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12 Foods to Avoid with IBS

12 Foods to Avoid with IBS

A healthy diet generally consists of eating a wide variety of nutritious foods in moderation. If you have irritable bowel syndrome (IBS), you may notice your symptoms are triggered after you eat certain foods.

Symptoms can vary between people, so there’s no one list of off-limit foods. But by avoiding some of the most common triggers for IBS symptoms, you may notice more regularity, fewer cramps, and less bloating.

Keep reading to find out which foods could be making your IBS more uncomfortable.

1. Insoluble fiber

Fiber adds healthy bulk to the diet. Whole grains, vegetables, and fruits contain fiber. Although fiber tolerance is different for different people, insoluble fiber may cause or worsen diarrhea in some people with IBS.

Focus on soluble fiber instead. Keep in mind that insoluble fiber may relieve constipation, but it can also make you feel bloated.

Foods with soluble fiber include:

  • grains, like oatmeal and barley
  • root vegetables, like carrots and parsnips
  • fruits, like berries, mangos, oranges, and grapefruit
  • legumes, like peas

2. Gluten

The insoluble fiber content in whole grains may cause IBS symptoms. Certain grains can cause other problems — namely rye, wheat, and barley, which contain gluten.

Gluten is a type of protein some people are allergic to. This condition is known as celiac disease. It can cause symptoms like those of diarrhea-predominant IBS.

Celiac disease is an autoimmune disorder that occurs in some individuals as a reaction to the ingestion of gluten. It can cause changes in the intestinal cells resulting in poor absorption of nutrients.

Some people have gluten intolerance without the immune response or changes in the intestinal cells. This is known as non-celiac gluten sensitivity. People with this condition may experience the same negative side effects and gastrointestinal symptoms of gluten ingestion as those with celiac disease.

Many people with IBS are also gluten intolerant. Some studies have shown that gluten sensitivity may be involved in the development of IBS symptoms for some people, and gluten-free diets may improve these symptoms. However, everyone is different. Discovering how gluten affects IBS will be based on the individual.

The good news is that more gluten-free products come onto the market every day. If you can’t do without pizza, pasta, cakes, or cookies, you can always substitute them with gluten-free options.

3. Dairy

Dairy is problematic for two reasons. First, it contains fat, which can increase diarrhea. You may need to switch to low-fat or nonfat dairy to lessen symptoms. And second, many people with IBS are lactose intolerant. If you’re lactose intolerant and have IBS, you might want to consider dairy alternatives like rice milk and soy cheese.

If you need to cut out dairy completely to make your life more comfortable, consider asking your doctor if you need a calcium supplement.

4. Fried foods

French fries and other fried foods are a staple in the typical American diet. Moderation is the key with these foods. The high-fat content may be especially hard on the system for people with IBS. Frying food can actually change the chemical makeup of the food, making it more difficult to digest. Consider grilling or baking your favorite foods for a healthier option.

5. Beans and legumes

Beans are generally a great source of protein and fiber, but they can cause IBS symptoms. While beans can increase bulk in the stool to help constipation, they also increase gas, bloating, and cramps. If you’re like most people with IBS, you’ll want to add beans to your list of foods to avoid.

6. Caffeinated drinks

Some people swear by their morning coffee for digestive regularity. But like all caffeinated drinks, coffee has a stimulating effect on the intestines that can cause diarrhea. Coffee, sodas, and energy drinks that contain caffeine can be triggers for people with IBS. If you need an energy boost or pick-me-up, consider eating a small snack or going for a quick walk.

7. Processed foods

Some people don’t always put a lot of thought into what’s in the processed foods they eat. People with IBS might want to avoid these foods. Processed foods often contain additives or preservatives that might trigger IBS flare-ups.

A large number of processed foods, like chips or premade frozen meals, are also often fried or high in fat. When possible, making meals yourself or buying foods that are made fresh is often a better alternative to buying processed foods.

8. Sugar-free sweeteners

Sugar-free doesn’t mean it’s good for your health — especially when it comes to IBS.

