IBS: What Can I Eat? (cont.)

You're basically writing down the time you ate, what foods and drinks you consumed and in what amounts, any symptoms and how severe they were, and what your stress and feelings were. I encourage people to keep a log for at least a couple of weeks. It's a great way to identify foods and eating patterns that are triggering your symptoms. There's a one-day diary sample form in the book that you can make copies of for the two to four weeks that you're keeping it.

MEMBER QUESTION: What about diarrhea? I'm so sick of eating food with no flavor so I don't flair up.

MAGEE: Let's talk about tips for people with diarrhea predominant IBS. The first thing I want to mention, though, is some people get this type of IBS as a result of a bout with food poisoning. For these people, their IBS can actually disappear after three to five years. And I've met quite a few people that this happened to. For those of us with the IBS gene, it ain't never going away, but by living and eating better we can certainly make ourselves more comfortable.

You could do what I do, and that is I have medication that I carry for extraordinary circumstances, like traveling and flying, because that's really the only time that I need help. There are several good over-the-counter and prescription medications available now for diarrhea predominant IBS.

From a food standpoint, by keeping track with this FFS diary, you will have a better idea about what your triggers are -- the types of foods and beverages and the amounts. It's really different for every person. I'll just give myself as one example. I can't eat very rich or greasy food. My body tells me, within half an hour, that I'm in trouble. But I can have half an order of tempura at a Japanese restaurant and not get into trouble. If I eat the whole order, I'm done for. That's just something I've learned about myself. I will never order Alfredo sauce at a restaurant because it's too rich for my system, but I have zero problems with my homemade version that's delicious and light. Spicy food, again, Thai restaurants, you'll never see me there, because spicy food is a trigger for me, but it may not be for you.

Some other tips to consider:

  • You may try emphasizing some soluble fiber sources. These add bulk to the colon but they're more gelatinous or gel-like and gentler to overly reactive intestines. You'll find soluble fiber in oats, barley, psyllium, and some fruit; half of the fiber in ground flaxseed is soluble.
  • It may not be a good idea to drink fluids with your meals. Space your meals and fluids about an hour apart. The liquid can make everything run through more rapidly. Together they may be overloading your system, so alternate beverages with your meals.
  • You might see if you have a reaction to the gassy vegetables: broccoli, onions and cabbage. They can cause gas in some people and it can make diarrhea sufferers feel worse. This is one of those instances where amounts can be important, so maybe half a cup of broccoli is no big deal but a cup and a half will cause problems.
  • Fried foods can send some people over the IBS edge. I happen to have written a book about this called Fry Light, Fry Right! where our favorite fried foods have gotten a makeover for extra fat and calories. It's a totally cool cookbook. This would help people with IBS to still have some of the fried foods, just made light at home.
  • Fructose can be a trigger for some people, so keep that in mind when you're looking through your food diary, if you're consuming foods with high fructose, like high fructose corn syrup in soda, for example. Let me add a statistic to this. A recent study found that 30 to 58 percent of people with IBS symptoms, particularly those with the diarrhea type, were fructose intolerant.
  • Large meals can trigger your symptoms, so try to eat less at each meal so that you're not overwhelming the system at any one time. Eat small, frequent meals.

MEMBER QUESTION: Stress seems to play a big part with my IBS. Is that the case with most?

MAGEE: In a word, yes. There is a subgroup of people with IBS that are mostly triggered by stress and not so much by what they eat. I would say from my experience though, that the majority are able to more easily control their symptoms through diet and lifestyle changes although stress plays a role for them as well. There's a subgroup where it's stress only that triggers their symptoms and a larger group of people where it's diet and stress.

It's important to identify your source of stress. Is it work, is it family stress, is it staying up late and not getting enough sleep, is it worrying when you're traveling, is it traveling in general because your body is somewhere outside its safe home space? For me it's being outside my home space and it's also flying in an airplane that changes my constitution. Everybody's a little bit different.

At the same time that we are trying different ways to make ourselves more comfortable with our diet, it's helpful to look at different techniques to reduce the stress. In my case I can't change some of the situations that come my way, like flying on an airplane or going on television, and those are times when I slow down my intestines with medication.

MEMBER QUESTION: It seems I have problems generally after restaurant dining.

MAGEE: There could be a couple things going on when you're eating out at restaurants. We tend to eat foods higher in fat when we eat out, let's just face that. Part of that could be we're served larger portions and we know from studies that the more food that's put in front of you the more food we tend to eat in that meal. Remember how one of the triggers is the larger size meals? We're overwhelming our system with too much at one time. Part of it could be we are treating ourselves, celebrating, so we may be choosing foods we don't normally eat. Any or all of these things can spell disaster.

So the trick is really trying to stick to a smaller-sized meal -- remember you can always take leftovers home and enjoy them tomorrow. We can try to choose menu items that aren't too high in fat and stick to the dishes we tend to do well with. We tend to eat at the same restaurants over and over again anyway, so when you find an entree you enjoy and it doesn't give you a reaction, you can order it in comfort from then on.


STAY INFORMED

Get the Latest health and medical information delivered direct to your inbox!