(fructose mal.) Is it just me, or....
#320364 - 12/10/07 01:05 PM
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Jordy
Reged: 08/12/06
Posts: 2095
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does this fructose intolerance theme seem to be chronic lately? Are we all just scaring ourselves from other people saying they are FI? I don't remember it being so common before.
I know some of you know for sure, but often times I worry that the boards put unwarranted fears into our minds....restricting our bodies out of more nutrients than necessary.
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IBS-C with pain and bloat
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I've always had problems with fruit in general - so it's not like fructose intolerance put a new idea in my head - just a name. It sort of validated why I always had such an awful time with fruit - especially fruit juices.
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IBS-A since age 12, and fructose sensitive; with the exception of my pregnancy, have been following Heather's diet since Nov. 19, 2007.
Taking 12g of Acacia per day. Relatively stable since March 2008!
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I think some people probably really do have FI, but I don't think it's the cause of everyone's IBS. However, I understand when someone has had IBS for a long time and nothing seems to help and they are trying to find answers/help. It's probably a good thing to rule out FI. I don't think it's a good idea to obsess over it -- because that would certainly cause a lot of anxiety and that would aggravate one's IBS symptoms. I think people need to remember that diet is only one part of it -- and that we're not using dietary changes to cure IBS or find a cause for it. We're just trying to eat in a way that minimizes over-stimulation of the GI tract.
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It is taking over the forum but I don't want to say anything because Murphy's Law and all, I would probably have it! I have never done a FI test/elimination and I love fruit so much that it would be so ironically cruel!!! I think lately there has been some intimidation caused by suggesting certain things other than Heather's trigger list are causing symptoms for us. We certainly want to give our gut the best chance but stress is much more of a factor than certain non-trigger-list foods- like OMG basil for crying out loud! Sorry I know I will get FI now. NOOOOOOOO! 
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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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Yeah, i'm with Erilyn. I've never been able to handle fruit juices and smoothies etc. They always screw me up even when i'm stable. I do agree that it does seem to be getting out of control on the boards though. Desperate times, desperate measures i guess.
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Sarah
IBS-C
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I've posted a lot about fructose intolerance as well as wheat/gluten type questions b/c I am generally stable with Heather's diet and meds but I am not quite "there" completely. I continue to have terrible gas and bloating which I am trying to alleviate and yes, I am searching for other possible triggers. I agree that newcomers may be confused but when I think back to when I was a newcomer, I think I understood clearly that talk of celiac, etc. did not mean that it necessarily pertained to me. Like many of you, I had always noticed sensitivity to some fruits and maybe syrup (or was it the pancakes/waffles/eggs in the french toast?). We are all looking for hope I guess when we're not feeling 100% which with IBS is rare of course.
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Originally IBS-D for a million years!
Then IBS-A, Now a transformed slightly C
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I think you are both right and wrong. Fear will without a doubt not make ones symtoms better (more likely worse).
But positive thinking will not make a lactose-intolerant (for example) absorbe lactose any better.
I believe that fructose malabsorbtion is not spreading and is not "contagiuos", but fear can definitely "spread" and it is important to make it clear that any beginners should try EFI diet and SF supplements for at least 1-2 months before making any ungrounded judgement about it not working for them. However, I also believe that after a trial period of several weeks (maybe months) one should definitely look in to other posibilities if the symtoms persevere. Maybe fructose or sorbitol could be the problem? And I dont think it would be dangerous at that point to try a modified EFI diet for a couple of weeks, just to find out. If the symtoms dont improve despite all the measurements, then maybe one should go back to EFI and pay their doctor another visit?
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I personally appreciate all of the posts I read about FI and appreciate the ability to ask questions about it. I was so depressed and needed and answer. I tried the FI diet and BAM! I feel soooooooooo much better. Not today however. I spent the weekend in vegas and fell off the wagon. I am paying for it, but I plan on getting back on the diet tomorrow. I am so glad I found a way to feel better.
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Pud
Long Island
IBS-D & SIBO - main symptom GAS 
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I am so happy for you! The fructose malabsorption diet in combination with EFI is what have really made all the difference for me! I used to have D up to 20 times a day (!!) and I was literally a prisoner in my own home. Now I have "normal" BMs and can be just as social as I have longed for all this time. A great victory!
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Okay
#320508 - 12/12/07 11:52 AM
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Jordy
Reged: 08/12/06
Posts: 2095
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I'm not trying to "blame" anyone or saying that some people don't have problems with Fructose. I just think that the boards have gone a little over board with putting the fear of fructose into people's minds....especially new posters or people, like myself, who fear the foods when so many people start stating that it is a trigger for them. A new poster might be so fearful of apples or applesauce if they just started reading this sight.
