Thursday, July 18, 2013

Finding my way through FODMAPs

(Image source)

This afternoon I had my long-awaited consultation with the dietitian to get to the bottom of my life-long battle with IBS. I was asked to keep a food diary for the week prior to my appointment. This might seem tedious and/or difficult for many people, but for me? Piece of cake. I've kept food logs off and on for years, so it was honestly no problem.

We had a long discussion about my history, symptoms and what I've already discovered about the types of foods that upset me. The dietitian agreed that wheat is 99% likely to be one of my intolerances; no surprise there. It's also not a big deal, because most of the time I don't eat the stuff. I'm a pro at making pancakes and other treats with oats, buckwheat, coconut or rice flour. My pantry is stuffed full of weird ingredients like quinoa flakes, xanthan gum, tapioca starch, chia seeds, potato flour and so on. No bread? No problem. I can't remember the last time I ate a sandwich for lunch anyway.

But even when I've gone completely wheat-free for months at a time, my symptoms haven't entirely disappeared. So we need to do some detective work and pinpoint what else is upsetting my poor old digestive system.

I gather that most people find the thought of an elimination diet terrifying, so the usual approach is to pick one or two likely groups of FODMAPs foods and cut those out to see what happens. Not me. The problem is that I regularly eat numerous foods from ALL of the groups, so it's impossible to deduce from my food diary and record of symptoms exactly what's giving my large intestine such a hard time. Plus, I really don't want to spend weeks eliminating one or two groups of foods only to find that my symptoms haven't improved and then have to go through it all again with other groups. So I'm going to take the hard-core approach and cut out all of them at once. Yay...  :o/

It's nowhere near as bad as it sounds. There are some foods that need to be avoided altogether, sure. But there are substitutions for many and for others, reduced quantities of the suspect food can be tolerated. So it's not like the super-strict six-day elimination diet I did a couple of years back where I could only eat about a dozen foods. Or even like the completely mental bodybuilding diet I did way back in 2006, which cut my allowable foods to chicken, fish, steak, three varieties of fruit, about eight veggies, oats, rice and plain yoghurt. I cannot believe I actually did that...

This time around, the things I have to avoid or minimise include:

Lactose - but lactose-free milk, some cheeses and some yoghurts are fine. Phew.
Fructose - lots of fruits & veg are OK, but some are off-limits, as is honey. No apples, pears, dried fruit, asparagus. *pouts*
Polyols - this one peeves me a bit because it means no erythritol for me. Bye-bye Natvia. Also? No mushrooms. Boo!
Fructans - the most difficult. Wheat, etc? No drama. Legumes & lentils? Meh. Who cares? But: Onions, garlic... *cries*

I'm still reading the notes and absorbing the information, but basically, I need to be quite strict about avoiding certain foods for six weeks (and keeping others to small portions) then go back to see the dietitian to sort out the reintroduction phase.

As some of my favourite foods are in the no-no category, I can't promise there won't be sulking.

It's unlikely that all of the FODMAPs are a problem for me - it's far more likely to be one or two of them, which is easily manageable.

Frankly, I'm heartily sick of spending many of my afternoons and evenings in pain, clutching a heat pack. I'm also sick of blowing up like a puffer fish to the point where I have to loosen my belt a couple of notches or undo the zip on my skirt. Not to mention the noxious emissions from my *ahem* nether regions. So if this process identifies my nutritional nemeses, it will be worth a few weeks of mild deprivation.

And on the plus side?  Chocolate is not on my no-go list. See? I knew it wouldn't be all bad.

Stay tuned. I'll let you know how it goes and will do my best to keep the whinging to a minimum.



Debstar said...

I agree with you, no onions or!
Hope they don't turn out to be the culprits. Best of luck.

Kek said...

I'm kind of hoping it's lactose, Deb - since I eat little dairy except yoghurt, it wouldn't be a big deal. There are low-lactose yoghurts, coconut yoghurt or lactase tablets you can take before eating lactose, so it's not like I'd have to go totally without it.

Onion is a total PITA. Quite apart from 90% of our savoury recipes containing it, onion powder is in EVERYTHING. Plus, it's the one thing I really have to completely avoid for this elimination stage - most of the rest won't be a drama if a tiny bit sneaks in somewhere. *sigh*

Sara said...

Could it be onion? I mean, you eat that all the time, but don't get IBS all the time...

Kek said...

Mmm, don't know. There ARE days when I don't eat any, or only tiny amounts, and there are actually very few days when I don't have any symptoms. There's some level of discomfort going on most of the time; I seem to have become so used to it that I barely notice unless it's more than "moderate" level.

I'm hopeful that it's something else. Not apples though. Please don't let it be apples.

Debbish said...

My doctor just gave me FODMAP info yesterday. I think I've mentioned that I'm constantly bloated and have constant diahhrea. All day. I talked to my GP yesterday and she suggested I read through the FODMAP stuff. I discovered years ago I'm lactose intolerant as well as coeliac but I do have some dairy type products, so I probably need to reconsider those... but like you I have onion and garlic every night. Without fail.

Kek said...

Perhaps you could try eliminating dairy, Deb and see if that sorts your problems? If so, there'd be no need to go any further. Lactose free milk and some yoghurts, plus a lot of cheeses are still fine. Brie, cheddar, parmesan, mozzarella, ricotta and feta are all OK according to my dietitian.

If my only intolerance turns out to be lactose, I'll actually be pretty happy. Shame about all the nice yoghurts and ice creams, but there's always coconut milk alternatives. :)

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