ibs daily journal - the low fodmap diet · 2018-09-02 · ibs daily journal while on the low fodmap...

IBS Daily Journal

while on the LOW FODMAP diet

SUZANNE PERAZZINICreator of Strands of My Life

[email protected]

© 2015

Copyright

Designed, Edited and Produced by Suzanne PerazziniAll rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or otherwise, without prior consent from the copyright owner and publisher of this book. This book is sold subject to the conditionsthat it will not, by way of trade or otherwise, be resold, hired out or otherwise circulated without the publisher’s prior consent.

IBS Journal

5 HOW TO USE THIS JOURNAL

6 SLEEP

9 EXERCISE

12 RELAXATION

15 BREAKFAST

16 SNACKS

17 LUNCH

18 DINNER

19 MEDICATION

20 SUPPLEMENTS

21 WATER

22 BOWEL MOVEMENTS

23 BRISTOL STOOL CHART

24 THE JOURNAL

Contents

“Courage doesn’t always roar. Some-times courage is the little voice at the end of the day that says I’ll try again

tomorrow.”

― Mary Anne Radmacher

4

The best way to work out what is happening with your digestive system is to record all the relevant information. Record every single thing that goes into your mouth including medication and supplements. Record your bowel movements, what sort they are and when they happen.

On top of that, record how much sleep you get, how much exercise you do and when you use relaxation techniques. These are essential parts of a balanced lifestyle which supports your IBS.

As time passes, this will be an excellent record to look back on to see what progress you have made. But most of all, it will be a way for you to start seeing patterns and work out what is causing your symptoms.

Assuming you are on a strict low Fodmap diet, this will be a fairly easy process because your symptoms will be minimal. However, there could still be some foods that upset you for reasons which are not Fodmap related. O r maybe you will see that too much of something or too many low Fodmap foods together are causing symptoms.

We are all individuals where Fodmaps are concerned, and it is rare for a person to have issues with all the Fodmap groups so you will be able to create your perfect personalized diet over time, especially once you have undertaken the reintroduction stage of the diet.

Make sure you eat five small meals a day spaced between three and five hours apart with your last meal at least three hours before bedtime. This information is repeated on the dedicated meal pages but it is worth remembering to never overeat, not to graze throughout the day and not to fast. All of these situations will cause your IBS symptoms to reappear or worsen. Follow the diet strictly and you will be amazed at how your IBS symptoms will disappear. Record, learn and adjust. Good luck.

How to use this journal

5

Sleep

Sleep is essential for a person’s health and wellbeing, and lack of good quality sleep is a serious problem which affects many people.

WHAT SLEEP DOES FOR YOU A good night’s sleep improves • learning. While alseep, new pathways are formed in your brain.Sleep helps you pay attention, make • decisions, and be creative.Sleep helps you control your • emotions and behaviour, and to cope with change. Sleep deficiency has been linked to depression, suicide, and risk-taking behaviour.Sleep is involved in healing and repair of your heart and blood vessels. Thus • preventing heart disease, strokes etc.Sleep deficiency increases the risk of obesity because sleep helps maintain a • healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don’t get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel less hungry when you’re well-rested.Sleep affects how your body reacts to insulin, the hormone that controls your • blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which may increase your risk for diabetes.Sleep supports healthy growth and development. Children grow while they are • asleep.Sleep helps build your immune system and fight common infections.•

6

WHAT HAPPENS IF YOU DON’T GET ENOUGH SLEEP? Irritability, moodiness and disinhibition are some of the first signs a person experiences from lack of sleep followed by apathy, slowed speech and flattened emotional responses, impaired memory and an inability to be creative or multitask. Then finally hypnagogic hallucinations are experienced.

HOW MUCH SLEEP DO YOU NEED?

Everyone’s individual sleep needs vary. In general, most healthy adults are built for 16 hours of wakefulness and need an average of eight hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as six hours of sleep. Others can’t perform at their peak unless they’ve slept ten hours.

WHAT CAUSES SLEEPING DIFFICULTIES?

Apart from rarer physiological and psychological disorders that may be involved, the following can be causes:

Stress, for example, school- or job-related pressures, a family or marriage • problem or a serious illness or death in the family. Drinking alcohol or beverages containing caffeine in the afternoon or evening.• Exercising close to bedtime. • Following an irregular morning and night-time schedule.• Working or studying right before getting into bed.• The room being too hot or cold, too noisy or too brightly lit. • Interruptions from children or other family members. • The habits of your sleep partner. • Physical problems like arthritis or having pain, backache, or discomfort.• Medications such as decongestants, steroids and some medicines for high • blood pressure, asthma, or depression.

7

YOUR EXERCISE

Let’s suppose you go to bed at 10.30pm and get up at 6.30am.

