Joy Bauer https://joybauer.com Life is hard, food should be easy Mon, 10 Jan 2022 21:47:30 +0000 en-US hourly 1 https://wordpress.org/?v=5.8.3 IBS Basics: What Is IBS (Irritable Bowel Syndrome)? https://joybauer.com/ibs/about-ibs/?utm_source=rss&utm_medium=rss&utm_campaign=about-ibs Tue, 09 Feb 2016 22:37:42 +0000 http://www.joybauer.com/?p=1240 Learn the basics of irritable bowel syndrome — and find out how food affects your condition.

The post IBS Basics: What Is IBS (Irritable Bowel Syndrome)? appeared first on Joy Bauer.

]]>
The best foods for IBS health are those that are gentle on the digestive system. By finding out what foods are your personal triggers, you can learn how to eat meals that are safe for your stomach.

Irritable bowel syndrome (IBS) is common, affecting aas many as 20 percent of Americans, and yet it remains a mystery. No one knows exactly what causes it, and there is no way for a doctor to make a definitive diagnosis. There is no single trigger and no single set of identifying symptoms: The symptoms can come and go in a day, or plague sufferers for months or years. So much uncertainty attached to very real physical discomfort makes coping with IBS frustrating in the extreme. IBS is called a functional bowel disorder, and not a disease, because it doesn’t cause permanent damage, it doesn’t progress to serious illness, and it can usually be controlled with diet and lifestyle changes. There’s another reason to be hopeful even if your case is a persistent one — people with chronic symptoms like yours have been successfully treated with new medications, making the condition less disabling than ever before.

Many people confuse IBS with IBD, which stands for Inflammatory Bowel Disease (talk about acronym confusion!). Although IBD and IBS both affect the intestines and can cause similar symptoms, they are very different conditions. IBD actually refers to a cluster of disorders, but the two major types are Crohn’s disease and ulcerative colitis; both are chronic conditions characterized by inflammation of the intestines, which results from the body’s impaired immune response. Treatment for IBD may require powerful medications to suppress inflammation, and sometimes even surgery. Unlike inflammatory bowel disease, IBS does not involve a dysfunctional inflammatory response, cause permanent damage to the intestines, or increase your risk of colon cancer and other intestinal disorders. Though IBS can certainly be painful and debilitating, it fortunately does not carry the same health risks as inflammatory bowel disease.

WHAT AFFECTS IBS?

The agony of IBS comes from the pain, discomfort, and embarrassing inconvenience of symptoms, which include diarrhea or constipation, cramping, bloating, excess gas, and mucus in the stool. To understand what happens in IBS, imagine a football stadium full of spectators doing “the wave.” If everyone cooperates, you can see the forward progression of the wave as each section stands and then sits again — it’s amazing to see so many bodies working in concert. Now imagine that you have some very nervous spectators — they see the wave coming at them, and they stand up too early, starting a secondary wave. So now the first wave stops midstream. The rhythm is disrupted. Or, imagine that one group stands up for the wave but doesn’t sit back down again. The wave is “stuck,” unable to move forward until the disrupting group decides to sit back down again.

Our intestines are lined with muscles that contract and relax in waves (ah-ha!) called peristalsis, which push the food you eat through the system. Along the way, nutrients are absorbed, and the residual is eventually eliminated in feces. In people with IBS, normal rhythmic waves are disrupted because your nervous system is not communicating effectively with the muscles that control your gut. Sometimes, the bowel contracts too much or too forcefully, so food moves through the intestines too quickly, resulting in diarrhea.

Other times, the intestinal muscles contract but don’t relax again, or they contract very slowly, resulting in constipation. These crazy, out-of-sync muscle movements are behind the pain of IBS, much like muscle spasms in your leg cause the pain of a charley horse. We all have intestinal gas, but for people with IBS, it can become trapped inside, resulting in bloating and distention. Some of my clients with IBS have admitted to buying two wardrobes — an everyday wardrobe and another specifically for their bloated, symptomatic days. Makes perfect sense — who wants to wear a snug pair of jeans or a fitted dress when feeling like the Pillsbury Doughboy? In addition, the intestinal nerves of people with IBS are highly sensitive, so that even minor bloating can have them doubled over in pain.

An individual with IBS might experience just a few of these symptoms — or all of them. Although most sufferers have either diarrhea-predominant IBS or constipation-predominant IBS, some people alternate between diarrhea and constipation. No matter what type of IBS you have, the underlying problem is that the rhythm of intestinal muscle contractions periodically gets messed up. There is no test for messed-up intestinal waves, however, and the symptoms of IBS are common to many other diseases, so arriving at a diagnosis of IBS is often lengthy and full of guesswork. Your doctor will want to rule out all other possible disorders, including Crohn’s disease, ulcerative colitis, and celiac disease, through a physical examination, blood tests, ultrasound, X-ray of your bowels, and sigmoidoscopy or colonoscopy, in which a lighted flexible tube is inserted into your lower intestines to get an up-close (and personal!) look at your intestinal lining. If there are no other problems, it’s IBS by default. Once you have a diagnosis, you and your doctor can get to work to find a treatment that works for you — IBS can be managed with appropriate diet and lifestyle changes and sometimes medications or behavioral therapy. It’s important to remember that although IBS can be uncomfortable, and strictly speaking there is no “cure,” it also won’t progress into anything more serious.

