Thursday, January 31, 2013

IBS: No out-of-the-box diet will work for you! (but you can tweak them)

I've written quite a lot about diets on this blog, since they are by far the most efficient way to manage IBS symptoms. In old articles, and on other blogs, you can get information about several of them. But the truth is, to get rid of your symptoms, you will probably need to adapt every one of them. Here are some guidelines to help you with this task.

Choosing a baseline diet

In my previous articles, I wrote about and recommended three well known diets: the low-fodmap diet, the specific carbohydrate diet, and the low-carb diet. Once you decided which one is right for you, follow it for one week or two. If you are still not satisfied with the results, try the following advice. Please keep in mind that tweaking requires a lot of research on your own, and that you will make mistakes. The important thing is to learn something from them!

Tuning the low-fodmaps diet

The good news with this one is that it's quite recent and being heavily researched. So most of the common triggers are already taken into account. In fact, Fodmaps represent several groups of foods: fructans (wheat, artichoke, onion, garlic...), galactans (beans), polyols (plums, cherries, apples...), fructose and lactose.

You may have problems with some groups, and others may be just fine. So your task will be to determine, by introducing one type of food, if you're ok with it, and which quantity you can safely eat. Be careful, some foods are in more than one section.

Here is a list of common fodmaps that you can print and consult easily.

You may also want to try limiting carbs while following the diet, in particular starches like potatoes.

Tuning the SCD diet

This one needs attention, because it is a bit old, and does not take into account the latest research. However, Elaine Gottshall states in her book breaking the vicious cycle, which is the reference for the SCD, that an "allowed" food does not mean it will be ok for every one! So it is clearly implied that tweaking is necessary. 

The recommended way to go for it is to start with the SCD intro diet for a few days. It is very hard to follow, so no more than five days! After that, you should add one food at a time, and see how it goes. Resist the temptation to add several at once!

As you can guess, this requires a lot of time and work. So here is a possible quick fix if you experience problems with the SCD: It relies heavily on fructose. It's in fact the only sugar allowed. The problem being that, in the mean time, it was discovered that lots of IBS sufferers are actually fructose-intolerant! So getting rid of high-fructose foods should help a lot.


Tuning the low-carb diet

Basically, the low carb diet does not take into account food intolerances and triggers. However, as most of these intolerances come from high carb foods, you will most probably reduce your trigger food consumption and feel better. Nonetheless, in some cases, it may not be enough, and you should try to get rid of everything containing the three common triggers:
  • lactose
  • fructose
  • gluten
For lactose, avoid milk, cream, yogurt  and creamy cheeses. Most hard cheeses are ok, since the lactose has been eaten by bacteria.
For fructose, consult this list.
For gluten, you have to avoid everything containing wheat. This can be really challenging, since it is present in bread, cakes, pies, pasta, pizza... but following a low-carb diet requires to avoid such foods anyway.

In the next articles, I will go more into depth about the various intolerances that IBS sufferers often have. Just keep in mind right now that, although following a recommended diet for IBS, you are different. Everyone's IBS varies a little bit, so don't get discouraged, and tweak your diet! Having a food journal can help you identify your problems.

6 commentaires:

Anonymous said...

I've been reading your blog for some months now but haven't yet commented so thought it was about time. I'm currently trying to refine a low carb/paleo diet based loosely on the 'Life without bread' book, and Diane Sanfilipo's 'Practical Paleo', I'd been clinging on to still having dairy and had assumed it was fine as I could tolerate cheese, however I think I need to give up the milk/cream/yogurt as well as nuts which don't seem to be agreeing with me. I've found your blog to be a brilliant resource and was the prompt I needed to return to low carb. Many thanks, Emily

Guillaume said...

Many thanks for your kind words, Emily! Yes, nuts can be a trigger for some people, although it's not common. Which proves that the only way to go is to write everything we eat until we found what I would call our "failsafe diet".

Domen Leskovec said...

For me, preparation of food is very important.

Almonds
A couple of times I tried eating raw alomonds (15 g) for breakfast and for the whole day I had a weird, heavy feeling in my intestines – like I could feel them traveling through my gut. For the last 2 weeks I have been soaking almonds in water overnight. In the morning almond skin is very soft and wrinkly. I scrape it off with small knife. I can eat up to 50 g of soaked and peeled almonds a day with no trouble.

Apples
Raw apple with skin gives me pain and gas, but applesauce (peeled, cooked and pureed apples) with cinnamon really helps my digestion (stops diarrhea).

Anonymous said...

I have been doing low-carb for more than a year, and have posted about my success with substantially reducing IBS-D. Recently, I have been testing the bounds - eating a little pasta, a piece of bread, a cookie, a few candies - convincing myself I could handle some of the treats I used to love. No, I can't. If I eat high-carb foods, I spend a lot of time in the bathroom and I'm nervous about leaving my house. When I keep my total carbs under ~80g, I free up my life. I'm glad your blog is here to help get me back on track.! -- Anne

Achieve Birmingham said...

Hello, I just wanted to say thank you for sharing this information on IBS. We are honoring IBS Awareness Month this April with some new posts and information about this common disorder on our medical research blog. Too many people are suffering in silence with irritable bowel syndrome, but we can help them by getting more people to openly discuss this illness. Plus as you know, one of the best ways that a person can manage their IBS is to learn as much as they can about it.

Anonymous said...

I'm doing cart-wheels. I've been taking Diarsoothe. It's at Amazon. (Sorry, I don't know where else.) It's this blackberry liquid, and I take about 1/2 cup a few times a week. It's a little tart. I sweeten it with stevia. It really calms my intestines, as I get severe spasms. My celiac friend loves it, says it soothes her stomach. Just thought I'd share- it's a God-send.

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