Doctor says I may have IBS but I'm not so sure - IBS Network

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Doctor says I may have IBS but I'm not so sure

Hello all

I'm writing here because, can't get any answers on the internet, Hope you guys can help… Iv’e been having stomach issues for about 2 years and stopped eating food that I like because of reaction in my stomach, things like bread, milk, porridge, apples you name it, I make all my own food most of the time and have mostly health diet. I went the doctors because more and more food causing issues Buck Wheat, Broccoli Healthy food. Doc says most likely IBS, I have chronic constipation and Diarrhea to follow. So Been on Fodmap Diet for two week, symptoms only got worse in terms of stomach pain and painful bloating. So I’m now eating tiny amounts of food 2 forks full of dinner tonight and I feel sick full as if I’ve had 3 courses. When I eat eggs or yogurt (Alpro) I feel like a have a brick inside my stomach… so I no longer want to eat, but I am hungry… I’m total stuck on what to even eat at the mo and very feed up. It’s not like me, I love cooking and food for that matter…

Hope you guys can help

....Cheers

32 Replies
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Hi Nicky - there are a few possibilities. It may be you have one or more food intolerances. Have you kept a food diary to check? Some people on this forum recommend paying for tests such as the York Test and have found the results helpful but my GP argued that these tests are not very accurate. It may be that you have inflammation such as leaky gut, or a bacterial overgrowth like SIBO, or adhesions or post infectious IBS. Possibly you are deficient in Vitamin D or some other vitamin, mineral or enzyme or have low stomach acid. To be honest the list can be a bit daunting and it is essential that you have a GP, gastroenterologist or nutritional therapist who you can work with to help find the best tests, treatments etc. Good luck!

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Thanks for advice, sounds like a lot of options, I will have to go back doctor get a referral... cheers Liz

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Same here but the doctors don’t want to diagnose me with IBS since I don’t have the typical constipation or diarrhea. I still have regular bowel movements everyday day..they’re hard to pass but they are soft and regular makes no sense. But they all float. Sorry TMI. My stomach is constantly sore and I too have been on the FODMAP without much relief. Do you have burning, burping and flatulence? I have side pain and low back pain along with pelvic pain. I recently had a both upper and lower endoscopes along with a CT all clear.

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Yes burping and flatulent but only with certain stuff like veg.... sorry your not getting a diagnosis, I think I will also have trouble... thanks for advice... cheers

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Floating stools can be a sign of parasites among other things.

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Do you know if they would have seen that when my stool was tested for H-Pylori? Or maybe I have to have a specific test for it??

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It wouldn't have shown up. You have to have a comprehensive stool test which is not available on the NHS. I had to go through a private consultant and pay.

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I live in the US. I’ll have to ask my doctor. I know we have direct/private labs where we can pay for different tests but I’ll have to do some research in case my doctor doesn’t want to order them for me.

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I believe Geneva Diagnostics have American branch. You do have to be referred though.

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Oh, interesting. Thank you. :) I’ll look into it.

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Floaters can be because you are not absorbing fats well. You can get enzymes to help you digest them, but see your doctor and mention this, as it could be to do with bile too.

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Sometimes healthy food like broccoli or brussels sprouts can cause bloating, stomach cramps, flatulence and burping. From what I have read, fibre can be a problem for some people with IBS.

I had similar troubles a few months ago ( severe constipation and so on), so I experimented by excluding certain foods from my diet and it kind off helped. I stopped eating bread and rice, and drastically reduced the amount of cheese and processed meat I eat as it constipates me. I never been diagnosed with IBS, but I have a lot of the symptoms.

As Liz1234ty suggested, keeping dairy of what you eat might help you to identify certain food that makes you feel unwell.

Hopefully you get better soon! Good luck!

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Thanks have been keeping a food diary, that helped me identify what’s affecting me, and it’s a big list now, but not wanting to eat anything when I am hungry is getting be down.... thanks for the advice Nicky

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Please, no matter what, keep drinking water, try to avoid tap water as you dont know what is in it. You could do like, when i think i ate somethjng that might give me a bad night sleep, i automatically take antihistamine before bed. It works most of the pain. I wake up with slight pain, different from the pain waking me up which pain is often unberable.

I went out with my niece and ate French food: mussels (no problem) but the creamy sauce could be. Cheesy mousse thing (definately), glass of wine (no doubt).... I had a good night, beautiful food.....but I am dreading sleeping!

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I have IBS and to be quite honest no two days are the same. I can’t take anything made with cows milk causes terrible bloating and cramps but can take any other milk such as goats ( which I use all the time) ewes etc. I have to be careful how much roughage I consume, I can’t eat the skin on fruit, and so it goes in. Some days I’ll eat a banana and feel fine and another time I’ll get stomach cramps. Because of my diet I do get constipated so have to take something to help and drink plenty of water. I think you just have to listen to your body and try and work out what is best for you. Good luck.

