Seasonal Stresses and Strains

IBS - Seasonal Woes

It is that time of year again, while next week we will look at the dietary issues which effect IBS sufferers over the festive period, this week we will take a look at some of the ways which we can avoid excess stress.

We frequently discuss the relationship between stress and IBS, however few periods of the year include so many contributors.  If you have a young family then you are most likely drowning under lists of presents and things to do.  The levels and type of pressure may vary form home to home, however everything from work to home appears to get sucked into to the festive madness.

Christmas is up there with divorce, moving house and changing jobs as the sixth most stressful life event. 86% of us say they find buying presents difficult and 65% find Christmas shopping a stressful experience, according to the results of a new survey of over 3,000 people*.

The results of the survey reveal that over 30% of us get stressed just at the mere thought of hitting the high street at Christmas, and 61% say they lack inspiration when shopping and worry that people won't like what they've bought them. 60% of us have at some time had the horrible experience of buying a gift for someone and seeing disappointment on their faces when they opened it.

Looking after you

If you suffer chronic IBS, you are highly likely to suffer over this period.  Below we have taken the best best article we could find, from experts on the subject to find some of the best tips to reducing seasonal stress.    Make sure this Christmas doesn’t become a day to remember for all the wrong reasons. Follow these tips from Relate counsellor Christine Northam:

• If there have been any family rows during the year, resolve them. Tell the people you argued with that you're looking forward to seeing them. Ask if you can get together before Christmas to talk about whatever problem you had.
• Plan the day and share out the jobs that need to be done. Don't slave away for hours on your own and feel like people have taken advantage of you.
• Discuss your plans with others, including any children who will be there, so that you can listen to their ideas and wishes for the day. Then you can come up with a celebration which includes things that please everyone.
• Have a timetable for Christmas Day so that you don’t all sit around for hours doing nothing. Try to make sure you won't be spending a lot of time with a difficult person or someone you don’t get along with. 
• Don’t drink too much. Drinking excessively is never a good idea. Find out more on safer drinking. 
• Children can get overexcited, so plan a lovely long walk for a change of scene and some fresh air. Everybody will feel better and pleasantly tired instead of irritably tired

For greater detail please click here for a guide to a stress free Christmas.

* conducted by MemoriseThis.com (1) - the UK's largest on-line gift giving company

Finding the Root Causes of IBS

The Root Cause

It has long been established that IBS is not 'just in the mind', it is clearly a physical condition.  Finding the root cause however remains something of a mystery. We take a brief look at why IBS can be so hard to cure for so many, and why it often takes so many attempts to ascertain just what is causing the problems in the first instance.

Cure

To begin with the thorny issue of curing IBS.  If you consult medical journals you will find most if not all clearly state that there is at present no cure for IBS.  Despite this if you search for IBS cures you will find many sites and claims that curing IBS is not only possible it is often easy.  So where is the truth?  

The reality is (as ever) the truth lies somewhere between.  Treatments and therapies exist which show that IBS can be successfully managed for many, but not all, and some may find that IBS comes and goes based on external factors.  Great examples of IBS which would come and go are often stress and medication related.  Medication such as antibiotics, Ibruprofen and Aspirin may do harm to our digestion.  If for example you take painkillers for a sporting injury, you may develop IBS, which later goes away after you stop taking strong medication.  Similarly highly stressful  periods in life can bring on IBS as a physical reaction to stress, which may also subside in time.

If you are lucky enough to have IBS come, and eventually go you will feel as though it was cured.  Sadly for most IBS does not simply come and go.  Yet again the problem relates to an excessive number of digestive disorders being classified as IBS.

Finding the Root cause

With such a 'wishy washy' diagnoses (the Rome Criteria), it is very hard to then simply get to a definitive answer to addressing the problem.  If the diagnosis is vague, how can the treatment be specific?

The best method you can follow is detective work and a diary.  Medical professionals do a wonderful job, however digestive disorders can often be like finding a needle in a haystack, for those that wish to see the level of complexity we recommend The Digestive System by Margaret E. Smith and Dion G.Morton.   It only takes minor issues and imbalances for our digestive system to be corrupted.  It is a field which we know an ever increasing amount, however we are some way from totally control of the digestive system.

