IBS Diet Choices
IBS Foundation
The fundamental idea of eating for IBS is to avoid foods that
over-stimulate or irritate the colon via the gastrocolic reflex that
occurs when food enters the stomach, and eat foods that soothe and
regulate it. This will relieve and prevent both diarrhea and
constipation, as well pain, gas, and bloating. This is best
accomplished by strictly limiting the amount of dietary fat (the single
most powerful digestive tract stimulant), eating soluble fiber
consistently with every snack and meal, eliminating coffee, carbonated
beverages, and alcohol, being very careful with insoluble fiber, and
avoiding overeating by having frequent small meals instead of large
ones. It is also important to avoid cigarettes, as tobacco wreaks havoc
on the digestive tract.
Trigger Foods - Warning! Eat at Your Own Risk
The most difficult foods for the body to digest are fats and animal
products. As a result, they are the most powerful IBS triggers, and you
must strictly limit or, preferably, eliminate altogether these foods
from your diet. Will this require an enormous change in the way you
eat? Probably. But it is a change for the better, and we will walk
together through the steps needed to make this change as easily and
deliciously as possible.
I sympathize tremendously with people when they are told of the dietary
changes they need to make to control their IBS. At first glance these
changes can seem overwhelming and just too difficult, as by nature most
of us are resistant to any great transformations of our lives. It is
almost always easier to not alter a habit, simply because inertia takes
less effort than action.
However, I really cannot stress enough that the changes in diet
required for IBS do NOT equal deprivation. You will not be expected to
simply give up all the foods you love, and offered a tasteless
starvation diet in return. These changes are in fact a terrific
opportunity for a better life, as you can easily learn how to eat
safely for IBS without giving up an ounce flavor, fun, favorite
restaurants, or delicious home cooking. It is simply a matter of
substitution, of replacing trigger foods with safe choices. Remember
that the only thing you're really giving up here is the constant worry
and dread of attacks, as well as the pain and agony they cause.
Please note that individual tolerances for IBS trigger foods may vary.
The following list is comprehensive and should include all potential
dietary sources of trouble. You may find through experimentation that
you have a higher degree of tolerance for some of these foods than
others.
Red Meat (Beef, Pork, Lamb, etc.) Poultry Dark Meat and Skin. Dairy
Products. Egg Yolks. Fried Foods. Coconut Milk. Oils, Shortening,
Butter, Fats. Solid Chocolate. Coffee, Regular and Decaffeinated.
Alcohol. Carbonated Beverages. Artificial Sweeteners. Artificial Fats.
What's All This About Fiber?
One of the most troublesome pieces of advice routinely given to people
with IBS is the dictate, 'Eat more fiber!' It prompts the question -
what kind of fiber?
Most people are never even told that there are actually two types of
fiber. The term 'fiber' in general refers to a wide variety of
substances found in plants. Some of these substances can be dissolved
in water ('soluble fiber'), and others do not dissolve ('insoluble
fiber'). Insoluble fiber is 'rough'; it passes intact through the
intestinal tract, increasing the frequency, water content, and
looseness of bowel movements. Insoluble fiber, and particularly wheat
bran, decreases the transit time of fecal matter in the G.I. tract.
Although this has the crucial benefit of reducing the colon's exposure
to carcinogens, thus inhibiting colon cancer development, it can also
trigger painful attacks in IBS sufferers, with severe cramping that can
result in diarrhea or constipation.
Soluble fiber, in contrast, is 'smooth', and soothing to the digestive
tract. It regulates the digestive tract, stabilizes the intestinal
contractions resulting from the gastrocolic reflex triggered by eating,
and normalizes bowel function from either extreme. That's right -
soluble fiber prevents and relieves both diarrhea and constipation.
Nothing else in the world will do this for you. How is this possible?
