This is long but is my firsthand deep dive into health problems, food, gut and diet. I hope there's something helpful in here for someone, or at least makes sense why I've been acting such a fool at restaurants lately ;)
The faces people have made when they've asked me to explain what diet I'm following for the past 3.5 months have been comical, that's for sure. It's like they think I made up a word: "Fodmap". I explain - "it is a funny word - it's actually an acronym". When they ask me to tell them what it stands for they usually glaze over somewhere after Fermentable Oligosacchardies.. the other letters if you're interested are Disacchardies Monosaccharides And Polyols. In lay terms, they're small sugar molecules (all those 'saccharides' and 'ols' really just mean certain sugars/carbs) that our small intestine isn't able to digest and absorb, so they move into the large intestine where they're Fermented (there's the "F"). This causes the body to bring in liquid, bloat, cause gas - all those things you KNOW about how you feel when you eat, say, raw onion, or too many beans. Those are FODMAPs and they're just doing their normal thing. The thing is in people with IBS (Irritable Bowel Syndrome - yup, I said bowel on my blog) like me, if your sensitive gut gets too disrupted these FODMAPs can wreak some havoc. This summer I went through a very stressful period (sadly, my dad's cancer is back, and not treatable aside from palliative chemo/pain management, so digesting and processing that information has been tough on my brain.. and my gut..not really interested in talking about it much, but feel free to send your good vibes his way - he's the best, and the toughest) and I must have eaten something, somewhere, and found myself in a bad stomach spiral that lasted for SIX WEEKS. I'm talking.. motility, folks... I'm talking.. every day... oh god. I lost a staggering 15 lbs because I had zero appetite and when I did eat, bad things happened. My usual tricks of bread and juice weren't working the way they normally did. I'd have days where I'd go "screw it!" and eat anything, because nothing was going to make me feel good. My doc suggested the BRAT diet (tough for someone with a banana intolerance, and who apple juice is suddenly giving a stomach ache to), and ordered a colonoscopy and endoscopy.. for 6 weeks out.
Then my buddy Jay, my saviour, really, told me about the low FODMAPs diet. I'm aware of it because my sister in law is on it, but she's a nightmare to feed so I never even thought about looking into it. Jay explained all the things you COULD have: a bit of bread! cheese! lots of different fruit and veg! all the meat and fat you want! chocolate! (oh man I quit sugar in Dec 2018 and came back to chocolate like a crack addict as soon as I had an excuse). I figured: what the hell. And gave it a shot. Within 3 days my appetite came back for the first time in 6 weeks. Within a few weeks I had the functionality of a normal person in the place where it matters a lot. I went in a helicopter with potential major donors and didn't have it end in a really really embarrassing story. And today, I'm pretty much a normal girl again. An RD I finally got an appointment with a couple weeks later told me it was the first line of defense she would have recommended and has walked me through the phases of it (more on phases below), and later a gastroenterologist recommended it too. Low FODMAP: the gold standard in gut care! Who knew.
But OMG.. what you CAN'T eat on this diet has made the whole journey really SOMETHIN! Garlic, onions, apples/peaches/any fruit with a pit, wheat, lactose, beans and legumes, asparagus (why? why??), mushrooms, etc. No pattern you can pick out with the fruit and veg, just a lot of "nope"s! Add this onto my Kristyn-specific food sensitivities that pop up randomly from time to time (coffee, alcohol, red meat) and I sure was eating a lot of chicken and rice. You can eat the tops of green onions (the leaves DIGEST THE FODMAPs.. kind of cool), and have any fresh herb you like - so flavour came, but was hella different. Garlic infused oil is neat - FODMAPs are water soluble but not fat soluble so you get all the garlic flavour without the pain! And talk about people making faces at you - try going to an Italian restaurant and asking them what on the menu doesn't have garlic in it. I have had some very nice salmon salads, and a life smothered in parmesan cheese for flavour. DYK... most cheese doesn't have much lactose, which made this bearable as cheese is a main food group for me. Saving grace: the Monash app/website - Monash is a school in AU that researches FODMAPs and launched this diet and super specific and helpful app, and improved symptoms in 75% of IBS patients who go on it.
So a full 8 weeks on Phase I, the elimination phase of the diet where I can't have a single FODMAP while I just calm and heal my poor gut. Thank goodness for companies like FODY that make garlic and onion free pasta sauce, salsa, ketchup, bbq sauce and the best granola bars ever! Thank goodness for the cookbooks I found that let me still eat Italian (polenta lasagna!) and Mexican (cheesy tortilla casserole!). Thank goodness for the restaurants that talked to me ahead of time so I could still celebrate special occasions with friends and family (and a quiet 'f*ck you' to those who treated me like dirt and discouraged me from coming, like Caroline Cellars in Niagara on the Lake, a former favourite lunch spot). Thanks goodness that the gluten free and lactose free landscape at the grocery store is super impressive these days too. And I got back into cooking which after 6 weeks of eating mostly bread, and a spring of living in hard denial about my dad with my best friend fast food, was a welcome treat. And I didn't mind bringing sugar back into my diet.. girl needs some FLAVOUR!