I just don't remember anyone ever being so restrictive with fructose in the past. There were many stable posters who ate apples and pears and were quite stable. And, Heather's diet doesn't have it as a trigger food like the other trigger foods, which I think she would have if it was truly a trigger food. In fact, she even has apples and pears included in her sample menus in the EFI book. She does emphasize that juices (which are much higher in fructose), but not high fructose fruits....the real thing.
I just know that for those, like myself, who are really struggling, you can convince yourself of something just because you want something to help.
If a low fructose diet helps you....then great. I'm sure it is a problem for many. My comment was that I have observed a huge increase in the number of posters now stating that Fructose is a problem for them. That's all. Didn't mean to ruffle any feathers. Maybe I just can't read these boards anymore because for me, I start to fear foods that others have reported problems with...and wonder what I'm missing. I'm sure I'm not alone with this. Or, that I'm not trying hard enough.
Maybe it helps those with D more???
Anyhow, please just
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IBS-C with pain and bloat
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You are quite right. I think that it is a risk that some people will start to have fears for foods that they used to have no problems with before. I really hope I havenīt contributed to such fears! I dont think that apples or applesauce are triggerfoods for the vast majority of IBS sufferers, but that they can be a problem to some. And, as you say, the fructose malabsorption diet might benefit those with D more than C. Maybe we should just drop this subject cause I really donīt want to offend or scare somebody. Best regards
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Re: Okay
#320520 - 12/12/07 02:46 PM
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Jordy
Reged: 08/12/06
Posts: 2095
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Quote:
I really donīt want to offend or scare somebody
Neither did I. Honestly. Cross my heart! Nobody should feel that they have to defend themselves or apologize. Heck, I still don't know if fructose is a problem for me or not.
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IBS-C with pain and bloat
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I don't really get D very often (once or twice a week - ha imagine that's being "normal")... my main problem is gas and bloating... when I first started the FI diet I was getting D.. but once I started adding different foods in I was fine... tonight is my last night before I go back to it.. I just ate a sandwhich and soup from Panera and I am so so so tempted to get a latte or ice cream!!! I am going to be paying for what I ate already.. why not make it worse?? lol
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Pud
Long Island
IBS-D & SIBO - main symptom GAS
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I hope your going to be okay with panera bread soup. As i ate the chicken noodle in a sourdough bread bowl and I stay mainly to the C side and with in an hour of eating this I was rumbling and wounded up with loose bowels. I think there soups have tooooo much fat. becareful over there..
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IBS-C gas, bloating and acid reflux
Babies is the plan for 2008!!Hope this IBS cooperates.
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instead of me. 
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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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Good point that newcomers should try to get stable with Heather's diet and sf supplements first. I would imagine that people who are FI probably could benefit from avoiding Heather's triggers also. Then if maximum stability is not reached, looking into other things like fructose and wheat or gluten would help. I am thankful for all of the talk about it here b/c it came at a time when I needed to look further. In fact, I'm not completely sure, but I can definitely see a huge improvement in gas since avoiding gluten products more often. If I was a new person, I guess I could get confused.
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Originally IBS-D for a million years!
Then IBS-A, Now a transformed slightly C
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The way to conquer fear is with knowledge!
If fructose malabsorption makes you afraid then one of the best ways to put this fear aside is to get tested or try the low fructose diet and see how it works for you! If it doesn't help then ignore the messages about fructose just like many of us ignore posting about such foods as soy because it give us too much gas and bloating even though it is recommended by Heather.
Don't be surprised to see a further increase in the number of people with IBS reporting that reducing their free fructose load improves their IBS. Over the past couple of years more GP & GI doctors have been including a fructose breath test or suggesting their IBS patients reduce their fructose load. And you will notice that more IBS diets from reputable GI centers are encouraging a greater reduction in the consumption of foods with excess fructose and fructans (for example see this web page ).
IBS is a syndrome. Heather IBS guidelines are excellent place to start for managing IBS symptoms. It is not the complete answer and for many of us we have to supplement her great EFI diet with other management tools that we have learned work well for us. Please have the courteous to allow us to share these additional IBS management techniques without worrying about who might be afraid of our useful knowledge!
Good Luck 
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STABLE: â, 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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That's okay...I can take it.  I know I'm not the only one who feels this way. I know others must have been thinking it also.
