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I have a question: can the stomach become irritated by eating too little?
In the last two days I have cut down food to a minimum following D, which I think was caused by Soy. I am doing this to try and prevent a flare-up happening. I am currently on Entocort 3x per day and been on it for two months.
My current eating pattern is as follows:
Morning - a small amount of rice porridge and honey
Lunch - a banana
6pm - grilled chicken and rice or backed potatoe (and some wine)
During most of the day and after about 11pm I have some rumbling and bloating. But the odd thing is that after my 6pm meal (the most substantial) the rumbling and boating stops for a while. Do others have similar experiences?
all best, ant
Rumbling and when to eat?
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Ant,
Is the rice porridge GF? Honey is high fructose but bananas are allowed on the low FODMAP diet, but you could just have a banana sensitivity. Sometimes they make me feel bloated and were high normal on my MRT test.
Your stomach can be irritated by eating nothing - in clinical settings when people are NPO (nothing by mouth) too long they can develop stress ulcers. But this shouldn't apply in your case because you are eating.
Pay attention to what you eat and timing. Often we associate symptoms with the last thing we ate, but depending on the symptoms it could be a delayed reaction from a previous meal.
IMO, wine probably isn't helping either. I used to drink my fair share but gave it up and I do feel better.
Mary Beth
Is the rice porridge GF? Honey is high fructose but bananas are allowed on the low FODMAP diet, but you could just have a banana sensitivity. Sometimes they make me feel bloated and were high normal on my MRT test.
Your stomach can be irritated by eating nothing - in clinical settings when people are NPO (nothing by mouth) too long they can develop stress ulcers. But this shouldn't apply in your case because you are eating.
Pay attention to what you eat and timing. Often we associate symptoms with the last thing we ate, but depending on the symptoms it could be a delayed reaction from a previous meal.
IMO, wine probably isn't helping either. I used to drink my fair share but gave it up and I do feel better.
Mary Beth
Dear Pat and Mary Beth
Thanks for your replies. The "porridge" is called "Brown Rice Cream" (I call it "porridge" because that is what it reminds me of). The brand is Erewhon (U.S. Mills) and the ingredient is listed as 'Organic Brown Rice - not a sodium free food'. I am assuming it is GF but maybe I should check with them.
I will cut back on honey and wine.
and test out bananas over a few weeks on and off.
Is fructose in all fruit (I assume it is)?
Best ant
Thanks for your replies. The "porridge" is called "Brown Rice Cream" (I call it "porridge" because that is what it reminds me of). The brand is Erewhon (U.S. Mills) and the ingredient is listed as 'Organic Brown Rice - not a sodium free food'. I am assuming it is GF but maybe I should check with them.
I will cut back on honey and wine.
and test out bananas over a few weeks on and off.Is fructose in all fruit (I assume it is)?
Best ant
ant and Mary Beth,
Sorry but yes, fructose is in all fruit and a lot of vegetables. Also check labels. Ketchup, bbq sauce, drinks, the list goes on and on. My diet has changed drastically! I really miss fruit. But, I don't have gas and bloating and muscle aches. Now if I can just get rid of the D! It is better but not normal by any means. The low FODMAP diet doesn't work for me. I have to eliminate all sugar. I can tell when I ingest the least little amount - I get that gurgle and later the gas. And a lot of times the gas is accompanied by pain. Even Sue Shepherd (the Fodmap dietician) says that some have to avoid it all. That's me unfortunately.
Pat
Sorry but yes, fructose is in all fruit and a lot of vegetables. Also check labels. Ketchup, bbq sauce, drinks, the list goes on and on. My diet has changed drastically! I really miss fruit. But, I don't have gas and bloating and muscle aches. Now if I can just get rid of the D! It is better but not normal by any means. The low FODMAP diet doesn't work for me. I have to eliminate all sugar. I can tell when I ingest the least little amount - I get that gurgle and later the gas. And a lot of times the gas is accompanied by pain. Even Sue Shepherd (the Fodmap dietician) says that some have to avoid it all. That's me unfortunately.
