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rice milk
      #364754 - 05/15/11 08:03 AM
ibsholly

Reged: 11/09/10
Posts: 98


just wondering am on a fructose's free diet and helping a lot
i have just started have acid reflux not a lot but enough i have burning when i eat even a raspberry
just wondering if rice milk was fructose's free or Alpo unsweetened milk was safe i no soya can cause gas but a unsure if rice milk will cause more constipation thank you for posting

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Re: rice milk new
      #364755 - 05/15/11 08:47 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Hi IBSHolly

Presumably you fructose malabsorption and not herditary fructose intolerance. The later is a serious genetic disease which requires the elimination of all foods contain fructose. The former only requires removing foods that contain more fructose than glucose such as honey, apples, pears, high fructose corn syrup, etc. You can read more about fructose malabsorption in the first link in my signature.

If you have fructose malabsorption then rice milk should not be a problem.


--------------------
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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Re: rice milk new
      #364760 - 05/16/11 12:49 AM
boron

Reged: 05/11/11
Posts: 47


White rice is not problematic because of fructose. White rice milk might cause constipation if you have FM or not.

Like said, in FM, it is a low-fructose diet, not necessary fructose-free diet, recommended. The amount of fructose someone can tolerate varies a lot from person to person. Search for "nutrition guide in fructose malabsorption" to find foods to try and to avoid.

Besides fructose, polyols (sorbitol, xylitol, maltitol...) used as sweeteners, fructans in wheat and onions, fructooligosaccharides (FOS) and HFCS are often problematic in FM.

I've interviewed several people with FM ad quite some cannot tolerate sucrose, despite its gluctose:fructose ratio 1:1.



--------------------
I don't have IBS.

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Re: rice milk new
      #364763 - 05/16/11 05:19 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

You might not be able to put much significance to self-reported problems with sucrose since the physiology of fructose malabsorption does not support the notion that sucrose can be much of a problem for individuals with FM. You can review the physiology of fructose and sucrose malabsorption in the reference below The authors say that "sucrose malabsorption is associated with sucraseisomaltase deficiency, a very rare congenital condition. It will not be considered any further in this review."

BTW - there are a few errors in the Nutrition Guide for Fructose Malabsorption. For example, there is no excess fructose in distilled vinegar, nuts, chick peas, etc which are in the try in moderation column. It looks like the author has mixed up some of the FODMAP stuff with soley FM problems.

Reference
Gibson, P. R., Newham, E., Barrett, J. S., Shepard, S. J. & Muir, J. G. Review article: fructose malabsorption and the bigger picture . Alimentary Pharmacology & Therapeutics 25, 349-363 (2007).


--------------------
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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The Role of Food & Dietary Intervention in IBS

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Re: rice milk new
      #364767 - 05/16/11 11:02 AM
boron

Reged: 05/11/11
Posts: 47


I'm the author of the mentioned article.

1. About SUCROSE in fructose malabsorption:

It is true that glucose helps in absorption of fructose, but this facilitation is limited, so large amounts of sucrose are not recommended in FM.

"Fructose, even when delivered...as sucrose, can induce symptoms of IBS in some people."

In the linked article below, drinks sweetened with sucrose are listed under problematic foods.

Source: article written by a leading fructose malabsorption researcher Susan Shepherd:
http://sacfs.asn.au/download/SueShepherd_sarticle.pdf

2. In FM, problematic nutrients, besides fructose and sucrose, include: HFCS, polyols (xylitol, maltitol...), fructooligosaccharides (FOS) or oligofructose, and inulin. In a "low-fructose" diet, excluding or limiting all of those nutrients is recommended, which makes a low-fructose diet very close to a low-FODMAP diet (Ref: the same link above).

It seems I have mistakenly added galacto-oligosaccharides (in chickpeas, lentils and other legumes), and there is not enough evidence to support exclusion of nuts (except coconuts) and vinegar in a low-fructose diet. I'm not the owner of the site where my article is, so I'll see what I can do.

--------------------
I don't have IBS.

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Re: rice milk new
      #364769 - 05/16/11 01:07 PM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Ah - ha - It nice to know who wrote that article. It is a pleasure to meet you. Glad to hear you will try to fix some of deficiencies. It would be helpful to those of us with FM.

