# questions for heather



## newpatient (Apr 7, 2002)

First of all, thanks so much for your books. They are helping me to feel more empowered. I have two questions for you:1. I have C.-predominant ibs, but when I am stressed it turns to D. Can I have too much soluble fiber in a day? I ask, because the day I got your book, I ate nothing but soluble fiber, plus I took metamucil and fibercon (which I've been doing for months), and I got a case of D. Is this because I overdosed on soluble fiber?2. I have bad acid reflux. Does this mean I have to give up peppermint tea and Altoids? Both seem to help my nausea. My doc put me on Zantac, which helps a bit. Will I be negating that effect if I pop an Altoid now and then?Again, Heather, you are great, and thanks!


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## Heather Van Vorous (Oct 2, 2001)

Hello - Thanks for your kind comments. For your questions:It's pretty difficult to have too much soluble fiber. Because it normalizes gut contractions and bowel water content, it won't take you from one extreme (d to c) or the other (c to d). This is especially true if your digestion has adopted to a high fiber intake (as your has from months of the supplements). I would check that your Metamucil is not artifically sweetened - those additives can sometimes trigger diarrhea. Remember too that soluble fiber takes a few days to really help diarrhea, and a good week to help constipation. Peppermint isn't such a good idea for people with acid reflux - it can really exacerbate this problem. Try ginger tea (either in bags or brewed from fresh gingerroot) instead - it is wonderful for nausea. You can also chew on a little candied ginger instead of the Altoids. Or, try chamomile, fennel, and anise teas - they're all digestive aids but won't affect reflux the way mint can.Hope you're feeling better soon.Best,Heather


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## newpatient (Apr 7, 2002)

Thank you, Heather. I'm still reading the "first year" IBS book, and have ordered Mike's tapes. I'm looking forward to getting better.Do you have any other advice for acid reflux? My doc has me on 150 of Zantac twice a day, but it isn't quite doing the trick. Any advice?


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## Heather Van Vorous (Oct 2, 2001)

Hi - For the acid reflux, the IBS diet will generally be appropriate for helping this problem too, as it's low fat and avoids red meat, dairy, greasy foods, coffee, and is careful with acidic foods (such as citrus fruits and cooked tomatoes) and alcohol - all of which can worsen GERD. However, you'll also want to be especially careful to avoid any foods with "hot" chili spices such as cayenne, jalapeno, habanero, etc. These contain capsicain, which can trigger reflux. Other herbs and spices in general are likely to be beneficial to digestion, though, so you don't need to stick to bland foods. Aside from ginger, fennel, anise, and chamomile, you might also try slippery elm. Slippery elm is a soothing herb derived from the inner bark of the tree bearing the same name. It's ideal for treating heartburn and GERD because it coats and protects mucous membranes inflamed by stomach acid. It can be taken as soon as reflux occurs or on a regular basis to help prevent its onset. You can find the herb in powder form and sprinkle it onto your food or you can use the powder to make a tea by adding one teaspoon to a cup of boiling water. Slippery elm lozenges are also available.Make sure that you're eating small meals frequently instead of large ones, and don't eat or drink anything for an hour or so before bedtime. Try to be gently active right after a meal - definitely don't lay down, and try to move around a bit instead of just sitting down.If the Zantac isn't working as well as it should, I'd ask your doc about this. It may not be the best choice for you, or the dosage may need to be adjusted.Best,Heather


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