New and confused

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new and confused

Hello, John here, 35 and practically diagnosed, so says my doc, with Crohn's. This occurred Jan. 13-17 with a hosp. stay and then re-entry Jan 31-Feb 4. I guess I am at the point where I have so many questions as to what I can eat, as do most I suppose. I was told to avoid dairy as it is very difficult to digest because the outside of the intestine is the part that actually digests dairy. When inflamed this is extremely difficult. I understand this is just a "trial and error" process but my questions arise when I still can not pinpoint what it is that may cause a symptom. Fortunately (in our world) the only symptoms I get are pain. I did not get diarrhea until my hospital stay and I was on gut rest.

Strangely now though I have been having "flat stool", ribbon like. I am not sure what that means. My first thought was "stricture" but I am not sure if that affects the colon or just the small bowel.

Currently I feel a bit bloated and sometimes of peaks of what I think is major gas but turns out to just be pain. I hope so much those pains are gas and am disappointed when they do not turn out to be so.

I tried half of a scrambled egg sandwich and had some negative effects but nothing major.

A question would be how quick do the foods negatively react for each of you. If you eat something that is going to hurt you, is it instantly? minutes? or hours? later that you feel it.
 
All of your questions vary from person to person. For some people it takes a few hours and for some people it can be within a half our or less. For me, food that bothers me usually takes about half an hour to an hour at most to affect me, even if its diarrhea.

I'm lactose intolerant so I feel the pain the second the milk hits my stomach and then as it goes through my intestines it feels like I've swallowed broken glass. Generally lactose only bothers you if you are lactose intolerant. Lactose intolerant means that you don't produce enough lactase to break down the lactose. Most adults don't produce enough lactase because milk was meant for us when we were babies to young children to help us grow because that's all we could eat but being older, there's less of a need for milk since we can eat regular solid foods so we don't produce lactase as much if at all. Also cows milk is harder to digest in general since we weren't meant to be utter fed by cows (the particles in cows milk are actually larger than human milk).

If you are not lactose intolerant, then there's no reason to remove it from your diet. Same goes with any food. If it doesn't bother you then go ahead and eat it. Keep in mind though that sometimes while we are in a flare and have a lot of inflammation that certain foods that don't normally bother us start to bother us. These foods are generally hard to digest for anyone even without IBD and does not necessarily mean they are a trigger food for you (just a "for now" trigger food I suppose). Lettuce is a good example because it contains cellulose (fiber - which all green plants contain) which humans in general cannot digest unless it were previously broken down (A LOT). So sometimes you may have a hard time with vegetables during a flare. Try to steam them first and remove any skins.

A trigger food means that it usually if not always triggers symptoms (diarrhea, gas, pain, constipation etc.) even if you are in remission. This is not a food allergy but for some reason your body just rejects it every time or it gives you pain each time etc. This could be spicy food, raw fruits, nuts etc. The list of random foods go on and on and are different for everyone.

Welcome to the forum! :D

Edit: Ribbon shaped stool could be the sign of a stricture caused by inflammation (I believe the beginning of the large intestines is what shapes our stools but I'll have to look that up again). I'd contact your GI first thing Monday and let them know or leave a message so they can get back to you first thing on Monday.
 
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It seems like you can't go wrong with an elimination diet of eating only rice and unseasoned potatoes suddenly, then slowly (although possibly after one day, or poop cycle,--depending on your body's response--you can begin) introducing foods or foodtypes and keep track of your body's reactions. Actually, the process is best when it is slowest and drawn out, but you can learn a lot quickly, just in a week or two, if you are methodical about it and if your body responds quickly to the benign foods of the initial elimination diet.

http://www.nealhendrickson.com/mcdougall/021200pudiet.htm

The Mcdougall diet at that site doesn't mention soy as an allergen. In our case, soy or anything derived from soy seems to be the #1 trigger for flaring.
 