These sweeteners, also known as sugar alcohols, polyols, artificial sweeteners, and sugar substitutes, are often found in sugarless candy, gum, most diet drinks, and even mouthwash. These products contain ingredients like sucralose, acesulfame potassium, and aspartame. These ingredients are hard for your body to absorbTrusted Source, especially when you have IBS. Make sure you read the ingredient labels of any sugar-free product you consume.

9. Chocolate

Chocolate bars and chocolate candy can trigger IBS because of their concentration of caffeine and their high sugar content. Some people experience constipation after eating chocolate. There are some vegan options for chocolate lovers that people with IBS often find to be more tolerable.

10. Alcohol

Alcoholic beverages are a big trigger for people with IBS because of the way the body digests alcohol. Beer is risky, to begin with, because it often contains gluten, and wines and mixed drinks usually contain sugar.

Alcohol can also be dehydrating, which can affect your liver function and digestion.

Limiting alcoholic beverages may help reduce symptoms related to IBS. If you have a drink, consider a gluten-free beer or a drink that’s mixed with plain seltzer and doesn’t have artificial sweeteners or added sugar.

11. Garlic and onions

Garlic and onions are great flavoring agents in your food, but they also can be difficult for your intestines to break down, which causes gas. Painful gas and cramping can result from raw garlic and onions, and even cooked versions of these foods can be triggers.

12. Broccoli and cauliflower

Broccoli and cauliflower are difficult for people to digest — which is why they are IBS triggers. When your intestine breaks these foods down it causes gas, and at times, constipation, even for people without IBS.

Grating the heads of broccoli and cauliflower (also known as ricing) might make the digestive process simpler for your small intestine. But it won’t eliminate the risk of painful gas and diarrhea that IBS triggers can cause.

What to eat instead

The FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet focuses on reducing or eliminating fermentable, short-chain carbohydrates. Research suggests that high FODMAP foods are not absorbed well by the small intestine. It’s thought that they increase fluid in the bowel and create more gas, resulting in pain, gas, and diarrhea.

If you choose to follow the FODMAP diet, you should restrict:

  • lactose and dairy
  • products containing high fructose corn syrup
  • added fiber
  • vegetables like broccoli, garlic, artichokes, and onions
  • chickpeas and lentils

Foods that you can enjoy while on a FODMAP diet include:

  • lactose-free milk or other dairy-free alternatives
  • cheeses like feta or brie
  • fruits like kiwi, honeydew melon, cantaloupe, and strawberries
  • vegetables like lettuce, carrots, cucumbers, bok choy, turnips, potatoes, and eggplant
  • proteins like tofu, chicken, beef, and fish

It’s important to remember that everyone’s digestion and food triggers will be different. Some people with IBS can tolerate certain foods, while others may not. Get to know your body and learn which foods make you feel the best, and limit those that you react to.

If you need extra help with your diet in relation to IBS, it’s a good idea to seek guidance from a registered dietitian.

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Is it all in my head?

Many of the symptoms we experience with IBD are invisible – joint pain and fatigue being the major players that spring to my mind! Low levels of iron, B12, and Vitamin D, plus the emotional impact such as anxiety, PTSD and depression are all invisible too, but we feel them, don’t we?

Living with lower abdominal pain

I began experiencing lower, right-sided abdominal pain in 2012, which got progressively worse over time. I had mentioned it frequently during my appointments with my IBD nurse, but it never seemed of interest. One time, when I had pushed the issue, she said: “It may just something you may have to live with.”

I would have found that much more acceptable if it had been investigated and there was nothing to be seen, but it wasn’t, so I continued taking painkillers every day to function and tried to accept that this may be my life now.

Do the doctors and nurses not believe me?

The lack of interest in my reported symptoms left me feeling deflated. I didn’t want a life on painkillers. When the pain had got worse, I had gone on to stronger painkillers, so when I reported that I had also started vomiting, my IBD nurse said that the painkillers were probably the cause. I kept wondering if they weren’t investigating because they did not believe me. Did they think it was all in my head? Was it?

