You may suspect high FODMAPs foods such as beans, cabbage or other foods you are fairly sure give you more wind than usual. On the other hand you have pain after moving further from a Low Chemical Diet with minimal added strong spices or additives.
IBS (irritable bowel syndrome) is more complex than is generally recognised.
You can see if some simple changes make a useful difference to your IBS.
You have your own particular symptoms bloating, cramping pain, strong urgency, wind.
You have your own particular foods you suspect.
You need to have information on the Low Chemical Diet food that are best excluded from the initial elimination diet:- which additives, salicylates, amines, glutamates and some flavours. You need information on the low FODMAPS Diet.
There is a quick way to start finding out what is best for you. The book: Your Diet for Your IBS tells you how and guides you through the diet detective process that will minimise your gut symptoms.
Even before you begin your elimination diet it will be useful to consider some ideas that may help. Use any of the following changes for two to three weeks to see if your symptoms improve. Then watch when you stop them and see if symptoms get worse again.
Think about eating times
Some of us lead busy lives and meals are often skipped. Note if your symptoms are less when you give yourself three meals each day. They don’t have to be perfect!
See if changing time of eating helps. Do have some food early after you get up. It doesn’t need to be fancy. And try not to delay the evening meal until late into the evening.
Avoid getting anxious
Avoid getting into a muddle where you’re trying to have the perfect diet. You are probably getting advice about how to be healthy from many people. Having a good, nutritious diet and being the right weight are quite separate from using diet investigation to decrease your symptoms. Decide which is most important now and concentrate on it. You can attend more to the others a few months later.
Amounts of food
As well, the amount of food matters. If you think you would feel better if you eat half of the main meal and the other half thirty minutes later give it a try. It may decrease some discomfort.
Snacks between meals
The snack between meals could be part of the next meal so the volume at that meal is reduced.
Fluid with meals
We all have our usual habits, but some are not helping with movement of food through the gut. It is important to have sips of plain water with meals, so food can mix well with gut enzymes and the ‘good bacteria’ have the best possible chance of increasing. We are talking about including one glass of water drunk over the whole meal, not more. If you usually drink separately from meals it is hard to change but keep on having the glass near your meal and having sips. This softening of meals also helps with movement along the gut, so wind is not being caught behind dry gut contents. This particularly applies to you if you have dry motions and constipation.
Reducing coffee is often recommended, but that does not mean excluding it altogether. If you have several cups of strong coffee it is worth reducing the number. Or you can try making it weaker and weaker and/or use decaf coffee still reducing the strength.
Chilli is a gut irritant. If you eat more-than-average amounts of “hot” food try reducing the amount.
Some people report gut discomfort after having a few drinks. Reduce your intake to a level where you enjoy the drink but do not have unpleasant symptoms.
There are a variety of probiotics on the market, however there is inadequate evidence on which are the most effective probiotic strains, doses or regimens for each person. I suspect that the gut flora that is right for you is the one you have when your symptoms are minimised. This usually involves diet investigation, but there is much research work being done in this area, so it is worth trying some probiotics. Test any recommended for you for at least 2 weeks, before you start any Low Chemical Diet, to see if you benefit.
Infections and antibiotics
Infections and antibiotics both produce variations in gut flora. Symptoms may get worse with any infection and the antibiotics may give different symptoms or they may even reduce gut troubles. If so, discuss with your doctor. Expect to take two weeks for gut flora to return to normal after finishing an antibiotic or take a probiotic.
Starchy food well cooked
Over many years Joan has had people report that any starchy food feels more comfortable if it is well cooked. Use crusty bread, toast, dry biscuits, crispy roast potato, crisp potato chips as well as well-cooked potato, rice and pasta. Note whether doughy bread, thick rice, or just-cooked potato are followed by discomfort.
Amount of wheat eaten
Some people improve after reducing wheat to just two slices of well-cooked wheat at lunch and just one wheat biscuit at mid meal breaks. You can rely more on oats, rice, potato, corn, or barley foods at other meals.
Wholegrain breads, cereals and biscuits
If you are more inclined to constipation use more wholegrain foods. Remember this is no use unless you drink water with these foods, so they stay moist throughout the gut and don’t form the beginnings of a dry bowel motion.
Oatmeal is a pleasant different type of fibre which can benefit some people.
Where constipation is a problem do think of it as a condition that you always have, not one you treat when it is great. Some people with constipation report feeling much better if they eat some fruit or vegetables with each meal. Just adding lettuce and celery sticks with lunch can help. Decreasing constipation can be a separate part of IBS care. Where increasing fibre and drinking much more water do not help, do discuss doses of laxatives or stool softeners with your doctor and dietitian. For more detail on managing constipation go to Chapter 5.
If you are more inclined to looseness you do not need wholegrain or wholemeal foods which may make your bowel motions even looser. Here it is important to remember to have fruit, lettuce, celery and salad, or cooked vegetables with meals every day. These provide necessary soft bulky fibre to ensure good bowel function. Looseness is a symptom whose reduction is often one of the main benefits of the Low Chemical Diet investigation action provided in this book.
Good enough nutrition
Think about presenting your body with all that it needs at your three meals each day
Food – to satisfy hunger and provide nutrition
Fluid – enough sips to soften that food
Grain fibre – fibre increases the volume of your bowel motion. It does not change the frequency nor thicken up very loose motions.
Fruit and vegetable fibre – whether you are loose or constipated it is worth having some fruit or vegetables at all three meals each day. Vegetables also add some more fluid to your meals.
If you attend to these “first things first” and your problems are reduced enough that is great! But if you want to learn more you can use Your Diet for Your IBS which I wrote with my clever dietitian colleague Ashleigh Jones. It which gives you a step-by-step guide to your own best diet for your own IBS. See http://foodintolerancepro.com/product/your-diet-for-your-ibs-ebook/