No caffeine in the form of tea, coffee or cold drinks after 6.30pm• No food or alcohol of any kind after 7.30pm• At 9.30pm stop all heavy mental activity and relax (preferably no electronic devices • at all)In your bedroom, minimize noise, light and excessive hot or cold temperatures• No non-sleep activities in the bedroom like reading, TV etc.• Try and wake up without an alarm clock after a few days of routine (preferably in •

the weekend if you work).

8 HOURS SLEEP A NIGHT

RECORD

Note in your diary pages how much sleep you have and the quality of that sleep, including if you wake up and how long you stay awake before getting back to sleep.

TIP: If you wake in the night and can’t get back to sleep, go through the alphabet naming one or more countries, mountains, flowers, animals etc. Focusing on something apart from your thoughts will help you to go back to sleep.

8

Exercise

HOW EXERCISE CAN IMPROVE YOUR LIFE

Exercise controls your weight by burning • calories. It’s a simple equation - you gain weight when the calories you burn, including those burned during physical activity, are less than the calories you eat or drink.

Exercise combats heart conditions, stroke, type • 2 diabetes, depression, arthritis, high blood pressure, high cholesterol levels and metabolic syndrome (a condition in which you have some combination of too much fat around the waist, high blood pressure, low HDL cholesterol, high triglycerides, or high blood sugar).

Exercise improves mood by stimulating various • brain chemicals that may leave you feeling happier and more relaxed and reduce your risk of depression. Regular physical activity can help keep your thinking, learning, and judgment skills sharp as you age.

Exercise boosts energy and improves your muscle and bone strength by • delivering oxygen and nutrients to your tissues and helping your cardiovascular system work more efficiently. It can slow the loss of bone density that comes with age.

Exercise helps you fall asleep faster and deepens your sleep. Just don’t exercise •

too close to bedtime.

9

WHAT EFFECT DOES EXERCISE HAVE ON IBS?

Exercise increases colonic motility, transit time, and transitive • intestinal gas. Exercise doesn’t seem to affect the symptomatic complaints of bloating, but it does change gas transit, so can help.

During exercise, the bowel typically quiets down because blood • is being pumped to other parts of the body. If you exercise regularly and become more physically fit, the bowel may tend to relax even during non-exercise periods.

Exercise helps tackle the psychological origins of stress by • triggering the release of endorphins (brain chemicals that improve mood and promote a sense of well-being).

WHAT EXERCISE SHOULD I DO?

It is best to minimize impact as this can irritate the internal organs including the small and large intestines. Suggestions are: cycling, walking, swimming, yoga, tai chi, pilates, golf, stretching and activities you enjoy.

Also try to schedule your exercise at least a few hours after a meal. It’s important to listen to your body, and if you are having an attack, it may be wise to ease off until you feel better.

10

RECORD

Note in your diary pages how much exercise you have done and what the exercise was. Also include the intensity of it and how you felt afterwards.

YOUR EXERCISE

MorningStretching and strengthening exercises for 15 minutes.

During the Daya) If you are used to exercising, continue doing so for at least 30 minutes, 5 times a week.b) If you usually don’t exercise or exercise sporadically, start with 15 minutes a day of gentle exercise for 5 days a week and increase gradually until you reach 30 minutes. Choose something like in the list above - cycling, walking, swimming, yoga, tai chi, pilates, golf, stretching.

EveningGentle stretching exercises for 5-10 minutes before bed.

20-30 MINUTES A DAY EXERCISE

TIP: In order for exercise to become a habit, you need to attach it to something else in your life which is already a part of your routine. For example: exercise after you put the washing machine on or after you get back from work.

11

Relaxation

There will always be a degree of stress in your life. That’s where relaxation techniques come into play. They can help counter the build-up of adrenaline which is released when under stress and bring you back to a state of calm. Relaxation physically changes the way your body functions. When your body is relaxed, breathing slows, blood pressure and oxygen consumption decrease.

RELAXING KEEPS YOUR HEART HEALTHYRelaxing lowers your heart rate, blood pressure and respiration rate.

RELAXING IMPROVES YOUR MEMORYShort bursts of stress impair the centres of the brain involved in memory and learning.

RELAXING LIFTS YOUR MOODIn humans, the prolonged presence of the stress hormone cortisol can reduce levels of serotonin and dopamine, which are linked to depression.

RELAXING KEEPS OFF THE WEIGHTCortisol (the stress hormone) increases the appetite. Stress makes it harder to resist comfort foods which are high in fat and sugar.

RELAXING REDUCES THE RISK OF STROKEStudies have shown that people who coped with stress the best had a lower risk of

strokes.