In 2014, after multiple medication failures for pouchitis, I was due to start Infliximab, but I had to have a pouchoscopy to verify active disease before I could start it. That pouchoscopy was particularly traumatic. I usually tolerated them pretty well, but this one had been different. The pain was unreal. I remember giving myself a good bash in the face with the gas and air mouthpiece as I wiped a tear from my eye because it had literally made my eyes water! During that pouchoscopy, a stricture had been identified where my j-pouch joined my small intestine, which was too narrow for the camera to pass through.

This all led to emergency surgery

Further testing led to the discovery of two strictures (narrowing’s in the intestine); one small and one long, right next to each other. A week later I was under the knife as the surgeon felt emergency surgery was necessary.

It turned out that the short one had been an abscess and the long one had been a twist in my intestine. After the surgery, the surgeon had said that he couldn’t understand how I was still walking around in such a state, but the truth was, by that time, I really had started to believe that maybe it was all in my head.

If you believe that something isn’t right, it probably isn’t

It sounds weird to say that it’s lucky that I had chronic pouchitis, but that’s how I feel. How much longer would the pain and vomiting have gone undiagnosed if I hadn’t needed that pouchoscopy to get Infliximab? It’s not something I even want to think about!

So, my story may not be about the most common issues we have with IBD (I have a fair few of those as well), but reaching a point where you actually begin to believe that it may all be in your head is not so uncommon.

The moral of the story? Be your own advocate! You are the only one that really knows what your “normal” feels like, so if you believe that something isn’t right, push for investigations. I will certainly never just leave it ever again!

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8 Symptoms of Crohn’s Disease That Don’t Affect Digestion

Crohn’s disease can cause symptoms that go beyond digestive problems, including skin conditions, osteoporosis, and even arthritis.

Gas, bloating, diarrhea, nausea: You’re probably all-too-familiar with these common Crohn’s disease symptoms, especially if they strike regularly. Yet because Crohn’s disease is a systemic or whole-body condition, its symptoms could extend beyond your digestive system.

“Crohn’s disease is a body-wide disease that is caused by excessive inflammation,” says Nirmal Kaur, MD, director of the inflammatory bowel disease center at Henry Ford Health System in Detroit. “Some people with Crohn’s disease only have inflammation in the bowel, but about 30 percent to 40 percent of people have what is called extra-intestinal manifestations, or Crohn’s disease symptoms outside of their gastrointestinal tract.”

In most cases, the treatments for non-digestive symptoms of Crohn’s are the same as the treatment for bowel-related symptoms: primarily medication. These medications may include aminosalicylates (for mild cases), immunosuppressive agents, biologic therapies, and corticosteroids. For most people, they work well for all Crohn’s symptoms. “Most people notice that when their digestive Crohn’s disease symptoms are treated, their non-digestive symptoms get better as well,” Dr. Kaur says.

Understanding Non-Digestive Symptoms of Crohn’s Disease

Here are eight symptoms of Crohn’s disease that show up outside of the digestive tract, why they occur, and how they can best be managed.

Increased arthritis risk. Because of the inflammation associated with the disease, up to 25 percent of people with Crohn’s also develop arthritis, according to the Crohn’s & Colitis Foundation of America. “This arthritis risk is highest in the larger joints, such as the knees, elbows, and wrists, which is called peripheral arthritis,” Kaur says. “But arthritis can show up anywhere in people with Crohn’s disease.” Usually, if the Crohn’s is treated, arthritis improves as well.

Increased osteoporosis risk. “People with Crohn’s disease are at higher risk for osteoporosis than the general population is,” says Mariam Fayek, MD, attending physician in the Center for Women’s Gastrointestinal Health at Women & Infants Hospital of Rhode Island in Providence. “The chronic inflammation of Crohn’s disease leads to increased bone loss, and people with Crohn’s are also more likely to be vitamin-D deficient, both of which contribute to osteoporosis risk.”

This vitamin D deficiency occurs partly because the portion of the bowel that absorbs vitamin D is diseased. Another contributor to an increased osteoporosis risk is steroid use, specifically the drug prednisone, which thins the bones. “Before the 1990s, there weren’t many therapies for Crohn’s disease outside of prednisone, so many people with Crohn’s disease who are older in age received a lot of this drug and now have osteoporosis,” Kaur says. Prednisone is still used as a temporary therapy for moderate to severe Crohn’s when other treatments don’t work, increasing osteoporosis risk in some younger people with the condition as well.

