IBS—Free at Last!

Survive Thanksgiving Dinner on a Low-FODMAP Diet

If you are in charge of the food preparation for your Thanksgiving dinner you can manage to serve a complete meal that matches the FODMAP elimination diet. But most of us share the cooking duties with others on this holiday, so you may have to settle for doing the best you can to make lower FODMAP food choices. Here are some suggestions:

Appetizers: Cheese and rice crackers; olives, carrot, celery sticks from the veggie plate with a little dip (not the french onion dip, though), potato or tortilla chips, shrimp, scallops or water chestnuts wrapped in bacon.

Beverages: A glass of wine; a frosty beer, or a classic martini, perhaps? Skip the sweet or fruity drinks.

Main: Turkey. Yeah, no FODMAPs here. A tablespoon or two of gravy, or more if it was thickened with cornstarch or sorghum flour.

Sides: Mashed potatoes made with lactose-free milk; tiny "no thank you" portion of stuffing"; mashed squash; 1/2 cup portion of either green peas or green beans or sweet potatoes (with marshmallows if you must--OK for FODMAPs). Skip the creamed onions, cabbage salad and waldorf salad.                         

Cranberries: OK, in my family, the cranberry sauce gets a food group all its own! Cranberries themselves are low in FODMAPs. Avoid the canned cranberry products that are sweetened with high-fructose corn syrup; instead, look for Grown Right Organic canned cranberry sauce. Almost any home-made cranberry sauce or relish made with granulated sugar will be OK, too. Make my grandmother's cranberry-orange relish today and it will be ready by Thanksgiving!

Dessert: Unless you make it your self with lactose-free milk (comes out fine, by the way), don't go near the pumpkin pie, which is usually made with lactose-bomb evaporated milk. Yes, there is wheat flour in the crust, but a blueberry pie will be lower in FODMAPs than some of the alternatives. You could consider a continental style dessert of cheese and fruit (grapes, clementines, fresh pineapple?) Make some fudge or peanut brittle to share, or splurge on some fancy chocolates.

Remember, its not all about the food! Take time to cultivate non-food holiday traditions with your friends and family, too. Please leave a comment if you'd like to share a non-food holiday tradition or a low FODMAP holiday food idea. Happy Thanksgiving!

 

How to Talk to your Doctor about IBS

If you’ve been suffering from gastrointestinal symptoms that interfere with your work or social life, you would be well advised to bring them to the attention of your primary care provider. You might decide to make a special appointment for this, especially if your symptoms are new, or to bring it up at your next scheduled check-up.  How can you make the most of your doctor’s appointment?

• Start with your primary care provider.
• For your own safety, do not self-diagnose. You want your provider to evaluate your symptoms using all of his or her diagnostic skills, not just note in your chart “history of IBS”.
• When you make your appointment, don’t be shy about the reason for your visit, what we call your “primary complaint”.  Your provider will put your primary complaint at the top of the list for discussion during your visit. If you aren’t sure how to communicate this to the scheduler without a lot of potty talk you could try “change in bowel habits” or “abdominal pain”; even “GI issues” is better than nothing.
• Make a list of your symptoms and bring it to your appointment. When did they start? What seems to bring them on? Review the alarm symptoms in Is it IBS so you can tell the doctor everything that he or she will need to know to plan your work-up or to make a diagnosis.
• It is perfectly OK for you to bring up the subject of a referral to a specialist. Try some of the following phrases: “Do my symptoms warrant referral to a gastroenterologist for evaluation? Why or why not?”; “I’ve been thinking I’d like to see a nutritionist for help with my IBS. Can you suggest a registered dietitian who works with GI patients?”; Depending on your insurance and local operating procedures, you may be able to self-refer to a gastroenterologist or registered dietitian, but your specialist will have more to work with if your primary care provider formally refers you and sends along your medical records.
• Be respectful of the doctor’s expertise and talk as though your two are on the same team when requesting lab tests. “I’d like to be more certain it isn’t celiac disease before I start changing my diet—how could we rule that out? I’m concerned about it because of my anemia and because it runs in the family.” This approach works better than either demanding tests or expressing worry that you might have this-or-that disease, which the doctor may dismiss as anxiety. The “rule out” idea is important in the diagnosis of IBS and your doctor will find it easy to relate to.

Even if you have suffered with gas, bloating, abdominal pain, diarrhea or constipation for years, now is the time to put these symptoms back on the examination table; many new treatment approaches have been developed in the past few years, including elimination diets, probiotics, and new medications. No one should settle for learning to live with IBS without a proper evaluation and a chance to try these new therapies.