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Before and after I was told I had IBS, I was keeping a diary of my food intake. Between the doctors and myself, we could find no pattern of what might trigger me having D. It just seemed like "Food" in general was the cause of my extreme pain and D. I'm skinny already (I never refered to myself as that) so I eat pretty much anything. I have very low blood presure,and calestrol (poor speller). My motabolizem stays high. I have now, because of the past several months of D, found myself at 15 pounds below my normal weight. I try to get as much of anything down me, and pray that it stays long enough to digest. I eat alot of little meals throughout the day. I guess my question is... does anyone else have IBS that does'nt seem to be triggered by anything? It just happens.
 

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Yes!! Food, in general, is a trigger for my diarrhea. Sometimes it is just a hit-or-miss thing. I am convinced my brain is sending inappropriate signals to my intestines for some reason. This is probably an inappropriate response to what my brain perceives as stress. However drinking a glass of ice water will sometimes cause it. Eating too quickly will sometimes cause it. I do seem to have specific triggers I know will bring it on--coffee, Hollandaise sauce, and artifical sweetners ending in "ol" such as mannitol, sorbital. However any food can bring on D for me.
 

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Yes!! Food, in general, is a trigger for my diarrhea. Sometimes it is just a hit-or-miss thing. I am convinced my brain is sending inappropriate signals to my intestines for some reason. This is probably an inappropriate response to what my brain perceives as stress. However drinking a glass of ice water will sometimes cause it. Eating too quickly will sometimes cause it. I do seem to have specific triggers I know will bring it on--coffee, Hollandaise sauce, and artifical sweetners ending in "ol" such as mannitol, sorbital. However any food can bring on D for me.
 

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Same here. What works for me one day might not the following day. It's hard to deal with it because I am hungry but never know if it's not going to play tricks on my bowels. What I do now is try to eat more often and smaller meals... I still think that my intestines are all screwed up for various reasons: stress, fast food, anxiety, lack of sleep. Things do get better... one day at a time (such optimism for me is very unusual!)Good luck!
 

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Same here. What works for me one day might not the following day. It's hard to deal with it because I am hungry but never know if it's not going to play tricks on my bowels. What I do now is try to eat more often and smaller meals... I still think that my intestines are all screwed up for various reasons: stress, fast food, anxiety, lack of sleep. Things do get better... one day at a time (such optimism for me is very unusual!)Good luck!
 

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The VAST majority of patients have this problem, and often either form the false conclusion thst this has nothing to do (food or additives) with their symptoms or are given false information like "...this is because your diet will not affect your symptoms...has nothing to do with you condition" or "...if you have IBS ANYTHING you eat will can trigger your symptoms..." and other such old wives, er, old practitioner tales. So they are doomed to suffer and be dependent on only interventional therapies which can produce partial success by attenuating physiologic consequences of reactions that already occuurred.The problem is that the majority of patients and practitioners alike do not understand the physiology of anything except food allergy, and approach dietary assessment accordingly. Therefore, they are doomed to only finding the "grossest" reactions, for example suche elemantary observations as large bolus of anything dumped from the stomach into the small bowel causes the "twitchy" upregulated system to react in one or more ways (exagerrated GC reflex, pain, increased motility, etc). Or that instillation of a bolus of food-goop high in fat into the proximal bowel elicits a response. Or certain specific comorbid food allergy, which may be present in IBS victims (and at a frequency that is higher than it is in the general population), can be isolated since the reaction is quick, severe, and repeatable. Or that the person is susceptible to pseudoallergy (lectin containing foods, certain peptides, and other specific chemicals like low-molecular weight sugars which either elicit fluid-dynamics changes and/or trigger mast cell mediator release without true allergy or are chemicals which directly effect the myenteric plexus, or other such easy to spot reactions).So the intrsuctions usually given on how to isolate food "TRIGGERS" are just that: