I've been vegan for 3 years, with roughly a 70/10/20 calorie breakdown. Prior to that, I was eating a "healthy" but non-vegetarian diet, that included lots of fruits, vegetables, no red meat, and only whole grains. 2 years ago, I began having severe stomach problems, to the point where I couldn't stand up because my stomach was cramping so much. I had bloating, diarrhea (going about 20 times a day), terrible pain, nausea, etc. I began going to specialist after specialist and was eventually diagnosed with fructose malabsorption, and irratible bowel syndrome (which runs (hehe) in the family ) about 6 months ago. Since going on a low-FODMAP diet, my symptoms have nearly disappeared, but I really miss all the fruit I used to eat (I was totally into 10 banana smoothies and entire watermelons, now I dream of being able to eat a clementine or some broccolli without buckling in pain).
At first I thought that all these sympotoms was from detoxing so I continued eating lots of fruits and vegetables, even dabbling in a mono-fruitarian diet, hoping to push the toxins out of my system, and things got worse and worse, but at no point did I start seeing any benefits, but coming from a decent diet and then being vegan for years, I don't see how the detox could last for this long...
Upon going on a low-FODMAP diet all my pain has gone away, but I hate not being able to have fruit in the quantites I like, I usually push through the pain so I can have a cup of OJ and some berries or a kiwi in a day, but that's nothing compared to what I want to, and should be eating.
Right now my diet is based on rice, potatoes, rice pasta, with the some other things like corn flakes, and some fruits and vegetables.
I really want to cure this pain without sacrificing my health....help!
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I've had testing (stool and blood studies) done for virtually every parasite that could cause stomach ailments. I've had testing done for amounts of gut bacteria, including to see if I have candida overgrowth. I had a bacterial overgrowth, and went on Rifaxin for 3 weeks, which is a semisynthetic antibiotic. This didn't help my symptoms, and though I didn't feel worse after taking it, I fear that it may have furture disrupted and damaged my digestive tract. I also have gastric reflux so I doubt lack of stomach acid is to blame. Also, when I was tested for fructose malabsorption, I had an empty stomach for 12 hours, and then drank 8 oz of water with 25g of fructose in it, then took readings on a machine that measures hydrogen and methane levels in my blood. The readings were taken every 15 or 30 minutes for three hours. The basis of the test is a failure to absorb the given sugar, which is then metabolized by bacteria that give off either hydrogen or methane. Therefore, the more gas that is produced, the less absorption has occurred. If the level of hydrogen rises above 20 ppm (parts per million) over the lowest preceding value within the test period, the patient is typically diagnosed as a fructose malabsorber. If the patient produces methane then the parts per million for the methane typically rises 12 ppm over the lowest preceding value to be considered positive. I was a methane producer, and my levels rose to nearly double that upon tkaing the test.
Feel for you. I've had IBS-D my whole life, wouldn't wish it on anyone. My symptoms have gradually improved since going vegan, and especially since going high-carb, but it's taken years to see the benefit. I experimented with FODMAPS for a long time but never saw any consistent benefits, sometimes I'd be certain one food group was at the root of my problems, but then I'd feel fine when I re-introduced it. Avoiding all the FODMAPS foods is particularly difficult on a vegan diet, and apparently there's a lot of uncertainty about which foods really belong in which groups... so refining the diet is a pain.
Have you tried banana island? If bananas are a trigger for you it might be impossible but if you can stick it out it might be worth trying. I've seen a few people on here claim to have resolved fructose malabsorption on banana island. I found it too painful the first few times I tried but was been able to do a 3 week banana island recently. It was hugely beneficial, my stomach's been better since finishing. My symptoms flare up for months and now I feel like I have a sort of 'reset' button to hand with banana island. It's a great base for an elimination diet too.
You're probably right that it's not detox. But it can take a long time to notice improvements. I think IBS is often mediated by bacteria, and changing your bowel flora takes a long time. Fructose malabsorption could be due to dysbiosis. Probiotics might be helpful - have you tried any high dose probiotics? Probiotics won't permanently colonise your bowel but they can help provide the right environment for other beneficial bacteria. The higher the dose the better. I'm about to start making my own water kefir, which contains exponentially more CFUs than commercial probiotics.
The only way to make immediate (semi-)permanent changes to bowel flora is with a faecal transplant. If you're not aware of FT, it's exactly what it sounds like :o Expensive and currently over-regulated in the US but maybe worth considering if you're desperate.
Some supplements have the potential to help, you should definitely try a high quality chromium supp or a multimineral. Sorting my B12 deficiency made a noticeable difference for me. Calcium can be a useful stool firming agent. Some people swear by glutathione, K2, D3, betaine HCl etc. I drink peppermint tea, it can stop the spasms.
I've tried to do mono-fruitarism with bananas (aka banana island) before my diagnosis, however I got about 2 days in and was no longer able to leave the house due to the excruciating pain, and other fun symptoms I was experiencing, so I stopped after day 5 when the symptoms became unbearable. - and yes the bananas were ripe, and all blended with water for better digestion.
I'm currently taking a chromium supplement, probiotic, B12, D3, multivitamin, zinc, digestive enzymes, peppermint tablets and ginger tablets. I've also tried the greens method where you eat some lettuce or spinach with fruit to assist in digestive, to no avail.
I've read extensively about faecal transplants, and my gastroenterologist and I aren't sure this is the right step to take, because they're more for introducing bacteria into your gut. Once the bacteria is there, it will grow to a healthy level, and since I have all my bacteria, the problem isn't them, it's that the environment they're in isn't allowing them to reach the right population, resulting in overgrowth/undergrowth.
You seem like you have a good understanding of things Jes. I get the feeling there's not much to suggest that you're not already aware of. What does your gastro want you to try next? If you've had rifaximin already I imagine they're running out of options. Have you had a course of nystatin?
If you search on here you'll find people claiming to have resolved FM by eating fully raw or juice fasting or just bananas. Dave Klein's book is the standard reference for healing IBS/IBD with a raw diet. Bananas I think have the least fructose of the higher-calorie fruits so if you can't tolerate them then I don't know if you'll ever be able to resolve your FM with diet alone.
I'd stick with the supplements and probiotics. They might help in the long-term. Make sure you're taking adequate amounts. 200ug Chromium polynicotinate or chromium GTF. 100mg selenomethione. >50mg zinc (with 1-2mg copper). B12 should be as 1mg sublingual methylcobalamin. >2000IU D3. Which probiotics are you taking? VSL#3? 2 sachets of VSL and a separate S. Boulardii source is probably the best regime.
Regarding FT, my impression is that stool testing isn't specific enough to confirm that your bowel flora is intact and not responsible for your symptoms. Intestinal ecology seems to be too complex a subject to predict whether FT will have a benefit or not. Gastroenterologists will tend to advise against it because it's novel and non-standardised but providing the proper procedure is followed it's pretty low risk. If your IBS is already so severe that a single orange is triggering, FT is almost certainly not going to make things worse. The only real drawback is the cost of arranging it, I doubt you'd be able to get it covered on insurance in the US. FT is the closest thing to a 'magic bullet' therapy there is.
I used to have moderate FM, not as severe as yours though. I've never been breath tested (the test's not readily available in the UK) but confirmed it when I was experimenting with FODMAPS. Now I can usually manage 2L of banana smoothie or a glass of apple juice without problems. I think taking a holistic approach has helped me. As well as supplements and probiotics I try to stick to a regime of meditation, yoga, epsom salt baths, visualization, breathing exercises, running etc. You might improve over time with a holistic approach of your own.