One very common obstacle to figuring out which foods are problematic is that even on an elimination diet you may not have truly eliminated all of your allergenic foods.
Assumptions are often made about which foods are allergenic and which foods are not. These assumptions are often wrong. Even on an elimination diet you may still be eating something that will trigger your Irritable Bowel Syndrome (IBS), even if you are eating foods that you normally don’t eat.
In order to solve your IBS you may need to stay away from entire food groups, not just one or two foods.
Food groups are much more difficult to avoid than you might think. One food group that commonly causes problems for IBS sufferers is dairy. But remember, dairy is not just milk.
Dairy includes cheese, butter, sour cream, cream cheese, ice cream, and yogurt. It’s found in many baked goods such as muffins, breads, and cookies, as well as in many cream soups, some salad dressings, and milk chocolate. Coffee and lattes are another common source of dairy. Even margarine contains dairy. The list goes on and on.
Two key components of dairy are whey and casein, which many people cannot tolerate. These are used as additives in a great variety of foods, even those you wouldn’t consider to be dairy foods. Look at the labels on the packaged or processed foods you buy. Even non-dairy coffee creamer contains casein, for instance.
This example demonstrates how complicated it can be to avoid entire food groups in order to assess the dietary trigger of your symptoms. Many other food groups are just as complicated. If you remove only one part of a food group from your diet, you won’t really know if that group actually causes your symptoms. You need a great deal of information about the foods you eat and what they contain in order to understand which foods trigger your symptoms.
Another problem is that you may react to more than one food.
In fact, most people with IBS are sensitive to more than one food or food group. You may suspect that your symptoms are caused by a certain food, but find that, even after you eliminate that food, your symptoms remain. This may lead you to mistakenly see the eliminated food as not part of the problem.
Time is another factor that complicates an elimination diet. Often you must eliminate the offending food or foods for extended periods of time – several days or even weeks – before your symptoms improve.
The quantity of food you eat is yet another factor. If your body is intolerant to a particular food, a tiny speck of it may be enough to trigger symptoms. For example, cutting out your regular glass of milk is not enough to determine whether or not dairy is the cause of your problem. Unless you have eliminated every dairy product from your diet, as well as all supposedly non-dairy products that contain dairy components such as whey and casein, you may never really know.
And finally, even if you avoid all of the right foods, you may have both a food allergy and a bacterial imbalance in your digestive tract. Either of these can cause IBS alone, and often they are found together.
The good news is that all of these problems can be avoided through proper testing. However, not all doctors use the same testing methods, so it’s important to see a specialist trained at working with IBS and related digestive illnesses. That’s where the IBS Treatment Center comes in.
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Dr. Wangen is the founder and medical director of the IBS Treatment Center, the award winning author of two books, and a nationally recognized speaker on digestive disorders. He has been on ABC, NBC, and Fox as well as public radio, and was named one of Seattle’s Top Doctors by Seattle Magazine.