If you check the second reference in my signature by Gibson and Shepherd which is a more recent article they say "Thus, fructose malabsorption manifests when free fructose (i.e. in excess of glucose) is in the lumen. This is the reason why fructose supplied in the form of sucrose is only malabsorbed if sucrase activity is diminished." In addition they say that foods with > 3 g per fructose per serving are termed a 'high fructose load' and possibly at-risk of inducing symptoms. They go on to say that the concept of a 'high fructose load' has not been evaluated in terms of its importance in the success of the FODMAP diet. I believe so far the clinical research has not supported the supposition about sucrose.

--------------------
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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Re: rice milk new
      #364771 - 05/17/11 12:01 AM
boron

Reged: 05/11/11
Posts: 47


To clarify: that article is about "functional gastrointestinal symptoms", which may be or not related to fructose malabsorption. The term "functional" disorder in medicine is used when no underlying organic/biochemical disorder can be identified. From what I understand now about FM, this is a distinct disorder (deficiency of fructose-transporting protein GLUT-5) and not a functional disorder (IBS). In the article, they try to cover the diet for both.

Despite the explanation about sucrose, they still recommend in the same article:
"Limitation of dietary fructose load (in the form of free fructose or sucrose) at any one meal;"


--------------------
I don't have IBS.

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Re: rice milk new
      #364772 - 05/17/11 04:49 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Yes - FM is not a functional disorders since fructose malabsorption is a physical problem in the GLUT transport system. However, FM and other FODMAPs can exacerbate functional GI disorders such as IBS. One of their recent studies suggested that 50% or more of all IBS subtypes have FM. Gibson and Shepherd original work was on FM only then they expanded it to include other short chained carbs in the FODMAP approach for managing functional GI disorders.

Notice that unlike the other papers where for example they specified the amount of fructose load at < 3 gram/serving in this paper they relaxed this statement and simply said "limitation of ..." with no amount specified and no information in the body of the text about limiting sucrose. Even in their orginal paper on FM they said that malabsorption of fructose when consumed as sucrose or equimolar fructose/glucose in large amounts occured in a minority of patients using the breath test. You might also find the reference below of interest on too.

Fortunately, while I am very sensitive to small amounts of excess fructose I have no problems with sucrose

Reference
Rumessen, J. J. & Gudmand-Hoyer, E. Absorption capacity of fructose in healthy adults. Comparison with sucrose and its constituent monosaccharides. Gut 27, 1161-1168 (1986)

--------------------
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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Re: rice milk new
      #364793 - 05/18/11 02:38 PM
Susie1985

Reged: 05/04/11
Posts: 211


'However, FM and other FODMAPs can exacerbate functional GI disorders such as IBS.'

So can FODMAP sensitivity in people with IBS be only inorganic?

if say fructose never caused problems when you were younger (and as we'd discussed earlier that apart from lactose intolerance other FODMAP woes are not likely to appear out of the blue as one ages?). In other words, if FODMAPs now exacerbate someone's IBS only, so if IBS is 'cured' with hypnosis, FODMAP sensitivity could also disappear?

Lactose is to be eliminated for me for ever, don't care to be honest, but I do get a lot of bloating from fructans, but still not sure whether it was a problem before IBS, ie it should not be an organic problem then if it doesn't usually increase with age... (unless IBS itself can create an organic problem?)

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: rice milk new
      #364794 - 05/18/11 04:23 PM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

I have not found anything from an authoritative source that can completely answer your questions. However, Prof. Whorwell at Manchester and others are beginning to address such issues using brain imaging techniques. He discusses some rudimentary thoughts in the paper referenced below. Here are my thoughts.

Lactose & fructose are FODMAPs. Lactose intolerance and fructose malabsorption have known organic causes. Hypnosis will not cure either.

A characteristic of IBS is hypersensitivity to GI stimuli. FODMAPs can produce stimuli that exacerbate IBS symptoms e.g. gas. Hypnosis can help desensitize one's sensitivity to GI stimuli. Depending on the degree of sensitivity one has to FODMAP or other GI stimuli it may be possible for you to become less sensitive and hence less bothered. This does not mean the underlying organic processes involved with FODMAPs or any other GI stimuli are gone. You have modified your perception and other physiological processes.

