I'm D type and so far for me it's anything fried (chicken, french fries), anything with lots of fat (hamburgers, chicken wings), anything spicy and anything too rich (rich, creamy desserts). A big trigger for me also is if I overeat, even if I eat my *safe* foods. My tummy has shrunk over the last month so a couple of times when I've filled my plate, it's the amount I used to eat which is too much for me now (especially since I snack a lot during the day).Fiona
HI KIM.Here's a "primer" on approaching dietary problems and IBS...I have tried to keep it "basic" in the phsyiology so it is not as mind-numbing as the subject can be. I hope this will help atrt you thinking about some of the alternative strategies for this very important aspect of IBS management. I try to recommend starting with "pseudoallergy inducing foods" as these are foods that can make anyone have GI problems, so they are often worse for IBS and IBD victims.From there, one can then start sorting out their personal profile of reactive substances. I have intetntionally kept this non-technical, for those tekkies who may think I left out something. I am trying to be 'practical".----------------------------------------------------------------------------------As we have all read over and over, once a correct diagnosis of IBS is made (all the post-infection, inflammatory bowel disease, enzyme deficiency, and traditional "rapid onset" allergy causes of bowel dysfunction have all been evaluated and ruled out or treated) what is left is a problem of a hyperactive/reactive gut combined often with systemic symptoms (that can manifest themselves a number of ways). Diet, mental state, and overall health at any given time influence symptoms. Mental state is managed with various "affective" therapies depending upon the disease management approach of the particular clinician/patient combo (some prefer cognitive therapies, meditation or yoga, hypnotherapy, and forms of supportive pharmacotherspy).Interventional pharmacotherapy and dietary supplement therapy is often used to manage direct GI symptoms as dietary therapy is often frustrated by inconsistency in results and accurate identification of the actual offending foods and additives.Why? Diet affects everybody, healthy and unhealthy alike, since your largest interface with the outside world is the digestive tract and it is designed to differentiate the good (nutrients) from the bad (pathogens, toxic chemicals, foreign substances)and then process each accordingly. The good stuff is supposed to be broken down into specific components far enough that it can be safely assimilated into the body through the intestinal absorption structures (see villous anatomy) and the waste leftovers disposed of competently. The bad stuff, once identified, can be attacked and neutralized, or otherwise processed within the normal gut, or if it gets into the bloodstream by other organs like the liver, and circulating structures and then disposed of. This involves evoking various protective mechanisms that are components of the immune system which are managed by a chemical management system (mediators) and linked to the nervous system (peripheral and central )which also contributes to controlling the process. Under normal circumstances and with a normal immune-neuro-gut structure interface, this whole complicated process works along fine processing your food and sorting out the wastes and foreign invaders. From time to time a person gets a bout of nausea, vomiting, diarrhea, chills, flushing, dizziness, maybe even body pains and inflammation in the upper respiratory mucosa at the same time, fevers, and all combos thereof. Which is nothing more than the immune system detecting (either quickly in the upper digestive tract or more slowly as the objectionable pathogen or chemical makes its way down into the intestines) a pathogen or potentially harmful chemical and then taking steps to isolate it and then remove it from the body. -----------------------------------------That simplified explanation in place, the first thing to explain is how if you did NOT have IBS or any allergy of any type whatsoever, you would still get sick digestively or otherwise from time to time from something you ate. FOODS THAT CAN BITE YOU!-------------Some foods, especially vegetable matter, developed genetically DEFENSE MECHANISMS like animals. HUH? Animals do not want to be killed and eaten so they develop defense mechanisms. We humans went from sticks and rocks to guns and grenades. Someone attacks you, nuke 'em. Animals develop camouflage, or teeth and fangs and claws not just for eating but for defense. A lot of plants that we eat do not want to be eaten either so they have their own defenses. These include plants (fruit, veggies) that produce chemicals designed to be in sufficient concentration to make a little animal sick if they eat them, so little animals do not eat them. THIS IS BY NO MEANS A COMPRHENSIVE LIST BUT AN EXAMPLE TO BE CONSIDERED. Time is short today again...One chemical weapon that some veggies have thats real cute is a weapon that causes your immune system to Turn On