IBS diet - How to eat for irritable bowel syndrome

[Guest guest]

Compiled from http://www.helpforibs.com/diet/

[Thanks to Ruth for pointing out this site!]

 

 

Irritable Bowel Syndrome Diet

by Heather Van Vorous

 

An estimated 15-20% of all Americans have Irritable Bowel Syndrome, and

it's often a devastating (not to mention incurable) condition. If you have

Irritable Bowel Syndrome, you are NOT alone.

 

Fortunately, Irritable Bowel Syndrome symptoms (pain, diarrhea,

constipation) can be controlled through diet.

 

More good news - the IBS diet is also beneficial for inflammatory bowel

diseases such as Crohn's and Ulcerative Colitis, plus diverticulosis and

diverticulitis.

 

Despite the fact that diet plays a direct role in gut function (which is

instinctively obvious to IBS sufferers, who are desperate for a reliable

diet as they know this will help them), many doctors fail to give their

patients any dietary guidelines for Irritable Bowel Syndrome at all.

 

Worse still, much dietary information available for Irritable Bowel

Syndrome is outdated and useless - or likely to trigger symptoms (have you

been told to eat bran? lots of raw veggies for fiber? this is wrong!)

 

The proper Irritable Bowel Syndrome diet (and yes, there is one - IBS is

not so highly individualized that no accurate generalizations can be made)

makes a world of difference for almost everyone with Irritable Bowel

Syndrome. For many, the IBS diet makes the difference between living a

normal, happy, outgoing life versus spending every single day stuck in the

bathroom enduring blinding pain, bowel dysfunction, and other Irritable

Bowel Syndrome symptoms.

 

I would bet you already know from personal experience that some foods

nearly always cause IBS problems, while others never seem to bother you. On

the other hand, you've also probably noticed that sometimes a specific food

will trigger an Irritable Bowel Syndrome attack, while at other times you

can eat the exact same item without difficulty. Odds are it doesn't seem

like there's any rhyme or reason to this. Odds are also that you've been

wracking your brain to figure out why.

 

There are, in fact, very clear dietary guidelines to follow for how to eat

safely for Irritable Bowel Syndrome, based on the well-established effects

certain categories of foods have on the GI tract. The key word here is

categories – most people with IBS drive themselves bonkers trying to find

that one specific food that is triggering their Irritable Bowel Syndrome.

 

The problem is, it isn't a single food that causes Irritable Bowel Syndrome

symptoms. It's ANY food that is high in fat, insoluble fiber, caffeine,

coffee (even decaf), carbonation, or alcohol. Why? Because all of these

food categories are either GI stimulants or irritants, and can cause

violent reactions of your gastrocolic reflex. This directly affects the

muscles in your colon and can lead to pain, constipation AND diarrhea, gas,

and bloating.

 

In fact, the happy truth is that eating safely for Irritable Bowel Syndrome

does not mean deprivation, never going to restaurants, bland food, or an

unhealthily limited diet. Nor does it mean living on " rabbit food "

available exclusively at health food stores, or following brutal

elimination diets, or keeping endless food diaries for the rest of your life.

 

It does mean learning to eat safely by realizing how different foods

physically affect the GI tract, and how the same foods can help or hurt

both Irritable Bowel Syndrome diarrhea AND constipation, as well as

bloating, gas, nausea, and painful abdominal cramps. Following the

Irritable Bowel Syndrome diet simply means learning how foods can prevent

or trigger a spastic colon.

 

It's important to note that the same dietary guidelines that are crucial

for managing Irritable Bowel Syndrome can also be very helpful for

inflammatory bowel disease symptoms, diverticulosis, and diverticulitis.

 

IBS Trigger Foods - Warning! Eat at Your Own Risk

 

The fundamental idea of eating for Irritable Bowel Syndrome is to avoid

foods that trigger or irritate a spastic colon via the gastrocolic reflex

that occurs when food enters the stomach, and to eat foods that soothe and

regulate the colon. This will relieve and prevent BOTH constipation and

diarrhea, as well as the painful spasms and cramps, gas, nausea, and

bloating of Irritable Bowel Syndrome.

 

The most difficult foods for the body to digest are fats and certain animal

products. As a result, they are the most powerful IBS triggers - for BOTH

constipation and diarrhea - and you must strictly limit or, preferably,

eliminate most of these foods from your diet altogether. 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.