Reference
Whorwell, P. J. Hypnotherapy for irritable bowel syndrome: The response of colonic and noncolonic symptoms . Journal of Psychosomatic Research 64, 621-623 (2008)

--------------------
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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Re: rice milk new
      #364796 - 05/19/11 02:34 AM
Susie1985

Reged: 05/04/11
Posts: 211


I see, thanks. When did fructose malabsorption rear its ugly head for you?

As I said, I'm pretty certain that I did not have it pre-IBS, which would indicate that I shouldn't have it as an organic problem now...

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: rice milk new
      #364800 - 05/19/11 07:17 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Not sure when FM first appeared fro me.

Recall that everyone - even normal individuals - are FMs when the fructose load is high enough. A diagnosis of FM is made when there is a change in the level of hydrogen and/or methane breath gas above 20 parts per million after consuming a 25 gram load of fructose. The test does not tell you if you can or cannot handle smaller loads such as 1, 5, 10 etc gram load. It is possible that you have always been a FM but only after after you got IBS did you consciously recognize that FM was causing bloating, etc due to increased sensitivity to GI stimuli.

--------------------
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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Re: rice milk new
      #364803 - 05/19/11 03:08 PM
Susie1985

Reged: 05/04/11
Posts: 211


I see. But if I was always FM but had no symptoms, ie no bloating, then how is that different from normal individuals, ie can it wreak havoc without even causing symptoms?

I may experiment with apples, I never used to eat anything else from that column. But fructans are 100% certain to be causing a lot of bloating for me and bread had been a staple all my life.


--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: rice milk new
      #364804 - 05/19/11 05:26 PM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Bloating is a sensation. Distention a physical change in girth. They don't necessarily go hand-in-hand. It is possible that you had some bloating pre-IBS but you were not sensitive to it.

Reference
Agrawal, A. et al. Bloating and Distention in Irritable Bowel Syndrome: The Role of Visceral Sensation. Gastroenterology 134, 1882-1889 (2008).

Agrawal, A. & Whorwell, P. J. Review article: abdominal bloating and distension in functional gastrointestinal disorders - epidemiology and exploration of possible mechanisms Alimentary Pharmacology & Therapeutics 27, 2-10 (2008).

--------------------
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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Re: rice milk new
      #364807 - 05/19/11 11:04 PM
skh

Reged: 08/05/09
Posts: 151


why does rice milk cause constipation?

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Re: rice milk new
      #364809 - 05/20/11 12:08 AM
Susie1985

Reged: 05/04/11
Posts: 211


Wow, thanks, I never drew a distinction... For me it was - have to unbutton my trousers or looking in the mirror I decidedly look pregnant....(Even now btw it's not usually associated with pain either.) So always used bloating and distention and gas interchangeably for this condition..

So it's an acute problem with IBS, but certainly had this problem before IBS, and may have been due to fructans/lactose. I used to have white bread sandwiches and cheese, then had this problem. Then when I had a lot of wholemeal bread/breakfast cereal on a massive scale during the couple of months before IBS started I had no such problems anymore...(but wholemeal bread is a fructan too!)

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: rice milk new
      #364811 - 05/20/11 02:38 AM
boron

Reged: 05/11/11
Posts: 47


Susie,

you've mentioned earlier that both bread and onions give you gas. Wheat and onions are high in fructans. Onions also contain fructose. Fructans are problematic for individuals with fructose malabsorption (FM). It depends on the severity of fructose malabsorption and the *amount* of wheat or onions eaten, how much gas will be produced. If you can eat two tablespoons of honey (high in fructose) without having obvious gas or diarrhea within 48 hours, you do not likely have fructose malabsorption.

--------------------
I don't have IBS.

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Boron - Question new
      #364816 - 05/20/11 06:37 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Do you have IBS, FM, both or neither?

Can you give me a reference source for the fructose content of onions indicating they have excess free fructose? The USDA database lists onions as having about 1.3 grams fructose and 2 grams glucose per 100 grams. Also, Gibson and Sherpherd make no mention of onions have excess free fructose. They definitely have fructans


--------------------
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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Re: rice milk new
      #364817 - 05/20/11 07:33 AM
Susie1985

Reged: 05/04/11
Posts: 211


You can have fructose malabsorption and be not sensitive to fructans and vice versa as far as I know. And no FODMAP table I've seen has ever indicated that onions are high in fructose.