If you have had IBS from birth then unless you are lucky enough to be able to identify the root cause then using a diary will assist you to manage your condition.  If IBS came to you later in life then a diary and detective work will offer you a wonderful insight into when the symptoms arrived and what you can do about them.

For example when the symptoms arrived and what lead to them.  You can look at changes in lifestyle (stress), or changes in diet and medication.  This information can be of great assistance to whomever you chose to assist.  It is so often in the little details that major problems can be resolved.  

Don't wait for the quick cure, or quick fix.  We all hope that the day will come, however until it does, the more information and knowledge you can gather, the greater your chances of ensuring you manage IBS, rather than vice versa.

IBS & Sleep

The Importance of Sleep 

Sleep is so rarely mentioned in relationship to IBS despite the key role it plays in ensuring that mentally and physically you are in prime condition.  If you are struggling with IBS then taking sleep seriously can really assist you, hence we have included a few tips:

Healthy Brain Function and Emotional Well-Being

Sleep helps your brain work properly. While you're sleeping, your brain is preparing for the next day. It's forming new pathways to help you learn and remember information.

Studies show that a good night's sleep improves learning. Whether you're learning math, how to play the piano, how to perfect your golf swing, or how to drive a car, sleep helps enhance your learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative.

Studies also show that sleep deficiency alters activity in some parts of the brain. If you're sleep deficient, you may have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change. Sleep deficiency also has been linked to depression, suicide, and risk-taking behavior.

Children and teens who are sleep deficient may have problems getting along with others. They may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation. They also may have problems paying attention, and they may get lower grades and feel stressed.

Physical Health

Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke. 

Sleep deficiency also increases the risk of obesity. For example, one study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up. Sleep deficiency increases the risk of obesity in other age groups as well.

Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested.

Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which may increase your risk for diabetes.

Sleep also supports healthy growth and development. Deep sleep triggers the body to release the hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in puberty and fertility.

Your immune system relies on sleep to stay healthy. This system defends your body against foreign or harmful substances. Ongoing sleep deficiency can change the way in which your immune system responds. For example, if you're sleep deficient, you may have trouble fighting common infections.

Daytime Performance and Safety

Getting enough quality sleep at the right times helps you function well throughout the day. People who are sleep deficient are less productive at work and school. They take longer to finish tasks, have a slower reaction time, and make more mistakes.

After several nights of losing sleep—even a loss of just 1–2 hours per night—your ability to function suffers as if you haven't slept at all for a day or two.

Lack of sleep also may lead to microsleep. Microsleep refers to brief moments of sleep that occur when you're normally awake.

You can't control microsleep, and you might not be aware of it. For example, have you ever driven somewhere and then not remembered part of the trip? If so, you may have experienced microsleep.

Even if you're not driving, microsleep can affect how you function. If you're listening to a lecture, for example, you might miss some of the information or feel like you don't understand the point. In reality, though, you may have slept through part of the lecture and not been aware of it.

Some people aren't aware of the risks of sleep deficiency. In fact, they may not even realize that they're sleep deficient. Even with limited or poor-quality sleep, they may still think that they can function well.

For example, drowsy drivers may feel capable of driving. Yet, studies show that sleep deficiency harms your driving ability as much as, or more than, being drunk. It's estimated that driver sleepiness is a factor in about 100,000 car accidents each year, resulting in about 1,500 deaths.

Drivers aren't the only ones affected by sleep deficiency. It can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and assembly line workers.

As a result, sleep deficiency is not only harmful on a personal level, but it also can cause large-scale damage. For example, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.

How Much Sleep Is Enough?

The amount of sleep you need each day will change over the course of your life. Although sleep needs vary from person to person, the chart below shows general recommendations for different age groups.

