# How effective is Hypnosis?



## Lynda S (Sep 2, 2002)

Hi all! I'm new to this bulletin board so I'll give some history. I've suffered from Ulcerative Colitis for 20 years in addition to IBS for about 7 years (I was told these are unrelated). I'm controlling the UC with topical steroids every night. The IBS hits me in the morning as well as when I go into any store (markets, k-mart, bloomies...) When it hits I take immodium and nulev (I'm up to 2 each/day) some day's I'm fine, others I can't leave the house. I can never go to a store without a public br. I have tried hypnosis to stop smoking and it did not help (I did stop eventually through a different program) Can hypnosis help? Any other alternatives? Does meditation help? Also, the doctor told me to take fiber supplements and this seems to make me worse the next day so I stopped. Is this normal?Thanks!Lynda


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## Nikki (Jul 11, 2000)

Yes, hypnosis does help with IBS is the simple answer. I am so much better after doing it. I owe so many people here a huge thanks! If you want a more detailed answer post forEric, Marilyn or Mike and they will help you.Good Luck!


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## JeanG (Oct 20, 1999)

Hi Lynda:Hypnosis does work wonders with IBS. The ulcerative colitis is another story, however, that I'm not sure hypno can do much for. Hopefully Eric will see your post and give you more information.







JeanG


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## cookies4marilyn (Jun 30, 2000)

Hi Lynda,And welcome. In answer to your question, there are many threads on this forum from people who have done the hypnotherapy for IBS. It is one complementary therapy that can be done along with any other medical conventional therapy. If you would like more information about Mike's program, click on the audio program link below my name. This is something you can do in the privacy of your own home over the course of 100 days, and is easy to do. The program addresses IBS and the very issues you mention of not being able to go out for fear there is no bathroom, etc. As far as the UC goes, that is something that has to be under doctor's care, but the hypnotherapy may help in terms of managing any pain, and coping strategies, but continue with your doctor for that as you say.Meditation and cognitive behavioral therapy, biofeedback are also good alternative therapies, and everyone is different with what method they prefer. Those who have done the other therapies may respond with their experiences also.Fiber supplements very often make those with D worse. Many patinets who have completed Mike's program no longer suffer from severe D and do not require supplements or even meds. He has worked with over 2000 patients, so he knows what he is doing.As far as effectiveness, 90% or more of users of the IBS Audio Program have been helped with either greatly reducing symptoms, or virtually eliminating them. The trials were done in England, where doctors and gastroenterologitsts were referring their patients to Mike when all other medical avenues were exhausted and ineffective, so clinical hypnotherapy has a good track record. You can also have sessions done in person 1 to 1, but the therapist should be trained in treating IBS. The home program is more cost effective and private, and for most people it has helped. Good luck no matter what method you consider, but just read around this board, and it will give you some insight as to others' experiences with the various methods.Take care.







(I had to repost, because I had my signature off! OOPS!)


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## eric (Jul 8, 1999)

Hi Lynda, welcome to the forum.I think it would help if we gave you information and you printed it and you talked to your doctor about all this. As far as the IBS and hypno go no problem, but the IBD requires a different approach do to its organic origins as oppose to functional origins in IBS.HT has been shown is some studies to help boost the immune system as do other relaxtion techniques basically, so in that regards it may help the IBD condition and also maybe by calming the brain gut axis which is in part why it helps IBS.I think this would all be fine really, but you should discuss it with your doctor as it can be really effective for pain in IBS and pain in general, but it maybe a concern with the IBD and pain and that is something to ask the doctor about and I will try to ask some of the ones I know about it. Other then that and staying with the treatments for IBD your doctor is working on with you I don't believe it would really be a problem. But like I said, discuss this with the doctor and see what he says to be absolutely sure.For information on HT for IBS here you go and it will help to read it all and some of the related posts I will post here. This information however is all geared more towards the IBS and not the IBD.Using Relaxation Coping with Functional Gastrointestinal Disorders http://www.med.unc.edu/medicine/fgidc/relax.htm The Effects of Hypnosis On Gastrointestinal Problems http://www.med.unc.edu/medicine/fgidc/hypnosis.htm Hypnotherapy for Functional Gastrointestinal Disorders By: Peter J. Whorwell, M.D., University Hospital of South Manchester, England http://www.aboutibs.org/Publications/hypnosis.html This is a whole public website, by a expert IBS doctor and hypnotherapy specialist, on HT for IBS.www.ibshypnosis.comHope this helps and let us know if you have any more questions.