12

RELAXATION TECHNIQUES

Guided Imagery

This is a technique which uses guided imagery, creating mental images.Ocean Retreat Trip to the Beach

Progressive Muscle Relaxation

This involves tensing one muscle group at a time and then relaxing it until you have covered all the muscles in the body. This is great for tense, tight muscles.Head to ToeToe to Head

Deep Breathing

This forces you to breathe more deeply, rather than with the short, shallow breaths that stress creates.Deep breathing

13

YOUR EXERCISE

Schedule a time every day for 10 minutes (lengthen the time gradually). Be 1.

consistent, you will see results in a couple of weeks.

Find a quiet place without distractions or noise. If needed use earplugs to block 2.

sound and an eye pillow to block light.

Loosen or remove any jewellery or clothing that could distract you.3.

Sit or lie down (don’t lie down if this tends to send you to sleep) in a comfortable 4.

position.

Choose one of the three techniques above, click on the link and run the tape and 5.

let your body relax and empty your mind. Don’t try too hard though – it will come

with time.

10+ MINS A DAY RELAXATION

RECORD

Note in your diary pages how long you relax for and which exercise you used. Also indicate how you felt afterwards. You could even record when you have needed to use this technique during the day and how effective it was. You should see this become easier as time passes.

TIP: Place this in your schedule as a non-negotiable appointment. Get up 10 minutes early and do your relaxation exercise before your day starts.

14

Breakfast

You should consume your breakfast as soon as you get up or perhaps after a shower. Breakfast, as it says in the word, breaks the fast. And it’s important with IBS to do that as soon as possible. Our digestive systems hate to feel starved and react with symptoms as if we have eaten something high Fodmap. The food arriving into the digestive system will also activate the urge to have a bowel movement, and it is great to get that out of the way before the day fully starts.

WHAT SHALL I EAT?A good choice is a wheat/barley/rye-free cereal like oatmeal [1/4 cup when raw], cornflakes [3/4 cup], rice flakes [3/4 cup] etc., a low Fodmap fruit and lactose-free milk. Weak tea or coffee is optional. If you need more protein that the milk will provide, have an egg prepared how you prefer. If you are on the constipated side of IBS, I suggest oats and a kiwifruit, which has a mild laxative effect.

RECORDTake note in your diary pages, what you eat, how much and when you eat it. Also note how you feel after eating the meal.

TIP: Check the ingredients of any cereal you choose and make sure you recognize all the ingredients as low Fodmap.

15

TIP: The best combination is to have a protein, a carbohydrate and a fruit or vegetable sticks so that you don’t get hungry.

Snacks

You need to have two snacks a day in between your main meals and you need to keep all meals small since our digestive systems don’t like large amounts of food arriving at the same time. Make sure you have the first snack 3-5 hours after your breakfast and keep that same spacing for your meals throughout the day, making sure that your dinner is at least three hours before bedtime. If you get up late, still have your breakfast straightaway and perhaps skip the morning snack if it would be too close to lunchtime. But distribute any important food from the snack into your other meals so you are not eating less.

WHAT SHALL I EAT?Homemade baking, as long as not too starchy would be suitable. But some good alternatives are a few of the following - low Fodmap fruit (2-3 pieces a day), low Fodmap vegetable sticks, cottage cheese, hard cheese, peanut butter, tahini, canned fish, gluten-free crackers, lactose-free yogurt.


16

Lunch

Lunch is your third meal of the day and should be 3-5 hours after your morning snack. Make sure you stop work or whatever you are doing and take a complete break so you can focus on eating your food. Any kind of stress or tension will affect how the food is received and therefore will determine whether you get symptoms or not. After eating, don’t get up straightaway and start anything physical or stressful. Wait until the food has had time to arrive and the digestive process is well under way. Any stenuous exercise or work should be delayed for an hour or two.

TIP: Before you eat your dinner, put aside your lunch so that it doesn’t get eaten.

WHAT SHALL I EAT?Eating leftover dinner is the easiest way to take care of lunch whether you are eating at home or at work. Most work places have microwaves so you can heat it up. If there are no leftovers or if they are not suitable, a gluten-free sandwich with fresh sliced meat

and low Fodmap salad vegetables would be a good alternative.


17

Dinner

Eat you dinner 3-5 hours after your afternoon snack and at least three hours before bed. When planning your dinner, make sure it has protein, carbohydrate and vegetables. Carbohydrate gives you instant energy which doesn’t last long while the energy from protein takes a little longer to kick in but lasts longer. Combining the two at all five meals is

ideal for keeping away hunger, which is your enemy. Eat in a calm situation and don’t allow any heavy discussions with family during meals. You can schedule a family meeting for such matters. Keeping your digestive system happy is your first priority.

WHAT SHALL I EAT?This will depend on your preferences and whether you follow a particular eating regime like vegetarianism. However, as above, make sure you balance your meal well with all food groups while staying low Fodmap. This is the largest meal of the day in many cultures, but you have to cut back on what you would usually eat because now your food is being distributed between five meals instead of the traditional three.


