# hunger pains, fiber and GERD - need advice



## Guest (Apr 10, 2002)

Hello,I posted this first on the general IBS board, but would like to have Heather's opinion on this also. I am new to these board, but not to IBS. I'm 28 and have had IBS and CFS for about 20 years now. I need help with new symptoms. For the past 6 weeks, I've had a sensation of uncontrollable hunger that tends to increase after eating. At it's worst, it sent me to the ER thinking that somethinghad gone awry with my blood sugar. Bloodwork fine (of course). The onset of symptoms was precipiated by a severe bout of reflux, trigger by a diet blowout heavy on Starbucks and Godiva. (I had to put my beloved companion dog to sleep and I didn't cope with it in a healthy way.) I started to try to balance back out by hitting my usual "Good patient" high-fiber diet of brown rice and steamed veggies.My MD thinks it may be the excess acids irritating the lining of my stomach. I've been taking Aciphex, but having side effects so I've not been taking it every day -- have taken probably a month's worht of medicine over the past 6 weeks. Yet the symptoms continue to wax and wane on a daily basis.I'm also wondering about an ulcer, but I had an endoscopy a year ago and was negative biopsy for H Pylori and had a completely healthy stomach - no signs of acid damage or ulcers. How long does it take for an ulcer to develop?The back of my mind keep saying "it's the fiber, it's the fiber" but logically I'm thinking that high fiber should be helping, not hurting. I've been eating lots of whole grain breads, brown rice, raw and steamed veggies - the basic simple, healthy veggie diet. A couple of days ago I stumbled across Heather's web site (I'm looking forward to getting my new books in the mail!) that talked about the differences between soluble and insoluble fiber, and I realized that I've been eating HIGH insoluble fiber and low soluble fiber. I'm wondering if this could be both irritating my stomach and souping up the transit time - causing these intense hunger pains. I'm usually a C, but have been bloated and D along with the hunger symptoms.Has anyone experienced anything similar? Does anyone have any ideas -- I've gotten to the hair pulling stage trying to resolve this, and of course anxiety never helps anything.Thank you so much!Cat


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## Heather Van Vorous (Oct 2, 2001)

Hi Cat - I would follow up with your doctor about the theory that the acids irritating your stomach are contributing to your hunger, and also let him know that you've been unable to continue your medication for this. There might be some other alternatives here.About the fibers, yes, a meal of nothing but high insoluble fiber foods is likely to fill you up very quickly but leave you hungry again very shortly. Insoluble fiber foods are very low calorie but have a lot of bulk. They're also primarily carbs, which digest more quickly than proteins and fats. Soluble fiber foods are also filling and pretty low calorie, but to a lesser extent. Soluble fiber slows the entry of calories into the bloodstream and helps stabilize blood gycemic levels, so it helps keep your appetite stable, which insoluble fiber will not do. Your brown rice is actually giving you a good soluble fiber base (and is one of the most tolerable whole grains for IBS). But if the only thing you have with it is raw/steamed veggies you aren't getting very many calories, and not enough protein or fat to stay full. If you're vegan, you might want to add some type of soy (seitan, grilled tofu, etc.) or gluten to your meals; otherwise, steamed/grilled fish or chicken breasts will work. Make sure you have a bit of oil with your meal - just a drizzle of flax oil on your rice, or sautee your veggies in some olive oil. You need a low fat content, but you don't want to have no fat at all. Fat is the food that satiates the appetite for the longest period of time.If you cook, you can combine all the foods you're eating in something like a rice stir fry - add some shrimp or tofu chunks. There's a recipe for a Thai version at http://www.eatingforibs.com/thaifried.htm. If you bake, making some type of fruit bread (banana, zucchini, pumpkin, etc.) will give you a soluble fiber base, fruits or veggies, and enough oil to satisfy your appetite.You might also try smaller meals more frequently. Snacking often on soluble fiber staples is actually a great way to keep IBS stable, and should keep your appetite in check too. Things like baked corn chips with some homemade low fat hummus or salsa, rice pudding, banana/soy smoothies, instant oatmeal made with soy milk, and fig newtons are all safe and yummy choices.Until your books arrive, there are quite a few recipes on the website you can try - the main link for that is http://www.eatingforibs.com/recipes.htm. Hope this helps and that you're feeling better (and less hungry!) very soon.Best,Heather


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