# PALEO DIET & IBS



## taro (Nov 16, 2013)

Has anyone had success with the PALEO diet? I'm thinking about trying it out, combining the FODMAP diet with the PALEO. There is a guy that does it and has a really good website (primalpalate.com if I remember correctly). I noticed while researching that it is often targeted to people that wish to lose weight, but that's not really my case, so I'm wondering if it would be good for IBS as well. Any thoughts?


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## tummyrumbles (Aug 14, 2005)

I tried the Paleo diet briefly. It's not designed for IBS so allows a fair bit of insoluble fibre. The recipe book I had had a lot of salads which I can't really take. The hardest thing with all these diets is the snack foods. The FODMAP diet allows horrible breads made out of tapioca or potato flour. These are full of starch and were worse than normal bread for me. The paleo diet allows breads and cakes made from either nut or coconut flour. Both of these are very high in fibre. The only real safe foods for me seem to be meat and well cooked low FODMAP veges but I'm always cheating because of the hunger.


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## Nojokeibs (Apr 14, 2014)

My experience was very similar to tummyrumbles. Eventually there was too much cellulose in the salads and I'd have this bloating issue that didn't go away unless I avoided veggies - even greens. Then if I ate fruit, I had hunger from the sugar. It might work if you do the keto option. Or it might work for you, period. People are different.

I've noticed lately that they are recommending more fermented foods, and my solution to the "greens are now making me sick" problem was to eat sauerkraut... so go figure. Maybe many of them had the same problems and decided to add that aspect to the diet. It wasn't there a few months ago (I mean, not back in March, from what I remember, except maybe Sisson's site which is not strict).

I'd be interested to hear if it works better for you. I went ketogenic traditional afterwards. But I started from Atkins, went even more strict Atkins, tried Primal-ketogenic (primal meaning I did not give up dairy), and then became ketogenic traditional. The fermented foods I eat now are almost the sum total of my veggies, since my carb portion is so low. OTOH, I can go with 2 meals a day and almost feel too full on that.


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## tummyrumbles (Aug 14, 2005)

Nojokeibs, you must be skinny! That's not your picture is it. I'd like to know what your actual diet is. Hunger is the worst aspect for me on any low gas diet. I'm envious if you can fill up on 2 meals a day. You must be efficiently digesting the foods you do eat. What kind of fats do you fill up on and do you have gas problems or is your IBS just constipation? You obviously seem to tolerate a lot more fibre than a lot of us. I think many people here do have a bacterial imbalance but that might not be the case with you. Or maybe you have a different type of flora that can digest fibre OK but not starches. Where I think my IBS originates is gas from malabsorbed carbs causing constipation in the first place. The gas itself seems to block stool. This fits in to a certain extent with the SIBO theory but how would you explain this if you don't have SIBO. I think for those of us that can tolerate them, healthy fats will help to fill you up but some people can't digest these well either.


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## Nojokeibs (Apr 14, 2014)

LOL, that's not a pic of me. It's from the Philadelphia Museum of medical Oddities, there's a statue of a guy there who had a megacolon, and I think even his actual colon is there. I should be more worried that more people have "signatures" turned off and don't know why that picture is there. My sig explains it.

I have definite gas problems, and it does seem to block up the orderly passage of stool out of my system. I've noticed that if I take Phazyme or something with simethicone in it, I have to burst/chew them because otherwise they don't break up the gas that's trapped much higher up than the ileum or beyond. I was unable to touch anything with a FODMAP in it (thank god for Monash U, because at least I could see what the problem was)... for a long time. But it was their research that put me on to the Sauerkraut idea. I honestly wasn't able to digest much fiber before I hit on that insight.

I'm pummeling my problems with every tool I have in my arsenal, but weight loss isn't something I've fully conquered yet. I have 80 more lbs to lose. But I've already lost over 60, so that's not bad. Ketogenic is not an easy diet, and it's hard to lose weight if you are very very obese when you start. Part of why it works is because it gives you energy and then you exercise, and then your body gives you more mitochondria, and your metabolism is fixed. If you're too obese to move around much, or you have chronic pain (I have chronic pain, actually having a flare atm), this particular aspect can be difficult at first. I often have to make the choice between being in more pain and losing weight and being in less pain and staying at the same weight. My reasons for being ketogenic aren't just weight or IBS or pain alone, it's all 3, so it's a bit delicate.

This is still a huge improvement over my previous condition. It took several pain control drugs, many of them "controlled" (read: the DEA knows your name), to get me through just one more miserable day. Now it's 3 drugs and they all prevent pain, and none of them are "controlled." I even got off of the anti-inflammatory (meloxicam) I was on, though that was the last one I gave up. That's another reason I went this way. With the pain lessened, I don't have all these funky drugs messing up my guts or my mind.

