IBS-C, IBS-D and My Take on Their Relation to Diet
My IBS-C diagnosis in 2016 gave the false impression that this form would be the one I’d have to manage indefinitely. For the longest time I was stuck in constipation, no pun intended, and I kept generous supplies on hand of Smooth Move tea and Miralax. But one year after diagnosis, my bowel pulled a switcheroo to diarrhea.
If we truck with the literature, diet is the culprit. Our gastroenterologists point us in the direction of food management as the main treatment strategy. For me, it’s been an exercise in frustration. Although studies have shown that diet is the trigger for IBS symptoms worldwide, there is scant evidence of a direct connection between food and IBS.
Is there a direct connection between food and IBS?
Gastroenterology researchers and I share a common attitude: This is a problem. More studies need to be done to pinpoint cause and effect, which I can safely guess will not be a straight line between two points. The problem with my situation is that the transition from constipation to diarrhea did not involve a change in diet. I was eating exactly the same thing before, during and after. My frustration escalates every time I read a patient’s revelations about the mystery solved in their own case, cementing the theory that if you work hard enough to isolate that one pesky food and eliminate it, your bowel will restore itself to normalcy. This is not my experience. In the beginning, it seemed as if it might be.
Nothing works for my IBS symptoms
Initially I identified high fiber veggies such as cruciferous plants---mainly cabbage and broccoli---as food to avoid. I couldn’t tolerate high fiber and suffered level 10 pain from gas along with uncontrollable flatulence, bloating and abdominal distention. It went against the one-size-fits-all advice we all read that if we suffer from constipation then we must not be getting enough fiber. I stuck to eating low-fiber veg, fish, chicken, turkey, and protein-rich dairy. The painful gas and flatulence subsided, but I was still constipated. I tried fiber supplements with disappointing results. Swallowing peppermint capsules, Bean-o, and other gas-busting supplements did nothing to flatten my abdominal distention and painful bloated feeling.
Another discovery was that eating starch such as a bowl of pasta could plug me up even worse. But no matter how I balanced simple carbs with complex carbs, these adjustments didn’t restore my bowel function. Now, with IBS-D, I can delay diarrhea with pasta or Imodium, but after the first bowel movement, I quickly return to loose stools. As it stands, everything I eat is a trigger, my symptoms don’t come and go. They just follow a circular track. Every approach I've explored has turned up a big fat zero.
In the beginning, I followed the directions: eliminate dairy and gluten and see if you feel better. But there was no difference. I took a probiotic for a year and it didn’t do squat—and no, it wasn’t the wrong strains and too few bacteria, it was exactly what was recommended. I did fine with cottage cheese and Locatelli Pecorino Romano and mozzarella. Eating gluten-free pasta felt no better than semolina. I did fine with strong coffee and a scotch on the rocks. Two years later, these things remain unchanged. There is, however, a connection to diet that resonates with me more.
In the article “Is Diet Related to IBS No Matter Where You Live or What You Eat?” the authors discuss IBS patients’ various diets in Japan, China, Southeast Asia, South Asia, South America, and those who use some form of a Mediterranean diet. The overarching points are that:
- As varied as diets are across these cultures, diet is a trigger, and
- A common treatment strategy is food avoidance, including fasting.1
It is the second point I embrace. In my own experience, the only way I have reduced my symptoms is by not eating. The less I eat, the better I feel, the less my tummy swells. But this is hardly a solution. I would have to eat so little that I wouldn’t get enough calories to stay healthy, not to mention I’d be hungry all the time.
I am far from finding answers. So many ingredients make up my particular stew that I'm wary of stirring the pot. I have multiple sclerosis, among other things. The approach I’m taking now and pursuing throughout 2019 is exercise. It won’t cure IBS, MS, or any other acronyms, but it will improve my general health. Right now that’s all I can hope for.
Is gluten a trigger for you?