they will spot things which produce a rapid reaction after ingestion, in theory anyway, and then they are removed from the diet. Then, when the patient experiences only partial relief, the pronouncement is made "thats all the food-effect on your IBS now do this {xyz Protocol...whatever the protocol du jour is). This is becasue there are other reactions which are ongoing, which elicit the chronic and ongoing release of chemical mediators which have the effect on nerves and muscle and blood vessels which not only can increase gut motor and sensotry response bu the CNS as well, and affect endocrine function.Now this simple approach does produce symptom reduction from mild to substantial, if done properly, in about 70% or more of the patients (this response to simply probability-eliminatuion dieting has been repeated many times). This is consistent with the partial-remission results of other therapies often touted as stand-alone therapies for IBS s well. Of course the degree of remission will be greater if these multiple therapies are properly combined, yet for some mysterious reasons lo' these many decades, exceedingly few patients achieve 100% remission without some form of ongoing interventional pharmacotherapy. SOME spend years and decades with only mild relief using the procedures designed to find "food triggers" and food allergy or pseudoallergy and "buy-in" to the fallacy that "thats as good as it gets", since the link between the mechanisms of IBS and thier diet is only beleived to be those I just described. This is wrong, it has been known to wrong for over 20 years, and it is continuing to be proved wrong daily, but it persists for reasons which are known but "editorially beyond the scope of this discussion".Without going into the specific mechanisms that can be and are quantifiable, so far "d" type and "cyclic" IBS symptom sets are the ones where the best study has been limited to on the "mechanisms" of the epsiodes, the bottom line is that there are an whole other classes of multiple abnormal mechanisms of response to dietary provocation...it appears that up to at least (8) known mechanisms can be involved singly or together which can be classified as either "immunologic" or "non immunologic". These reactions occur starting in the small bowel (though some chemicals to which the patient may react are small enough to be absorbed through the buccal mucosa, so the systemic immune cells can get a head-start on the small bowel systems), when a provoking food is instilled into the small bowel. The food can be something as benign as, oh, rice or as inscrutable as FD&C red Dye #40, or anything in between, since the reactions are not mediated by identifiable systemic immunoglobulins like IgE detetcable by food allergy tests. The presentation and findings on immunologic observation of the small bowel responses would be termed "novel reactions" I guess by those doing the work.These reactions, which are both delayed and dose dependent, can be delayed (perceptually) up to 72 hours from time of ingestion to onset of perceptible symptoms. They can also be dose-related such that a small amount of the provoking substance does not produce enough chemical-release by certain target cells to notice symptoms BUT if enough of the provoking food is consumed the reaction is strong enough to be noticed.ALSO, as they are dose-dependent. This means that they are also potentially combinant in totally random fashion. That is, for example, take "me". When my IBS-d cyclic was at its worst, it seemed ANYTHING and EVERYTHING or NOTHING could and would set off the severe debilitating episodes.Later, after working with immunologists and allergists who specialize in this field (food sensitivity or intolerance or whatever your own personal favorite word is who cares...non-IgE food reactivity, say, for examples sake), one of the interesting things that was discovered is that I was moderately reactive to such things as wheat, tomato, oregano, basil, garlic and onion (though onion was severe, almost like an IgE reaction so lets leave "Herr Zwiebel" aside).So if I ate some toast today, there would be some mild response I did not notice. But If I ate some pasta with marinara, however, 36-48 hours later the debilitating epsiodes would begin. If all I did was keep a food log, which I did, for eons, or listened to those who cared for me for many years withe their "eat more fiber, calm down, get a hobby, this is largely stress-related, seek psycholigical counselling, this is functional so accept it, ad nauseum" I would and did keep barking up the wrong tree. Yet endless experimentation of removing what I ate "today", for example, did not bring remission. I did isolate some of the obvious ones.I got lucky on the most obvious things, like the onion, as the reaction was so strong and repeatable (you should have seen an Onion Soup Challenge...OMIGAWD>>>that ruined more than one budding romance...), but never got past, maybe, a 20% symptom reduction.So the