The 'soluble' in soluble fiber means that it dissolves in water (though
it is not digested). This allows it to absorb excess liquid in the
colon, preventing diarrhea by forming a thick gel and adding a great
deal of bulk as it passes intact through the gut. This gel (as opposed
to a watery liquid) also keeps the GI muscles stretched gently around a
full colon, giving those muscles something to easily 'grip' during
peristaltic contractions, thus preventing the rapid transit time and
explosive bowel movements of diarrhea as well. By the same token, the
full gel-filled colon (as opposed to a colon tightly clenched around
dry, hard, impacted stools) provides the same 'grip' during the muscle
waves of constipation sufferers, allowing for an easier and faster
transit time, and the passage of the thick wet gel also effectively
relieves constipation by softening and pushing through impacted fecal
matter. If you can mentally picture your colon as a tube that is
squeezing through matter via regular waves of contractions, it's easy
to see how a colon filled with soluble fiber gel is beneficial for both
sides of the IBS coin.
As a glorious bonus here, normalizing the contractions of the colon
(from too fast or too slow speeds) prevents the violent and irregular
spasms that result in the lower abdominal cramping pain that cripples
so many IBS patients. This single action alone is the reason I don't
eat anything on an empty stomach but soluble fiber. Ever. The only
foods I want to trigger my gastrocolic reflex are soluble fiber, as
that's the only way I can keep those contractions (and thus my life)
normal.
Soluble fiber also lowers LDL ('bad') blood cholesterol levels and the
resultant risk of heart disease, helps prevent colon cancer, and
improves glycemic control in diabetics by slowing the digestion of
carbohydrates and the subsequent release of glucose into the blood. In
addition, soluble fiber may help prevent blood vessel constriction and
the formation of free radicals (both risk factors for heart attacks) by
slowing the absorption of fat and carbohydrates into the bloodstream.
Metamucil, made from psyllium husks, and Citrucel, made of
methylcellulose, are both soluble fiber, and can be extremely helpful
when taken daily (make sure they are NOT the sugar-free varieties,
which have artificial sweeteners in them, and can trigger attacks).
Please be aware that although both of these products are marketed as
laxatives, they actually help treat and prevent diarrhea as well as
constipation. Soluble fiber alone has this remarkable ability to
normalize colonic activity from either extreme.
Foods that are naturally high in soluble fiber include oatmeal, pasta,
rice, potatoes, French or sourdough bread, soy, barley, and oat bran.
These starchy foods are also high in complex carbohydrates, which are
an important source of readily accessible fuel for energy. Nuts, beans,
and lentils are also good sources of soluble fiber but should be
treated with care, as nuts are high in fat and both lentils and beans
contain some insoluble fiber.
Soluble fiber should ALWAYS be the first thing you eat on an empty
stomach, and it should form the basis of EVERY snack and meal. Your
goal is to keep your colon consistently stabilized by providing it with
a regular supply of soluble fiber.
Insoluble Fiber - How Can Healthy Foods Hurt You?
Insoluble fiber, although crucial for good health, can be a powerful
IBS trigger. It needs to be incorporated into your diet in the largest
quantities possible, but with great care. Insoluble fiber should NEVER
be eaten alone or on an empty stomach.
Remember that it is much better to have a wide variety of insoluble
fiber foods in small amounts than to not eat any at all. You are also
likely to find that your tolerance for insoluble fiber will increase if
you are consistently eating it, even in tiny portions. However, it's
important to note that individual tolerances vary. The following list
is comprehensive and should include all potential insoluble fiber
sources of trouble for a hyperactive colon; you may have a degree of
tolerance for some of these foods and absolutely none for others. IBS
is a highly personalized problem, so you will need to learn your own
food tolerances and work around them.
Raw fruits, raw vegetables, raw greens, raw sprouts, and seeds
(including those from fresh fruits or vegetables), are all very high in
insoluble fiber. Be particularly careful with fruits and vegetables
that have tough skins or hulls such as blueberries, cherries, apples,
grapes, peas, corn, bell peppers, celery, etc. It helps tremendously to
peel and cook these fruits and vegetables until tender, as this makes
their fiber content dramatically less likely to trigger attacks. It is
also a healthy habit to routinely incorporate fruits and veggies as
secondary ingredients in recipes with soluble fiber foods as the main
ingredients. If possible, buy organic produce only, as the chemical
pesticides and herbicides used on fruits and vegetables can have
adverse health effects.