Like they've said it will vary person to person.
Before I got diagnosed I was TDY to Romania and their food is very heavy on the grease so it was a game to see how much food I could get in my body before it hit my belly and made me nauseous, I usually got about 15-20 mins from the time I sat down to the time I had to dash out of there.
Now I've noticed some problems with lactose but that's taken a little longer, about an hour and a half I think before it was really painful, and it wasn't so much a nausea thing that time just some crampy pains.
The best thing you can do is the elimination diet and a very detailed food log, to include times that you eat and then times that you notice symptoms and just what they were. Your the only one, and maybe your doctor, that will see the log so as much discription as you can do the better.
I've started on some lactaid so if you notice dairy is an issue that is always an option, it seems to be helping a little but to be honest I've really tried to limit my dairy.
 
Hi John. Most of my problems seemed to stem from quantity more than the what I actually ate, and prior to my surgery I had a lot of the same issues that you are describing. I didn't have to eat a lot to be in pain, however I got to a point I could barely eat solid food (and didn't eat solid food on many days). I had a lot of pain, bloating, and nausea. I also wish it had been gas related, but sadly it was not, even though I had some pretty crazy noises coming from my guts. I did have a stricture and 2 fistulas. I have now had all of that removed and I'm on the road to recovery. :) Hopefully now that all of the diseased sections have been removed I will be in remission for a while! :D Hope you get answers soon!
 
If I am in the middle of a flare up and I eat foods not on my good list (salads, wheat thins, anything with pepper, cherrios) I will have trouble fairly fast. When I am feeling good and eat an offending food its usually the middle of the night. Varying levels of pain. All disturbing and all ending one way in doubled over in the bathroom in severe pain and everything else that goes with it! If a food item gives you trouble try and find the offending ingrediant its all trial and error.

Good luck and I hope you get a firm grip on this and feel better very soon
 
Strangely now though I have been having "flat stool", ribbon like. I am not sure what that means. My first thought was "stricture" but I am not sure if that affects the colon or just the small bowel.

I have this type of stool too...you gave a really good description. It's like constricted and ribbon like. Have you had any luck figuring out what this could be?
 
I have this too when I am bloated, ie: the small intestines are inflamed. Stools are floaty too usually because fats are not absorbing correctly.
 
not sure what tests they did on Steelerfan but if they were able to do a colonoscopy then I think we can guess he did not have a stricture as a stricture would have prevented the scope from getting past the rectum.

For a safe start, to insure you get your Iron, Calcium, Potassium and Vitamin D,
I say you can never go wrong with these:
Grits
Cream of wheat (Iron and Calcium)
Apple Juice,
Banannas, (potassium)
Yogart
Mixed Fruit

Avoid nuts and seeds,
Avoid Beans, especially the red kidney beans,

also,
have some Rice Chex
Rice Crispies,

Jello
Pudding
Water Ice

oh, and apple sauce :)
 
Strangely now though I have been having "flat stool", ribbon like. I am not sure what that means. My first thought was "stricture" but I am not sure if that affects the colon or just the small bowel.

I have this type of stool too...you gave a really good description. It's like constricted and ribbon like. Have you had any luck figuring out what this could be?

I have had 2 bowel resections, and have experienced this strange phenomenon for years... All I can tell you is from what I've read and seen, this is not related to a stricture, but rather the way your bowel is processing food... I've not found an explanation, only documentation indicating it's common. Somewhere I read that it is more common as part of what has been termed loosely as "short bowel syndrome", to describe the change in bowel behavior after a surgery.... but I can't remember if I had this before surgery or not, it's been too long. Not a real solid answer, no pun intended, but I am thinking it's probably pretty common and no one talks about it :)
 
I've had Crohn's for 30 years, with 2 resections. Currently enjoying a severe flare. As others have said, everyone's different, but here's my $.02...