only possible hope of picking up more than the short-response non-dose dependent reactions using typical intake logging is that you have to do it with a log which keeps a space for every hour of every day, day and night, wherein you log precisely each item that is eaten and drunk in both the quantity-time and ingredients reference (keep the labels of ANY prepared foods of any kind....right down to canned fruit labels)...and in the same time slots you have to have a symptom SURVEY you complete that is day-time matched which records any symptoms as to time of perceivebale onset and degree for each symptom.You also have to do this for a LONG TIME. One week will not do it by long shot. For some people with wildly fluctuating diets and cyclic symptoms a MONTH is just the beginning. PATTERNS HAVE TO BE ISOLATED AND ANALYZED doing it manually like this and you must match up the ingredients lists too, not just the whole foods.Now this canm be greatly simplified by using a simple bland, low fat diet, BUT the trouble is when you do you have CHANGED THE STATE UNDER WHICH YOUR SYMPTOMS ARE BEING PROVOKED. So the results of people who are instructed to do THIS are compromised by the fact that you have eliminated potential offenders.OR one can go the modified food allergy stoneage diet approach (one protein, one oil, one carb, water or whatever the diet-du-jour is) with a non-allergenic supplement to maintain nutrition, and then when symptoms recede (assuming you chose wisely) start doing single open challenges one at a time. THIS has to be done meticulously too, and allow for time for any possible reaction to fulminate THEN allow a washout period before the next challenge.Or....Oh hell, it goes on....I recomend the first step is get a book written by someone who knows the damn subject in-and-out (food intolerance and allergy) since that person is a physician who has spent 40 years studying it and writing immunology and allergy texts and is constantly consulted on the subject by other practitioners:�FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT�, Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings� College, London) http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 ....then read it and it will be clearer what some of the mechanisms are AND what a poor patient with this persistent "d or cyclic symptom set needs to do. [C-type is much more difficult at this time as not enough work, both on the neurologic side and the immunoendocrine side, has been completed yet to isolate out the unique mechanisms which produce this symptom set. But its getting closer]. So at least the 2/3 of so called IBS patients are ones whose mechanisms of dietary provocation of symptoms are much better understood than they were even as little as 3-4 years ago.As an aside, this character of the mechanisms and the difficulty of accurately isolating non-allergic food reactivity (its inscrutable yet clincally unmistakable presentation and consequences) is what led some allergists and immunologists to work together for over 15 years to devise in vitro test methods which could be used to isolate the foods or chemicals which provoke these abnormal responses form a blood sample of the victim....a reliable short cut which people who wanted one could access to find these other hidden provocations and thus remove them from the diet all at once rather than working diligently to isolate them (or just surrensering to the fallacy that they do not exist and filling those prescriptions or loading up on all manner of OTC after-the-fact remedies to try to suppress the symptoms of the reactions that have already occurred).So I do understand that frustration completely. But do not be led to beleive that this is the end-game ("not the problem"). There are options, there are ways, there are things to do which will get results. Like the needle in the haystack, either dig systematically and patiently...or get a big magnet.Eat well. Think well. Be well.MNL_____________ www.leapallergy.com
 

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The VAST majority of patients have this problem, and often either form the false conclusion thst this has nothing to do (food or additives) with their symptoms or are given false information like "...this is because your diet will not affect your symptoms...has nothing to do with you condition" or "...if you have IBS ANYTHING you eat will can trigger your symptoms..." and other such old wives, er, old practitioner tales. So they are doomed to suffer and be dependent on only interventional therapies which can produce partial success by attenuating physiologic consequences of reactions that already occuurred.The problem is that the majority of patients and practitioners alike do not understand the physiology of anything except food allergy, and approach dietary assessment accordingly. Therefore, they are doomed to only finding the "grossest" reactions, for example suche elemantary observations as large bolus of anything