 

Fat is quite simply the single greatest digestive tract stimulant. When

food enters your stomach, it triggers the gastrocolic reflex, which cues

your colon to start contracting. (Have you ever had an IBS attack within

minutes after eating the wrong thing, even though common sense tells you

that the food was nowhere near your colon at that time? The gastrocolic

reflex is why.)

 

Fat will trigger this reflex more powerfully than any other category of

food. While this is normally something that would simply result in a a

bowel movement, it is paradoxically likely to cause problems for people

with IBS constipation OR diarrhea. This is because people with IBS do not

have a normal gastrocolic reflex response, and their colons tend to spasm

irregularly and often violently. In people prone to constipation, if those

spasms are too strong they'll actually " seize up " the colon in a type of

charley horse, and motility can halt altogether. This will cause severe

pain from the ongoing cramping of the colon, and it wll also result in or

worsen constipation, because motility has shut down and fecal matter is not

moving through. Only when the muscles finally relax will you begin to feel

a little better, but it can take quite a while after suffering such violent

spasms for normal colonic motility to return.

 

In a corollary way high fat foods also typically worsen IBS diarrhea, as

the muscle spasms triggered by fats result in gut contractions so fast and

hard they rush matter through the colon, without enough time for water to

be absorbed. This causes pain from the spasms and diarrhea from the

hypermotility. So, though it sounds odd, high fat foods are triggers for

BOTH diarrhea AND constipation if you have IBS, as they are each a possible

result of the gastrocolic reflex gone awry.

 

When it comes to reducing or eliminating the high fat trigger foods from

your diet, I sympathize tremendously with you. 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 of 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 is the

constant worry and dread of attacks, as well as the pain and agony they cause.

 

Irritable Bowel Syndrome Danger - High Fat Foods Ahead

 

Please don't read this list and assume that you can never again eat any of

these foods, so life is no longer worth living. These are all IBS triggers,

yes, and some of them you will probably have to completely eliminate from

your diet. BUT - others can be eaten in small quantities when you follow

the How to Eat guidelines coming up, many of the items listed have safer

substitutes you can use freely, and there are quite a few tips and tricks

you'll soon learn for cooking with the nutritious foods on the list in a

safe manner. So take heart, this isn't the end of the world – it's just the

beginning of a better diet.

 

Red meat (ground beef, hamburgers, hot dogs, steaks, roast beef, pastrami,

salami, bologna, pepperoni, corned beef, ham, bacon, sausage, pork chops,

and anything else that comes from cows, pigs, sheep, goats, deer, etc. )

 

Poultry dark meat and skin (skinless white meat is fine, as is seafood by

the way – try to buy organic turkey and chicken)

 

Dairy products[1] (cheese, butter, sour cream, cream cheese, milk, cream,

half-and half, ice cream, whipped cream, yogurt, frozen yogurt). Dairy is

an Irritable Bowel Syndrome trigger even if you're not lactose intolerant.

It's simply not just the lactose. It's also not just the high fat content

of most dairy products that can cause your IBS to flare. Even skim and

lactose-free dairy can trigger IBS attacks. In addition to fat and lactose,

dairy contains components such as the proteins whey and casein, which can

cause severe digestion problems. Though yogurt is traditionally recommended

as an " easily digestible " dairy product because fermentation has reduced

the lactose levels, even non-fat versions contain whey and casein, and

should be avoided.

 

Egg yolks (whites are fine, do try to buy organic)

 

Meat, dairy products, and egg yolks are particularly dangerous for all

aspects of Irritable Bowel Syndrome. In some people their high fat content

causes violent, rapid colon spasms and triggers diarrhea. Alternately, for

others their heavy animal proteins, complete lack of fiber, and very low

water content can lead to drastically slowed colon contractions (or one

prolonged colon spasm, which is extremely painful) and severe constipation.

No matter what Irritable Bowel Syndrome symptoms you're prone to, these

three categories of foods pose high risks and are really best eliminated

from your diet altogether. Other high fat foods to watch out for:

 

French fries

Onion rings

Fried chicken

Corn dogs

Anything battered and deep-fried

Anything skillet-fried in fat of any kind

Shortening

Margarine

All oils, fats, spreads, etc.

