Ibs-d and low fodmap fruits?: Question is, is it... - IBS Network

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Ibs-d and low fodmap fruits?

Aghu profile image
Aghu
18 Replies

Question is, is it normal that even low fadmap fruits, in low quantities cause trouble. Such as a single kiwi. Some strawberries. I always hear that ibs patients consume them all the time. There’s quite some fructose in them though.

Is it normal, that someone (myself) can’t tolerate even a single kiwi or a small banana (not overripe)?

I, to this age, have not been diagnosed with hfi. Now, my gi tract acts as if i’m hfi, although it doesn’t make me violently ill. ??

Can it be put down to a severe case of fructose malabsorption?

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Aghu profile image
Aghu
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18 Replies
FRreedman profile image
FRreedman

It can be put down to about 250 different things, but the thing is if you find something upsets you, then you shouldn't be trying it again, for quite a while.

I, for some weird reason, am now IBD-c and d, alternating, so I have to eat kiwis and sometimes take Imodium, it is weird this blooming disease.

Aghu profile image
Aghu in reply toFRreedman

I won’t be having fruit for a long time indeed. I’ve just never heard anyone who has the same restriction. Wondered if it might be something that’s not that uncommon among ibs patients.

huggit profile image
huggit in reply toAghu

HI I cant have fruit either especially bananas, I still after 30 years cannot find my triggers, I am sorry that isn't much help, but you are not alone.

Aghu profile image
Aghu in reply tohuggit

Thanks so much for the response. Of course, I’m wondering if there’s any reason to the trouble with fruits, apart from fructose. Lime&lemon (or generally citrus, it’s said) because of their acidity is only other possible answer I could come up with.

xOceanx profile image
xOceanx in reply toAghu

Your Just probably intolerant😔 to the individual foods

xjrs profile image
xjrs

You are not alone. I have been referring to the Monash University fodmap app lately when trying to get off of the highly restrictive diet I am on (white rice, protein, certain quantities of certain vegetables) due to intestinal pain. I have IBS-C and the fodmap app says that I am allowed 2 Kiwis to help with constipation. I had this amount and boy was I in pain. I think there are factors other than fodmaps with our guts. For instance Kiwis are quite acidic. I know that tomatoes (which are fodmap friendly) make me really ill - bad intestinal pain and heartburn. So the Kiwi, due to its acidity, may have had a similar effect. Some fruits may contain small seeds which might irritate the gut. The fodmap app says that I should tolerate 2 tablespoons of chia seeds - this gave me pain. I would love to be able to eat all those fodmap friendly foods the app says I can eat, but am unable to for other reasons.

Aghu profile image
Aghu in reply toxjrs

If i was asked to sum up my diet that’d be what I’d say. White rice, Lean meat ( pretty much chicken breast and canned tuna) and some green veggies. I too started to use the app few months ago in order to introduce some variety to my immensely bland (and that’s certainly missing some nutrients) diet.

I had asked this question on the forum before concerning my suspicion of acidic foods and also vinegar causing food to pass through way too quick, too undigested. There wasn’t really many who experience the same. Do you think then, a splash of lime or vinegar on salad or some vinegar in this or that jarred food such as pickles or olives or something might lead to irritation?

Thanks so much for the response.

xjrs profile image
xjrs in reply toAghu

Hi Aghu, It is hard to say, since we are all individual with our IBS and can react to different things. It is a possibility those things you mention could irritate. I would like to try jarred (fermented foods) such as sauerkraut, since they have been partly digested by bacteria and may allow me to eat things like cabbage (in a different form) that I wouldn't normally be able to eat. However, it is a case of trying things out. I keep a detailed diary in a spread sheet and only change 1 thing (e.g. new food in specific quantities or supplement etc.) every 3 days or so and record symptoms. That way I know what I am reacting to and whether the symptoms are tolerable if I have them. It is really laborious and I can get frustrated with the process, but it's worth it in the end.

Sorry to hear that you have been on such a restricted diet - the same as me! I too didn't think there were many of us who have had to go to these lengths to control their symptoms. What are the main things you are battling at the moment or need to be on this diet for (such as IBS-D, IBS-C, IBS-M or intestinal pain etc.)?