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: rice milk new
      #364820 - 05/20/11 10:11 AM
ibsholly

Reged: 11/09/10
Posts: 98


can i ask there is winter and summer sqaush in uk i think its callled corggettes and there green but what about the oranges sqaush are they safe for fructouse

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Re: rice milk new
      #364822 - 05/20/11 10:39 AM
Susie1985

Reged: 05/04/11
Posts: 211


Courgettes=zucchini

butternut squash:
http://www.mysupermarket.co.uk/tesco-price-comparison/Vegetables/Tesco_Organic_Butternut_Squash_Approx_155Kg.html

never eaten this in Britain: http://www.cookhereandnow.com/cookhereandnow/images/2007/09/30/yellow_zucchini.jpg

let's wait for Syl to confirm but as far as I know these are all ok on both the fructose/SF-IF front

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: @ Susie and Syl new
      #364824 - 05/20/11 11:51 AM
boron

Reged: 05/11/11
Posts: 47


Onions contain fructose
Source: Fineli.fi

Onions are on the FODMAP lists, like here:
http://www.mecfs-vic.org.au/sites/www.mecfs-vic.org.au/files/Article-BarrettPractGastro.pdf

I don't find onions especially sweet, and I believe several people with FM can safely eat them.

I have neither FM nor IBS. If I eat few pears at once I have two-day free abdominal orchestra, but no problems with apples, honey, HFCS. If I eat white bread and drink soda I get constipated; wholegrain bread solves this nicely.


--------------------
I don't have IBS.

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Re: @ Susie and Syl new
      #364825 - 05/20/11 12:16 PM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Yes - they contain fructose but they don't contain more fructose than glucose so the fructose is not a problem.

According to the Barrett reference you provided it say "Thus, fructose is well absorbed in the presence of equimolar glucose in the proximal small intestine (25), whereas free fructose is slowly absorbed and such absorption occurs right along the length of the small intestine." They go on to say "since fructose is absorbed efficiently in the presence of an equimolar concentration with glucose, people with fructose malabsorption need to avoid foods high in free fructose, but can manage those with balanced concentrations of fructose and glucose (or a greater concentration of glucose)."

Onions fall into the latter category. It is the fructans that can be a problem for some but not the free fructose.

It would be helpful if you noted in your signature that you don't have IBS. As far as I known almost everyone in this forum has IBS.


--------------------
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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Re: @ Susie and Syl new
      #364826 - 05/20/11 01:00 PM
ibsholly

Reged: 11/09/10
Posts: 98


so winter squash is safe as well as courgettes i cant have them both the one from tesco and the green courgettes or zucchini

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Boron! How dare you be lurking on this forum when you don't even have IBS? new
      #364827 - 05/20/11 01:02 PM
Susie1985

Reged: 05/04/11
Posts: 211


we hate healthy people, you know...

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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overall amount of IF new
      #364828 - 05/20/11 01:10 PM
Susie1985

Reged: 05/04/11
Posts: 211


Pardon, you can't have them both?

I think they are both safe. as for quantity, a lot of people esp those who are particularly sensitive to IF have found that it's not enough for you to have enough SF with IF, the overall amount of IF within a meal must also be kept low. E.g. Syl is v careful with his diet in this regard and does not for instance have spinach, even though it is FODMAP greenlighted. Half a cup of spinach has 0.5g SF and 1.1g IF. If I want to be extra safe I'd eat it with around 0.5g SFS and I have no trouble. (But Syl for instance restricts his IF intake to a lot less than 1.1g IF per meal.) Depends on the individual.

Here is a great pointer, courtesy again of Syl: http://huhs.harvard.edu/assets/File/OurServices/Service_Nutrition_Fiber.pdf

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Boron new
      #364833 - 05/20/11 08:24 PM
Gerikat

Reged: 06/21/09
Posts: 1285


Boron, you sound very knowlegeable. Good for you that you are not bothered with IBS. I was just wondering, do you just suffer from occasional stomach issues?

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Re: All new
      #364834 - 05/21/11 02:45 AM
boron

Reged: 05/11/11
Posts: 47


@ Syl. It would help if you say in your signature you have FM and not IBS. As you know, IBS is an exclusion diagnosis. Yes, onions might be more about...onions than fructose.