Mayonnaise

Salad dressings

Tartar sauce

Cool Whip

Coconut milk

Shredded coconut

Solid chocolate (baking cocoa powder is fine)

Solid carob (carob powder is fine)

Olives

Nuts and nut butters

Croissants, pastries, biscuits, scones, and doughnuts

Pie crust

Potato chips (unless they're baked)

Corn chips and nachos (unless they're baked)

Store-bought dried bananas (they're almost always deep fried)

 

Fats are usually fairly obvious foods to identify, but not always. The

worst culprits are listed above, and many (particularly meat, dairy, egg

yolks, and fried foods) can simply be eliminated from your diet entirely

and your whole body will be healthier for it.

 

I know the thought of this can be deeply shocking, but giving up these

foods does not equal deprivation. Honestly, it doesn't – I promise. There

are a great many easy substitutions that will let you cook and eat safely

while still enjoying many of your traditional favorite foods. There's also

a lot of fun to be had in trying a wide variety of new ones. And when

you're tempted to indulge in a dangerous treat, just remember that

everything tastes a lot less delicious when it's followed by a vicious IBS

attack.

 

There are also some hidden sources of fat to watch out for. Cookies,

crackers, pancakes, waffles, French toast, biscuits, scones, pastries,

doughnuts, and mashed potatoes can all be sky-high in fat (virtually always

so at restaurants), so be careful. Give thanks for the recent fat-free

craze that has given us supermarket aisles full of safe alternatives. I

certainly would have killed for fat-free Saltines as a kid. Every time I

had an attack I was given soda crackers – and I sure wish I'd known then

why this so often made me worse, not better.

 

As an aside here, while it's crucial to maintain a low fat diet in order to

manage Irritable Bowel Syndrome, it's equally important that you do not go

fat free. Though it makes no difference to your gastrocolic reflex if

you're eating lard or extra-virgin olive oil, it will make quite a

difference to your heart and your health in general. Your body needs

healthy fats in order to function. Keep your fat intake to 20% - 25% of

your total calories, and make your fats count. They should be

monounsaturated and contain essential fatty acids, so choose fat sources

such as olive oil, canola oil, avocados, finely ground nuts, fatty fish,

flax oil, etc. Because all fats, even heart-healthy choices, are still

potential IBS triggers, please follow the Irritable Bowel Syndrome dietary

guidelines detailed in How to Eat for IBS.

 

Warning! GI Irritants

 

These foods and beverages offer no IBS benefits but plenty of risks. Avoid

them.

 

Coffee ~ both regular AND decaf contain an enzyme that's an extremely

powerful GI tract irritant. Go cold turkey today and drink herbal teas instead.

 

Caffeine is a GI stimulant and should be avoided, especially in higher doses.

 

Alcohol is a GI irritant and often triggers IBS attacks, especially on an

empty stomach (though small amounts of alcohol used in cooking are fine).

 

Carbonation in soda pop and mineral water can cause bloating and cramps.

 

Artificial sweeteners, particularly sorbitol, can trigger pain, cramps,

gas, bloating, and diarrhea.

 

Artificial fats, namely Olestra, can cause abdominal cramping and diarrhea

in people who don't even have IBS – imagine what it can do to you.

 

MSG has acquired lots of ugly anecdotal evidence against it regarding all

sorts of digestive upsets. It can simply be avoided, so why take a chance?

 

 

While fats and GI irritants are best reduced or completely eliminated from

your diet, there's another crucial component to eating safely for Irritable

Bowel Syndrome: understanding the difference betweeen soluble and insoluble

fiber.

 

Soluble Fiber ~ The Irritable Bowel Syndrome Good Guy

 

Hmmm....You've heard of fiber, you're pretty sure you know what it is, and

you've probably had it recommended to you as beneficial for Irritable Bowel

Syndrome. But soluble fiber? Is this something special? Yes, it is.

 

Soluble fiber is the single greatest dietary aid for preventing Irritable

Bowel Syndrome symptoms in the first place, as well as relieving them once

they occur. Here's the kicker. Soluble fiber is NOT typically found in

foods most people think of as " fiber, " such as bran or raw leafy green

vegetables. Soluble fiber is actually found in foods commonly thought of as

" starches " , though soluble fiber itself differs from starch as the chemical

bonds that join its individual sugar units cannot be digested by enzymes in

the human GI tract. In other words, soluble fiber has no calories because

it passes through the body intact.