Thanks for your support Little Minnie. Thank you for understanding the purpose of my post.
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IBS-C with pain and bloat
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Add me to the list of people who are glad this was finally mentioned, too.
If this had been an issue when I started the diet, I would have been too terrified to eat anything but white bread and rice.
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Great post Syl! Wise, reasonable, and logical- love it! Thank you
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Sarah
IBS-C
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it wasn't good... by i also had hot chocolate and cake... i wasn't thinking it would go well... back on the diet today!
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Pud
Long Island
IBS-D & SIBO - main symptom GAS
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For those who think their IBS will be cured by finding the magic number of things not to eat and worriedly suspecting everything they ate when having an attack, do this:
Eat the same exact thing several days in a row and notice how your symptoms will vary day by day. I ate the same thing today and yesterday but have much worse bloating and pain today. I would be a wreck if I tried to figure out what food did it. It is much more likely that I sat more today and possibly had more stress/irritation and didn't sleep that great.
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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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Quote:
I ate the same thing today and yesterday but have much worse bloating and pain today.
Me too. So frustrating!
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IBS-C with pain and bloat
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I also think it can be the food "build up." For example, I have been trying to avoid wheat products and so far I was feeling better, but I did have some real pasta this weekend. Now today I had my first regular bagel which I thought was a real gas/bloat trigger, yet I was fine, go figure. I may feel it tomorrow or if I have another bagel tomorrow, that might be too much. Hey, I'd be happy if I could do all things in moderation. But yes, soooo frustrating.
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Originally IBS-D for a million years!
Then IBS-A, Now a transformed slightly C
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The tricky thing is that it really applies to everything, even the EFI itself. I remember when I first read Heather's books and I was so happy. Wow, all the things that are safe, according to her. But the thing is, I can't eat all of the things she says are safe. I realized that pretty quickly. And I have never been able to eat all the spicy stuff or the beans, lentils et.c. that she often includes in her recipes. Plus I have always found it strange that some of her recipes call for quite a lot of onion or garlic and I would have to take maybe 1/4 of the amount when I have onions or garlic.
However I still think the general guidelines are useful. Though that is what they are - guidelines - and not necessarily the golden rules for every one.
Then there is the other side of the coin, which is what you mention here, READING about people who have problems with this and that. And then thinking, ok, I'd better eliminate that too from my diet. It's very easy to fall into that trap. I have done it myself several times. But it's the same thing with that. If you don't notice having any problems from a certain type of food then don't worry about it. If you suspect it then try to cut back or eliminate the particular food item and see what happens.
And then there is the fact too that you may blame food when the real reason for a flare might be stress or exercise or something unusual happening in your life.
For me, the only thing I really know causes problems is IF, too much fat (it seems, though I'm not even sure about that) and eating/drinking cold stuff too quickly. So I might experiment more with my diet in the future, once my pelvic floor muscle problems have been taken care of so I can feel comfortable even if my digestive system isn't perfect.
/Ulrika
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This made so much sense to me. Thank you. I, like you, wonder how the recipes can include so many spicy, onion, garlic, and soy filled ingredients. Onions, even cooked, kill me!
My problem, is that I don't trust my own body. I'll eliminate a food to test it, yet if I don't feel better, I think that I really can't have that food, but that I am also intolerant of something else I still am unaware of. So, if I add the "fear" food back in, I might be "erasing" any gain or any piece of the puzzle. Does that make any sense?
What is your pelvic floor muscle problems? And what can they do about it? I went to a PT to help strengthen the muscles, but didn't get any results.
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IBS-C with pain and bloat
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I'm the same as you Jordy... The fear factor definitely comes into it big time for me! I tend to panic when trying out some things which makes the test redundant!
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Sarah
IBS-C
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I think I have found my twin! 
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IBS-C with pain and bloat
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I understand what you mean. I think it's really easy to get something bordering on an eating-disorder with IBS, because of all the anxiety around food.
Doing elimination tests can be quite tricky. If you want to you could ask a dietitian for help and either do a basic diet and then add new stuff in one at a time or try to eliminate one thing at a time. I think the general protocol is, if you start with a very basic diet, to add in one new thing at a time every 2 days or so and then if you think you have a reaction to something, eliminate it again and then wait till you stabilize before adding more stuff in. Then you should do a second round with the stuff you think might be bothering you. This is so that you can see if it's really the food or if it might have been something else, like stress for example.
