Dealing with stomach pain: Elimination method, FODMAP & tips to cope

Many people in todays society deal with stomach pain and discomfort, to certain degrees. Some people just get a little pain from time to time after overeating or maybe eating certain foods, while others can barely live a normal life due to their stomach issues.

In the past, I was the latter. I struggled with a lot of stomach issues and pain.

In this post I am giving you some tips on what you can do to figure out what causes your stomach issues via an elimination method. Though I do advise you to seek help from both a doctor and dietitian so that you don’t end up restricting your intake far too much and far too long so that you end up unhealthy or with nutrient deficiencies.

I have written a post about FODMAP and IBS, which you can read here.

Also a post about dealing with bloating HERE

As well as a post about eating a high fiber diet, which can often lead to cramps and digestive issues, HERE

When you are dealing with stomach pain or digestive issues it can easily lead to a very restrictive diet, either because you don’t want to eat something that triggers the pain, but you don’t know what causes the pain and therefore restrict everything you think might cause pain. Or you infact become scared of certain food because you don’t want the stomach pain and therefore cut it out and get scared to eat those foods.

FODMAP

When someone has IBS they are often recommended to try doing FODMAP with the help of a professional. FODMAP is not a longterm diet or way of eating, it is a way of eating for a (short) period of time to help figure out which foods that cause flareups and stomach issues and which foods you can tolerate.

What is FODMAP?

FODMAP stands for “fermentable oligo-, di-, mono-saccharides and polyols”

Common FODMAPs include:

  • Fructose: A simple sugar found in many fruits and vegetables that also makes up the structure of table sugar and most added sugars.
  • Lactose: A carbohydrate found in dairy products like milk.
  • Fructans: Found in many foods, including grains like wheat, spelt, rye and barley.
  • Galactans: Found in large amounts in legumes.
  • Polyols: Sugar alcohols like xylitol, sorbitol, maltitol and mannitol. They are found in some fruits and vegetables and often used as sweeteners.

These carbohydrates/fibers don’t fully digest and some become nutrition for gut bacteria while others don’t digest at all and can therefore cause bloating, gas, cramps.

In some individuals, FODMAPs are poorly digested, so they end up reaching the colon. They draw water into the intestine and get fermented by hydrogen-producing gut bacteria.” (Healthline.com)

A low FODMAP diet means you eat very little or no foods which contain those carbohydrates/fibers. I.e limiting the amount of foods which can cause symptoms.

When following the FODMAP diet for a period of time you are very restricted in what you can eat, and even more so if you are vegan. (I had to try the FODMAP diet for 3 days during one of my university courses and I didn’t eat much those three days as I was so restricted in food choices.) But overtime you begin to reintroduce foods and eventually have a much more varied diet and will hopefully have figured out which foods you can tolerate and you may even figure out which foods you tolerate in smaller doses and which you can consume in larger doses. However along with FODMAP you also have to look over your lifestyle and the way you eat.

Sometimes the problem may not actually be the food, but it may be that you are very stressed, that you are anxious around food, that you don’t actually sit down to eat or you eat your food within 5 minutes while standing or on the go. All of these can cause stomach issues, but also foods such as gum, carbonated drinks, alcohol, certain sweeteners and caffeine can lead to gas, stomach issues and caffeine can heighten anxiety which can lead to stomach discomfort or pain.

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HOW YOU EAT:

So along with looking at what you eat, you also have to look at how you eat. Changing how you eat and even where you eat can make a big impact on your stomach issues. If you are eating in very stressful environments or you don’t have time to eat, then you can easily feel anxious and stressed or you don’t really enjoy or chew your food and all of that can lead to stomach discomfort. So making time to eat while resting and preferably sitting and in quiet environments can make a big difference.

