LOW-CARB DIETING AND IRRITABLE BOWEL SYNDROME

[Jude]

I am writing this post for two reasons - one to inform people about IBS and secondly to ask the experts if they have any sugestions.
I have been living with IBS for over 35 years now and my life has been very restricted by it. For those of us with chronic IBS solube fiber carbs are the basis of our diet (rice, pasta, oatmeal, bread, all root vegs, bananas, mangoes are some) then there are the insoluble fiber foods (wholegrains, most fruit, nuts, salad, cabbage, cauli etc.) which must not be eaten on an empty stomach and eaten carefully alongside soluble fiber. Then the trigger foods are red meats, dairy, egg yolks, butter, coffee, solid chocolate, ARTIFICIAL SWEETENERS - these should be avoided!

So having joined this site last June I have felt quite uneasy reading all the low-carb discussions because I have just felt like I might as well give up!! - now dont shout at me - but the overall impression I get is that if I dont cut out or down on my carbs then I will never achieve a lower stability with my glucose levels. And on top of all this I need to lose weight (weight issues all my life) and thanks to Gliclazide and then Lantus I have even more weight to shift.

I would like those of you who are committed low-carbers to just have a little understanding of where those of us with IBS are coming from. I know that IBS is often dismissed by people but I can tell you it is very real - I have spent years trying to get some stability and in many ways I am more stable now hence I am very wary about cutting out/down.

The other ingredient which is absolute poison to IBSers is SWEETENERS - I was reading a post yesterday about a low carb milkshake/smoothie, I thought this would be helpful until I looked at the ingredients. In fact alongside carbs IMO sweeteners would be the other main problem.

Thanks for reading and I am open to any suggestions. Jude :?

 

[peppiB]

Hi Jude,

I have been living with IBS for 15 years. My triggers are coffee and most vegetables (but not all)

I started low carbing 3 weeks ago and find I can eat eggs, all meats, dairy produce, capsicums, tomatoes, cauliflower, mushrooms, onions without any problems. I started metformin last week and did make the mistake of taking the first one with a chilli meal :shock: - just the half hour stuck on the loo in absolute agony. I then started taking a colorfac tablet (IBS treatment) with the metformin and have not had any problems since.

Sadly my BS are still too high (starvation 8.4 2 hours after low carb meals 9.5 - 12 )

I have lost over half a stone in weight in that time as well.

It is just a question of trial and error - what works well for one may not work well for another. I am still experimenting and testing. I always cook from fresh ingredients and that way I don't get caught out with artificial sweeteners and other additives which may cause problems.

I don't miss my rice, bread and pasta. Try reducing quantities of these and see what happens.
The only downside I have found is my weekly shopping costs much more!

 

[Jude]

Hi peppiB

Thanks for your reply. Are you taking regular Metformin? I started with those and actually didnt suffer with the gastric side effects (amazing considering ibs) but I now take Metformin slow release - my GP has been very good with my various medications and gives me slow release whenever she can.
I am going to try Byetta starting next week - I still take Metformin but after the addition of Gliclazide (more weight) that was swapped for Lantus insulin last November and I am going to ditch that now.
I also take a soluble fiber supplement for my ibs & Imodium daily as a precaution and take more Imodium when I am unstable and need to go out.

Jude 8)

 

[peppiB]

Hi Jude,

Started on metformin last week (500 morning and evening) but it hasn't reduced my BG. Took the colorfac with it til Sunday. Managed without it yesterday and so far today. I keep Imodium handy, but rarely need it as I usually manage to control the IBS. Unless you have it, people just don't realise how painful it is.

