Food Cures (65 page)

Margarine, soft tub reduced-fat, trans fat-free (no dairy)

Nonstick cooking spray

Oil, olive

Pepper, black

Potato chips, plain baked (no olestra)

Preserves, strawberry (low-sugar)

Rice milk, low-fat plain and vanilla

Salt

Sugar

Vanilla

Personal Safe Items

STEP 3…
GOING ABOVE AND BEYOND

If you want to do everything you can to try to alleviate your IBS symptoms while still staying healthy, here are some additional things you might try:

• Consider taking a chewable or liquid multivitamin to assure that you get the basic level of nutrition, even if your food choices are limited.
  
• If your IBS symptoms are triggered by dairy products, take a calcium citrate supplement that also includes vitamin D
  ₃
  to make up for any shortfall in dietary calcium.
  
• Consider taking supplements to reduce your symptoms, such as a probiotic, peppermint oil, or artichoke leaf extract.
  
• If you can’t get relief from dietary and lifestyle changes, talk with your doctor. There are new medications that can help you get control over your worst symptoms.
  

STEP 4…
MEAL PLANS

For severe diarrhea-predominant IBS, follow the Extreme Elimination Diet—No Fiber, which follows.

For severe constipation-predominant IBS, follow the Elimination Diet with Added Fiber, Chapter 17.

EXTREME ELIMINATION DIET—NO FIBER

For severe diarrhea-predominant IBS (follow for five to seven days)

This elimination diet is extreme and should not be followed for longer than one week. It’s designed to help people who suffer from severe persistent diarrhea-predominant IBS determine which foods may be aggravating their condition. It avoids ALL IBS potential trigger foods
plus
additional common allergens (including shellfish and eggs). This plan is very low in dietary fiber and is based on the few foods I’ve found that clients with this type of IBS can tolerate. Fiber
and nutrition
will be slowly increased as you introduce new foods. Rice cereal (hot and cold varieties) and rice milk can be purchased at a local health food store or online. Make sure you buy a soft tub reduced-fat, trans fat-free margarine spread that does not contain dairy.

If you’re a candidate for this extreme plan, follow it for one week. Every day, choose
one
option for each of the three meals—breakfast, lunch, and dinner. Then, one or two times per day, choose from the variety of my suggested snacks. Eat slowly and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage, and drink at least 8 cups throughout each day.

After following this plan for one week, you can start experimenting by adding new foods. You should add one new food every two to three days (it’s best to stick with one portion of a new food per day). Keep an IBS diary and write down everything you eat…and everything you feel. Pay close attention to how you feel after eating each new food, which will help you determine if it can be permanently reintroduced into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next food category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will (we hope) have identified most of the foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:

1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
   
2. Sweet potatoes and/or yams
   
3. Eggs
   
4. Wheat products: Stick with white versions of bread, crackers, and pasta. In the future when symptoms subside, you can slowly test small amounts of whole wheat varieties.
   
5. Oats, oatmeal, and barley
   
6. Brown and wild rice
   
7. Nut butters
   
8. Cooked vegetables (noncruciferous, no corn, no peppers, no eggplant)
   
9. Fruit (peel fruits with tough outer skins at first; avoid citrus)
   
10. Shellfish
    
11. Soy foods
    
12. Whole nuts and seeds
    
13. Garlic and onion
    
14. Citrus fruits
    
15. Cooked cruciferous vegetables (plus cooked peppers and eggplant)
    
16. Beans and lentils
    
17. Raw vegetables
    
18. Corn
    
19. Ketchup, mustard, soy sauce, and other condiments (test one at a time)
    
20. Dried fruit
    
21. Chocolate
    
22. Fruit juice, sugar, and honey
    
23. Alcohol
    
24. Coffee or tea
    

BREAKFAST OPTIONS

(Approximately 300 to 400 calories)

