Well, here i am talking about unpleasant bodily functions again… well, someone has to!
As i said in my recent post about my visit to see the POTS specialist, i explained to her how my IBS has been getting gradually worse and worse over the last few months. She gave me a diet sheet and said that advice has recently changed on how to deal with it diet-wise. (She is heavily involved with ME patients, which is why she probably had an IBS diet sheet in her unrelated hospital ward!)
This is interesting to me as i have had IBS symptoms throughout my illness to some extent, it was particularly bad early on, but seems to be flaring up now as well, who knows why… I have experiemented radically with my diet before and had very limited success with it. These symptoms were some of the most distressing and debilitating that i had when i first became ill, i lost a lot of weight and i would often not leave the house because of it, never mind due to other symptoms or energy issues. Nothing i did seemed to make much difference and after quite some time it seemed to improve along with my general levels of health for reasons and logic unknown to me. It was a bit “chicken and egg”: did i feel better because my IBS was better? Or did my digestive function improve as my body was functioning better in general? I really can’t say.
So anyway, this new leaflet has sections on “wind and bloating”, “diarrhea” and “constipation”; and has advice for each set of symptoms. It says to try adjusting diet according to which symptoms are the most problematic at the current time…
The advice used to be to increase the amount of fibre in the diet, but now it is not necessarily a good idea, and that people with a very high fibre diet may need to decrease the amount. I am a vegetarian and have a very high fibre diet and have noticed that if i eat extra fruit and raw veg it makes things much worse. I also reacted very badly to “Fibogel” a brand of powdered drink that contains soluble fibre and it meant to help with digestive problems.
The leaflet has a section on “resistant starches”. I have never heard of them but it seems that they are a type of starch that is not broken down in the small intestine, but that travels through to the colon where it is broken down by fermentation… It is apparently a healthy thing (there is “good gas”) and is added to a lot of food products to increase the fibre content and “healthy values” associated with it. BUT it seems that if you have IBS or trouble with your digestive system it can be hard to digest and cause a lot of unpleasant wind production (that’s the fermentation bit) and be too laxative. I think as these are my main issues that i should try to reduce these type of starches and see if it helps, but as a veggie this is going to be very hard, and i have yet to find much detailed info about which food products are ok…
It seems that the amount of resistant starch in some things actually goes up when they are cooked then cooled, so it is best to eat things freshly cooked and still hot and not the next day as leftovers (something i do a lot as it helps me energywise when my partner is not in to prepare food for me).
The diet sheet says: Resistant Starches (explains what they are, see above, then…) Try reducing your intake of the following foods:
- pulses, whole grains, sweetcorn, green bananas, and muesli that contains bran
- undercooked or reheated potato or maize/corn
- oven chips, crisps, potato waffles, fried rice – choose baked potatoes or boiled rice
- part-baked or reheated breads, such as garlic bread, pizza base – choose fresh breads
- processed food such as potato or pasta salad, or manufactured biscuits or cakes
- ready meals containing potato or pasta
- dried pasta – use fresh pasta instead
So the things that concern me here are firstly the pulses and whole grains… being a veggie and health conscious i hardly ever eat an unwhole grain and as i think beans must be included in the “pulses” category as they are not otherwise mentioned i am really scuppered… As with most veggies, my main protein source is beans of various types… i eat soya products like tofu and soya milk but am unsure if they count, as are not in wholegrain form and may be more digestible? I also eat muesli every morning but i don’t think it has bran in it…
I find that eggs do not digest well for me, which is a shame, so then i am just left with dairy products (protein wise) and as a person who cannot exercise i cannot really eat lots of cheese for protein if i don’t want to pile on the pounds can I? Plus dairy products do upset some people… i eat a lot of low fat yogurt so hope this is not a problem as well.
The other thing that could be an issue is that i like to crunch on rice cakes and oat cakes, but do these count as reheated/processed grains as they are baked (like biscuits/cakes mentionned in the list above)? I have avoided eating too much wheat in the past as I wondered if it was upsetting me, but maybe bread would be better than crispbread type things after all?
So as you can see this has opened up a can o worms…
It also says for wind and bloating:
- limit fruit to 3 portions a day and make up rest with veg (it explains what a portion is)
- Oats and golden linseeds may also help with wind and bloating
- you may wish to try probiotics… (more detail given, including to try different ones for month at a time as they have different bacteria that may suit some more than others…)
The advice for diarrhea is fairly similar to the above, as well as avoiding fatty foods.
For constipation (not really my problem but may be yours!) it says
- fibre may help with constipation, but can make wind, bloating, pain and diarrhea worse. Fibre intake should be adjusted according to effect and reduced if necessary. If you do increase your fibre intake do so gradually because any sudden increase can make things worse.
- For symptoms of constipation only, try wholegrains, along with fruit and veg, introducing no more than one extra portion over a 2 day period.
- Oats and golden linseeds are good sources of soluble fibre which make the stool softer and easier to pass
- Drink least 8 cups of non-caffinated fluid per day
- probiotics may help
I also found this power point presentatin online about IBS and diet:
It has more information about what foods are likely to be ok and which may not, and goes into more detail about how to do what is basically an elimination diet. This is where you eat only safe foods for a time (usually several weeks) then when your system is calm and symptom free you introduce one food at a time (often just one per week) to see if there is any reaction. This is used to see if you have any food sensitivites/intolerances. I have done this before and with no real conclusions – it is a real challenge and i am not really prepared to do it again unless things get a lot worse!
I think what i am going to do is to eat a basic diet for a week or so and see if my symptoms do improve. If they do then i will know it is worth playing with my diet to see if i can avoid the worst symptoms in future when i have a flare-up. Just giving my system a rest may help in itself. I think my diet in general is pretty good and has not changed radically for years and most of the time there have only been minor issues on the digestive front so i think it is more a case of managing flare-ups than identifying food intolerance and making great changes. I already do not eat great quantities of dairy products (only really live yogurts and a tiny bit of cheese), and i also avoid eating a lot of wheat, which are the main triggers for people in general… this has generally worked for me.
From reading about it and thinking about it i feel my main issue is likely to be speed of digestive transit. My main issues are wind and stomach pain and going to the toilet too frequently. I think that maybe food is not being completely digested as it is going too fast to have enough time to break down properly, and not enough is being digested in the small colon. Reducing fibre (particularly resistant starches) i think may help this. Also from the power point presentation i think i maybe need to eat less raw foods so that they are easier to digest (no more raw sugar snap pea snacks for me! See how healthy i should be – it’s so unfair!)
I am going to detail my plan of action in the next post as this one is getting overly long!