I've been following the low fiber/low fat/low residue diet my doctor prescribed for about 2 weeks now. I also stopped drinking Diet Cokes. I've been taking Cholestyramine. Originally I took 1 packet per day, but now I'm taking 1 every other day. I don't like diarrhea, but I like constipation even less!
So the question is....where to start with the diet. I know that the diet my doctor prescribed is not necessarily the right diet for those with LC, although it did help the symptoms. I'm just not sure it helped the problem. My lactose and fructose breath tests were both negative. I've read about gluten free, paleo, and primal. I've read about the elimination diet. The problem is that if the medicine is stopping the diarrhea, how would I know if a food bothers me? Pain hasn't really been a problem with me.
So, how do you recommend I start? I'm thinking if I cut way back on wheat, fat, and dairy.....perhaps I could add back some of the vegetables that I had to eliminate on the low residue diet.
Where to Start?
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Hi Lisa,
Unfortunately, for the foods to which we produce antibodies, cutting back provides few benefits. If you are actually gluten-sensitive, or casein-sensitive, it will be necessary to eliminate those foods and ingredients from your diet 100% -- including trace amounts. Research shows that l we are at least as sensitive to gluten as the average celiac, and in many cases we're more sensitive. There's a small chance that you may not have any food sensitivities, and if that should turn out to be the case, then a low fiber, low sugar diet for 6 months to a year should be sufficient to allow your gut to heal enough to allow you to resume a normal diet. Very few of us are that lucky, however.
Are you taking any NSAIDs, SSRIs, SNRIs, PPIs, or statins? If so, discontinuing the offending drug can often bring remission. Along with avoiding diet coke, you may need to avoid all artificial sweeteners -- most of us react adversely to all artificial sweeteners. Sugar alcohols (such as sorbitol, maltitol, mannitol, etc.) can be a problem, also.
To determine whether Gluten, dairy or soy is a problem, avoiding them for about a month or so and then "challenging" yourself with them, one at a time (try one for about 3 consecutive days, and then try another, etc.), should tell you whether or not either of them is a problem. Or a few tests at EnteroLab would also confirm or rule out those possible sensitivities. During an elimination diet, raw fruit and vegetables should be avoided, and only small to moderate amounts of certain overcooked veggies should be included. Good choices are veggies such as squash, potatoes, broccoli and green beans, but be aware that broccoli can be a problem if you are having problems getting rid of gas (bloating). Veggies such as lettuce, cilantro, tomatoes, onions, peppers, etc., are very irritating for most of us. Canned (cooked) fruits such as pears, peaches, etc. are OK for some of us, but don't overdo it, because they contain a lot of sorbitol and fructose.
If cholestyramine is the only medication you're taking, it shouldn't prevent a reaction on a food challenge. Cholestyramine is only a bile acid sequestrant, so it does nothing to suppress the inflammation. It can however, cause cramps and/or constipation, so regulating the dosage, as you mentioned, is definitely prudent.
Reducing fat intake may or may not have an effect. Reducing fat in the diet will certainly prevent it from showing up in the toilet bowl, but it may not have a significant effect on the D. Most of us have a fat malabsorption problem while our intestines are inflamed, but that's not the primary cause of diarrhea -- it's the result of collateral damage caused by the inflammation.
Most of us can continue to drink coffee (provided that it didn't always cause us to run to the bathroom -- before the MC symptoms ever showed up), but even the non-dairy coffee "creamers" contain either dairy ingredients or soy. As a substitute for milk in coffee, some of us use coconut milk, almond milk or hemp milk.
Tex
Unfortunately, for the foods to which we produce antibodies, cutting back provides few benefits. If you are actually gluten-sensitive, or casein-sensitive, it will be necessary to eliminate those foods and ingredients from your diet 100% -- including trace amounts. Research shows that l we are at least as sensitive to gluten as the average celiac, and in many cases we're more sensitive. There's a small chance that you may not have any food sensitivities, and if that should turn out to be the case, then a low fiber, low sugar diet for 6 months to a year should be sufficient to allow your gut to heal enough to allow you to resume a normal diet. Very few of us are that lucky, however.
Are you taking any NSAIDs, SSRIs, SNRIs, PPIs, or statins? If so, discontinuing the offending drug can often bring remission. Along with avoiding diet coke, you may need to avoid all artificial sweeteners -- most of us react adversely to all artificial sweeteners. Sugar alcohols (such as sorbitol, maltitol, mannitol, etc.) can be a problem, also.