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Hello, this is my general response to help people find a baseline. First, go to the doctors and get yourself checked for intestinal infections, and whatever other tests they want to do. Most people find they are all clear, and that IBS is a condition brought on by our modern diet, freely accessible food, sedentary lifestyles and is usually initially set off by a GI infection or other trauma to the GI tract. The gut becomes hypersensitive to certain triggers, and the official description is that a physical brain-gut dysfunction develops which causes the gut to over-reacts to very mild stimuli. Be aware that you can get new GI infections, or other GI issues that are not connected to IBS, so you need to be vigilant for this, and if concerned then visit your doctor again. However this post is to help you to establish a baseline of understanding what is probably down to IBS.

After 27 years of suffering with IBS I have found that the long-term solution that actually works for controlling it is about FIVE key topics: your vitamins, daily fasting periods, digestive enzymes, toxins that are freely dished out by the food industry, and adrenalin control. You are effectively the manager of a “food nutrient extraction factory”, I know that may be obvious, but I have found that IBS is not about medicines, but about changing the way you run the factory, and learning how to get the best performance out of it. I don’t recommend any medicines for long term use, as they only work in the short-term and eventually become less effective, and I just don’t want to be dependent on medicines until one day when I have no other choice.

So after your doctor’s tests, if IBS is the diagnosis, then the first thing to sort out is your vitamins and the timing of your eating and fasting periods. An incident of food poisoning or infection can start you on a cycle that you need to make a really concerted effort to break out of. IBS causes vitamin deficiencies which are practically impossible to overcome in most people’s diets, especially because you are probably eating selectively to manage your symptoms. Your vitamin levels affect the health of your intestines, and the health of your intestines affects your vitamin absorption and your production of digestive enzymes; it is a vicious circle that you have to break.

If your farts really stink like something died in your guts, then this is because partially undigested proteins are making it through to your large intestine and the amino acids lysine and arginine are being metabolized by bacteria into cadaverine and putrescine which are the compounds that give the smell to rotting flesh! – do not worry that you yourself are rotting, this is just temporary, but it shows that you really need to sort your digestion out. In most cases, I would suggest to try some digestive enzyme (multi- enzyme) supplements, and take these for as long as you need to while your small intestine repairs. Enzyme production can decrease as you get older, is affected by stress/anxiety, and you want to be sure that undigested food does not get to your large intestine where the bacteria will go to town on it. It could be that sporadic sufficiency of enzyme production may be one of the factors why IBS is so variable. But it’s not just the enzymes, there are other factors.

So, get some really good, expensive, multi-vitamins (ideally constituted for your age) and take them without fail every day before your breakfast. Get a blood test for Vitamin D and get you doctor to judge your supplement level required in IU’s to get you well healthy for Vitamin D. Do not get vitamins with high calcium and magnesium content initially as certainly in large doses these minerals can mess you up as they consume your stomach acid, and magnesium particularly can give you diarrhoea. You should get enough of these minerals from your diet. If you are on the low FODMAP diet, go for all lactose free dairy products to boost your calcium, as unfortunately the diet tends to cut out almost all of the good calcium sources.

Second, sort out your fasting periods immediately. This is normally overlooked by GP’s, but is an absolutely essential element for resolving IBS. Your small intestine should be practically sterile, and your stomach acid along with bowel cleaning contractions during fasting (called MMC) will usually do the cleaning. But, you need to fast for this to be effective, and by that I mean, ABSOLUTELY NO eating in between meals, ideally drinking only water. Imagine that you never washed your dinner plates and just kept putting food on them all the time!, they would be filthy and full of bacteria. In your guts, this results in SIBO (Small Intestine Bacterial Overgrowth), which is apparently responsible for 85% of IBS cases, but is only one of factors that you need to address. You need to give your small intestine plenty of time free of food for cleaning and maintaining the factory. The modern scenario of have cupboards full of rich foods permanently available day and night is a modern luxury outside of human evolution. Your stomach will sort itself out when you have got control of your small intestine (although if you've got gastritis you'll need to finish a course of omeprazole first), and then your large intestine will improve later as nutrients are more efficiently absorbed from your small intestine. Furthermore, you should be able to avoid future bouts of gastritis as during the fasting periods, your stomach acid is more neutral at nearly pH 4. As a basic program, eat a good breakfast at say 7am (porridge with 50% almond milk or lactose free milk) or what suits you and then a good lunch at 12 o'clock - absolutely no food in between. After lunch, no food at all for at least 5 hours, and eat well again for your evening meal because it has got to get you through the night. Ideally, no food after 7 pm, no supper or snacks, no food or milk at all until breakfast the next day.