itself! There are a lot of chemicals found in foods that can do this but one of the most prevalent is a group of similar chemicals called "lectins". In short, lectins are a group of chemicals which trick mast cells in the mucosa of the digestive tract into "degranulating". The mast cells contain chemicals (mediators) which either act directly on an invader or casue things to happen which bring other immune chemicals and cells into the fight to control an invader. And when the mast cell releases these chemicals it also causes local irritation and ven systemic reactions.In the lung, spasm of the muscle and swelling of the local tissues engorged with fluid beraing defensive cells, and an outpouring of secetions can happen. In your gut, smooth muscle spasm, incresed mucous production, swelling, and then systemic effects of mediators that get taken into the lymphatics and blood stream can cause the other symptoms we discussed as the body tries to expel the foul substance. Now most peoples bodies are structurally sound enough to process the results of this defense mechanism sufficiently that the person does not get clinically sick (or very little) from consuming a normal 'dose' (side dish) of these veggies that contain lectin. But a compromised and reactive gut, overreactive central and peripheral nervous sytem combined with the anxiety accompnaying the syndrome which is part of the trigger-loop can make a person with IBS get an "attack" from something another might not. When this happens it is not an allergy, becasue your immune system is functioning normally. It has been tricked into reacting by the veggies weapon, and with IBS it is more reactive than normal (the gut and the rest of the nervous system) and this can be amplified by the stress/anxiety responses. This is sometimes called "false food allergy" or "pseudoallergy".Lectins are found in high concentrations in legumes (peas, beans, lentils, peanuts, etc.)Some contain so much that if they are not prepared properly without a lot of presoaking and cooking even a healthy person can get a diarhea attack. Kidney beans, improperly prepared and put in a dish or salad, or in a slow-cooker instead of the usual high-temp cooking, have been responsible for more than one attack of "I must have an intestinal flu bug". And since it takes a while for the beans to get eaten, processed, start moving through the bowel and releasing quantities of lectin, we are talking many hours or even the next morning (if the persons transit time is slowed as it is in some gut dysfuntion) after breakfast before the dreaded explosion occurs! And lectin response is different in everybody, normal and IBS alike. That is why they are called "lectins". This is from the Latin ,means "to choose" I think (see Dr. Brostoffs Book referenced below for a better discussion). Some of the lectins interract differently with different even healthy people due to each persons slightly different makeup of the short-chain carbohydrate molecules that are attached to the bodies cells. Different lectins are specific to specific to certain carbo structures. AGGGHHH! Smart beans! It gets more complicated as some lectins trick the mast cells directly ans some lectins can bind IgE creating an "antigen" and actually can make a person have a positive skin-prick test for a pea or bean when they are not actually allergic! ----Some other foods (strawberries, shrimps, crabs, lobsters, tomatoes, fish pork, chocolate and more) contain special types of "peptides" which can also trick mast cells in your gut into losing their integrity and dumping mediators. Again, a normal person might not notice as the body processes these inappropriate mediators without clinical symptoms, or do not notice unless they eat a high concentration of them (plus ketchup and tomato sauce tend to concentrate the chemicals as they are processed). But an IBS or IBD victim might get "killed" once the stuff gets into the gut, and the farther it goes the worse it gets until they reactions finally expel it all.---- Histamine is another beauty. You know Histamine is one of the main chemical mediators released in allergy (immediate-like hay fever or the severe anaphylactic reaction to peanuts, say) or in other slower allergic reactions, or in tissue reactions which seem delayed because it takes time for the trigger to get in contact with mast cells. But some foods are high in histamine, and if consumed either in larger quantities or by a compromised gut or both can make you say "AHHHHH there it goes again!". Red wines, champagnes, even beer and white wine are beverages that can contain can contain histamine. And of course lets have a little party and put some cured sausages out (summer sausage, genoa,and other hard sausages) and some well-ripened cheese and you will get a real good soe of histamine from these. Mackeral and tuna can have histamine in them as well, especially if they are not kept very cold during the processing and canning process. These histamines come from the normal bacterial action in these foods as a byproduct. This direct-release of histamine can trigger fsater responses if the concentration is high, especially in beverages, because it can be directly absorbed through the buccal mucosa (oropharynx-mouth & throat) and bang you with a headache, dizziness, nausea, then just wait as it gets to your reactive gut..BAM ZOOM TO THE MOON.