# Sugars and starches and everything not so nice



## Jerry84 (Jul 30, 2014)

Hi. I'm a 29 y/o male. I've had my share of issues over the years (mostly knees, shoulders, and neck related), but I was in decent physical shape otherwise before all this started. 6'1 ~175 normally. I'm occasionally prone to anxiety but never needed any treatments as it's been in response to life stresses and has abated when they've gone.

For 3+ years now I've had diarrhea and upset stomach that is caused primarily by starch and sugars. I figured this out by trial and error during the first few months of distress. First, I tried fixing my upset stomach by going on a BRAT diet. That made it worse. It seems to be that certain things make it much much worse - peaches, apples, bananas... fruits are probably the worst offenders. Breads and lactose-containing foods don't sit well either. I do not know if it's relevant but the year prior to this all starting I had taken antibiotics (Clindamycin twice, and Erithromycin once) for tooth infections and during post-operative wisdom teeth recovery as a precaution. I had 2-3 bouts of gastroenteritis during that year from eating out at restaurants (2010 I think?) and then this issue occurred shortly after the third bout of gastroenteritis. That happened during a business trip to California. I came back and was under a great deal of stress and changed jobs. No fever during the time that I can recall, just weird diarrhea with undigested food and then a slow not full recovery.

At present, the exact result of eating starchy and sugary food is gastrointestinal distress 3-5 hours after eating. Typically, this involves bloating and strong cramping with some gas. If severe enough I'll feel sweaty, tired, and need to lay down. After about an hour of this it will normally go away. Later, when I have a bowel movement it will be very loosely formed, often full of undigested food, sticky, and irritate the skin around my anus. I'll usually need to go to the bathroom often during the day if I've eaten many carbs and it will feel incomplete. If I don't stop eating carbs I can get some leakage and general malaise that really wipes me out. I haven't seen any blood.

I first tried FODMAP, but onion and brussel sprouts don't really bother me where bananas and white potatoes definitely do. Then I tried SCD. It didn't really fit either. As a result of this I found I operated best on a very low carb ketogenic diet for the last 2 and a half years. This made everything manageable and I had some additional fiber plus a large number of vegetables daily for a while to do normal, daily solid bowel movements with all the protein and fat I was eating. This made me lose ~20 lbs but I got back up to my normal weight once I learned how to eat.

I found a kind of peace with it all in 2012. I was able to still work out, play video games, do things with friends and family. The ketogenic diet gave me a huge amount of energy. I was doing well at work. I looked for a solution, but it hadn't consumed me. It became kind of a stupid joke. Recently, I've disrupted that peace.

My gastroenterologist asked me to add rice into my diet. I found I could somewhat tolerate BROWN rice and sweet potatoes and added them in. Additionally, sugary drinks with no food seem to not cause issues. I guess my small intestine just absorbs the carbs before whatever issue can arise. Sweet potatoes caused hives on my legs at first, but didn't again later. More recently, I have had an issue with dryness of mouth/nose/lips and eye irritation that seems proportional to the amount of carbohydrates I eat. The more I eat, the worse it gets. I don't have diabetes, but I tested blood sugar just to make sure... it has not been excessively high ~110 I've seen occasionally a bit after eating. Adding carbs has recently made my stomach symptoms significantly worse and more sensitive to carbs. However, being on low carb for so long has irritated my thyroid or something else. Trying to switch back to low carb caused extreme fatigue, coldness etc. that's gone on for a couple months. I don't want to downplay the fatigue. When it happens, I'm done for an hour+ at a time. It's like all the energy I had is sapped out of me. This gets somewhat better adding carbs back in but then I deal with terrible digestion and possible immune problems (eye irritation, dryness, etc.). I'm stuck in this limbo now, and I'm pretty scared. Doctors seem to want to shuffle me along.

...

Over these past 3 years I've been to 2 gastroenterologists and a colo-rectal specialist. I tested negative for lactose and fructose intolerance. I had a hydrogen breath test and tested negative for SIBO. I have not had a methane breath test - doctor doesn't believe in it. Blood tests - negative for celiac. Stool test (from Quest) - negative for bampylobacter, shiga, leukocytes, giardia, ova, salmonella/shigella,

I had an upper endoscopy with biopsy - it showed negative for helicobacter and negative for celiac. Mild chronic inflammation in my stomach (mild gastritis). They found I have a very minor hiatal hernia as well.