TIP: Vary your proteins between red meat, chicken, fish, tofu etc. throughout the week.

18

Medication

Those on the low Fodmap diet sometimes forget that everything that is swallowed affects your gut, and that includes medication.Some medication like insulin for diabetics or high blood pressure pills are lifesaving and can’t be stopped. But that medication may contain high Fodmap inactive ingredients so do have a chat with your doctor and ask about all the ingredients in the medicine you are taking and not just the active ones. It can be possible to make a change if it is found that a certain medication is increasing your gastrointestinal problems.Many with IBS are on anti-depressant or anti-anxiety medication because they haven’t been absorbing tryptophan, which plays a part in regulating a person’s moods. This situation will gradually change as you start to actually absorb the nutrients in your food for the first time in ages. And so those medicines can be reduced under the careful supervision of your doctor – because many of them are habit-forming and the withdrawal from them has to be done with care.Many medicines have common side effects that affect the gut and so it’s almost impossible to know if it is food or pills that are causing symptoms. This is a very tricky situation and has to be handled with care.

TIP: Having a doctor who fully understands your personal situation and understands the concepts of the low Fodmap diet will go a long way to helping you resolve these problems together. If your doctor is uncooperative and doesn’t listen to your concerns, change doctor.

19

Supplements

Many people with IBS are taking a whole raft of supplements in an attempt to get better. And that is very understandable. But most of them will be unnecessary once you are eating a diet which is healthy for you because you will finally be absorbing all the nutrients in your food.

Some supplements contain high Fodmaps, and it takes some work to find the very best supplements which won’t hurt your gut. Regard every single thing that goes down into your gut with suspicion and do your research into them all. Google the ingredients and side effects of these things, become informed about what you are consuming and talk to your doctor or chemist about any doubts you have.

RECORDRecord on your diary pages all the supplements you are taking. If you are still having symptoms on a strict low Fodmap diet, then you have to start looking at your supplements.

TIP: Look for an ingredient ending in “ol” - it could be one of the Fodmap groups, a Polyol.

20

Water

Water is needed by every sytem in our body and makes up 60% of our body weight. Even mild dehydration will make us listless and tired.

HOW MUCH WATER DO YOU NEED?That depends on a variety of things:

How much exercise you do. A serious athlete will • require considerably more fluid than someone who walks for 20 minutes a day.

Location is important. Hot temperatures cause • loss of fluids through perspiration. Even heated interiors dry out your skin. Higher altitudes also cause a greater loss of hydration through increased respiration and urination.

Some illnesses like a bladder infection or a tummy • bug with diarrhea cause dehydration.

On average a man requires 3 litres and a woman needs 2.2 litres of fluid a day. Making sure that your urine is light yellow is a good test.

RECORDMake note of how many glasses you drink in a day and when you drank them.

TIP: Drink a glass of water with each of your 5 meals and a glass in between each meal.

21

Bowel Movements

During the elimination and reintroduction stages of the diet, it is important to monitor your bowel movements carefully and make adjustments to your diet according to your stools that day. On the next page you will see the Bristol Stool Chart. This is the generally accepted measure of a person’s stools. Our aim is to have a number 3 or 4 stool on a regular basis. This means that we are neither constipated nor have diarrhea. The average person has one to three bowel movements a day. But some people have one every two days or four movements a day. You have to find what is right for you. Create a routine that your body comes to recognize but the very best time to go is staright after breakfast before starting your day. If you need a second visit, make it just before bedtime so that you can have a good settled night’s sleep. A third time, if necessary, could be straight after lunch.

RECORDRecord any bowel movement you have during the day with the time and the type.

TIP: Don’t ignore an urge to visit the toilet especially if you are constipated. That can make the condition worse.

22

Bristol Stool Chart

Type 1 Separate hard lumps, like nuts - hard to pass

Type 2 Sausage-shaped but lumpy

Type 3 Like a sausage but with cracks on the surface

Type 4 Like a sausage or snake, smooth and soft

Type 5 Soft blobs with clear-cut edges

Type 6 Fluffy pieces with ragged edges, a mushy stool

Type 7 Watery, no solid pieces. Entirely liquid

23

Sleep ____________ hours From _____________ to ______________

Quality of sleep ___________________________________

Exercise ____________ hours From _____________ to _____________

Type _________________________________________________________

Relaxation ____________ minutes From _____________ to ______________

Type _________________________________________________________

Personal Challenge Tell someone close to you that you love them

Date: ___/___/___

24

Meal Time Notes/SymptomsBreakfast

Morning Snack

Lunch

Afternoon Snack

Dinner

Medication

Supplements

Total glasses of water

Bowel Movements


Quality of sleep ___________________________________


Type _________________________________________________________


Type _________________________________________________________

Date: ___/___/___

Quote “Don’t compare your beginning to someone else’s

middle.”

Jon Acuff