Bad Bellies in the New Year

I hope everyone has had a good holiday and New Year! :)

I don’t usually make New Year’s resolutions, but this year I thought I’d make an exception.

In 2015, I continued to slowly gain weight, and by November I discovered that I was now the heaviest I have ever been. I am not in danger, but I do not feel good about myself, and don’t feel healthy either. Therefore, I have decided that my New Year’s resolution for 2016 is to prioritise my health!

There are three parts to this resolution: more exercise, more cooking for myself, and more focus on understanding my belly.

EXERCISE

I have already started working on this part of my resolution. In November, I realised that while it was good for improving my fitness in the long term, swimming twice a week was not intensive enough to help me lose weight. I was very conscious of not pushing my body too hard, as this can put extra stress on the body as previously discussed, so I decided to add walking to my weekly routine.

I first started with a gentle 10 minute walk to and from my local public swimming pool on my swimming days, and after a few weeks, added a 30min walk on Monday evenings. After I was comfortable with this, I started trying to jog some parts of my walking route. At this point, I am now going for a walk/jog twice a week on top of swimming twice a week, and have already lost 3kg!

To help me with this, I have also invested in some good quality running shoes and comfortable clothing, and borrowed my partner’s old GPS watch (see photo below). My partner has been running regularly for a couple of years, and he has been very helpful and encouraging in this, which has really helped with my confidence and motivation! ♡

COOKING FOR MYSELF

As I have mentioned previously, I am not the best cook. I can cook basic things, but have no instinct or creativity for it, and often no energy either. However, last year I started living with my sister who is a very good cook, and she has helped motivate me to try cooking new things and experiment with making things that are more suitable for my belly. :) I have decided to put much more effort into learning how to cook more for myself this year, which will hopefully help me to both improve my health and decrease my symptoms.

I am also looking forward to trying out the below cookbook, which was a Christmas gift from my family. Sourdough bread (particularly when made with spelt flour) has been confirmed by Monash University to be better for those with fructose malabsorption and IBS in general, as the long fermentation process seems to use the FODMAPs in the flour, thus making it easier to digest.

UNDERSTANDING MY BELLY

I have also realised that while I now have a much better understanding of UC and fructose malabsorption, I still have a lot to learn about my belly and its trigger foods. Therefore, I have resolved to put more effort into testing my tolerance levels for different foods, and working on my diet in general.

The first step in this was creating a new food table card (see photo below), which has a more up to date list of good and bad foods based on fructose and fructan levels (using the Monash University Low FODMAP Diet and FODMAP Friendly apps as guides), and it is now colour coded – including putting the best and worst foods in bold, based on what I currently understand about my trigger foods. I have also given copies of this card to my family and others close to me, to help them better understand my situation with food, and work as a guide if they are cooking for me.

Bad Bellies and Appetite

This week I have experienced some loss of appetite, which is not usually something I have trouble with. Therefore, this week I would like to explore the causes of loss of appetite, particularly with a bad belly like mine, and share my thoughts on how to manage this symptom.

COMMON CAUSES OF LOSS OF APPETITE

There are many possible causes of loss of appetite, and I have listed the most common ones below (summarised from here, here and here):

• Bacterial or viral infection
• Stress
• PMS
• Hypothyroidism
• Pregnancy
• Irritable bowel syndrome
• Inflammatory bowel disease
• Side effect from medication
• Depression
• Kidney, liver or heart disease
• Colon cancer
• Eating disorders

When looking at this list, I think that my problems with loss of appetite this week have been mainly caused by stress from work, as I have taken on a new role at work recently, and it has been very tiring. I am pretty sure that I do not have an infection or cancer, am not pregnant or suffering from an eating disorder, and do not have kidney, liver or heart disease. Also, I am generally excited about my new role, so I don’t think depression is a factor.

As previously discussed, stress can also exacerbate the symptoms of IBS and IBD, and I did also have quite a bad belly week in general. Additionally, loss of appetite is also common with both IBS and IBD. In particular, loss of appetite can be caused by many of the other symptoms or complications of these two conditions – bloating, nausea, pain, diarrhea, fatigue, and even mouth ulcers. You can read more about the relationship between appetite and IBS here, and with IBD here.

MANAGING APPETITE

Although some people might say it can be useful to lose weight, and look for appetite suppressants when on a diet, loss of appetite is generally not a good thing. It is especially problematic for people with bowel conditions, as the body may already be missing out on some nutrients.

Therefore, I believe it is important to find ways to increase appetite when experiencing loss of appetite. Here is a list of possible ways to treat loss of appetite (summarised from here, here and here):

• Treating the underlying condition, usually with medication
• Eating smaller meals, to help avoid bloating
• Eating food you enjoy
• Eating bitter foods, which can stimulate digestion
• Eating foods that can help settle the stomach
• Maintaining a regular meal schedule
• Creating a relaxing environment when eating

In my situation, I found that my appetite improved when I was more relaxed, and also when I was eating foods I liked. Stress relief activities also helped, such as dancing to my favourite music, or talking things out with people close to me.

