I.B.S Page (Irritable Bowel Syndrome)

Living with IBS &/or Lactose Intolerance

You may suffer from one or the other or both - there are many overlaps.  Once you learn your triggers and to avoid them you will feel so much better!  Understanding your own body and what makes it tick can change your life.  It changed mine.

To live comfortably with IBS (Irritable Bowel Syndrome also known as Spastic Colon) you have to understand what you can and can't eat. Otherwise, you may as well give up the social life, huge mortgage & newly modeled kitchen & sunken great room & take up residence with a cell phone & laptop in a cozy, comfortable bathroom for one.

The DO's & DON'Ts:
Very simply, if you've got IBS,

SOLUABLE FIBER IS MORE EASILY DIGESTED.
INSOLUABLE FIBER and FAT 
DO NOT DIGEST EASILY AT ALL!!! 

Everyone is different so try foods in small quantities to get to know your body and how it reacts to different foods.  It's so complicated and frustrating because to be a healthy, thriving person, giving up all insoluable fiber & fat is not realistically possible.  You have to find YOUR balance and what works best for you and your body.
Below is a general guideline:

The Good - Soluable Fiber Foods           The Bad - Insoluable Fiber Foods
rice                                                                whole wheat, wheat bran
pasta                                                             melon, dates, prunes
oatmeal                                                          seeds & nuts
barley                                                             granola
French bread                                                  popcorn
sourdough                                                      cherry, pineapple, peach, nectarine
rice cereal                                                       apricot, pear, apple, berries, grapes
flour tortilla                                                      corn, eggplant
soy (some are soy-sensitive)                          garlic
quinoa                                                             peas - snap peas & snow peas
cornmeal                                                          green beans, lentils, celery
potato                                                              peppers, cabbage, brussel sprouts
carrot                                                               broccoli, cauliflower
sweet potato                                                    tomato, cucumber, sprouts
turnip                                                               citrus fruit & juice
rutabaga                                                          onions, leeks, scallions, shallots
parsnip                                                             rhubarb, figs
beet                                                             *insoluable fiber only comes from
squash                                                              plants, not animals.
pumpkin                                              
mushroom                                          
avocado (but has fat)
banana               
applesauce         
mango
papaya                                           .

The Ugly - Dangerous Trigger Foods - Ultra Bad No No's - AVOID! AVOID! AVOID!

FAT is the #1 offender & hugest digestive tract stimulant!, red meat, dark meat & skin of poultry, dairy, egg yolk, french fries and anything fried, shortening, margarine, mayo, dressings, Cool Whip, milk chocolate, coconut, olives, nuts, chips, baked goods, coffee (regular & decaf), caffeine, cocoa (it has stimulants: theobromine & caffeine), alcohol, carbonated beverages, MSG, all oils, raw veggies.  JUST SAY NO!

Helpful Hints:
* Soluable fiber should be the only thing you eat on an empty stomach.
* Never eat insoluable fiber on an empty stomach!
* Eat insoluable fiber sparingly and always with other soluable fiber food.
* Remove the toughest insoluable fiber wherever possible:
  - Fruits are easier to digest if the skin is peeled.
  - Vegetables are easier to digest if they're peeled & un-seeded, cooked, mashed, pureed, etc.
 
What causes IBS?
The medical answer: A highly abnormal gastrocolic reflex.
The gastrocolic reflex is a reflex in which the act of eating stimulates movement in the gastrointestinal tract. IBS is caused by deviations in normal gastrocolic reflex muscle contractions.  HUH? 
The "IBS for Dummies" answer: The digestive tract doesn't work how it's supposed to. There is an abnormality in the way the intestinal muscles contract. The colons of people with IBS have significantly more violent and prolonged contractions (which leads to diarrhea) or almost no contractions at all (which leads to constipation), usually both reactions alternately occur. That's the fun part.

The bottom line: Eating large meals or meals high in fat or insoluable fiber can increase the stimulation of this reflex and result in stronger intestinal contractions which = PAIN and a lot of bathroom reading time.  So do the opposite!  Eat smaller meals, lower in fat.
 