dumped from the stomach into the small bowel causes the "twitchy" upregulated system to react in one or more ways (exagerrated GC reflex, pain, increased motility, etc). Or that instillation of a bolus of food-goop high in fat into the proximal bowel elicits a response. Or certain specific comorbid food allergy, which may be present in IBS victims (and at a frequency that is higher than it is in the general population), can be isolated since the reaction is quick, severe, and repeatable. Or that the person is susceptible to pseudoallergy (lectin containing foods, certain peptides, and other specific chemicals like low-molecular weight sugars which either elicit fluid-dynamics changes and/or trigger mast cell mediator release without true allergy or are chemicals which directly effect the myenteric plexus, or other such easy to spot reactions).So the intrsuctions usually given on how to isolate food "TRIGGERS" are just that: they will spot things which produce a rapid reaction after ingestion, in theory anyway, and then they are removed from the diet. Then, when the patient experiences only partial relief, the pronouncement is made "thats all the food-effect on your IBS now do this {xyz Protocol...whatever the protocol du jour is). This is becasue there are other reactions which are ongoing, which elicit the chronic and ongoing release of chemical mediators which have the effect on nerves and muscle and blood vessels which not only can increase gut motor and sensotry response bu the CNS as well, and affect endocrine function.Now this simple approach does produce symptom reduction from mild to substantial, if done properly, in about 70% or more of the patients (this response to simply probability-eliminatuion dieting has been repeated many times). This is consistent with the partial-remission results of other therapies often touted as stand-alone therapies for IBS s well. Of course the degree of remission will be greater if these multiple therapies are properly combined, yet for some mysterious reasons lo' these many decades, exceedingly few patients achieve 100% remission without some form of ongoing interventional pharmacotherapy. SOME spend years and decades with only mild relief using the procedures designed to find "food triggers" and food allergy or pseudoallergy and "buy-in" to the fallacy that "thats as good as it gets", since the link between the mechanisms of IBS and thier diet is only beleived to be those I just described. This is wrong, it has been known to wrong for over 20 years, and it is continuing to be proved wrong daily, but it persists for reasons which are known but "editorially beyond the scope of this discussion".Without going into the specific mechanisms that can be and are quantifiable, so far "d" type and "cyclic" IBS symptom sets are the ones where the best study has been limited to on the "mechanisms" of the epsiodes, the bottom line is that there are an whole other classes of multiple abnormal mechanisms of response to dietary provocation...it appears that up to at least (8) known mechanisms can be involved singly or together which can be classified as either "immunologic" or "non immunologic". These reactions occur starting in the small bowel (though some chemicals to which the patient may react are small enough to be absorbed through the buccal mucosa, so the systemic immune cells can get a head-start on the small bowel systems), when a provoking food is instilled into the small bowel. The food can be something as benign as, oh, rice or as inscrutable as FD&C red Dye #40, or anything in between, since the reactions are not mediated by identifiable systemic immunoglobulins like IgE detetcable by food allergy tests. The presentation and findings on immunologic observation of the small bowel responses would be termed "novel reactions" I guess by those doing the work.These reactions, which are both delayed and dose dependent, can be delayed (perceptually) up to 72 hours from time of ingestion to onset of perceptible symptoms. They can also be dose-related such that a small amount of the provoking substance does not produce enough chemical-release by certain target cells to notice symptoms BUT if enough of the provoking food is consumed the reaction is strong enough to be noticed.ALSO, as they are dose-dependent. This means that they are also potentially combinant in totally random fashion. That is, for example, take "me". When my IBS-d cyclic was at its worst, it seemed ANYTHING and EVERYTHING or NOTHING could and would set off the severe debilitating episodes.Later, after working with immunologists and allergists who specialize in this field (food sensitivity or intolerance or whatever your own personal favorite word is who cares...non-IgE food reactivity, say, for examples sake), one of the interesting things that was discovered is that I was moderately reactive to such things as wheat, tomato, oregano, basil, garlic and onion (though onion was severe, almost like an IgE reaction so lets