Underweight, poor appetite and always feeling bloated - any suggestions?
#366807 - 02/05/12 07:04 AM
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I just wondered whether anybody else has been having the same trouble as me - I don't get cramps or spasms (unless I take an aloe vera tablet or something but I hardly ever do), I just get a dull, irritated aching pain in my lower abdomen and have no proper appetite and feel so bloated that the pressure itself hurts.
My diagnosis is IBS-C, but bowel movements don't usually make things any better (which makes me think it might be more of a gas transit issue but to be honest I just don't know).
I get the odd couple of days where I feel totally fine and normal and what I eat doesn't seem to matter much but the rest of the time there seems to be nothing I can eat that makes any difference.
If anybody else has this sort of IBS and has any suggestions for me I would be very grateful as it's getting me down rather. I am underweight and worry that I'll be unable to have children if I can't find some way of eating more without feeling completely rotton 24/7...!
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Have you checked out the FODMAP approach to managing bloating, etc in functional GI disorders such as IBS. I use this approach in conjunction with Heather's EFI diet. For information on the clinically FODMAPs to reducing bloating and discomfort functional GI disorders check the first two links in my signature.
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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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Yep, I've tried eliminating FODMAPs, had already tried cutting out wheat and dairy and following the eating for IBS guidelines. Each time I eliminated stuff things improved somewhat but would then go pear-shaped after some really innocent meal, like fish and rice or chicken and vegetables.
I'm still keeping FODMAPs low as I think it makes a lot of sense, but my symptoms still aren't well-controlled.
I have noticed that I seem to react quite badly if I have any normal sized servings of meat or fish, even though I always have them lean and low fat, so I don't know what the underlying problem is. My doctor is (quite understandably) at a loss and has prescribed me something to try and boost my appetite but when you feel bloated and uncomfortable and eating makes this worse it's not really possible to feel properly hungry is it?
I think controlling FODMAPs does help, but I wonder if there's anything else I can do to relieve the symptoms if they still persist...
What I really don't get is why I am having this trouble now - I used to be able to eat anything and everything till I was about 19 then all this started. I'm 24 now, and jealous of all the other people my age who seem to be completely fine :-P My bloods are always perfect, no inflammation, no coeliac, no malabsorption. Sometimes I just wish something would show up so I knew there was something clear to deal with.
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You might consider eating 4 or 5 meals a day instead of 3 main ones. Many people with IBS find this helps manage symptoms.
Which veggies are you eating and how are you preparing them? Did you experiment with remove of fruits with excess fructose such as apples, pears, etc and reducing galactans found in onions, garlic, soy, etc?
Have you considered trying the gut-directed hypnotherapy CDs? Clinical trials have shown hypnotherapy to be quite effective particularly in younger individuals. You might find the article Hypnosis treatment of IBS on the International Foundation for Functional Gastrointestinal Disorders web site of value.
Did you GI doc describe you as being IBS-C, IBS-D or IBS-A? It would be helpful if you gave us a list of the meals and snacks you have eaten in past 2-3 days. 
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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 actually eat very few fruits and vegetables, usually only bananas (but never unless ripe), well-boiled root vegetables like carrots, parsnip, squash and potatoes. I have been pretty rigourous with eliminating FODMAPs as I figure if you're going to try something you might as well do it properly!
Diagnosis is IBS-C with bloating and lower abdominal dull, aching pain.
I can probably list all the foods I have had in the past few days in a couple of lines, the range has just got narrower and narrower as I've tried to control symptoms though as you say the way I eat does make a difference like eating little and often instead of large meals which I virtually never attempt as it never ends well!
At the moment my staple foods are porridge (made with rice milk and oats which I've put in the food processor to make them easier to digest), bananas, white rice, potatoes, carrots, lean meat or fish, rice cakes, rice crispies (riice milk again), quinoa, chocolate (I know this is a trigger food but I never have much of it!), oat biscuits + a bit of peanut butter. I always boil or bake, rarely fry. I drink fruit teas or weak black tea with a dash of milk. Oh yes and mints (no artificial sweeteners, just sugar!).
Is the gut directed hypnotherapy to do with past life regression? Or is it focussed on the gut? Because I went to a hypnotherapist but when she started wanting to go back to my birth I got a bit weirded out and ditched it... I have a tape she made me to try and make me relax but stress really doesn't seem to be a factor in my IBS, I'm just as bad in holiday time as exam time! In fact at some very bad times in terms of stress my physical symptoms have been better than usual (adrenaline perhaps? I know it sounds contrary to all the research on IBS but that's just my experience).
If hypnotherapy would really help me of course I think it would be worth a shot, but it's expensive if it doesn't work! I'm a student and will be for another 4 years so a bit low income...