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## eric (Jul 8, 1999)

Opps, forgot one I thought you should read for the information in general in regards to IBS. http://www.ibsgroup.org/other/usnews000403.htm


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## kamie (Sep 14, 2002)

Hi everyone, I'm new here too. I have found this discussion on Hypnosis to be very interesting. a lot of good information.One comment struck me as important regarding hypnosis and alternative procedures in general to help manage health conditions.eric wrote>>>>As far as the IBS and hypno go no problem, but the IBD requires a different approach do to its organic origins as oppose to functional origins in IBS.<<<<<I have been a holistic practitioner for many years. I've had access to the best of the best in practitioner modalities including hypnosis.I handled a lot of my physical problems for years with the help of alternative practices.There are a number of things going on with my body that are turning out to be the luck of the genetic draw as far as my health is concerned.Alternatve practices have at times worked very well with my needed medications and at times not worked well. It's important to find the delicate balance and knowing which modality fits with which medication or therapy process.In addition to IBS I have hypertension and chronic pelvic pain.Hypnosis, acupuncture, body work, energy rebalancing, massage therapy, yoga,aroma therapy, and a lot of ther stuff too kept me well enough to be able to enjoy a full and athlethic life until my inner condition became so advanced that it was time to seek a surgeon.There were a lot of things that contributed to the difficulties in my body and that's a whole other story.........however, when using an alternative modalitiy it's important to have that finely balanced awarenss to know when a modality is helping or simply blocking important signals from the body that alert us to knowing that the body needs a different kind of tending.I've had both things happen with my body.With the IBS problem, which turned out to be intricately and literally linked with some serious gynecology problems,I finally recognized that it was time to shift modalities when a treatment of accupuncture left me with a festering scab on my lower back from a needle placement.The Acupuncture Doctor knew her process but for me, the disharmony in the recently tuned vehicle was my signal to pay attention.If an aletrnative therapy does not seem to be working or if hypnosis does not seem to be helping, then it is possible that one might be looing at a deeper physical reason for continueddifficulty.In my case, it turned out that my colon was fliped over the ovary and was attaching itself to the ovary by endo and adhesions and that combination had also plastered itself to the musculature of the pelvic girdle.Eventually my pian and body condition became so compromised that I had to stop riding my horse and stop scuba diviing. That was a most depressing and unhappy realisation for me.However, when the surgeon finally got inside of my body and found things that never showed up on both internal and external sonograms, I was relieved to have a much needed surgery because the alternatives of allowing the destructive growth process going on within my body was just not a good answer. My surgery ran 4 1/2 hours on what should have been a "simple" hysterectomy.There was no separating colon from the ovary and pelvic involvement with out causing damage to one of the organs so the surgeon chose to destroy the ovary in the process of trying to liberate the colon.Needless to say, alternative methods had probably done about all they could do for me and then it was time to address some real organic issues.So, I guess what I am saying here, as someone who is a practitioner on the world of holistic thinking and health application,is that we should always listen to our bodies and we don't want to over program our bodies to over ride critical responses that could be our bodies only way of communicating with us.Hypnosis and so many of the alternative processes are so very helpful in assisting us as we wander through the maze of trying to find the right answers for our bodies.Currently, my IBS issues are still unresolved and at now 5 months post op I am still searching for answers.However, over all, I am much much better and I can attribute the amount of better health I've had to good doctors and good alternative help.Kamie


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## Lynda S (Sep 2, 2002)

Thank you all for your feedback - it was quite helpful! I will look into Mikes hypnosis tapes and ask my Doctor about it when I see him this week for my Colonoscopy. It's great to hear that I am not crazy when I feel that the fiber supplements are making me worse! When I first went to a Dr. about my problems he put me on a low fiber diet with fiber supplements. I realized that fruits and veggies were not part of my problem - animal fats were making me ill! I was allowed to have any meat on that diet! It goes to show that they really don't know what can help or hurt.Lynda


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## kamie (Sep 14, 2002)

Lynda, For me some really serious go to the hospital triggers are red meat and SOY!I've had to get as much soy and soy additives out of my diet as possible.I shop at special places where I can buy bread with out a soy additive and I buy only POST brand cereals because they make soy free bran flakes.It's amazing what turns out to be a bad trigger for us.Oh yes.....no apples for me either. Pears work fine but apples, unless it's applesauce makes everything icky. I think the process of keeping a food diary and elimination of possible triggers is a good way to troubleshoot.Kamie


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## eric (Jul 8, 1999)

Lynda S, its good your asking your doctor and print and take some of the information I posted there with you as it will help and the doctor will probably even be glad for the info if he or she does not already know about it.On the food issues here is some info for you from Heather Van Vorous the author of "Eating for IBS." that may help.