Mstlyharmless profile image
Mstlyharmless in reply toxjrs

I am like you two I think. There isn't a trigger food. It's just food. When I only drink fluids I can feel great for days but fasting doesn't help a laborer much I build houses and repair stuff if I can't be agile and limber I can't work. I dont really have constipation, I definitely never have diarrhea, just pain. Lots of it. Right about the 40 hour mark of digestion. (Now I'm on buprenorphine 10mcg patch and it has helped alot) then I feel fine again elimination usually about 12 hrs later after the pain ends. Same story everyday almost. Now I eat only some rice or noodles, broth green beans or carrots and some protien usually chicken or fish. Over 7 years I've had every scan and test available half of them for cash since I lost my insurance. I'm about to try and file to social security under lost capacity to work. I don't think it willever go back into remission again as it has alot since it began in my 20s now 46 and rather hate daily.life don't like or want friends or a partner. Wrecked my marriage and has about lost my house as well.

xjrs profile image
xjrs in reply toMstlyharmless

So sorry to hear about your difficulties. My main presenting symptom is intestinal nerve pain (but I have IBS-C as well). I believe what you are experiencing visceral hypersensitivity or functional abdominal pain syndrome (intestinal nerve pain) - see info here: iffgd.org/lower-gi-disorder.... This is the brain interpreting the normal activity of the bowel as pain. This is due to neurons in pain control centres in the brain being worn down (by negative life events). The first line treatment for this is nerve pain agents such as 10mg amitriptyline or potentially gabapentin. Have you been offered any of these? I couldn't tolerate either of them. I am now trialing Linaclotide which is for pain and IBS-C. This subject is also currently under research: medicalnewstoday.com/articl....

Aghu profile image
Aghu in reply toMstlyharmless

Obviously, totally different medical circumstances but I’ve lost everything too. Past, present, future. All gone. Not only gone but turned into misery. And there’s no getting out of it. Same feelings toward all that.

Genuinely sorry.

Aghu profile image
Aghu in reply toxjrs

Thanks sooo much xjrs! Diary is inevitable as you’ve suggested. But when there’re so many factors involved, it leads to confusions. And, after adding a single variation, i usually continue with it, if i didn’t see any adverse result after the first day. Such was the case with acidity. I’m pretty sure it’s ok when i use some lime first. But simply can’t do that day after day. Once cut off, back to normal.

What i’m wrestling with is, gluten intolerance or coeliac (easy to manage), ibs d (not easy to manage when there are so many factors -as you said- other than fodmaps and first line measures), lactose intolerance (easy to manage). Cancer and ibd have been medically ruled out. The trouble is that i certainly have many other disorders i can’t pinpoint (intolerance/allergy/malabsorption whatever they are) That’s what makes you feel desperate. As in the case with dairy. That’s my biggest mystery now as i can’t get enough calcium and simply miss cheese&yoghurt so badly.

Lactose free didn’t work (yoghurt- say, it was high sugar). Tried low sugar this time with having lactase tablet separately (example, tasty cheese) Didn’t work. Thought it may be high saturated fat. Then tried just a slice of low fat virtually no lactose light swiss cheese. No. Lactose free milk, no.

I could only find one dairy substitute product i can handle to a degree. Which is soy protein milk and then it’s really exasperating that they always add sugar to it. It really is a dead end there too...

There are probably also some ibs triggers for me that are really uncommon. You may find some of them to be mentioned on this or that websites seperately but never on the same source.

xjrs profile image
xjrs in reply toAghu

In relation to dairy products there is more involved than lactose. The fodmap diet says I should be able to tolerate cheese since cheese is low lactose. Cheese gives me IBS-D (which can take about 3 days to appear). I believe it is an intolerance to the casein protein which is also found in milk that I am reacting to. Milk products contain casein protein, whey protein and lactose sugar. It is possible to be intolerant to any of those components (the proteins have nothing to do with fodmaps). For instance I used to supplement with pure whey protein (which also contains calcium) which I was OK with. After a course of antibiotics whey protein gave me bad nausea, so there was something altered in my microbiome that made me no longer tolerant to it. I will also be calcium deficient on my current diet. There is so much conflicting advice around calcium that it is difficult to know what to do.

Here is the ibsnetwork.org advice which seems quite useful:

theibsnetwork.org/assets/fi...

- I am unable to tolerate some of the recommendations but I did used to be able to consume tofu without issue.

Personally I am stuck between calcium supplementation (I used to take this: lifeextensioneurope.co.uk/c... or calcium fortified foods. However, I've read about risks with calcium supplementation (e.g. cardiovascular).

This is an interesting study - but it is just one study and it doesn't look at risk factors:

yadda.icm.edu.pl/yadda/elem...

