Sunday, 27 March 2016

My Low-Fodmap Life

There's an aspect of my life that I haven't shared much about on this blog: IBS.  I've often thought about sharing my story, but have never quite gotten to that point.  In short, about eight years ago, I became really sick with a parasite, and even after using a couple rounds of antibiotics and going through a few natural cleanses, I was still having problems.  So my road of testing began, and we were able to solve a smaller problem, but still didn't have an explanation for my stomach pains and bowel patterns.  After a series of tests, some very uncomfortable and humiliating, the results were in. Nothing.  However, with my set of symptoms, I was diagnosed with Irritable Bowel Syndrome, a functional bowel disorder where nothing appears to be wrong with the bowels, but they don't function properly.  As a result, the patient often experiences abdominal cramping, constipation and/or diarrhea, gas, bloating, etc.

Well, there seemed to be ways to at least control symptoms, and the mantra my doctor gave me was "fibre, water, exercise" as well as managing stress. And so I tried a high-fibre diet, eating All-Bran, Fibre 1, multigrain bread products, adding inulin to my drinks, etc.  Also, yogurt and probiotic supplements were recommended.  I also tried using an antispasmodic drug for a while.  So I tried different things. However, as much as I was pushed to have a big bowl of fibre cereal every morning, I kept telling my doctor that milk in the morning made me feel queasy.  Eventually this led to the question of lactose intolerance, and about a year after my initial testings, I was confirmed somewhat lactose-intolerant.  Now I was diving into experimenting with expensive dairy free milks and lactase enzymes.

In short, after some time, I learned to manage my condition, and when I didn't feel good, I could usually trace it to something I ate.  Then about two years ago, it all started to go downhill.  This happened after a rather stressful time in my life, and I confess I prayed suffering upon myself.  Soon, no matter what I ate it seemed, almost every afternoon I was plagued with pains in my stomach, back, and got bad gas.  After awhile, this sent me back to a doctor's office to see if anything else was going on.  Tests related to my digestive tract were clear and I was back to assessing my diet.

While working with a dietician, I learned about the Low-Fodmap diet, a diet developed in Australia, with credible research behind it. About 70-80% of individuals that suffer from IBS experience improvement.  The basic theory behind the diet is that there are certain groups of carbohydrates that don't digest and then create a lot of water and gas in the digestive tract, causing pain, bloating, discomfort, gas, etc.  In order to go through the diet, you cut out all five carb groups (fructose, lactose, fructans, galactans, and polyols) for about 6-8 weeks, until you see improvement, and then add each group in individually to see which foods cause symptoms.  So it means a time commitment of several months to follow through with the elimination process.  The research and success rate did make me consider it, but the lists of foods to avoid were outrageous.  I tried finding recipes for this diet, and most of them contained unfamiliar ingredients, would have been expensive, or just didn't look like food I would eat.  Many other books on IBS recommended high fibre recipes including lots of beans or carciferous vegetables; not good when they really cause gas issues.  Besides all this, in a home down to three people, I would have to make most of my own food, which hardly made sense.

So, I left it on the shelf.  But since my husband and I started dating last year, my health became a frequent topic of discussion, and often caused inconvenience.  After we were married, I tried a few different elimination diets, including gluten and dairy.  This seemed to provide some relief.  But I was still daunted by the Low-Fodmap experiment.  However, my husband was supportive and willing to go through it with me.  A trip to El Paso was also necessary to get ingredients, due to lack of availability of certain products in Mexico.

To give readers unfamiliar with the diet an idea of what I was up against, here is a brief list of foods that were off the menu, or could only be eaten in limited amounts.
  • apples, pears, peaches, plums, mangos, guayaba, blackberries, apricots, watermelon, dried fruits
  • honey, fructose syrups
  • milk products like milk, cottage cheese, cream cheese, yogurt, ice cream, etc (unless lactose free)
  • beans
  • wheat based bread, pasta, crackers, baked goods
  • garlic and onions (the green part of green onions was allowed, as well as garlic/onion infused oils)
  • barley, rye, regular oats
  • avocados, mushrooms, asparagus, cauliflower, celery, cabbage, beets, peas, corn
  • almonds, cashews, pistachios
  • chocolate
Giving up gluten especially was hard.  Cooking without garlic and onion.  Being limited as to which fruits and vegetables I could eat.  Having to read labels on pretty much any packaged food.  It was daunting.

So I spent a lot of time preparing, researching, gathering recipes, and becoming a Pinterest addict.  And we began our endeavour. We started the process in early January and we're still going at it.  We have a couple weeks of the process left, after which I will start eating more foods I can tolerate, but still be careful for a few months while I experiment with others I'm still unsure about.  Although some dairy is allowed in this diet, for most of it, I have been very low dairy/dairy free.  I have also done a natural cleanse, taken probiotics, bone broth, sauerkraut, other supplements, etc. It has been a lot to keep up with.  Also, I cook all my own broth, make my own salad dressings, ketchup (which we actually like better than Heinz), and my own sausage.

When people hear about all this stuff I can't have, they wonder what we actually eat.  Well, I have been able to adapt and cook really good meals.  I cook more with raw herbs and spices and use fruit/citrus flavours.  There are things that are still harder.  There are foods I miss terribly.  But we have managed.  At home, it's not too bad.  The challenge becomes greater when we go out somewhere to eat.  But here are some examples of the great food we do enjoy.

Breakfasts generally consist of some sort of potato and egg combination, heuvos rancheros, veggie omelettes, baked oatmeal, gluten free pancakes, or simply fruit, cereal, or smoothies.

This orange french toast on homemade gluten free bread was a real treat.

Lunch is generally our biggest meal, and I've discovered some great new recipes and played with some different flavours.  Chinese five spice and fresh ginger is what makes this an awesome beef ginger stir fry.

Sometimes a little modification is all that's necessary to make a dish that you normally enjoy. Such is the case with this Hawaiian chicken and Herbed Basmati Rice.

This Cincinnati Chili included a unique blend of spices and is served on gluten free pasta.

Homemade Jamaican jerk seasoning and warm sauteed pineapple totally puts a new favourite kick on chicken fajitas.

Orange marmalade isn't just for toast. Sometimes it's for Spicy Orange Glazed Pork Chops too, with a rice and veggie pilaf.

Comfort food can be had too, and we enjoyed a classic Shepherd's Pie with a salad and homemade ranch.

And sometimes, you just need some gluten-free chocolate pudding cake! :)

In addition to this, we also eat lots of salads (although we avoided raw veggies for awhile), and eat lots of soups to get cooked veggies for easier digestion.

I must say, I am looking forward to being done with this process. It hasn't been easy to stick out, and without my husband, I think I would have caved numerous times.  It hasn't brought as much relief as we had hoped for, but slowly we're working through what's okay, what's not, and what we're still not sure about.  We've had to work with the challenge of getting enough fibre without eating wheat.  Right now, it looks like I may have to stay low-gluten or gluten-free, although we're not entirely sure yet. That is one really sad possibility for me. There is definitely a wealth of fantastic gluten-free recipes out there, and although I have succeeded in baking a few fairly good breads, it still doesn't measure up to wheat. And in times when I get super frustrated about what I can't eat, I have to be thankful for what I can still eat, remember that I'm not alone, and know there's more to life than food.

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