In my thirty years in medicine, I have never diagnosed anybody with “irritable bowel syndrome.”
Not that I didn't want to make the diagnosis. But it always seemed to be the last resort - if there wasn't a better explanation for the patient's symptoms. And there always was.
If my patients came with the label, I quietly looked for a more appropriate diagnosis, mostly some kind of food intolerance and/or infections. And if they came with any of the myriad of gastrointestinal complaints, they deserved a thorough workup.
Food allergies: Physicians differ between food allergies and food intolerance. For the patient the difference is minimal: The only action that will help is leaving out the offending food.
Allergies are mediated either through blood – then they show up in blood tests. Or they are cell-mediated, which means they can’t be detected by blood tests; skin prick test is the way to go then.
If you usually feel good (or even just better) in the morning before you eat, food problems are likely. – Floating stools point to a food culprit, too.
There are rare and dangerous diseases, therefore a doctor should eliminate serious diagnoses. But this is what you can do yourself:
• Write a food journal. Everything that goes into your mouth should go in here – including beverages, pills and chewing gum. A pattern might become clear once you regularly record everything.
• In my experience, these are the most common food offenders: dairy, soy, nuts, gluten, corn – especially HFCS (High Fructose Corn Syrup), nightshades (tomato, potato, eggplant, bell and hot peppers), citrus, seafood, lectins, food colorings, preservatives, flavor enhancers (like MSG), eggs, apples and other fruit, chocolate (though probably less common than people think – it usually are the non-cacao ingredients that cause trouble), yeast. And don’t forget: prescription medication! Recreational drugs.
• Read labels! Of course, foods without labels – like kale and carrots – are healthier anyway because only processed food is required to be labeled.
• Has anybody in your family a bowel disease? You might have the same.
• Jot down pains, headache, heartburn, stomach ache, bloating, diarrhea, constipation, blurred vision, slow urination, skin rashes, blocked nose or ears,
• Don’t eat after dinner – and don’t have dinner late. The sheer bulk in your stomach may create the discomfort; besides it prevents the cell repair that should be taking place nightly – but can’t happen when your body is busy digesting.
• Are you very thirsty – especially during and after a meal? That might be a sign of a food allergy. Don’t suppress your thirst – this is how your body gets rid of the offending food: by diluting it.
• If you suspect food allergies, leave out the whole list above plus whatever you suspect for a week. Then one by one, every few days reintroduce another food from the list. – Sometimes only repeated exposure shows the problem – that happens mostly with cell-mediated allergies.
• Blood-mediated allergies are the quick ones – that can bring you to the emergency room - like peanuts. Never try to force your body into accepting any food that it doesn’t want!
• Slow allergies make you sick over time – by the chronic inflammation in your body. That causes for instance cancer in the long run.
• Take a probiotics regularly. I personally like Primal Defense (this is not an endorsement – only an idea to start with. Begin with a small dose, slowly take more. If a probiotic does not agree with you, change the brand.
• Most people benefit from fish oil – to counteract the constant inflammation that comes with food allergies.
• Chew well.
• Eat vegetables, vegetables, vegetables. Not only are they good for you – they also seem to cause fewer allergies.
• Serious runners suffer from a curious disease called “runner’s diarrhea” (about fifty percent of them.
• Obesity might be a sign for food allergies: We tend to crave exactly the foods that are worst for us.
• And most importantly: Don’t eat it if it hurts you!
Unfortunately, you can even have a bowel disease without any gastrointestinal complaints: About fifty percent of gluten intolerance (celiac sprue) patients never notice anything wrong with their belly. But they might have joint or back pain, diabetes, autoimmune disease, mental fog, depression – and a host of other problems. Read More
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Summer Fare
July 19, 2010
In the summer, we don’t like to eat heavy foods. We have a natural tendency, an innate knowledge, to eat lighter in hot weather. Braised lamb red, cabbage and sweet potatoes is a combination I would not serve now; in the fall, with temperatures down, it will be delicious.
Here is a recipe for a light shrimp salad, easy to make:
• About five to ten cooked shrimps per person. Remove tails and slice the shrimp lengthwise. (Instead of shrimp, cooked lobster, chicken, mussels, crab meat, mushrooms would work).
• Add an onion, finely chopped.
• A can of mandarins or pineapples, or fresh apple or pear (or whatever fruit, you fancy).
• Walnuts or almonds or whatever nuts.
• A bit salt and pepper.
• Fresh or dried dill (or any herb).
• And mayonnaise – as little as possible. I prefer a mayonnaise made with olive oil. You can stretch the mayonnaise with juice from the mandarin can, or with a few drops of olive oil; or both.
• Serve the shrimp salad with corn on the cob, broiled (with sunflower or sesame seeds and olive oil) asparagus, and lentils or a multi-grain bread.
• End the meal with fresh fruit – a watermelon or cherries or strawberries from the field.
This is a good example how I cook: I use what I have at hand and what is fresh and in season and therefore cheap. It never tastes the same twice. And never ever ask me: How much? I am a “feeling” cook, not a measuring one.
This is a Sunday dish. Eating mayonnaise every day is not such a good idea for the waist line – even if it is finger-licking good. By the way, if you have a mixer, you can make your own mayonnaise: Separate eggs into yolks and egg white (use the whites for making meringues later). Beat the yolks until they stiffen a bit. Drop by drop add olive oil – never stop beating, slowly first, then faster. The secret is in never to add too much oil at a time so that the mayonnaise does not curdle. Takes five minutes to make.
Summer fare is about freshness and moderation. Thinking about it: It's the same in the winter. Except that in the summer, the heat helps you with the moderation part - it curbs our appetites. Read More
Aches and Pains
May 11, 2010
In my twenties doctors had different explanations about the weird aches and pains I complained of. They were either from aging (in my twenties!!), or they were all in my head, or – poor redheads all over the world! – it was just that redheads had lower pain thresholds.
Research meanwhile has confirmed that redheads have actually higher pain thresholds. Besides, I had a whopping but unrecognized case of gluten intolerance, probably since birth. Took me many years to figure it out.
You, too, might have gluten intolerance. Estimates go that one of one-hundred-five people has, most of them not yet diagnosed. Most of them are blond and blue-eyed – but not all of them (otherwise the diagnosis would be easy!).
Of course, aches and pains can have other causes than celiac disease (another word for gluten intolerance; as is non-tropical sprue). But food is often the culprit - dairy, in my opinion, the worst since it is highly inflammatory (besides fattening). If you have arthritis, tendinitis, bursitis, fasciitis – or any “…itis" in your body, leave out milk and milk products for at least a month, and see if you get better.
Other suspicious foods are nuts (which, on the other hand, are very wholesome if you can tolerate them), nightshades (tomato, potato, eggplant, bell and hot peppers). Food additives can give bad reactions (and should not be in your food in the first place). Food intolerances can be very individual – for some it is an innocuous apple, for others shrimp or peanut or banana. By keeping a food journal you might find out – or help your doctor to find out.
Finding the cause and avoiding the offender, is the first step. On top of it, there are many herbs that reduce inflammation, like turmeric, garlic, rosemary. In fact, so many plants contain inflammation-dousing phyto-nutrients that eating more vegetables and herbs already might give you relief. If you want an herbal preparation, I usually recommend Zyflamend (be sure you have no allergy to any individual herb in there).
A good fish oil (you should not burp up fish!) has excellent anti-inflammatory action. As does olive-oil (unheated) in your salads. And lastly, a good probiotic, to quench the fire in your belly: Most inflammation originates in an inflamed bowel. Read More