# Water and IBS



## bloatcity (Jul 14, 2001)

Hi Heather. I am IBS-d & have been for many yrs. It seems to be getting worse as I age. (I'm 40) Also have fibromyalgia. Anyways, was looking on your website the other day and you mentioned something to the effect that people w/ IBS have a hard time drinking water and I was just wondering why? I drink 8-10 glasses a day. Does the liquid exacerbate IBS-d? Thanks for your reply. Also, what are good milk substitutes for someone that also has a soy allergy (like myself). Not all that keen on Rice Milk, tried Almond Milk but wondering if fat content in it would bug me. Also, I know mint is supposed to help IBS however with my stomach acid problem, can't do it. Anything else?Doctors have never been that helpful w/ this. I have been prescribed Dicetel and take it once in a while however it irritates my stomach/esophagus even if I take it w/ water before eating. (I also have a lot of stomach acid). Sorry long post but Thanks.


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## Heather Van Vorous (Oct 2, 2001)

Hello there - I'm not quite sure where you saw the comment about water and IBS. It is very important to drink a lot of fresh water all day long when you have IBS, because you'll want to base your diet on soluble fiber (which stabilizes GI contractions and normalizes both diarrhea and constipation). Soluble fiber needs plenty of water to work.Maybe you saw a note that I don't recommend ice-cold water? This is because any cold causes muscles to contract, and you want to keep your GI tract soothed. But cool or hot water is just fine.If you can't drink peppermint tea (and it is such a powerful smooth muscle relaxant that it can definitely aggravate reflux) try chamomile, fennel, anise, or ginger instead. They're all great for IBS and shouldn't affect heartburn (ginger can help it).If you can't drink soy or rice milk, you could try oat milk. It's pretty darn tasty though more difficult to find. A good health food market should carry it though. Almond milk does have a bit of fat but it shouldn't be enough to bother you. Oat milk is even safer, though. Have you tried different brands of rice milk? This can make a huge difference. Some are quite bitter and awful, others are very mild and tasty. It might just take some experimenting. Hope this helps a bit, and that you're feeling better soon.Best, Heather


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## bloatcity (Jul 14, 2001)

Hi Heather. Thanks for your reply. I probably misunderstood about the water thing or read it somewhere else - I can't remember. Doubt I'll find oat milk in Canada but will try different rice milks - are there any that are fortified with Calcium, Vitamin D, etc.? That's why I haven't given up dairy and milk completely - concerned about calcium intake.I have a question re soluble fibre. From what I understood, some of the sources of soluble fibre are things like white bread, white rice, pasta, etc. ? re how much fibre is in a piece of white bread? Also, what about the high glycemic index of these foods and the fact that once potatoes, white bread, etc. bind with the saliva in your mouth, immediately turned into glucose in your tummy, thereby increasing risks of Type 2 diabetes, etc.? I'm just asking and concerned. Everything I read about eating healthy says these types of food are the kiss of death and yet, the food the health gurus say you are supposed to eat are the kiss of death for IBS people. Thanks Heather.


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## Heather Van Vorous (Oct 2, 2001)

Hi - There should be some calcium fortified rice milks in Canada. There seem to be more brands available every day, so I would bet you'll find something perfect.For concerns about the high soluble fiber foods - the high soluble fiber foods at the foundation of the IBS diet (rice, pasta, oatmeal, potatoes, white bread) should not cause weight gain as you are also going to be eliminating high fat foods such as red meats, dairy, egg yolks, and fried foods. Soluble fiber (and insoluble fiber, which you’ll be incorporating carefully but as much as possible) is calorie-free as it passes through the body undigested, and it is also quite filling. Soluble fiber also stabilizes blood glycemic levels because it regulates the rate at which food leaves the stomach, which helps keep appetite levels under control and is very helpful for diabetes. If you wish to avoid the soluble fiber foods with that are high on the glycemic index, you can use brown rice (one of the whole grains that is safest for IBS) and oatmeal instead of white rice or potatoes. Many people who are overweight actually find that they effortlessly lose weight with the IBS diet because the decrease in fats and increase in soluble fiber foods results in a calorie reduction. The nice corollary to this is that for people with IBS who are underweight, the diet can let them gain weight and maintain it because they no longer have to be afraid that eating will trigger an attack, so they end up eating more food in sheer terms of quantity than they’ve been able to in the past. Soluble fiber foods are always plant foods, and almost always high carb foods, but it is simply untrue that a higher carb/lower fat and protein diet is unhealthy or leads to weight gain or diabetes. Americans average only 45-55% of their diets from carbs, and our obesity rate is now 35%. In contrast, Asian countries average 60-75% of their diets from carbs (with white rice as the staple) and their obesity rates are 1-2%. They also have lower colon cancer, heart disease, diabetes, and osteoporosis rates. For glucose concerns, your body eventually breaks down all carbohydrates (simple and complex, and no matter what the source or how much/which type of fiber they contain) into glucose, as this is the only fuel the brain can use. It is always more nutritious to eat whole grain foods such as brown rice and whole wheat breads than refined grains such as white rice and white bread, because it is the bran portion of the grain that is removed during the refining process, and the bran is high in vitamins and minerals. However, the bran is also pure insoluble fiber, and thus a trigger for IBS attacks. This doesn’t mean that you won’t eat any whole grains on the IBS diet – in fact, you will incorporate as many of them as you can into a high soluble fiber foundation, but you’ll do so very carefully. You’ll also be adding many fresh fruits, veggies, beans, and nuts to the soluble fiber foods, but again with care. This will dramatically increase the safety of these insoluble fiber foods in terms of the strength of the gastrocolic reflex they trigger (people with IBS suffer from irregular gastrocolic reflexes, and are prone to having the muscle contractions triggered by this reflex go violently out of control, resulting in cramps, diarrhea, and/or constipation). Insoluble fiber (and fats) are the single greatest stimulants of the gastrocolic reflex.The difference in soluble vs. insoluble fibers in foods can be confusing because many foods contain both. Grains and cereals especially have insoluble fiber in their outer layers (the bran, husk, or hull of wheat berries, rice grains, corn kernels, etc.) but soluble fiber in the interior. This is actually true for many fruits, vegetables, beans, and lentils as well (the skins are insoluble, the interior flesh soluble). You are going to be eating these whole foods, but their insoluble fiber makes them too risky to eat alone, on an empty stomach, or in large quantities at once. That’s where the plain soluble fiber food choices (the white rice, pastas, white bread, potatoes, etc.) can act as safe foundation foods for people with IBS. It’s as much a matter of how you eat as it is what you eat. So do make sure you get the whole foods in your diet, but recognize that their insoluble fiber (and fructose in the fruit, sulfur in the cruciferous vegetables, etc.) pose challenges to IBS folks and don’t be afraid to eat the high soluble fiber foods first and foremost.Hope this helps.Best, Heather


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