Two categories of fruits and vegetables, those that are acidic and
sulfur-containing, require extra precautions. Citrus juice and cooked
tomatoes have very high acidity levels, which can cause GI distress, so
they must be eaten with care. Incorporate them into meals (or drinks
served with meals) with a high soluble fiber content, and don't eat
them on an empty stomach. They must not be eliminated from your diet
altogether, however, as they contain crucial vitamins and
anti-oxidants. Tomatoes are also very high in lycopene, which prevents
some forms of cancer.
Garlic, onions, leeks, broccoli, cauliflower, cabbage, and Brussels
sprouts, though among the most nutrient-packed of all vegetables, can
also pose problems. In addition to their high amounts of insoluble
fiber, all contain sulfur compounds, which produces gas in the GI tract
and can thus trigger attacks. As with other vegetables, cook these
until tender, combine them with soluble fiber, and don't eat them when
your stomach is completely empty - but do make sure and eat them.
To incorporate raw fruits and veggies into your diet, peel and eat them
in small quantities (just two or three bites) finely chopped, as
additions to high soluble fiber foods such as French breads, pastas,
rice, etc. It should also help to eat them towards the end of a meal.
This is especially important when it comes to green salads. Eating them
as is customary in America, on an empty stomach at the beginning of
lunch or dinner, is likely to trigger an attack. Eating them at the end
of a high soluble fiber meal is typically quite safe. For fruit salads
follow the same guidelines. At breakfast have a bowl of oatmeal or
toasted French bread first, then the fruit, and at lunch or dinner have
the fruit for dessert.
Whole wheat and bran are extremely high in insoluble fiber, and foods
such as whole wheat breads and cereals need to be eaten with great
care. For a daily safe staple, French and sourdough breads are safe,
but whole wheat breads are not. Whole wheat breads are more nutritious,
because the outer coating of bran on the grain has not been removed as
is the case in white breads. However, this bran is also very high in
insoluble fiber, and can thus trigger attacks. For this same reason
bran cereals are not a safe choice, though rice, corn, or oat varieties
are. Does this mean you should never eat whole wheat bread or bran
cereal? It most emphatically does not. As with fruits and vegetables,
the more whole grains you can eat the better. It cannot be stressed
enough that overall good health is dependent on insoluble fiber.
However, whole wheat and bran need to be eaten just as carefully as
green salads. Do not eat them on an empty stomach, in large quantities,
or without soluble fiber foods.
Whole nuts are not only high in insoluble fiber, they are also high in
fat. Although this fat is monounsaturated and lowers your risk of heart
disease, it is still an IBS trigger. Like other high insoluble foods,
nuts are crucial for good health, but must be eaten carefully. Finely
grinding nuts and incorporating them into recipes with soluble fiber is
a very safe way to eat them. Small amounts of nut butters on toasted
French or sourdough bread are usually very tolerable as well.
Popcorn is full of hard kernels that are pure insoluble fiber. There is
no great nutritional value to popcorn so it can simply be eliminated
from your diet. I realize this may make movies a lot less fun, but
having to bolt from a theater for the bathroom halfway through a film
is a worse alternative. Sneak some pretzels or baked potato chips into
the theater instead, and console yourself with the thought that you'll
actually get to see the end of that movie.
Fresh fruit juices, especially apple, prune, and grape, are sky high in
fructose, which can trigger cramps and diarrhea. Fruit juices in
general should be avoided on an empty stomach. Cranberry juice is
usually a safe choice. Rhubarb, prunes, figs, licorice are all natural
laxatives. As with fresh fruits in general, you may be able to safely
incorporate these foods into recipes with soluble fiber. Just beware
that they pose additional risks.
Fringe Benefits!
Eating for IBS has benefits far beyond controlling your bowel symptoms.
The IBS diet follows the FDA Food Pyramids, which means that while
eating safely for IBS you'll also lower your risk of heart disease,
cancer, arthritis, diabetes, high blood pressure, and obesity.
Bowtrol has been formulated to address the needs of all IBS sufferers,
whether they experience mainly diarrhea or constipation or both as part
of their symptoms. For more information on Bowtrol and how it can
change your life visit: http://www.bowtrol.com