------------------------------------------That is a quick summary of NORMAL immune functions and food, as it can make our IBS go-off even if we are NOT hypersensitive. Add to this the fact (for details www.leapallergy.com) that your food triggers may be also from one of several types of ABNORMAL immune reactions (hypersensitivity reactions), not just regular Type I allergy (immediate reaction) but reactivity that is delayed either by the reaction onset is slow, or by the time it takes the reactive substance to get spread around the area of the GI mucosa so it is "seen" to react to, is absorbed and circulated or all these variables, before the process and symptoms even begin and you can be talking about 12, 24, even 48 hours for full-onset. In this case there is slim chance a standard food and symptom log is ever going to have a HIGH correlation to the onset of symptoms unless done in a very specific and structured manner, starting with a base diet that is established to be 100% "non-reactive" for that patient.It could be something or things eaten or drunk 3,4,5 meals ago...and since the consumption patterns fluctuate, as do the amounts consumed (some reactions are not seen as clinical symptoms until a reactive-threshold is passed by a certain dose of the trigger food, just like an asthmatic not going into a full-blown event until a certain dose of antigen is taken in).-------------------------------------------WHAT DOES ALL THIS MEAN?-------------------------------------------This is why some various (and at times stringent) dietary regimens have been developed to try to uncover more accurately these triggers. There are (2) general types of approaches. One is to go on a specific diet that is given, is very structured to remove just ALL KNOWN PSEUDOALLERGIC POTENTIAL FOODS. Then see if the symptoms start to subside over time (not a week...must be followed for NO LESS than 30 days before evaluated). Then if that worked, reinstituting foods one at a time by challenge is done. If not, one must rotating foods OUT ofthe base diet and allowing sufficient time to pass for symptoms subsidence...then the patient has a starting point.There are several specific diets to choose from that are layed out as daily menus that follow this approach from authorities on the subject. One of the best info guides and "options" for base diets for different people (this is not a "one size fits al" syndrome unfortubately), see FOOD ALLERGY AND INTOLERANCE: THE COMPLETE GUIDE by Professor Jonathan Brostoff, MD ($18 on AMAZON)for the ones he has found effective in 40 years of practice ( he is a reknowned immunologist in the U.K., and a recognized authority on the subject by his peers.)ANOTHER way is to start with a stoneage diet regimen which removes all the pseudallergic sources AND all the PROBABLE allergic and delayed-allergic foods. Like the Rice-Lamb-Pear diet. There are several.Ditto the procedure (in general...specifics are explained in the book). Then there is the BRAT diet...each is a variation of a low-reactivity base diet.In any case of an investigatory diet, because any of the reactions may not be the FOOD but an ADDITIVE, ALL processed foods, additives, and colorings are forbidden. And nowadays organic is one step better, since there may be an antibiotic in the Chicken you bought that they gave it your immune system reacts to, not the chicken. Or some people are told or lead to beleive they are "lactose intolerant" when it is actually another milk-fraction (casein, whey). Or its not the milk at all. They get diarrhea from Ice cream but when they drink a glass of milk: nothing. Sorbates (polysorbate, sorbitol) in the ice cream may be the culprit. ------------------------------OK summary over. Dr. Brostoff's book is a good one, probably the best for patients written by the top immunologist in the field. I recommend it for people trying to get a grip on their eating patterns and how they realte to constitutional symptoms that have been linked to food and additive sensitivity.There are also tests available to speed the identification process by analyzing immune reactivity in vitro to antigens. Type I allergies are easy to spot (IgE/IgG mediated for example). If you have one and you are an adult you have either figured it out already (you eat, get sick right away in one or more ways within minutes to an hour) so you are avoiding those items. Or you had an antigen-specific type of blood test for specific immunoglobulins(variable to low accuracy, non-inclusive of multiple mechanisms, and just because one is test-positive for an antigen-specicic immunoglobulin does not mean one is necessarily reacting to that food).There are several other types of in-vitro tests that have been developed which can identify the other multiple sources of hypersensitivity reactions to a greater or lesser degree (non Type I reactions that