lifting_heavy_things | dietary downer

dietary downer

No matter how great the rest of my body feels when I'm eating fewer carbs and more protein and vegetables, my guts HATE it. My IBS has gotten so much worse in the past two years. I'm now on yet another medication to try to control it, but the thing that helps the most is just not eating anything with fiber, especially vegetable fiber. Low-fiber vegetables include cucumbers and zucchini. (Before anyone asks, yes, I've been tested for celiac disease and I've been thoroughly examined inside for IBD, and I don't have those things.)

I was sort of limping by and still eating other things that I really love, like kale (well cooked), carrots, a few bites of sweet potato (any more than that and I'd pay), green beans, spinach, gai lan, bell peppers...all the good stuff. But then I came down with norovirus and couldn't eat much of anything for a couple of days, and it went on and on for most of a week during which I survived on toast and frozen french fries (anything I could keep down/in, really). I saw my doctor near the end of this period, for the purpose of discussing new meds and getting the prescription, and he said that if I'm unable to tolerate the meds I could "consider the Atkins diet." ACK. I think this will actually not work for me, because Atkins allows all kinds of stuff that my gut won't tolerate, such as broccoli and garlic. Later I talked with a sympathetic co-worker who has similar IBS and she let me know some of her diet survival skills, which include eating no vegetables except lettuce, spinach and carrots, extremely small amounts of fat, and lots of white refined carbs, because even brown rice or a slice of wheat toast gives her hellacious pain. Is this my next step? My husband, a biologist, points out that I'll "get cancer" eating like this.

I just want to have a nice chopped salad and a big piece of fish; is it so much to ask? Apparently it is, because a meal like that means 24+ hours of cramps, pain, gas that stays in my clothes for up to an hour, and numerous runs to the bathroom. Imodium slows but does not stop it. This makes a lot of activities hard, such as working my office job (my poor co-workers, OMG) and going to the gym (hard to deadlift if you've got the runs). So ever since I got sick, even though I'm not in bed anymore, I've continued eating like an invalid: toast, pretzels, rice, baked potatoes (no skin), cheese and yogurt. I tried eating an egg and ended up with nausea for an hour. I made a burger one night and was up half the night dealing with the side effects. So, essentially sick-people food. Eating like this, I have almost no pain, and no other symptoms.

The thing that bugs me the most: how am I going to maintain a healthy weight and muscle mass as I get older (I'm 48 now) and get stronger, if I have to live on white carbs and cheese? I have seen several dietitians in the past few years, all of whom have answered, "Gosh, I don't know."

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That sounds incredibly hard to manage. You have my sympathies. I think finding a good dietician versed in IBS would be essential for short and long term management as most doctor's don't have enough training in nutritional support.

Luckily for humans, as omnivores, we can exist and survive on a wide variety of diets. Our bodies can make muscle from fat and carbs and most foods (even potatoes) contain protein.

Since you posted to ask -- I'd suggest using an app like "food allergy detective" to get a better list of what's tolerated (I know IBS isn't the same, but the app's a symptom tracker) and as for the trying to get more antioxidants, I'd talk to a dietician about what sweetmeats (organ meats) may be tolerated if you're open to trying them. Sweetmeats are way more nutritious than muscle meat and can have more vitamins, etc. than vegetables and fruits. It's why many hunter-gatherer societies can survive and thrive.

Thanks! In general I am not crazy about the texture or the odor of organ meats, particularly with no onions or garlic (and I married into an Asian family, so I have had plenty of opportunities to develop a liking for them). If I can figure out some way to get them down the hatch...

I avoid most organ meats myself, so I hear you there. About the only thing I eat is chicken liver (and chicken heart if it is in the chicken packet when I get it).

I really like chicken liver for some reason (when cooked it reminds me of a tasty mix of mushrooms and cheese curd) and I hate beef liver. Totally different to me. My mom told me I used to get it from her when I was as young as 5, so not a new thing.

Kidneys, to me, smell like urine. It's got to be totally psychological but that does make me reluctant to eat them. I'm guessing they're more passable in a steak and kidney pie. Which I have Nigella's recipe for, and naturally it has loads of onions!

For the record, I do love onions and I miss the way they give body to a dish. I can sub in asafoetida when I'm making chili (zucchini, not beans; carefully seeded tomatoes, etc.) but the finished product has the wrong texture. Although at least I can tolerate it.