Pat
Mary Beth and Pat
Thanks for your posts. I do not know at this point if I am fructose sensitive/intolerant. Apart from noting my symptoms are there any reliable tests?
Pat, that is a real pity you have to cut out all sugar. Getting energy must be a problem (apart from missing the pleasure of sweetness in food)?
Best wishes, ant
Thanks for your posts. I do not know at this point if I am fructose sensitive/intolerant. Apart from noting my symptoms are there any reliable tests?
Pat, that is a real pity you have to cut out all sugar. Getting energy must be a problem (apart from missing the pleasure of sweetness in food)?
Best wishes, ant
Ant,
The Erewhon Brown Rice Cream is gluten free, and everything-else-free, (it only contains brown rice).
All of us are different in many ways, of course, and that obviously applies to the way that sugar affects us, while we are healing. I too, had to avoid most sugars, while I was recovering. The only sugar that I could tolerate in any significant amount, was maple sugar - I have no idea why.
In my case, I believe that my issue with sugar was due to the leaky gut syndrome. The leaky gut syndrome can be caused by several different influences, but the most common cause is alcohol, and I believe the second most common trigger is sugar. In my case, I'm sure that it was sugar, because for most of my life, I routinely pigged out on sugar, and I never used alcohol. Anyway, since the leaky gut syndrome can prolong an MC flare, if I ate more than trace amounts of any common sugar, (except for maple sugar), it would make me sick for a few days. I was not particularly sensitive to fructose, in fact, I could drink a coke, (with high fructose corn syrup), with no problems, but if I drank two on the same day, it would affect me.
Incidentally, it's not easy to get a reliable test of fructose intolerance, due to the fact that it's a breath test, and as such, it relies on certain gut bacteria to generate a certain gas, by fermenting fructose farther down the GI tract than it would normally be digested. (IOW, if the fructose is split by enzymes in the duodenum, as the system is designed to do, then it should not be available for fermentation, farther down the GI tract, or so goes the logic. The problem is, any form of enteritis disrupts enzyme production, so the test will almost always indicate some degree of fructose fermentation, whenever anyone is having digestive issues, because as enzyme production is affected, some amount of fructose will not be properly split, so it will end up being fermented. The question is, "at what point do you consider the patient to have fructose intolerance?" That requires judgment expertise, that most lab technicians doing that test will not have. After the enteritis passes, of course, normal digestion of all of the fructose will once again resume. (Of course, it's true that the fructose is not being properly digested, while enzyme production is temporarily interrupted, but that is strictly a temporary situation, which will automatically resolve, when the enteritis passes). Another issue is SIBO, (Small Intestianal Bacterial Overgrowth). If the wrong bacterial balance is present in the small intestine, then a fructose breath test is not going to be reliable. Also, research shows that those tests tend to yield erratic results, because they require a high degree of skill in interpreting the test results, (the operator has to judge subtle differences in colors, when compared with a reference chart). IOW, one person might get an accurate test result, while the next, (done by another lab technician), might get a totally off-the-wall result. IMO, you're better off deciding something like that, by observing your own reactions to fructose.
The bottom line is, breath tests may be better than nothing, but they are far from an exact science. Anyway, FWIW, there's my biased view of the sugar issue.
Tex
The Erewhon Brown Rice Cream is gluten free, and everything-else-free, (it only contains brown rice).
All of us are different in many ways, of course, and that obviously applies to the way that sugar affects us, while we are healing. I too, had to avoid most sugars, while I was recovering. The only sugar that I could tolerate in any significant amount, was maple sugar - I have no idea why.
