Onset of symptoms the next day after trigger foods

[GlasgowGirl86]

I'm slowly trying to figure out what foods set my symptoms off and I've discovered a few however I've noticed that it tends to be the morning after that I get the abdo pain and upset stomach. Does anyone else experience this or is it usually more or less an immediate reaction?

 

[SarahD]

For me a reaction can take about 3 days of eating a test food to appear. I have a few big triggers that appear with a few hours, but most take about 3-4 days.

 

[GlasgowGirl86]

I'd imagine it must have been difficult for you to pinpoint trigger foods if they took a few days to have a bad effect. I'm struggling to even remember what I had for dinner the night before! I really should start a food diary.

 

[SarahD]

It's not too bad, I'm doing an elimination diet so I try new foods one at a time for 4 days to see if they agree with me or not. It's a slow process but for me it's been worthwhile. A food diary does help too

 

[buttER]

I'm the same GlasgowGirl86, the next morning is usually the reminder of how naughty I was the day before. The diarrhea and nausea usually subside by about lunchtime thank goodness and then it is all forgotten about by the evening. Is that the same with you?

More often than not I know what the trigger was (sometimes it is not what it is, but the quantity - I can manage half a chicken breast but not a whole one). But sometimes I have no idea what the cause was. This week: new vitamin pills? Different apples for the apple puree? The chocolate? Whatever, when the stomach pains and bathroom trips happen at night then I cut out everything that could have been the culprit and try and give my guts a rest.

Sarah D how do you decide what comes next in the elimination diet? Is it the same for everyone or is it tailored for you?

 

[SarahD]

Sarah D how do you decide what comes next in the elimination diet? Is it the same for everyone or is it tailored for you?

In the beginning I was following the LOFFLEX diet. That failed miserably and I then started a full eliminiation diet instead. My dietitian gave me a list of foods to test first - mainly ones which were less likely to cause problems. After I'd gone through the list provided by my dietitian I more or less just tested foods of my own choice. I've been doing the elimination diet for about 3 years now, and now have a reasonably wide diet, but it's been a slow and difficult process getting here. The diet hasn't been enough to put me in to remission unfortunately, but it's definitely helped minimise my symptoms, so for that reason it's been worthwhile.

 

[StarGirrrrl]

Sometimes a trigger sends me to the toilet right away, other times it's the next morning (my normal time to have a daily BM) I have problems.

I know for example having more than 1 cocktail sausage roll will produce mush the next day, but rough but potato crisps (chips) are going to cause problems within 20-120 minutes!

 

[GlasgowGirl86]

King of Orange yeah it pretty much happens the same way with me, have multiple mucousy loose bowel movements in the morning which disappear by the afternoon but the cramping/burning pain in my lower right abdomen remains for a day or two. I've only been ill with this for a couple of months and undiagnosed at the moment so I'm still in the early stages of trying to pinpoint trigger foods and avoiding them.

 

[FrozenGirl]

If varies by food for me too. Some (like fiber enriched pasta) are within 20 minutes. Others can be up to 12 hours later.

 

[buttER]

I know for example having more than 1 cocktail sausage roll will produce mush the next day, but rough but potato crisps (chips) are going to cause problems within 20-120 minutes!

StarGirrrrl I can't do crisps either, but the M+S tortilla crisps (natural flavour gluten free) are a pretty good alternative for me, if I don't eat the whole pack at once.

 

[UnXmas]

I don't really have trigger foods now I have an ileostomy, but before I used to find my reactions to foods were not immediate. But I also did not react to specific foods but to the overall content of my diet. So if I ate a lot of fibre over consecutive days, by about the second or third my symptoms would worsen. The same would happen with too much rich food, and with just the amount of food I ate regardless of what foods it consisted of (which is one reason why it was so hard for me to keep my weight up).

 

[UnXmas]

More often than not I know what the trigger was (sometimes it is not what it is, but the quantity - I can manage half a chicken breast but not a whole one). But sometimes I have no idea what the cause was. This week: new vitamin pills? Different apples for the apple puree? The chocolate? Whatever, when the stomach pains and bathroom trips happen at night then I cut out everything that could have been the culprit and try and give my guts a rest.

I wouldn't overthink this. Symptoms can vary regardless of diet. Besides other factors that we know about (e.g. medication), there are things going on inside our bodies that we can't detect which cause symptoms in the first place and determine how bad they're going to be at any given time. The control we can have over disease is limited, which also means we're not always to blame for it - an increased severity of symptoms does not necessarily mean you've eaten something wrong. Don't worry too much about analysing everything you eat or cut foods out of your diet because you have symptoms after eating them. Just look for consistent reactions, particularly when eating foods that are common trigger foods (e.g. high fibre foods, dairy, spicy food, etc.), and try to keep to a balanced diet.