You will feel hunger in the fasting periods, but you will not starve, and this is doing you good!, You must NOT respond to the hunger - only with water or black tea. This is CRITICAL. Unless you are in a very healthy GI state, a mid-morning or afternoon snack interrupts your set meal digestion, causing acidity, SIBO, and driving premature advancement of food into your colon resulting in the putrid gases mentioned above. Importantly, when you are feeling better, do not resort to your old ways, you are still recovering as you villi repair and become more efficient, and you need to make a life-style change to have this level of discipline in your eating and continue with it. It takes a few weeks at least, and you need to persevere with this. Failing on this will undermine all of your other good works. In a couple of weeks, you should be able to be getting off the low FODMAP diet, and begin mixing back in the higher FODMAPs. However, if you feel that this is not enough and symptoms are returning then just back off on the high FODMAPs for a while, and go for the wheat free options.

The third aspect of IBS is that some food additives are quite simply toxic for you and cause direct inflammation of the colon, allergic reaction of the colon, or they are laxatives that give you diarrhoea that you didn’t realise you were eating. These are to be considered separate to the usual SIBO and vitamin mechanisms that you are dealing with above:

1.) Try to seek out and eliminate “trans-fats”. These cause direct inflammation of the colon, and you will be more sensitive than most people and this confuses what is causing you trouble. Chips, hash browns, butter, doughnuts, popcorn and things cooked in cheap or old frying oil as you find in many restaurants and commercial products can give you colon pain directly through inflammation. It can take up to three or four days to recover from this inflammation, but trans-fats are bad for you in a miriad of ways (cardio-vascular and diabetes), not only by inflammation of the colon. There is evidence that as cooking oil is re-used that the trans-fats (and other compounds) increase. So, if you want fried food as a treat, do it at home with good oil at a low temperature, and use it only once. Ideally, starches should only be boiled, rather than fried.

2.) E407, or “Carrageenan” – is a food additive derived from a red seaweed, which is only present in small quantities as a thickener, but even at low levels it has been shown to be “highly inflammatory to the digestive tract” and associated with IBS, colitis and other GI diseases. There is loads of literature and objections to this substance on the internet. It is present in cheap Crème Caramels, and many other dairy and meat products. After weeks of good health, just one of these products knocks me out for 24 hours with colon bloating and pain. I have found this by trial and error several times. Food tests show that even the food grade carrageenan contains between 2 and 25% of the non-approved “degraded” carrageenan, which is colon damaging and carcinogenic. Some food agencies now prohibit this additive altogether, and it may be responsible for a lot of IBS cases. It might be found in chocolate milk, cottage cheese, cream, crème caramel, ice cream, almond milk, diary alternatives, such as vegan cheeses or non-dairy desserts, coconut milk, creamers, hemp milk, rice milk, soy milk, and particularly processed meat. It is used extensively in cheap meats and is even injected into beef joints – so always get organic or local butcher fresh good quality meat!). It may be labelled as E407 or Carrageenan, but if you’ve got IBS, consider it as highly toxic for you.

In the same category is carboxy methyl cellulose (CMC) which is more widely used in the food industry, but has similar toxicology in animal studies, giving inflammation of the colon. However, the jury is still out on CMC to its impact on humans.

I’ll also mention here mono-sodium glutamate (MSG). Clinical trials and several scientific articles connect MSG with IBS, so given the option to avoid it you should avoid it.

Also, NICE advises against the use of Aloe Vera for IBS - although I would say for skin burns it is miraculous, so get a tube of the pure plant gel for your medicine cabinet for minor burns.

3.) E338, E339, E340, E341, E450, E451 and E452, are phosphates, diphosphates or polyphosphates as different salts. Natural phosphates are essential for life, and your body is full of organically bound phosphates, however, free ionic phosphates have several problems. Firstly, they are laxatives and will give you diarrhoea (sodium phosphate was once used to prepare patients for colonoscopies!). Secondly, they are associated with cardiovascular disease and accelerated aging. Since the 1990’s we are now exposed to twice the amount of added phosphate in foods, and this is bad. There are calls to have added phosphate labelled on products as a health warning. Particular culprits are mass produced sausages and processed ham and chicken slices (and other meats), some cheeses, and cola (both diet and normal). Personally, for me all phosphate additives make me ill.

4.) Aspartame and other sweeteners definitely have a negative role to play in IBS for many people. As with the other toxins above, your ability to cope with them varies on a spectrum. If you look at some of the work of K.J. Mielke, many of these additives can be allergens or “pseudoallergens” and with time you can develop a reaction to them. The best sweetener for IBS is normal table sugar (sucrose), but it will rot your teeth in tea / coffee all day unless you do extra teeth cleaning. Ideally, general advice is to cut down on these stimulants, no more than 3 cups a day is the NICE guidance.

You must remember that there are many different causes of IBS, and one person’s solution may not be another’s - because of the allergies that you may or may not have developed, plus all other factors in play.