Good Nutrition and Great Food When Youï¿½re Eating for IBS By Heather Van Vorous No, this title is not a contradiction in terms. Itï¿½s not only possible, but actually very easy to eat a healthy ï¿½ and delicious - diet that will actively prevent IBS symptoms. There are, in fact, very clear guidelines to follow for how to eat safely for IBS, based on the well-established effects certain categories of foods have on the GI tract. The key word here is categories ï¿½ if youï¿½re like most people with IBS, the odds are youï¿½ve been going crazy trying to figure which one specific food triggers your attacks. The problem is, it isnï¿½t a single food that causes attacks. Itï¿½s any food that is high in fat, insoluble fiber, caffeine, coffee (even decaf), carbonation, or alcohol. Why? Because all of these food categories are either GI stimulants or irritants, and can cause violent over-reactions of the muscles in your colon. So does this mean you can never again eat any of these foods? No, not at all. It just means youï¿½ll have to recognize them as triggers, and eat them carefully, according to guidelines weï¿½ll cover below. More importantly, youï¿½ll need to focus on what you can and should eat, and the primary food category here is soluble fiber. Soluble Fiber Hmmmï¿½.Youï¿½ve heard of fiber, youï¿½re pretty sure you know what it is, and youï¿½ve probably had it recommended to you as beneficial for IBS. But soluble fiber? Is this something special? Yes, it is. Soluble fiber is the single greatest dietary aid for preventing IBS symptoms in the first place, as well as relieving them once they occur. Hereï¿½s the kicker. Soluble fiber is NOT typically found in foods most people think of as ï¿½fiber,ï¿½ such as bran or raw leafy green vegetables. Soluble fiber is actually found in foods commonly thought of as ï¿½starchesï¿½, though soluble fiber itself differs from starch as the chemical bonds that join its individual sugar units cannot be digested by enzymes in the human GI tract. In other words, soluble fiber has no calories because it passes through the body intact. Soluble Fiber Foods ï¿½ the Basis of the IBS Diet As a general rule, the grain and cereal foods at the top of this list make the safest, easiest, and most versatile soluble fiber foundations for your meals and snacks. Rice Pasta and noodles Oatmeal Barley Fresh white breads such as French or sourdough (NOT whole wheat or whole grain. Please choose a baked-daily, high quality, preservative-free brand.) Rice cereals Flour tortillas Soy Quinoa Corn meal Potatoes Carrots Yams Sweet potatoes Turnips Rutabagas Parsnips Beets Squash and pumpkins Chestnuts Avocados (though they do have some fat) Bananas Applesauce Mangoes Papayas (also digestive aids that relieve gas and indigestion) Why is soluble fiber so special? Because unlike any other food category, it soothes and regulates the digestive tract, stabilizes the intestinal contractions resulting from the gastrocolic reflex, and normalizes bowel function from either extreme. Thatï¿½s right ï¿½ soluble fiber prevents and relieves both diarrhea and constipation. Nothing else in the world will do this for you. How is this possible? The ï¿½solubleï¿½ in soluble fiber means that it dissolves in water (though it is not digested). This allows it to absorb excess liquid in the colon, preventing diarrhea by forming a thick gel and adding a great deal of bulk as it passes intact through the gut.. This gel (as opposed to a watery liquid) also keeps the GI muscles stretched gently around a full colon, giving those muscles something to easily ï¿½gripï¿½ during peristaltic contractions, thus preventing the rapid transit time and explosive bowel movements of diarrhea as well. By the same token, the full gel-filled colon (as opposed to a colon tightly clenched around dry, hard, impacted stools) provides the same ï¿½gripï¿½ during the muscle waves of constipation sufferers, allowing for an easier and faster transit time, and the passage of the thick wet gel also effectively relieves constipation by softening and pushing through impacted fecal matter. If you can mentally picture your colon as a tube that is squeezing through matter via regular waves of contractions, itï¿½s easy to see how a colon filled with soluble fiber gel is beneficial for both sides of the IBS coin. As a glorious bonus here, normalizing the contractions of the colon (from too fast or too slow speeds) prevents the violent and irregular spasms that result in the lower abdominal cramping pain that cripples so many IBS patients. This single action alone is the reason you shouldnï¿½t eat anything on an empty stomach but soluble fiber. Ever. The only foods you want to trigger your gastrocolic reflex are soluble fiber, as thatï¿½s the best way to keep those contractions (and thus your life) normal. Try to routinely snack on small quantities of sourdough bread, rice cakes, homemade quick breads (pumpkin, zucchini) from IBS safe recipes, bananas, baked corn chips, etc. all day long, every single day. If you donï¿½t have a chance to eat or youï¿½re not that hungry, take a supplement such as psyllium powder, Fibercon tablets, Benefiber, or a glass of Citrucel (these are simply soluble fiber supplements ï¿½ they are NOT laxatives, even though theyï¿½re often marketed as such). Your goal is continual stability, and a steady ingestion of soluble fiber insures this. In the short run this strategy allows you to prevent problems from snack to snack and meal to meal, but in the end it adds up to long-term stability from day to day, week to week, and even month to month. Youï¿½re likely to find that the single best method for completely preventing IBS symptoms is basing your diet on soluble fiber foods. You can keep your colon stabilized each and every day by building all meals and snacks on soluble fiber foods. Fat ï¿½ The Bad Guy Well, you probably knew this one. Most people quickly figure out on their own that greasy foods cause problems. High-fat foods are usually easy to identify, and after getting sick for the third or fourth time in a row after eating French fries or ice cream it becomes painfully obvious that fat is an IBS trigger. Have you been wondering why? Fat is the single greatest digestive tract stimulant. Nothing else will trigger a more powerful gastrocolic reflex. For those of us already prone to wildly unstable colon contractions, this is bad news indeed. Interestingly, the type of fat doesnï¿½t matter at all ï¿½ saturated, monounsaturated, polyunsaturated, theyï¿½re all equal triggers. It simply makes no difference to your gastrocolic reflex if youï¿½re eating lard or extra-virgin olive oil. It will make quite a difference to your heart and your health in general, of course, but in terms of controlling IBS the less fat of all kinds, the better ï¿½ period. This doesnï¿½t mean following a fat-free diet, by the way, but simply a low-fat one. Danger - High Fat Foods Ahead Please donï¿½t read this list and assume that you can never again eat any of these foods, so life is no longer worth living. These are all triggers, yes, and some of them you will probably have to completely eliminate from your diet. BUT - others can be eaten in small quantities when you follow the guidelines coming up, many of the items listed have safer substitutes you can use freely, and there are quite a few tips and tricks for cooking with the nutritious foods on the list in a safe manner. So take heart, this isnï¿½t the end of the world ï¿½ itï¿½s just the beginning of a better diet. Red meat (ground beef, hamburgers, hot dogs, steaks, roast beef, pastrami, salami, bologna, pepperoni, corned beef, ham, bacon, sausage, pork chops, and anything else that comes from cows, pigs, sheep, goats, deer, etc. ) Poultry dark meat and skin (the white meat is fine, as is seafood by the way ï¿½ try to buy organic turkey and chicken)


