Irritable Bowel Syndrome (IBS): What Do I Eat? (cont.)
Moderator: The recipes in that book are great. Step six just seems to be common sense, that is, avoiding hot spices.
Elaine Magee: It's a problem with some spices. Some people with IBS have trouble tolerating certain spicy condiments, such as hot sauce, spicy BBQ sauce, chili powder, hot chili peppers, garlic, curry, and ginger. With ginger, small amounts may be fine for you.
Moderator: Again, keeping the diary will help you to keep track of whether or not you can tolerate those small amounts?
Elaine Magee: Totally. You don't have to do it all the time. Once you get a handle on your personal trigger foods, you may only need to keep a diary every now and then.
Moderator: How does alcohol affect someone with IBS?
Elaine Magee: Alcohol stimulates the digestive track by getting digestive juices flowing. This can cause heartburn, stomach pain, and diarrhea for some people. Notice, the food step says overdoing alcohol. Some people do just fine keeping it moderate, which is no more than one drink for women and no more than two drinks a day for men.
Moderator: Step eight says to avoid gassy foods, but what are "gassy foods?"
Elaine Magee: It can help relieve the symptoms of abdominal pain, gas, and bloating. Again, it could be the amount that bothers you. After you eat a certain amount you might start seeing symptoms. Raw vegetables, in general, can cause problems for some including cucumber and lettuce in salads. The following vegetables can cause problems even when cooked: broccoli, brussel sprouts, cabbage, cauliflower, corn, kohlrabi, leeks, onions, bell peppers, pimentos, radishes, rutabaga, sauerkraut, scallions, shallots, turnips, and chili peppers. Dried peas, beans, and lentils (the bean group) can cause problems, and some fruits such as apples with peels, avocadoes, cantaloupe, honeydew melon, prunes, and watermelon. Other foods and drinks that may cause trouble include beer, seeds (sesame, poppy, sunflower and flaxseed), hard-boiled eggs, soft drinks (bubbles), nuts, wheat germ, popcorn, and the spices mentioned earlier.
Moderator: You said beans were a good source of fiber, but they are among the gassy foods. How do you decide if you should eat them?
Elaine Magee: Amount, amount, amount. You may be able to get away with a smaller amount of beans, especially if in a meal. One of my favorite lunches is a burrito with brown rice, and I have no problems managing that at all. A not-so-spicy chili made with lean meat, if you have a small cup, may be OK.
darher_msn: I have noticed that any fruit that I eat with a skin on it will start IBS, but I can eat any canned or frozen fruits with no problem. Why?
Elaine Magee: Great comment. Canned fruit or well-ripened fruits tend to be better tolerated. Please understand that some people with IBS are mostly bothered by spicy or high-fat foods, but some are bothered by the peel. There are so many possible triggers. In the book, we try to give you the tools to help you figure your own personal IBS triggers. There is so much individual difference from one sufferer to another.
Moderator: Why should people with IBS eat smaller, more frequent meals?
Elaine Magee: Large meals can bring on cramping and diarrhea in people with IBS. So by eating smaller meals, we're reducing the intestinal load at one time. This is why so many people have trouble after eating out at a restaurant, because we tend to eat foods we don't normally eat. We eat high-fat foods and large portions of them.
Moderator: Food step 10 is exercise. Could you please explain this further?
Elaine Magee: Exercise really helps people with bouts of constipation. It is another intestinal stimulant. So people with diarrhea-predominate IBS might find themselves most comfortable exercising at the time of day when they tend not to have their symptoms. For example, I am mostly bothered with symptoms in the morning, so I exercise in the evening. Here's another reason to exercise: It is a great stress reducer, which can help people with IBS who's symptoms tend to worsen under times of stress.
Moderator: Lima asks, "It seems like every time I eat meat, I have a hard time with it in my bowels. Does meat make things worse with this IBS? What are the best things I could eat? I love cereal, is that OK? Thanks so much for your time."
Elaine Magee: I hear this question from a lot of people, and what I would suggest to you is to look at my meat choices. The leaner the better. If you cook your meat and cook it in a lean way and eat smaller portions, like a piece of meat the size of the palm of your hand, about 4 ounces, you might find it actually being better tolerated. I would also try to see if chicken breast, fish, or pork tenderloin are more comfortable for you as well.
Moderator: Omar asks, "I've found that in the past year or so, I can't eat yogurt because it causes massive diarrhea for me. This seems strange to me because yogurt is supposedly good for your digestion because of 'good' bacteria. Does anyone else with IBS react to yogurt so badly?"
Elaine Magee: Only the people who have, perhaps, lactose intolerance, too. Now this is tricky because there is a crossover between people who have lactose intolerance. Lactose is the carbohydrate found in yogurt. They cannot digest it. They lack enough of the enzyme to break it down. That is different than IBS, but there are people with IBS who may have a lactose intolerance, and vice versa. So figuring out which one you are will help you perceive. Let me remind you, if you haven't already done so, please see your physician or gastroenterologist to make sure you indeed have IBS, because there are other gastrointestinal diseases that can have similar symptoms.
Moderator: VJ asks, "I have problems if I have any dairy products, margarine, mayonnaise, caffeine, MSG (monosodium glutamate), or pickles. Are these food sensitivities common to IBS sufferers? It is so difficult to eat anywhere but home. I haven't found products (like Lactaid) helpful. Do you have suggestions?"