What should I do to pinpoint the cause of my diarrhea?

July 27, 2016 4:20 PM

I went from having easy, formed, once daily bowel movements to diarrhea 2+ times a day. I am pretty sure my terrible diet is to blame, but how do I figure out what to stay away from?

I used to eat very healthy: minimal whole grains, tons of fruits and veggies, some lean meats. My bowels were the stuff of legend. Then I met my now husband since we've been cohabiting in the past year or so my diet has gone down the tubes.

I was eating fast food daily and junk (chips, candy, pizza). I would have explosive diarrhea multiple times daily. Now my husband and I are trying to clean up our act a little bit, but I'm still having the loose stools.

Lately my daily food diary would be: two cups of coffee, grilled chicken sausage on a roll, half of a trader joes curry packet, two rolls with butter and ham, some fruit, and a McDonald's double cheeseburger. Or: burger kind French toast sticks, yogurt, Fast food French fries, ice cream, and ear of corn.

I feel guilty when I compare the way I eat now to the way I used to eat, but I am super super busy and cannot cook: I'm out of the house 8:30am-midnight 5 or 6 days a week and usually have class on my days off. My husband is a saint and packs me food and is willing to pack whatever I'd like but the call of fast food is too strong.

That was probably too much background, but based on this diet what do you think is causing my diarrhea and what can I swap out?

posted by pintapicasso to Health & Fitness (24 answers total)

The guiltiest looking suspect in that lineup is the McD's/Burger King stuff. And the coffee. And the sausage. It sounds like you have access to a Trader Joe's, they have tasty premade wraps that aren't too bad; maybe you could sub those in and see if it helps?
posted by fingersandtoes at 4:24 PM on July 27, 2016 [3 favorites]

Caffeine, dairy, and fats all stand out here. But, it's worth noting that just changing your diet (even from one healthy set of choices to a drastically different set of healthy choices) is enough to induce substantial GI stress.

Anyway, I'd start with halving the caffeine, and seeing how much that alone helps. It's the easiest change I can see.
posted by SMPA at 4:33 PM on July 27, 2016 [1 favorite]

A#1 would be the fast food, probably the grease and oil. I'm a infrequent cook myself but I definitely notice a change in my gut and its byproducts when I eat fast food vs pre-made meals from the grocery store or deli sandwiches or local restaurant takeout.

but the call of fast food is too strong.

Snack on healthier things (Kind bars? nuts? I'm sure there are a million questions and answers here on Ask about eating healthier when you have no time) throughout the day, easy portable stuff, so you're less likely to be starving when you drive past the golden arches and are thus more able to resist their siren song. We all love the sugar and fat, biologically, but the willpower is stronger when you're just not very hungry.
posted by soundguy99 at 4:40 PM on July 27, 2016

It might be what you haven't told us you're consuming. I have to avoid gum and breath mints that are sweetened with Xylitol.
posted by tilde at 4:41 PM on July 27, 2016 [4 favorites]

The oily food in your descriptions would go through me like a fast prune through a short granny.

There's a chance that you've picked something up. I got giardiasis from a fast food joint in Illinois, which meant six months of malodorous slime-laser pooping and some very, very tentative farting.
posted by scruss at 4:44 PM on July 27, 2016 [9 favorites]

How much dairy did you eat on your previous healthy diet? I suspect lactose intolerance as well. Since cutting out most dairy from my diet a few years ago (by "most" I mean that I eat ice cream or cheese a few times a month but otherwise am strictly dairy-free), I've noticed that my stools are stickier and less formed even when I take my lactase pills religiously.
posted by serelliya at 4:52 PM on July 27, 2016

Is there any variation, such that a food diary would be helpful? Under similar circumstances a food diary helped me figure out that greasy food, coffee, dairy, and carrots were not-great individually and had a horrifying synergistic effect in combination.
posted by tchemgrrl at 4:55 PM on July 27, 2016 [2 favorites]

Check the nutrition information on sweet things you eat for their "sugar alcohol" content. Some types of sugar alcohols will cause diarrhea if eaten in anything but small quantities.

Things containing sugar alcohols are usually labeled "sugar-free" or "no sugar added" but recently I've come across stuff that isn't labeled, "protein bars" for example. I've also run into trouble in the past when I've been watching my intake in food, but started using sugar free cough drops without counting those because they weren't food in my mind.
posted by XMLicious at 5:05 PM on July 27, 2016 [3 favorites]

When I recently turned 35, my strong and regular bowels that helped support me through frequent eating of kale salads through rubber boots turned completely unreliable. I have yet to pinpoint everything that causes tummy upsets but so far it's been extra spices (I was previously able to eat whole chillies and my bowels would just not bat an eyelid,) uncooked cookie dough, and roach coach tacos. I can still eat rubber boots, they just have to be a little cleaner than they used to be.

