IBS Rant - triggers and alternatives...never ending
#351156 - 10/25/09 07:49 AM
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PMartin
Reged: 08/05/08
Posts: 140
Loc: Niagara Region
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I previously posted about Hemp, as I'm looking for a non-dairy, non-soy source of protein and it sounded very good but I couldn't find any info about it's fiber make-up. Well, it turns out that 80% of its fiber content is insoluble so as for the EFI diet it doesn't look like a good alternative.
This is becoming a frustrating theme to having IBS. It seems like every time I seemingly make progress and find a food alternative, it turns out to have its own problem...
For example, after eliminating Cow's Milk, I was happy to drink Soy Milk until I discovered it too has a downside. So, onto Rice Milk, which again I'm fine with but now I hear Brown Rice could be a trigger and of course it seems to be in every rice product including the Rice Pasta I've been eating. Do I bother with Almond Milk? Aren't nuts a potential trigger?
I also took a look at the nutrition facts of the steel cut oatmeal I often have for breakfast and see that it has 3g of insoluble to 1g of soluble fiber. Should I be concerned?
And then, I look up IGG sensitivities after reading another post and uncover a whole new list of terms and potential culprits http://aca.ninemsn.com.au/article.aspx?id=656229
While most, if not all of the specific foods listed here aren't new or already scrutinized through EFI or FODMAP's, I've never heard of them referred to by their chemical nature as Salicylates, Amines or Glutamates before.
And a couple of them that really got my attention were peppermint and bananas...two foods that I bet most of us are eating.
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IBS-D. Or so a doctor says.
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You're not alone in your frustrations. I feel so limited by what I can I eat, and even though I try to eat carefully according to the EFI diet and of course I try to also listen to my body for my unique triggers (garlic and onions for example), I am still symptomatic pretty much 24/7. Next up for me is to eliminate added sugar for a while, which I'm pretty bummed about. I so appreciate this board for helping me figure this out and just for knowing that there really are people who understand how miserable I am. You will figure the food thing out in time. Take comfort in the fact that lots of people on this board have figured out how to stabilize their symptoms. 
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I can absolutely identify with your frustration here. What I have found is that if I try to combine (mix) one author's suggestions or their website information with another's recommended relief, this most always fails and does nothing but make the problem worse.
I have to tell you honestly that you need to stick with ONE program ONLY for a period of time and see how you do.
If there is not enough soluable fiber in a recipe (meal) then simply add some of Heather's acacia powder somewhere, as it does not change the taste nor texture of a recipe.
I encourage you not to seek incorporating suggestions from various authors' programs or you WILL get frustrated, just like I have in the past. Each program is meant to work in synchrony within its own boundaries... may work, may not. Heather's simplicity of treatment ALWAYS works if followed faithfully, and then you can explore your own tolerances to specific foods from there.
Some days I can indulge in some extra things, and some days I cannot. Every 'body' is different, and it seems for me a lot depends on the stress level in my life at the time, and believe it or not even the weather outside can in some ways dictate what foods I can or cannot tolerate on any given day. Talk about a merry-go-round. The secret for me is to keep my pantry well stocked with a variety of things I know are safe to eat and choose the ones that I have found will work for me on a given day. Quick homemade soups are a favorite of mine any time of the year... tummy and spirit soothers if made with appropriate ingredients.
Pick a program and follow it, see what happens. I recommend Heather's, as it is simplistic and not complicated at all. I see no need to throw away money on what MIGHT work and then doesn't, only making matters worse, and increasing the frustration and stress level.
Give some thought to all of this. I wish you the best in your symptom control.
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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I understand what you mean. This is a problem I got when spending a lot of time at these message boards. I developed food related anxiety just from reading what other people had problems with. Remember - the key is to find what works for YOU. It doesn't really matter if it works for the next person or not. People mean well and explain about their triggers because they want to help - and it can be helpful in case you try a diet and it doesn't work or you get an unexpected flare up. But you simply can't stop eating everything that ANY other people have problems with. You need to figure out for yourself what works for you. If you think the EFI general guidelines as presented in Heather's books seem logical to you, then use that as your basis of knowledge and then work out the details for yourself.