Analyses were conducted for calcium intake from dairy products linked with the consumption of calcium supplements and consumption of calcium- fortified food in respect to bone mineral density (BMD) of women (n=39) aged 34-56 years. A relationship was demonstrated between bone mineral density (BMD) of the women and calcium intake from dairy products, calcium-fortified food products and calcium supplements. Low BMD of the women resulted from a very low intake of calcium from dairy products and restricted use of calcium supplements and/or consumption of calcium- fortified foods. Appropriate calcium intake from dairy products was insufficient to reach high BMD values. The high BMD values of the women were determined by calcium intake from calcium-fortified foods and the consumption of calcium supplements, and – to a lesser extent – by calcium intake from dairy products with an average calcium intake.

Something I'll need to do more research on. Hey ho.

xjrs profile image
xjrs in reply toxjrs

By the way calcium can also be constipating.....Here is some advice on that here:

livestrong.com/article/4487...

Aghu profile image
Aghu in reply toxjrs

Thanks so much. Such a valuable response for me. I’ll answer in instalments until i’ve read all the content of the links.

The subjects we’ve been looking into seem to be very similar indeed.

As for dairy, what you’ve suggested was the most probable explanation that i was able to come up with too. Casein. But the contradiction there was (because I’m trying to find answers myself on websites) that there’s no info about such thing as ‘casein intolerance’. Casein allergy on the other hand is well known and has more prominent reactions. So it’s never added up for me. But now hearing you mention that.. yeah, perhaps rare then.

And, there was a time, about a year ago or so, i was actually able to eat lactose free yoghurt with no adverse effects. And i’ve been through a colonoscopy after that (and through these obvious prep procedures) , and never been the same far as dairy is concerned. I still wonder if there might be a way though. Some pre/probiotics so the microbiome will be altered in a way...

Just as a note, not missing all that breads and pasta/pastry and stuff but missing dairy (altogether) is where i’m struggling the most. And all the stuff i do to make up for calcium is way too expensive and forced. Yeah talking about cans with edible fish bones. And i’m still testing it but, soy protein may be interfering with thyroid function perhaps as I -seems to me so far- consistently lack energy next day. Lethargic, sleepy and such. But no d. So this soy milk is still the best bet for me. Btw,my blood counts are every time indicative of a slight hypo thyroidsm.

It’s no easy feat to be able to detect a trigger that shows its signs 3 days later. But for me, i don’t really think it would happen. Aside from the factors of cumulative effect or some wearing down following a repetitive use maybe. For instance, our subject dairy takes as little as 12 hours to reach to the end of gi tract. Of course i start to feel abnormalities way earlier than that.

I fear the side effects of cal supplements (will be reading further about it)

And i crossed off cal containing tofu before. Maybe there was other factors caused it on their own. Maybe it was the combined effect. And i fear retrying it. Prepping/cooking it was oh so very impractical to boot.

I am sure likely to be deficient on quite a few other things but calcium is the most obvious. You probably think the same for yourself.

xjrs profile image
xjrs in reply toAghu

Indeed. Until I can improve my diet further I take a low level multi-vitamin and mineral supplement: lifeplan.co.uk/shop/shop-by....

Mstlyharmless profile image
Mstlyharmless in reply toxjrs

The doctor I saw who was so enamored with the wheat belly book told me that milk products have ingredients that evoke a similar response to gluten intolerance and so they usuay suggest giving up milk and wheat. Personally Everytime I give up or start a food again any change in symptoms seems to be only momentary so I'm always back to where I started "my colon doesn't want any kind of food in it and it will damn we'll decide on its own when "

xjrs profile image
xjrs in reply toAghu

With fodmap reintroductions it recommends starting at one dose of a food, then increasing the next day and the day after. I did wonder if people who are as sensitive as us maybe need to try a small amount one day - then wait 3 days for symptoms. I do wonder if 'flooding' the system with the same item over a 3 day period, might make very sensitive people reject some foods that we might otherwise be able to tolerate on a rotation basis e.g. every 4 days. Eating on rotation not only could help with tolerance but would also help with diet diversification; this in turn could diversify the microbiome, which is good for your overall health. There is also the advice that your body or microbiome can get used to certain foods after a week or so i.e. the microbiome shifts to so that you have less symptoms, so maybe trying small amounts and then working through symptoms to see if they disappear might be another approach. I haven't trialed any of this yet myself.

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