 

Soluble Fiber Foods ~ the Basis of the IBS Diet

 

As a general rule, the grain and cereal foods at the top of this list make

the safest, easiest, and most versatile soluble fiber foundations for your

meals and snacks.[1]

 

Rice

Pasta and noodles

Oatmeal

Barley

Fresh white breads such as French or sourdough (NOT whole wheat or whole

grain)*

Rice cereals

Flour tortillas

Soy

Quinoa

Corn meal

Potatoes

Carrots

Yams

Sweet potatoes

Turnips

Rutabagas

Parsnips

Beets

Squash and pumpkins

Mushrooms

Chestnuts

Avocados (though they do have some fat)

Bananas

Applesauce

Mangoes

Papayas (also digestive aids that relieve gas and indigestion)

 

*Please choose a baked-daily, high quality, preservative-free brand. White

bread does not mean Wonder.

 

Why is soluble fiber so special? Because unlike any other food category, it

soothes and regulates the digestive tract, stabilizes the intestinal

contractions resulting from the gastrocolic reflex, 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. I routinely snack on small

quantities of soluble fiber foods all day long, every single day. If I

don't have a chance to eat or I'm not that hungry, I'll take a soluble

fiber supplement.

 

My goal is continual stability, and a steady ingestion of soluble fiber

insures this. In the short run this strategy allows me to prevent problems

from snack to snack and meal to meal, but in the end it adds up to

long-term stability from day to day, week to week, and even month to month.

I've never found a better method for completely preventing my IBS symptoms

than basing my diet on soluble fiber foods.

 

You can keep your colon stabilized each and every day by basing all meals

and snacks on soluble fiber foods.

 

Insoluble Fiber ~ Good or Bad for Irritable Bowel Syndrome?

 

Both! Here's the type of fiber everyone is familiar with – insoluble fiber

is in bran, whole grains, raw fruits and vegetables (note the exceptions

under Soluble Fiber), greens, sprouts, legumes, seeds, and nuts. In short,

the healthiest foods in the world are high in insoluble fiber, and what

everyone should be eating as much of as possible. Right? Well, right,

except for one small problem.

 

Insoluble fiber, like fat, is a very powerful GI tract stimulant, and for

those of us with Irritable Bowel Syndrome this can spell big trouble.

Unlike fat, however, you cannot simply minimize your insoluble fiber

intake, as this will leave you with a seriously unhealthy diet. It's a

Catch-22, but the insoluble fiber conflict can be solved fairly easily.

 

Insoluble Fiber Foods – Eat with Care for Irritable Bowel Syndrome

 

Once glance will tell you these insoluble fiber foods are the best (and

tastiest) around, but your colon simply can't handle it if you eat them

with abandon. You can (and absolutely must) eat insoluble fiber foods, as

much as safely possible, but within the IBS dietary guidelines. Treat

insoluble fiber foods with suitable caution, and you'll be able to enjoy a

wide variety of them, in very healthy quantities, without problem.

 

In general, if a plant food (no animal products contain fiber) seems rough,

stringy, has a tough skin, hull, peel, pod, or seeds, be careful, as it's

likely very high in insoluble fiber. This is not a comprehensive list of

insoluble fiber foods by any means but it should give you the general idea.

 

Whole wheat flour, whole wheat bread, whole wheat cereal

Wheat bran

Whole grains, whole grain breads, whole grain cereals

Granola

Meusli

Seeds

Nuts

Popcorn

Beans and lentils (mashed or pureed they're much safer)

Berries (blueberries, strawberries, blackberries, cranberries, etc.)

Grapes and raisins

Cherries

Pineapple

Peaches, nectarines, apricots, and pears with skins (peeled they're much safer)

Apples (peeled they're safe)

Rhubarb

Melons

Oranges, grapefruits, lemons, limes

Dates and prunes

Greens (spinach, lettuce, kale, mesclun, collards, arugala, watercress, etc.)

Whole peas, snow peas, snap peas, pea pods

Green beans

Kernel corn

Bell peppers (roasted and peeled they're safer)

Eggplant (peeled and seeded it's much safer)

Celery

Onions, shallots, leeks, scallions, garlic

Cabbage, bok choy, Brussels sprouts

Broccoli

Cauliflower

Tomatoes (peeled and seeded, especially raw, they're much safer)

Cucumbers (again, peel and seed them and they're much safer)

Sprouts (alfalfa, sunflower, radish, etc.)

