Requesting advice please.
#351690 - 11/05/09 04:35 PM
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Mohammed
Reged: 10/25/09
Posts: 8
Loc: London, England
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Hi all. I have been having some problems with my stomach for the last couple of months. The doctor suggested I may have a mild form of IBS. So, I decided to follow the IBS cheat sheet, just in case- I cannot afford to take another week off work (my symptoms were like IBS-D).
Had a few queries:
1) Most fruits are on the insoluble fibre list. So, if I want to have e.g., oranges or grapes, I would need to eat them after a main meal. This is difficult if I want to have a fruit snack during afternoon breaks, or if I already had vegetables with a meal. In fact, my diet is lacking in fruit, and I am worried about low vitamin C intake.
2) I am also worried about not getting enough fat in my diet- can anyone recommend good fat sources. And how can I tell if I am getting my minimum amount?
I would really appreciate any advice.
Many thanks
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Mohammed , what are your exact symptoms, just d or do you have pain or discomfort. What tests has your doctor done?
hopefully others will give you some advise on the diet aspects.
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My website on IBS is www.ibshealth.com
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It started on the 26th August 09, when I had diarrhea once. Since it was the fasting period (Ramadan), I was eating less and it came back very occasionally as semi-diarrhea. All I did was eat bland foods for for the remainder of Ramadan. After Ramadan, I was fine for a couple of weeks, eating everything except hot spicy foods. Around the beginning of October, I got D again (7 times in 24hrs), and took a whole week off work to recover from a semi-starvation diet. Doctor said it could be bug, but was unlikely (since it was a short period of time since the Ramadan problems). She thus suggested I may have mild IBS. So, I have been trying to follow the cheat sheet for the last month. I do not eat hot (as in chilli) foods or chocolate.
My symptoms: in the beginning of following cheat sheet, I used to get bloating after eating, especially after lunch.
The bloating is more or less gone now, but do get flatulence after lunch sometimes.
Strangely enough, I get no problems at all after breakfast, which consists of goat's milk with Rice Krispies cereal, white bread toast and tea.
So, some may say I do not have IBS, but I am being careful as I cannot afford another week off work, and besides, my diet is now relatively healthier compared to my previous normal diet.
Another thing; chocolate seems to cause me problems- when I was having problems during Ramadan, and I took even a little chocolate, gas immediately evolved in my stomach. So, have not had it since then. I could eat all the chocolate I wanted before these problems.
Apologise for the long post, and thank you and all for the attention.
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Mohammed, do you get pain or discomfort?
So just bloating that has gone away and D as far as symptoms?
Have you been back to a doctor again?
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My website on IBS is www.ibshealth.com
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Hi,
I do not get any pain. If I do get anything, it is gas, which normally happens after lunch. When this is released (either way), I feel fine. Such things did not occur before I had this bout of problems. I got blood tests done to rule out other serious diseases, and fortunately, they came back good.
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Have you had any other tests done, such as a colonoscopy, endoscopy or faecal occult blood test? These may be useful in ruling out other disorders such as coeliac disease.
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kat
IBS-A + gas and bloating
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I have not had the tests you have mentioned- only blood tests. Apparently they are sufficient to rule out most diseases.
The doctor said it MAY be mild IBS. Thus, I am being cautious. Even if I don't have IBS, I think there is no harm in following the IBS diet- it has been in a lot of ways beneficial- my diet included much biscuits, caramel bites, doughnuts and chocolate. Except crackers and low fat biscuits, I don't eat such things now, and I eat veggies now. I also take my own food to work rather than buying sandwiches, which means I know what I am eating.
I have just had problems in planning- like when to eat citrus fruits if I have just had a meal including IF veggies, or if it is okay to have a small orange a few hours after lunch.
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If you don't get any pain or discomfort, its not IBS, because that is part of the criteria. There is functional D and some other functional disorders, like functional bloating however.
No one can diagnose you here so its important to work with a doctor on it. Stool tests could be of some help and are simple. Celiac is one condition, if you have d as is SIBO.
It still maybe possible you have some kind of bug perhaps.
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My website on IBS is www.ibshealth.com
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sometimes a big switch in diet itself can cause issues, if for example you start eating a lot of fiber, when you weren't before.
ON the lunch, how soon after eating do you get the gas and D? 15 minutes or an hour for example?
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My website on IBS is www.ibshealth.com
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After lunch, if I do get anything, it is only gas, but not D. Have not had D since that large episode over a month ago. On days I get gas, it is usually within the hour after lunch.
Few days back, I got some gas- for a minute, I thought I felt nauseous, but was then okay after releasing via throat.
Regarding the doctor, she seems unsure herself. Blood tests were good. I forgot to mention- I did have one stool sample done, but that was during the Ramadan problems (2 mnths ago). They found nothing. What I will do is see how it goes for some more weeks, then think about going to the doctor again.
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Thanks for the heads up on SIBO- never heard of it till now. Will ask my doctor about that. Regarding bug- can a bug really stay in the stomach for 1 month, 2mnths? Sounds strange.
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Some bugs can stay in the gut for years.
Stool testing can tell the doctor a lot, including certain tests that look for inflamation.