Example of the choices I make: Pretty soon now I'm going to switch from keto to a VLCD (also ketogenic, but not nearly as effective at pain control), but first my current pain flare has to be completely extinct. Do I increase or avoid exercise to do that? Do I eat differently or increase fish oil? Should I stop the pain with aspirin/advil or let the body heal itself? I don't have perfect answers to these questions. Nobody can. I just have to behave like I'm well and hope my body switches off the alarm. (A VLCD is a 'very low calorie' diet where you mostly focus on adequate protein and vitamins so that your body can eat up its stores of fat as quickly as possible. it's for weight loss.)

BTW, it's amusing to me that IBS is considered a misspelling on this site.


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## tummyrumbles (Aug 14, 2005)

Any idea where your pain comes from - is it a bloating pain or something else like cramping? I don't really get pain unless I'm trying to hold gas in but then I find I can't hold it in for too long once the pain starts. Sometimes if I have too much fibre I get a cramping sensation but that doesn't happen too much and it's not really painful. Have you tried spending longer in the toilet? It's a hassle but it works well. Bone broth is good as well. I bought a pressure cooker just to make these. Ham hocks seem to make the tastiest broths and the glutamate helps to heal the gut. I understand the theory for a high protein and fat diet but worry about the constipating effect of a diet like this. A lot of dietary theory is written by people who don't necessarily understand IBS which is why everyone gets so confused. I'd worry too about health implications with a ketonic diet. It's possible you don't really tolerate fibre all that well. If your pain is from retained gas it could be that the fermented veges are causing the gas. Have you tried a diet similar to mine and found it didn't work? I think for a lot of us we have to accept that a certain part of constipation is just genetic. Plus a lot of it is tied up with the ENS brain so we're never completely going to understand exactly what causes constipation. I work around constipation by spending a long time evacuating as you probably know by now. This cures the gas problem for a few hours until peristalsis pushes through a new lot of gas. My typical evacuation time is 2 hours so I can understand people thinking that's just not do-able. I can't get consistent results with diet so I rely on this more than anything else. I've found that the well cooked low FODMAP veges seems to produce the least gas of all foods, excepting meat and fats. This means that assuming evacuation is complete when peristalsis does move the next lot of food forward there shouldn't be a lot of gas. The less gas the less of a gap between stool. I've had a few days when all the stool was continuous and evacuation was very quick but this diet is very hard to keep to. My problem is willpower because starches are the digestible parts of carbs. We don't digest fibre at all so low-starch high fibre veges tend to be the least satisfying, which makes sense. We need calories because being hungry isn't a pragmatic cure. I honestly don't know anything better than the well-cooked low FODMAP veges to fill up on. I think these are a near perfect food and you can always boil these according to your personal fibre threshold.


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## Nojokeibs (Apr 14, 2014)

tummyrumbles said:


> Any idea where your pain comes from - is it a bloating pain or something else like cramping?
> 
> I have a clue here and there, but overall, no. One mechanism I've noticed is that if I annoy my digestive system, I pretty much instantly get a backache. If the backache goes on too long, it can trigger other things like a migraine with aura. Some of the reasons I have pain may be simply explained if someone were to physically look inside me. I suspect I have adhesions from an abdominal surgery when I was just a child. I sidestepped a second surgery in childhood thank god. I'd rather not contemplate what I'd be like if I'd had 2.
> 
> ...


Agreed, I can't fault your logic, nor would I try, especially if it works for you. I also found that this was the best combination. Assuming I was comfortable within the limits of Low-FODMAP; I wasn't though. I really missed garlic and onions and summer peaches (okay on keto, just one peach). Even the smallest bit of onion, no matter how well cooked gave me agony. But now it doesn't. I do still get the gas, but it is less gas and it actually leaves my body without my having to do dances and contortions and prayers... etc... If you'll let me theorize for a minute, I think the bacteria themselves have an effect on the function of my bowels. If I have dysbiosis, I think it's possible for them to cause dysfunction of the muscles. And the reverse may also be true. I took a big leap of faith and so far it has worked out. I wish I could say "here's why it worked, this is the proof, it's all explained here" but I can't. I'm just glad it is working so far.