The fourth major topic in treating IBS, is adrenalin control. The GI tract is very sensitive to adrenalin. There is some literature about serotonin along a similar vein. A friend of mine says that “adrenalin not used by your muscles goes to your guts” and there may be some truth to this. If you have a busy life, you are probably not coasting along on a bed of feathers, and you probably not aware of your almost constantly high adrenalin levels – that is until you start actively lowering them. Crucially, what does work, is hard exercise to burn up your adrenalin and stop it interfering with the nervous system of your guts – and this is a powerful effect. My advice is to do something every day, whatever you can manage in your busy life, it will all help. It will improve your gut motility, general health, bone strength, relieve tiredness, help you sleep better, improve your mental agility and help get your anxiety under control. To many people, exercise may seem like a waste of time, but it is equivalent to spending a bit of time sharpening an axe – it is not wasted time, but time very well spent in servicing your whole body and mind.

Other points...

Red meats generally take a long time to digest, and also contain some trans-fats, but are usually tolerable. Only have them once a day, ideally for lunch, and just a light salad to go with them, not a load of starchy food or grains, as they have long digestion times. You don’t want carbohydrates being held up in transit because of heavy meat digestion late in the day.

There is a lot of support for L-glutamine to help with repair of your small-intestinal lining; this means buying 500g of the bodybuilder powder type and having a couple of tea-spoons of this a day - one before breakfast and one just before you go to bed, and you can have this in a light cordial drink. I don’t think this is a permanent requirement, but I think can help you recover more quickly from long term issues.

I am not a fan of pro-biotics, I have never found that they actually do anything, although some people may disagree. However, I am a big fan of pre-biotics, which is basically food for your large intestine good bacteria. This helps to strengthen the lining of your colon, and further improve your resilience to potential trigger foods and inflammation. Again, I would only use these periodically for a few weeks to help you back to a good state which you can then manage with the other good behaviours. Not that they do you any harm, just another thing to buy and take. They are the icing on the cake for me, with a noticeable improvement in your GI comfort and performance.

I should add that although I eat bread and milk now in moderation, I am still cautious about high FODMAP fruits and tend to avoid them. The FODMAP fruit list is complicated, but an easy way to remember it is like this: "fleshy", juicy fruits are bad, i.e. (nectarines, peaches, apricots, pears, apples, plums, dates etc), but segmented fruits (oranges, mandarins etc.) and all berries are generally OK, as you are not likely to eat lots of them. Best of all is bananas which you can eat loads of. (Microwave three of them until they are mushy and put a couple of fried eggs and cheese on them is my favourite weekend breakfast!).

I should also mention hormone changes in women can be connected with IBS, affecting the brain-gut nervous system, but I have no personal experience in this. Similarly, hypnosis is actually recommended by NICE as the best alternative therapy, again trying to get a grip on the nervous dysfunction. I have tried this, I still don’t know if I believe it, because for me I was just very relaxed with my eyes shut for half an hour, and I didn’t have the heart to tell the woman that I wasn’t really hypnotised! However, like other therapies it concentrates on repeatedly putting loads of positive thoughts in your mind, and this is good by anyone’s standards, so I’d say it is a good complement to your psychology and anxiety, although it will not address organic issues like SIBO. But, as an example of your sub-conscious on your guts, try taking yourself off camping for a few days in a proper tent – and I don’t mean glamping! The change of living environment will slow down your digestion into emergency mode as your mind tells your body to get everything it can from the food you eat in case you don’t have any in the future. Camping also removes you from your usual daily anxieties, and will get you more active.

Dealing with Flare-ups

First thing is, fix your SIBO as described above. If you still have SIBO symptoms, oregano oil capsules are very good, it is bactericidal, anti-inflammatory and can help with acute SIBO problems. It is not “gassy” as you may find with peppermint oil. Take some digestive enzymes, to ensure your digestion is complete. Fixing your SIBO has got to be your priority.

If you are on top of your SIBO, then a bowel toxin such might hit you 5 to 8 hours later as the food gets to your large intestine. The first line of attack in this case is ibuprofen which is far more effective than paracetamol for bowel pain, and I find that 200 mg alone is enough. Second, a couple of Buscopan will stop the cramps. Have available in advance some linseed (seeds) and natural aniseed (Star Anise), and make the following tea: in a saucepan, add 1 teaspoon of linseed, ½ to 1 anise star, 1 teaspoon of sugar, a squirt of lemon juice (bottled is fine), and one mug full of water. Boil to simmer for 3 to 5 minutes, then sieve off the hot liquid back into the mug. This is a very effective remedy that I have used countless times, and it really does help. The reason that it helps (anecdotally) is that the “gooey” linseed extract coats the intestinal lining. There may be some truth to this, as some propose that the mechanism of bowel inflammation is a chemical attack on the mucus lining of the intestine which then allows food particles be exposed to the more delicate tissues underneath, causing inflammation. The linseed goo would provide a temporary replacement to the mucus lining, preventing further inflammation. In fact, NICE recommends oats and linseed for daily consumption for IBS patients.

