Question About D - What Caused It?
#347052 - 06/09/09 04:44 PM
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Hello all,
So, while I can't say that living with this for the past three and a half months has been a cakewalk, one of the small victories that I claimed was that since going on the diet, taking fiber, and making the lifestyle changes I needed to, I haven't had any serious D, which was an occasional problem in my life prior to IBS and was what initiated my recent adventure through the circus of doctors leading to my diagnosis.
That all ended today, when I suffered from serious D, had to leave work early (something I also was proud I haven't had to do lately) and for the life of me can't figure out why. I have recently changed some things, and I wanted to list eating and supplement changes here to see if anyone can have an "aha!" moment and point to me where I went wrong.
In the longer term, I went off 25mg daily Nortryptiline a week and a half ago. I feel that was too long to affect me now, but the reason I went off it, despite being successful at reducing my general overarching stomach pain/discomfort, was the severe C side effect, so it's a valid thing to note I guess.
I saw an acupuncturist on Saturday who suggested a number of supplements that I began taking that same day: 2 fluid ounces of Aloe Vera gel a day, a calcium/vitamin D/Magnesium twice daily supplement (I take it once a day though), a digestive enzyme (Betaine HCI, Glutamic HCI, Papain, Pepsin, Pancreatin 6x, and Ox Bile Extract - with each meal), and a GI herbal blend pill (Marshmallow, Cranesbill, Slippery Elm, Chamomile, Aloe Vera Powder, Cabbage - 600mg total three times a day). She also asked that I consume more "hot" food, and so I have made some Near East Long Grain and Wild Rice Garlic and Herb, and Near East Couscous with Pine nuts (I mixed in canned tuna in water).
I also have begun taking three new teas - Organic Nighty Night and Organic Ginger Aid from Traditional Medicinals, and Yogi Tea Stomach Ease. All herbal, no caffeine, etc.
On Sunday I went out to dinner where I had grilled salmon with capers, along with some white rice and steamed veggies. I did have a green salad before the meal along with a leek soup, but only after copious amounts of french bread as a base.
Today for lunch (though it seems too recent to have cause this) I had grilled mahi mahi and a salad with grilled corn kernels, cucumber chunks, and tomato chunks.
A lot of the items in the above two meals I know are on the "risky" section of Heather's list, and have caused trouble for people on here that I have read, but I must stress that I have eaten all of these foods in some form or other over the past three months with no problem. Nothing I have eaten is a "trigger" food, at least as per the cheat sheet.
I have also been eating my usual stuff, pretzels, french bread rolls, Amazake rice drinks, Align daily (I missed on one Sunday, but that shouldn't make such a huge effect) and 2-3 teaspoons of Acacia a day.
I have friends coming over this weekend to stay with me, so I'm pretty close to declaring a starvation/only SF diet, but I know that's not healthy.
Can anyone help? Does anything jump off the page as being a cause? Thanks!
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I know if you are ibs-d you should take the calcium supplement without the magnesium in it, that make d worse.
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You changed so many things at one time, it's hard to say what caused it. It could have been a combo of all of your changes or just one or two. There are several things that jump out at me, but I think you need to stop and go back to square one...with a safe diet, your acacia and align, and then move forward, easily and gradually. You did so much at one time, your gut probably doesn't know what hit it. I would take things a little slower, so that you can see what is affecting you. Sometimes, simple is better.
There are many on here who will tell you what they think bothered your gut based on their experience, but that may or may not be the case for you. That is why I am hesitant to say for a fact that "this or that" is the culprit. You need to slow down some, and add things back gradually, to find out what exactly is bothering your system. We are all different, and what may bother me may not bother you.
Also, just because a food does not bother you one time, does not mean it won't bother you the next time. That is the frustration of IBS.
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Thanks, I understand. If nothing else, then, I wouldn't mind if someone could "clear" one of the supplements (such as the GI herbs or the Aloe) since they are reputed to be helpful and so for example if you know it couldn't cause D (or even is someone takes it and it doesn't cause D in THEM), then I'd be happy to hear that. Please let me know what jumped out at you.
Also, to answer mrae, though I have had D before, more often than not since being diagnosed three months ago I have had more C than anything. I haven't had D like this since before I was diagnosed. So I was thinking calcium w/o magnesium would be a problem since it could have exacerbated C I was having recently.
Thanks for the help!
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Mike,
I wonder about the cabbage in the supplement, the slippery elm, and the corn. Also, when I do nuts, they have to be ground up, or I will be C for weeks. These things may or may not affect you.