Starting in mid-Oct was a full 8 weeks of Phase II "challenges", where I stay on the elimination diet but reintroduce FODMAPs one at a time to see which ones are actually a problem for me - 3 days of intro, 3 days of rest. Great news - in doing this I haven't regressed to my symptoms being as bad as they were in July, but I did find a couple of things that caused me some (manageable) pain and bloating (so I can extrapolate that if my gut is off, they're going to cause the full monty of symptoms). Turns out I am mostly a fructan master. WTF is a fructan? It's just a whole bunch of fructose molecules together. You have to test 5 types of fructans during the challenge phase and I mastered wheat (THANK GOD!), fruits/veg fructans, galactoligosaccharides (fructans found in chickpeas, beans, etc.).. I'm going to do onion fructans this week (promise!) and I somewhat failed garlic fructans. A small amount of garlic was fine, but increasing the dose on day 2 caused enough stomach pain that I didn't need to see what would happen on day 3. The hope is I can try again down the line. I've always loved and cooked with garlic and do believe my gut is still on the mend. I did well with lactose, except got bloated after a big glass of milk. So lesson learned to get the kid sized ice cream cone (...I already knew this. I have a very clear memory of a morning in Carden after a night at Kawartha Dairy where I made eye contact with a cow in a field during a critical moment...). And I tested a bunch of weird stuff like mannitol, and sorbitol - turns out sorbitol, found in things with pits (avocado, apple, peach, cherry) among other food, is a real jerk to me, but only in higher doses. I typically don't want to eat a whole avocado at one time anyway, but it explains why apple juice became an enemy last summer. You definitely want to get as many FODMAPs back in your diet as you can, since they're important prebiotics that feed your microbiome and are associated with great nutrients and fibre in the foods that carry them.
So I'm almost at Phase III - customize, based on what you learn from using your body as a science experiment during Phase II, and then live yer life. Can't friggin wait. I've been tracking every bite I've eaten for month and this week I got so bored of it I started using emojis instead. The kiwi one is the cutest. I track my stress, and sleep, and gut feelings and BMs too. My FODMAP life, in snapshots.
And a crazy thing that came out of this was the results of my first colonoscopy. It's almost funny how weird the prep is (I felt well prepared for it emotionally after the summer I had lol - once you've been in trouble in the woods, there's nothing left to fear..). I had SEVEN polyps found and removed. And the lab tests showed they're all pre-cancerous.. WTFFFFFF!!!!???? If this hadn't happened, I may not been screened routinely until I was 50, and then guys I quite likely would have had full blown colon cancer. So now I'll be heading back for a screening every 3 years, and would encourage anyone who has a chance to to get the damn test! Worth the cleanout. Good news otherwise - no celiac, no crohn's, no colitis, no cancer.. just inflammation associated with good ol' IBS.
My weight bottomed out after that procedure (as you'd expect) at -20 lbs (yikes), but I started eating small and high calorie meals very often and I don't know what I weigh but my pants aren't hanging off me anymore, and I can wear everything I own comfortably, which seems great. PSA: don't tell people who look like they've lost weight "you look fabulous! what's your secret?!" - because my answer was, "I don't mind the results, but I wouldn't recommend the method". What I would have given to eat normally over the past few months, I tell ya... Plus, I was grey. Health is measured in a rosy cheek, not a skinny leg, I say!
And that's it. My FODMAP adventure. I'm not exactly going to recommend it for fun, but it might be neat to think about the foods that cause you trouble and have a look at what portions of them you can truly tolerate to avoid that post-restaurant bloat/pain. And if you're ever in a tricky digestive spot, or are a fellow IBS sufferer, then I think you have nothing to lose by giving it a go. Phase I can last only three weeks if you don't start out in as bad shape as I was, and the challenge phase really has been a fun experiment, selecting from the app what foods to try next with my coworkers at the lunch table. Though figuring out how to eat 1 cup of chickpeas was interesting. I need the barf face emoji. That's just too many chickpeas.
Thanks everyone who's been supportive, listened to me talk about my stomach, my guts, and short chain carbohydrates ad nauseum for months on end. Thanks Jay for saving my life before I spent 2 weeks on the water in Georgian Bay and in a helicopter over Timmins. I do think Jeff enjoyed all the cooking and definitely the birthday polenta lasagna. Anyways, now I gotta go figure out how to palatably eat 1/4 of an onion tonight to start this second to last challenge. I'm scared for Day 3 -who eats half an onion anyways? Should I just chomp it down like George when he didn't have his glasses? Stay tuned to find out ;)