Fecal calprotectin in differential diagnosis of irritable bowel syndrome.
Article in Chinese
Li XG, Lv YM, Gu F, Yang XL.
Department of Gastroenterology, Peking University Third Hospital, Beijing 100083, China.
OBJECTIVE: To assess the value of fecal calprotectin as a non-invasive screening biomarker in differential diagnosis of irritable bowel syndrome compared with fecal occult blood test (FOBT), erythrocyte sedimentation (ESR) or C reactive protein (CRP). METHODS: Subjects were a total of 240 persons, including 60 patients with irritable bowel syndrome, 60 patients with colorectal cancer, 60 patients with chronic inflammation, and 60 healthy controls. 5 g fecal samples were collected within one week of endoscopy or before surgical operation. Fecal calprotectin was measured by an enzyme-linked immunosorbent assay (ELISA) kit in spot stool samples. At the same time, FOBT was measured; the results of ESR and CRP in hospital lab were collected. RESULTS: The median of fecal calprotectin concentrations were 12.21 mg/kg and 15.36 mg/kg in IBS and healthy controls,respectively. There was no statistical significance of calprotectin concentration between patients with IBS and healthy controls (P>0.05). The median of fecal calprotectin concentrations were 159.00 mg/kg and 466.00 mg/kg in colorectal cancer and chronic inflammation respectively. There were statistical significance between patients with chronic inflammation, colorectal cancer, and others (P<0.01). The maximal calprotctin concentration was with chronic inflammation; the medium with colorectal cancer; the minimum with IBS and healthy controls. When the cut-off limit was set as 50 mg/kg of fecal calprotectin, the positive rates of colorectal cancer, chronic inflammation, IBS and healthy controls were 85.0%, 91.7%, 10%, and 5%,respectively. Fecal calprotectin was much superior to FOBT, ESR and CRP. CONCLUSION: Fecal calprotectin as a non-invasive screening biomarker in the differential diagnosis of IBS and symptomatic chronic large intestinal organic disease was better than FOBT, ESR and CRP. It was simple, inexpensive, repeatable and no-invasive. It can be used as a biomarker in exclusion from related organic diseases before the diagnosis of irritable bowel syndrome.
PMID: 16778979
Inflamm Bowel Dis. 2006 Jun;12(6):524-34. Related Articles, Links
Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease.
Konikoff MR, Denson LA.
From the Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
ABSTRACT:: Calprotectin is an abundant neutrophil protein found in both plasma and stool that is markedly elevated in infectious and inflammatory conditions, including inflammatory bowel disease (IBD). We conducted a systematic review of the published literature regarding fecal calprotectin to evaluate its potential as a noninvasive marker of neutrophilic intestinal inflammation. Reference ranges for fecal calprotectin have been established in healthy adults and children, and elevated concentrations of fecal calprotectin have been demonstrated in numerous studies of patients with IBD. Fecal calprotectin correlates well with histological inflammation as detected by colonoscopy with biopsies and has been shown successfully to predict relapses and detect pouchitis in patients with IBD. Fecal calprotectin has been shown to consistently differentiate IBD from irritable bowel syndrome because it has excellent negative predictive value in ruling out IBD in undiagnosed, symptomatic patients. Fecal calprotectin also may be useful in determining whether clinical symptoms in patients with known IBD are caused by disease flares or noninflammatory complications/underlying irritable bowel syndrome and in providing objective evidence of response to treatment. Although more studies are needed to define fully the role of fecal calprotectin, convincing studies and growing clinical experience point to an expanded role in the diagnosis and management of IBD.
PMID: 16775498
The sibo testing is harder.
Certain tests are more accurate then others, I believe it is the hydrogen breath test as the most accurate at the moment.
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My website on IBS is www.ibshealth.com
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If you don't have d, is it just gas that is a problem?
You might have thrown your gut bacteria out of whack by fasting. You might try probiotics to see if that helps with the gas and normalizing your gut bacteria.
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My website on IBS is www.ibshealth.com
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Yes, it is just gas that is the problem. Fasting has never before caused me problems- I have been fasting every year for around ten years now. Strange.
I will give the probiotics a try- do you have any suggestions for products except yoghurt? Could probiotics make situation worse? I have always been wary of trying them.
How about pre-biotics?
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Really shouldn't make things worse, occasionally it may at first as bacteria change. But they are changing all the time anyway for varied reasons. They have been shown to help gas though for some people.
It may or maynot have been from fasting, but its possible.
I don't think its a bug if all you have now is gas and no d, for the most part d and nausea is part of getting rid of a bug. But perhaps still.
You might also try something like beano maybe for the gas or activated charcoal.
On the proboitics there are many different kinds. Digestive Advantage, align, activa yogurt, and many more.
Controlling Gas
http://www.aboutibs.org/site/about-ibs/management/controlling-gas
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My website on IBS is www.ibshealth.com
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Shawn, thank you for your advice over the past few days. You have been great.
Thanks to everyone else who contributed.
May have more questions regarding diet later.
Take care, all.
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No Problem and good luck with it and let us know how it goes for you.
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My website on IBS is www.ibshealth.com
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