I actually have 2 questions. Can you recommend a probiotic for ibs? During an ibs attack when I have consumed the wrong food do you have any advice on how to help the extreme Nausea feeling and the severe cramping? Any help would be appreciated because when I have an attack I’m in severe pain for 4/6 hours till it passes. Thanks
When things have calmed down enough to eat a little bit get some plain soluble fiber in your gut with more strong peppermint tea - plain white rice is perfect, or some tummy fiber, etc.
If you are in a medical marijuana state that can also be an option for help with the pain and cramps - there are delivery methods that can stop pain really fast. You may have to play with the THC vs CBD varieties to see what helps you the most, the fastest, and also try vape vs sublingual vs some type of edible (hard candy to suck on), etc. There are an increasing number of options in this whole area of treatment.
Hi Heather Do you know if your delicious maple oat bread and apple spice walnut bread would work with GF flour or rye flour? Still trying to work out what I can eat - psyllium and yeast are out and i think I am better without wheat. Its difficult to sort these out.
Hi Heather, I’ve read about how hormones around a woman’s period can affect IBS symptoms, but can it work the other way around, too? I’m asking because I’m on hormones for premature ovarian insufficiency and I find that I have breakthrough bleeding when I’m constipated. I’m still figuring out the right dosage with my doctor (I also have Hashimoto’s, which is the cause of the poi, and am on thyroid hormone as well). Any information or ideas where to look for information would be greatly appreciated. Thanks!
Hi - I have never seen any research to show that IBS affects hormones. But, logically anything that physically stresses your body, like an IBS attack, could then affect hormonal issues as well if they respond to stressors. For example, having a bad bout of IBS could certainly contribute to a bad round of menstrual cramps.
I'm not at all sure how this would play in to hormonal medications that are affecting things. Thyroid meds can also really affect IBS.
You might call your pharmacist and ask for some advice as well - they often have better medication info and feedback from patients than the docs do. XXOO Heather
Thank you so much for creating this new forum to respond to specific questions. I haven't been on your site for a few years because I have been very stable on your diet, but now I have a huge challenge for which I need advice!
I need to have some major surgery on my liver in which more than half may be removed. For the past 2+ years I have been IBS-C (constipation) predominate. I am able to successfully manage my condition on your diet.
My questions in regards to my surgery are as follows ...
1. Will an enema (if required before the surgery) create IBS discomfort and potentially put me in agony)?
2. After surgery, I would like to only receive intravenous medications ... nothing orally because I am fearful medications will trigger an IBS attack ... and especially because I won't be able to take medications safely with soluble fiber (since I will be on a liquid diet for awhile). In the past, I have been unable to orally tolerate painkillers (other than a small dose of children's Tylenol). What painkiller received intravenously (morphine is commonly used here in Canada) would be the least likely to exacerbate my constipation? (I understand painkillers received intravenously or orally cause severe constipation.)
3. Will the painkiller have any other IBS impact other than constipation?
4. What can I do to combat constipation if I get it from painkillers, combined with my IBS? (I already have severe constipation, I can't take laxatives because they exacerbate my IBS condition and I will be on an initially liquid, later pureed, diet)
5. Do you have any idea what affect reducing the size of my liver might have on my IBS? (Hopefully over time things will get better because the liver regenerates)
I have no idea how to find out this information. I hope you may have some connections to find out. I am trying to figure out how best to manage my situation for the surgery. I will also need to receive painkillers when I get home, but I am not sure how I can take them if they can't be given intravenously. I hate being a person with special needs due to my IBS because the medical profession doesn't seem to know how to deal with it.
Hi Belinda - I am so sorry you have to go through this, and I hope you have a super easy time and speedy recovery.
I do not know how the end result of this will impact IBS, hopefully it will not.
An enema might cause symptoms to flare, that is not uncommon. If you can try to just overwhelm your gut with peppermint tea in advance of this - that will prevent spasms and keep things calm.
A liquid diet can still include soluble fiber. If you can dissolve your fiber supplement in clear water, and it just stays looking/feeling like clear water, docs normally okay that use. Ask to be sure, but typically this is fine, so if that's the case you can keep up your soluble fiber supplement to head off the constipation.
You may need to gradually increase your soluble fiber after surgery to help counteract the constipating effects of the painkillers they will have you on. Oral or IV painkillers will all have that side effect if they are opioids. Morphine will for sure. It would have to be non-opioid to not be constipating, and those won't be strong painkillers - that would be things like NSAIDS or Tylenol.
Other than constipation, the opioid painkillers won't hurt IBS, and they'll certainly stop/prevent painful spasms and cramps.