A few references…

“Treatment and Management of SIBO — Taking a Dietary Approach Can Control Intestinal Fermentation and Inflammation, by Aglaée Jacob, MS, RD; Today’s Dietitian; December 2012, Vol. 14 No. 12 P. 16”.

badgut.org/information-cent...

guidelines.co.uk/gastrointe...

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Fodmaps never worked for me either mine was anxiety have you every thought about that? X

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Yeast is also a gut murderer, along with cow milk products, soya for some people and, wine. I know, many people like wine! I don't know about red wine, I hate the smell of it, but white wine is a killer for me. I can manage beer, a little of it though, like half a pint per day.

Smoking....murder. Too much inhaled gas.....

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Anxiety and stress are one of the biggest causes of digestive issues especially if you have a highly stressful job/home life. I learnt this the hard way. Try to find ways to relax and make time for yourself. Health is more important then any job, if you dont have your health you wont be able to do your work effectively anyway.

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You could be right anxiety bad last 2 weeks, usually I over eat to feel better but definitely couldn’t do that now feeling full on the time... thanks for the advice..

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Complete shot in the dark here but try digestive enzymes with meals. You will take a while to work out your main triggers but these may help you along the way. Best of luck

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Hey nicky 74

I had same problem, i always had a bit of a weird stomach ... constipation and certain foods would give me crippling gut ache or feel bloated and heavy.

Then 3 years ago things just got worse to point ended up in A&E in agony not 💩 for 2 weeks!

After alot of tests and trying to empty myself out i found out i had a wheat( gluten) intolerance and it was getting to point my stomach was not goin to tolerate it anymore and had basically stopped working.

I gave up wheat , yeast and not so much dairy and within month was soooo much better.

I also read alot about our gut and bacteria and how we build intolerances and decided to get a healthy gut so i started taking probiotics( give healthy gut bacteria)digestive enzymes( break down food and fats) peppermint capsule( help digest food) . Vit c and d.

Now 3 years down line im 2 stone lighter, my hair and nails look great and i always suffered with eczema and that cleared up( they think it was the intolerance that was giving me that) i wished id known this years ago

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thanks Lulabubs, that sounds bad what happened to you, guess you can get theses food allergy tests on the NHS? I will investigate

thanks

Nicky

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No sorry u cant i paid to have mine done privately.

They dont do allergy or intolerance testing on the NHS.

So it showed gluten , yeast and dairy but since i started taking All the gut balancing tablets im ok with dairy ,I can even have a tiny bit of gluten every now and again but i never eat yeast. Bread and things..

It bad for gut, yeast is really not good for people that have ibs, it bloats u and clogs the colon.

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Thanks everyone, loads of ideas to take forward?

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Just the anxiety alone from wondering what is going on inside would be enough and has been enough to set me off. So perhaps this could be happening with you to? As IBS sufferers we tend to be super tuned into our tummy’s and systems and sense every little pain and twinge. And this makes us more sensitive to them. I am just starting out on this journey with IBS myself and it’s a minefield on information I must say. Hope you get sorted soon

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Yes Rebeccap81 it's a minefield of info, good luck we will get there, I will look at getting food intolerance testing done.

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Yes that is something I think I will ask for too as seems to be a big problem for lots of people! Thank you

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You should go back to your doctor + ask for a double appointment. Tell them all your concerns. Sounds like you have got in an anxious state about food which is the story with ibs + other gut problems Good luck x

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Hello, this is my general response to help people find a baseline. First, go to the doctors and get yourself checked for intestinal infections, and whatever other tests they want to do. Most people find they are all clear, and that IBS is a condition brought on by our modern diet, freely accessible food, sedentary lifestyles and is usually initially set off by a GI infection or other trauma to the GI tract. The gut becomes hypersensitive to certain triggers, and the official description is that a physical brain-gut dysfunction develops which causes the gut to over-reacts to very mild stimuli. Be aware that you can get new GI infections, or other GI issues that are not connected to IBS, so you need to be vigilant for this, and if concerned then visit your doctor again. However this post is to help you to establish a baseline of understanding what is probably down to IBS.

After 27 years of suffering with IBS I have found that the long-term solution that actually works for controlling it is about FIVE key topics: your vitamins, daily fasting periods, digestive enzymes, toxins that are freely dished out by the food industry, and adrenalin control. You are effectively the manager of a “food nutrient extraction factory”, I know that may be obvious, but I have found that IBS is not about medicines, but about changing the way you run the factory, and learning how to get the best performance out of it. I don’t recommend any medicines for long term use, as they only work in the short-term and eventually become less effective, and I just don’t want to be dependent on medicines until one day when I have no other choice.