Fresh herbs

 

Never eat insoluble fiber alone or on an empty stomach. Always eat it with

a larger quantity of soluble fiber, and you will keep your gastrocolic

reflex stable.

 

What does this mean in practical terms? Cook some diced vegetables into a

low-fat sauce for pasta, stir-fry veggies into a fried rice, or blend fresh

fruit into a smoothie to drink after a breakfast bowl of oatmeal. For

fruits, vegetables, and legumes in general, peeling, chopping, cooking, and

pureeing them will significantly minimize the impact of their insoluble fiber.

 

Make soups, drinks, sauces, breads, and dips from your veggies and fruits

instead of eating them whole and raw. For beans and lentils, cook and blend

them into sauces, dips, soups, or spreads - their insoluble fiber is found

in their outer skins and their insides are actually rich in soluble fiber.

For nuts, finely grind and incorporate them into breads or cakes with white

flour, which gives a safe soluble fiber base. For bran and other whole

grains, eat them in small quantities following soluble fiber foods – have a

little whole wheat dinner roll after a big sourdough one, or mix a small

amount of fat-free granola into a large bowl of cream of rice or Corn Chex

cereal. For raw fruit and green salads, eat them at the end of a soluble

fiber meal instead of at the beginning. For all insoluble fiber foods,

start with small quantities and gradually increase your intake.

 

Some fruits and vegetables are particularly troublesome for IBS:

 

Sulfur-containing foods (garlic, onions, leeks, broccoli, cauliflower,

cabbage, asparagus, and Brussels sprouts), in addition to their high

amounts of insoluble fiber, also produce significant gas in the GI tract

and this can trigger attacks. As with all other fruits and veggies,

however, these are extremely nutritious foods with significant health

benefits, so they need to be treated with caution but definitely not

eliminated from your diet.

 

Acidic foods (citrus fruits and cooked tomatoes) should be treated with

extra care as well, as their acidity can cause both upper and lower GI

distress. Once again, follow the rules for insoluble fiber and eat these

foods in smaller quantities incorporated with soluble fiber – but please do

eat them.

 

Fructose, a fruit sugar, can cause gas, bloating, and diarrhea (this is

typically not true for sucrose, or plain table sugar). Honey contains

fairly high amounts of fructose. Fruit juices, particularly apple and grape

juice, are often sky high in fructose and even more problematic than whole

fresh fruit. It's simply much easier and faster to drink a large glass of

juice (and ingest a great deal of fructose) than to eat an equivalent

amount of whole fruit. So treat juices as you would insoluble fiber and

drink them carefully, with soluble fiber foods.

 

Easy Tips & Tricks

 

* Eat soluble fiber first whenever your stomach is empty

 

* Chew thoroughly. This will help prevent you from eating too fast and

swallowing air, which can cause problems.

 

* Eat at a leisurely pace - if you must eat in a hurry, serve yourself half

portions.

 

* Eat small portions of food, and eat frequently - the emptier your stomach

is, the more sensitive you will be.

 

* Avoid eating large amounts of food in one sitting as this can trigger an

attack

 

* Avoid ice-cold foods and drinks on an empty stomach. Cold makes muscles

contract, and your goal is to keep your stomach and the rest of your GI

tract as calm as possible.

 

* Avoid chewing gum, as it causes you to swallow excess air, which can

trigger problems.

 

* Drink fresh water constantly throughout the day (not ice cold). Limit the

amount of water or other fluids you drink with your meals, as this can

inhibit digestion.

 

* Only eat green salads - tiny portions, non-fat dressing - at the end of

the meal, not the beginning (tell people you're French).

 

* Peel, skin, chop and cook fruits and vegetables; mash or puree beans,

corn, peas, and berries. Finely chop nuts, raisins and other dried fruits,

and fresh herbs. Nuts in particular can be quite tolerable when finely

ground. To keep dried fruit from sticking to your knife when chopping,

spray the blade with cooking oil first.

 

 

What to Eat When You Can't Eat Anything

 

We've all been there. There are some days when it seems like everything you

eat triggers an attack. This is not your imagination; when your IBS is

raging, your gastrocolic reflex can be so sensitive that simply drinking

water can trigger dysfunctional colon contractions.

 

When this happens, you need to give your body a rest and stick to the

safest foods and drinks possible in order to break the cycle of IBS.