It could be that you're the victim of an extreme case of older bowels. Welcome to the club?
posted by Everydayville at 5:08 PM on July 27, 2016

I can't eat bought salads. I guess they spray them with some preservative now for the past few years? Whatever it is it goes through me near instantly. Restaurants, lettuce in burgers etc. I can eat it fine at home.
posted by fshgrl at 5:29 PM on July 27, 2016

Response by poster: Thanks everyone. I'm only 29 so that's why I think it's a circumstance change rather than aging.

I'm thinking that grease could be the culprit. Unfortunately that's like 50% of my diet so I'm going to have to do a major overhaul which is too much to handle at the moment. I guess I could start with just cutting out fast food.

I'm trying to avoid going to a doctor as I'm not dehydrated, not crampy/in pain, and because my diet has honestly been so bad it has to be related. and also because I don't have a doctor.
posted by pintapicasso at 5:30 PM on July 27, 2016

Are you taking vitamin or herbal supplements or meds?
posted by A Terrible Llama at 5:52 PM on July 27, 2016

You don't mention their use but strong antibiotics may be a cause. That effect may be countered with probiotics, yogurt, and other recommended foods. And perhaps probiotics (they're chewable and found in drugstores) could get you past your current condition. IANAD and I don't play one on television.
posted by Lornalulu at 6:02 PM on July 27, 2016

Try a different fast food restaurant? Chipotle and Panera come to mind. Or prepared foods in a supermarket? You can get food at these places just as quickly as at McDonald's. True, it costs a bit more, but keeping your tummy happy is a good long-term gain. Works well if you reroute your commute and/or tweak your errands so that you go past one of these options on the way.

You might also consider adding more soluble fiber to your diet, especially considering your previous diet had quite a lot of it. This article says "Soluble fiber helps diarrhea by absorbing water and adding bulk to stools. Insoluble fiber, which is not digestible, may help with constipation but make diarrhea worse." There's a good list of foods there and also on this page. Some options that require little to no prep are oatmeal (just add hot water), brussels sprouts (carry it with you in whatever package it came from the supermarket, snack throughout the day), and apples. You could get your husband to help you make or pack these so you barely have to think about it.
posted by danceswithlight at 7:53 PM on July 27, 2016

There isn't a lot of fiber in there, except for the fruit; some fruits are high in FODMAPS - I (a person who needs to watch those) can't even go near any of the ones in the leftmost box here. If you're having a lot of sugars like the ones in those fruits and starchy carbs (bread and fries), and not much good fiber, maybe your guts are having a bit of a spasmic reaction.

I would try adding more legumes and other sources of soluble fiber (eg avocados, cooked broccoli [uncooked might be too crazy until you settle, bc it's got some insoluble fiber]). And lower FODMAP foods, like rice and potatoes (but with skin, for fiber). (Salads with legumes might be a good addition somewhere in your day, eg lentils with goat cheese, red onions, cherry tomatoes; chickpeas with steamed broccoli and cauliflower, garlic, lemon - could make them the night before and ask hubs to pack. Or have something like that for dinner?)

But, all the food you're eating now is high protein/high cal and really portable; for fast food, could you do Starbucks sandwiches or wraps (some are decent & have some fiber in the wrap); Middle Eastern wraps, if there's a nearby place (eg shish taouk; falafel would be great for fiber); sushi?

on preview, covered above!
posted by cotton dress sock at 7:58 PM on July 27, 2016 [1 favorite]

Is the coffee new? It takes a while to adjust to the oils in it, which are the part that causes, um, urgency -- well and above the actual caffeine content. Tea and/or diet soda don't have this effect. Also, are you putting regular milk or cream in it? (Potential lactose issue.)

If you want to cut out BK/McD's but are time-poor, TJ's frozen-meal aisle has some healthier options that only require standing in front of a microwave.
posted by en forme de poire at 8:17 PM on July 27, 2016

I totally understand not having the time or energy to do a diet overhaul & pre-plan meals. Until you can, I think the "find healthier fast food" camp has your answer. The grease/fat content (even the good fats) in your current diet stands out to me as a potential primary cause. The good news is that Starbucks has fruit & an assortment of pre-packed lunches/snacks that are half-way decent. As many have already pointed out, Trader Joe's also has a wide variety of no-fuss, very portable options. When it comes to grabbing something on the go, I would vote for Panera or something similar. If those are not readily available to you, however, I would imagine McDonald's & Burger King have something akin to Wendy's grilled chicken sandwich, which may not be healthy per say, but is better than a cheeseburger. Wendy's also has options like a baked potato instead of french fries. Again, it's not an ideal choice but it satisfies the carb craving in a healthier way. Try subbing out & choosing items that are better for you.