I love to cook, which makes this even less fun.

FWIW, I looove a lot of offal and have various recipes (including some without onions or garlic).

It's not the first thing I'd recommend reintroducing, because most offal is pretty rich and that can be hard to digest when you're recovering from any kind of stomach illness -- if eggs are still making you nauseous, liver certainly will.

But if you get to the point where you want to try offal, I'd be happy to have my brain picked.

Oh, that is so annoying.

You have been seeing enough doctors about this, with little effect -- am I reading that right?

I would suggest, eat what becomes you. Everything else won't make you healthier, and probably won't help you become more athletic or maintain your weight. You'll "get cancer" if you don't make youself sick? Sorry to say that, but your husband has a strange sense of humour.

Sometimes one can start with things one likes but cannot digest well in small doeses, well-cooked and well-chewed. Maybe some specific supplements can help, either help you digest, or make up for lack of micronutrients throuh a limited diet. A good nutritionist might be able to help. There are a lot of snakes oil salespersons out there, unfortunatly.

AFAIK keeping muscle mass is more a thing of training and of sufficient food than of optimizing macronutrients (unless you are competing). Cheese, especially half- or low fat cheeses and sour milk cheeses have a lot of protein. Potatoes, well, whole peoples have been living on a diet of mostly-potatoes, as plant-based protein source they are not bad.

I have a link to a web page, in German, unfortunately, where you can have your diet analyzed to the last micronutrient. There has to be something similar in English. You could use it to get most out of those things you can eat.

I seem to remember reading some, hm, kind of "tough gal"-approach to IBS on gokaleo, but I cannot seem to find it anymore. Might be worth looking for it.

Take it slow, don't hurt yourself by eating things your body is not ready for, and, sometimes it gets better if you do not force it.

ETA: Wasn't at gokaleo, was at Your Eatopia: Tummy Troubles. I cannot evaluate the quality of the source, so just throwing it in here.

Edited (ETA) 2014-02-28 20:05 (UTC)

Ah, yes--this sounds so much like my mother's friend Barbara, who developed all kinds of "food sensitivities" after chemotherapy and has only recently decided to eat some foods she used to like because avoiding them wasn't making her better. It's interesting reading, though.

I'm doing it kind of backwards, I think--I've been pushing through the pain for years and have decided to step back from eating some things rather than constantly living in pain! Avoiding carbs and enthusiastically eating nuts, garlicky homemade paleo-friendly curries and vegetables I'd always dreamed of, unfortunately, wasn't the right strategy.

In an amusing twist, it appears that I picked up some kind of 24-hour bug when I ordered in a regular, normal turkey sandwich on normal bread with regular lettuce and tomato. That was Wednesday; I'll spare you a description of Thursday and Friday. HAHAHAHA! I don't think it was what I ate, I think what I ate was contaminated. Darn it. I wanted that sandwich.

*hugs* That sounds extremely frustrating. Just wanted to mention that I've heard a lot lately about something called the GAPS diet, do you know of it? From what I understand it's a dietary protocol to help heal damaged and/or very irritated guts, involving low fiber and bone broth. Chris Kresser talks about it on his podcast often. His website has a lot of info about digestive issues & there's also a user forum there that might be helpful.

Have you ever checked that diet out? It's interesting. Unfortunately, it relies on things I can only eat in small amounts, like nuts, avocados, sauerkraut, and fruits high in fructose. The induction diet is great, all you eat is meat and broth. Next, you start on raw egg yolks--cooking them is not permitted. It's pretty intense! I'm not sure where I'd find eggs safe to eat raw.

I totally miss nuts--when I was eating closer to paleo, I baked with almond flour, I ate them for snacks, I put them in salads...I still have them in the cupboard but I eat like 3-4 nuts a day max. Right now I have a teenager at home, but when she goes off to college I'll probably quit buying avocados, because my husband doesn't eat them and I can eat maybe 1/4 of one per day. I know you can freeze them for stuff like guacamole, but I can't eat the onions!

I wonder if the induction diet would promote healing to an extent that you could then tolerate more of the foods that you couldn't before? I definitely share your concern about raw eggs. I think I'd only eat them if they came direct from a farmer I trusted.

Didn't know you could freeze avocados. I'll have to try that.

Oh--forgot to mention I have a friend who had IBS pretty bad, she ended up having good results with something called the Specific Carbohydrate Diet which I believe is grain free & dairy free.