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A couple of things for you to consider. Aloe vera is consider a no-no. See Heather's newsletter for details. There is also more information on other parts of this web site.
The GI herbal blend pill sounds like to contains most insoluble fiber. It contains aloe vera which as mentioned above is a no-no for IBSer, especially IBS-D, it also contains cabbage, a sulfurous veggie and high in insoluble fiber which can be problematic. Pine nuts are also high in insoluble fiber. If you are going to eat them then they should be well ground and eaten with a good soluble fiber base.
It seems you are making many changes at once. It might be best to stick with Heather's diet strictly and remove all unnecessary supplements from you diet until you are stable.
of time before adding unusual things.
Out of curiosity what fruits do you eat? The reason I ask is that I wonder if you have problems with high fructose fruits such as apples, pears, managos, grapes, etc which are know to cause gas, bloating, cramps and D in some 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
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You really got me thinking about the Aloe. I checked when I bought it though and the kind I'm taking has the "bad" ingredient removed. I got it at Whole Foods and it specifically is marketed toward digestive problems and states on the container that it doesn't have the (I'm at work and can't remember the specific name).
As far as fruits, I basically eat only bananas regularly. Occasionally I will have some dried mango slices, frozen papaya, or sometimes a handful of berries (blue, rasp, and black) with a good SF cereal like Cheerios and after acacia. I would say fresh fruit is under 5% of my diet, and 4% of that is bananas. Now I do eat applesauce regularly, now with acacia.
The pine nuts were not ground, but I did eat them with a good SF (cous cous) base.
Also, I had no problem yesterday with gas, bloating, or cramps, just sudden D. There wasn't even much of the feeling of urgency, which used to be typical for me, so something I'm doing is helping that. I'm suprised the acacia failed to soak up the excess water though, as I have been taking more and more of it lately.
Thanks!
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I wonder if the aloe in the herbal blend has been similarly treated. Is the applesauce newly added or have you been eating it for awhile?
Have you found that when the insoluble fiber content in your diet gets a bit too high you get D? It definitely is a problem for me and it has been reported in the IBS research literature too.
While a SF supplement may soak up a high amount of water compared to its weight it has relatively little impact on the total water in the gut. The amount of water in the bowel is controlled by a complex system on which SF has relatively little influence.
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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Really good question about the pill aloe. I don't have an answer on that one.
Applesauce has been a food I religiously eat since this all began three and a bit months ago. Since with the exception of yesterday and the way beginning I have had frequent C and no D, I feel applesauce is safe. I put cinnamon in it as well, get organic, no added sugar, etc.
I have been, up to this point, increasing IF due to the same factors noted above. This D really caught me by surpise specifically because I thought I somehow "changed" my system to be C predominant.
Granted, this all may be a long term reaction to my going on the Nortryptiline for a month (which had the side effect of a lot of C) and then going off of it a week ago. However, I also trended C for the month and a half prior to beginning it, as well, so all I know is that I don't seem to know anything. >:(
Thanks for your help. I'm just going to get back to basics. I'm going to ask my acupuncturist at the next session about the things she recommended (aloe, herbal G.I., etc.) and if I do reinstate them I will do so easily, one at a time. Until then I think I had best invest in a rice cooker and just bland my brains out for awhile .
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Like your comment "bland my brains out for awhile". I have been doing the same thing for awhile which has now turned into a few years My rice cooker is one of the most important things I have in the kitchen
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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I have an open question here because I'm frustrated and confused. So after the D yesterday afternoon I ate a few handfulls of cheerios and felt ok. This morning I had some pretzels and felt ok. It's been about 3-4 hours since then and I just had two small sourdough rolls with nothing in them but flour, salt, yeast, and water, and a small cup of applesauce with just apples, water, and natural flavors. The only thing I don't recognize is "gum arabic." I don't know if that's bad or not. The total calorie consumption is likely under 500, with 4-5g fiber (I'm assuming all SF), no fat, 8g protein, and the rest carbs (13g "sugars" the rest regular carbs I guess).
Anyway, despite feeling pretty ok (if very hungry) all day, before I was even finished with this I immediated felt like I was running a fever. My head just lit up with warmth and I had to take a moment and concentrate to kind of retain clear thinking. My GI doesn't feel particularly problematic, but even now, about 30 min later, I still feel warm in the forehead and my mind lacks focus. I have been drinking plenty of water today, like always (8-16 ish 8oz glasses).