 

[wellen1981]

Yes OP, this is generally how it works for me, usually its a problem only after having got up for the day. Almost like it is routine formed based on when your motions are to a certain degree.

It can differ for everyone though but that is how it goes for me, usually its waking up followed by the need to visit the loo.
Always feel worse as the day goes on if i dont go when i need to.

 

[ncman]

In the beginning I was following the LOFFLEX diet. That failed miserably and I then started a full eliminiation diet instead. My dietitian gave me a list of foods to test first - mainly ones which were less likely to cause problems. After I'd gone through the list provided by my dietitian I more or less just tested foods of my own choice. I've been doing the elimination diet for about 3 years now, and now have a reasonably wide diet, but it's been a slow and difficult process getting here. The diet hasn't been enough to put me in to remission unfortunately, but it's definitely helped minimise my symptoms, so for that reason it's been worthwhile.

Sarah D, may I ask why the diet wasn't enough to keep you in remisssion? Surely, following the LOFFLEX principle, if you are flaring up then you're eating something to which you're reacting to?

 

[SarahD]

Sarah D, may I ask why the diet wasn't enough to keep you in remisssion? Surely, following the LOFFLEX principle, if you are flaring up then you're eating something to which you're reacting to?

ncman, I did an elemental diet prior to starting LOFFLEX. The elemental diet is supposed to put you in to remission, and then usually once you're in remission you can move onto LOFFLEX. The elemental diet managed to clear up my symptoms about 90%, but even after 8 weeks I wasn't in remission. My dietitian decided that I should just proceed with LOFFLEX at that stage, as she didn't think further time spent on elemental would help me that much. So I started LOFFLEX and after a couple of weeks on that I had a massive flare up. I spent another 8 or so weeks on an elemental diet getting things under control again before I started a full elimination diet.

My symptoms do worsen when I've eaten a trigger food, but even in the absence of triggers I still have some simmering inflammation unfortunately.

 

[ncman]

My symptoms do worsen when I've eaten a trigger food, but even in the absence of triggers I still have some simmering inflammation unfortunately.

It's interesting, but also rather worrying to hear your experience.

Because I'm following the LOFFLEX method, and it's my understanding that success on the diet should result in no underlying inflammation.

When you say simmering inflammation, how has this been measured? Calprotectin, CRP, ESR or via colonoscopy?

Because for me, my calprotectin was still raised after doing the stint on purely elemental for 2 weeks. It took about 4 months for me to be under the 200 mark. And even when my calprotectin was 1000+, my CRP was normal.

 

[ncman]

My symptoms do worsen when I've eaten a trigger food, but even in the absence of triggers I still have some simmering inflammation unfortunately.

It's interesting, but also rather worrying to hear your experience.

Because I'm following the LOFFLEX method, and it's my understanding that success on the diet should result in no underlying inflammation.

When you say simmering inflammation, how has this been measured? Calprotectin, CRP, ESR or via colonoscopy?

Because for me, my calprotectin was still raised after doing the stint on purely elemental for 2 weeks. It took about 4 months for me to be under the 200 mark. And even when my calprotectin was 1000+, my CRP was normal.

 

[SarahD]

It's interesting, but also rather worrying to hear your experience.

Because I'm following the LOFFLEX method, and it's my understanding that success on the diet should result in no underlying inflammation.

When you say simmering inflammation, how has this been measured? Calprotectin, CRP, ESR or via colonoscopy?

Because for me, my calprotectin was still raised after doing the stint on purely elemental for 2 weeks. It took about 4 months for me to be under the 200 mark. And even when my calprotectin was 1000+, my CRP was normal.

Calprotectin, ESR and colonoscopy all show inflammation. My CRP is always normal. I had a scope a month ago which showed a lot of inflammation in the TI, and my most recent Calprotectin was >600 (that's the cut off for the test my hospital use). My Calprotectin hasn't dropped under that cut-off once the entire time I've been doing EN or the elimination diet.

I did EN for 8 weeks more than once and each time I still had a few symptoms remaining. My ESR did come down a bit on EN, but not all the way. I still definitely have food triggers, so I've been able to calm my symptoms by removing those triggers, but for me there must be something else causing some of my inflammation other than food.