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## eric (Jul 8, 1999)

Dairy products (cheese, butter, sour cream, cream cheese, milk, cream, half-and half, ice cream, whipped cream). Even skim and lactose-free dairy can trigger IBS attacks. In addition to fat and lactose, dairy contains components such as whey and casein, which can cause severe digestion problems. Egg yolks (whites are fine, do try to buy organic) Meat, dairy products, and egg yolks are particularly dangerous for all aspects of IBS. In some people their high fat content causes violent, rapid colon spasms and triggers diarrhea. Alternately, for others their heavy animal proteins, complete lack of fiber, and very low water content can lead to drastically slowed colon contractions and severe constipation. No matter what IBS symptoms youï¿½re prone to, these three categories of foods pose high risks and are really best eliminated from your diet altogether. French fries Onion rings Fried chicken Corn dogs Anything battered and deep-fried Anything skillet-fried in fat of any kind Shortening Margarine All oils, fats, spreads, etc. Mayonnaise Salad dressings Tartar sauce Cool Whip Coconut milk Shredded coconut Solid chocolate (baking cocoa powder is fine) Solid carob (carob powder is fine) Olives Nuts and nut butters Croissants, pastries, biscuits, scones, and doughnuts Pie crust Potato chips (unless theyï¿½re baked) Corn chips and nachos (unless theyï¿½re baked) Store-bought dried bananas (theyï¿½re almost always deep fried) Fats are usually fairly obvious foods to identify, but not always. The worst culprits are those at the top of the list and many (particularly meat, dairy, egg yolks, and fried foods) can simply be eliminated from your diet entirely and your whole body will be healthier for it. I know the thought of this can be deeply shocking, but giving up these foods does not equal deprivation. Honestly, it doesnï¿½t. There are a great many easy substitutions that will let you cook and eat safely while still enjoying many of your traditional favorite foods. Thereï¿½s also a lot of fun to be had in trying a wide variety of new ones. And when youï¿½re tempted to indulge in a dangerous treat, just remember that everything tastes a lot less delicious when itï¿½s followed by a vicious IBS attack. There are also some hidden sources of fat to watch out for. Cookies, crackers, pancakes, waffles, French toast, biscuits, scones, pastries, doughnuts, and mashed potatoes can all be sky-high in fat (virtually always so at restaurants), so be careful. Give thanks for the recent fat-free craze that has given us supermarket aisles full of safe alternatives. Insoluble Fiber ï¿½ Good or Bad? Both! Hereï¿½s the type of fiber everyone is familiar with ï¿½ bran, whole grains, raw fruits and vegetables (note the exceptions under Soluble Fiber), greens, sprouts, legumes, seeds, and nuts. In short, the healthiest foods in the world, and what everyone should be eating as much of as possible. Right? Well, right, except for one small problem. Insoluble fiber, like fat, is a very powerful GI tract stimulant, and for those of us with IBS this can spell big trouble. Unlike fat, however, you cannot simply minimize your insoluble fiber intake, as this will leave you with a seriously unhealthy diet. Itï¿½s a paradox, but the conflict can be solved fairly easily. Insoluble Fiber Foods ï¿½ Eat with Care Once glance will tell you these are the best (and tastiest) foods around, but your colon simply canï¿½t handle it if you eat them with abandon. You can (and absolutely must) eat them, but within the IBS dietary guidelines. Treat these foods with suitable caution, and youï¿½ll be able to enjoy a wide variety of them, in very healthy quantities, without problem. In general, if a plant food (no animal products contain fiber) seems rough, stringy, has a tough skin, hull, peel, pod, or seeds, be careful. This is not a comprehensive list by any means but it should give you the general idea. Whole wheat flour, whole wheat bread, whole wheat cereal Bran Whole grains, whole grain breads, whole grain cereals (the two big exceptions here are oatmeal and brown rice, both of which are very safe whole grains) Granola Meusli Seeds Nuts Popcorn Beans and lentils (mashed or pureed theyï¿½re much safer) Berries (blueberries, strawberries, blackberries, cranberries, etc.) Grapes and raisins Cherries Pineapple Peaches, nectarines, apricots, and pears with skins (peeled theyï¿½re much safer) Apples (peeled theyï¿½re safe) Rhubarb Melons Oranges, grapefruits, lemons, limes Dates and prunes Greens (spinach, lettuce, kale, mesclun, collards, arugala, watercress, etc.) Whole peas, snow peas, snap peas, pea pods Green beans Kernel corn Bell peppers (roasted and peeled theyï¿½re safer) Eggplant (peeled and seeded itï¿½s much safer) Celery Onions, shallots, leeks, scallions, garlic Cabbage, bok choy, Brussels sprouts Broccoli Cauliflower Tomatoes (peeled