As mentioned above, a FODMAP diet should be done with the help of a professional, otherwise it is easy that your diet becomes far too restrictive and that you don’t actually begin implementing certain foods again, instead you just stick to the “green” foods. It is also important to note, that everyone is different. Some people with IBS may be able to consume foods that are listed as red, while they get stomach pain while consuming certain foods that are green. So you do have to try

different foods and see what works for you.

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WRITE A FOOD DIARY

If you don’t have IBS, just stomach issues, the first thing you can do is to write a food diary for 2-3 weeks.

Write down what you eat, what time you eat, the environment/situation when you ate and even how you felt before/during/after, along with any symptoms you felt during or after the meal.

This will help you get a better overview of what and how you eat as well as tracking symptoms.

After 2-3 weeks it will give you better understanding and overview, compared to just a few days or one week of tracking. The important thing is to eat just as normal… don’t begin cutting out food or changing your diet. Write down everything, even the handful of nuts, the latte on the go or the piece of chocolate you eat standing in the kitchen waiting for dinner to cook.

The diary may just be for you to analyse and get a better understanding of how/what you eat, but may even be useful if you do go to a doctor or dietitian for help.

Once you have written the food diary, begin to look over it. Are there certain meals with certain ingredients that cause symptoms or flareups? Are there certain situations that cause pain and discomfort… such as the rushed lunch during school/work, or maybe the dinner straight after training or the lunch you ate while super stressed?

Once you have found out which meals or situations cause the most flare ups it can be easier to make adjustments.

However, now is when the long process begins. The important thing is to not cut out everything at once…. Instead, you do it one by one. If you think that maybe garlic, onion, chickpeas and gluten cause stomach pain… then begin by just omitting garlic from your meals and diet for a week… see what happens and how you feel. Then the next week omit onion and add in garlic (depending on how you felt the previous week i.e symptoms or no symptoms). It is a long process of finding out what works.

You could of course group certain foods together such as all beans, all sweeteners, all foods with gluten, onion and garlic, all dairy products etc and then one week remove all the foods in one certain group, and slowly reintroduce them one by one. Because it may be that you are sensitive to chickpeas but not to blackbeans, or it may be that you can’t tolerate aspartame but you are fine with stevia.

I would also recommend that you do infact limit your caffeine intake (coffee, black tea, energy drinks) as well as not chewing gum or sugar free pastilles, as they can all cause stomach discomfort.

I do also want to note that many believe they are gluten intolerant and cut out all products with gluten, however many products that include gluten also include certain fibers that are hard to break down. So it may not be the gluten you are sensitive too, but the fibers.

Which is an important thing to note, fibers can cause stomach discomfort and pain. There are certain fibers that are hard to break down and cause gas and bloating. So limiting fiber intake and drinking plenty of water can be one step if you don’t want to do the whole elimination process. Though then you won’t be able to tell which foods cause pain or symptoms if you eliminate them all at once.

I also recommend that you keep your meals very simple, just 2-4 different ingredients. The more ingredients and foods you eat in a meal the harder it can be to digest as well as figure out what causes your pain or discomfort.

FOODS THAT CAN CAUSE STOMACH PAIN

There are certain foods that are more likely to give stomach discomfort and they are:

Beans and peas – this is due to their fiber content and that the fibers are hard to break down

Sweeteners – Many sweeteners aren’t broken down or absorbed in the body and therefore lead to gas and bloating

Carbonated beverages, sugarfree pastilles, gum – the bubbles in carbonated drinsk along with both caffeine and sweeteners, basically a triple whammy. With gum, when you chew you are swallowing air which can lead to gas and bloating, as well as gum usually having sweeteners (even if it’s only very small doses)

High fat meals – including creamy and/or, oily dishes. Typically fast food, dairy full fat (specifically cream) or certain takeout meals such as Chinese. Fat leads to feeling full quicker and is also harder to break down compared to carbohydrates. It can also often lead to heartburn. Many find that eating fat sources from avocado, nuts, nut butters and seeds don’t cause the same stomach issues.