Push your doc about continuing your soluble fiber along with your liquid diet - don't let them say no because they don't understand the question or importance. If you can drink anything liquid, you should be able to have your soluble fiber in that liquid. That would keep the constipation at bay.
I am going to have a chat with the surgeon next week. I doubt I would be allowed to drink or eat anything before the enema, if one is required. I also probably won't be able to have much more than water or chicken broth after the surgery.
I'm going to ask if I could take a non-opiad intravenous painkiller ... one that doesn't cause constipation. It is causing me so much anxiety worrying about whether I am going to have an IBS attack when I go for surgery. I have been stable for so many years. I shudder at the thought of returning to my unstable days. I would rather endure a little pain to avoid an IBS attack because it inflames my tummy and takes weeks to recover.
I will try and keep you posted. I hope everything is going well for you. I hope we can meet one day in person when I am visiting the west coast. I still make trips several times a year to the San Francisco/Bay Area. Perhaps one day I will make it to Seattle too!
Hello Heather, First and foremost, I am so grateful to have stumbled upon your books. I bought them thinking they wouldn't be much help, but oh how they are. My boyfriend was diagnosed with IBS a little under a year ago and it caused a lot of stress in our relationship. Because of you, I was finally able to help and sympathize with him more (since prior to his condition I had no idea that IBS even existed), he stopped having constant diarrhea, and was able to be a normal person. He has come so far in such a small amount of time and I am so grateful for that. Although he has been getting better he still feels so drained of energy at all times (especially after work). I was wondering what could be done so that he can start having more energy. I really look forward to hearing back from you and from anyone that has the same problem. Thank you so much for all that you have done and continue to do.
Hi Daniela - thanks so much for your kind comments!
Make sure he's eating small but frequent snacks/meals, and using his soluble fiber foods as a safe foundation to add in small amounts of IBS safe proteins (seafood, skinless white meat poultry, egg whites, finely ground nuts, pureed beans/lentils) and small amounts of heart healthy fats (olive, flax, avocado, etc.). Both the proteins and fats are important for energy and satiety, but use them as additions to the foundation of soluble fiber foods so his gut stays calm.
If he's eliminated coffee but needs the caffeine he can use black or green teas.
He may also just need some extra rest and sleep. IBS can be really draining and exhausting, physically and mentally. It is a wonderful sign that he's feeling better, and as that continues he should see his energy pick up as well.
If he can add in some gentle (not extreme, like sprinting) exercise that will help him increase his energy levels as well, and also likely help IBS. Yoga is the perfect fit for both of these.
Please keep me posted, and give him a hug for me. And you too - caretakers need taking care of, as well.
I was diagnosed (because all my other tests came back normal) with IBS-d about 10 years ago. I found your site researching on my own and the diet was the only thing that saved me! I am so appreciative.
I had my gallbladder removed last week and it seems all the early problems I had with IBS-D have came right back...immediately having to go, painful cramping, etc. I have been trying to stay on a liquid diet but introduced white rice and toast and it didn’t go so well.
Has anyone had issues with their gallbladder removal and setbacks? I’ve been researching enzymes, probiotics, etc but I’m afraid to ask the surgeon later this week because I fear he won’t know anything that can help!
Keep up your soluble fiber supplement, gradually increase that if you need to.
Ask that doc about Questran or equivalents - he should hear about this side effect from the surgery all the time. No stupid questions here - you do not have to live with this aftermath at all, so don't let him just blow you off.
I am newly diagnosed with IBS-C. Why is it suggested to eliminate the high-fodmap foods, then reintroduce them later to see which ones gave you trouble. To me the whole point is if it gave you trouble in the first place don't eat it??? Also, some of the fodmap cookbooks have recipes in them that have high-fodmap ingredients in them???
I underwent a successful, 5-hour surgery last week to remove more than half of my liver and I am back home now. I didn't require an enema prior to the surgery. I arranged for all my own food to be brought to the hospital by my husband and adopted daughter. I had an absolutely wonderful surgeon -- Dr. Ian McGilvray of Toronto.
My problem now is that my reduced bile production is causing certain symptoms that are posing challenges with my regular IBS-safe diet. I am in great need of a dietician (or whoever you would suggest) who could help me with a diet to manage my IBS and reduced bile situation while my liver rejuvenates over the next month or so.
Would you have a dietician to recommend -- someone knowledgeable in treating IBS? I find so many dieticians think they know how to treat IBS, but, in fact, they really do not understand it at all.
As you know, I live in Toronto, Canada, so I would need someone willing to take me on right away by phone. I can pay them via a Canadian-based credit card.
Please let me know. I remain very grateful to you for all that you have done for me over the past 16 years of my life. Because of you, I lead a relatively normal life IBS-wise. I refer everyone I know with IBS to you for help.