So after your doctor’s tests, if IBS is the diagnosis, then the first thing to sort out is your vitamins and the timing of your eating and fasting periods. An incident of food poisoning or infection can start you on a cycle that you need to make a really concerted effort to break out of. IBS causes vitamin deficiencies which are practically impossible to overcome in most people’s diets, especially because you are probably eating selectively to manage your symptoms. Your vitamin levels affect the health of your intestines, and the health of your intestines affects your vitamin absorption and your production of digestive enzymes; it is a vicious circle that you have to break.

If your farts really stink like something died in your guts, then this is because partially undigested proteins are making it through to your large intestine and the amino acids lysine and arginine are being metabolized by bacteria into cadaverine and putrescine which are the compounds that give the smell to rotting flesh! – do not worry that you yourself are rotting, this is just temporary, but it shows that you really need to sort your digestion out. In most cases, I would suggest to try some digestive enzyme (multi- enzyme) supplements, and take these for as long as you need to while your small intestine repairs. Enzyme production can decrease as you get older, is affected by stress/anxiety, and you want to be sure that undigested food does not get to your large intestine where the bacteria will go to town on it. It could be that sporadic sufficiency of enzyme production may be one of the factors why IBS is so variable. But it’s not just the enzymes, there are other factors.

So, get some really good, expensive, multi-vitamins (ideally constituted for your age) and take them without fail every day before your breakfast. Get a blood test for Vitamin D and get you doctor to judge your supplement level required in IU’s to get you well healthy for Vitamin D. Do not get vitamins with high calcium and magnesium content initially as certainly in large doses these minerals can mess you up as they consume your stomach acid, and magnesium particularly can give you diarrhoea. You should get enough of these minerals from your diet. If you are on the low FODMAP diet, go for all lactose free dairy products to boost your calcium, as unfortunately the diet tends to cut out almost all of the good calcium sources.

Second, sort out your fasting periods immediately. This is normally overlooked by GP’s, but is an absolutely essential element for resolving IBS. Your small intestine should be practically sterile, and your stomach acid along with bowel cleaning contractions during fasting (called MMC) will usually do the cleaning. But, you need to fast for this to be effective, and by that I mean, ABSOLUTELY NO eating in between meals, ideally drinking only water. Imagine that you never washed your dinner plates and just kept putting food on them all the time!, they would be filthy and full of bacteria. In your guts, this results in SIBO (Small Intestine Bacterial Overgrowth), which is apparently responsible for 85% of IBS cases, but is only one of factors that you need to address. You need to give your small intestine plenty of time free of food for cleaning and maintaining the factory. The modern scenario of have cupboards full of rich foods permanently available day and night is a modern luxury outside of human evolution. Your stomach will sort itself out when you have got control of your small intestine (although if you've got gastritis you'll need to finish a course of omeprazole first), and then your large intestine will improve later as nutrients are more efficiently absorbed from your small intestine. Furthermore, you should be able to avoid future bouts of gastritis as during the fasting periods, your stomach acid is more neutral at nearly pH 4. As a basic program, eat a good breakfast at say 7am (porridge with 50% almond milk or lactose free milk) or what suits you and then a good lunch at 12 o'clock - absolutely no food in between. After lunch, no food at all for at least 5 hours, and eat well again for your evening meal because it has got to get you through the night. Ideally, no food after 7 pm, no supper or snacks, no food or milk at all until breakfast the next day.

You will feel hunger in the fasting periods, but you will not starve, and this is doing you good!, You must NOT respond to the hunger - only with water or black tea. This is CRITICAL. Unless you are in a very healthy GI state, a mid-morning or afternoon snack interrupts your set meal digestion, causing acidity, SIBO, and driving premature advancement of food into your colon resulting in the putrid gases mentioned above. Importantly, when you are feeling better, do not resort to your old ways, you are still recovering as you villi repair and become more efficient, and you need to make a life-style change to have this level of discipline in your eating and continue with it. It takes a few weeks at least, and you need to persevere with this. Failing on this will undermine all of your other good works. In a couple of weeks, you should be able to be getting off the low FODMAP diet, and begin mixing back in the higher FODMAPs. However, if you feel that this is not enough and symptoms are returning then just back off on the high FODMAPs for a while, and go for the wheat free options.

