Posted 12 July 2013 - 09:41 PM
I'm new to the site and am asking a question for my daughter who has IBS, and also chronic fatigue syndrome and fibromyalgia. Her IBS symptoms include bloating, fullness, occasional waves of nausea, with her stools results migrating between more diarrhea like and more constipation like, although not quite at each extreme. She also had a stool test, which showed that she had very low secretory IgA, which implied permeable intestine, a.k.a. leaky gut. Recently, she went on a food elimination diet with the intent of testing various food groups via food challenges.
She removed soy, sesame, peanuts, tree nuts, gluten, and dairy. (She has already been off of eggs for about a year). She was on a baseline diet for about 6 weeks. The reason the baseline took so long is that 1) she never felt that much better being off of these foods, 2) she actually got bad stomach pains about 2 weeks into the baseline, 2) reintroducing gluten causes her to feel so so, thereby causing her to take it out and try again, and 3) per her nutritionist's advice, she reduced further down to 20 whole foods, to make things easier to diagnose, if she was still having GI issues. Her doc thought those bad GI pains might be kidney stones, and an ultrasound revealed that instead she had scattered gas in the colon.
Recently, she has had 3 separate food challenges in which she reintroduced soy, then gluten and then diary back into her diet. Without going into all the reintroduction details, she has had a reaction of diarrhea about 3 days into each trial. Then, her symptoms subside. In the last food challenge (dairy), we thought perhaps that she was reintroducing the foods too quickly, so she went really slow. This means that she had 1/2 serving on the 1st day, 1/2 on the 2nd day, 1 on the 3rd, 4th and 5th days. On the 6th day, which was the rest day, is when she got diarrhea.
We think that she really might be sensitive to soy, since she felt exhausted after being on it for a couple of days, but we really aren't sure about the dairy and the gluten. She's already tested negative for lactose intolerance (via a breath test), but I think it's possible she could be sensitivie to the milk protein.
One theory that her naturopath might at play is that if she has leaky gut, then any food she takes away for a while and then reintroduces, might be seen as offensive to her body, and therefore giving her the results she is having.
At this point, my daughter is not sure if she should abandon the rest of the food trials, and just go back to eating normally (for her). She might have GI issues for a couple of days, but we hope she would not be any worse than she was before the elimination diet. Due to her fatigued reaction with soy, we think it would be prudent to keep avoiding that.
She's on a variety of supplements, including digestive enzymes, betaine HCl, ox bile, EFAs, and probiotics.
Has anyone had a similar reaction in having diarrhea when consistently reintroducing different food groups? Also, if it is leaky gut, then we might need to help her "fix" that, before doing anything else with diet.
I would appreciate any advice anyone would have.
Posted 13 July 2013 - 03:59 PM
I can share what I have learned in my IBS journey. I have had reactions similar to what you're describing while re-introducing foods. At the time I was really sick and I think my system saw everything as an attack. The time delay thing can cause confusion too. Some things I'll react to immediately, others it can take days so I don't know what caused the problem.
One thing rarely discussed is the temperature of foods. Cold foods and drinks make my digestive system shut down. Even water has to be room temperature. And I keep a heating pad on my stomach after meals whenever I can. If I have anything cold, anything I put in my stomach after that is going to cause cramping, gas and basically agony.
For me, the cramping kicks in within 30 minutes of eating dairy but with both corn and especially gluten it could take days before I'd feel it. So it took a long time for me to get that corn and gluten were causing issues for me. Eliminating dairy, corn, gluten and eggs has helped a lot. And those are all sneaky ingredients. Obviously there's gluten in bread and pasta, but it's also in vegetarian burgers and soy sauce.
When I had CFS, it was the acupuncturist who helped me. She said I had to absolutely cut out sugar completely and told me it had to do with "leaky gut." It helped a LOT.
I eat mostly cooked veggies like green beans, squash, mushrooms, carrots and celery but no onions or garlic. Still waiting to see how peppers and tomatoes sit but they may be out too.
Rice is always good and I just eat a variety - jasmine, brown, short grain, long grain, etc. I season it with gluten free chicken stock.
Most meats are okay but I need to watch the spices because they can have onions and gluten. Roasted chicken is especially good. Beef can be a little like trying to swallow a pillow - especially with flares. Shrimp and crab sometimes work. Fish almost always works but if I cook it with too much oil I get a flare up.
Fruits - nothing that's super high water and no citrus. I like berries and mangoes mostly. Dried can cause flares for me. Maybe they use something in the processing.
Split peas and lentils are good. Strangely enough, potatoes have been making my stomach unhappy lately.
Best of luck to your family. It can get better.