IBS-C questions re: SF and IF and laxatives
#356910 - 03/23/10 07:35 AM
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eisaachsen
Reged: 03/20/07
Posts: 21
Loc: northern VA, USA
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I've been on the diet for several weeks now and I've been able to get myself up to almost 1 Tbsp of acacia 2x/day. I only add 1/2 tsp every 3 or 4 days depending on how I feel. Up until Sunday I felt pretty good, much better in general than before starting the diet. However for the last two days I have felt bloated and am not having complete BMs, plus having uncomfortable gas, and the BMs I do have require straining. I haven't been eating anything different, plus I take as much IF as I can with veggies and fruit, but adding extra, for example flax seed, really causes me a problem, so I avoid supplementing with flax or any other IF. I also take 2 doses of Miralax per day, and have for a long time, even before starting the diet. I figured that eventually all this fiber will cause me to swing toward looser more frequent BMs and then I can slowly reduce the Miralax. I have two questions. For those with IBS-C who used to take a laxative of some sort, is this how it works? I'd really like to be able to ditch the Miralax because I think that is responsible for some gas and bloating. Also, I'm afraid that I am not getting enough IF, but with all this SF I take, plus the mostly SF food I use to "pad" the IF I get in fruit and vegetables, I just cannot eat any more! I am full! Have any other IBS-C's had this problem?? Also, I suspect a level of fructose malabsorption, so I do not eat alot of fruit at one time. BTW I drink so much water I feel like I am going to float away (~1 1/4 gallons per day).
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IBS-C, gas, bloating
female, age 48
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You say you suspect a some fructose malabsorption and you don't eat a lot of fruit. What fruits do you eat?
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STABLE: ♂, IBS-D 50+ years - Science of IBS
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I've given up on pears. Cherries, blueberries, strawberries, bananas. I eat a fair amount of them, I just try to not eat too much at once.
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IBS-C, gas, bloating
female, age 48
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Be careful of cherries which like pears, plums and prune contain sorbitol which in itself can be a problem. If you have troubles with the excess fructose in fruits sucha as apples, pears, grapes, mango and melons sorbitol exacerbates the effects of excess fructose. Sorbitol is also sold as a laxative 
Banana and most berries are fine.
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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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Is it a good idea to get tested for fructose malabsorption or is it usually diagnosed with response to dietary changes? Does the test indicate the degree of the malabsorption?
Regarding the cherries, I guess the Cherry Chocolate Pound Cake from Heather's book should be suspect, too. And maybe I should try the no-wheat route...here we go again, grasping at straws.
I'd still like to hear from IBS-C's out there. I just can't believe I'm backed up even though I'm taking 2 doses of Miralax per day. I have to get some relief, so I guess I'll have to back down on the SF. Or try a different one.
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IBS-C, gas, bloating
female, age 48
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Unfortunately, the test does not tell you the degree of malabsorption. It only tells you if you are a fructose malabsorber at the level of 25 grams.  The simplest test is to remove excess fructose foods from you diet for a couple of weeks and see how it goes.
You could also restrict your consumption of wheat products to about the equivalent of two thin slices of bread a day. Wheat is high in fructans - long chains of fructose molecules - that are indigestible. When they reach the colon there are lots of bacteria there capable of fermenting it quickly.
As for SF and IBS-C there have been some reports in the research literature that you may need to get the amount of SF plus dietary fiber up as high as 50 grams a day before satisfactory results are seen.
Good luck.
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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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as you increase soluble fiber here http://www.helpforibs.com/news/newsletter/060705.html#askheather that might help a bit.
You're right, this can be done, but it can also be a very slow and steady process.
- H
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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!
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Wow. 50 gm. I'm not disputing you read that, but if you can point me to some research literature that talks about that it would be great, just so I can learn more. I'll look myself, too.
So at 2 gm SF/teaspoon for acacia, that would be 25 tsp or about 8 Tbsp/day. Or 100 fibercon pills! Yikes! Of course I do realize that the food eaten also adds to the SF you take in, so you can reach 50 gms without taking that much of a SF supplement. I was shooting for 5 Tbsp, but it's good to know that I might still have to go further than that. For right now I have to back off a bit because I feel so rotten. I will also try the low fructose/low fructan route. I've printed out the research article on fructose malabsorption and I plan to read it more carefully when I have time.
I'd still love to hear from any IBS-C's that have gotten better with the SF therapy and to find out how much they ended up having to take to make a difference.
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IBS-C, gas, bloating
female, age 48
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I knew I should have noted that reference when I was reviewing the fiber/IBS research literature last week. I will see if I can dig it out.
I am not suggesting you take 50 grams of soluble fiber supplement (SFS). Your total daily dietary fiber intake may need to be as high as 50 grams per day including the extra you may get from taking a supplement. In this study they used 30 grams of psyllium (ispaghula husk) per day in addition to the fiber in the diet to relieve C. The total dietary fiber intake would have easily been above 40-50 grams per day.
The minimum recommended daily intake of dietary fiber in North America is 20-30 grams. The WHO recommends 27-40 grams per day. Many cultures consume much more than 40 grams of dietary fiber per day alot of which is insoluble fiber which sure won't be good for IBSers.
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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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