Age	Recommended Amount of Sleep
Newborns	16–18 hours a day
Preschool-aged children	11–12 hours a day
School-aged children	At least 10 hours a day
Teens	9–10 hours a day
Adults (including the elderly)	7–8 hours a day

If you routinely lose sleep or choose to sleep less than needed, the sleep loss adds up. The total sleep lost is called your sleep debt. For example, if you lose 2 hours of sleep each night, you'll have a sleep debt of 14 hours after a week.

Some people nap as a way to deal with sleepiness. Naps may provide a short-term boost in alertness and performance. However, napping doesn't provide all of the other benefits of night-time sleep. Thus, you can't really make up for lost sleep. Some people sleep more on their days off than on work days. They also may go to bed later and get up later on days off.

Sleeping more on days off might be a sign that you aren't getting enough sleep. Although extra sleep on days off might help you feel better, it can upset your body's sleep–wake rhythm. Bad sleep habits and long-term sleep loss will affect your health. If you're worried about whether you're getting enough sleep, try using a sleep diary for a couple of weeks.  

Write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel during the day. Show the results to your doctor and talk about how you can improve your sleep. You can find a sample sleep diary in the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."

Sleeping when your body is ready to sleep also is very important. Sleep deficiency can affect people even when they sleep the total number of hours recommended for their age group. For example, people whose sleep is out of sync with their body clocks (such as shift workers) or routinely interrupted (such as caregivers or emergency responders) might need to pay special attention to their sleep needs.  

If your job or daily routine limits your ability to get enough sleep or sleep at the right times, talk with your doctor. You also should talk with your doctor if you sleep more than 8 hours a night, but don't feel well rested. You may have a sleep disorder or other health problem.

Who Is at Risk for Sleep Deprivation and Deficiency?

Sleep deficiency, which includes sleep deprivation, affects people of all ages, races, and ethnicities. Certain groups of people may be more likely to be sleep deficient. Examples include people who:

• Have limited time available for sleep, such as caregivers or people working long hours or more than one job
• Have schedules that conflict with their internal body clocks, such as shift workers, first responders, teens who have early school schedules, or people who must travel for work
• Make lifestyle choices that prevent them from getting enough sleep, such as taking medicine to stay awake, abusing alcohol or drugs, or not leaving enough time for sleep
• Have undiagnosed or untreated medical problems, such as stress, anxiety, or sleep disorders
• Have medical conditions or take medicines that interfere with sleep

Certain medical conditions have been linked to sleep disorders. These conditions include heart failure, heart disease, obesity, diabetes, high blood pressure, stroke or transient ischemic attack (mini-stroke), depression, and attention-deficit hyperactivity disorder (ADHD).

If you have or have had one of these conditions, ask your doctor whether you might benefit from a sleep study.

A sleep study allows your doctor to measure how much and how well you sleep. It also helps show whether you have sleep problems and how severe they are. For more information, go to the Health Topics Sleep Studies article.

For more click here

Good Foods for IBS - Rice

The Joys of Rice

Few ingredients are as kind to the digestion as rice 

White Rice

White rice is a bland, low-fiber food because it is processed, like white flour and bread. White rice is easy on your digestive system, making it a suitable item on bland menus for people recovering from various digestive ailments like an upset stomach, gastroenteritis and diverticulitis. You can eat plain white rice or derivatives like cream of rice hot cereal or plain rice porridge, according to San Francisco State University Student Health Services. White rice's low fiber content makes it less likely to irritate your intestines, and it does not contribute to diarrhea.

Brown Rice

 

Brown rice is a high-roughage food rich in insoluble fiber on its outer part, with soluble fiber inside. The soluble fiber controls blood sugar and lowers cholesterol, but the insoluble fiber promotes good digestion. Unlike the soluble type, which changes its form into a jelly, the insoluble type retains its shape and resists digestion. This allows it to move other digestible foods along more efficiently. The insoluble fiber also absorbs water that moisturizes stool, and it bulks up your waste product into soft but solid pieces.

The beauty of rice, is now its versatility with all manner of wonderful noodles and flours available, today we include one of our favourite rice based recipes from our low FODMAP recipe website.