We don’t know exactly what disrupts the workings of the intestines in the first place, but we do know what can trigger flares of the disorder. Food is a biggie, and I’ll address that in the next section. Aside from food and eating issues, another significant IBS trigger is stress.

Stress can trigger a flare of IBS, and it can make food-triggered IBS symptoms worse. (That’s why many health experts recommend that people suffering from IBS actively explore a variety of ways to de-stress — there might be a terrific way to relax that you just haven’t tried yet.) Some doctors even talk about an IBS personality, one that is noticeably tense and anxious. I’ve seen this is my own practice. The client who comes to mind is Amy, a kindergarten teacher. The first time I saw Amy, I was struck by her rigid body language — every move she made told me that she was a very controlled person. Whether sitting or standing her posture was perfect, and she held her arms close to her body using minimal gestures. She spoke in a clipped, drill-sergeant sort of way. Everything Amy did, she did quickly. She was always on the run doing things for the kids in her class, running errands for her family, getting stuff for her classroom, and gobbling down her food. Amy didn’t sit down to eat. If she couldn’t wolf down a meal in five minutes it wasn’t worth eating. The challenge with Amy was getting her to recognize her food triggers, and also — perhaps more importantly — helping her to understand that her stressful, on-the-go lifestyle was only making her IBS worse.

On a very basic level, eating quickly is risky because you are more likely to swallow air, which can directly lead to bloating and distention. But stress can also stimulate spasms in the gastrointestinal tract — like feeling butterflies in your stomach when rumors about impending layoffs start floating around the watercooler. In people with IBS, those butterflies are on a rampage. Amy’s IBS was certainly made worse by her tense, never-stop, full-of-stress lifestyle. Fortunately, we were able to get her symptoms under control in pretty short order. We identified her food triggers (starchy beans, raw vegetables, gum, and coffee), which eliminated most of her problems, but stress education was the biggest eye-opener for her. Amy had no idea how much her driven personality affected her bowels. Although she still has a way to go, it’s easier for her to relax now that she doesn’t have to worry about whether her diarrhea will strike unexpectedly, and she’s made a determined effort to ease up. Ironically, she’s as driven about finding time to de-stress as she is about everything else, but she’s on her way to achieving the type of balanced life that can keep her IBS symptoms to a minimum.

Discover more Food Cures for your health.

 

NEXT: How Food Affects IBS

The post IBS Basics: What Is IBS (Irritable Bowel Syndrome)? appeared first on Joy Bauer.

]]>
How Food Affects IBS https://joybauer.com/ibs/how-food-affects-ibs/?utm_source=rss&utm_medium=rss&utm_campaign=how-food-affects-ibs Tue, 09 Feb 2016 22:33:08 +0000 http://www.joybauer.com/?p=1237 The best foods for IBS health are those that are gentle on the digestive system. By finding out what foods are your personal triggers, you can learn how to eat meals that are safe for your stomach.

The post How Food Affects IBS appeared first on Joy Bauer.

]]>
The best foods for IBS health are those that are gentle on the digestive system. By finding out what foods are your personal triggers, you can learn how to eat meals that are safe for your stomach.

A sensitive stomach should be treated like a fussy baby — you have to put it on a regular feeding schedule, keep it calm, and protect it from potential irritants.

IDENTIFYING TRIGGER FOODS

Identifying your particular trigger foods can be difficult. Even people without IBS will have a gastrointestinal reaction to certain foods once in a while. It just happens, and it’s perfectly normal. People with IBS, however, have a heightened sensitivity to foods, and this may cause them to overly limit themselves. For instance, they might eat a spicy bowl of chili, have a reaction, and condemn chili to a list of foods to be avoided forever. But what if the reaction was really due to unusual stress, or a mild case of food poisoning, or just one of those normal gut reactions? You might avoid a food forever for no good reason. By the time some clients come to see me, they’re downright food-phobic. They are so afraid of an attack of diarrhea, constipation, or horrific gas that they err on the side of caution — but too much caution can result in low blood sugar, weight loss, poor nutrition, and another kind of socially awkward situation; they can become afraid of eating with friends or leaving home for fear of an attack.

For people with extreme IBS, the simplest way to identify the right trigger foods is to first follow an elimination diet for five to seven days — a meal plan that avoids all potential offending foods, then slowly reintroduce those same foods one by one. Along the way you keep track of reactions to foods you are reintroducing in a food diary. Depending upon your symptoms, my guidelines for an elimination diet vary slightly. (Please note: Following an elimination diet can be very difficult. It’s just a week, but you still need to be pretty committed to put up with such a limited selection of food. Then again, if you’re currently suffering, it’s better to put up with a week of discomfort than a lifetime of untreated, debilitating abdominal pain.)

If you have severe diarrhea-predominant IBS, your five-to-seven-day elimination diet will avoid all trigger foods plus all fiber, including soluble fiber (see Extreme Elimination Diet — No Fiber). If you have severe constipation-predominant IBS, your elimination diet will avoid all trigger foods, but incorporate foods rich in soluble fiber and insoluble fiber (see Elimination Diet With Added Fiber). The addition of soluble fiber can help encourage your intestines to “wave” more effectively.

