# Triggers



## nsmith4366 (May 4, 2002)

I had my gallbladder removed in 2000 and was diagnosed with IBS last fall.







I eat an unprocessed protein low carbohydrate diet (with benefiber soluable fiber with each meal)and lc vegetables each day - cooked soft. I also eat only healthy fats/oil, no trans or hydrogenated. My triggers include: Processed food, milk/products, coffee, citric acid, pepper, caffeine, sugars, all starches, cocoa products, fatty red meats including bacon and uncooked egg yolk.







This week I goofed and ate lots of bacon and I got puritis ani extremely bad.







Could the sugar in the bacon or the nitrites be the cause of puritis ani?







Sometimes I eat a high fat/protein diet and I get diahrea, but this does not bother me if I don't have puritis ani with it. I also took lots of tylenol (is this an irritant for some people?)







LEAN beef does not seem to bother me...but regular beef does. ?? Should I cut out all red meat? LEAN porkloin (4g fat per serving) does not bother me, but a t-bone steak does! I think I can eat beef if lean...anything if lean yes?All added HEALTHY fats (olive oil, canola oil etc) do not bother me unless I really binge on them. Does all this make sense? Could all this be due to IBS or simply a missing gallbladder? Did having the gallbladder out cause IBS?What role does bile play in my situation???? Do you think I'm on the right track?







sorry so many questions/I'm new. I plan to get your book today.


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## Heather Van Vorous (Oct 2, 2001)

Hello - One thing you said jumped right out at me. You had your gallbladder removed, and then you were diagnosed with IBS. Did your IBS symptoms begin right after your gallbladder was removed, or did you have IBS previously? If your symptoms onset following the gallbladder removal, you probably don't have IBS at all. You have a malabsorption of bile acids, which normally are stored in your gallbladder. Instead, the acids are being dumped directly into your intestines, causing chronic irritation and resultant diarrhea. Fatty foods exacerbate this problem. This disorder is often misdiagnosed as IBS. If you fit this scenario, call your GI doctor and ask his/her opinion, and about a trial with the prescription drug Cholestyramine (brand name Questran). This drug binds the bile acids and prevents them from causing GI irritation. If you don't fit this scenario, let me know and we'll work on the dietary aspects for IBS.Best,Heather


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