After a year 'flying blind' as a diabetic I am just getting to grips with what is required, and it is very much trial and error. I find this forum and its members very helpful

 

[reuben]

Hello Jude,
I can really appreciate your predicament. I am extremely careful with my diet with regard to IBS (mine is so much better after various life factors changed) but still flares up no and again. Yep sweetners were my biggest problem - the smallest amount and ...... With the diabetic diet it seems to be almost the opposite to what is good for the IBS (and I'm mainly vegetarian that doesn't help ) Still for me I find cheese is the best compromise - hugely calorific, but rarely upsets my digestive system, the other wonder food that I find helps no end is Quorn (in almost any form) low in carbs, almost non existent in fat and doesn't seem to cause problems.

The other thing I found helps is to have a substantial amount of food with the metformin - if I just try a small bowl of cereal -sometimes problems but my old standby a full tin of tomatoes on one piece of toast -no problem , same with an omelette, baked beans (strange never upset me) etc. Volume seems to be the key with the metformin

 

[Dennis]

Hi Jude,

From what you have described it sounds like a low-carb approach would not work for you because of the IBS. So have you considered instead a low-GI diet? Effectively it means that you can still have those things that are best for your IBS but, by ensuring that you only have the low-GI versions of each food type, you can also control blood sugar. OK the control will not be as rapid as it would have been on low or reduced carbs, but it will still get you to the end result. Tubs is our resident expert on low-GI diets and has posted some very interesting information, such as this viewtopic.php?f=2&t=5877&start=345#p53844

 

[Jude]

Hi Dennis

Many thanks for your reply. Yes I have considered GI dieting and I am going to look at it again more closely - my main problem with other forms of dieting is that I have been a yo-yo dieter for 35 years now and I always counted calories (mm thats when the ibs was diagnosed!!) so getting ones head around another method requires more effort!! Anyway, I have my first Byetta pen at the ready and Kath my DSN is coming to see me at home on Tuesday next. I havent been prescribed any needles - I already have 5mm which have been using with the Lantus - are they the right ones do you know?

You have already given me advice about the byetta but I would you be kind enough to just list the main points to help me and any foods to avoid or keep minimal.

Many thanks as always

Jude 8)

 

[Dennis]

I havent been prescribed any needles - I already have 5mm which have been using with the Lantus - are they the right ones do you know?

Hi Jude,

I don't carry a great deal of fat but nearly all of what I have is round my midriff :roll: I personally prefer the 8mm x 31g Microfine needles, but I do occasionally give my stomach a rest and inject in a thigh. As my thighs are pretty lean I use a 5mm needle there. I'm not an insulin expert but I believe that it is injected subcutaneously, the same as Byetta. If you have found the 5mm needles are ok for your lantus then they should also be ok for Byetta.

You have already given me advice about the byetta but I would you be kind enough to just list the main points to help me and any foods to avoid or keep minimal.

I know you have been researching so you will already be aware that the most common side-effect is nausea. Sometimes this can be just a nauseous feeling but sometimes the full works. The best way to avoid this is
- eat as soon as possible after the injection
- avoid highly spiced food
- avoid greasy food
- if you feel nauseous, eat or drink something containing ginger - it seems to calm the nausea (a ginger biscuit or very diluted ginger cordial or Bottlegreen's ginger & lemongrass cordial).

This is only until you are past the nausea phase - can be anything from 3 days to 3 weeks. Once you are over the nausea stage then you can eat pretty much anything that you could before, providing of course that it doesn't damage your BS control. I know you are looking at a diet restriction and this will certainly help the Byetta to give you great control, but I wouldn't try any diet changes until you are fully acclimatised to Byetta - if anything goes wrong you wouldn't know whether the Byetta or the change was the cause.

If you are taking any other oral meds then it is best to take them at least an hour before the Byetta because Byetta slows down the passage of food in the stomach and this slows absorbtion (sometimes to the point where it renders the other med completely ineffective). This doesn't affect metformin, which seems to work just as well when absorbtion is slowed down .

When you get your first Byetta pen have a good read of the information leaflet that comes in the pack. It is well written and informative.