Whichever plan you follow, after about a week you’ll be ready to test some of the potential trigger foods. I recommend trying one new food every two to three days and carefully documenting what you eat and how you feel during the 24 hours afterward. This is a big job. If you try it on your own and find it unmanageable, I encourage you to work with a registered dietitian who specializes in gastrointestinal issues.

As I said, these elimination plans are only for severe cases of IBS. If you’re among the majority of people who experience less debilitating IBS, feel free to skip the Extreme Elimination Diet plan altogether and go straight to keeping an IBS journal. Your journal should list exactly what you eat, when you eat, what symptoms you experience, as well as your emotional state for the day. Make a special note if you feel particularly tense, anxious, or stressed.

When you have an IBS attack, consult your diary to see which foods you ate in the previous 24 hours and start a list of your potential triggers. Keep eating normally, always noting which foods you ate in the 24 hours prior to an attack and adding new items to your potential trigger list. When a food already on your list precedes an attack, make an X next to it each time it comes up. After a few weeks, those marks should tell you which foods are most likely to trigger an episode. Narrow down your list to the three most likely triggers, and avoid those foods entirely for two weeks. Continue to keep your IBS journal, and repeat the process. Every once in a while, test your trigger foods again (one at a time) to make sure you’re not avoiding them for no reason. Over time, you’ll have a good handle on which foods you need to avoid and which you can eat safely. NOTE: If you find yourself with more than five main trigger foods, see a dietitian to make sure that the rest of your diet is making up for whatever nutrients you’re missing by eliminating those foods.

For everyone fighting IBS, there are a few mealtime guidelines that can make your life easier:

1. Try to eat meals at approximately the same time each day to get your body used to a schedule.
2. Eat smaller, more frequent meals so you don’t overload your gut at any one time.
3. Slow down — sit, relax, and take time to thoroughly chew your food. Think of it as time invested in training your digestive system to behave.

GOOD FOODS TO CHOOSE

The best foods for IBS health are those that are gentle on the digestive system and encourage “smooth passage” through the intestines. Thus, vegetables, fruit, and whole grainsit pains me to say — should be limited until your symptoms subside and you identify foods that are problematic for you. It’s hard to imagine I just said that! Truth be told, these healthful foods are a bit hard for the body to break down, but remember I’m recommending you watch your intake only until you’ve got a handle on your triggers — even with diarrhea-predominant IBS, you should eventually be able to tolerate moderate amounts of all three groups, although you’ll probably need to cook vegetables.

  • Soluble Fiber: Fiber comes in two main varieties — soluble and insoluble. During digestion, soluble fiber dissolves in water and turns into a kind of gooey, gummy consistency — think what happens to oatmeal after it sits in a pot of water for a time. Insoluble fiber is tougher. It doesn’t dissolve and pretty much keeps its form.Although insoluble fiber is generally healthy, it can be hard on the intestines of people with IBS. Insoluble fiber food moves quickly through the colon, something that many diarrhea-predominant IBS sufferers want to avoid. People with constipation-predominant IBS may want to experiment with how much insoluble fiber they can eat without experiencing too much gas and bloating.Soluble fiber, on the other hand, promotes gentle regularity, regardless of the type of IBS you have. That’s why you’ll find plenty of soluble fiber integrated into my Elimination Diet With Added Fiber. (However, my Elimination Diet doesn’t include foods rich in soluble fiber that also act as potential triggers, such as beans, lentils, broccoli, and cabbage. Of course, these foods can be added back to your diet during the experimentation phase in order to identify if they are personal triggers. If it turns out that beans or broccoli don’t upset your system, feel free to include them on a regular basis.).Most foods high in soluble fiber are considered safe, and even beneficial, for people with IBS. The trick is to eat a variety of foods in moderation, without eating too much of one particular food or too much food in general at one time. If you have diarrhea-predominant IBS, I recommend slowly adding more foods high in soluble fiber to your diet. If you experience loose stools, back off a little, wait a few days, then add fiber again. The key is to eat just a little bit of extra fiber, building up to about six servings a day over a course of weeks, not days. However, for constipation-predominant IBS, you can be more aggressive, fiber-wise. The Elimination Diet With Added Fiber for constipation-predominant IBS works in three to six (or more) daily portions of soluble fiber, depending upon the meals and snacks you chose. Of course, even then you’ll want to moderate the portions and spread them throughout the day — as opposed to eating them all at one sitting — to avoid the risk of excess gas and discomfort. And, remember to drink plenty of water to help move it along.In my Elimination Diet With Added Fiber, I incorporate at least one serving of food rich in soluble fiber at each meal. If you have diarrhea-predominant IBS, and you’re ready to follow the less-extreme Elimination Diet With Added Fiber, you may want to move more slowly, starting with a single serving of one soluble fiber-rich food for the entire day. All foods rich in fiber included in IBS Shopping List have an asterisk (*), so you’ll know what to include and what to avoid.Raw vegetables — whether rich in soluble OR insoluble fiber — tend to be difficult for IBS sufferers (both diarrhea-predominant and constipation-predominant) to digest and can often trigger diarrhea, gas, and bloating. When you’re ready to introduce vegetables into your diet, I strongly recommend you stick to cooked vegetables. Once you’ve got a handle on the cooked produce, you can experiment with adding small amounts of raw vegetables to your diet on occasion.IBS-FRIENDLY FOODS FOR SOLUBLE FIBER: Winter squash, parsnips, turnips, sweet potatoes, green peas, okra, eggplant, barley, oats, oranges, grapefruit, clementines, tangerines, strawberries, blackberries, raspberries, bananas, white potatoes, avocado, cooked carrots, cooked green beans, cooked spinach, cooked kale, cooked Swiss chard, ground flaxseed *The following fruits are high in fructose and/or sorbitol and may be trigger foods for some people. If you find that you do not have a personal sensitivity to these foods, they are excellent sources of soluble fiber and should be regularly included in your diet: apples, peaches, plums, nectarines, pears, mango, apricots.
  • Liquids: All people with IBS should strive to drink flat water regularly throughout the day. If constipation is your problem, water will help keep your stools moist so they pass more easily; the soluble fiber in your diet will help too. If diarrhea is your problem, you’ll need to replenish the water you lose through loose stools. Plain water and decaffeinated tea should be your first choices. Carbonated beverages are not advised because the gas from the carbonation can get trapped in your intestines, amplifying discomfort. You’ll also want to avoid drinking caffeinated beverages and alcohol — which can stimulate the intestines and make symptoms worse — while following the Elimination Diet, particularly if you have diarrhea-predominant IBS. When you get to the experimentation phase and begin adding back foods, you can test your personal tolerance for caffeinated beverages and alcohol and decide whether you need to avoid them completely.