One thing: I strongly suggest you get tested for food allergies too... Food allergies can manifest as creating an urgent need to go to the bathroom 15-20 minutes after eating them! No other symptoms! I have had Crohn's for years, but found out only 2 years ago on a hunch, that I am allergic to egg yolks and coconut... and coconut oil is used in nearly every over the counter bread, pie, cake, pastry, as well as shelf-stable coffee creamers, many ice creams, and most things labeled vanilla flavor, including cereals! I eliminated these foods from my diet and had immediate relief from symptoms I assumed were Crohn's. Unfortunately, I still do actually have Crohn's, so... here's my list....

Clear liquids:
In addition to the usual chicken broth, I can tolerate vietnamese pho soup broth (chicken-based only) and completely un-spiced Thai Tom Yum broth (lemongrass soup), which gives you some flavor options :) Just be sure to tell the restaurant people you have tummy issues, so absolutely so spice!

You can mix water or club soda (if you can tolerate the carbonation) a little grape, apple, pear, or berry juice to make a natural soda, to get some of that good 'fizzy' feeling after you're sick of drinking flat stuff.

Otter Pops or Flavor Ice freezer pops are cheap, have lots of flavors and give you an excellent 'chewing' sensation which is satisfying! Same for snowballs/snowcones (shaved ice with flavor poured over - can be done at home with condensed Kool-Aid, also nice chewing sensation).

Knorr - the soup company - makes a kind of 'jello bullion' now, which has much more flavor than the usual bullion, with real veggie flavor... excellent stuff. You can also mix veggie buillion 1:1 with chicken to get richer, more satisfying flavor, but make sure to find one that is NOT tomato-based. Try several - Harris Teeter store brand is my favorite.

Full liquid diet:
Tricky when you have lactose intolerance, as many with IBD do, Goat's milk is usually ok, as it is different from cow's milk - the taste is a bit stronger at first, but you won't notice after a bit, and it comes powdered so you can also make it more watery if you want.

Puddings are good - you can make them with goats milk at home, or buy prepared but take a Lactaid tablet first.

Also, cream of potato soup is a staple of my full-liquid diet, though I've recently seen posted here that potato skins and the top 1.5mm of potato contain bad natural chemicals that we should avoid, I would generally say a pureed potato soup is a good option - in a pinch, Cambell's makes one that you can strain out the chunks of potato. Again, Lactaid first, and/or make with goat's milk.

Yogurt smoothies - no chunks of fruit, of course - or Indian "Lassi" drinks are good, as well as drinkable Greek yogurt Kaffia I think it's called.

Sorbets are also ok - you can find some good ones now in larger grocery stores, or Pitango makes all-natural ones that are amazing... just avoid chocolate or spiced ones, or ones with seeds mixed in.

First foods after liquid diet, before full soft diet:
When you're "testing" solid foods, I am very conservative - Rice is a great testing food, as it doesn't have gluten or any other irritants. Cream of Rice instant is a staple in my pantry - you can cook it sweet with brown sugar, or savory with chicken stock (or a bit of butter, if you can tolerate it).

Similiarly, in a rice cooker or a pot, use 3-4x the water with 1 cup of rice, you'll get a porridge that Japanese moms make when people are sick... it breaks down the rice to virtual liquid mush. Cooked with chicken buillion instead of water and you get a kind of proto-chicken rice soup...You can season with other things based on what you tolerate. If you're doing well, you can mix in some eggs or egg whites, or a little plain chicken, and it will all cook like a crock pot meal.

I do not have a problem with gluten, so I will also take a creamed soup, or clear broth soup, and mash up handfulls of crackers (saltines work best for me) into them, in place of noodles, so I can manage the amount of solid food I'm taking in at first. You could also eat the soup with a piece of plain white toast - though recommend to buy a brand that is unbleached, unbromated to minimize chemical irritation of your gut.

From there, I move on to soft diet... Applesauce, bananas, egg whites, plain boiled or baked chicken (not fried, not grilled, no sauce), rice noodles and regular rice, goat cheese, fruit jelly, and canned chicken-rice or chicken-noodle soups.

Hope this helps someone who's looking for safe food options.

Please do consider getting food-allergy tested... digestive allergies may be worsening your symptoms or complicating your recovery.
 
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