Please keep in mind that since you've become accustomed to these foods, & might even find psychological comfort in them during a stressful time, less healthier options may have an intense pull as you try to switch over to something better. Resist the pull & your cravings will change. I always remember this random factoid that it takes 7 weeks to make (or conversely break) a habit. I have no idea if that's true, but if you can make it to week 8, I think you'll have concretely broken the pattern. Good luck!
posted by katemcd at 8:18 PM on July 27, 2016 [1 favorite]

Regarding additional fiber: Metamucil or generic psyllium husk is a good all-around first bet; if you see no improvement, perhaps also try methylcellulose and/or whatever's in Benefiber. Unless you've recently taken antibiotics or had food poisoning or something, I'd try fiber before probiotics.

If you do try probiotics, don't keep taking it if you don't see an improvement in short order. Whether a given probiotic will help depends on what's in it, what's in you, and what your diet is, among other things, and sometimes probiotics can actually make symptoms worse. Tldr, bowels are complicated.

(P.S. Possibly TMI, but for what it's worth, Panera reliably makes me shit lava. IDK why, other fast food doesn't have this effect on me. Chipotle and Subway are fine.)
posted by en forme de poire at 8:28 PM on July 27, 2016

So you were eating a healthy diet for a long time and your digestive flora have adapted to that and are expecting it. Now you're eating garbage and they don't know what to do with it except wave it through. You are also eating way too many carbohydrates and not enough fiber. At the very least take some psyllium husk (e.g. Metamucil, but plain and unflavoured is best), a tablespoon with water at morning tea and another with afternoon tea.
posted by turbid dahlia at 8:38 PM on July 27, 2016 [1 favorite]

Whenever my kids get constipated, I buy them McDonalds. It works like a charm. Switch to Chickfila. I think they use more food in their products than McDonalds, which uses a lot of binders that will unbind anyone's poop shoot.

If that doesn't help, you may have a food intolerance and will have cut out something specific for awhile. You could also have picked up (from someone not washing their hands properly at McDonalds) a parasite. If you have insurance, you may want to go have your poop tested right away.

Can you tell that I detest McDonalds?
posted by myselfasme at 4:29 AM on July 28, 2016 [1 favorite]

So, you say here that your husband would be willing to cook/pack you whatever you want? Something I have worked on when I'm stressed and need comfort food is to cook whatever it is you'd be getting from a fast food place. Like, a homemade burger is almost certainly going to make my digestive system happier than one from McDonalds. So that's something to consider...you don't have to have your husband make you a salad and then in desperation run over to McDonald's because you're craving a burger. Have him pack you whatever comfort foods you really love, but homemade from real ingredients.

Alternately, I like the ideas above of going for quick/fast foods that are at least a little healthier. Like, you probably don't want to be doing this forever, but at least choosing the healthier stuff will be a stopgap until your schedule can improve. (You are doing something to change that insane schedule, right? Because aside from diet, that is going to wear you down big time and is something you should be actively working to change.) My top picks:

1. Jamba Juice makes an awesome steel-cut oatmeal. You can get sliced bananas on it instead of a sugar-y topping (although even if you pick one of the sugar-y toppings, you'll still be getting a little fruit and lots of fiber).
2. Starbucks is great if you can resist the pastries. I am particularly a fan of their fruit cups, their protein box, and some of their lunch wraps/salads. I also like that they sell mini treats so you can get a little sweet snack without going crazy.
3. Chipotle -- go for the "bowl" option and try to limit yourself to one of the calorie-rich toppings (like, cheese OR sour cream, not both). They will give you veggies and both kinds of beans for free if you ask, which boosts your fiber/vegetable content even if you also add a meat topping.
4. Wendy's baked potato. Actually really good! Hits the carb craving without all the grease.
5. Depending on your area, fast casual places like Au Bon Pain or other sandwich-type shops can be just as quick as fast food but you can pick up soup or a salad or a simple sandwich.

Basically, I feel like there are a lot of answers here that your problem could be lactose or FODMAPs or antibiotics or whatever other thing -- when the most likely explanation is that your digestive system really does not like that large amount of fast food grease. I have zero food intolerances but my tummy still is not going to be happy with me if I eat fast food in the quantities you are eating. So I would say work on that first, and then if you are still having issues of course you can then go down the list of common food intolerances and see if there are any additional issues.
posted by rainbowbrite at 5:35 AM on July 28, 2016 [1 favorite]

Oh, yeah, to piggyback on the stress comment, the other thing I don't see mentioned in this list yet is sleep. Lack of sleep makes my GI tract extremely unhappy. If the coffee means you're not sleeping as much as you need to, that might be a big part of the issue.
posted by en forme de poire at 2:21 PM on July 28, 2016

Is the candy you have been eating by any chance sugar-free? I was going to say exactly what XMLicious already said about sugar alcohols. They give me and a couple of other people in my family terrible diarrhea. We each learned this independently after eating sugar free candy. It is dose dependent, so one piece of candy is ok but eating a whole handful in one day is bad news.
posted by insoluble uncertainty at 4:02 PM on July 29, 2016

Response by poster: So for the past few days I've kept a food journal. The problem was grease. Thanks everyone.
posted by pintapicasso at 8:57 AM on July 31, 2016 [2 favorites]