What do these foods have in common?
June 19, 2012 4:02 AM   Subscribe

I've identified the things my digestive system doesn't like, but I don't really understand why these foods are causing me trouble. Can you tell me what these foods (list inside) have in common so I can get a better understanding of what it is I am reacting to and so I can avoid other related things?

Foods I can't eat ever, under any circumstances without serious and immediate Bad Consequences (I can't stress enough how eliminating these things has completely changed my life):
High fructose corn syrup
Onions - all kinds, even onion flavouring seems to be a problem
Fruit juice - especially apple juice
Any and all breakfast cereals - I've found a single one I can eat without trouble
Wholegrain wheat and seeded breads - white bread seems to be mostly okay for me, though
Milk chocolate - dark chocolate is okay
Yoghurt (the typical store-bought kind, either plain or sweetened) - but Greek-style yoghurt has been okay so far

These are okay in limited amounts:
White wheat - I seem to be okay with white bread and pasta, but only if I limit it to a couple times a week and only if it's plain white bread and not seeded
White rice - again, eating this occasionally is okay and long grain or wild rice seems to be better
Lentils - more than twice a week and I'm hating life, but small quantities are okay

Is there a pattern here that I'm not seeing? I don't know what these things have in common, so I find this all really confusing. My doctor had me try the elimination diet in the first place, for which I am grateful, but he has not been incredibly helpful since then. I am told that my list is not consistent with common food intolerances so I must be wrong about some of these things. I guess this is possible, but I've been keeping track of my diet for about a year now and while I do still have some troubles and the list needs refinement, this is what I've figured out so far. Any ideas?
posted by abashed to Health & Fitness (22 answers total) 3 users marked this as a favorite
I am told that my list is not consistent with common food intolerances so I must be wrong about some of these things.

I don't know why they wouldn't suggest that you might have some combination of allergies and intolerances, rather than a single thing.

I think seeing a specialist would be worthwhile, because it sounds like a hard to manage group of things to avoid and it might be at least a little easier if you had more clarity on it but you might need to progress past an elimination diet to get more data.
posted by A Terrible Llama at 4:24 AM on June 19, 2012

It might not be an allergy or intolerance at all. I've suffered from terrible gastric issues for the past 15-20 years, and certain foods are worse for me than others, but it's not an allergy, per se, it's just the way my digestive system handles the process of digesting things.

See a gastroenterologist and explain exactly what happens when you eat these foods, because allergies/intolerance and other gastric issues or diseases can feel somewhat similar but aren't necessarily the same things.
posted by xingcat at 4:54 AM on June 19, 2012 [4 favorites]

Many of those foods are on the "gas-producing" list (your doctors likely have their own more definitive versions), which may be helpful.
posted by argonauta at 5:14 AM on June 19, 2012 [2 favorites]

I know someone who suffered from some very bad gastric issues. Finally, after years, he mentioned it to a pharmacist, who said he probably just needed to replenish his digestive enzymes. He bought some over the counter digestive enzymes, and after a week or so, he's been fine since. Perhaps, worth giving a shot.
posted by backwards guitar at 5:16 AM on June 19, 2012 [5 favorites]

Yogurt, sweetened milk, juice, HFCS, and sweetened cereals could all be fructose intolerance.

Cereal, wheat bread and oats could all be gluten. Some people with a gluten intolerance seem to be dose-dependent, so a slice of white bread a week might fall under your stomach's radar.

Onions are kind of a wild card, but hey, you could have a bonus onion allergy or sensitivity.

You could also have a condition like IBS, in which what bothers you is not always 100% consistent, but triggers will depend on stress, exercise levels, and what else you've been eating.

The doctor is a jerk for saying you must be wrong about some of these, and not considering that this might be multiple allergies or sensitivities at work. If you can find another, better doctor, you should. But also, in my experience of food intolerance in myself and my children... doctor support is not great, and frankly doing your own trial and error winds up being the most effective thing. Good on you for doing the hard part: The science to work out what's giving you trouble.

Good luck to you, and I'm glad you're feeling better!
posted by Andrhia at 5:16 AM on June 19, 2012 [1 favorite]

Yeah, what the people above said. This sounds like a combination of things.