The third aspect of IBS is that some food additives are quite simply toxic for you and cause direct inflammation of the colon, allergic reaction of the colon, or they are laxatives that give you diarrhoea that you didn’t realise you were eating. These are to be considered separate to the usual SIBO and vitamin mechanisms that you are dealing with above:

1.) Try to seek out and eliminate “trans-fats”. These cause direct inflammation of the colon, and you will be more sensitive than most people and this confuses what is causing you trouble. Chips, hash browns, butter, doughnuts, popcorn and things cooked in cheap or old frying oil as you find in many restaurants and commercial products can give you colon pain directly through inflammation. It can take up to three or four days to recover from this inflammation, but trans-fats are bad for you in a miriad of ways (cardio-vascular and diabetes), not only by inflammation of the colon. There is evidence that as cooking oil is re-used that the trans-fats (and other compounds) increase. So, if you want fried food as a treat, do it at home with good oil at a low temperature, and use it only once. Ideally, starches should only be boiled, rather than fried.

2.) E407, or “Carrageenan” – is a food additive derived from a red seaweed, which is only present in small quantities as a thickener, but even at low levels it has been shown to be “highly inflammatory to the digestive tract” and associated with IBS, colitis and other GI diseases. There is loads of literature and objections to this substance on the internet. It is present in cheap Crème Caramels, and many other dairy and meat products. After weeks of good health, just one of these products knocks me out for 24 hours with colon bloating and pain. I have found this by trial and error several times. Food tests show that even the food grade carrageenan contains between 2 and 25% of the non-approved “degraded” carrageenan, which is colon damaging and carcinogenic. Some food agencies now prohibit this additive altogether, and it may be responsible for a lot of IBS cases. It might be found in chocolate milk, cottage cheese, cream, crème caramel, ice cream, almond milk, diary alternatives, such as vegan cheeses or non-dairy desserts, coconut milk, creamers, hemp milk, rice milk, soy milk, and particularly processed meat. It is used extensively in cheap meats and is even injected into beef joints – so always get organic or local butcher fresh good quality meat!). It may be labelled as E407 or Carrageenan, but if you’ve got IBS, consider it as highly toxic for you.

In the same category is carboxy methyl cellulose (CMC) which is more widely used in the food industry, but has similar toxicology in animal studies, giving inflammation of the colon. However, the jury is still out on CMC to its impact on humans.

I’ll also mention here mono-sodium glutamate (MSG). Clinical trials and several scientific articles connect MSG with IBS, so given the option to avoid it you should avoid it.

Also, NICE advises against the use of Aloe Vera for IBS - although I would say for skin burns it is miraculous, so get a tube of the pure plant gel for your medicine cabinet for minor burns.

3.) E338, E339, E340, E341, E450, E451 and E452, are phosphates, diphosphates or polyphosphates as different salts. Natural phosphates are essential for life, and your body is full of organically bound phosphates, however, free ionic phosphates have several problems. Firstly, they are laxatives and will give you diarrhoea (sodium phosphate was once used to prepare patients for colonoscopies!). Secondly, they are associated with cardiovascular disease and accelerated aging. Since the 1990’s we are now exposed to twice the amount of added phosphate in foods, and this is bad. There are calls to have added phosphate labelled on products as a health warning. Particular culprits are mass produced sausages and processed ham and chicken slices (and other meats), some cheeses, and cola (both diet and normal). Personally, for me all phosphate additives make me ill.

4.) Aspartame and other sweeteners definitely have a negative role to play in IBS for many people. As with the other toxins above, your ability to cope with them varies on a spectrum. If you look at some of the work of K.J. Mielke, many of these additives can be allergens or “pseudoallergens” and with time you can develop a reaction to them. The best sweetener for IBS is normal table sugar (sucrose), but it will rot your teeth in tea / coffee all day unless you do extra teeth cleaning. Ideally, general advice is to cut down on these stimulants, no more than 3 cups a day is the NICE guidance.

You must remember that there are many different causes of IBS, and one person’s solution may not be another’s - because of the allergies that you may or may not have developed, plus all other factors in play.

The fourth major topic in treating IBS, is adrenalin control. The GI tract is very sensitive to adrenalin. There is some literature about serotonin along a similar vein. A friend of mine says that “adrenalin not used by your muscles goes to your guts” and there may be some truth to this. If you have a busy life, you are probably not coasting along on a bed of feathers, and you probably not aware of your almost constantly high adrenalin levels – that is until you start actively lowering them. Crucially, what does work, is hard exercise to burn up your adrenalin and stop it interfering with the nervous system of your guts – and this is a powerful effect. My advice is to do something every day, whatever you can manage in your busy life, it will all help. It will improve your gut motility, general health, bone strength, relieve tiredness, help you sleep better, improve your mental agility and help get your anxiety under control. To many people, exercise may seem like a waste of time, but it is equivalent to spending a bit of time sharpening an axe – it is not wasted time, but time very well spent in servicing your whole body and mind.

Other points...

Red meats generally take a long time to digest, and also contain some trans-fats, but are usually tolerable. Only have them once a day, ideally for lunch, and just a light salad to go with them, not a load of starchy food or grains, as they have long digestion times. You don’t want carbohydrates being held up in transit because of heavy meat digestion late in the day.