About the pelvic floor muscle problems: I got an autoimmune paralysis from waist to toes from a regular cold virus when I was 12. I recovered pretty well but my right leg is still partly paralyzed and my pelvic floor muscles don't work properly. I also have bladder emptying problems. The combination of IBS-D and not having normal sphincter function is stressful so I have been through tests at the surgery department and this fall I have been going there once a week and doing electrical stimulation of the sphincter and also biofeedback training, where I can see what happens when I try to use the muscle. Unfortunately this hasn't helped so now I am waiting to try a procedure where they put electrodes in the lower back. They then stimulate the nerve connecting to the sphincter. If that works they will put temporary electrodes in and connect them to a pacemaker. I hope it will work as that would probably help prevent any future problems related to a weakened pelvic floor.
/Ulrika
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I think you can overcome this with time. I used to be really neurotic about trying new things. But lately I have been trying new stuff every now and then and if I have had a day afterwards when things have been a bit worse than usual that still hasn't stopped me from trying the new stuff again after a few days and it has worked just fine meaning it probably wasn't the new food item that caused the problem.
But I think this is something that comes with time. I don't think you can make yourself think differently. You need to ease into it. I am doing the hypnotherapy program right now too so that is probably also part of the reason why I am more relaxed about these things. However I am still more careful when it's important to be well, like now before Xmas I am not trying any crazy things as it is really important to me to be able to go home and spend Xmas with my family.
/Ulrika
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Are you taking any probiotics? I'm also following Heather's diet and continue to have a problem with gas and bloating - My nurse suggested today that I probably need a good probiotic so I called the co op and got some info will go get some tomorrow. Good luck to you!
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Jeanette IBS-D, then switched to IBS-A, now stable with Udo's Choice Super Bifido Plus Probiotic
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No, I tried some probiotics when I first went on Heather's diet but I was adding/changing too many things at once. I was also taking digestive enzymes and I had no more d, but MULTIPLE bms daily. I suppose it was the probiotics way of cleaning me out. I stopped b/c I had too much anxiety and I wanted to see if the acacia and the diet would stop the d by themselves (which they did along with an AD later on). I bet they are great...not sure how effective for gas/ bloating, but I'm too leery of changing anything in my routine b/c my bm schedule is pretty normal. Let me now how it goes if you try.
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Originally IBS-D for a million years!
Then IBS-A, Now a transformed slightly C
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I just read "fat malabsorption" in your signature... I haven't heard of that.. how did you know you have it? can you not eat any fat? or just large amounts of it don't work for you?
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Pud
Long Island
IBS-D & SIBO - main symptom GAS
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Quote:
I just read "fat malabsorption" in your signature... I haven't heard of that.. how did you know you have it? can you not eat any fat? or just large amounts of it don't work for you?
I'm sorry I'm so late in responding back to you. I had a 24 hour fecal fat test - You eat 100 grams of fat in a day then 24 hours later, you collect your stools for 24 hours and bring it to the lab. They look at it to see how much fat is contained in the stool. The maximum amount that a person should have is 7 (I don't know the units), I had 14. My doctor didn't say anything about eliminating fat from my diet, but he hasn't given me a whole lot of useful information on anything. What I do know is that my body just doesn't absorb fat like it should - which is an indicator of many things: crohn's, celiac, pancreatic insufficiency, SIBO, giarrdia. I've been tested for all of the above with the exception of SIBO which I'll be getting tested for soon. I am very careful of the amount of fat I eat and things have been better - but who knows at this point.
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Jeanette IBS-D, then switched to IBS-A, now stable with Udo's Choice Super Bifido Plus Probiotic
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100 grams of fat in one day??? yikes!! sounds yucky lol... i am so used to eating low fat that i can't even imagine that.. but i guess it would be easy... two burgers at mcdonalds and that should do it..
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Pud
Long Island
IBS-D & SIBO - main symptom GAS
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5 grams of fat is 1 diabetic fat exchange. 1 diabetic fat exchange is about 45 Kcals. A fat exchange is about 1 tsp of oil.
100 grams of fat would be 20 fat exchanges I believe unless my memory is malfunctioning. That is a lot of fat.
Jeanette are you sure about the 100 grams of fat to eaten in a day for this test, maybe it was 100 Kcals instead? What exactly did they have you eat? How many Ts or ts of fat? Or what was the menu?
When my gall bladder stopped working I couldn't even eat 1/4 a tsp of oil without symptoms.
100gs of fat would likely give me pancreatitis; as I still can tolerate very little fat. My liver wouldn't appreciate it either.
I'd avoid such a test if they did ask me to eat that much fat in a week let alone 24 hrs, as I know fat is what really gets my guts in major pain. Yikes!