Click here for 6 common IBS trigger foods.

Discover more Food Cures for your health.

The post How Food Affects IBS appeared first on Joy Bauer.

]]>
Lactose Intolerance and IBS https://joybauer.com/ibs/lactose-intolerance-and-ibs/?utm_source=rss&utm_medium=rss&utm_campaign=lactose-intolerance-and-ibs Tue, 09 Feb 2016 22:29:37 +0000 http://www.joybauer.com/?p=1229 How do you know if you have lactose intolerance or irritable bowel syndrome?

The post Lactose Intolerance and IBS appeared first on Joy Bauer.

]]>
How do you know if you have lactose intolerance or irritable bowel syndrome?

 

Q: How do I know if I have lactose intolerance or IBS?

 

A: Milk can sometimes trigger IBS, that’s why you’ll find dairy on the list of foods to initially avoid. But sensitivity to dairy foods is most commonly a sign of lactose intolerance. Lactose intolerance is not IBS. In fact, it’s a completely different problem and one that’s easily remedied.

 

What is lactose intolerance? Milk products contain a form of natural sugar called lactose. In order to digest lactose, our bodies produce a specific enzyme called lactase. For a variety of reasons, including genetics, digestive disorders, intestinal injury, and/or the natural aging process, some people end up with very low levels of lactase. Depending on how much of the offending food you eat, and how much lactase enzyme your body can produce, symptoms can be mild or severe, and include nausea, cramping, gas, bloating, and diarrhea. Sound familiar? The symptoms can be remarkably like IBS symptoms. So, how do you tell the difference?

If you suspect you’re lactose intolerant, make dairy the first thing you test. Avoid milk and anything containing milk for three to five days (see my list of Common IBS Trigger Foods). If your symptoms disappear completely, you’re most likely lactose intolerant. If you want a definitive diagnosis, you can ask your doctor about taking a Hydrogen Breath Test. This simple test looks for a higher-than-normal amount of hydrogen in the breath, caused by the extra gases produced by the bacteria fermenting the undigested lactose in the intestines. Fortunately, many people with lactose intolerance can enjoy hard, aged cheeses (like cheddar and Swiss), which have insignificant amounts of lactose, as well as lactose-reduced milk products, without any symptoms. You can also take lactase enzyme in a tablet or liquid form with your first bite or sip of a milk product and voilà — no digestive trouble.

If you test positive for lactose intolerance and avoid all milk products but still have gastrointestinal symptoms, it’s possible that you have both lactose intolerance and IBS.

The post Lactose Intolerance and IBS appeared first on Joy Bauer.

]]>
Fiber Supplements for IBS https://joybauer.com/ibs/fiber-supplements-for-ibs/?utm_source=rss&utm_medium=rss&utm_campaign=fiber-supplements-for-ibs Tue, 09 Feb 2016 22:23:13 +0000 http://www.joybauer.com/?p=1225 Many experts recommend fiber supplements, but they are not always the best medicine.

The post Fiber Supplements for IBS appeared first on Joy Bauer.

]]>
I’ve read that I should take fiber supplements for my IBS. Are they helpful?

Q: I’ve read that I should take fiber supplements for my IBS. Are they helpful?

 

A: Many experts recommend fiber supplements, but they are not always the best medicine. I say this because many of my clients have complained they’ve become more bloated and gassy after taking them. And this goes for both types — soluble and insoluble fiber supplements. People with IBS are very sensitive to fiber, so adding a concentrated dose of fiber isn’t always beneficial, especially if you go overboard on the amount. Personally, I tend to treat IBS by focusing on foods.