and seeded, especially raw, theyï¿½re much safer) Cucumbers (again, peel and seed them and theyï¿½re much safer) Sprouts (alfalfa, sunflower, radish, etc.) Fresh herbs Never eat insoluble fiber alone or on an empty stomach. Always eat it with a larger quantity of soluble fiber, and you will keep your gastrocolic reflex stable. What does this mean in practical terms? Cook some diced vegetables into a low-fat sauce for pasta, stir-fry veggies into a fried rice, or blend fresh fruit into a smoothie to drink after a breakfast bowl of oatmeal. For fruits, vegetables, and legumes in general, peeling, chopping, cooking, and pureeing them will significantly minimize the impact of their insoluble fiber. Make soups, drinks, sauces, breads, and dips from your veggies and fruits instead of eating them whole and raw. For beans and lentils, cook and blend them into sauces, dips, soups, or spreads - their insoluble fiber is found in their outer skins and their insides are actually rich in soluble fiber. For nuts, finely grind and incorporate them into breads or cakes with white flour, which gives a safe soluble fiber base. For bran and other whole grains, eat them in small quantities following soluble fiber foods ï¿½ have a little whole wheat dinner roll after a big sourdough one, or mix a small amount of fat-free granola into a large bowl of cream of rice or Corn Chex cereal. For raw fruit and green salads, eat them at the end of a soluble fiber meal instead of at the beginning. For all insoluble fiber foods, start with small quantities and gradually increase your intake, making sure you follow these guidelines. Iï¿½m confused! How can the same food have insoluble and soluble fiber? Most all grains, cereals, legumes, and tubers have an outer insoluble fiber layer, and a soluble fiber interior (and the same is true for some fruits and vegetables, such as apples and zucchini). Itï¿½s very easy to actually see this with your own eyes. If you take a cooked grain of brown rice, wheat berry, kernel of corn, potato, or bean you can separate the tough exterior (the bran, skin, or shell) from the creamy interior. When the bran is removed from wheat berries and theyï¿½re milled the result is white flour; when the bran is removed from brown rice the result is white rice. There arenï¿½t many similar common commercial processes that remove the insoluble fiber exterior from legumes, fruits, or vegetables, but finely blending, pureeing, or peeling these whole foods will greatly minimize their trigger risk. Wheat in particular causes confusion for many, many people with IBS who are unsure about whether or not it is a safe food for them. There is no flat yes or no answer to this concern because, as weï¿½ve just learned, it depends. Whole wheat, with its outer layer of bran, is high in insoluble fiber. This means that itï¿½s a trigger. Thatï¿½s why whole wheat bread, whole wheat cereals, and bran can cause such awful problems for people with IBS. However, when you remove the bran from whole wheat you end up with white flour (the regular kind you can buy in any grocery store, that you using in baking cookies, breads, muffins, etc.). Though this is still wheat flour, it is not whole wheat flour, and this makes a world of difference. White flour contains no insoluble fiber but it does have soluble fiber, which is the stabilizing force of the IBS diet (just picture the thick gel that results when you dissolve a piece of white bread in a glass of water). This is why white breads are such great safe staples. When you read the ingredients on packaged foods they might not specify if the wheat flour used is ï¿½whiteï¿½ or ï¿½wholeï¿½, but itï¿½s usually pretty easy to tell. For breads, a brief glance will tell you if there is whole wheat in it (youï¿½ll see little brown flakes). If the bread is pure white, like French or sourdough, youï¿½re safe. For most crackers, pretzels, muffins, etc. only white flour will be used. The exception is health food store products, which are likely to use whole wheat. However, they will almost always tout this fact so you wonï¿½t be left wondering. The whole wheat (and other insoluble fiber) intolerances so common to IBS are markedly different from true food allergies. If youï¿½re allergic to wheat, it will make no difference if the grain is left whole or refined by removing the bran. In addition, with many allergies even minuscule quantities of the trigger, whether eaten with other foods or alone, can trigger violent reactions. Fortunately, with IBS this is rarely the case, so we just have to be careful with whole wheat and other insoluble fibers. If we do take care we can easily and frequently eat them in small quantities when theyï¿½re combined with high soluble fiber foods. In addition, with wheat, once the bran has been removed so has the risk of an IBS attack, and this gives us great dietary freedom when it comes to white breads and other refined wheat flour foods.


