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.INSOLUABLE FIBER and FAT
DO NOT DIGEST EASILY AT ALL!!!
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!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 pain & suffering 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.
Symptoms: excessive gas, bloating, diarrhea, abdominal pain, nausea and sometimes dehydration.
The bottom line: THERE ARE NO DO'S ONLY DONT'S! This one's easy. Avoid foods with lactose!!! Stay away!!
Foods Containing Lactosemilk
creambutter
ice cream
sour cream
cheese and cheese culture
milk chocolate
(pure chocolate, with high cocoa aka cacao, content, doesn't contain lactose i.e. cocoa powder, bakers chocolate & cocoa butter. Cocoa butter is not butter, it's vegetarian; the fat extract of the cocoa bean)
yogurt: some people can tolerate yogurt because it's got cultures that produce lactase to digest the lactose.
frozen yogurt: once yogurt is frozen though, it loses the cultures, so frozen yogurt will cause the same reaction as ice cream
bread and other baked goods
frozen products with breading, like french fries
candies
instant potatoes, breakfast drinks & soups
seasoning mixes
liquid & powdered milk-based meal replacements
margarine
powdered & liquid coffee creamers
non-dairy whipped toppings
potato chips, corn chips and other processed snacks
processed breakfast foods like cereals, donuts, waffles, pancakes
processed meats like bacon, lunch meats (cold cuts), hot dogs
(kosher cold cuts do not contain lactose)
protein powders, meal replacement powders, protein bars
salad dressings, tartar sauce
mixes for pancakes, biscuits & waffles
Note: LACTOSE IS NOT ONLY IN DAIRY PRODUCTS. Lactose and milk are not synonymous. Lactose is a type of sugar. It is very sneaky and stealthily hides in lots of things you never thought it would. Lactose hides in many prepared foods and many medications - prescription & over-the-counter so read those labels!
Watch words on labels: Watch out for products that list these as ingredients -
milk, lactose, whey, whey solids, whey protein, curds, milk by-products, dry milk solids, dairy solids, cream, non-fat dry milk powder, casein, sodium caseinate, ammonium caseinate, calcium caseinate, potassium caseinate, caramel.
Some products labeled "non-dairy" may actually include ingredients derived from milk and contain lactose such as: powdered coffee creamer & whipped toppings.
Not everything starting with LACT means it has lactose. Lactalbumin, lactoglobulin & lactoferrin are whey/milk proteins and don't have lactose but people with a milk allergy should stay away from them. (Milk protein is not the same thing as milk sugar (lactose) and milk allergy is not the same thing as lactose intolerance.) Lactylate, lactic acid, lactate do not contain lactose.
Check The Allergy Site for info on milk allergies/intolerances. (theallergysite.co.uk/dairy.html)
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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!
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* Disclaimer: I'm not a doctor or an expert on health/nutrition. The only thing I claim to be an expert about is how IBS and LI have affected me. I've read tons of information on the subjects as well and I'm simply passing along what I've learned. I've been to a gastroenterologist, and if you experience symptoms, you should get checked out too to be sure you don't have a more serious gastrointestinal disorder or illness. Please don't diagnose yourself because there are so many serious GI disorders to rule out. Depending on your symptoms your doctor may want to do a colonoscopy to examine the inside of your colon and/or other tests. For lactose intolerance there is a non-invasive hydrogen breath test available through your doctor.
If you choose to try any recipes in this blog please make sure to read all labels on products you use in them to be sure they are safe for your own personal health situation. I do not get paid to review any products recommended or reviewed in this blog.
Resources
Johns Hopkins overview of IBS
Johns Hopkins overview of LI
Very helpful website: Helpforibs.com
Very helpful book: Eating for IBS by Heather Von Vorous
On a personal note ~ After a lifetime of discomfort from what seemed like everything I put in my mouth, I finally spoke to a GI doc and was tested to find I was dealing with IBS (thankfully nothing more serious) and a lactose intolerance level that was high off the chart. I was so tired of being uncomfortable and having daily activities disrupted by feeling constantly ill, that I started doing a lot of reading and experimenting with food. I am grateful that both of these disorders can be controlled through diet with no need for medication. I've learned that substitution doesn't have to mean deprivation.
I hope I can help others with what I've learned & what I continue to learn every day. ~ Carole