 

I start by asking my clients about their symptoms. If it’s predominantly diarrhea, I’ll have them take a rest from most fiber-rich foods. Then, ever so slowly, we start adding them back — focusing first on the soluble type, which can be easily dissolved in your gut, as opposed to insoluble. If a client complains of persistent constipation, I immediately incorporate foods rich in soluble fiber (along with some insoluble fiber) evenly sprinkled throughout the day. When my clients feel well enough, we add more. Since I’ve had much more success with food than supplements, I suggest you skip the pills and instead add fiber-rich foods (slowly!) along with lots of flat water (not carbonated, which will add gas) to your diet.

I prefer dietary modifications as the first line of defense, but if you still can’t find relief, you can certainly experiment with fiber supplements. Just be cautious — start with a small amount of a soluble fiber supplement (such as psyllium, wheat dextrin, methylcellulose, or inulin) and see how you react. If the product appears to be beneficial, you can slowly work your way up to the recommended daily dose. And if one type of supplement doesn’t work for you, consider trying another; individuals can respond differently to different forms of fiber. Make sure to follow directions and take your supplements with plenty of water to minimize bloating and constipation. This is definitely a trial-and-error process!

Discover more Food Cures for your health.

 

The post Fiber Supplements for IBS appeared first on Joy Bauer.

]]>
Extreme Elimination Diet https://joybauer.com/ibs/extreme-elimination-diet/?utm_source=rss&utm_medium=rss&utm_campaign=extreme-elimination-diet Tue, 09 Feb 2016 22:15:34 +0000 http://www.joybauer.com/?p=1222 This diet is meant for people with severe diarrhea-predominant IBS. Follow it for five to seven days to determine what foods are triggering your IBS.

The post Extreme Elimination Diet appeared first on Joy Bauer.

]]>
This diet is meant for people with severe diarrhea-predominant IBS. Follow it for five to seven days to determine what foods are triggering your IBS.

This elimination diet is extreme and should not be followed for longer than one week. It’s designed to help people who suffer from severe, persistent diarrhea-predominant IBS determine which foods may be aggravating their condition. (If you have occasional symptoms from IBS, the elimination diet plan is not appropriate or warranted. Search the rest of the IBS section for helpful information on managing milder cases.)

My Extreme Elimination Diet avoids all common IBS trigger foods. This plan is very low in dietary fiber and is based on the few foods I’ve found that people with this type of IBS can tolerate best. Fiber (and nutrition) will be slowly increased as you introduce new foods.

If you’re a candidate for this plan, follow it for one week. Every day, choose one option for each of the three meals: breakfast, lunch, and dinner. Then, one or two times per day, choose from a variety of my suggested snacks. Eat slowly and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage, and try to drink at least 8 cups throughout each day.

After following this plan for one week, you can start experimenting by adding new foods. You should add one new food every two to three days (it’s best to stick with one portion of a new food per day). Keep an IBS diary and write down everything you eat — and everything you feel. Pay close attention to how you feel after eating each new food, which will help you determine if it can be permanently reintroduced into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next food category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will have identified most of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:

  1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
  2. Sweet potatoes
  3. Wheat products: Start with white versions of bread, crackers, and pasta. In the future, you can slowly test small amounts of whole wheat varieties.
  4. Oats, oatmeal, and barley
  5. Brown and wild rice
  6. Cooked vegetables (non-cruciferous)
  7. Fruit (peel fruits with tough outer skins at first)
  8. Whole nuts and seeds
  9. Garlic and onion
  10. Starchy beans and lentils
  11. Cooked cruciferous vegetables
  12. Raw vegetables
  13. Ketchup, soy sauce, and other condiments (test one at a time)
  14. Dried fruit and all-fruit jams
  15. Chocolate
  16. Fruit juice, sugar, and honey
  17. Coffee or tea
  18. Alcohol

Get your one week Extreme Elimination Diet here.

Click here to view my list of IBS-safe recipes.
Click here for the Elimination Diet With Added Fiber.

The post Extreme Elimination Diet appeared first on Joy Bauer.

]]>
Elimination Diet with Added Fiber https://joybauer.com/ibs/elimination-diet-with-added-fiber/?utm_source=rss&utm_medium=rss&utm_campaign=elimination-diet-with-added-fiber Tue, 09 Feb 2016 22:11:54 +0000 http://www.joybauer.com/?p=1219 Follow this diet for severe constipation-predominant IBS and as a follow-up to the extreme elimination diet.

The post Elimination Diet with Added Fiber appeared first on Joy Bauer.

]]>
Follow this diet for severe constipation-predominant IBS and as a follow-up to the extreme elimination diet.

This elimination diet is extreme and should not be followed long-term. It’s designed to help people who suffer with persistent constipation-predominant IBS (and other debilitating types of IBS that cause gas, cramping, and pain) finally figure out which foods may be aggravating their condition. It avoids common IBS trigger foods and provides a moderate amount of dietary fiber, with a good amount specifically coming from soluble fiber sources. All foods rich in fiber are marked with an asterisk (*). If you’re feeling gassy or uncomfortably distended, go easy on these foods. Your total fiber intake (and nutrition!) will slowly increase when you start introducing new foods.