To reduce the risk for osteoporosis:

  • Avoid prolonged use of prednisone
  • Perform regular weight-bearing exercises
  • Avoid smoking
  • Minimize alcohol and caffeine
  • Eat a healthy, balanced diet

“You should also get your vitamin D levels checked and have regular bone density tests,” Dr. Fayek says.

Skin conditions. Crohn’s disease can cause certain skin conditions, including erythema nodosum, which is characterized by tender red nodules on the legs and shins, and pyoderma gangrenosum, which are large painful ulcers. “These skin conditions are caused by the inflammatory process of Crohn’s disease, and the treatment for them is to treat Crohn’s disease, sometimes along with topical therapy by a dermatologist,” Kaur says. Another possible skin condition is psoriasis. Although psoriasis appears to be a skin disease because of its red patches covered with silvery scales, it’s an inflammatory disease. It’s also linked to arthritis and Crohn’s disease by way of psoriatic arthritis, an inflammatory joint disease that can cause bone and joint damage.

“Some of the medications used to treat Crohn’s disease increase the risk of non-melanomatous skin cancers and melanomas,” Fayek says. For instance, azathioprine and mercaptopurine may increase the risk for basal and squamous cell carcinomas of the skin, she adds, and biologic agents such as the anti-TNF class of drugs may increase the risk for melanomas. Always apply sunscreen, minimize excessive sun exposure, and get yearly skin checks by a dermatologist when on these medications, Fayek says.

“People with Crohn’s disease can become anemic and experience fatigue because of blood loss and inflammation,” Fayek says. “Fatigue can also be associated with depression, which is common in people with chronic conditions such as Crohn’s disease.”

Vitamin D deficiency can also contribute to fatigue, as can the body-wide inflammation that may go along with Crohn’s disease. “Taking vitamin D and iron supplements and effectively treating Crohn’s disease can all help to ease fatigue,” Kaur says.

Canker sores. While mouth sores aren’t a common symptom of Crohn’s disease, Crohn’s inflammation can involve any part of the GI tract, from the mouth to the rectum. “Severe oral involvement may present with aphthous ulcers [canker sores] or pain in the mouth and gums,” Fayek says. These painful mouth sores usually occur during Crohn’s flares and appear on the gums or the underside of the tongue. In addition to regular Crohn’s treatment, oral pain-relief rinses or gels, an oral antibiotic rinse, or corticosteroids may help.

Fever and infection. “Fever can be a symptom of Crohn’s disease because of the low-grade inflammation associated with the disease,” Fayek explains. “A fever is particularly concerning if someone is taking drugs for Crohn’s that suppress the immune system.”

Some people with severe Crohn’s disease can develop abdominal abscesses from the inflammation extending through the wall of the intestine to the abdominal cavity, Fayek explains. “Patients on immunosuppressive medications are particularly at risk for certain fungal infections and reactivation of tuberculosis,” she says. If you have a fever over 100.5 degrees Fahrenheit, she says, you should contact your gastroenterologist right away. If the source of the fever is an infection, you’ll likely be treated with antibiotics.

It’s important for people with Crohn’s who are on immunosuppressive therapy to be up to date on their vaccines, Fayek says. However, live, weakened virus vaccines should not be given to people on immunosuppressive therapy; they can and should receive the following inactivated vaccines:

  • A yearly flu vaccine.
  • Certain pneumonia vaccines. (Talk to your doctor about which ones should be offered to people starting immunosuppressive therapy.)
  • DTaP (diphtheria, tetanus, and pertussis), which should be given as a booster, particularly if it’s been more than 10 years since your last vaccine.

Other inactivated vaccines include: the hepatitis A vaccine, Haemophilus influenzae type B (Hib), meningococcus, and HPV vaccine, Fayek say.

Your doctor can help you determine what kind of vaccination schedule you should follow.