Remember - IBS attacks are not always triggered by food. If you get overly anxious about trying different food items or get scared because of what other people tell you then that anxiety may in itself bring on attacks. When you feel really bad it is really hard not to get anxious I know. But please - don't limit yourself more than you have to. Food is supposed to be fun too. That's why Heather keeps talking about substitution instead of deprivation.
If you look at the food strategies a lot of people have on these boards they are based on the EFI but people have then added rules of their own based on what works for them. This can mean more limitations than the original EFI. The point is that these specific limitations are very different from one person to the next. So you shouldn't try to incorporate all of these extra rules into your own diet. You should just follow the general guidelines and then if you find a need for it, figure out what YOUR extra rules are. The basic EFI diet as presented by Heather in her books is actually a very non-limited diet in my opinion - with plenty of variety and delicious things to enjoy.
Try not to make your whole life revolve around what you eat. Exercise, relaxation and stimulating hobbies are also ways to deal with IBS.
Good luck!
/Ulrika
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GREAT post Ulrika! We DO need to remember to balance mind, body and spirit... and NOT get stuck in thinking about 'food fears' constantly. Hopefully some day this will all become 'natural' to us and we won't even give a second thought, as our subconscious mind will step in and help us choose appropriate foods for us individually absent giving this much 'conscious' thought!
Thanks for this post and the great reminder.
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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I agree with the other poster who said stick with one diet. I like Heather's suggestions because I have tried them and they seem to work. As far as the different fibers, in the book it doesn't say you can't have both, but it does say that if you are eating insoluble fiber that it MUST be eaten with the other soluble fiber. Never eat insoluble fiber on an empty stomach. It's not just what you are eating but how you are eating it (i.e. putting the different foods into the right combination). If you do not have Heather's book "Eating for IBS" I would suggest getting it. It explains a lot about IBS and has some great recipes too. I was a little hesitant at first too because I thought it was teeling me to eat trigger foods, but it has some great alternatives and shows how to have certain foods in combination with other things. Also, I cannot have the dairy as it is a BIG trigger for me so I now use Rice Dream Rice Milk in plain flavor for drinking, but I also use soy milk for cooking. Also I cannot have anything with nuts as I am allergic so I eat Soy Butter-I.M. Healthy. I really like it. I also ordered the Acacia fiber and the teas and I think they are great, not only for the effect they have on my body, but I enjoy hot tea anyway and they are great when you want that sweet something. I use regular sugar with no problems.
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When all else fails.....have tea.
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I appreciate everyone's concern and advice...it is comforting to have people to talk to who know what you're talking about and going through.
I do realize food is not the only factor related to IBS and I try to utilize other ways of stabilzing it...mostly through exercise. It does seem however, that food plays the biggest role? While my, like everyone elses I'm sure, stress can change from day to day, overall it is pretty low...my biggest stress is the stress of having IBS.
So, finding a way of eating to suit me, is exactly what I'm trying to do. I do use EFIBS for my base but have added a few things like cutting out wheat and am now concerned and wondering about brown rice. I will always eat white rice but find that brown rice is used in almost every secondary food like rice milk and rice pasta. And when I come across things like FODMAP's (i.e. fructose malabsorption) I am naturally curious. I am a Chef (in a fine dining restaurant), so food is my life. On any given day I have access to any food you can imagine. But, my usual day of eating is either oatmeal or 2 slices of wheat-free toast or IBS friendly cereal with rice milk for breakfast. I don't really eat lunch but have snacks of baked chips or rice crackers and then a banana and orange either. Dinner will be white rice or a baked potato with either chicken or fish and I try to get in some vegetables. And somewhere in there will be a protein shake. All I drink is water or rice milk.