What the heck is going on? I have friends coming into town from out of state for three days this weekend and I will be expected to entertain and show them around and I simply cannot be under the weather. What is the absolute bare minimum GI safe diet I can follow from now to Monday to ensure no problems? It doesn't have to be nutritionally complete or anything, I can go without for a few days, I just need to be able to function. Any ideas?
Thanks!
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I know exactly what you are talking about. My GI docs have dismissed these symptoms too. Recent advances in the understanding of IBS indicate that there can be sub-clinical inflammation processes active in the bowel of some IBSers. Chemical and mechanical irritants such as byproducts produced by the fermentation of indigestible food in the bowel or cereal bran may stimulate the inflammation causing symptoms you described. They usually pass within a few hours.
For me two things are guaranteed to cause these symptoms: (a) too much insoluble fiber, particularly from bran, raw or unpeeled veggies, nuts, seeds, fruits and salads and (b) foods with excess fructose such as apples, pears, honey, HFCS, etc. Since I eliminated these from my diet I rarely have these symptoms. Previously they would occur almost daily sometimes with chills and sweats too.
I have base diet that I use when I travel or when I have a flare-up. Oatmeal w/banana & brown sugar for breakfast and grilled chicken breast or fish, white rice and soft boiled peeled carrots for lunch and supper. Snacks consist of toasted sourdough bread with berry jam and Kettle low salt, low fat potato chips. Heather describes a break the cycle diet which may give you some clues.
Gum Arabic and acacia are the same thing. Gum Arabic is frequently called gum acacia. It is a commonly used as a thickening agent.
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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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Thanks Syl! You are a wealth of information and I appreciate it!
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Quote:
saw an acupuncturist on Saturday who suggested a number of supplements that I began taking that same day: 2 fluid ounces of Aloe Vera gel a day, a calcium/vitamin D/Magnesium twice daily supplement (I take it once a day though), a digestive enzyme (Betaine HCI, Glutamic HCI, Papain, Pepsin, Pancreatin 6x, and Ox Bile Extract - with each meal), and a GI herbal blend pill (Marshmallow, Cranesbill, Slippery Elm, Chamomile, Aloe Vera Powder, Cabbage - 600mg total three times a day).
It isn't just the aloe there that is a problem but the enzymes too. Not that enzymes are bad, but when starting or when taking too much, sudden D is probable. I took enzymes a few months ago when a friend said how well they worked and to take one an hour then start tapering off. I got bad sudden D from it.
And those GI pills, all of them, are who-ha. They don't work and oftentimes make people worse. Your diet and your teas sound fine. To get back on track after D up the acacia slightly and drink lots of tea and eat real safe foods for about 2 days.
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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 Minnie! I won't be going back to the GI mix. I am typically at about 60% (that is, of normal what I used to be) and thought maybe they would help me get up to 80 ish anyway, but they made me drop down!
Did you ever find a sweet spot with the enzymes where they worked and didn't cause you D?
My problem is I have C now but I'm afraid to throw in more IF because I definitely can't have D this weekend. I feel like I'm caught between a rock and a hard place.
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Hi Mike,
Unfortunately the herbal blend given to you are mostly laxative ingredients. Aloe is considered a harsh laxativie and so are the other herbals in the formula. For an individual without IBS, these ingredients help to soothe the gut, but they are much too abrasive for IBSers. Also, Calcium magnesium can make diarrhea worse. You might want to consider Calcium carbonate. Stress is also a huge factor in IBS "relapse".
I hope this helps and you are feeling much better very soon!
Erin
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Thanks Erin! I really am flying blind since I just do what health care people say. I need to get a book on herbs myself (wikipedia is terrible for this) that tells me what they all do before I just try something.
Also, it's annoying to have C one week, D the next, because most herbs and medications do tend to focus on one or the other, so by fixing one I make another one worse.
Anyway, thanks again!
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Alternating IBS is the pits. although I still have bloating and gas my A is completely under control. If something causes D once in a while I never get C afterward.
I guess I sort of forgot about the enzymes. I leveled them off and that was ok but I never bought more for some reason. This friend at work gives lots of bad advice, but really talks the talk. 
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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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Is it possible to ever get stable with the gas and bloating? That has probably been my worst symptom throughout this whole ordeal. I look pregnant sometimes I get so bloated! 
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IBS-C, GERD, Lactose Intolerant, "Allergic" to Legumes (Soy!), Tree Nuts.
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Good question. I have conquered my bloating and gas almost completely the first two summers on the EFI diet. So it is possible to get rid of it, but very, very difficult.
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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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