Low FODMAP Chicken Pilaf

1 tsp sunflower oil

1 stick celery, chopped

2 carrots, chopped

1 zucchini, chopped

6 tomatoes

1 large or 2 small boneless, skinless chicken thigh fillets, cut into chunks

2 tsp low FODMAP curry paste

a third of a mug basmati rice

two-thirds of a mug low FODMAP chicken stock

half a mug frozen leaf spinach

Method

Heat the oil in a frying pan, then fry the carrot and celery for 5-6 mins until softened. A

dd the chicken pieces, fry for a further couple of mins just to colour the outside, then stir in curry powder and rice.

Cook for another min.

Pour in the chicken stock and throw in any larger bits of frozen veg.

Bring to the boil, lower the heat, then cover the pan with a lid. Cook for 10 mins, then stir in the remaining veg.

Scatter over the spinach, cover, then cook for 10 mins more until all the stock is absorbed and the rice is tender.

Give everything a good stir, season to taste, then tuck in.

Recipe adapted from: Good Food

Can you still enjoy food with IBS?

Can you still enjoy food with IBS?

 It is surprising the number of IBS sufferers we meet who have a passion for food.   Despite the fact that many have to endure a highly restricted diet  food remains in their hearts. So how can you maintain a sincere and genuine love of food, when so many of the great treats remain problematic to sufferers of IBS?

Before proceeding  I must come off the fence at this point and confess that the first ten years of my career centered around the hotel and restaurant industry in a variety of guises.  I entered the profession as I had a bona fide passion for food and cooking and could imagine little else.  Despite going on to gain other professional qualifications and a degree the passion remains strong.

There remains some debate about the role of diet in IBS.  While it is a source of frustration, we have always struggled to see how it could not have an effect.  The nature of the modern world means that our diet bears little resemblance to that which our bodies were designed.  Our increased life expectancy suggests that it is not all bad, however only the churlish would suggest that a good diet is not a valuable tool in maximising our potential.

Say goodbye the good stuff

When tackling IBS there are foods which commonly cause problems.  In the past we have detailed how and why that is (click here for more), however the bottom line is that for foodies they mean eliminating some of the tastiest food around.  We talk of gluten and dairy.

While gluten free food has improved dramatically, it is never going to be as silken and as a delicious wheaty treat.  Much of the gluten free bread available is dry unless warmed, and without gluten lacks the texture of a good bread.  The flavour is often impaired by excess sweetness and some of the flours used contain distinct flavour tones, which may or may not be to your taste.

Dairy omission, is equally hard when you consider what you may lose.  One of lifes simple pleasures is a good lump of cheese* and warm bread.  With IBS that pleasure may be gone forever.  Although many soya, oat and rice based milk products exist, some of which are very good, they are not ideal replacements for lovely cheese and cream.

So as an IBS foodie, you already lose wheat and dairy, the next hammer blow is spice.  While not everyone has a passion for exotic spicy food, for those of us who do, the repercussions of indulging in a spicy meal can be quite dramatic.  Pepper of any variety can upset the digestive system, from chilli to simple ground black pepper, a whole world of food enlivenment can be removed.

 The food news for an IBS foodie

 It would be easy to fixate on the omissions, however that would failing to acknowledge a number of truths and some good news.  Firstly that while we mentioned a humans ‘natural’ diet earlier it must be remembered that until relatively recently we ate what was local and in season.  Everyone man woman and child around the world has a naturally healthy diet based on geography.  By fixating upon what we are no longer able to enjoy, we are simply failing to acknowledge this basic and obvious fact.

We also need to acknowledge that wheat and fatty dairy are not great for us anyway.  They are clearly not evil and both contain benefits, however they are rarely at the forefront of any healthy diet, whether you are reducing fat or carbs, in many senses an IBS restricted diet can remove some of the temptations  which would have a negative effect.

Finally, while gluten free bread products may not be great, if you need an unhealthy treat, gluten free flours are often very short, thus they make great crisp biscuits and pastry.  You can also make wonderful crispy coatings using gluten free products, it is only the bread which represents a problem.  We realise that this contradicts our healthy point above, however no one suggests that the occasional treat in moderation is a bad thing.