If someone told me all I had to do to get rid of IBS was eat bark for the rest of my life...I would do it no questions asked.
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IBS-D. Or so a doctor says.
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About the brown rice - when it comes to rice milk the risk of it causing problems should be very low. I don't know exactly how they make rice milk but when you make nut milk you finely grind the nuts with water and then strain it through a fine cloth so there isn't really any real "fiber" left. And remember - the finer fiber stuff is chopped or mixed the smaller the risk of it causing problems.
/Ulrika
P S I think it's great you work as a chef and still consider your stress levels low in general. Hard though to be around exciting food all day long and sticking to "boring" stuff. But you'll find a way to get there.
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PMartin
#351172 - 10/25/09 11:50 AM
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Gerikat
Reged: 06/21/09
Posts: 1285
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It is an experiment and a process. It takes time. If you read every author's suggestions, every person's suggestions, every expert's suggestions, etc....you will remain confused. 
What is a trigger for one is not for another. You will find you own way in time. There are no easy or cut and dried answers for everyone.
When you stress so much about what you read, it creates anxiety about food/eating. Maybe you should stay off the boards for awhile, work on experimenting with your diet, try the hypno tapes or something to relax a little, and just settle into the fact that it may take a little time.
Sometimes it is best to just stay away from the boards for a period of time, to clear your head.
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Re: PMartin
#351188 - 10/25/09 09:21 PM
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PMartin
Reged: 08/05/08
Posts: 140
Loc: Niagara Region
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You may be right Gerikat. I'm seeing my doctor this week and hopefully it won't take too long to get in to see a dietitian. I think I'll focus on the alternative approaches to "stabilizing" my IBS - exercise as always but some reading too...I've got a book that was recommended to me http://www.harpercollins.com/book/index.aspx?isbn=9780060851781 on the way.
I do appreciate everyone's concern and efforts to help.
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IBS-D. Or so a doctor says.
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Oh wow, are you ever heading in the right direction. I read one of Sarno's books about healing back pain and it helped tremendously. Once you get in to see the dietician and also progess to alternative approaches to heal yourself, well you can't do much better than that.
Good luck! I think I am going to read that book, since I read his first one and found it to be helpful. You know there is a local sportscaster who had chronic back pain and had tried everything. He started to experience the pain after the birth of his son. He picked up Sarno's book on back pain and is well today. I just happened to catch his story one night on the local news. I had already read the book, so I knew where he was coming from.
Let us know how it goes for you.
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Thanks for the link. I have to check that book out.
Another one I highly recommend is called "Full Catastrophe Living" by Jon Kabat Zinn. He's an MD who runs mind-body clinics for patients with chronic illness. The book really changed my perspective on mental and physical wellness.
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Frygirl
#351195 - 10/26/09 08:29 AM
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Gerikat
Reged: 06/21/09
Posts: 1285
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I have that one too, Frygirl. Love his writing and I work with his meditation practices.
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I've read J.K.Z. too. Pretty practical and helpful. Though frankly, and this may be pride I suppose, I'm sad that I'm put into the same position of the truly hard luck cases he cites in his examples.
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PMartin
#351227 - 10/27/09 08:13 AM
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Gerikat
Reged: 06/21/09
Posts: 1285
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I got the book from my library, and so far I am liking what I am reading. This doc is so darn intelligent! (and I don't say that about many) 
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I really got a chuckle out of this post! This is good, given a good chuckle can release bodily tension and stress.
The truth is... We can get stuck in "analysis paralysis", stress out about it all, and then end up with nothing but yet another MAJOR flare-up.
I find that if I learn the nutritional basics, stay as relaxed as I can from day to day, and stop focusing on controlling IBS exclusively, I actually can eat a lot of things in moderation while diversifying and rotating what I eat from day to day.
Somes WE are oour own life's biggest triggers without even realizing it! Perfectionism is not a good thing.