To determine whether Gluten, dairy or soy is a problem, avoiding them for about a month or so and then "challenging" yourself with them, one at a time (try one for about 3 consecutive days, and then try another, etc.), should tell you whether or not either of them is a problem. Or a few tests at EnteroLab would also confirm or rule out those possible sensitivities. During an elimination diet, raw fruit and vegetables should be avoided, and only small to moderate amounts of certain overcooked veggies should be included. Good choices are veggies such as squash, potatoes, broccoli and green beans, but be aware that broccoli can be a problem if you are having problems getting rid of gas (bloating). Veggies such as lettuce, cilantro, tomatoes, onions, peppers, etc., are very irritating for most of us. Canned (cooked) fruits such as pears, peaches, etc. are OK for some of us, but don't overdo it, because they contain a lot of sorbitol and fructose.
If cholestyramine is the only medication you're taking, it shouldn't prevent a reaction on a food challenge. Cholestyramine is only a bile acid sequestrant, so it does nothing to suppress the inflammation. It can however, cause cramps and/or constipation, so regulating the dosage, as you mentioned, is definitely prudent.
Reducing fat intake may or may not have an effect. Reducing fat in the diet will certainly prevent it from showing up in the toilet bowl, but it may not have a significant effect on the D. Most of us have a fat malabsorption problem while our intestines are inflamed, but that's not the primary cause of diarrhea -- it's the result of collateral damage caused by the inflammation.
Most of us can continue to drink coffee (provided that it didn't always cause us to run to the bathroom -- before the MC symptoms ever showed up), but even the non-dairy coffee "creamers" contain either dairy ingredients or soy. As a substitute for milk in coffee, some of us use coconut milk, almond milk or hemp milk.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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lisa in lj
- Posts: 15
- Joined: Thu Jun 07, 2012 11:49 am
- Location: Texas
Thanks.
The only NSAID I take is an 81mg aspirin once a day. That goes along with the Coumadin that I take for my mechanical heart valve, so I'm a bit leery of discontinuing it.
As to avoiding gluten, soy and dairy for a month, guess I need to start reading labels! Gluten is pretty easy as it is "en vogue" to mark things "gluten free". I typically avoid large amounts of soy as it interacts with Coumadin, although I haven't eliminated it entirely. Dairy will be more difficult as my guess is it can be disguised by many names. My Coumadin has lactose in it. Since my lactose test was negative, can I assume that this shouldn't be a problem? Any secret words that I should look for on labels and avoid?
The only NSAID I take is an 81mg aspirin once a day. That goes along with the Coumadin that I take for my mechanical heart valve, so I'm a bit leery of discontinuing it.
As to avoiding gluten, soy and dairy for a month, guess I need to start reading labels! Gluten is pretty easy as it is "en vogue" to mark things "gluten free". I typically avoid large amounts of soy as it interacts with Coumadin, although I haven't eliminated it entirely. Dairy will be more difficult as my guess is it can be disguised by many names. My Coumadin has lactose in it. Since my lactose test was negative, can I assume that this shouldn't be a problem? Any secret words that I should look for on labels and avoid?
Lisa
Right, don't just stop taking the aspirin. It may or may not be a problem for your MC. Ask your doctor about Clopidogrel. Now that there's a generic substitute for Plavix, it's affordable. I started with a baby aspirin, too, (a Bayer enteric-coated product), but since my second TIA, I've been taking Plavix instead, and now I take the generic (clopidogrel). I'm not sure how it relates to Coumadin, though, but your doctor should know.Lisa wrote:The only NSAID I take is an 81mg aspirin once a day. That goes along with the Coumadin that I take for my mechanical heart valve, so I'm a bit leery of discontinuing it.
Here are some lists of foods and ingredients to avoid for gluten, dairy, and soy, respectively:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=733
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=735
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=736
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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lisa in lj
- Posts: 15
- Joined: Thu Jun 07, 2012 11:49 am
- Location: Texas
Plavix and Coumadin have a major interaction, which can cause potentially fatal bleeding episodes. It's possible to take both together, but they usually only prescribe it for very high risk patients. Regardless, I will talk to my Cardio the next time I see him.
I have had several TIAs while on Coumadin, luckily all minor, but that is why they added aspirin about a year ago. At 71, my mom is in the early stages of dementia, thought to be related to small TIAs. I'm trying to avoid that.
Thanks for the links.
I have had several TIAs while on Coumadin, luckily all minor, but that is why they added aspirin about a year ago. At 71, my mom is in the early stages of dementia, thought to be related to small TIAs. I'm trying to avoid that.
Thanks for the links.
Lisa