Irritable Bowel Syndrome (IBS) Case Study 2

IBS cleared naturally with a Low FODMAPs diet

by Sue Kira, Naturopath & Clinical Nutritionist

Client name and identifying information changed

Nigel had an embarrassing case of bowel gas that left him feeling reluctant to eat during the day for fear of gassing the office workers with his foul-smelling farts. Not only did he have terrible gas, he frequently had stomach cramps that doubled him over in pain several times a day. Apart from that he seemed quite healthy.

His doctor diagnosed irritable bowel syndrome (IBS). He was told to drink peppermint tea, ginger tea or take muscle relaxant pills. These helped to relieve his symptoms but didn’t treat the cause, which was why Nigel decided to see me.

I suggested tests for SIBO and Leaky Gut, including a hydrogen breath test for fructose malabsorption and a bacterial count of his digestive system, but Nigel couldn’t afford them. So instead we went for the diet options.

Because of Nigel’s English and Indian heritage, he was fond of eating onions and garlic with most of his meals, which alerted me to the possibility that he might be intolerant to FODMAPs, so I suggested a low FODMAPs diet to see if it would help to alleviate his symptoms.

We started with the complete removal of all higher FODMAPs foods as he also ate loads of chickpea hummus, lentils and wheat bread toast, as well as the onions and garlic. Within three days his symptoms reduced by 75% and by the end of one week he had no symptoms, so we knew we were on track.

I asked him to stay on the low FODMAPs diet for three weeks before reintroducing the foods so his digestive system had time to heal and fully clear the foods.

After three weeks, I suggested to reintroduce the foods that were less likely to be an issue, such as normal fruits and vegetables, but to leave out grains, legumes, pulses and the onion family for the time being. He did this in a bit of a hurry as he intuitively felt that the main foods I suggested to leave till last were going to be the culprits, so instead he introduced all the fruits and vegetables he normally liked to eat in one hit, and did so for a week (not my advice).

But this seemed to work fine for him and he still had no reactions. He kept the fruits and vegetables separated to different meals, because he was aware of good food combining principles to not mix fruits and vegetables at the one meal (which he had tried previously with some success).

When he was ready to trial the legumes, pulses and grains, I suggested to soak them for 24hrs and allow them to sprout before rinsing and cooking them and to only use gluten free grains to help his digestion. This seemed to work quite well, although he still had a small amount of manageable wind, so I suggested that he cut these out again for a few days until we tested the other food ingredients so there was no confusion as to what was causing the wind.

The next group was the onion and garlic family, including leeks, chives and spring onions. These were his favourite foods and he was most disappointed to discover that these foods caused the majority of his pain.

He discovered that if he only had a tiny amount of very well cooked (caramelized) onions once every three days he could get away with that, and he could also tolerate garlic infused oil instead of full garlic cloves in stir fry veggies.

The next challenge was to bring them all together by eating his favourite meal of curried chickpeas with caramelized onion and high FODMAP vegetables cooked in garlic infused oil. This was fine provided he only had one small serve once a week. We found it worked better for Nigel when he diluted the curry with low FODMAPs vegetables, left out onion and garlic and instead used the garlic infused oil plus a few extra spices.

By cooking up a batch of curry, he could eat one serve on the day he made it, then freeze the rest for another day, for about a week later.

That way he could still eat most of the foods he loved and only have minor wind issues, provided he spaced the meals apart.

Nigel also discovered that if he ate curry on a Friday night and even sneaked in a little onion now and then, all would be clear by Monday for work, which was fortunate for him (and for others).

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