If you’re a candidate for this plan, follow it for one week. Every day, choose one option for each of the three meals — breakfast, lunch, and dinner. Then, once or twice per day, choose from my suggested snacks. Eat slowly, and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage and try to drink at least 10 cups throughout each day.

After following this plan for one week, you’re ready to add new foods. You should add one new food every two to three days. (It’s best to stick with one portion of a new food per day.) Keep an IBS diary and write down all the foods you eat, the amounts, and how they affect your constipation. Pay close attention to how you feel after eating each new food and determine if that food can be permanently reintroduced back into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will hopefully have identified all (or most) of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods.

  1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
  2. Wheat products (preferably whole wheat bread, pasta, cereal, and more) and other whole grains
  3. Increased portions of daily cooked vegetables (noncruciferous)
  4. More daily fruit
  5. Whole nuts and seeds
  6. Garlic and onion
  7. Starchy beans and lentils
  8. Cooked cruciferous vegetables
  9. Raw vegetables
  10. Ketchup, soy sauce, and other condiments (test one at a time)
  11. Dried fruit and all-fruit jam
  12. Fruit juice, sugar, and honey
  13. Chocolate
  14. Coffee or tea
  15. Alcohol

ELIMINATION DIET WITH ADDED FIBER

Breakfast Options

(300 to 400 calories)

Oatmeal with Strawberries and Ground Flaxseed
Prepare 1/2 cup dry *oats with water and top with 1 cup sliced *strawberries and 2 tablespoons ground *flaxseed.

Cold Cereal with Banana and Soy Milk
Mix 11/2 cups puffed rice cereal with 1 cup soy milk (or rice or almond milk) and top with 1 sliced *banana (or 1 cup *berries) and 1 to 2 tablespoons ground *flaxseed.

Banana Almond Muffin with Scrambled Eggs
Beat 2 whole eggs with 2 egg whites and preferred seasonings, and scramble in a hot skillet coated with oil spray. Enjoy with 1 *Banana Almond Muffin or 2 rice cakes, each topped with 1 teaspoon soft tub, trans fat–free spread.

Lunch Options

(400 to 500 calories)

Curried Chicken Salad with Sweet Green Peas and Rice Cakes
Enjoy 1 serving *Curried Chicken Salad with Sweet Green Peas divided over 2 rice cakes. Serve with 1 *orange or 1/2 *grapefruit.

Turkey and Avocado on Rice Cakes
Divide 5 ounces sliced turkey (or chicken) over 2 rice cakes and top each with 1 thin slice *avocado. Serve with 1 cup *berries (blackberries, raspberries, sliced strawberries) or 1 *orange.

Turkey Burger with Sweet Potato
Top a 5-ounce bunless turkey burger with 1/2 cup mushrooms sautéed in oil spray. Serve with 1 plain medium baked *sweet potato.

Dinner Options

(500 to 600 calories)

Salmon with Green Peas and Rice
Enjoy 1 serving Easy! 3-Step Microwave Salmon (page 00; omit the garlic) or 5 ounces grilled salmon, sole, cod, haddock, or tilapia with 1 teaspoon olive oil and other preferred seasonings. Serve with 1/2 cup *green peas mixed with 1/2 cup cooked *brown or wild rice.

Rosemary Chicken with Sautéed Spinach and Sweet Potato
Enjoy 5 ounces grilled Rosemary Chicken, 1 cup *spinach sautéed in 1 teaspoon olive oil with a pinch of kosher salt and pepper, and 1 plain medium baked *sweet potato.

Roast Turkey with Cooked Carrots and Brown Rice
Enjoy 5 ounces roast turkey with 1 cup cooked *carrots and 1 cup cooked brown or wild rice (or 1 plain medium *sweet or *white potato topped with 1 tablespoon soft tub trans fat–free spread).

Snack Options

100 calories or less

  • IBS-friendly fruit rich in soluble fiber: 1 banana or orange; 1 cup berries (sliced strawberries, blackberries, raspberries); 1/2 grapefruit; 2 tangerines or clementines; 20 whole strawberries
  • 1 hard-boiled egg (or 4 egg whites)
  • 1 rice cake topped with 1 teaspoon nut butter

100 to 200 calories

  • 100 to 200 calories’ worth of plain rice crackers
  • 1 ounce baked potato chips
  • 1/2 baked *sweet or *white potato with 1 teaspoon soft tub, trans fat–free spread (or 1 tablespoon guacamole)
  • 2 rice cakes, each topped with 1 teaspoon nut butter
  • 2 rice cakes, each topped with 1 tablespoon guacamole
  • 8 ounces soy, rice, or almond milk
  • *Banana Almond Muffin
  • 1/2 cup *oats prepared with water, topped with 1/2 cup *berries or 1/2 sliced *banana
  • *Strawberry-Banana Smoothie: Combine 1 full cup strawberries (fresh or frozen), 1/2 medium banana, 3/4 cup soy milk (or almond or rice milk), and 3 to 5 ice cubes in a blender and purée until smooth.

Click here to view my list of IBS-safe recipes.
Click here for the Extreme Elimination Diet (With No Fiber).

The post Elimination Diet with Added Fiber appeared first on Joy Bauer.

