactions and for various reasons can trigger the gut to behave badly. Therefore, the best chance an IBS sufferer has is in treating the irritable gut with kid gloves and giving it as little reason as possible to react. That is why the triggers are to be avoided. People always talk about being able to eat this one or that one, but what that does is set the gut up for irritability and our only chance, being IBS is incurable, is to prevent attacks/symptoms as best we can.
There are definitely levels of severity. If stress or some other condition brought on IBS for you, your digestive life is now changed and what you could eat in the past is possibly not tolerable anymore. When you really get going on the IBS diet you find it isn't as restrictive as you or many people think. Your IBS is so new that you cannot be sure how touchy your gut will be and so your best chance for health is to get into it and follow the diet without pessimism and complaining. If you stabilize you can then add back foods that you may be ok with. Don't start with a bad attitude because it makes it way harder on you. Instead think about how you could lick it quickly and be normal again (unlike us chronic suffers).
Example:
My boss's husband was diagnosed with type 2 diabetes last year. He now is watching his diet to stay healthy as you would expect. He has to avoid the foods that probably 2 years ago were fine for him. They didn't cause a diabetic attack back then but now they would. See what I mean?
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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!
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Thanks to everyone for all your help. I just went to the store and bought a lot of starches. I kind of chuckle at the irony of being forced to eat foods I felt forced NOT to eat before because of the stigma attached to high glycemic carbs. Although, when I note both of my parents are diabetics, well, it's not that funny, but rather scary.
I'm a bit bummed to hear that people who have been dealing with this for awhile and are following the diet correctly are still having symptoms.
I likely have anxiety, but related to this condition, not an external factor. I got really stressed at work the week this started and now knowing what I know (that I caused this condition by my stress) I wish I had just taken the dang week off.
I have some more questions though, if that is ok: One of the symptoms I did not have in the beginning (the three weeks that started with D and where I was eating whatever) was gas and bloating, and now I have that. I have changed a few things though. I use Align (today was day 8), I take a teaspoon of berry blast metamucil every afternoon with about 12 oz of water (same time as the Align) and of course I have begun to eat more in line with this diet. I'm wondering if the gas and bloating isn't being caused by my condition, but by one of the "solutions."
Also, I know chocolate is out, but what about gummi candies? How about goldfish crackers? They supposedly have cheese, but if you look at the nutrition panel they seem not so fatty and with no insoluble fiber. I also got an "extra fiber" oatmeal today that was a trade off. Regular oatmeal has 3g fiber 2 insol 1 sol. This has 10, with 8 being sol, so it seems perfect, buy they didn't have plain, so I got cinnamon swirl, which has more sugar, and some sucralose (splenda, I think), but it's way down the ingredient list and plain natural sugar is much higher. Was that a good choice or a bad one?
I'm thinking of buying the Acacia and the peppermint caps (since peppermint tea seems to hurt more than help me) to support this site and community. The peppermint caps say they have fennel in them, too. Does that mean I don't need the fennel tea? Heck, even the hypnosis tapes sound awesome, but I'm going to save that for later down the line if nothing else works.
Also, a coworker told me today (male, late 30's) that he was diagnosed with digestive symptoms indicative of IBS (his physician told him there was no technical IBS, but a whole bunch of similar digestive problems where the brain failed to communicate correctly with the gut that fit under the umbrella of the term IBS) and his physician prescribed a low dose (75mg) of an anti-depressant called Nortriptyline. He claimed it was non addictive and virtually side-effect free, and was intended for sufferers of severe depression but had an off label use in a number of cases, one being IBS. Anyway. this co-worker, after three months of abdominal pain and discomfort, began taking it and said he was symptom free in a month, and though he has a very strict diet these days, it's not as strict as the IBS diet (he's vegetarian, but he does consume dairy and he drinks a cup of coffee in the morning and black/green tea in the afternoon). He has been cool for two years now, and is requesting to lower his dosage from 75-50mg. Has anyone here tried this and had success/no success with it? I'm a bit nervous to take a drug intended for severe depression when I don't even have minor depression, but he didn't either and it worked like a miracle for him. I'm going to ask my GI specialist, but figured you all are battle scarred veterans and have likely tried everything.
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I will answer one of your questions. Align may possibly be the culprit with your gas and bloating. It states on the box that you may experience changes in bowel habits for a couple of weeks. I am also on Align, and after I got through the first week, the bloating subsided. It does work well for me.
Don't put more stress on yourself by blaming yourself for causing your condition. It may have happened even without the stress. Just know, that for some people, as myself, stress is a very big trigger.
I will leave the diet part to the others on this board.
Be well,
Lynn
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Bloating and gas are a common IBS symptom. An temporary increase can occur from the Align or even from an increase fiber intake. The berry burst metamucil has artificial sweetener and food coloring which for some can be a problem. It took me a long time to figure out that some artificial coloring and flavors where causing me problems. It is best to stick with supplements and foods that don't contain unnecessary added ingredients.
Presumably you bought the Quaker oats cinnamon swirl instant oat meal which has sucralose and guar gum to increase the soluble fiber. It might be best to stick with the plain oatmeal that has no added ingredients, however, it does take 15-20 minutes to cook. I have it every morning for breakfast.
Regarding candies you may want to makes sure the candies you buy don't contain artificial food coloring or sweeteners. Also, make sure they don't contain high fructose corn syrup or added fructose which can cause increase bloating, gas and D.
Low doses of antidepressant particularly tricyclic antidepressants such as nortriptyline have been used for some time to control IBS pain. The reference below has a good section (2.15) on the use of antidepressant use for IBS. It says "Tricyclic antidepressants (TCAs)and selective serotonin reuptake inhibitors (SSRIs) are more effective than placebo at relieving global IBS symptoms, and appear to reduce abdominal pain. There are limited data on the safety and tolerability of these agents in patients with IBS (Grade 1B)." The Grade 1B indicates that a strong recommendation (1) for their use with moderate (B) amount of research evidence to support the recommendation. I believe generally speaking these drugs only help with pain and not other IBS symptoms.
Reference
Brandt, L. J., W. D. Chey, et.al, 2009: An Evidence-Based Systematic Review on the Management of Irritable Bowel Syndrome - American College of Gastroenterology Task Force on IBS. The American Journal of Gastroenterology, 104.
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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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I forgot to mention in my last post. Stick with the Align and give it a fair trial before stopping. I almost stopped it because of the gas/bloating, but after the 1st week it got much better. So give it some time, and then evaluate if you need to continue it. For me, it has actually stopped the gas and bloating.
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I take Elavil a low dose antidepressant. I started in February and it's been almost two months, and (knock on wood) I haven't had a flare up in over a week now. I probably shouldn't have said that now, but hopefully, I have found my saving grace. I don't mind taking drugs if it will help me.
Anyway, I used to eat the extra fiber oatmeal, it was a bad decision for me. Regular Quaker oatmeal old-fashioned is the only one I can tolerate. And it actually has 4 grams of fiber 2IF 2SF and I add the Acacia fiber to it. I suggest cutting out ALL artificial colors, sweeteners and flavors. After doing that, I saw a big improvement.
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IBS-C, Gas, Bloating, HURTING!
I'm married and it's so wonderful!
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