In a moment Ill let you know how
to eat to minimize or eliminate IBS, but first Im going
to explain how and why it is effective. Once you understand whats
going on, it will be clear why the diet for IBS works so well.
The most important thing to know is that
your body has a cleansing wave that occurs regularly
throughout the day. These are waves of activity that move through
your intestines. The purpose of a cleansing wave is to clean
out the small intestine.
When you eat, food is churned up in your
stomach and mixed with stomach acid, which kills bacteria. Then
the food is let into the small intestine where enzymes break
up the food into molecules that can be absorbed into your body.
When your small intestine has extracted the nutrients, whats
left over needs to be flushed out of the small intestine and
into your colon. Thats the job of the cleansing waves.
Question: After the nutrients are extracted,
whats left in the small intestine? What needs to be flushed
out? Answer: Indigestible carbohydrates like fiber and certain
sugars (the sugars you dont have enzymes for). Lactose-intolerant
people, for example, dont have the enzyme needed to digest
lactose (the sugar in milk) so when digestion is finished and
all the nutrients in the meal have been absorbed, lactose sugar
would still be left in the small intestine.
These indigestible sugars and fibers become
food for bacteria. Thats fine if the bacteria are in the
colon. It is not fine if the bacteria are in the small
If the cleansing wave doesnt come
after digestion is finished, bacteria feed on leftover fibers
and sugars and multiply. Its called fermentation
and it produces gas. The gas accumulates in the small intestine.
It cant be expelled as easily as gas in the colon, which
is expelled through flatulence. In the small intestine, the gas
accumulates, producing a feeling of bloating and pain. The gas
can also create either constipation or diarrhea depending
on what kinds of bacteria or food are present. Different foods
and different bacteria produce different gases. If the main gas
produced is methane, it causes your intestines to slow down,
producing constipation. If the main gas is hydrogen, it causes
These are the core symptoms of IBS: bloating,
pain, diarrhea, and/or constipation.
Given all this, the two most important
things you can do if you have IBS is to 1) make sure your cleansing
waves do their job, and 2) give the bacteria in your small intestine
less food to eat.
Question: What causes the cleansing waves
to work? Answer: The period of no food in between meals. When
you eat, your digestive system does its thing, extracting nutrients.
When its finished, the cleansing waves begin and wash everything
leftover into the colon (including the bacteria in your small
But if you eat more food before the cleansing
wave starts, the digestive process starts again and the cleansing
wave is postponed. The indigestible food left in the small intestine
stays there, feeding bacteria, while the new food
is mashed up in the stomach and released into the small intestine
to be absorbed. All this while, the bacteria feeding on the leftovers
of the last meal are still in the small intestine, multiplying
and producing gas, causing pain, bloating, diarrhea and/or constipation.
And it can happen again and again. Some
people soothe their painful guts by eating something more. If
they do it before the cleansing waves start, and then do it again,
the remains of their previous meals will continue to stay in
their small intestine while the new meals or snacks are being
digested. The bacteria keep fermenting and multiplying, and the
gas keeps accumulating.
To avoid all this, the solution is to eat
a meal and wait four or five hours before eating anything,
which gives your migrating motor complex a chance to do its job
and move the leftover food (and the bacteria) into the colon
where it can be removed from your body or comfortably fermented.
So the first rule of the diet for IBS is
to eat three meals a day and not eat or drink anything
else (except water) the rest of the time.
The other thing you can do to reduce the
pain, bloating, diarrhea and/or constipation of IBS is to give
the bacteria in your small intestine as little food as possible.
That is, eat very little that is indigestible. This entire article
can be summed up like this: Starve the bacteria and wash them
Let me tell you something: The list of
recommendations below will seem in many ways the opposite of
what weve been told is good for our health. The IBS diet
does not contradict what weve been told about eating. But
in some ways, a healthy diet helps perpetuate IBS. Youll
find out why in a minute.
Here is a list of recommendations for IBS:
1. Dont eat more than two pieces
of fruit in a day. If you want
faster results, dont eat any fruit. The primary sugar in
fruit is fructose, which is digested very slowly, allowing the
bacteria in the lower part of your small intestine (where too
much bacteria resides in people with IBS) to ferment it.
2. Avoid all lactose. Do not eat milk, cheese, yogurt, butter, sour cream,
etc. Even for people who dont have a lactose-intolerance
problem, lactose is a difficult sugar for human bodies to digest,
and those sugars linger in the lower part of the small intestine.
So lactose feeds bacteria in your small intestine. Avoid it.
Lactose-free milk products are fine, of course.
3. Avoid all sweeteners except glucose. If you must have sugar and glucose is not available,
eat regular table sugar (sucrose) but limit it as much as you
can. Completely avoid fructose, sucralose (an artificial sugar),
sorbitol, mannitol, and corn syrup. All these sugars are difficult
or impossible for your body to digest, so they feed bacteria
in the lower part of your small intestine. Glucose, on the other
hand, is absorbed very quickly usually in the first two
feet of the small intestine (the small intestine is fifteen feet
long). So glucose leaves nothing for the bacteria to feed on.