cannot be found except by careful oral challenge, represented by other technologies developed over the past 2 decades). These were developed for the purpose of seeking speed and convenience, as the dietary trial regimen is quite difficult for some. The exchange for saving time is they are not free, and some are better than others.The point is that doing it yourself is more tedious, but it costs nothing except time and self-discipline and often can achieve success rates as high as 70% (or as low as 0% depending upon carefully it is done).There are other advantages to trying it yourself first as well. This effort raises both awareness of your diet and how it affects your health, and tends to increase both knowledge and discipline in dietary matters, and can build a sense of committment and satisfaction when implemented carefully and results are obtained.Both of which can only help IBS victims.------------------------------------------A REPEAT NOTE ON ADDITIVES AND FLAVORINGS:Additive reactivity is very hard to discriminate with challenges...think of the possibilities...300 additives and 3,000 flavorings (not all are commonly used in all societies...there are usually around 100 or so to dal with and some are of the same chemical family so find one reaction, elimante the others).With IBS we should avoid additives anyway. The 3P's RULE is a good rule: Packaged + Processed = Poison. Many can irritate your colon all by themselves without any allergy due to the reactive nature of the gut. So we always try to direct patients to an additive-free diet.-----------------------Hope that helps get you thinking anyway...Have a DFDMNL
Tough to figure out, been doing it for 4 years. Wheat, wine, beer, cloves, eggs, Smoked food, and I don't eat much in the way of starches. I eat some Dairy products, corn chips, lettuce, meat, bananas, and m&m's with or without peanuts. Pretty screwy diet huh? When I first got sick I cut out sugar ( because its bad right?) and ate more good stuff like Oatmeal, natural Whole wheat Bread, And other healthlyWhole foods. Damn near killed me. Luckly 1) I'm smart with allergies having had other types my whole life, or I'd be in pretty bad shape right now. Unforunatly I got off the track early on with the conviction that I had a pathogen and insisted on flooded my GI tract with all kinds of Herbs, teas, etc. Thta didn't work too well and was a waste of money for me. Almost as big a waste as going to Kaiser Permente.
BALIR:LOL at your 'screwy' diet. Thats how it ends up sometimes because people can be reactive to thigs trhat cross-over food groups or are extracted and put into other foods...and finidng the "straight" food which is unreactive through elimination can lead to intersting diets. Or boring ones like me.Rotate straight grilled or fried (in canola oil) plain chicken breast (salt only) with ground lamb patties and combined ground lamb&pork patties for a 3 day meat rotation. Occasional fish thrown in like a snapper.No potatoe of any kind, no wheat, no quinoa, no spelt (wheat anyway) etc. But can use oat, barley, millet, rice and cheat with small amounts of highly-refined wheat bread (make it as unwheat like as possible). So the side dishes have to be comprised of those.No Spices. even tumeric in a dab of mustard...D time...no spice veggies like onion, garlic, but can use red pepper. No black pepper.Then rotate peas, carrots, wax beans. No high elctin veggies like the lentils, navy beans, pintos, etc.No carbonated bev's or caffaien or sorbitaol, sorbitan, polysorbates, or food dyes. BUT I can get away with (1) cup of coffee a day with 1 Immodium if I want to challenge myself.No dairy of any kind (whey, casen and lactoglobulin intolerant). No soy products or soy extracts or lecithin. Must restrict corn greatly but can do 2-3 oz. every third day.Water all day long.----------------------------But....asymptomatic unless I cheat-----------------------------Feel less screwy yet I hope?Have a great eve...time to grill a chickenMNLPS I would kill for a Heinekin[This message has been edited by Mike NoLomotil (edited 09-19-2000).]
Ditto for me on the fatty and fried foods. I had to keep a journal for three months to determine some of triggers, one being eating any corn product along with tomatoes in the same day, or eating tomatoes two days in a row. Another trigger for me is the amount of food. I have to eat 5-6 small meals a day, anything larger than that, even low-fat healthy foods, will trigger D.
Me? Fatty foods, dairy products of any sort, a whole host of artificial sweeteners, and artificial colors in combination. I can cope with a single artificial color, but not a lot at once. (This means that if I want Jelly Bellies, for instance, I go with one color and stick to it. My favorites are Juicy Pear and Margarita which are both green, so I can also have Apple, Lime, and several others in the Green Family!)I alos have a bunch of foods that I haven't been allowed to try yet, so I can't tell you whether they are triggers or not. And over eating of anything will do it.------------------JennT
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