Food with lactose or gluten – many cut out lactose and gluten thinking they are intolerant to them. Some may be, but as already mentioned. Many foods with gluten also include hard to break down fibers which may be the issue and not the gluten. With lactose, many can’t handle a lot of lactose or they don’t have enough lactase enzyme which breaks down the dairy. Though this isn’t so strange considering that dairy is actually for baby cows, and not for humans… or well, not in the huge amounts that many consume dairy products now a days.

Too much fruit – Fruit has a lot of fiber but also fruit sugar which can cause certain individuals discomfort if they eat too much of it. And by that I mean eating maybe 4-6 fruits in one go.

Note, just because i mention these foods doesn’t mean that YOU are sensitive to them. Everyone is individual and everyone reacts differently to different foods. You may be able to digest those in small amounts, ,aybe not at all or maybe they don’t trigger you at all.

When you are dealing with stomach pain, it is easy to get scared of food because oyu don’t want to deal with the stomach pain. But you can not completely restrict yourself, the best is to get proffessional care, but if you can’t because of reasons- Then remember to not completely cut out food and if you do cut out food youshould try to reintroduce it. Otherwise your diet can become very restrictive. Also be reintroducing it into your diet after not eating the food(s) for a while you can better understand what is causing stomach pain.

Also remember, if you do think you are sensitive to gluten and want to get it checked. Youahve to eat gluten to do the tests… so don’t cut out gluten and then get checked because the results won’t show any intolerance/allergies then.

Stomach issues and pain is complex. Many get the diagnosis IBS because doctors can’t find any other diagnosis that causes the pain. But IBS is about more than just food, as previously mentioned. Stomach issues aren’t always due to food, but due to other factors which also makes it hard to treat. It often requires changes in diet, lifestyle and way of eating.

It is incredibly debilitating to live with stomach pain, I did for several years. Many plans that were cancelled, many evenings I lay curled in a ball on my bed with extreme pain, many tears due to the discomfort and a lot of constant bloating. What helped me was to go vegan and start eating plantbased, but of course that also meant letting my body adapt to a higher fiber diet. I can still get stomach pain from certain foods, but I have learnt to figure out which foods cause me pain and also know that too much of certain food will give me discomfort… and then it is up to me to make the decision whether I want to eat the food and deal with the discomfort afterwards or to just skip the food or choose something else.

For stomach pain and nausea ginger or peppermint tea can help, as well as having something warm on your stomach.

If you are dealing with a lot of stomach pain, I highly recommend you go to both a doctor and a dietitian. Be persistent with your doctor so that you get all tests done, just to rule out any serious conditions. However, I do also recommend that you keep a food diary for 2-3 weeks, get an overview of your symptoms, how and what you eat and see if your symptoms may just be due to anxiety and stress and certain foods such as caffeine, sweeteners and high fiber.

(From personal experience I can also add that when I am very stressed and anxious, then I can get stomach pain and bloating even if I am eating the same as usual. So it is important to look at your stress and anxiety levels).

Celiac, gluten intolerance and IBS | Nutrition post

Now a days being gluten free is very much a trend. People saying they are gluten free but don’t even know what gluten is…. and some people are gluten free just when they want to be and with certain foods. They will buy gluten free bread and gluten free oats and pasta but then still drink beer, eat soja sauce and time to time eat desserts and baked goods with gluten.

If you want to know what gluten is and whether it is healthy or not, read my post HERE.

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If you were to talk to someone who has celiac disease, which is an autoimmune disease and they are forced to avoid all gluten. (Some can digest up to a crumb size of gluten without feeling symptoms, but it can still effect their small intestines). Many with celiac disease wish they didn’t have the illness as it affects their intake so much and they can’t just have a day where they don’t care about gluten free food, because not only will they feel symptoms but it is also damaging to their intestines.