]]>
Extreme Elimination Diet – No Fiber https://joybauer.com/ibs/elimination-diet-no-fiber/?utm_source=rss&utm_medium=rss&utm_campaign=elimination-diet-no-fiber Tue, 09 Feb 2016 22:07:59 +0000 http://www.joybauer.com/?p=1216 This elimination diet is designed to help people who suffer from severe, persistent, diarrhea-predominant IBS determine which foods may be aggravating their condition.

The post Extreme Elimination Diet – No Fiber appeared first on Joy Bauer.

]]>
This elimination diet is extreme and should not be followed for longer than one week. It’s designed to help people who suffer from severe, persistent, diarrhea-predominant IBS determine which foods may be aggravating their condition. It avoids all common IBS trigger foods. This plan is very low in dietary fiber and is based on the few foods I’ve found that people with this type of IBS can tolerate best. Fiber (and nutrition) will be slowly increased as you introduce new foods.

If you’re a candidate for this extreme plan, follow it for one week. Every day, choose one option for each of the three meals &mdash breakfast, lunch, and dinner. Then, once or twice per day, choose from my suggested snacks. Eat slowly, and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage, and try to drink at least 8 cups throughout each day.

After following this plan for one week, you can start experimenting by adding new foods. You should add one new food every two to three days. (It’s best to stick with one portion of a new food per day.) Keep an IBS diary and write down everything you eat and everything you feel. Pay close attention to how you feel after eating each new food, which will help you determine whether that food can be permanently reintroduced into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next food category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will have identified most of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:

  1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
  2. Sweet potatoes
  3. Wheat products: Start with white versions of bread, crackers, and pasta. In the future, when symptoms subside, you can slowly test small amounts of whole wheat varieties.
  4. Oats and barley
  5. Brown and wild rice
  6. Cooked vegetables (noncruciferous)
  7. Fruit (without tough outer skins, at first)
  8. Whole grains (whole wheat breads, cereals, pasta; popcorn; quinoa; millet; amaranth; etc.)
  9. Whole nuts and seeds
  10. Garlic and onion
  11. Starchy beans and lentils
  12. Cooked cruciferous vegetables
  13. Raw vegetables
  14. Ketchup, soy sauce, and other condiments (test one at a time)
  15. Dried fruit and all-fruit jams
  16. Chocolate
  17. Fruit juice, sugar, and honey
  18. Coffee or tea
  19. Alcohol

EXTREME ELIMINATION DIET

Breakfast Options

(300 to 400 calories)

Hot Cereal with Banana Slices
Prepare 11/2 cups cream of rice cereal with water and 1 tablespoon soft tub trans fat–free spread. Enjoy with 1 sliced banana.

Cold Cereal with Soy Milk
Enjoy 2 cups puffed rice cereal with soy milk (or rice or almond milk).

Scrambled Eggs with Rice Cakes
Beat 2 whole eggs with 2 egg whites and scramble in a hot skillet coated with oil spray. Season eggs with preferred herbs. Enjoy with 2 rice cakes, each topped with 1 teaspoon soft tub, trans fat–free spread.

Lunch Options

(400 to 500 calories)

Grilled Chicken with Rice
Enjoy 5 ounces grilled chicken (or fish, shellfish, or lean beef) with 1 cup cooked white or yellow rice with preferred seasonings.

Turkey Burger with Baked Potato
Serve a 5-ounce, bunless turkey burger with 1 medium baked potato topped with 2 teaspoons soft tub trans fat–free spread. Do not eat the potato skin.

Turkey and Avocado on Rice Cakes
Divide 4 ounces sliced turkey (or chicken) over 2 plain rice cakes, and top each with 1 thin slice avocado. Enjoy with 1 ounce of baked potato chips.

Dinner Options (500 to 600 calories)

Salmon with Rice
Enjoy 1 serving of Easy! 3-Step Microwave Salmon or 5 ounces grilled salmon (or sole, haddock, cod, or tilapia) seasoned with 1 teaspoon olive oil and a pinch of kosher salt. Serve with 1 cup cooked white or yellow rice with preferred seasonings.

Rosemary Chicken with Baked Potato
Enjoy 5 ounces Rosemary Chicken with 1 medium baked potato topped with 1 tablespoon soft tub trans fat–free spread. Do not eat the potato skin.

Roast Turkey with Mashed Potatoes
Enjoy 6 ounces skinless roast turkey with 1 medium baked potato scooped and mashed with 1 tablespoon soft tub trans fat–free spread (or 1 cup cooked white or yellow rice). Do not eat the potato skin.

Snack Options

100 calories or less

  • 2 plain rice cakes
  • 1 banana
  • 1 hard-boiled egg (or 4 egg whites)
  • 1 rice cake topped with 1 teaspoon nut butter
  • 8 ounces soy, rice, or almond milk

100 to 200 calories

  • 100 to 200 calories’ worth of plain rice crackers
  • 1 ounce baked potato chips
  • 1/2 baked potato with 1 teaspoon soft tub, trans fat–free spread (or 1 tablespoon guacamole); do not eat the potato skin.
  • 2 rice cakes, each topped with 1 teaspoon nut butter
  • 2 rice cakes, each topped with 1 tablespoon guacamole

Click here to view my list of IBS-safe recipes.
Click here for the Elimination Diet With Added Fiber.