@Susie. So, you have a pseudo disease. That's beyond my knowledge.

@Gerikat. I got butterflies in my stomach after reading your post. Do I qualify now?

@ibsholly. I'm starting to believe there is no safe food list for IBS. Insoluble fiber > soluble fiber concept seems to have so many exceptions to the point being unreliable. For example, Psyllium husk is SF>IS but many cannot tolerate it.

--------------------
I don't have IBS.

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Re: Boron new
      #364835 - 05/21/11 03:40 AM
Susie1985

Reged: 05/04/11
Posts: 211


That is a bit insulting. How is IBS or indeed FODMAP sensitivity a pseudo-disease?

And FYI I don't think you can be constipated if you eat white bread and not wholemeal bread... (Do wonder what your definition of constipation is then... And you seem to think you are an expert yet think that onions are problematic for fructose malabsorption sufferers just because they contain fructose, that's v helpful.. (not) but totally misleading..)

And how many people did you find that said that psyllium didn't work for them? In case you didn't read my post closely enough, for me it does/would work, most things with excess SF as opposed to IF do (but I wouldn't experiment with wholegrains as grains are different from vegetables) but anyhow I'm not going to waste my IF intake on a SFS when I can get that from healthy fruit and veggies that's why I use a 100% SF SFS.

Syl restricts his overall IF intake drastically btw, if you read some of the other posts you'll see that that is the case. And on what grounds you worked it out that he hasn't got IBS is beyond me.



--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: All new
      #364836 - 05/21/11 05:14 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Quote:

It would help if you say in your signature you have FM and not IBS. As you know, IBS is an exclusion diagnosis




Fortunately, I like many others on this board have been officially diagnosed with both. I would have thought you might have known from reading the FODMAP literature that FM and IBS can co-exist. Over 50% of individuals diagnosed with IBS have FM too (See the reference below) so you can assume that a high percentage of individuals with IBS have FM too. This is one reason the FODMAP approach is used to manage functional GI disorder symptoms.

As for IBS an exclusion diagnosis you might want to consider this an old notion. The International Foundation for Functional Gastrointestinal Disorders has a web site aboutIBS.org that has an excellent article titled Current Approach to the Diagnosis of Irritable Bowel Syndrome

Quote:

In the past three decades, medical opinion has changed regarding how to diagnose IBS. The older view emphasized that IBS should be regarded primarily as a "diagnosis of exclusion;" that is, diagnosed only after diagnostic testing excludes many disorders that could possibly cause the symptoms. Because many medical disorders can produce the cardinal features of IBS, in particular abdominal discomfort or pain and disturbed bowel habit, this approach often led to extensive diagnostic testing in many patients. But there is no end to the studies that can be done to exclude other diagnoses. The perceived need by both physicians and patients to pursue other diagnoses rests in part with their limited understanding of IBS. It is a real condition with well defined clinical features and specific diagnostic criteria; this recognition can reduce unneeded testing.




This is partially a result of the Rome III diagnostic criteria used to diagnosis functional GI disorders such as IBS. In a naive sense any procedure that involves a differential diagnosis could be consider a diagnosis by exclusion.



Reference
Barrett, J. S., Irving, P. M., Shepherd, S. J., Muir, J. G. & Gibson, P. R. Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders Alimentary Pharmacology & Therapeutics 30, 165-174 (2009).

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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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Re: Boron new
      #364837 - 05/21/11 05:40 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Susie - a pseudodisease is the term used by a radiologist and lung-cancer specialist (William Black) to describe tumors that will never cause harm. A pseudodisease is nearly impossible to identify in an individual who is still living, because the medical community doesn't know enough about some cancers to predict how they will behave over time. There is an excellent discussion on it on this web page

It has nothing to do with IBS or FM

--------------------
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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Re: Boron new
      #364838 - 05/21/11 06:25 AM
Susie1985

Reged: 05/04/11
Posts: 211


Thanks, that is interesting. But not really sure how Boron diagnosed me with it (over the internet) and why he thinks I should have it.

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: Boron new
      #364839 - 05/21/11 07:10 AM
Thai

Reged: 10/04/09
Posts: 104


susie....

your signature line states you have IBS (pseudo)D, so no doubt this is where he got it from...

