Friday, April 4, 2014

What is IBS, and what am I gonna do about it?

Last week I shared with you that this blog would be headed in a slightly different direction and that I would be focusing on improving my digestion. This week I want to share a little more about IBS and my plan for tackling it. 

Years ago my gastroenterologist had indicated that I had a "functional" problem, because none of the tests (endoscopy and colonoscopy) showed any physical signs of damage or inflammation. I strongly suspect that, after all these years of dealing with a variety of symptoms, I have Irritable Bowel Syndrome.

So what is IBS exactly? According to the NIH (National Institute of Health):

"Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning symptoms are caused by changes in how the GI tract works. People with a functional GI disorder have frequent symptoms; however, the GI tract does not become damaged. IBS is a group of symptoms that occur together, not a disease. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a person's imagination."

Rather than quote the entire website, which by the way does an excellent job of describing the condition, I would simply direct you there, if you're interested in knowing more. Click here for more information.

Estimates show that anywhere from 10-15 million Americans suffer from unexplained digestive problems that could be considered Irritable Bowel Syndrome.

So what can one do about it? The NIH recommends the following:
  • making changes to one's eating, diet, and nutrition
  • taking medications (if needed)
  • taking probiotics
  • exploring therapies for mental health
Hippocrates said, "let food be thy medicine and medicine be thy food", and I have always believed this. I also realized that just "eating healthy" wasn't going to be enough, because I was doing that and things weren't improving. I knew that I'd have to make some changes to my diet, so following the first NIH recommendation was a given. 

My internet research on diets for IBS led me to a variety of sites that kept talking about FODMAPs. WebMD covered it, as did the Irritable Bowel Syndrome Group Forum, the IBS Information Page on, and of course, there's even "an app for that".  But what in the world are FODMAP's? 

FODMAP stands for:

"Short-chain carbohydrates (oligosaccharides), disaccharides, monosaccharides and related alcohols that are poorly absorbed in the small intestine. These include short-chain (oligo-) saccharide polymers of fructose (fructans) and galactose (galactans), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols) such as sorbitol, mannitol, xylitol and maltitol.

The term FODMAP is an acronym, deriving from "fermentable, oligo-, di-, mono-, saccharides and polyols". The restriction of these FODMAPs from the diet has been found to have a beneficial effect for sufferers of irritable bowel syndrome and other functional gastrointestinal disorders (FGID). The low FODMAP diet was developed at Monash University in Melbourne, Australia by Dr. Peter Gibson and Susan Shepherd, PhD."

I promptly went on Amazon and bought this book by the creators of the diet. Though there are many books on IBS out there, I wanted to hear this news directly from the people who developed it. I read their well-written and detailed explanation of the diet, how it works and why, and it convinced me to give it a try. 

In short, this pdf provides a quick and dirty list of what to eat and not to eat. But I would advise you to read the book, or any book on the subject, to better understand how and why this might work for you.

So I started the other day. The hardest thing for me, believe it or not, is giving up onions and garlic. I cook everything in onions and garlic. You know - I love FLAVOR! The second hardest is giving up the high-lactose dairy products I count on for protein (like cottage cheese and yogurt) and half and half in my coffee. Gluten is no big sacrifice, since I'd already more or less given that up anyway. But, I want to feel better, so I'm ready to do whatever it takes.

The book also has recipes. The very first recipe sounded really good to me and it was. (I violated another rule of IBS sufferers: don't eat too much at one meal as this puts strain on the digestive system. I couldn't help myself - they were just too good)! This recipe serves 3-4. 

Pumpkin, Chive and Feta Fritters

10 oz. fresh pumpkin or other winter squash, cut into 3/4 inch cubes
(or use a can of pumpkin. See note below)*
1/3 cup fine rice flour
2 Tbsp. cornstarch
1/2 tsp. xanthan gum 
1/4 cup chopped chives
1/2 cup crumbled feta
2 eggs, lightly beaten
1/2 to 1 tsp. ground cumin
salt and freshly ground black pepper
2 Tbsp. oil
3 Tbsp. light sour cream if you're not lactose-intolerant
Garden Salad 

Cook the pumpkin in a medium saucepan of boiling water for 8-10 minutes until soft, then drain and mash*. Allow to cool.

Sift the rice flour, cornstarch, and xanthan gum into a large bowl, whisking to ensure they are well combined. Add 2 Tbsp. chives, the feta, mashed pumpkin, eggs and cumin and mix well. Season with salt and pepper.

Heat 1 Tbsp. of the oil in a medium skillet over medium heat until good and hot. Add a heaping tablespoon of batter per fritter and cook 3-5 minutes. Flip over and flatten with the back of a spatula cooking for another 3-4 minutes until golden brown and cooked through.

Transfer the fritters to a plate and and keep warm while cooking the rest with the remaining oil. Mix together the sour cream and remaining tablespoon of chives. Serve the fritters with a nice big garden salad and a dollop of the sour cream. I skipped the sour cream because I am avoiding nearly all dairy at the moment.

* If you're short on time, you can always open a can of pumpkin, which is what I did. If you do this, you may need to add a little more starch. Make sure your batter isn't too wet after mixing everything together. I added a little sorghum flour that I had on hand.

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