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Quote:
5 grams of fat is 1 diabetic fat exchange. 1 diabetic fat exchange is about 45 Kcals. A fat exchange is about 1 tsp of oil.
100 grams of fat would be 20 fat exchanges I believe unless my memory is malfunctioning. That is a lot of fat.
Jeanette are you sure about the 100 grams of fat to eaten in a day for this test, maybe it was 100 Kcals instead? What exactly did they have you eat? How many Ts or ts of fat? Or what was the menu?
When my gall bladder stopped working I couldn't even eat 1/4 a tsp of oil without symptoms.
100gs of fat would likely give me pancreatitis; as I still can tolerate very little fat. My liver wouldn't appreciate it either.
I'd avoid such a test if they did ask me to eat that much fat in a week let alone 24 hrs, as I know fat is what really gets my guts in major pain. Yikes!
Yep, it was 100 grams of fat. The purpose of the test is to see if you have a fat malabsorption. I don't think I got 100 grams in though because I got horrible D before I could eat everything planned. What I ate was sausage egg mcmuffin and hasbrowns from McDonald's (which if I remember correctly that was 25 or 35 grams) then I ate at Olive garden, I don't remember everything I ate there, but I do recall the fried cheese sticks and mushroom appetizers. I think I probably got in about 80 grams by the time the D kicked in. My doctor told me (after the fact) that they recommend you eat 3 meals at McDonalds and that should get you the 100 grams. I believe the reason for the 100 grams is that they know how much your body should expel with this specific amount and if the amount in your stool is greater than that, then they know you have a malabsorption problem. A healthy small intestine will absorb almost all of that fat, but an unhealthy one will expel more.
I knew going into the test that it was going to cause me some problems but I also NEED to know what is wrong with me, and if 1 or 2 days of pain and discomfort is what it takes then so be it - and I can say that I would do it all over again because otherwise I would be diagnosed simply with IBS and receive no treatment. Now they know that there is something more going on with me that won't show up in any of the scopes, xrays etc.
Here's a link that describes this test: http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/stool_fat_test.jsp
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Jeanette IBS-D, then switched to IBS-A, now stable with Udo's Choice Super Bifido Plus Probiotic
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I just read "fat malabsorption" in your signature... I haven't heard of that.. how did you know you have it? can you not eat any fat? or just large amounts of it don't work for you?
So, here's an interesting story regarding fat. I've been following Heather's diet for about 4 weeks now and doing much better. Last week, I was out of town all week on business - which could make diet pretty tough but I planned very carefully bringing single serving containers of rice, tuna, bread, oatmeal, applesauce and my teas. All week, I ate the above foods for breakfast and lunch but had dinner at the hotel each night. My dinner each night was grilled skinless chicken breast and baked potato (with nothing on it). But one night I decided to have salmon instead of chicken, they served it with green beans (which have never upset my stomach) so I ate about 1/4 of the beans... The next day I was back to my "Old Normal" - I had 8 BMs the next day, felt horrible with gas bloating and pain. So I was trying to figure out what I had eaten that could have gotten me so upset and all I could figure was maybe they put butter on the beans so I asked the next night when I went back and yep they sure did (even though I had explained to the waitress that I cannot have butter or oil in any quantity). But what is so intersting about this is how much butter do you suppose would be in the small amount of beans I ate - maybe 1/2 tsp at most which I believe would be about 2 grams of fat (plus the fat from 1/2 filet of salmon) - That is how intolerant my system is of FAT!!
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Jeanette IBS-D, then switched to IBS-A, now stable with Udo's Choice Super Bifido Plus Probiotic
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isn't salmon a fatty fish? i don't eat fish, but i thought salmon as fatty... i could be wrong
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Pud
Long Island
IBS-D & SIBO - main symptom GAS
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Yes, salmon has one of the highest contents of fat in terms of fishes... 3.5 oz of salmon has about 7 grams of fat. I typically eat it once a week and am fine with it though. I eat skinless, boneless grilled chicken breasts the rest of the week which has only 3 grams....
So, it is possible that the fat from the butter on the beans just put me over the top in terms of the amount of fat I can safely eat. I have no idea. I've only been following the diet for a month now so I'm sure I have plenty to learn yet. I just know that I eat salmon once every week with no problems, so I assume it was the butter on the beans that caused my problem on this particular day - since that was the first time I've had butter since following the diet.
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Jeanette IBS-D, then switched to IBS-A, now stable with Udo's Choice Super Bifido Plus Probiotic
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