 

Diarrhea and pain should resolve in just a few days. Constipation,

especially if it's been chronic, can take up to two weeks, so please hang

in there.

 

The best thing to do to break the cycle of IBS is to really restrict your

diet for a few days to nothing but

<http://www.helpforibs.com/diet/fiber1.asp>soluble fiber foods and

<http://www.helpforibs.com/supplements/sol_fiber1.asp>supplements, and lots

of strong hot peppermint tea (if you're prone to acid reflux, try fennel or

chamomile or anise instead of the mint).

 

<http://www.helpforibs.com/supplements/peppermint.asp>Peppermint is a

powerful muscle relaxant and a painkiller.

<http://www.helpforibs.com/supplements/fennel.asp>Fennel is the best for

bloating and gas - it can really, tremendously help. Try to be mildly

active, even if just around the house, as gentle exercise will work the

muscles of the bowels and help get them back into a pattern of normal

contractions. Walking or stretching or an easy yoga practice is ideal.

Exercise is especially crucial for constipation.

 

Soluble fiber foods and supplements will stabilize the GI contractions that

are going haywire with IBS and causing pain, and will normalize bowel

function from either extreme (diarrhea AND constipation). So stick to foods

like plain white rice, oatmeal, pasta, white breads, peeled potatoes, etc.

Boring, I know, but it's just a few days. Make sure you've added in a

supplement like Citrucel, Benefiber, FiberChoice, Equalactin, or Fibercon

too - this is crucial. If you're prone to bloating or gas avoid Metamucil

(and psyllium) and try the other brands instead. Click here for

<http://www.helpforibs.com/diet/faq.asp#sol_supplement>detailed soluble

fiber supplement dosage information.

 

After a few days, you should be feeling much better, and your gut

contractions will have stabilized. Diarrhea should have resolved though

constipation may take a while longer. At this point, start carefully

expanding your diet with insoluble fiber, by blending fresh fruits into

smoothie drinks, or blending cooked veggies into pasta sauces or soups to

serve over white rice. The

<http://www.helpforibs.com/books/efi/recipes.asp>Eating for IBS recipes for

zucchini, banana, and pumpkin breads work well here, and so does the jok

rice porridge soup. Add in a little low fat soy milk to your oatmeal, and

have a bit of grilled fish or skinless chicken breast with pasta or rice.

Safe treats are the <http://www.helpforibs.com/books/efi/recipes.asp>Eating

for IBS recipes for Will's dreamy lemon rice pudding, vanilla or chocolate

silk puddings, peppermint fudge cake, and banana cream pie.

 

Keep your fat content very low and be extra careful as you start to

incorporate the insoluble fiber. As you stay stable, you can expand to all

the other IBS recipes, follow the general IBS diet guidelines (still low

fat, no triggers, careful with insoluble fiber), and you'll be back to a

healthy diet overall and not just plain soluble fiber. You should always

continue to make soluble fiber the basis of your diet, though, and have

those foods as the foundation of your meals and snacks. Continue the

soluble fiber supplements on a daily basis as well. Remember, it's the

<http://www.helpforibs.com/diet/fiber1.asp>soluble fiber that is key to

normalizing a spastic colon and preventing IBS symptoms in the first place.

 

 

Safe Foods To Eat When You Can't Eat Anything

 

* White breads (such as French or sourdough), not whole wheat or multi-grain

 

* Toasted plain bagels

 

* Toasted plain English muffins

 

* Cream of Rice cereal

 

* Pretzels (salted or unsalted)

 

* Fat-free Saltines

 

* Fat-free fortune cookies

 

* Plain angel food cake, homemade or from a mix

 

* Plain baked potatoes (without the skin)

 

* Plain white rice

 

* Arrowroot crackers

 

* Cold fat-free cereal such as Corn Chex, Kix, Rice Chex, Rice Krispies,

Honeycomb, or Corn Pops, eaten dry. At all costs avoid bran, granola, and

whole wheat choices, as well as cereals with raisins, other dried fruits,

or nuts

 

* Homemade dried or fresh bananas

 

* Plain cooked pasta (not egg), sprinkled with a little salt

 

* Lots and lots of strong hot peppermint, fennel, chamomile, or ginger tea

 

 

The 10 Commandments of Eating for IBS

 

 

1. ALWAYS eat soluble fiber first, eat soluble fiber whenever your stomach

is empty, and make soluble fiber foods the largest component of every meal

and snack.