-Fructose intolerance -- high fructose corn syrup, apple juice, potentially added to some varieties of yoghurt
-Onion allergy (not uncommon)
-Fiber intolerance -- the oats, the breakfast cerceals, the wholegrain breads, the lentils. Some people have issues with higher fiber foods. (Some people have issues with low-fiber diets, too, but it doesn't sound like you're one of them.) Have you tried black beans, humus, that sort of thing? If you have fiber issues, I'm guessing you'll have trouble tolerating much of them as well.

Some of the yoghurts you've been trying may also have fiber added -- it's an active ingredient in most digestive-regulating yoghurts (in addition to the pro/pre-biotics). The companies just don't blare that from the headlines, because the Power of All-Natural Probiotics! is a much more appealing marketing tagline than We Supplement Your Fiber!

I would ask for a referral to a specialist.

Also, have you had a workup to rule out the potentially bad things that can cause these symptoms? If not, I'd ask for some additional testing -- some of these sensitivities could go along with, say, Crohn's, or gluten intolerance (your ability to eat *some* gluten is not incompatible with that diagnosis). It's much better to know and get it under control than to assume it's just an allergy you need to manage.
posted by pie ninja at 5:18 AM on June 19, 2012 [1 favorite]

(If you sometimes have problems with white rice, might it be those times you put soy sauce on it? Soy sauce often contains gluten.)
posted by Andrhia at 5:24 AM on June 19, 2012

Do you still have all of your digestive organs? I had my gallbladder removed, and quite a few of these things also bother me.
posted by timetoevolve at 5:35 AM on June 19, 2012

Diverticulitis? Have a gastroenterologist check you for that. A friend has it and my mother had it, and anything with seeds makes you sick. That may be one of your problems, worth looking for at least, and do see a specialist, we are not your doctor.
posted by mermayd at 5:42 AM on June 19, 2012 [1 favorite]

If onions are an issue I would suggest removing all items in the allium family which includes garlic, shallots and chives.
posted by Constant Reader at 6:37 AM on June 19, 2012

It looks like this to me.

When you eat more of the types of sugars than your body can absorb, they move into the lower gut and either get eaten by gut bacteria (causing gas) or cause some kind of osmosis trouble in which your gut can't pull the excess water out before reaching the colon.

One thing it mentions is that fructose can sometimes be balanced by glucose to reduce the symptoms.

That, and (as mentioned) something like diverticulitis would account for pretty much everything on the list. (Although not necessarily- if the whole grain breads contain a lot of fructose, as they sometimes do to improve the taste, that might be the cause.)
posted by gjc at 6:43 AM on June 19, 2012 [1 favorite]

Thats sugars grains and dairy, could be parasite / blastocystis hominis + endolimax etc, did you have a full stool analysis yet? some people are asymptomatic and some are symptomatic to different bugs, could you have picked something up? I'd get a full parasite test and see what comes back, probably would Fast for a couple of days leading up to test too to make sure any bugs purge, some are notorious for being invisible without purging.
posted by Under the Sea at 7:23 AM on June 19, 2012

some of those are FODMAPs (particularly onions).
posted by Neekee at 7:44 AM on June 19, 2012 [1 favorite]

This is tricky. Lectins may be part of the puzzle. There are more lectins in whole grain breads than white ones, so perhaps that is a clue.
posted by Surprised By Bees at 9:57 AM on June 19, 2012

I had pretty much the same list a few months ago when having gallbladder issues, but eggs was on the top of mine.
posted by 3dd at 11:34 AM on June 19, 2012

With the exception of onions, all these foods would be the sorts of things you would avoid on a Paleo diet, under the theory that glutins and lignans (and cassein) can cause systemic inflmmation and thence both digestive and immune problems. Many people find that if they cut the danger foods (or a wider category, say including all grains even though you don't feel the problems with light wheat) for a number of months, then their gut can recover to the degree that they can begin to tolerate those foods again at lower frequency -- you might want to research along those lines and see what you can find.
posted by acm at 11:57 AM on June 19, 2012

The fructose free diet is pretty complicated, and I think onions are on the list to avoid.

(my neurologist suggested a fructose free diet to help with my IBS/Fibromyalgia, and I've been researching it.)
posted by hotelechozulu at 12:19 PM on June 19, 2012

Fructose Malabsorption could cover the HFCS, fruit, fruit juices, onions and whole wheat, all of which are high in fructans. Though, Fructose Malabsorption can be caused by a variety of other conditions and can be a sign of practically any gut disorder, so you don't necessarily have it, it may be temporary. Is glucose/cane sugar ok for you?

