Tummy trouble? Solve the mystery

By Debbie Herbst, RD, LD, CDE
Mercy Hospital Carthage

CARTHAGE, Mo. – Many Americans suffer with “irritable bowel syndrome” (IBS). That means they have stomach pain and constipation or diarrhea.

IBS can happen at all ages. The brain, gut and nervous system do not seem to work together right. So what do you do?

Start with a food diary. That means writing down everything you eat and drink. Make notes about whether you have belly pain and when you to go to the bathroom.

Also, jot down any stresses. Some people have problems, like stomach pains or diarrhea, when they get upset or overly tired.

The food diary can help you find out what foods or feelings are triggers. Stay away from those “trigger foods.” Work on managing stress.

Try to eat a meal or snack every four to five hours. Limit caffeine and drink at least 48 ounces of water per day.

If you still have problems, don’t despair. It just means you need to look harder to solve the mystery. Because each person is an individual, diet changes that work for one person may not work for another.

Look at your food diary. If you have stomach pain after drinking milk or eating ice cream or yogurt, you may not tolerate lactose. Lactose is the natural sugar found in milk.

If you have stomach pain and constipation after eating bread or spaghetti, you may be sensitive to gluten. Gluten is protein found in foods made with wheat flour. Cutting back or avoiding foods with gluten (bread, crackers, pasta and baked goods) may solve the problem.

If you still are having stomach and bowel problems, another diet to try is called “low FODMAP.” FODMAPs are certain carbohydrates that are not well digested in some people.

FODMAP foods cause fluid to be pulled into intestines and are fermented quickly, which causes more gas and more stools. The amount of FODMAP foods eaten over time can cause problems.

Following the low-FODMAP diet is a learning diet. You can try it for a few weeks, then add in one type of FODMAP food and see whether you have problems.

Examples of high-FODMAP foods to avoid:

• Dairy – milk, yogurt and ice cream
• Fruit – fruit juice, apples, pears, stone fruits and watermelon
• Vegetables – broccoli, cauliflower, Brussels sprouts, corn, celery and onion garlic
• Breads, cereals, pasta, crackers – any made with wheat, barley or rye
• Other – sugar-free items made with sorbitol, mannitol, maltitol or xylitol, as well as any food or drink made with high-fructose corn syrup

Examples of low FODMAP foods to eat:

• Dairy – lactose-free milk products and hard cheeses
• Fruit – strawberries, blueberries, grapes, cantaloupe, kiwi, ripe bananas and oranges
• Vegetables – spinach, kale, fresh tomatoes, carrots, zucchini, white potatoes and bell peppers
• Breads, cereals, pasta, crackers – rice, cornmeal and gluten-free products.
• Other – regular candy, leafy herbs, sweet spices, oils, vinegars, lemon or lime juice and foods sweetened with sugar

These are not complete food lists as there is more information about how to cook and eat on low-FODMAP diets. If you are interested in learning more or trying this diet, contact a registered dietitian. Other options include visiting www.ibsfree.net or talking to your doctor.

The bottom line is the mystery of your tummy trouble can be solved.

Mercy clinical nutrition dietitians at Mercy Hospital Carthage on the McCune-Brooks Campus, 3125 Dr. Russell Smith Way, can be reached at 417-359-1359.