Chance to experiment and create

The reality is that even if you are the most rabid food lover, the omissions recommended are only really a problem if you fixate upon them.  There are still thousands of alternative and thousands of new idea to be discovered.  Even a heavily restricted diet such as the low FODMAP diet will leave you with lots of choice, we now have in excess of two thousand recipes and counting on our sites.

So while a food lover with IBS will have to make concessions there is no doubt that we are in fact very lucky.  There are still lots of ingredients to play with and most importantly it is our choice,(unless you are a celiaic obviously).  If you want to enjoy so of the known IBS trigger foods you can, it is your option and yours alone,  we all know the consequences.

 *Many cheeses use their lactose content up during the ripening process.  Do check to see if you are completely dairy intolerant, or whether it is just lactose.  If it is just lactose then the degree of dietary omission will drop significantly and few products are unavailable.

The Low FODMAP Diet - Where we stand

The Low FODMAP Diet

Having been around for some time we look at the low FODMAP diet, and ask has it worked.

We write the following blog with the following in mind.  As part of our attempt to help IBS sufferers we have three Low FODMAP Recipe sites.  As with all our work, the purpose of the sites are simply to give IBS sufferers free and easily accessible information, they are not there as financial opportunities.

Mixed

It is with this in mind we are able to be relatively objective about the subject.   We use the word relatively as the low FODMAP diet has worked for us , thus we are aware that it can work.  The trouble is that for any IBS treatment it is unlikely to work for all and herein lies the problem.

While the low FODMAP diet has been a wonderful move forward in the treatment of IBS, helping thousands to feel so much better, it has alienated many when it has been oversold as being the panacea of IBS treatment.

We continue to believe that the low FODMAP diet can be a tremendously advantageous for many sufferers, particularly in the reduction of bloating and cramping.  With that said, we would not suggest to any IBS sufferer that the low FODMAP diet will resolve their IBS.  It is one of many treatments to try, one that is very successful, however it has no guarantees.

Our Advice

We are always concerned when we see any IBS treatment aggressively pushed as experience tells us that the diversity of IBS symptoms means there is no sure things.  As a result we would always keep our advice simple on this or any other IBS treatment matter.  Try it with an open mind, and give it everything, if it does not work you have learnt something else which will benefit you in the long term.

Sacrifice and IBS

How much are you willing to sacrifice for IBS?

One thing that has always been hugely fascinating is the 'dieting' industry.  Over the past forty years the fundamental advice has never altered.  A) Eat a healthy balanced diet, lots of fruit, vegetable and exercise.  B) To lose weight you need to expend more calories than you intake.  Simple.

Despite this thousands of 'fad' diets exist which offer dramatic short term results as they generally correspond to point B), however nutritionally they are often found wanted/dangerous, and they fail to offer a long term solution.  On top of which none offer any help with the psychological side of the issue.  So why are they so damned popular?

IBS and Quick Fixes

The problem seems to lie around the natural human response of impatience.  We want things now. Losing weight sensibly and responsibly takes time.  It may be better for our health, it may be longer lasting, however it is not quick.

As a species we often follow the typical 'route of minimal resistance'.  To be clear there is nothing spectacularly wrong with this, why would you take the long route when a short cut is available?  The point is that for most the issue the lasting outcome. 

If you look at a populist example of the many lottery winners around the world, it is surprising to see how badly it ended up for many, compared to how fastidiously those who worked hard for their wealth looked after there money.

To avoid laboring this point, we simply wish to raise this issue in the context of IBS.  My greatest personal breakthrough came upon the acceptance that the reality of IBS meant that quick fixes were not optional.  In the same way diet and weight loss are best addressed by looking at your life as a whole rather than myopically examining what you eat.

While there are a number of treatments now which offer greater hope, for many the reality is that IBS remains a grey area that requires a great deal of restraint and sacrifice to treat.  This is not a popular message, nut it may be one which helps you a great deal more, than offers of a quick fix.