The post Extreme Elimination Diet – No Fiber appeared first on Joy Bauer.

]]>
Starting a Low-FODMAP diet: What you need to know https://joybauer.com/ibs/starting-a-low-fodmap-diet-what-you-need-to-know/?utm_source=rss&utm_medium=rss&utm_campaign=starting-a-low-fodmap-diet-what-you-need-to-know Tue, 09 Feb 2016 22:04:48 +0000 http://www.joybauer.com/?p=1212 FODMAPs are a group of carbohydrates that are often poorly digested in the intestine and, when fermented by bacteria that live in the gut, can cause a host of digestive woes. Find out if you should go on a low

The post Starting a Low-FODMAP diet: What you need to know appeared first on Joy Bauer.

]]>
If you’re a nutrition nerd like me, you might be familiar with the word FODMAP, which stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” FODMAPs are a group of carbohydrates that are often poorly digested in the intestine and, when fermented by bacteria that live in the gut, can cause a host of digestive woes.

While all people appear to poorly break down certain FODMAPs, some people are particularly sensitive: those who have irritable bowel syndrome (IBS) and those who have small intestinal bacterial overgrowth (SIBO).

IBS is a functional gastrointestinal disorder that is often identified once other, more severe conditions have been ruled out. The most common symptoms of IBS include lower abdominal pain, bloating, excessive gas, and diarrhea and/or constipation.

SIBO is a condition in which an overgrowth of bacteria from the large intestine moves up into the small intestine. Symptoms of SIBO can be very similar to those of IBS, so it’s important to work with your physician to determine the root cause.

You can test for the malabsorption of a few specific FODMAPs: fructose (a monosaccharide), lactose (a disaccharide), and sorbitol (a polyol). The test involves drinking a measured volume of one of these carbohydrates and later blowing into a tube attached to a special bag. If your body is unable to absorb that carbohydrate, intestinal bacteria will ferment it, producing gasses that are carried from the intestine to the bloodstream to the lungs, where they are exhaled into the test bag.

While there are currently no tests to confirm malabsorption of other FODMAPs, this is an area of intense research so more tests and information might become available in the future.

If you have the benefit of these test results, you can refine your approach to the low-FODMAP diet. For example, if you learn that you can absorb lactose without any issues, you can proceed with the low-FODMAP diet but not restrict lactose-containing foods such as milk and cheese. However, if you are not able to do the test, following the full low-FODMAP diet is recommended.

The low-FODMAP diet has two phases. The first phase is a strict elimination of high FODMAP foods for anywhere from 2 to 6 weeks (though some dietitians recommend completing a full 8 weeks on the low-FODMAP diet). The purpose of this phase is to observe whether your symptoms are relieved when these potential triggers are removed. If this is the case, you would move on to the second phase of the diet.

The second phase carefully and systematically reintroduces specific FODMAPs back into the diet. It’s important to do this one by one, and in gradually increasing amounts, so you can pinpoint the specific foods (and amounts) of foods you can and cannot tolerate without symptoms. These triggers vary from one individual to the next.

Working with a knowledgeable team of a registered dietitian and physician is key here, as determining whether you have sensitivities to certain foods (or certain amounts of specific foods) can be quite complex. To find a registered dietitian in your area, go to eatright.org.

The following list gives you a glimpse of high-FODMAP and low-FODMAP foods, but there are many, many others. For a comprehensive guide, visit Monash University or Low FODMAP Central.

High FODMAP Foods:

  • Breads and cereals: Crackers, cookies, and pasta made from wheat or rye
  • Dairy and most alternatives: Milk, yogurt, ice cream, custard or pudding made from cows or sheep
  • Protein sources: Baked beans, kidney beans, soy beans
  • Vegetables: Asparagus, Brussels sprouts, butternut squash, cauliflower, garlic, leek bulb, mushrooms (including shiitake, button and enoki), onion, peas (snow and sugar snap), shallots, sweet corn
  • Fruits: Apple, apricot, blackberry, cherry, lychee, mango, nectarine, peach, pear, plum, prune, watermelon
  • Nuts and seeds: Pistachio, almonds (>10), cashews
  • Sweeteners: Agave, corn syrup, high-fructose corn syrup, honey, molasses, mannitol, sorbitol, xylitol

Low FODMAP Foods:

  • Breads and cereals: Gluten-free bread or cereal products, 100% spelt bread, rice, oats, polenta, arrowroot, millet, quinoa, tapioca
  • Dairy and alternatives: Lactose-free milk or yogurt, rice milk, hard cheeses, brie, camembert
  • Protein sources: Tofu (plain and firm), tempeh, most meats, fish, chicken, eggs
  • Vegetables: Alfalfa, bok choy, carrot, endive, ginger, green beans, herbs, lettuce, olives, parsnip, potato, pumpkin, red bell pepper, spinach, sweet potato, tomato
  • Fruits: Banana, clementines, grapes, oranges, papaya, strawberry
  • Nuts and seeds: Almonds (<10), macadamias, walnuts, pumpkin seeds
  • Sweeteners: Maple syrup, artificial sweeteners that don’t end in -ol, sugar (brown, confectioners, table, palm, raw, white)

The post Starting a Low-FODMAP diet: What you need to know appeared first on Joy Bauer.

]]>