Pt. 2 of Diagnosed with IBD. . . Now What?

Elizabeth Roberts Health Guide
  • So, you’ve surfed the internet, signed up for every IBD-related chat room possible, your head is swirling with what you do know and what you still can’t figure out, what you’re being told you should and shouldn’t eat, and still you don’t feel a whole lot better. 

    Well, don’t despair. Remember, very few IBDers respond to the exact same treatment protocol. That means that what works for me may or may not work for you. Here’s an example: Like me my dad has UC, but that’s pretty much where our similarities end. A flare-up knocks me down for the count with low-grade fever, joint aches, chronic diarrhea, lack of energy, and eczema. A flare-up for my dad might cause some diarrhea but he’s able to muscle through it without missing many beats. I have to constantly watch what I eat but my dad can eat pretty much whatever he wants without many repercussions. I’ve taken Asacol for ten years to help control my symptoms, and only just last year did my dad start taking Asacol when a colonoscopy showed some inflammation in his colon. So, there you are, we’re related, we both have UC, and how it hits us and how we treat it is pretty diametrically opposed.  

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    What I’ve noticed in the past 5 years of working with other IBDers is that for some patients prescription medications do the trick and that’s all they need to get a flare under control. Other IBDers go through drug after drug after drug and nothing seems to help. And then there’s the other group of patients who find that diet is the key to improving some of their symptoms. I, and many other IBD patients I speak with, fall into the category where between one prescription medication and some serious diet changes I’m able to keep pretty good control of my symptoms and the disease. 

    But, how does one figure out if diet, or better yet, specific foods, are making your symptoms worse? It’s not an easy question to answer. In fact, answering that question is going to come down to you putting some serious effort into 1. keeping a food diary, and 2. doing an Elimination diet. 

    A food diary is a daily log where you write down everything that you eat and drink in the course of a day. Now, keep in mind I said everything, if it passes your lips write it down, even if it’s a hard piece of candy or two sips of Coca-cola. Don’t cheat, because in the end you’ll only be cheating yourself. Then, also make notes about how you feel after you eat – bloated? crampy? diarrhea? constipated? irritable? fine? However you feel write it down. Also keep note of how many bowel movements (BMs) you have each day and their consistency. 

    Keep your food diary for at least two weeks, but one or two months is even better. As you work through the first two weeks of keeping your food diary chances are you’re going to notice patterns emerging. For example, I noticed by the end of week one that after I drank cow’s milk I would feel bloated and my stools would become more frequent and loose. If you notice that drinking soda causes issues, then stop drinking it. Or if McDonald’s chicken nuggets or French fries send your gut over the edge then don’t eat them. Use the diary to see, on paper, what foods are causing you problems.  


  • It’s also a good idea to take your diary with you to your next doctor’s appointment so that your GI can also see what foods and drinks are affecting your IBD symptoms. It’s only been recently that GI’s are admitting that there does seem to be a correlation between what an IBDer eats and how they feel. 

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    After I kept my food diary for a couple of months I had been able to identify a good handful or so of foods that were adding to my IBD discomfort. This is when I also found a book titled, Breaking the Vicious Cycle, by Elain Gottschall. This book details how to eat on what she calls the Specific Carbohydrate Diet (SCD), which is sometimes called an Elimination diet because it eliminates all wheat, gluten, dairy, and certain carb-based fruits and vegetables from your diet. 

    Conducting an elimination diet is a very good idea for all IBDers, but know that it is hard and it takes perseverance and dedication. When I did the diet I was very sick – I had lost about 25 pounds, was having 20+ diarrhea BMs each day, had no energy, had quit my job, and really just wanted to lie down and die. I was at rock bottom and I was willing to do anything to feel better. And, by the second week of doing the elimination diet I was feeling just a little bit better. I was able to eat without immediately feeling sick and landing in the bathroom, I was taking in food and keeping it with me, and I had even gained a pound – something I hadn’t been able to do for nearly 9 months. After staying with the diet for 8 weeks I had identified a long list of foods that simply made me sick – what I now call my food sensitivities. Things like yellow corn, cow’s milk, red food coloring, food additives, food preservatives, oranges, cantaloupe, watermelon, apples, white potatoes, spicy hot foods, wheat-based foods, alcohol, soda, and most fruit juices are just some of the foods I now no longer eat.  

    Why should you go through with keeping a food diary and the elimination diet instead of just getting tested for food allergies? Because, the simple fact is that actual food allergies affect only a very small portion of the entire population. On the other hand, food sensitivities, like what I found, affect a far larger number of people and this is what you tend to find by keeping the food diary and conducting an elimination diet – you find those food affect you adversely.

    Next week I’ll conclude this series of Shareposts by talking about how the mind/body connection can also help when coping with chronic illness.  

    You can read more about various IBD-related diets in my Sharepost titled: Diets, diets, diets. . . what’s an IBDer to do - http://www.healthcentral.com/ibd/c/2623/37082/diets-diets-diets-ibder
    Or, you can read about my experience with the Elimination diet in fuller detail in my book: Living with IBD & IBS: A Personal Journey of Success – www.ibdandibs.com

Published On: March 17, 2009