Additionally, there are ways to prevent loss of appetite from occurring, as discussed here and here. In particular, these methods include changing your eating habits, avoiding stress, exercising, keeping hydrated, changing your routine, or adjusting medications.

Do you have any tips for managing your appetite? Share below.

Planning Meals for Bad Bellies

One of the things that I find most difficult about having two digestive disorders is planning my meals within the constraints of both, while also keeping to my budget. Some days, the question “What am I going to eat?” can therefore be very difficult to answer.

This week, I would therefore like to share my progress in this, and what I have learned so far.

MY GENERAL EATING PLAN

For several years, through school, university and now work, I have typically kept to the following daily meal structure: a small breakfast (usually some yoghurt), medium-sized lunch (like a sandwich or some fruit), and then my largest meal in the evening. This has been largely influenced by my general lifestyle – something quick as I leave in the morning, a slightly bigger meal in the middle of the day to keep me going at work, and then a good dinner when I get home and can relax. In particular, having yoghurt for breakfast seems to settle my stomach in the morning, which I believe is due to the probiotics in the yoghurt. Occasionally, I will also have some small snacks during the day, such as some biscuits or nut clusters, and try to keep hydrated as much as possible. This is the general pattern on weekdays, as I work full time during the week.

On the weekends, things are generally a bit more relaxed – I might have a larger brunch after sleeping in, rather than two separate meals for breakfast and lunch. Additionally, it is more common for me to eat out on the weekends, either with friends or my partner, whereas during the week I tend to prepare my own meals at home.

As discussed in this previous post, there are several different diets that could be useful for managing IBD or IBS, and I generally follow a combination of two or three different diets, depending on the situation. Similarly, you can find several suggested meal plans for IBD and IBS, such as this one, this one, or this one. However, I have found that neither of these are completely suitable for my situation, and thus I continue to rely on my own process of trial and error.

DIFFICULTIES WITH MY MEAL PLAN

I do try to be strict with my meal schedule during the week at least, as it is recommended to have regular meal times to help with digestion, both with IBD and IBS. There are a few factors that can make this difficult for me however, as summarised below:

• I am not the best cook. – Because I don’t seem to have much of either a talent or instinct for cooking, I find that cooking can take a lot of effort, and as a result, I often end up cooking very basic meals. Sometimes this can be good for avoiding trigger foods, but at the same time it means that I often lack variety in my meals.

• Specialty foods or ingredients are often expensive, or difficult to find. – While I try to be strict about avoiding my trigger foods, this can sometimes be quite costly, as specialty foods, often found in the health food aisle of the supermarket or in specialty supermarkets, are often more expensive than other “regular” foods. Additionally, although this it is becoming more common in Australia due to products by GlutenFree4U and Dr. Sue Shepherd’s Low-FODMAP range (see image below), it is often quite rare to find foods that are suitable for people with FM.

• It is easy to be lazy after a long day at work. – As discussed above, I am not the best cook, and when you add feeling tired after a long day, cooking can be the last thing I want to do!
• Sometimes I lose my appetite during a flare. – On days where I am feeling bloated or have a stomach ache, eating and cooking are often the last things on my mind.
• It is more difficult to avoid trigger foods when eating out. - As previously discussed, eating out can add an additional layer of complexity for avoiding trigger foods, as you often have less control over what you eat, and restaurants are not often able to cater for food intolerances – but this is becoming more common.

I am slowly working on my cooking skills and learning new recipes, but this has been a slow process. To help with this, I make sure to have leftovers to put in the freezer at much as possible when cooking, and when eating out, I look for restaurants or cafes that can cater to dietary requirements.

Do you have other suggestions for planning meals for IBS and/or IBD? Please share below. 

Bad Bellies and Diet

In my opinion, the most frustrating thing about having FM is its sheer complexity, as fructose is in almost every food. Additionally, having UC adds an extra layer of complexity for me. From what I understand, this is a common problem in general for people with IBS and/or IBD. Many people, including myself, have therefore tried to simplify things by creating special types of diets, hoping to make things easier to manage on a daily basis.

This week, I am therefore going to share some of my research into these types of diets, as well as how I have adapted them for my own needs.

COMMON DIETS FOR BAD BELLIES

In my research and so on, I have often come across discussions about different types of diets that are suitable for IBS and/or IBD. Here is a summary of the ones that I have read about most:

The Gluten-Free Diet – This diet is mainly designed for people with Coeliac Disease, and focuses on eliminating all foods containing gluten (wheat, rye, triticale and barley). This diet can also be useful for people with FM, as many foods that contain gluten also contain high amounts of fructans. Here is a good summary of this diet. For those with FM, however, this diet can still be risky, as mainly gluten free products use corn flour as a substitute for wheat flour. Additionally, specialty gluten-free products can be expensive, so some people can find it difficult to maintain this diet.

