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Hi there! I was diagnosed with IBS by my gastroenterologist following a colonoscopy in January 2022. I am 58 years old and my last colonoscopy was in 2010 When I was diagnosed with Ulcerative Colitis, or actually Proctitis since it was so localized. My symptoms in 2010 were bloody stool so it was very obvious when I was flaring. I was given a prescription for Canasa and found a support group that recommended a Paleo diet. This worked great for me for many years. I stayed (mostly) grain free and dairy free and felt that I had a very good handle on what foods could trigger an attack. In January, I had another colonoscopy because I was waking up with horrible cramping and abdominal pain. After my colonoscopy my doctor told me, " Good News! No UC, Bad News you have IBS." He also prescribed Dicyclomine for my cramping. Interestingly enough, my cramping usually happens in the middle of the night- not during the day. I also have not been able to find any correlation between my diet, abdominal pain and quality of my stool. In October, My daughter in law, who is a dietitian, gave me a blood test- believe it is called the Mediator Release Test. The results were very confusing to me. My number one and only "red" food was peanuts- something I rarely eat. I have a number of "yellow" foods- mushroom, celery and apple amongst others that I consumed on a regular basis. I was very surprised to also see almond as a yellow food- Since my UC diagnosis I mostly use almond flour, eat almond chips and avoid wheat! For the last few months I have avoided peanuts and most of my yellow foods. Yesterday I did something different! I ordered a rice bowl with chicken, steak and black beans from Chipotle. I enjoy spice but to say this was extremely spicy is an understatement! I was at work with nothing else to eat so I did have most of it. I woke up at 4AM with intense cramping and belly pain- a 9 on a scale of 1-10. I took a Dicyclomine and tried to sleep. Two hours later I had a normal formed stool but still intense pain. I started looking for support groups and found this one! I'm really at a loss-the only thing I can think of is that I was not tested for black beans- just pinto. I would appreciate any advice- I don't know if I have IBS-D or C, I feel that my main problem is pain. I am also HLA-B27 positive so I have the inflammatory marker. I would appreciate hearing from others that may have the same issues as I do. Thank you so much!

Mice study offers new insight on irritable bowel syndrome Sometimes the end of an intestinal infection is just the beginning of more misery. Of those who contract traveler's diarrhea, for example, an unlucky few go on to develop irritable bowel syndrome (IBS), a chronic inflammation of the intestinal tract. Scientists aren't sure exactly how this happens, but some think an infection may contribute to IBS by damaging the gut nervous system. A new Rockefeller study takes a close look at why neurons in the gut die and how the immune system normally protects them. Conducted with mice, the experiments described recently in Cell offer insight on IBS and could point toward potential new treatment approaches. Keeping inflammation in check In a healthy gut, the immune system must strike a careful balance between responding to threats and keeping that response in check to avoid damage. Full article >> https://www.news-medical.net/news/20200112/Mice-study-offers-new-insight-on-irritable-bowel-syndrome.aspx Source: Rockefeller University Matheis, F., et al. (2020) Adrenergic Signaling in Muscularis Macrophages Limits Infection-Induced Neuronal Loss. Cell. doi.org/10.1016/j.cell.2019.12.002. AZoNetwork, © 2000-2020

IBS might be more than IBS IBS is a range of disorders - gut / brain dysmotility, food intolerance, excess gas, incomplete evacuation, mushy stools, constipation and diarrhea. IBS is considered to be a functional disorder rather than a disease. This is because there are very few inflammatory biomarkers, but they are there. Because of this IBS is considered by some to be a low level inflammatory or low level auto immune disease. A leaky gut, or intestinal permeability, is when food proteins leak through the intestinal wall and directly into blood stream. The protein which sets this off is wheat, which is the most immunogenic of all foods. Your genetics determines whether or not you might have a problem with wheat at some stage in life. There is no known cause of Autoimmune disease, apart from Celiac Disease which has specific biomarkers. This is a similar story to IBS, which also has no known cause. Autoimmunity is an insidious and progressive disease that can damage the proteins in the body long before any symptoms are felt. This is why autoimmunity can strike seemingly out of the blue. It doesn’t really; it might have been working behind the scenes for decades but suddenly becomes apparent in the form of Crohn’s Disease, Inflammatory Bowel Disease, Diabetes, Arthritis, or any number of autoimmune diseases. The Paleo theory believes that wheat is a precursor to all autoimmune diseases, not just Celiac Disease. Wheat and all grains are excluded from most IBS diets. One of the reasons is because the protein Gluten in wheat can directly damage the intestinal wall, in effect creating a hole which allows large molecules to leak through the intestinal wall and into the blood stream. The innate immune system sees these amino acid shapes as potential pathogens called PAMPS (pathogen associated molecular patterns). Once the innate immune system is primed to attack wheat, it can also attack similar protein structures in the human body. This is the basis of autoimmunity. IBS could be initial warning signs of this process Chronic diarrhea, for example, could be the immune system’s attempt to flush out what is sees as a toxin, but what to most people would be a harmless vegetable or grain. This can set up a cascade of inflammatory responses to other foods, not just those containing wheat. The safest course of action is to stop eating whatever food sets off this inflammatory process. As a general, blanket rule, most people do better by giving up grains. A summary of the main diets The FODMAP diet excludes certain complex sugars (fructose, fructans, lactose etc) but not polysaccharide starches! Polysaccharides are also complex sugars (glucose), but the founders of the FODMAP theory assume that we all digest starch just fine as starch is digested in the small intestine, before bacteria can get to it. This is true if you don’t have SIBO (small intestinal bacterial overgrowth) in which case, the bacteria will ferment a good percentage of the starch before the enzymes can break it down. Some people might also be deficient in the enzyme Amylase, and so the FODMAP diet won’t be enough on its own and you would need a low starch diet as well. The FODMAP diet doesn’t exclude all grains, only grains that are high FODMAP, so rice is allowed. Most other IBS diets restrict grains completely. The Specific Carbohydrate (SCD) diet restricts high starch foods, including grains, but allows FODMAPs. The SCD was created long before the FODMAP theory was devised, and so can’t be blamed for including such things as legumes as safe foods. The Paleo diet allows starchy foods and high FODMAP foods but disallows all grains and dairy, due to their anti-nutritive and immunological qualities. Grains & dairy contain proteins that inhibit digestion: lectins, phytates and opioid peptides. In susceptible people these proteins can lead to constipation or diarrhea, or both. So the main IBS diets can ban the same foods, but for different reasons. You can see why it makes sense to combine all the main diets, even though this is very tough to do. An IBS exclusion diet might lead to a diet poor in essential nutrients. A good, free website to track the nutrient levels in your daily diet is Chronometer. If you are deficient in any important nutrients or minerals the website will tell you. As the Paleo diet forbids dairy for example, you may find you are lacking in calcium. In cases like this you might need to add the least harmful form of dairy - and this will take some experimenting. Cheese might be one of the safest options as it is low in lactose. The fibre conundrum Any food that is fermentable by bacteria is potentially a cause of unwanted gas. In IBS this gas can cause either diarrhea or constipation, depending on the make-up of the gas. Dr Mark Pimentel authored a study showing that hydrogen producers tend towards diarrhea and methane producers, constipation. For some people, even low FODMAP vegetables can also cause gas and gastrointestinal symptoms. Everyone is different in terms to tolerance to certain carbs. Fibre needs to be introduced very cautiously, to give the good bacteria time to multiply and to provide the enzymes to break down the fibre.