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## eric (Jul 8, 1999)

Some fruits and vegetables are particularly troublesome for IBS. Sulfur-containing foods (garlic, onions, leeks, broccoli, cauliflower, cabbage, asparagus, and Brussels sprouts), in addition to their high amounts of insoluble fiber, also produce significant gas in the GI tract and this can trigger attacks. As with all other fruits and veggies, however, these are extremely nutritious foods with significant health benefits, so they need to be treated with caution but definitely not eliminated from your diet. Acidic foods (citrus fruits and cooked tomatoes) should be treated with extra care as well, as their acidity can cause both upper and lower GI distress. Once again, follow the rules for insoluble fiber and eat these foods in smaller quantities incorporated with soluble fiber ï¿½ but please do eat them. Fructose, a fruit sugar, can cause gas, bloating, and diarrhea (this is typically not true for sucrose, or plain table sugar). Fruit juices, particularly apple and grape juice, are often sky high in fructose and even more problematic than whole fresh fruit. Itï¿½s simply much easier and faster to drink a large glass of juice (and ingest a great deal of fructose) than to eat an equivalent amount of whole fruit. So treat juices as you would insoluble fiber and drink them carefully, with soluble fiber foods. Other Pesky Creatures to Avoid Coffee ï¿½ both regular and decaf ï¿½ contains an enzyme thatï¿½s an extremely powerful GI tract irritant. Go cold turkey today and drink herbal teas instead. Caffeine is a GI stimulant and should be avoided, especially in higher doses. Alcohol is a GI irritant and often triggers attacks, especially on an empty stomach (though small amounts of alcohol used in cooking are fine). Carbonation in soda pop and mineral water can cause bloating and cramps. Artificial sweeteners, particularly sorbitol, can trigger pain and diarrhea. Artificial fats, namely Olestra, can cause abdominal cramping and diarrhea in people who donï¿½t even have IBS ï¿½ imagine what it can do to you. MSG has acquired lots of ugly anecdotal evidence against it regarding all sorts of digestive upsets. It can simply be avoided, so why take a chance? Size Matters No matter how safe any food is for IBS, eating a huge portion of it in one sitting can trigger an attack. Your gastrocolic reflex gains strength in direct correlation to the number of calories you consume in a meal. While this makes it easy to see why high fat foods causes problems (fat is more than twice as calorie-dense as carbohydrates and proteins) it also means that bingeing ï¿½ on anything ï¿½ carries serious risks for those of us with IBS. So donï¿½t kid yourself that when your friend breaks out a pint of ice cream and a spoon that you can do the same with fat-free sorbet. Itï¿½s not just ingredients, but quantity too. Size really does matter. Keeping your portions small has some fringe benefits, particularly in that it should make it easier to eat more frequently, and this is a helpful strategy for maintaining a constant intake of soluble fiber. Unfortunately, the Western world has gotten used to ï¿½supersizingï¿½ just about everything we eat, and this can be a hard habit to break. One thing to try at home is serving yourself on salad plates and soup bowls, so that visually you donï¿½t feel faced with a skimpy meal. Remember too that you can always take a second small portion after you finish the first one, as long as you eat at a slow-to-moderate pace and you still feel hungry. This is a great way to keep from over-serving yourself initially and then feeling obligated to eat everything on your plate even if youï¿½re full (a ï¿½donï¿½t waste foodï¿½ lesson ingrained in most of us as children). Snacking on small amounts of food throughout the day will keep you from getting ravenous and then over-eating, which can trigger an attack. At restaurants make a point of dividing your plate in half the moment youï¿½re served and take that portion home with you for a later meal. Once you develop this habit youï¿½ll likely be astonished to realize how oversized most restaurant meals are, and it will be clear why itï¿½s so common to suffer an attack if you eat all that food at one sitting. I have a few favorite restaurants (Ethiopian and Middle Eastern) whose dinner portions are so generous I actually get three complete meals out of them. Even someone without IBS is likely to feel pretty uncomfortable if they down that much food at a one dinner. Thereï¿½s another aspect to portion control that has some happy possibilities for IBS. The risk of trigger foods can be tremendously minimized if theyï¿½re eaten in tiny quantities following soluble fiber. In this regard, it is as much how you eat as what you eat that will help you manage your symptoms. While this is most important as a tool to allow you to incorporate all those healthy insoluble fiber foods as often as possible, itï¿½s also a means of treating yourself to a ï¿½mini-splurgeï¿½ every once in a while. Letï¿½s say youï¿½re well-stabilized and just dying for a chocolate bar. Eating a full-size candy bar as a snack when your stomach is empty will likely wreak havoc and send you into an immediate downward spiral of attacks (why? because itï¿½s sky high in fat and dairy, and has very little soluble fiber). However, if your symptoms were well under control and you instead decided to treat yourself to a snack-size individual candy bar (a tiny portion equals a tiny quantity of fat/dairy triggers) for dessert, immediately following a nice low-fat, high soluble fiber meal, youï¿½d likely do just fine. I eat solid chocolate almost every day in this manner. (Of course, this may just be sheer willpower because as God is my witness I will not go through life without chocolate, but I think this is probably the less likely explanation.) Whatever your favorite trigger food, this strategy gives you a good means of allowing yourself the occasional small indulgence. IBS food intolerances are, fortunately, not like food allergies, where the quantity of a trigger (say, peanuts) may not matter. For this we can thank our lucky stars, as it means that few things are truly forbidden to us as long as we follow some common sense rules and exercise a little self control. Will eating for IBS make me fat? Youï¿½re not alone if youï¿½re wondering whether eating safely for IBS will lead to excess weight gain. Rest assured, it wonï¿½t. The basis of the IBS diet, soluble fiber, has no calories at all as it is indigestible. High soluble fiber foods are virtually always high in complex carbohydrates and low in fat. This is a good thing, as the healthiest diets in the world, associated with the lowest obesity rates, are those