Probiotics have not helped. I tried VSL#3, florastor, Align, and Jarrow S Boulardii with FOS. The S Boulardii with FOS seems to blow through me pretty fast or at least it causes some kind of reaction - maybe the FOS?. I have a protein powder with inulin that doesn't do the same thing though. Prescription enzymes did not help. 550mg Xifaxin for a week showed no improvement.

I'm going to see an endocrinologist for the fatigue but not until Sept. I have a colonoscopy scheduled for October. My parents and friends have been worried about me lately because of the combination of digestive issues + the new fatigue thing. I'm starting to get worried I'll lose my job. The fatigue messes me up. During my most recent blood draw the guy commented "you do not look good, man" hah. Yeah, I don't feel good either.

My working theory is there's some sort of bad, maladapted organism, maybe bacteria, somewhere in my intestines fermenting carbohydrates. I tried a lot of natural herbs for a while, and anti-candida crap but I don't think I have fungus. No other related symptoms on skin. Coconut oil does nothing except make me all jittery. Herbs didn't do anything that I could tell. Peppermint oil made me have weirdly minty smelling poops so I guess that was fun. I wish I had some answers to what this is or a direction I could take from here, but I'm just trying to get by a day at a time. Thanks for reading if you got to the end of this.


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## tummyrumbles (Aug 14, 2005)

The IBS diets are often contradictory. The FODMAP diet only concentrates on complex sugars but assumes we digest starches OK. The SCD assumes we can't digest starches but can tolerate complex sugars OK so they basically contradict one another. Neither diet seems to think that fibre itself is a problem, but most of us seem to have a problem with fibre as well.

If onions and brussel sprouts don't bother you but white potatoes and bananas do you could have more of a problem with starch than FODMAPs. I think I'm the same.

This is an excellent site for learning which foods are high and low in starch.

http://nutritiondata.self.com/foods-000007000000000000000.html

Rice is a real problem food for me because it constipates. No-one really knows how constipation works but it could be related to opioid peptides. Protein in general can be constipating because of this.

Itching can be a sign of leaky gut. Typical foods that can cause this are wheat and nightshades like potato, tomato etc. Non-celiac wheat intolerance is a fairly new science. A gluten test won't show this.

Starch, high-fibre foods and FODMAPs all feed bacteria and cause gas. So any diet that reduces these 3 things should result in less IBS symptoms.

My daughter started getting post infectious IBS after food poisoning. Even though her partner also got vomiting and diarrhea, he didn't get the PI-IBS afterwards, only my daughter. I think there's an underlying genetic basis for IBS but have no idea what that actually is. My father took a long time to go. It takes me 1 to ½ hours to go typically, and that's on a pretty good diet. My daughter had absolutely no IBS symptoms as she was growing up, only lactose intolerance, but she carries the gene, whatever it is. She got better because I gave her loads of information about a good low-flatulent calming diet for the colon. She's better now with no symptoms at all. She mainly gave up bread and dairy as she's OK with vege carbs. Gas causes IBS and for us with constipation, methane gas can act like a neurotransmitter, causing non-propulsive contractions that cause constipation. It's not a widely accepted theory by family doctors because SIBO testing is very flawed. Family doctors are ridiculously stupid when it comes to IBS.

Methane, a gas produced by enteric bacteria, slows intestinal transit and augments small intestinal contractile activity

http://ajpgi.physiology.org/content/290/6/G1089

Don't get hung up about testing. Just assume you have SIBO, it's easier. Assume there is a bacterial imbalance as there probably is, wherever it is. You don't want to feed the bacteria any more than you have to, and hopefully we want to reduce the population.

My diet isn't perfect but a lot better than it was.

Porridge oats for breakfast (lowest in starch out of the cereals), citrus fruit mid-morning (sugars are easily digested), toasted jaffles for lunch (not advised but I don't know what else to have), dinner is some protein with well cooked low FODMAP veges. Most of my intake is fibre, but it's well-cooked, mashed or toasted fibre. I keep constipating foods to a minimum. The protein and jaffles are probably constipating. Toasting reduces the starch content of bread by converting the starch to dextrins. I tolerate toast a lot better than bread. I eat banana and yoghurt but not sure whether I should or not.


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