To be diagnosed with celiac disease you need to do tests at your doctor and it is recommended that you DON’T cut out gluten until you have been diagnosed. And if you have cut out gluten and you want to be tested for celiac disease, then you will need to start eating gluten products again for a while before you can get tested. (This is so that they can see the autoimmune response and whether you have antibodies/allergens against gluten). (2)

I am not going to get so much into celiac disease as it is an autoimmune illness, but i thought i would talk about the difference between celiac disease and gluten intolerance. And then write about gluten intolerance vs IBS.

(Note there is also a thing called gluten allergy, but i am not going to mention that in this post).

Celiac disease vs gluten intolerance:

So first off, celiac disease is an illness where gluten actually harms the small villi/microvilli (they absorbed nutrients from your small intestine). So eating gluten when you have celiac disease is actually harmful. In the long term undiagnosed celiac disease can lead to malnutrition, anemia, extreme fatigue, weightloss, infertility and even behavioural changes. The only real treatment for celiac disease is to avoid gluten completely. (1)

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Whereas gluten intolerance, the main symptoms come from your large intestine and eating gluten doesn’t actually cause any harm, even if the symptoms may not be so nice. As gluten intolerance isn’t so well studied and researchers still don’t really know what may cause the intolerance, there seems to be no long term consequences… aside from maybe mental distress from the pain you feel or missing out on social events/social life because of pain or gas or bloating.

You can take tests to see if you have celiac disease, but also you need to have the genes to have the illness i.e if you don’t have the genes you can’t have the illness. Whereas gluten intolerance, or IBS there are no tests to diagnose the sensitivity. It is just an elimination process and you need to track your food intake over a period of time and see what helps or makes the symptoms go away.

Both celiac disease and gluten intolerance can give the same type of symptoms such as cramping, diarrhea or constipation, headaches, fatigue etc which is why it can be easy to jump to the conclusion that you have celiac disease, without getting tested. (Note, the same symptoms can occur if you have IBS.)

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What about IBS?

There seems to be alot of research about IBS and i would need to do several weeks of reserach and write a whole book to explain it all, but IBS is a sort of elimination illness. When there are symptoms and pain when eating or when eating gluten, but nothing that can cause the pain shows up in tests. I.e there is no test to be done to diagnose IBS.

There are 3 types of IBS.

IBS-C (i.e mostly constipation along with other symptoms)

IBS-D (i.e mostly diaherra along with other symptoms)

IBS-CD (Alternating between constipation and diaherra)

Many people can alternate between these types of IBS.

IBS can often be linked with stress or anxiety. There is extra movement in the large intestine which causes bloating and gas and uncomfortable feelings.

Doctors still don’t really know what causes IBS, however there seems to be a link between the messages your brain sends to your large intestine which can cause the digestive issues. Also stress has been seen to make IBS symptoms worse, even if stress isn’t the cause of IBS. (3)

Also symptoms can be worse during or before your menstrual cycle if you have one. Also many girls can self diagnose IBS when they infact have endometriosis (a condition/disease resulting from the appearance of endometrial tissue outside the uterus). The symptoms of IBS and endometriosis can be very similar, however both conditions can take a long time to diagnose. (4)

There is no physical long term physical consequences of IBS, however it can definitely impact the quality of your life if you are constantly suffering from stomach pain, bloating, gas and constipation and/or diaherra. Also it can lead to weightloss or malnourishment if you begin to fear eating due to the pain or symptoms it may cause. Also it can limit the things you do in life which can then affect your mental health and leave you feeling lonely as you can’t socialize the way you want to. But also it can leave you feeling frustrated and angry to never get a real diagnosis or help with IBS.

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One of the main treatments for IBS is to try to follow  FODMAP (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) diet, i’ll explain below and maybe write a post more in detail of the FODMAP diet. (I have also tried eating FODMAP vegan as part of an assignment in school, so i can write about that as well.) There is also advice to try to eat in a calm place with no stress, to be mindful when eating and not stress eat as well as it being recommended to eat smaller portions more frequent rather than big portions few times a day.