Take care.  
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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I wouldn't worry so much about the IF in those things. Brown rice is fine for many and with a little SF side it can be tolerated way better than wheat or even oats! Rice milk may be made from brown rice but IMO it is just the sugar out of the rice that is in rice milk- no IF. (yes I think rice milk is sugar water because brown rice syrup is a natural sweetener used in organic foods). I drink rice milk mostly.
Almond milk has a little higher fat content but close to soy milk IIRC. It can be safe for most.
Syl would have to tell you more about the fiber facts of oats. As far as I have heard they are half and half. I always put acacia in oatmeal anyway and that makes it more tolerable. That gives me my morning acacia dose.
IF tolerance level is a personal thing. Many with C can handle more than those with D. I am tolerant of quite a bit but if I go overboard and maybe wait too long after SF and eat IF I get D from it. People with C may just get cramps and pain from too much, but everyone's tolerance is different. It seems to me at this time that fat intolerance is more uniform than IF intolerance for those who have posted here.
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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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Its important also that the "act of eating" can be a trigger and not the food. Doesn't mean foods and diet aren't important they are important, but
"Dr. Drossman: Shawn - eating causes stretching of the stomach when the stomach strecthes it releases hormones or peptides that stimulate the lower bowel. Because people with IBS overrespond to stimuli (like peptide release) you get an exaggerated motility response and pain, so smaller meals reduce this"
Have you ever heard of the gastro colonic reflex?
It is altered in IBS, so just the act of eating can bring on symptoms in 15 minutes. This is not from a specific food in general, but like I said the act of eating.
In the middle of this page are two graphs of a normal person sigmoid colon 15 minutes after they eat and an IBSers sigmoid colon. You will see the IBSers is off the chart.
http://www.webpotential.com/falcon/uploadpic/
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"Postprandial abdominal discomfort may be attributed to an exaggerated gastro-colonic reflex (the colonic contractile response to a meal), the presence of colonic high amplitude-propagated contractions, increased intestinal sensitivity (visceral hyperalgesia), or a combination of these. Fat ingestion may exaggerate hypersensitivity."
http://www.merck.com/mmpe/sec02/ch021666/ch021666a.html
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Basically what this means is the act of eating itself can cause a problem. The stomach sends a signal to the large intestines food is on the way and the lower intestines can overreact, casuing d. Part of this reaction, a big part actually is the amount of calories in the meal and fat. Fat is a big trigger to the reflex.
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This is one reason why a lot of IBS sufferers sometimes think that a particular food is the culprit to symptoms when it may or may not be.
"gastrocolic reflex
This is the reflex system that tells the colon to empty when food hits the stomach, or even in anticipation of a meal. This is why baby poops every time he nurses. It is also why kids with constipation complain of their belly aches right around mealtime. "
"Medical Dictionary
Definition: increase of muscle movement in the gastrointestinal tract when food enters an empty stomach; may cause the urge to have a bowel movement right after eating. "
In IBS this reflex is exaggerated.
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"Why Symptoms Occur During normal digestion, foods are broken down in the stomach and small intestine so that their nutrients can be absorbed into the body. Undigested or partially digested portions -- mostly in liquid form -- then enter the large intestine colon where most of the water is reabsorbed. Movement through the intestines results from peristalsis, a wavelike contraction of muscles in the intestinal walls that propel their contents forward. When all is well, the end result is stool that is solid but soft enough to be excreted easily.
Diet, eating habits, stress, and various environmental factors can disrupt the normal function of the intestines. If the intestines squeeze too hard or not enough, the partially digested food can travel too rapidly or too slowly through the digestive system. Movement that is too fast will result in diarrhea, because not enough water is reabsorbed. Movement that is too slow can result in constipation, because too much water is absorbed. Overly hard squeezing (spasm) can result in cramps. However, the diarrhea of IBS can also occur without pain.