 

2. Minimize your fat intake to 25% of your diet, max. Read labels and at

restaurants, ask.

 

3. Never eat high fat foods, even in small portions, on an empty stomach or

without soluble fiber. Better still, don't eat them at all.

 

4. Eliminate all red meat, dairy, fried foods, egg yolks, coffee, soda pop,

and alcohol from your diet. This may be the most difficult dietary strategy

to adopt, and I know it probably won't be fun or easy – but neither are IBS

attacks.

 

5. Never, never, never eat

<http://www.helpforibs.com/diet/fiber2.asp>insoluble fiber on an empty

stomach, in large quantities at one sitting, or without soluble fiber.

 

6. Eat small portions frequently, calmly, and leisurely.

 

7. If you're unsure about something, DON'T EAT IT. It's not worth the risk.

 

8. Food is fun and eating should be pleasurable. Take the time and make the

effort to eat safely, and then enjoy yourself.

 

9. Remember that you have absolute and total control over your diet. No one

can force you to eat something you know you shouldn't – if anyone tries,

think of them as a drug dealer and just say no.

 

10. Practice <http://www.helpforibs.com/diet/substitution.asp>creative

substitution, not deprivation. Use soy or rice replacements for dairy, two

egg whites to replace a whole egg, try low-fat vegetarian versions of meat

products, replace some oil with fruit purees in breads or cakes, use veggie

broth instead of oil in sauces, bake with cocoa powder (it's fat free)

instead of solid chocolate. Use herbs, baking extracts (vanilla,

peppermint, maple, etc.) and mild spices generously to heighten flavors.

 

If you're currently trying to break the cycle of ongoing attacks, it is

best to strictly limit your diet to soluble fiber foods and peppermint tea

for several days. This will allow your GI tract to stabilize, and then you

can gradually and carefully add in other foods following the rules. At that

point you'll be ready to go shopping, re-stock the pantry with your new

safe staples, and learn how to cook fast, easy, fabulous meals following

the IBS guidelines.

 

 

Substitution, Not Deprivation

 

* Substitute soy, rice, or oat milk for all dairy milk (check the

ingredients to be sure there is no oil added). Try a wide variety of brands

and flavors as the difference in taste can be dramatic. Some brands are

truly wretched and some are delicious.

 

Most people are happily surprised by Silk (vanilla and chocolate) and Soy

Dream. I've also had good luck with health food store generic brands such

as 365 by Whole Foods, and they're very inexpensive.

 

It can be helpful to keep two types of soy or rice milk on hand:

unsweetened or plain for cooking, and vanilla for cold cereals or drinking.

Chocolate milk is delicious cold and heated up for glass of hot cocoa!

 

* Use soy or rice substitutes for cheese, cream cheese, sour cream, ice

cream, yogurt, and other dairy products (check the ingredients to be sure

the items are low-fat). For cheese, pay attention to whether the brand is

truly dairy-free or simply lactose-free. Most soy cheese brands contain

small amounts of casein, a dairy protein. The tiny quantity is often very

tolerable for IBS, but if you're completely intolerant to casein you'll

have to find a soy or rice cheese that is entirely dairy-free.

 

* Many hamburger-based recipes such as tacos, sloppy joes, chili, etc. can

be easily adapted to IBS guidelines by substituting TVP (textured vegetable

protein, a soy food available in health food stores) for the ground beef.

Simply eliminate the cooking oil and season the TVP as you would the meat.

When well-prepared most people honestly can't taste the difference. In

addition, there are many vegetarian cookbooks available that replicate

traditional American homestyle recipes with vegan substitutes for the dairy

and meat ingredients. Try out several of these books from your local

library and buy your favorites.

 

* Find a well-stocked local health food store and try a wide variety of

vegan versions of deli meat, hot dogs, burgers, chicken wings, etc. There

are tasty versions of just about every fast food and junk food on the

market - just check the ingredients for a low fat content.

 

* Use only fat-free salad dressings, mayonnaise, etc.

 

* Substitute cocoa powder for solid chocolate in baking - fabulous

chocolate cakes are your IBS-safe reward!

 

* For most recipes, you can almost always reduce the amount of oil called

for by at least 1/3.