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Gut directed hypnotherapy is a type of hypnotherapy designed specifically to target IBS symptoms. It has nothing to do with past life regression which is not really a medical form of hypnotherapy. Over the past 25 years or so there have been many clinical trials of the effectiveness of gut-directed hypnotherapy which generally shown to be effective frequently for individuals who don't have success with drugs and diet. The American Gastroentrology Society's report An Evidence-Based Systematic Review on the Management of Irritable Bowel Syndrome say that "Cognitive behavioral therapy, dynamic psychotherapy, and hypnotherapy but not relaxation therapy are more effective than usual care in relieving global symptoms of IBS". If you have medical insurance it may be covered but you will have to look for a hypnotherapist conversant in gut directed techniques.
Something you might also consider is that rice cakes are usually made from brown rice and they have a considerable amount of insoluble fiber. Also, some people find that no matter how fine insoluble fiber is ground that it makes no difference to IBS symptoms. You might try removing the oatmeal, oat biscuits and quinona (a whole grain product) to see if it makes a difference. You can always try them again when you are more stable.
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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'm in the UK so no health insurance since we have the NHS, though hypnotherapy is only now being considered as a medical treatment and not a complementary therapy (most are not available on NHS).
That kind of gut-directed hypnotherapy sounds much better though, can you do it just using CDs or do you need to see someone? I looked up hypnotherapists in the area and this lady had IBS on her list of things she could treat but she clearly had a different approach to the kind you're talking about! There are some CDs recommended on this website aren't there? Might they be suitable for me do you think?
I seem to tolerate oats and rice cakes quite well, I'm feeling a lot better today than I have for a while and all I've had is porridge, a banana, rice crispies, oat biscuits and rice cakes, then jacket potato and butter and carrots and a bit of sliced pork for dinner, though I suppose it could just be because I've not eaten that much overall... the trouble is, if I cut out those things then I wouldn't be left with much at all!
Thank you so much for your advice by the way, I'm conscious that I sound very moany! I really appreciate it :-)
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If you are in the UK then you are lucky. You might ask your GP for a referral to the South Manchester Functional Bowel Service . The Director, Prof. Whorwell, did some of the first clinical studies in the use of hypnotherapy for managing IBS in the early 1990s. He has done leading edge research in the use of diet, probiotics and other mechanisms for managing functional bowel disorders. He is a world leader in IBS research and clinical practice.
You don't sound like a moaner to me. You sound like a person in search of knowledge and tools.
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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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Hi! I thought I'd replied to this post but for some reason it doesn't seem to have worked.... can't remember what I put now. Drat.
Well I have looked at the website for the Manchester IBS clinic and it is amazing! I am definitely going to ask my doctor if she is willing to refer me there, I can't believe I've never come across it before. Their hypontherapy stuff looks far better than the experience I had when I tried before, and their eating guidelines look very similar to the EFI guidelines, plus they have the link to a paper about FODMAPs suggesting eliminating them.
Thank you so much for this info, it's excellent!
The only thing that worries me is how limited I am if I eliminate FODMAPs and stick to the EFI rules too - pretty much leaves me with white rice, potatoes, a few vegetables, lean meat/fish, limited bananas, sweeties, rice crispies with rice milk.... is there anything else obvious that I can have? I just don't want to limit myself more than I have to because of the weight issue!
Thanks again :-)
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Hi,
The initial stages of the FODMAP diet are restrictive, particularly if you're combining them with the EFI guidelines. However, the aim, as I'm sure you know, is to reintroduce the FODMAP groups individually to see which foods and in what portions you can tolerate them.
For example, mushrooms and beetroot are both foods to avoid in the 'elimination phase', however, I've found that I can tolerate both in moderate portions with a basis of soluble fibre.
I notice, from a previous post, you mention eating pork (red meat) and butter (dairy/fats). Both are IBS triggers. You might want to substitute those.
Have you tried rice noodles or rice/corn pasta. There are also a number of techniques, detailed on this website, that you can adopt to incorporate more FODMAP friendly insoluble fibre (e.g. fruits and veg)into your diet.
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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You sound a lot like me symptom wise. I have used the hypnosis CDs and love them. They were really a life saver. No regression in these. They are all gut related or relaxation. Relaxation helps the message get through. I still use them when I get bad symptoms. They really helped me.
My food are very limited too. There is a product you can get called PB2 that is a powdered peanut butter with 85% of the fat removed. You mix it with water to use it. To me it tastes just like regular peanut butter and I can tolerate it just fine.
I too lost tons of weight when I first got this thing. Took over 2 years before I could even get a doctor to help me. I now have normal weight, a bit more than I would like because I eat mostly starches & fruit. No red meat, only chicken and fish, root vegetables, and bananas, canned peaches (they are soft & more digestable, and applesauce. It's a big pain for sure. I've had this for almost 5 years now. Gotten myself better through lots of research and this website.
Good luck.
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