The Low FODMAP Diet – The Low FODMAP Diet was developed by Dr. Sue Shepherd in 1999, as a form of treatment for people with IBS, and has two phases – first, restricting all high FODMAP foods for 6-8 weeks, and then developing the diet to suit the individual’s condition. FODMAP stands for Fermentable Oligosaccharides (includes fructans), Disaccharides (includes lactose), Monosaccharides (includes fructose) and Polyols (includes sorbital and xylitol). Dr. Shepherd has now began developing her own range of "FODMAP Friendly" foods, as well as encouraging other companies to make their foods "FODMAP Friendly." Foods identified as "FODMAP Friendly" carry the below logo. While this is a very good diet to help with identifying trigger foods and tolerance levels, in some cases it may not be appropriate, as some people only have problems with one or two types of foods, or their problem foods may not be fully covered by the FODMAP categories.

The Paleo (Paleolithic) Diet – Reportedly the most popular diet in the world in 2013, the Paleo Diet is based on the premise that we should only eat the same sorts of foods as our ancestors did, and keep to the types of foods that our bodies are built to digest. In essence, this means no processed foods. Here is a good resource for understanding this diet. This diet is said to be very healthy and this has been supported by several studies. Some are still sceptical however, arguing that this diet is not necessarily sustainable, as the life expectancy of our ancestors was much lower than it is today.

Going Organic – This diet focuses on consuming only foods grown naturally, in order to avoid consuming harmful chemicals and environmental damage. This includes avoiding plants grown using pesticides or fertlisers, avoiding meat from animals given growth hormones or other drugs, and only using products from animals raised in a “free range” environment. Here is a useful summary of the main arguments for going organic. This diet can also be problematic however, as it can be difficult to determine whether foods are definitely organic, and organic foods are often more expensive.

The High-Fibre Diet – The High-Fibre Diet is often recommended for people with IBS-C, as previously discussed in this post, as it can help to reduce constipation. The most fibre-rich foods are often fruits, vegetables, and whole grains. However, this diet is not suitable for people with IBS-D, as too much fibre can cause diarrhea. Here is a good list of fibre-rich foods. Additionally, it can be difficult for people with FM to maintain this diet, as many high-fibre foods also contain high amounts of fructose or fructans.

The Low-Fibre (Low-Residue) Diet – The Low-Fibre Diet is therefore recommended for people with IBS-D, as it can help to reduce diarrhea. It is also recommended for people who have had bowel surgery. Rather than completely eliminating all fibre, this diet focuses on consuming only soluble fibre. Here is a useful summary of high- and low-fibre foods.

The Low-Fat Diet – This is of course a very common diet for weight loss, however it is also recommended for people with IBS because high-fat foods usually have lower levels of fibre, and can therefore cause constipation. Here is a good guide for following the Low-Fat Diet. When following this diet though, it is important to remember that not all fats are unhealthy, as discussed here.

The above diets are generally more appropriate for managing IBS, however some aspects of them are also applicable for those with IBD. As discussed in this article, people with IBD should avoid high-fibre and high-fat foods. In addition to this, it is important to keep hydrated, foods with prebiotics or probiotics may be helpful, and vitamin supplements may be necessary (as discussed in this previous post).

Have you found a diet that works best for you? Please comment below.

MY DIET

While all of the above diets have their benefits, in my own experimentation so far, I have found that neither of them are quite right for my situation. This is because none of them are specifically tailored for people with FM or UC. Therefore, through a combination of trial and error, elimination and substitution, I am slowly developing my own diet.

I have previously discussed my main trigger foods and tolerance levels, and these elements have helped guide me when I am thinking about what to eat each day. Additionally, I have found that different types of diets can be useful for certain situations. For example, when I am going to a function or event, it is sometimes easier to just list “gluten-free” for my dietary requirements. When cooking for myself, however, I will usually aim for something closer to the Low FODMAP diet - selecting the aspects applicable to my FM - as I am able to have more control over the ingredients used. Additionally, if I am having trouble with my bowel movements, I may try to either reduce or increase my fibre intake.

In my experience, and also in my general opinion, there is no such thing as a perfect diet, and it is neither healthy nor sustainable to be too restrictive in what you eat. As I mentioned in my first post, restricting my diet too much following my FM diagnosis just resulted in weight gain and fatigue. I am therefore focusing on what my version of healthy is, both because of, and in spite of, my FM and UC.

Have you had similar experiences with your diet? Please comment below.