Saturday, May 14, 2011

Tedious acronyms and inner workings

There’s a character in the Tom Robbins book Fierce Invalids Home from Hot Climates, who is so squeamish about the goings-on of his insides that he prefers to think of his digestive system as a ‘ball of white light’. I must say I can relate. I’d really prefer not to think about my inner workings; once my food has passed my lips I don’t think I should have to think about what happens to it.  You can keep your toilet humour; fart jokes do nothing for me; even the word colon makes me clench a little bit.

Unfortunately I’ve recently been forced to contemplate my bowel a lot more than I am comfortable with. It’s because of IBS. Irritable Bowel Syndrome (even the full name is a bit Too Much Information for my liking). But it can’t be helped. Because I’m embarking on something I’ve been putting off for about a year. It’s not cleaning out the garage. I wish it were that easy. It’s an elimination diet to finally get to the bottom (so to speak) of my IBS.

Anyone who’s suffered from IBS will have no need of an explanation of the symptoms (and the rest of you are probably switching off right now). It’s pretty much as the name suggests – I’ll leave it to your imagination. It’s something that’s been with me for years, on and off, and for years I’ve tried, half-heartedly, it must be said, to figure out what sets it off.

IBS is a diagnosis of elimination: other possible causes of the symptoms (some of which are serious) need to be eliminated first. So over the years I’ve had a series of delightful tests including but not limited to: a colonography, a colonoscopy, tests for Coeliac disease and ultrasound scans for ovarian cancer. What all this has shown is that I don’t have any serious conditions, fortunately; so what I’m left with is IBS. It’s not debilitating, but it is inconvenient, uncomfortably painful and occasionally embarrassing.  And in this I am not alone; a surprisingly large percentage of women, particularly, experience IBS in varying degrees.

It’s not all the time, for me. Sometimes I’m good, and other times I’m not. I know that stress is a trigger; so not ideal for someone in a business with constant deadlines. I know that too much alcohol isn’t good, and too much coffee can be disastrous. I know a lot of onions are not a good idea, likewise beans. But beyond that I can’t explain why one day I have the runs, the next nothing’s going anywhere, and the next I wake up with such a bloated stomach it causes a re-think on what I was planning to wear that day. When my gut started to get in the way of my wardrobe choices, I knew I had to do something.

I’ve been privy to much of the research into IBS due to my job at Healthy Food Guide. For several years now it all seems to be honing in on foods: specific foods that people who suffer from IBS have trouble with. I’ve been putting all this off because I know that the standard way to find out which foods are the problem ones, is to embark on a scientific process known as ‘elimination and challenge’. It’s how food allergies and intolerances are diagnosed. It involves, as the name suggests, first the elimination of all possibly problematic foods, followed by individual food ‘challenges’. It’s a tedious and long-winded process, not to mention anti-social. It would turn me into one of those whiny people of whom I have been myself, quite intolerant: the people who ‘can’t’ eat things. Get over yourself, I usually want to shout. Just eat the damn bread.

However, the ball of white light theory just wasn’t working for me any more. Something had to be done. So, I find the blueplan for an elimination diet, formulated by American dietitian Patsy Catsos, and outlined in her book  IBS  - free at last (terrible name; even worse cover, trust me, but actually very scientifically sound and rigorous within). After running it past our HFG nutritionist, I’m ready to give the IBS elimination diet a go. It involves, first, eliminating all the FODMAPs.

FODMAPs – like many things in nutrition - is a very un-catchy acronym. It stands for Fermentable Oligo-, Di- and Mono-saccharides and Polyols. What they actually are, are different types of carbohydrates: lactose, fructose, fructans, polyols and galactans. (I know, it gets no better with the names). These are found in groups of foods which are the subject of emerging research, much of it coming out of Australia, and much of it focussed on IBS. Some people (possibly me) can’t fully digest one or more of these FODMAPs in food, leading to the symptoms we know as IBS. The diet is a process to try and figure out which, if any, are causing problems for me. It’s not something to stick to long term; rather a learning exercise. Which is good, because I’ve never been on a diet in my life, and I’m not sure how I’ll do on one now. Plus, I really really don’t want to be one of the intolerant people.

Before I start the diet, I psyche myself up. During my ‘baseline’ week I binge on things I won’t be able to eat for a few weeks: I make sourdough bread; braised lentils; broccoli and blue cheese soup; apple pie. Quite a lot of the FODMAPs foods are ones I’m pretty fond of: onions, garlic, broccoli, beans, chickpeas, bread, pasta, honey, yoghurt, milk and quite a few different fruits. How will I cope? I try and time it so I can start during a week without potentially problematic eating out occasions. I buy lots of the things I can still have and make a bit of a menu plan, promising my husband he won’t feel deprived (he’s worried I’ll turn into a whiny person, too).

On the plus side, there are quite a few foods that are fine on the elimination diet; I won’t be surviving on a diet of rice milk and bean sprouts. One bright spot is that I can still have wine – a couple of small glasses a day. Thank goodness for small mercies.

And so I start. I am hoping that, at the end of this, I’ll have a better idea of what upsets my rebellious bowels, and I’ll be able to take it from there. I can’t see myself ever eliminating whole food groups. How could I, as a professional eater? It depresses me more than words to think of myself ever saying “Oh no, I can’t eat that,” when faced with some new delicious thing. But at least if I know what it is that makes my insides grumbly, I can choose what to do about it – limit, eliminate or compensate. Fingers crossed. I will keep you posted. 

1 comment:

Sharron said...

You are not alone there. I was diagnosed with frutose & lastose intolerance about 4 mths ago. Exactually the same symptoms as described. Since following the fodmap diet I am back to my self after years of slow decline. Tiredness, lethargy, extremely bloated and cranky being the main symptoms.
I love to cook and with a family of 5 to feed it took me a while to adjust. The main items I keep in my pantry I can not go with out now are onion and garlics oils (Prenzel). As the onions or garlic are infused in the oil then I do not have problems with it. I will use a little in the pan if frying or add a little to replace liquid if you need it in the recipe. A bag of gluten free baking mix & gluten free flour. I made my own baking powder which works a treat. Gluten free pasta and lactose free milk (Liddels) tastes just like real milk. All the best. Love your blog.