It's not perfect. Kombucha (I make my own) is the most likely to make me sick before better. It contains some alcohol and my body hates alcohol and makes me sick whenever I drink it (exactly as if I were on one of those aversion programs with the pills that make you sick, but I'm not). It also contains vinegar, quite a lot, the way I make it, mostly I want acetobacters from it. I'm thinking to switch to apple cider vinegar for acetobacters. Maybe it will have less alcohol in it. Or I have to aerate it or something. Skyr doesn't seem to stop a bellyache if it's caused by some restaurant food that probably has something creepy in it like salmonella. But anything with bifidus does. Skyr is very useful stuff and so is kombucha, I wouldn't lose them for the world but they're trickier to use than sauerkraut and kefir. My local WF has some canned (but with FODMAPS reduced - as you pointed out, not absent, but reduced) fermented vegetables from Greece, including beets which I love. One hint is the ingredient "grape must." It gives me an idea...









Aren't you glad Whole foods didn't name themselves World of Whole Foods? Then I'd be abbreviating it, WWF!


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## tummyrumbles (Aug 14, 2005)

It must be tough to have chronic pain. It must make things a lot more difficult for you if you can't identify what exactly is causing the pain. I agree that bacteria have a direct effect on the bowels and I think bacterial gas does as well. Part of the SIBO theory suggests that gasses can act like neurotransmitters. Yes the toilet thing is a problem for relationships. Everyone deserves enough privacy to spend as much time as they need. I can't stick to the low FODMAP myself. I love onions and still eat wheat products even though it's possible they could be creating a leaky gut problem as well (I have eczema too). If probiotics allowed you to have high FODMAPs without pain, or with less pain, it could be due to a general bacterial overbalance, maybe in the colon. So the sauerkraut and other probiotics feed the good bacteria at the expense of the bad. I was thinking before, your IBS didn't sound like IBS although the pain does. Most of us here definitely couldn't tolerate a high level of fibre because bacteria feed just as much on fibre as they do starches. If the SIBO theory is correct, constipation-predominant people probably are methane producers, and methane can retard peristalsis by causing non-propulsive contractions, or spasms, which some people could possibly perceive as pain if they're sensitive enough. The SIBO theory seems to suit my situation more, because all carbohydrates seem to feed the bacteria. A general (colonic?) dysbiosis seems to suit your situation more, maybe because certain types of fibre reduce pain for you. There's not a whole lot of studies on gasses and the SIBO theory seems to be on the fringe as well. I think IBS is caused by gas. I believe gas is a bioactive agent in the colon. The question is why normal people eat complete rubbish but don't produce a lot of gas. I was a heavy drinker at one stage and could have damaged the colon so I have to accept there could simply be neuromuscular damage and I'm not sure if this can be repaired. Maybe the bad bacteria interfere with the digestive process of the good bacteria. It's possible your pain is mainly from gas. Constipation also traps even more gas, especially if the stool is full of malabsorbed carbs. This is basically gassy stool which would also be releasing volatiles in the colon. This could also be a reason for the false positives for SIBO. Breath tests are picking up the methane from stool gas. If your stool is the typical solid type then maybe you don't experience the malabsorption I do. Mine are always mushy which suggests chronic maldigestion to me. I can understand your liking for saurerkraut if you're convinced that foods like this mean less pain overall. The real test would be to go meds-free if you ever get to that stage. Most normal, non-IBS people benefit from probiotics, short chain fatty acids etc but they're not producing copious amounts of gas. Most of us here do produce a lot of gas. It's possible that the high fibre moves things through faster, which is what fibre does, but it will still produce a lot of gas on its way. It all comes down to whether you believe most of your pain is functional or organic. IBS is supposed to be functional although I think that's changing a lot with the SIBO theory . If it's caused by bacterial gas then it's organic and there's a rational explanation as well. If IBS is caused by gas then meds won't really help. It's the lack of gas in the first place that will reduce the pain.


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## Nojokeibs (Apr 14, 2014)

just on the fiber part, I use cronometer to track my nutrition every day, my fiber never really gets above 15g/day, usually it stays around 8g/day, so I'm not sure if you consider that "low" or high" for IBS. I consider 30g/day to be way too high fiber for me, sauerkraut or not. I don't think that program breaks down soluble and insoluble though. And I have no idea whether it would consider inulin a fiber and mannitol a sugar or not? There's a lot of fuzzy logic these days.

Not sure if I said this, but the fermented food I eat, it is always the probiotic one if I buy it in a store. In WF, the brand they have here is "Farmhouse Culture" but there are a couple of "Raw Vegan" ones also that look like they've been put through a masticating juicer (like a Champion or something) and then allowed to ferment. Either of those are good for me. Not sure what you mean by "bad" bacteria from fermentations. I think the dominant bacteria in sauerkraut is lactobacillus plantarum, but I'd need to do more research (and intend to) to identify the methanogens and the ones I think are most important, the ones that use sulfur. I'll be spending lots of time with the microbiology book in a bit, and on Microbewiki. ATM I'm deeply involved in understanding the mysteries of the various types of monosaccharides in a biochemistry book. One thing at a time.


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