In my case, I believe that my issue with sugar was due to the leaky gut syndrome. The leaky gut syndrome can be caused by several different influences, but the most common cause is alcohol, and I believe the second most common trigger is sugar. In my case, I'm sure that it was sugar, because for most of my life, I routinely pigged out on sugar, and I never used alcohol. Anyway, since the leaky gut syndrome can prolong an MC flare, if I ate more than trace amounts of any common sugar, (except for maple sugar), it would make me sick for a few days. I was not particularly sensitive to fructose, in fact, I could drink a coke, (with high fructose corn syrup), with no problems, but if I drank two on the same day, it would affect me.
Incidentally, it's not easy to get a reliable test of fructose intolerance, due to the fact that it's a breath test, and as such, it relies on certain gut bacteria to generate a certain gas, by fermenting fructose farther down the GI tract than it would normally be digested. (IOW, if the fructose is split by enzymes in the duodenum, as the system is designed to do, then it should not be available for fermentation, farther down the GI tract, or so goes the logic. The problem is, any form of enteritis disrupts enzyme production, so the test will almost always indicate some degree of fructose fermentation, whenever anyone is having digestive issues, because as enzyme production is affected, some amount of fructose will not be properly split, so it will end up being fermented. The question is, "at what point do you consider the patient to have fructose intolerance?" That requires judgment expertise, that most lab technicians doing that test will not have. After the enteritis passes, of course, normal digestion of all of the fructose will once again resume. (Of course, it's true that the fructose is not being properly digested, while enzyme production is temporarily interrupted, but that is strictly a temporary situation, which will automatically resolve, when the enteritis passes). Another issue is SIBO, (Small Intestianal Bacterial Overgrowth). If the wrong bacterial balance is present in the small intestine, then a fructose breath test is not going to be reliable. Also, research shows that those tests tend to yield erratic results, because they require a high degree of skill in interpreting the test results, (the operator has to judge subtle differences in colors, when compared with a reference chart). IOW, one person might get an accurate test result, while the next, (done by another lab technician), might get a totally off-the-wall result. IMO, you're better off deciding something like that, by observing your own reactions to fructose.
The bottom line is, breath tests may be better than nothing, but they are far from an exact science. Anyway, FWIW, there's my biased view of the sugar issue.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Dear Tex
Thanks for the heads up on "Erewhon Brown Rice Cream". It is actually quite nice, especially if cooked slowly to get the "creamy" texture - it is the nearest I get to cream these days!
Thanks also for the info on sugar and fructose. I think for the moment I will try and experiment with different levels. The important thing is I am now more aware that it could be a problem (along with all the other possible problem foods).
Best ant
Thanks for the heads up on "Erewhon Brown Rice Cream". It is actually quite nice, especially if cooked slowly to get the "creamy" texture - it is the nearest I get to cream these days!
Thanks also for the info on sugar and fructose. I think for the moment I will try and experiment with different levels. The important thing is I am now more aware that it could be a problem (along with all the other possible problem foods).
Best ant
Ant,
I have a friend who is a dietitian in Australia. She recently went to a conference with Sue Shepherd, who did the original FODMAP work. Here's the list of foods she gave me (foods they actually tested). There seems to be be alot of FODMAP info floating around the internet that isn't accurate. They are doing ongoing research to add to the list below.
Acceptable fruits: Banana, kiwiw, strawberries, orange grapefruit, blueberry, raspberry, rhubarb, lemon, mandarins, papaya, pineapple, tangelo, grapes.
Acceptable vegetables: Bok choy, bell pepper, green beans, carrot, celery, chives, cucumber. eggplant, endive, potato, zucchini, winter squash/pumpkin, green part of spring onion, ginger, olives, parsnip, tomato, coral lettuce, iceburg lettuce, swiss chard
Cane sugar may be used (not honey, agave) so some desserts like GF cake or cookies might be tolerated OK in small amounts.
The key is to start with very small servings. An important concept is that the effect is additive, so you really need to watch amounts.
Take care,
Mary Beth
I have a friend who is a dietitian in Australia. She recently went to a conference with Sue Shepherd, who did the original FODMAP work. Here's the list of foods she gave me (foods they actually tested). There seems to be be alot of FODMAP info floating around the internet that isn't accurate. They are doing ongoing research to add to the list below.