There is a lot of support for L-glutamine to help with repair of your small-intestinal lining; this means buying 500g of the bodybuilder powder type and having a couple of tea-spoons of this a day - one before breakfast and one just before you go to bed, and you can have this in a light cordial drink. I don’t think this is a permanent requirement, but I think can help you recover more quickly from long term issues.

I am not a fan of pro-biotics, I have never found that they actually do anything, although some people may disagree. However, I am a big fan of pre-biotics, which is basically food for your large intestine good bacteria. This helps to strengthen the lining of your colon, and further improve your resilience to potential trigger foods and inflammation. Again, I would only use these periodically for a few weeks to help you back to a good state which you can then manage with the other good behaviours. Not that they do you any harm, just another thing to buy and take. They are the icing on the cake for me, with a noticeable improvement in your GI comfort and performance.

I should add that although I eat bread and milk now in moderation, I am still cautious about high FODMAP fruits and tend to avoid them. The FODMAP fruit list is complicated, but an easy way to remember it is like this: "fleshy", juicy fruits are bad, i.e. (nectarines, peaches, apricots, pears, apples, plums, dates etc), but segmented fruits (oranges, mandarins etc.) and all berries are generally OK, as you are not likely to eat lots of them. Best of all is bananas which you can eat loads of. (Microwave three of them until they are mushy and put a couple of fried eggs and cheese on them is my favourite weekend breakfast!).

I should also mention hormone changes in women can be connected with IBS, affecting the brain-gut nervous system, but I have no personal experience in this. Similarly, hypnosis is actually recommended by NICE as the best alternative therapy, again trying to get a grip on the nervous dysfunction. I have tried this, I still don’t know if I believe it, because for me I was just very relaxed with my eyes shut for half an hour, and I didn’t have the heart to tell the woman that I wasn’t really hypnotised! However, like other therapies it concentrates on repeatedly putting loads of positive thoughts in your mind, and this is good by anyone’s standards, so I’d say it is a good complement to your psychology and anxiety, although it will not address organic issues like SIBO. But, as an example of your sub-conscious on your guts, try taking yourself off camping for a few days in a proper tent – and I don’t mean glamping! The change of living environment will slow down your digestion into emergency mode as your mind tells your body to get everything it can from the food you eat in case you don’t have any in the future. Camping also removes you from your usual daily anxieties, and will get you more active.

Dealing with Flare-ups

First thing is, fix your SIBO as described above. If you still have SIBO symptoms, oregano oil capsules are very good, it is bactericidal, anti-inflammatory and can help with acute SIBO problems. It is not “gassy” as you may find with peppermint oil. Take some digestive enzymes, to ensure your digestion is complete. Fixing your SIBO has got to be your priority.

If you are on top of your SIBO, then a bowel toxin such might hit you 5 to 8 hours later as the food gets to your large intestine. The first line of attack in this case is ibuprofen which is far more effective than paracetamol for bowel pain, and I find that 200 mg alone is enough. Second, a couple of Buscopan will stop the cramps. Have available in advance some linseed (seeds) and natural aniseed (Star Anise), and make the following tea: in a saucepan, add 1 teaspoon of linseed, ½ to 1 anise star, 1 teaspoon of sugar, a squirt of lemon juice (bottled is fine), and one mug full of water. Boil to simmer for 3 to 5 minutes, then sieve off the hot liquid back into the mug. This is a very effective remedy that I have used countless times, and it really does help. The reason that it helps (anecdotally) is that the “gooey” linseed extract coats the intestinal lining. There may be some truth to this, as some propose that the mechanism of bowel inflammation is a chemical attack on the mucus lining of the intestine which then allows food particles be exposed to the more delicate tissues underneath, causing inflammation. The linseed goo would provide a temporary replacement to the mucus lining, preventing further inflammation. In fact, NICE recommends oats and linseed for daily consumption for IBS patients.

A few references…

“Treatment and Management of SIBO — Taking a Dietary Approach Can Control Intestinal Fermentation and Inflammation, by Aglaée Jacob, MS, RD; Today’s Dietitian; December 2012, Vol. 14 No. 12 P. 16”.

badgut.org/information-cent...

guidelines.co.uk/gastrointe...

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One of the biggest factors causing digestive issues that people tend to ignore is stress. E.g. if you have a highly stressful job or home life. I learnt this the hard way. Stress nearly ruined my life. Only this year I have realised I need to make changes, I put on so much weight I couldn't recognise myself. Try to relax and take time for yourself. The work will still be there in the morning. Health is more important than any job.

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Anxiety and stress are one of the biggest causes of digestive issues especially if you have a highly stressful job/home life. This is ignored by a lot of people as the cause. I learnt this the hard way. Try to find ways to relax and make time for yourself. Health is more important then any job, if you dont have your health you wont be able to do your work effectively anyway.

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