Symptoms
Recurring lower abdominal pain which seems like spasms or cramping (from the mild to the excruciating) associated with altered bowel motility (diarrhea, constipation or both).  Attacks may strike suddenly and at any time.  Gas and/or bloating are common, dehydration may occur. It can sometimes take a couple of days to get back to normal after an attack.  There is no cure but it can be controlled.

The bottom line: To avoid the pain & suffering we endure, the idea is to keep the colon calm by eating more soluable foods;  (in other words, foods that don't need a lot of breaking down causing the colon to work harder) and avoiding foods that are GI tract stimulants (like insoluable fiber & fat).  Eat smaller amounts of food at a time.  IBS colons just can't handle it!

What Helps?  In addition to eating the IBS way, drinking warm/hot water or hot caffeine-free teas such as fennel or peppermint tend to help digestion.  My gastroenterologist gave me a prescription for Levsin which I never filled.  It's supposed to relax the colon so it doesn't go into spasm.  I told him I'm not into taking medication but he suggested then, that I only take it in emergency situations, like if I knew I was going to a restaurant where it would be difficult to find something that wouldn't trigger my IBS.  Side effects include drowsiness so I never got the pills... but this is not a bad idea if you need it.

Important Notes so Pay Attention!:Most people in general are sensitive to some or all of the following sugars (in addition to lactose), so those with IBS & LI should be especially careful with them:


* Raffinose - in beans (ex: chick peas & hummus, kidney beans, lentils), cabbage, brussel sprouts, broccoli, asparagus, other veggies & whole grains.  It is sometimes known as melitose.

* Stachyose - in greenbeans, soybeans & other beans.

* Other Fructans -  artichokes, leeks, onions, garlic

* Soy contains 2 hard-to-digest-sugar compounds - raffinose + stachyose!  Lots of dairy subs are made with soy so be careful - you may also have a soy sensitivity!

* Fructose - in agave, honey, high fructose corn syrup, naturally in stone fruits (plums, apricots, cherries, peaches), apples, pears, grapes, artichokes, asparagus, watermelon, dried fruits (prunes, raisins, figs), onions, leeks, wheat, fruit juices & jams, sodas & sweet wine, foods with sorbitol and other polyols.

* Sweeteners: Sugar Alcohols a.k.a. Polyols, derived from plants are low digestible carbohydrates which means they are only partly absorbed during digestion.  That's a good thing in terms of not spiking your blood sugar but it makes them a trigger for intestinal problems.  Commonly added to foods because they have a lower calorie content and lower glycemic index than sugar (sucrose). They're used in lots of foods labeled, "sugar free".

They may cause SEVERE diarrhea, bloating and intestinal discomfort! 

 Read labels!

Sorbitol

Isomalt

Xylitol

Maltitol

Mannitol

Lactitol

Erythritol - Different from other sugar alcohols because it has a greater absorption rate so it causes less intestinal distress.

Hydrogenated Starch Hydrolysates- sometimes listed as maltitol, hydrogenated glucose syrup or HSH)

Artificial sweeteners: aspartame (NutraSweet & Equal), saccharin (Sweet'N Low), sucralose (Splenda).  Truvia made from stevia & erythritol seems to be better tolerated for IBS.

(Also avoid Carrageenan - (not a sugar) Some people are triggered by this food additive used as a thickener in ice cream, yogurt, cottage cheese & other processed foods including soy milk).

FYI - all of these sugars cause bloating & gas & other GI discomfort because foods that contain them cannot be digested by enzymes in the stomach or small intestines so they are not broken down until they make their way all the way to the large intestines where they are finally broken down, by bacteria, creating carbon dioxide, hydrogen and methane aka gas.  (Most people have a hard time digesting these other sugars.) It's not pretty but someone's gotta tell you the gaseous stinkin' truth!


Resources
Johns Hopkins overview of IBS
Very helpful website: Helpforibs.com
Very helpful book: Eating for IBS by Heather Von Vorous