Hot Cereal with Banana Slices

Cold Cereal with Rice Milk

Breakfast Potato with Cinnamon Applesauce

LUNCH OPTIONS

(Approximately 400 to 500 calories)

Grilled Chicken with Rice

Turkey Burger with Baked Potato

Turkey and Avocado on Rice Cakes

DINNER OPTIONS

(500 to 600 calories)

Grilled Fish with Rice

Rosemary Chicken with Baked Potato

Roast Turkey with Mashed Potatoes

SNACK OPTIONS

100 calories or less

• 2 plain rice cakes
  
• ½ cup natural unsweetened applesauce
  
• 1 small banana
  

100 to 200 calories

• 3 to 5 plain rice crackers
  
• 1 ounce baked potato chips (no olestra, check labels)
  
• 1 cup natural unsweetened applesauce
  
• ½ baked potato with 1 teaspoon soft tub reduced-fat, trans fat-free margarine spread; do not eat the potato skin.
  

ELIMINATION DIET WITH ADDED FIBER

For severe constipation-predominant IBS, and follow-up for the extreme elimination diet

This elimination diet is extreme and should not be followed long term. It’s designed to help people who suffer with persistent constipation-predominant IBS (and other debilitating types that cause gas, cramping, and pain) finally figure out which foods may be aggravating their condition. It avoids
all
IBS potential trigger foods
plus
additional common allergens (including shellfish and eggs). It provides a moderate amount of dietary fiber—with a good amount specifically coming from soluble fiber sources. All foods rich in soluble fiber are marked with an
asterisk (*)
—if you’re feeling gassy or uncomfortably distended, go easy on these foods. Your total fiber intake (
and nutrition!
) will slowly increase when you start introducing new foods. Puffed rice cereal and low-fat rice milk can be purchased at your local health food store (or online). Make sure your soft tub reduced-fat, trans fat-free margarine spread does not contain dairy.

If you’re a candidate for this plan, follow it for one week. Every day, choose
one
option for each of the three meals—breakfast, lunch, and dinner. Then, one or two times per day, choose from a variety of my suggested snacks. Eat slowly and thoroughly chew your food. Approximate calories have been provided to help adjust for your personal weight-management goals. If you find yourself hungry (and if weight is not an issue), feel free to increase the portion sizes for meals and snacks. Stick with flat water as your beverage and drink at least 10 cups throughout each day.

After following this plan for one week, you’re ready to experiment by adding new foods. You should add one new food every two to three days (it’s best to stick with one portion of a new food per day). Keep an IBS diary and write down all the foods you eat, the amounts, and how they affect your constipation. Pay close attention to how you feel after eating each new food and determine if it can be permanently reintroduced back into your diet. If any food bothers your stomach, stop eating it and add it to your list of problem foods. Move on to the next category. You can always retest a problem food at a later date.

At the end of this tough assignment, you will hopefully have identified all (or most all) foods that aggravate your IBS. Let’s hope it’s a short list. For the sake of good nutrition and food variety, here’s my suggested order for reintroducing new foods:

1. Dairy (fat-free and reduced-fat milk, yogurt, cheese, etc.)
   
2. Wheat products (preferably whole wheat bread, pasta, cereal, and more)
   
3. Eggs
   
4. Increased portions of daily cooked vegetables (noncruciferous, no corn, no eggplant, no peppers)
   
5. More daily fruit (but avoid citrus varieties)
   
6. Shellfish
   
7. Soy foods
   
8. Nut butters
   
9. Whole nuts and seeds
   
10. Garlic and onion
    
11. Citrus fruits
    
12. Cooked cruciferous vegetables (plus cooked peppers and eggplant)
    
13. Beans and lentils
    
14. Raw vegetables
    
15. Corn
    
16. Ketchup, mustard, soy sauce, mayonnaise, and other condiments (test one at a time)
    
17. Dried fruit
    
18. Fruit juice, sugar, and honey
    
19. Alcohol
    
20. Coffee or tea
    
21. Chocolate