 

* When baking replace from 2/3 to 3/4 of the oil called for with applesauce.

 

* Use only egg whites - simply replace each whole egg in a recipe with two

egg whites. Egg Beaters are also a good choice.

 

* Use non-stick pans and cooking spray, as this will dramatically lessen

the amount of oil you cook with. You can get wonderful crispy, golden, and

crunchy food with just a little cooking oil spray and a non-stick skillet

instead of deep frying - try it!

 

* If you have a weakness for a particularly deadly food (mine's

cheesecake), try slowly eating just one to two measured tablespoons after a

satisfying meal of low fat, high soluble fiber foods. I've found this to be

a pretty foolproof method for occasionally treating myself.

 

* Watch out for hidden fat in seemingly safe foods: biscuits, scones,

pancakes, waffles, restaurant French toast, crackers, mashed potatoes,

store-bought dried (usually fried) bananas.

 

 

 

Size Matters

 

No matter how safe any food is for IBS, eating a huge portion of it in one

sitting can trigger an attack. Your gastrocolic reflex gains strength in

direct correlation to the number of calories you consume in a meal.

 

While this makes it easy to see why high fat foods causes problems (fat is

more than twice as calorie-dense as carbohydrates and proteins) it also

means that bingeing – on anything – carries serious risks for those of us

with IBS. So don't kid yourself that when your friends break out a pint of

Chunky Monkey and a spoon for that video you're watching, you can do the

same with fat-free sorbet. It's not just ingredients, but quantity too.

Size really does matter.

 

Keeping your portions small has some fringe benefits, particularly in that

it should make it easier to eat more frequently, and this is a helpful

strategy for maintaining a constant intake of soluble fiber. Unfortunately,

Americans have gotten used to " supersizing " just about everything they eat,

and this can be a hard habit to break. One thing to try at home is serving

yourself on salad plates and soup bowls, so that visually you don't feel

faced with a skimpy meal. Remember too that you can always take a second

small portion after you finish the first one, as long as you eat at a

slow-to-moderate pace and you still feel hungry. This is a great way to

keep from over-serving yourself initially and then feeling obligated to eat

everything on your plate even if you're full (a " don't waste food " lesson

ingrained in most of us as children).

 

Snacking on small amounts of food throughout the day will keep you from

getting ravenous and then over-eating, which can trigger an attack. At

restaurants, make a point of dividing your plate in half the moment you're

served and take that portion home with you for a later meal. Once you

develop this habit you'll likely be astonished to realize how oversized

most restaurant meals are, and it will be clear why it's so common to

suffer an attack if you eat all that food at one sitting. I have a few

favorite restaurants (Ethiopian and Middle Eastern) whose dinner portions

are so generous I actually get three complete meals out of them. Even

someone without IBS is likely to feel pretty uncomfortable if they down

that much food at a one dinner.

 

There's another aspect to portion control that has some happy possibilities

for IBS. The risk of trigger foods can be tremendously minimized if they're

eaten in tiny quantities following soluble fiber. In this regard, it is as

much how you eat as what you eat that will help you manage your symptoms.

While this is most important as a tool to allow you to incorporate all

those healthy insoluble fiber foods as often as possible, it's also a means

of treating yourself to a " mini-splurge " every once in a while. Let's say

you're well-stabilized and just dying for a Snickers. Eating a full-size

candy bar as a snack when your stomach is empty will likely wreak havoc and

send you into an immediate downward spiral of attacks (why? because it's

sky high in fat and dairy, and has very little soluble fiber).

 

However, if your symptoms were well under control and you instead decided

to treat yourself to a snack-size individual Snickers bar (a tiny portion

equals a tiny quantity of fat/dairy triggers) for dessert, immediately

following a nice low-fat, high soluble fiber meal, you'd likely do just

fine. I eat solid chocolate almost every day in this manner. (Of course,

this may just be sheer willpower because as God is my witness I will not go

through life without chocolate, but I think this is probably the less

likely explanation.)

 

Whatever your favorite trigger food, this strategy gives you a good means

of allowing yourself the occasional small indulgence. IBS food intolerances

are, fortunately, not like food allergies, where the quantity of a trigger

(say, peanuts) may not matter. For this we can thank our lucky stars, as it

means that few things are truly forbidden to us as long as we follow some

common sense rules and exercise a little self control. Now, where's that

Hershey's kiss I've been saving?