highest in complex carbohydrates and lowest in fat and protein (particularly from animal products). This fact completely contradicts the current and misguided popularity of high protein/low carbohydrate fad diets. Tellingly, the obesity rates for cultures with high carb/low fat and protein diets (primarily in Asia) are a fraction of the obesity rates in the Western world. Americans average only 40-50% of diet from carbohydrates ï¿½ but most Asian nations average 60-75%. The US national obesity rate is now one of the highest in the world, at 35% for adults and 20% for children. The average Asian countryï¿½s obesity rate is just 2-3%. Striking, isnï¿½t it? It is simply very difficult to eat enough high soluble fiber foods (theyï¿½re very filling) to gain weight while still keeping your diet low fat. The high soluble fiber diet necessary for controlling IBS should actually result in weight loss - if you're overweight. If your weight is already normal it won't result in weight gain unless you significantly up your portion sizes, which would likely trigger an attack, or gorge yourself on refined sugar foods that have no soluble fiber to fill you up. The IBS diet is essentially low-fat vegetarian-based, plus chicken breasts and seafood. Eliminating the meat, dairy, fried foods, and soda pop drastically lowers the calorie count for people who switch from a "typical" Western diet. Upping your soluble fiber food intake will increase your calories from complex carbohydrates, but these are much less calorie-dense than all the fats youï¿½ve eliminated. It also takes more energy for your body to store excess carbohydrates, versus excess fats, as body fat, so you have to eat more carbohydrate calories than fat calories in order to gain weight. Carefully incorporating as much insoluble fiber as you can tolerate will not add any significant calories at all. Plus, both types of fiber are very filling, and will help with appetite control. Eating small portions frequently, important for minimizing the risk of attacks, also helps keep you filled without having to eat as much. Finally, please realize that soluble fiber is extremely beneficial for a lot of health problems besides IBS. It not only regulates and normalizes colonic activity, it also lowers LDL (ï¿½bad) blood cholesterol levels and the corresponding risk of heart disease, prevents colon cancer, and improves glycemic (blood sugar) control in diabetics by slowing the digestion of carbohydrates and subsequent release of glucose into the blood. It also helps prevent blood vessel constriction and the formation of free radicals ï¿½ both risk factors for heart attacks ï¿½ by slowing the absorption of fat and carbohydrates into the bloodstream. Best of all, it really and truly does dramatically help prevent IBS attacks. So don't be afraid of it, and don't worry about weight gain or difficult weight loss. Eating for IBS should safely and easily normalize your weight, helping you lose pounds if you need to. And if youï¿½re looking for a weight gain, finally having the knowledge of how to eat without fear should allow you to up your calorie intake significantly and add on the pounds you need for good health. The 10 Commandments of Eating for IBS Is your head spinning from all these new categories of food? Donï¿½t worry. I know it can be confusing at first to start thinking about what you eat in terms of fats and types of fibers. But what seems foreign today will be old hat tomorrow, so just take things one day at a time. Making the effort here is truly worthwhile, because following the IBS diet will make a world of difference in your life. So letï¿½s take the knowledge of how to eat safely and put it into practical terms. Here areï¿½ The Ten Commandments of Eating for IBS 1. ALWAYS eat soluble fiber first, eat soluble fiber whenever your stomach is empty, and make soluble fiber foods the largest component of every meal and snack. 2. Minimize your fat intake to 25% of your diet, max. Read labels and at restaurants, ask. 3. Never eat high fat foods, even in small portions, on an empty stomach or without soluble fiber. Better still, donï¿½t eat them at all. 4. Eliminate all red meat, dairy, fried foods, egg yolks, coffee, soda pop, and alcohol from your diet. This may be the most difficult dietary strategy to adopt, and I know it probably wonï¿½t be fun or easy ï¿½ but neither are IBS attacks. 5. Never, never, never eat insoluble fiber on an empty stomach, in large quantities at one sitting, or without soluble fiber. 6. Eat small portions frequently, calmly, and leisurely. 7. If youï¿½re unsure about something, DONï¿½T EAT IT. Itï¿½s not worth the risk. 8. Food is fun and eating should be pleasurable. Take the time and make the effort to eat safely, and then enjoy yourself. 9. Remember that you have absolute and total control over your diet. No one can force you to eat something you know you shouldnï¿½t ï¿½ if anyone tries, think of them as a drug dealer and just say no. 10. Practice creative substitution, not deprivation. Use soy or rice replacements for dairy, two egg whites to replace a whole egg, try low-fat vegetarian versions of meat products, replace some oil with fruit purees in breads or cakes, use veggie broth instead of oil in sauces, bake with cocoa powder (itï¿½s fat free) instead of solid chocolate. Use herbs, baking extracts (vanilla, peppermint, maple, etc.) and mild spices generously to heighten flavors. In summary, if youï¿½re currently trying to break a cycle of ongoing attacks, it is best to strictly limit your diet to soluble fiber foods and peppermint tea (a powerful GI muscle relaxant and painkiller) for several days. This will allow your GI tract to stabilize, and then you can gradually and carefully add in other foods following the rules. At that point youï¿½ll be ready to go shopping, re-stock your pantry with your new safe staples, and cook fast, easy, fabulous meals following the IBS guidelines. Credit: Heather Van Vorous is the author of Eating for IBS and The First Year: IBS. Her groundbreaking dietary guidelines for IBS have resulted in her inclusion in the 4th edition of Whoï¿½s Who in Medicine and Healthcare, an ongoing Canadian clinical research study of the Eating for IBS diet, and recognition as the foremost ï¿½patient-expertï¿½ on IBS in America. She has had IBS since childhood and is the president of Heather & Company, an organization dedicated to meeting the needs of IBS patients through education, products, and services. Her IBS cooking show, Heather Cooks!, airs weekly on the internet and will be broadcast on American public television. www.heatherandco.com www.eatingforibs.com www.firstyearibs.com www.heathercooks.comHope that helps and just want to thank Heather for the information she provided us.