Before anyone asks, yes, I've been tested for celiac disease

FWIW, it's increasingly looking as if non-celiac gluten sensitivity may be a real entity:

http://celiacdisease.about.com/od/glutenintolerance/a/Gluten-Intolerance-Research.htm

(Obviously you may already have established that gluten isn't a problem for you.)

My husband, a biologist, points out that I'll "get cancer" eating like this.

Apparently evidence on that now seems to be more equivocal than previously thought:

http://www.webmd.com/diet/fiber-health-benefits-11/fiber-cancer

The protective effects of fibre seem to be specific to cancers of the digestive tract, and even then, it's not clear.

So if you find you need a low-fibre diet long-term, it's not a sentence of doom.

So ever since I got sick, even though I'm not in bed anymore, I've continued eating like an invalid

How long have you been recovered for? Maybe your digestive tract is still recovering from the norovirus and needs the "invalid diet" for a while longer while it heals, but will then allow you to get back to your previous less-restrictive diet.

The thing that bugs me the most: how am I going to maintain a healthy weight and muscle mass as I get older (I'm 48 now) and get stronger, if I have to live on white carbs and cheese?

Can you tolerate whey or other protein powders at all?

And cheese and yoghurt can be good protein sources. I particularly love Greek (strained) yoghurt; much higher protein, serious creaminess, and friendly bacteria. It's the basis of my standard breakfast.

You might need to take a multivitamin supplement and watch out for micronutrients you may be missing. It seems like getting enough "good fats" may be the biggest problem.

(Obviously you may already have established that gluten isn't a problem for you.)

Gluten-free as part of a recommended low-FODMAP diet all last summer, about 8 weeks. No improvement.

I do like yogurt and I can tolerate about 4 ounces a day as long as I'm not eating cheese that day. Too much dairy is ouchy!

I'm hoping I am just recovering and things will get better soon! I felt totally dreadful all day...

Gluten-free as part of a recommended low-FODMAP diet all last summer, about 8 weeks. No improvement.

Aaargh, how frustrating. Worth doing, I guess, as something to rule out, but how frustrating nevertheless.

I'm hoping I am just recovering and things will get better soon!

Fingers crossed!

Belated thought:

the thing that helps the most is just not eating anything with fiber, especially vegetable fiber.

What about getting one of those juicers that people don't like because they extract so much of the fibre? *g* I'm wondering if you might be able to tolerate some vegetables juiced, and get some of the micronutrients that way.

Green tea and various herbal teas might also be good sources of anti-oxidants, if you can tolerate them.

I can tolerate all kinds of tea, and coffee! Just not fiber and FODMAPs. Maybe I will contact Kate Scarlata, the online FODMAP dietitian, to ask her advice before I invest in a juicer. It had occurred to me too, but sorting through the various vegetables trying to find those with juice that won't kill me...I admit, it's a little overwhelming.

sorting through the various vegetables trying to find those with juice that won't kill me...I admit, it's a little overwhelming.

Yes, it must be. I have something which is probably interstitial cystitis (no official diagnosis because that requires a biopsy, which my doctor and I agreed not to go for since it's mostly controlled by diet), so I am not unfamiliar with the "ooh, let's see if this will cause a horrible reaction" game. Not to mention the "guess which of the things I ate was the one which sent me to the bathroom at 15-minute intervals all through the night" game.

It might be an option to stick with the "invalid diet" for a few weeks more --"almost no pain, and no other symptoms" is not a small deal, and it gives your digestive tract more time to heal, and you some time when you're not having to think about this stuff. Then you could start adding in other things again, beginning with things you could tolerate before.

It may not be nutritionally optimal, obviously (without supplementing protein and vitamins, at least), but a couple of weeks of it isn't long enough for major deficiencies to set in.

Hopefully it's a temporary blip caused by the virus, and you can at least get back to enjoying some of the things you could manage before.

Hopefully it's a temporary blip caused by the virus, and you can at least get back to enjoying some of the things you could manage before.

Yes...and maybe it's an opportunity to get more precise about what really makes me the sickest. I was just eating-things-anyway and living with some pretty nasty symptoms for many months before virus, but the doctor did point out that this was not much of an improvement. He still thinks medication is going to help.

Yes...and maybe it's an opportunity to get more precise about what really makes me the sickest.

Good point. You can treat it as an elimination diet.

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