--------------------
IBS-D

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Re: Boron new
      #364840 - 05/21/11 07:20 AM
Susie1985

Reged: 05/04/11
Posts: 211


gosh.. which obviously means pseudo-diarrhoea... as D on this forum always means diarrhoea

thought that was obvious but apparently not to him.

thanks anyway, I'll edit it right now.

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: All new
      #364841 - 05/21/11 07:26 AM
Gerikat

Reged: 06/21/09
Posts: 1285


Hey Boron you're funny. You qualify!! teehee. It's all good. By the way, I don't get the signature thing. He controls/runs the boards (or at least he thinks he does) with an iron fist, so you better follow his rules or you will be in big twouble. I was giving you a compliment, by the way, not questioning your right to be here.

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Re: Boron new
      #364842 - 05/21/11 07:31 AM
boron

Reged: 05/11/11
Posts: 47


I came on this forum to read experiences about effects of dietary fiber and foods in general on gastrointestinal symptoms, since I'm writing an article about nutrients and I'm trying to get an impression about what can be good or bad "for many" and what only for some.

@Susan. You have a "pseudo" word in your sig, what made me think you consider your condition complicated, so I did not planned to come with some specific advice. I'm not trying to devaluate any condition. White bread constipates me, it may be annoying and I even don't have IBS.

I believe, a doctor can give a diagnosis of IBS based on symptoms (abdominal discomfort for at least three months, at least three days in a month...), but only after exclusion of organic disorders, including fructose malabsorption (FM). Diarrhea is a typical symptom in FM and insoluble fiber may worsen diarrhea in FM, since it absorbs water and makes stool bulky and thus acts as a laxative. I don't know why additionally include IBS principle here, but I'm sure Syl has some reason to sig with IBS rather than FM.

These search results show that *some* (not all) people on this forum believe psyllium may worsen their symptoms, despite its SF>IF ratio. It might simply be an *amount* of IF in psyllium that is problematic.

Fructooligosaccharides (FOS), a soluble fiber, may worsen symptoms in IBS, at least in first weeks after introduction.

--------------------
I don't have IBS.

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for Boron new
      #364843 - 05/21/11 07:34 AM
Susie1985

Reged: 05/04/11
Posts: 211


there you go:
http://en.wikipedia.org/wiki/Pseudodiarrhea

D on this forum has never ever meant disease.

and thanks, 'beyond your knowledge', I never asked for your help/ knowledge in the first place. When I posted something specific, e.g. asparagus and apricots, I asked fellow sufferers. you asked us specific questions which I happily answered regarding me. but to be honest now I am unsure whether I would trust the opinion of someone like you, slightly self-righteous and a bit full of themselves (if I may), who will go and spread misinformation (either about onions or psyllium) on a board where sufferers may take his word at face value. FYI if I am interested in the science behind anything I usually email Syl privately, as don't mean to take up space when a lot of people on this board are not particularly interested in/may be irritated by the science behind this.

am quite annoyed as you can tell, but I feel v strongly about others propagating false information with such full conviction.

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: for Boron new
      #364846 - 05/21/11 08:19 AM
boron

Reged: 05/11/11
Posts: 47


Susie,

it is this very forum, where some people have clearly said psyllium husk may cause them problems, so this is not misinformation from me. If you write in Google "psyllium IBS" you can see good and bad experiences with it.

I've already corrected myself about fructose/onions in one post above.

--------------------
I don't have IBS.

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Re: for Boron new
      #364848 - 05/21/11 09:58 AM
Susie1985

Reged: 05/04/11
Posts: 211


ok, thanks.

I think by and large anything that has more SF than IF should work, but overall IF matters too. plus, this is where the FODMAP thing comes in that there are additional caution rules.

Btw if someone like Syl has FODMAP trouble, the most obvious way to test whether they have problems on top of that, ie have IBS (which is most often characterised by responding negatively to digestive stimulants such as alcohol, caffeine, IF and fat) - do you think that if Syl ate spinach and ate strawberries and raspberries, beansprouts or even oranges (as a fruit) that he'd be fine? These are all FODMAP safe yet you may still have trouble with them ie have IBS as well, these two conditions very often overlap..

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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