1st May 2017
I have suffered from IBS for many years, and at times Crohn's Disease with varying symptoms and treatments. This time last year I was suffering from diarrhoea on average about 4-5 times a day. My symptoms have never been as severe as for many people – they never stop me going out or working or living a relatively normal life. However, the symptoms are inconvenient, annoying and embarrassing and do not make me feel great or healthy.
Having been on a low fibre diet and finding this was no longer effective, I thought there must be something I eat regularly that is contributing to the problem. I figured that bread was one of the foods that I was eating every day – so I tried cutting this out for a couple of weeks and my symptoms improved.
I went to my GP for advice, hoping to be referred to a Dietitian. This followed a process of being referred to a hospital consultant and having a ‘pill camera’ to look for inflammation due to my history. Some inflammation was found but was inconclusive and a Coeliac test also came back negative. So, I asked again to be referred to a Dietitian and eight months after seeing my GP, I finally had my appointment. After listening, the Dietitian recommended the low FODMAP diet – I had looked into this before but had been put off as it looked too hard!
At The IBS Network event last year, the message was “do not attempt to do this unless under the guidance of a Dietitian” so, I was very pleased to finally have professional support, which also provided the motivation to follow their advice. The Dietitian went through the diet and the huge list of things to completely exclude for eight weeks (starting after my summer holiday last year so I could have some ice-cream!).
I have to admit – the diet is very daunting. When you are used to eating wheat products, cow's milk and a variety of fruit and vegetables every day, cutting out all the foods on the list is hard work. It has been challenging, just because of the time needed to dedicate to meal planning, shopping and cooking from scratch. Convenience foods do not really work. Having to find meals that my fussy little children will eat too, has added to the challenge!
The Kings College FODMAP app has been incredibly useful, especially in supermarkets – the first few shops took ages as I was scanning everything to look for the smiley face (allowed!). I have relied on the app, the Dietitian's information and recipe booklet and the excellent 'Cooking for the sensitive gut' by Joan Ransley and Dr Nick Read (available via The IBS Network online shop}.
There are also loads of recipes online but I find I can only cope with so many new dishes. It has also been a challenge for my mother who cooks for us once a week. I have turned down a lot of offers of biscuits at work (who knew there were so many!) and eaten quite a few chips and jacket potatoes. I have discovered a range of interesting new milks as well as some really tasty alternative recipes: buckwheat pancakes, yummy smoothies and delicious rice salads. However, I still miss cake. I have managed to stick to the diet, despite some conflicting advice in the various sources of information about what is allowed. I have also recorded everything I have eaten and my daily symptoms in a notebook.
So, you all want to know is – was it worth it?
Well, I am pleased to report that my symptoms have greatly reduced. Most days, I now have bowel movements of a normal consistency – I probably still go the toilet more often than most people, but the frequency is less too. I think that stress still brings my symptoms on, but there is no doubt there has been a huge improvement.
So, what now? The Dietitian refused to tell me about the reintroduction phase before I had finished the elimination phase, but I am now starting it. I have to re-introduce one FODMAP food at a time for up to three days, recording symptoms and keeping the low FODMAP diet as a baseline. She said that there may only be a few problem foods – it could even be one or two. I am hoping so, as this phase may take another three months which is quite long enough, thank you!
Nicola was diagnosed with IBS over 18 years ago, experiencing symptoms ranging from bloating and wind in the early days, to diarrhoea and bloating but these have varied over the years. Nicola, who is married with two children, leads a busy life working part-time in an office, helping with community activities and tries to take regular exercise.
Nicola is happy to share her story but has asked not to be identified.