Hi Belinda! I am so sorry you had to go through all this, but thrilled that you sailed through it and are doing well. That is fantastic!
I unfortunately do not have any referrals for dietitians in this area. I would ask your surgeon, general GI doc, and even regular family doc.
Reduced bile usually means reduced ability to digest fats, which is already kind of an issue with IBS. Go low fat, even very low fat, just not fat free. Peppermint can stimulate the production of bile, so you may add in peppermint tea and/or peppermint oil caps and see if those help. They will help with IBS as well.
I can't find any responses to your question so I'll take a stab at it. Your question is, "why eliminate foods only to reintroduce them later?" Your initial conclusion is that, if you eliminate a food that causes, why not just stick to that program. That is a great question.
As I understand it, not everyone has issues with all the elements of the FODMAP program. For example, you may be be sensitive to sorbitol. If that is the case, you will likely not be able to reintroduce blackberries into your diet. Same holds true for other FODMAP groups.
I am following the elimination diet right now and can assure you that after my initial 6 weeks effort, the first thing that I'm going to reintroduce is bread. I certainly hope that works because I am good baker and thoroughly enjoy bread. If adding bread works, that will be great; if not, I'll learn to live without it. No big deal either way.
I hope this helps you understand the process. The elimination phase doesn't have to be forever ... just long enough to clear your system and see what works for you. Try to not look at the elimination phase as a limit on what you can eat for the rest of your life; rather, as a way to identify those things that work for you and those that cause problems.
Hello..... So I read on your IBS website that you say that Fat is an IBS trigger....Why then do you recommend a Low Fat Diet and NOT a Fat Free Diet? ....Is there a reason behind this that really makes a difference in cotrolling IBS symptoms?....Would following a Fat Free Diet hinder progress improving IBS symptoms?.... Since fat is NOT supposed to be good for IBS....Then why have it in your diet to any degree if you can avoid it?.....I'm not looking for the standard..We all need fat answer...Rather..I'd like to know if going as Fat Free as possible hinders person's progress with IBS symptoms?...Or helps them?....Does it really make a difference to have some fat...A Low Fat Diet if you're battling IBS?...
Since fat is an IBS trigger as I understand it to be.
Hi - yes, that is actually easy, vegan as well. Rely on your plant meat substitutes, any of the non dairy milk/cheese subs (rice, soy, oat, almond, flax hemp), use egg whites, and add in very well cooked and pureed beans/lentils.
There are a ton of veggie recipes in Eating for IBS and for many of the non-veggie ones you could easily swap in firm tofu or seitan.
The principle would be the same - soluble fiber foundation, add in as much insoluble fiber - carefully! - as you can, and avoid the triggers. Red meat and dairy are major triggers, so you're already avoiding those. Go low fat, not fat free. Even easier as a veggie.
Hi Heather! I recently sent you an email with a question similar to the one you were responding to here, as I hadn’t yet seen this post. I had been avoiding any caffeine because it seems to have been one of the triggers for me, but dealing with cutting out caffeine was really hard, and I had already been struggling with a lot of exhaustion in general. One thing I wanted to ask you about is that I’ve had it happen a few times when I was feeling really nauseous and tired that i ate or drank something sweet that I really like - like chocolate almond milk, or a chocolate chip cookie or something (that was before I was on your diet), but I found myself feeling a lot better almost immediately. I haven’t been doing this often because I am concerned about eating too much sugar as I know it’s generally not healthy, and I also have a history of a lot of yeast infections. Have you heard of this happening for others? Do you have any advice on what I should do?
It is good to hear that sometimes IBS can be really exhausting (ie that this is normal) but that it won’t last (at least I hope that’s what you were implying).
I would definitely like to learn anything there is to learn about how to have more energy consistently.
Hi there. I am new to this as of yesterday, so if I'm asking this in the wrong place, please excuse me! IT is also not my strong point, so I'm glad to have gotten this far! I have very loose bowels and I think that stress and anxiety plays a part! I started to take the tummy fibre about 5 days ago. I started on 2 half teaspoons a day and then increased to 1.5 teaspoons a day. At the same time I increased fibre food intake - ryvitas, veggies and oat cereal and I have had dreadful tummy pains and diarrhoea. I'm feeling deflated, so could you please advise me on whether to cut out the cereal etc and just build up your fibre powder? Should I stick to 2 half teaspoons a day or increase? Sorry for the TMI and questions! many thanks, Millie
I have had IBS for about a dozen years. I was diagnosed this year. I stopped eating gluten, eggs and dairy about 8 months ago. I also stopped eating brown rice as well, not sure why. I tried switching over last night and I got the symptoms I associate with accidental gluten ingestion. I read some things about IBS and brown rice, should I avoid it? I have other issues with gluten free grains like buckwheat, sorghum, millet, flax and quinoa. I can tolerate white rice well in large amounts. I have not started the low fodmap diet though my doctor has advised it. I have already been overwhelmed with so much, but I am ready to take the next step!