Acceptable fruits: Banana, kiwiw, strawberries, orange grapefruit, blueberry, raspberry, rhubarb, lemon, mandarins, papaya, pineapple, tangelo, grapes.
Acceptable vegetables: Bok choy, bell pepper, green beans, carrot, celery, chives, cucumber. eggplant, endive, potato, zucchini, winter squash/pumpkin, green part of spring onion, ginger, olives, parsnip, tomato, coral lettuce, iceburg lettuce, swiss chard
Cane sugar may be used (not honey, agave) so some desserts like GF cake or cookies might be tolerated OK in small amounts.
The key is to start with very small servings. An important concept is that the effect is additive, so you really need to watch amounts.
Take care,
Mary Beth
Mary Beth
Brilliant. Just what I was looking for. The research I was reading - Clinical Ramifications of Malabsorption of Fructose and Other Short-chain Carbohydrayes (Jacqueline Barrett and Peter Gibson) - seemed to be telling me what I should consider avoiding, but not a list of what could still be acceptable (even if in small amounts).
Thanks ant
Brilliant. Just what I was looking for. The research I was reading - Clinical Ramifications of Malabsorption of Fructose and Other Short-chain Carbohydrayes (Jacqueline Barrett and Peter Gibson) - seemed to be telling me what I should consider avoiding, but not a list of what could still be acceptable (even if in small amounts).
Thanks ant
Mary Beth,
Thank you for the updated list. I found another "acceptable foods" list that seemed to contradict some of the suggestions from the original authors. For example, mandarins are not acceptable on the other list I have. A list from the person who did the original FODMAP work helps a lot.
I've eliminated almost all fruits from my diet, but this list gives me some fruit I can test.
I'm curious about the lettuce. Have you tested this? Most of us aren't able to eat lettuce until our guts are healed, but if iceberg lettuce is acceptable, it would open up a lot of options.
Gloria
Thank you for the updated list. I found another "acceptable foods" list that seemed to contradict some of the suggestions from the original authors. For example, mandarins are not acceptable on the other list I have. A list from the person who did the original FODMAP work helps a lot.
I've eliminated almost all fruits from my diet, but this list gives me some fruit I can test.
I'm curious about the lettuce. Have you tested this? Most of us aren't able to eat lettuce until our guts are healed, but if iceberg lettuce is acceptable, it would open up a lot of options.
Gloria
You never know what you can do until you have to do it.
Gloria,
I have not tested lettuce yet - it was high reactive for me on my MRT test, so that's a ways off. Keep in mind there could still be individual sensitivities. For example, my dietitian friend who is on the diet found she could only tolerate very small amounts of eggplant or pumpkin, but was OK with everything else. With the mandarins I am assuming they mean fresh clementines, not canned in syrup. I have found that onions, coconut milk, and avocado were particularly rough on me. Hopefully once I heal I will be able to tolerate those things again.
I have incorporated FODMAP into my MRT diet and it seems to be working quite well. Norman has been visiting regularly and I have not had other food reactions (GERD, swallowing issues/itchy mouth/throat etc). I will give a complete update in a few weeks, but I am hopeful I am going into remission.
Mary Beth
I have not tested lettuce yet - it was high reactive for me on my MRT test, so that's a ways off. Keep in mind there could still be individual sensitivities. For example, my dietitian friend who is on the diet found she could only tolerate very small amounts of eggplant or pumpkin, but was OK with everything else. With the mandarins I am assuming they mean fresh clementines, not canned in syrup. I have found that onions, coconut milk, and avocado were particularly rough on me. Hopefully once I heal I will be able to tolerate those things again.
I have incorporated FODMAP into my MRT diet and it seems to be working quite well. Norman has been visiting regularly and I have not had other food reactions (GERD, swallowing issues/itchy mouth/throat etc). I will give a complete update in a few weeks, but I am hopeful I am going into remission.
Mary Beth