leave "Herr Zwiebel" aside).So if I ate some toast today, there would be some mild response I did not notice. But If I ate some pasta with marinara, however, 36-48 hours later the debilitating epsiodes would begin. If all I did was keep a food log, which I did, for eons, or listened to those who cared for me for many years withe their "eat more fiber, calm down, get a hobby, this is largely stress-related, seek psycholigical counselling, this is functional so accept it, ad nauseum" I would and did keep barking up the wrong tree. Yet endless experimentation of removing what I ate "today", for example, did not bring remission. I did isolate some of the obvious ones.I got lucky on the most obvious things, like the onion, as the reaction was so strong and repeatable (you should have seen an Onion Soup Challenge...OMIGAWD>>>that ruined more than one budding romance...), but never got past, maybe, a 20% symptom reduction.So the only possible hope of picking up more than the short-response non-dose dependent reactions using typical intake logging is that you have to do it with a log which keeps a space for every hour of every day, day and night, wherein you log precisely each item that is eaten and drunk in both the quantity-time and ingredients reference (keep the labels of ANY prepared foods of any kind....right down to canned fruit labels)...and in the same time slots you have to have a symptom SURVEY you complete that is day-time matched which records any symptoms as to time of perceivebale onset and degree for each symptom.You also have to do this for a LONG TIME. One week will not do it by long shot. For some people with wildly fluctuating diets and cyclic symptoms a MONTH is just the beginning. PATTERNS HAVE TO BE ISOLATED AND ANALYZED doing it manually like this and you must match up the ingredients lists too, not just the whole foods.Now this canm be greatly simplified by using a simple bland, low fat diet, BUT the trouble is when you do you have CHANGED THE STATE UNDER WHICH YOUR SYMPTOMS ARE BEING PROVOKED. So the results of people who are instructed to do THIS are compromised by the fact that you have eliminated potential offenders.OR one can go the modified food allergy stoneage diet approach (one protein, one oil, one carb, water or whatever the diet-du-jour is) with a non-allergenic supplement to maintain nutrition, and then when symptoms recede (assuming you chose wisely) start doing single open challenges one at a time. THIS has to be done meticulously too, and allow for time for any possible reaction to fulminate THEN allow a washout period before the next challenge.Or....Oh hell, it goes on....I recomend the first step is get a book written by someone who knows the damn subject in-and-out (food intolerance and allergy) since that person is a physician who has spent 40 years studying it and writing immunology and allergy texts and is constantly consulted on the subject by other practitioners:�FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT�, Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings� College, London) http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 ....then read it and it will be clearer what some of the mechanisms are AND what a poor patient with this persistent "d or cyclic symptom set needs to do. [C-type is much more difficult at this time as not enough work, both on the neurologic side and the immunoendocrine side, has been completed yet to isolate out the unique mechanisms which produce this symptom set. But its getting closer]. So at least the 2/3 of so called IBS patients are ones whose mechanisms of dietary provocation of symptoms are much better understood than they were even as little as 3-4 years ago.As an aside, this character of the mechanisms and the difficulty of accurately isolating non-allergic food reactivity (its inscrutable yet clincally unmistakable presentation and consequences) is what led some allergists and immunologists to work together for over 15 years to devise in vitro test methods which could be used to isolate the foods or chemicals which provoke these abnormal responses form a blood sample of the victim....a reliable short cut which people who wanted one could access to find these other hidden provocations and thus remove them from the diet all at once rather than working diligently to isolate them (or just surrensering to the fallacy that they do not exist and filling those prescriptions or loading up on all manner of OTC after-the-fact remedies to try to suppress the symptoms of the reactions that have already occurred).So I do understand that frustration completely. But do not be led to beleive that this is the end-game ("not the problem"). There are options, there are ways, there are things to do which will get results. Like the needle in the haystack, either dig systematically and patiently...or get a big magnet.Eat well. Think well. Be well.MNL_____________ www.leapallergy.com
 
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