Glucose is also called dextrose on some labels.
4. Dont eat raw vegetables very
often. Non-starchy cooked vegetables
are fine no more than five cups a day. Raw vegetables
are difficult to digest. Potatoes are the one exception to the
non-starchy vegetable rule.
5. Eat potatoes, white rice, pasta,
and white bread. I told you this
would be the opposite of what were told is good for us.
Some starches are digested quickly. Some are digested more slowly,
and the slower ones make it to the lower part of the small intestine
without being absorbed, so they feed the bacteria. Weve
all been told to eat more of the slow carbohydrates
because they are slower to raise your blood sugar. But thats
exactly why someone with IBS or SIBO (small intestinal bacterial
overload) should avoid slow carbohydrates. You should
eat foods that will be easily and quickly absorbed. So if you
have IBS, eat white bread, not whole grain bread, because
whole grains have more fiber and therefore will feed the bacteria
in your small intestine. Avoid whole grains.
6. Avoid beans. This
includes soybeans. Avoid lentils, garbanzo beans, peas, etc.
They all have indigestible fibers and sugars. You shouldnt
eat them if you have IBS or SIBO.
7. You can eat beef, poultry, fish and
eggs. Those do not feed the bacteria
in your small intestine.
8. Avoid alcohol. A
study by Dr. Scott Gabbard indicates that alcoholic beverages
may contribute to bacterial growth in the lower part of the small
intestine. Read the study here.
9. Drink eight cups of water a day. You need enough fluid to produce good cleansing
waves. Mark Pimentel, MD, the author of A New IBS Solution (which goes into detail
about a perfect diet for IBS) suggests two cups of water with
each meal, and then one cup between breakfast and lunch, and
one cup between lunch and dinner.
10. Relax your body. Relaxation helps make the cleansing waves stronger.
Tension and stress interfere with the digestion process. Relaxing
helps everything work better.
Does this list surprise you? It surprised
me. It sounds like the way everyone ate when I was a kid back
in the 60s three square meals a day,
no snacking in between, no artificial sugars, only one or two
pieces of fruit a day, not many raw vegetables (but cooked vegetables),
and white bread. Dinner was meat and potatoes and cooked veggies.
This is the diet for IBS if you want to
feel better. Follow those ten guidelines and eat only three times
a day, four or five hours apart, and you have a good chance of
getting rid of your IBS for as long as you maintain the diet.
Of course, its possible this diet
wont work for you. If it doesnt work, you may need
a round of antibiotics first. Then follow the diet above.
Some people need to kill off the bacteria in the lower part of
the small intestine first, which is often done with rifaximin
and/or neomycin both of which stay primarily in the intestines
(in other words, not much is absorbed into your blood stream).
Some people may require a prescription
for a drug that stimulates the cleansing waves because their
migrating motor complex has been damaged by the event that started
their IBS in the first place.
For many people, their IBS started with
a terrible bout of food poisoning or a parasitic infection. Sometimes,
one of the results of the event is an impairment of the migrating
motor complex. In other words, the poisoning or infection impaired
their bodys ability to create cleansing waves. So now they
dont have strong cleansing waves. The indigestible foods
dont get washed into the colon very well, so they multiply
where they shouldnt be: In the lower part of the small
If your migrating motor complex has been
damaged, you may need a prescription for a cleansing wave stimulator.
Talk to your doctor about this.
In fact, its a good idea to talk
to your doctor first (before you change your diet) in order rule
out other causes of your IBS. Many other conditions can create
IBS-like symptoms: Crohnes Disease, colon cancer, celiac
disease, etc., and these can be very serious. So see your doctor,
take the tests, and make sure you really have IBS. If you do,
follow the above diet for IBS. If it doesnt do the trick,
see your doctor for a round of antibiotics.
Another alternative to antibiotics, or
something to use in addition to antibiotics, is two weeks
of an elemental diet, which means only consuming
Vivonex a food formula with all the essential nutrients
you need in a predigested form, which means the nutrients are
absorbed quickly. This starves the bacteria in the lower part
of your small intestine. You can read more about how that works
in the book I mentioned above: A New IBS Solution. Treatment with antibiotics
and/or Vivonex, followed by the diet for IBS, successfully eliminates
IBS in 80 to 90 percent of patients.
So if youve ruled out serious diseases
that may be masquerading as IBS or SIBO, try the diet for IBS
above. If that doesnt work, try a round of antibiotics
and/or a couple weeks of Vivonex to kill off the bacteria first,
and then follow the diet for IBS. And from now on, eat
three meals a day, four or five hours apart, with nothing in
between meals except water.
Starve the bacteria and wash them away.
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