IBS symptoms occur after eating because of the gastrocolic reflex -- increased movement of the intestinal contents in response to food entering the stomach. The strength of this reflex can be influenced by the volume and temperature of the food and the number of calories. Large meals particularly high-fat meals and large amounts of cold beverages can trigger IBS attacks."
This is in Heathers book, under altered gastro-colonic responce and is well known in IBSers.
I personally think its important not to chase down every food molecule that could be a trigger. As well as possible ignore othertriggers like stress, emotions, fear, anxiety antispatory anxiety as they can be very important as well. Some of these emotions trigger the same cells in the gut the foods trigger.
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My website on IBS is www.ibshealth.com
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For as long as I can remember, I have not been able to eat anything solid when I feel stressed or upset about something until the situation has passed. The very LAST thing I want is food under such circumstances. If I force myself to eat under such circumstances, I feel sick (not necessarily trips to the bathroom, but bloated and nauseous).
Most people I know (non-IBSers) run right to the frig or pantry when they are feeling stressed or upset. Not me! Even the thought or smell of food makes me feel like I want to throw up.
Thanks for the helpful info here. I think I just made some progress in understanding some things about myself, and I can now give myself permission not to eat when my body is not cooperating, even if others insist that I MUST eat something. I'll stick with tea and broth during those times, and be the one to decide when I can resume eating solid food meals again.
I will also say that it is so very important (at least to me) to set boundaries with the people and situations that are known stressors in life. We all have stress at times, yet we need not invite more!
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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Windchime, stress/anxiety which are differnt things,in IBS or in general is not what a lot of people actually understand or know or think about when it comes to how it actually works. Also it is both physical and mental stress.
There circuits hard wired to the brain that influence the digestive system.
The Central nervous system is connected to the peripheral nervous system and then very importantly the The Autonomic Nervous System, that runs many of the bodies functions, importantly Digestion.
The ANS is most important in two situations:
In emergencies that cause stress and require us to
"fight" or take "flight" (run away)
and
In nonemergencies that allow us to "rest" and "digest."
http://faculty.washington.edu/chudler/auto.html
The fight or flight effects digestions and can through emotions,such as fear, antisapatory anxiety, anxiety and others.
Have you ever heard of people getting the S**t scared out of them?
http://www.thebodysoulconnection.com/EducationCenter/fight.html
The fight or flight can make you go and sometimes make you vomit even or cause nausea. This is connected to IBS in many ways. Importantly through whats called the HPA axis or The hypothalamic-pituitary-adrenal axis.
Have you ever heard the term homeostasis?
"Comment from Emeran A. Mayer, M.D. -- In contrast to the common interpretation of the term "stress" as a psychological phenomenon, it should be understood as any real or perceived perturbation of an organism's homeostasis, or state of harmony or balance. For example, in this viewpoint a severe hemorrhage, starvation, extreme temperature, or worry about the unpredictable onset of abdominal pain all qualify as stressors -- some as "physical" stressors, others as "psychological" stressors. The fear to leave the house in the morning without knowing if one can make it to work without having to stop on the freeway because of an uncontrollable bowel movement, or the fear of experiencing uncontrollable abdominal discomfort during an important business meeting are sufficient stressors to activate the central stress system.
The central stress system involves the release of chemical stress mediators in the brain (such as corticotropin releasing factor), which in turn orchestrate an integrated autonomic, behavioral, neuroendocrine, and pain modulatory response. This biological response in turn will alter the way the brain and the viscera interact, and this altered brain-gut interaction can result in worsening of IBS symptoms. Thus, pain and discomfort, fear of these symptoms, activation of the stress response, and modulation of the brain-gut interactions by stress mediators are part of a vicious cycle which need to be interrupted to produce symptom relief."
Careful about not eating somewhat, some IBSers don't eat for long periods of time, then eat and that can physically stress the gut and cause problems, which is one reason why small meals are important.
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My website on IBS is www.ibshealth.com
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