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## kamie (Sep 14, 2002)

The above is well done wonderful advise.I would like to add that women with endometriosis and adehsions on the outside of the bowel might want to do a little research into the estrogen fed conditions of endometriosis and certain pelvic & female cancers (breast cancer too) before adding soy to ones diet.Right now there is a big debate on the safety of soy for such conditions.Last year the FDA gave a huge approval for the makers of Soy products to place medical claims on their products. Howevr, two of the researchers filed a complaint to their own department saying that soy was not as safe as has been promoted.I believe you can find the news story on that theory the archives of 20/20 and possibly on CBS news. So for those women who have the medical condition of estrogen dominance or a strong family historyof female estrogen fed cancers, please do your own personal research before adding soy to your diet.I made my pelvic situation worse by using healthy soy.It was a horrible mistake that I would hate to see a woman unknoingly fall into because of lack of vital information.I had an almost radical hysterectomy in April.I had severe colon involvement that now, 5 months after a hysterectomy and an emergency colon surgery is still giving me problems.Women and soy and the whole phytohormone issue is something that needs specifics for diet with respect to the vastly misunderstood realities of estrogen dominance and female cancers.And yes, our gynecological pelvic conditions mostcertainly do affect our whole digestive system. Kamie


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## BarbC (Feb 17, 2002)

Eric, thank you for your very informative and helpful post. I will get the book today.


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## eric (Jul 8, 1999)

Barb, your welcome and hope the book helps, but I have to say the thanks is really for Heather who is a really nice cool person.







let us know if we can help anymore for you. Still troubles with the bloating aspects?


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