Many who say they are sensitive to gluten may not actually be sensitive to gluten, but the carbohydrates from the products containing gluten. Many foods with gluten can have carbohydrate forms such as fructans and galactans which ferment in the large intestine which can cause bloating and gas. These carbohydrates are often found in vegetables, beans, wheat, rye, barley, legumes etc on the FODMAP diet it is also advised to avoid sweeteners (polyols), foods with lactose (I.e dairy products) and many fruits with fructose as those can cause gas and bloating. So to summarize…. when you have IBS, it may not be the gluten that causes the pain, but the fermentable carbohydrates which cause gas and bloating in your large intestine.

Many people with IBS feel better/less symptoms when following a FODMAP diet. It is not a long term diet, instead you follow it for a few weeks and then begin to slowly reintroduce certain foods back into your diet to see which ones give you symptoms and how much you can eat of certain foods. 

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I will write more about IBS and FODMAP in another post.

Even if there may be no real diagnosis for IBS, instead it is a process of elimination, don’t self diagnose yourself with the illness. Instead go to the doctor and get checked incase it is celiac disease or if it is an illness such as Chrons or ulceros Colit (typically, those illnesses will give more severe symptoms and they can be diagnosed via tests, but it is important to not self diagnose yourself with an illness.) Also note, even if you are given the IBS diagnosis, and you try following a FODMAP diet as well as the other tips and the symptoms still don’t go away, be persistent and keep doing tests incase it is something more serious.

 

There is so much i could write about these 3 conditions/illnesses, but to end with some final notes.

  1. You can have celiac disease without having any real symptoms for a long time, wheras you can’t have IBS without having the symptoms.
  2. Gluten free doesn’t mean healthier. Unless you have celiac disease, gluten isn’t unhealthy. HOWEVER, you may get symptoms from foods that contain gluten but then it may be the fermentable carbohydrates from the foods and not actually gluten.
  3. Gluten free products can often have less vitamins and fiber, have more sugar and be more expensive than regular non gluten-free products… so GF doesn’t mean better or healthier.
  4. If you find that you are suffering with alot of stomach pain, bloating, gas and discomfort seek professional care. Also recommended to write a food diary for several weeks as well as writing down your symptoms & when they are present to easier help with diagnosis.
  5. Take probiotics daily. Try not to stress eat, also anxiety or guilt around food can cause more stomach pain when eating. So it may not be IBS or any other illness, just your mental state causing physical pain when eating.
  6. Do you need to eat gluten? No, it is not a vital food/ingredient you need to eat. Just like with sugar and oil, it is not something you need in your diet. But as long as you aren’t allergic to it or have celiac disease it is ok to eat it…. however if you feel that you do get symptoms from certain foods with gluten, then don’t eat them. Just don’t be scared of eating gluten if there is no real illness towards it.

And lastly, there are IBS doctors and dietitians you can go to if you suffer from IBS or celiac disease, which i highly recommend you reach out to and try to get help so that you can make life better with less symptoms. Also there is quite alot about IBS but it is still rather “unknown”, not to mention that people can experience the symptoms differently and to different degrees, so i may not have written everything about IBS but just an overview regarding IBS and gluten.

Sources:

  1. https://www.gluten.org/resources/getting-started/celiac-disease-non-celiac-sensitivity-or-wheat-allergy-what-is-the-difference/
  2. https://www.verywellhealth.com/gluten-vs-irritable-bowel-syndrome-562696 
  3. https://www.webmd.com/ibs/celiac-disease-ibs#2
  4. https://endometriosisnews.com/2018/03/28/endometriosis-ibs-symptoms-link-irritable-bowel/ 
  5. https://irritablebowelsyndrome.net/clinical/how-are-celiac-disease-and-ibs-different/ 
  6. https://www.celiac.com/articles.html/celiac-disease-gluten-intolerance-research/how-solid-is-the-evidence-for-non-celiac-gluten-sensitivity-r4096/