The other thing that sticks out though, is with the beans, oats, lactose is that these are all fermentable sugars and gas-producing fiber. Do you have trouble with gas, bloating, diarhrea? I'd recommend taking a probiotic (a milk/casein-free capsule) will help.

The cereals thing makes me wonder if you have trouble with grains in general, or whether it's the milk with the cereal. Is lactose-free milk better for you or do you have to avoid it completely? Have you tried any alternative milks? Almond, coconut, hemp milk? (Rice and Beans bother you in large amounts, so I would avoid rice or soy milk) If it's the lactose, then small amounts of hard block cheeses like aged cheddar should be ok. If they bother you maybe it's dairy in general. Also wheat- have you considered gluten-intolerance? Maybe try giving up wheat for a week and see how you feel.

Anyway, you may want to try an alternative diet like Paleo or SCD that is grainless (without fruit and beans of course) You didn't list any meat or vegetables, so you should eat more of those (but not the fibrous ones, and cook your veggies well. Raw veggies might bother you too, and gassy ones like cauliflower/broccoli) Potatoes and Yams should be more agreeable than rice, maybe some kind of meat, veggie and potato stew would be good. Also nuts, sunflower seeds and the like if they are ok for you. Or in the more general diet territory, you might want to try the FODMAP diet. It's got some alternative grains that most people don't have trouble with (like quinoa- can be cooked in a rice cooker) but avoids the most problematic foods.

Good luck! I know firsthand how frustrating elimination diets can be.
posted by Aliera at 12:53 PM on June 19, 2012

Oh, except yogurt and chocolate are very low in lactose, so I doubt it's lactose. Do you have problems with other dairy-products?

Anyway, I'd really recommend a probiotic. In general they help reduce symptoms for most people with digestive issues. And by probiotic I mean a capsule- yogurt doesn't have enough and you might be having issues with dairy.

Have you been tested for food allergies? And Celiac disease? While I'd guess it's most likely a food intolerance issue, an allergy test is a quick and easy test and can rule out that at least. And ditto the Celiac test is a quick blood test. If you want to try stop eating wheat (google gluten intolerance) make sure you get tested first before you stop eating it, or the test will be less accurate.
posted by Aliera at 1:08 PM on June 19, 2012

Response by poster: Thanks for the info. Lots of interesting areas for further reading suggested here.

Just a quick follow up to address a couple things:
I still have all my organs. The white rice issue is definitely not related to soy sauce because I don't use it (it's way too salty for my taste). No trouble with eggs, cheese, or milk in general. I can drink a glass of milk with no problem, though that happens only rarely as I really only use milk for coffee and cooking. I don't know much about glucose specifically, but I never ever add sugar to anything so ... ?

The Always Avoid List Foods cause bloating, cramping, and sudden, painful, explosive, diarrhoea, and by sudden I mean while I'm still eating. It would usually last throughout the day and this was my life for, well, most of my life. Moving in with my fiance was the impetus for getting checked because he clued me in that normal people don't have to poo 4-5 times a day.

I agree that my doctor is kind of a jerk about this and has not suggested any further testing. I get the impression he thinks I'm a bit of a hypochondriac. I'm new to the NHS and easily intimidated by doctors. Is it possible to push for a referral to a specialist even if my GP is not totally convinced there is a problem?
posted by abashed at 1:27 PM on June 19, 2012

You haven't had any testing? Yes, please get a new doctor and get a referral to a gastroenterologist. This is not normal and could be a symptom of something serious, such as Crohn's, diverticulitis/diverticulosis, Celiac/gluten intolerance, or a number of other things.

Keep pushing until they test you, and don't stop until they've genuinely ruled the other possibilities out. You have a right to get this dealt with. Personally, I found it easier to get help by being extremely specific about symptoms and how they affected my daily life. (Other people could help on the NHS specifics better than me, since I'm in the US.)
posted by pie ninja at 1:41 PM on June 19, 2012

Seconding the testing piece. Also seconding the get a doctor that will provide you with answers to your questions.
posted by Blue_Villain at 1:53 PM on June 19, 2012

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