I would take the whole grains out until you are stable, stick to the white rice, rice noodles, peeled cooked root veggies, bananas, etc. from the safe soluble fiber list https://www.helpforibs.com/diet/fiber1.asp
Thank you! I will check out these links! I also tried your advice from your video about flares, I had quite a few cups of peppermint and fennel tea as well as white rice and I am feeling much better. Celiac has been ruled out, but I have fibromyalgia and for years my doctor had suggested gluten free. Once I tried it, I felt
amazing and when I have accidentally ate gluten since I felt miserable. The fodmap diet is so confusing and not consistent across all literature. Though, I do want to try it as I am still fine tuning my diet. I have a lot of allergies and sensitivities. Also, I had Covid 19 in March and I have never fully recovered. Neurologist and GP think I have some sort of post viral syndrome or CFS and my tummy has never recovered either! I am interested in your products and cookbooks! Thank you for your hard work and dedication! Be well!
I started on the first stage of the diet and am retaining quite a lot of water- enough for people to notice. The only other thing that’s changed is I stopped taking laxatives which although not abusing, I was using a few times a week to manage the IBS-C
Thank you, Heather. I have definitely noticed a decline in what I can tolerate since my surgery. I've had to remove some things that I was tolerating before. Oh well. It's the story of my life. I stick to a strict diet and live each day to the fullest. On the plus side, my husband does his own cooking because he can't stand what I make.
I don't know what happened when you tried re-introducing bread but I have been following a fodmap diet for a long time - created by a registered dietician who specializes in gut disorders and on her version of the low fodmap sourdough bread (even if it is wheat) is considered low Fodmap.
I have made the maple oat bread w/gluten free flour & I'm about to make it again. The first time I made it I substituted only tapioca flour for the egg white (I'm vegetarian & recently trying vegan again). It tasted wonderful but was crumbly and would fall apart when sliced. I then made the Banana bread recipe & substituted ground up chia seed & a little water (1 tbsp ground chia & 2 tbsp water = 1 egg white). This came out with a great consistency and later today I'm going to try the chia seed substitution for the oatmeal bread...substituting GF flour seems to work perfectly fine!!!
Hello, I'm new to the group and apologize if this issue has already been addressed, but I couldn't find in when I searched. I recently started taking Fosamax and it has triggered a bad case of IBS, which I have been successfully treating through diet and exercise for the past 40 years. Does anyone recommend probiotics and/or prebiotics, and, if so, is there a brand that you have found works best? I would appreciate any input you might share, and thank you in advance!
Does anyone know what to do before you go to bed at night so you won't have a problem in the morning? It seems it doesn't matter what I eat I still have diarrhea. And this is since Christmas. So frustrating.
After years of struggling with worsening IBS, I have recently been diagnosed with pancreatic enzyme insufficiency -- which means I don't have enough enzymes to absorb food and nutrients properly. I am now taking a very expensive enzyme replacement drug, sticking with a low-fat diet, and hoping this will have a positive impact on my IBS (which still exists!). I'm wondering if anyone else has had this diagnosis, or if you are aware of the latest research on the connection Heather?
I am confused about the IBS diet. I have read about the SCD diet (specific carbohydrate diet) for digestive disorders, and it in conflict with Heather's book, Eating for INS”. The SCD diet allows no sugar, no rice, no pasta, and no bread, and a whole egg. Heather's book allows all that, but only egg whites. Now I don’t know what to eat. Sugar is bad for me as it ferments in my digestive tract, but honey is allowed on SCD diet. Looking for an explanation on the differences. Thanks.
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Hi, I don't know if this is still an active board but, I have struggled with IBS for 20 years now. Heather's program helped me tremendously when I was first diagnosed. Her cookbook is my savings grace. However, no matter what I do, I continue to have issues with very thin stool that is very difficult to pass. Oftentimes I have to sit on the toilet for hours to get as much of it out as possible. And then it still feels like there's more. This is not only very unpleasant but it prevents me from getting anywhere on time, or sometimes, at all. I have lost many jobs and job opportunities due to it. And now may lose more things due to my lack of money. Anyway, if you Heather, or anyone out there knows of anything that may help with this issue Please respond. I have been to many different types of Drs, and they are if no help. I currently ake 1/2 tsp. or Heather's Tummy Fiber daily. And a probiotic. Thank you so much for any help. My heart goes out to all of you.