Normally I don’t like to share my personal stuff here on the World Wide Web, however, once in a while I come across something that I think, if I share this with the world, maybe, just maybe, it will help someone else. In this article, I want to share with you my very personal (and embarrassing) experience with irritable bowel syndrome (IBS), and a way to help diagnose and manage further episodes of diarrhea and stomach upset.
My “tummy troubles” started when I was in my early 20’s. I was in university and I remember having cramps and diarrhea that would seem to come out of nowhere. Sometimes it was worse when I felt stressed, but it usually took me by surprise. I usually had little warning and a short amount of time before I needed to relieve myself. It was embarrassing, and I remember once when I was working with Home Care, I had to use a client’s bathroom. Another time, I had to cancel a support group I was running because I was suddenly taken over by vomiting and diarrhea.
The doctor I saw at the time recommended I have a colonoscopy to determine if there was anything going on such as colitis. The results came back as “minor irritable bowel syndrome.” I am not sure how that was determined, but for me, it was more than minor. I had also been tested for celiac disease (gluten allergy), and that test came back negative.
Fast forward to 30 years later, plus a bout of chemoradiation for anal cancer, I was really desperate to figure out how to control this irritable bowel. My sphincter muscles are no longer as strong or healthy as they used to be (imagine your bum being put into a microwave oven and fried!) so my IBS symptoms are much more concerning. The control I had before is now at half the strength it used to be (I’ve never lost control, thank God!). I asked my doctor once again for a referral to a specialist, this time to a gastroenterologist (GE).
I saw the GE in April 2019. He recommended I go on a low-FODMAP diet. He told me about a mobile app I could use on my phone. He then said he would schedule a flexible sigmoidoscopy and a biopsy for microscopic colitis. He also took a blood test to check for celiac disease.
When I went home, I looked up low FODMAP. I had heard of this before, but I was not totally sure what it was. I came across the Monash University in Australia and found out they have done a lot of work in the last 12 years on helping people manage their IBS. They had an app that cost around $10 CAD, and from the reviews I had read on it, it was something I felt I could really get some good use out of. I purchased it and never regretted it. It is something I use regularly. I can look up things for my friends, too!
FODMAP (pronounced “fawd-map”) stands for a group of carbohydrates found in foods – Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Many people (about 10-15%) find these types of ingredients hard to digest, therefore, causing an abdominal upset. These symptoms include abdominal pain, bloating, gas, nausea, diarrhea, constipation, and could include a combination of any or all of these. For me, it can get so severe, that I also vomit. This may be too much information for some of you, but unfortunately at times, when I am having a bad “attack,” my body expels my stomach and bowel contents at the same time. I have it “coming out of both ends.” It is very quick and short-lived. I feel better soon after these attacks. So, I get it pretty bad sometimes.
The low-FODMAP process includes eliminating all foods that have the FODMAP irritants until all symptoms noted above are gone. The foods fall into different categories: Fructose, Lactose (many people are lactose intolerant), Mannitol, Sorbitol, GOS, and Fructan. This process can take two to six weeks. For me, it only took a couple of weeks. My family was very supportive and I avoided eating out. Once symptoms are under control, then you start reintroducing each of the foods to see if it triggers a response. There are “safe serving sizes” for each food that are very helpful.
For me, it turns out I am sensitive to GOS –- Galacto-oligosaccharides. These are found in foods such as nuts, beans, legumes, wheat, and grains. I found out quickly that I can only handle 8-10 pistachios or almonds at a time and I need to wait a few hours between having these foods again, in fear of “stacking” and causing an attack.
All those years I thought I was eating healthy (12-grain bread, almonds, cashews, pistachios, legumes, etc.) turned out to be one of the worst things I could be doing for my body. Thirty years of suffering, not understanding why I was having so much trouble. One time I remember calling a restaurant to say I was sure I had food poisoning. Looking back now, it was probably just an IBS attack.
By June of 2019 (two months later) I was feeling I had a handle on my diet. I had also seen a dietician for nutrition counselling, and I had a Nutrigenomix DNA test to help me personalize my dietary approach. I had also started intermittent fasting and tried out the ketogenic diet for a bit.
Overall, the low FODMAP diet and Monash University FODMAP Diet app changed my life, for the better. Every once in a while I have an upset, and I go to the app or I find out what the ingredients were in a meal I ate. I am still learning as I go, and unfortunately, durum wheat semolina pasta with a side order of brioche garlic bread is the equivalence of dynamite for me. Enzyme therapy is another option that I could consider to help manage my GOS sensitivity. I am looking into this.
I am hopeful that research will continue and the lives of people with IBS with improve. Although it is not a cure-all, considering doing a low-FODMAP diet to help improve and manage your “tummy troubles” is highly recommended. Working with your healthcare professionals and specialists is also important.
Angela G. Gentile, MSW, RSW
For more info: www.AngelaGGentile.com