Migraines. Some people with Crohn’s disease or ulcerative colitis can get migraine headaches, which are thought to be rooted in inflammation. Once people take medications for other symptoms of Crohn’s disease, their migraine headaches usually also improve, Kaur says.

Eye infections. “There are two types of eye conditions that can occur in people with Crohn’s disease, and both are emergencies,” Kaur says. The first is episcleritis, which is irritation and inflammation of the episclera, a thin layer of tissue that covers the white part of the eye. “Episcleritis is extremely painful, and it makes the eye very red,” she says. The second is uveitis, which is inflammation of the uvea, the middle layer of the eye. “Uveitis causes distinct pain,” Kaur says. Sudden redness, blurred vision, and light sensitivity are other possible symptoms, according to the American Academy of Ophthalmology. “Both eye conditions are rare, but if you have Crohn’s disease and experience any eye pain or redness, call your doctor or head to the emergency room right away.”

Like the digestive symptoms of Crohn’s disease, these non-digestive symptoms are more likely to crop up during a flare or if your Crohn’s is severe. If you have Crohn’s disease and experience any of these symptoms, talk to your doctor promptly to get the care you need.

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How to Manage Crohn’s Disease and IBS

If you have both Crohn’s disease and irritable bowel syndrome (IBS), it can be hard to tell which condition is causing what symptom. Understanding the differences can help you feel better faster.

Having Crohn’s disease — a chronic, inflammatory bowel disease (IBD) that can affect different parts of the digestive tract — doesn’t make you immune to other gastrointestinal ills. In fact, some people with Crohn’s disease also have irritable bowel syndrome (IBS), also called “spastic colon.” Here’s how to tell whether you have both conditions.

IBS Symptoms, Crohn’s Symptoms, or Both?

How can you tell if your diarrhea is a result of IBS or Crohn’s disease? It’s not always easy, says James Marion, MD, director of education and outreach for The Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai Hospital in New York City. “The symptoms of Crohn’s disease and IBS are notoriously difficult to distinguish,” he says, “and this can be a source of serious confusion among patients and physicians, and can, on occasion, lead to misdiagnosis or misguided treatment.”

Diarrhea, abdominal pain, and urge to evacuate one’s bowels, or abdominal distension can be seen in both conditions, whereas “red flag symptoms such as weight loss, vomiting, fatigue, fever, or bleeding raise concern for Crohn’s disease or ulcerative colitis,” Dr. Marion says.

Sometimes testing can provide a more definitive answer about the cause of gastrointestinal symptoms. “The critical difference in determining the cause of the symptoms, which can be accomplished with a thorough physical exam, blood and stool tests, imaging, and colonoscopy to confirm the presence or absence of inflammation or anatomic stricture seen with Crohn’s disease,” Marion says.

How Treatment for Crohn’s and IBS Differs

Although the symptoms can be similar, treatment for Crohn’s and IBS differ, which is why it’s important to know which condition your symptoms are related to, Marion explains. Treatment for Crohn’s disease depends on the severity of your symptoms. For example, sometimes you may need steroids to control a flare. Or you might need medication that targets the proteins involved in the inflammatory process of Crohn’s.

Treating IBS, however, is largely aimed at easing symptoms. If you have diarrhea, some over-the-counter medications may help. Diet also plays a role in treating and preventing an IBS flare, according to the Crohn’s & Colitis Foundation of America.

Recommendations from the American College of Gastroenterology include consuming soluble fiber (such as psyllium) to relieve IBS symptoms. Probiotics may also ease the bloating and flatulence associated with IBS, the group says.

By contrast, there’s no specific nutrition plan for Crohn’s disease, but eating a healthy, well-balanced diet can help your immune system function better, which is beneficial to Crohn’s. In addition, you may notice that certain foods, known as “triggers,” worsen your symptoms. Avoid these triggers, and see if you feel better.

If you’re experiencing digestive symptoms you didn’t have before, or if your existing symptoms aren’t getting better, make an appointment with your doctor. By understanding, if Crohn’s or IBS is behind your discomfort, you can take the steps you need to treat it.

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