Oh, and make sure that they start you on the 5mcg dose! I have come across a few people who have been started on the 10mcg dose (contrary to the manufacturers warnings) by GPs (and in one case a consultant) who think they know better and in every case the patient was so violently ill they had to be hospitalised.

I'm not sure whether they intend to switch you from insulin to Byetta or to use the two in tandem. If you are saying on Lantus for the present then it will need to be reduced by up to a half, otherwise you will hypo. Personally I think it is better to wean a Byetta patient off insulingradually, rather than just drop it completely.

I can't think of anything else that you need to know up front, but if you think of any questions please fire away. Keep us informed on how you get on, and good luck.

 

[Chanah]

I'm new here, but not to diabetes or IBS, unfortunately. And I can empathise, I know how painful IBS is.

I mostly do low-carb and don't have too much problem with it - I'm on a fixed income but I do allow myself the splurge of organic butter, as that seems to be the worst offender in the non-organic category and I've not had a problem with it. If you've not tried it, you might want to, see if it helps any.

If you're going low glycaemic, well, I'm middle-eastern by origin, and I believe the reason the diet works is partly the food preparation. If you're going to cook rice, for example, you soak it in cold water overnight, then rinse it well and change the water and soak it all day again, then give it another good rinse and cook it. It helps get out the starches. With things like chickpeas that have more badness in them it's sort of the same, except after you soak them all night, you boil them for five minutes, then change the water and soak them again, and cook them that night. Plus I think the spices - and they aren't always hot or spicy-tasting - do help. Like rice is often cooked with cumin, and cumin is one of the herbs that's used to moderate blood sugar in Unani (a lot of middle eastern) medicine. Also, with most meals there's a yoghurt (full fat) with chopped up garlic side dish that helps, or you can put some of it directly into sauces - it tastes a lot better than it sounds, and the whole concept is based on balancing meals, though it's a different kind of balance, and usually things like bread and rice are no-no's for diabetics. Yoghurt is often prescribed for diarrhoea, though.

Here's what the Unani medicine page on diabetic food says:

Instructions: Avoid sweets and sweet fruits. Avoid such carbohydrates as white potato, sweet potato, and rice. Mild exercise is advised.

As for sweetners, I give up. I don't have much of a sweet tooth, but if the eighth of a teaspoon (that's really all it takes) of demerara or honey I put in my coffee or tea sometimes is going to kill me, so be it.

But I do think you can make a reasonable compromise between low glycaemic index and low carb. I've been doing it for a lot of years now, and most of my A1cs are in the low 5s - the most recent was 6.1, but I think that's because my childhood tuberculosis reactivated and I got a massive sinus infection at the same time, and that always drives up blood sugar. On antibiotics for them now, and the blood sugar is getting back to normal - or at least as normal as mine is likely to get. I don't take diabetes medicine, metformin completely did in my tummy, and I wanted to try to get it under control without drugs. So far, so good, but who knows what the future holds?

Don't give up!

 

[cugila]

Hi chanah.

It's nearly ten in the morning here and my taste buds are quivering with all the talk of food and spices.

You talk some real sense. Your methods for dealing with starchy things are spot on. I too use a low GI and Low Carb routine, only since the last few months though. My results are amazing. Proof, I think.

Keep posting with more of your great food advice. Good luck with your anti med stance - way to go !

Ken

 

[sandymaynard]

Hi jude,
I am a type 2 diabetic just diagnoised a month ago! The bit that concerns me is that my partner I share a house with! He suffers bad with IBS, he is trying to do the low carb with me to give me support!
But he was told by the hospital that he needs carbs, bread etc! I just don't want to upset his IBS by him doing the low carb with me!
I don't want him to get hurt by my low carbing! I am worried about the food that he could safely eat on low carb with me! Sorry to hijack your thread, it just seems that you know what to do here!
I am so confused with it all! Sorry.

 

[Jude]

Hi Sandy

I have sent you a PM.

Jude 8)