What to eat?

Posted by Bluegrass Gal @cindychesler, Nov 3, 2018

Hello, I suffer from IBS (diarrhea), GERD, diverticulosis and I have a hiatal hernia. Does anyone know of a successful eating guide that covers all of these conditions? Thanks in advance for your help.

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Hello, @cindychesler, and welcome to Mayo Clinic Connect. We have members who have talked about all the conditions you've mentioned - IBS (diarrhea), GERD, diverticulosis and hiatal hernia - so I'd like to introduce you to a few of them here: @safetyshield @falconfly @peabody88 @suez @musicflowers4u. I trust that they will have some input for you as you seek to determine the best way to eat with this combination of diagnoses.

Here is some guidance from Mayo Clinic on diet individually addressing the conditions you mentioned:

- IBS diet and other lifestyle guidance: https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/the-role-of-lifestyle-related-treatments-for-ibs/mac-20431272

- Lack of restrictive diet needed for GERD: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-restrictive-diet-usually-not-necessary-to-control-symptoms-of-gerd/

- Hiatial hernia (see Lifestyle and Home Remedies section): https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/diagnosis-treatment/drc-20373385

- Diverticulosis diet: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/diverticulitis-diet/art-20048499

@cindychesler - has your physician in gastroenterology or a dietician offered guidance on an appropriate eating plan customized to your mix of diagnoses?

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I am presently following the Specific Carbohydrate. Diet under the guidance of a nutritionist. It limits or forbids the use of dairy, gluten, all grains and complex carbs (those that remain longer in the intestines, are harder to digest, and bad bacteria tend to feed on or ferment). It is a fairly restrictive diet, similar to GAPS. There is also the low FODMAP diet which is less restrictive and allows for rice, yams and potatoes. I was purchasing gluten free products without realizing they are made with rice and potato flour. Therefore I would do a little better, then eat half of a gluten free muffin and end up with diarrhea. It was not until I eliminated all complex carbs and grains (which was only two weeks ago) that I started to improve. My stools are now gradually more solid and I only go once or twice a day. There is a book readily available on Amazon called Breaking The VIcious Cycle. Costs $20.00 for paperback version and it is not hard to read. Diet is restrictive and the only carbs you are allowed are those coming from fruit. There are also lots of You Tube videos you can watch for free.

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@guthealth

I am presently following the Specific Carbohydrate. Diet under the guidance of a nutritionist. It limits or forbids the use of dairy, gluten, all grains and complex carbs (those that remain longer in the intestines, are harder to digest, and bad bacteria tend to feed on or ferment). It is a fairly restrictive diet, similar to GAPS. There is also the low FODMAP diet which is less restrictive and allows for rice, yams and potatoes. I was purchasing gluten free products without realizing they are made with rice and potato flour. Therefore I would do a little better, then eat half of a gluten free muffin and end up with diarrhea. It was not until I eliminated all complex carbs and grains (which was only two weeks ago) that I started to improve. My stools are now gradually more solid and I only go once or twice a day. There is a book readily available on Amazon called Breaking The VIcious Cycle. Costs $20.00 for paperback version and it is not hard to read. Diet is restrictive and the only carbs you are allowed are those coming from fruit. There are also lots of You Tube videos you can watch for free.

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I must add that my diagnosis is less clear cut than yours. My symptoms (mainly diarrhea) started three months ago) after taking two different antibiotics for two different conditions. It was first thought I had CDiff. Then SIBO. I was given two more rounds of antibiotics which always helped for a week or so and then I gradually slipped back into diarrhea. It was only after the second round of antibiotics that GI doc recommended a nutrición consult. Also lost a great deal of weight.

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@lisalucier

Hello, @cindychesler, and welcome to Mayo Clinic Connect. We have members who have talked about all the conditions you've mentioned - IBS (diarrhea), GERD, diverticulosis and hiatal hernia - so I'd like to introduce you to a few of them here: @safetyshield @falconfly @peabody88 @suez @musicflowers4u. I trust that they will have some input for you as you seek to determine the best way to eat with this combination of diagnoses.

Here is some guidance from Mayo Clinic on diet individually addressing the conditions you mentioned:

- IBS diet and other lifestyle guidance: https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/the-role-of-lifestyle-related-treatments-for-ibs/mac-20431272

- Lack of restrictive diet needed for GERD: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-restrictive-diet-usually-not-necessary-to-control-symptoms-of-gerd/

- Hiatial hernia (see Lifestyle and Home Remedies section): https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/diagnosis-treatment/drc-20373385

- Diverticulosis diet: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/diverticulitis-diet/art-20048499

@cindychesler - has your physician in gastroenterology or a dietician offered guidance on an appropriate eating plan customized to your mix of diagnoses?

Jump to this post

My primary care physician referred me to a dietitian. The dietitian suggested I try FODMAP to determine my triggers. The dietitian also referred me to a gastroenterologist who recommended I NOT try FODMAP. She (Gastroenteroligist) said it was a last resort and to delay following up with the dietitian. She did a colonoscopy which turned up nothing of note. After the colonoscopy I followed up with the Gastro's nurse practitioner who had ZERO eating guidance. Color me frustrated.

Thanks for the links above, I will check them out.

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@guthealth

I am presently following the Specific Carbohydrate. Diet under the guidance of a nutritionist. It limits or forbids the use of dairy, gluten, all grains and complex carbs (those that remain longer in the intestines, are harder to digest, and bad bacteria tend to feed on or ferment). It is a fairly restrictive diet, similar to GAPS. There is also the low FODMAP diet which is less restrictive and allows for rice, yams and potatoes. I was purchasing gluten free products without realizing they are made with rice and potato flour. Therefore I would do a little better, then eat half of a gluten free muffin and end up with diarrhea. It was not until I eliminated all complex carbs and grains (which was only two weeks ago) that I started to improve. My stools are now gradually more solid and I only go once or twice a day. There is a book readily available on Amazon called Breaking The VIcious Cycle. Costs $20.00 for paperback version and it is not hard to read. Diet is restrictive and the only carbs you are allowed are those coming from fruit. There are also lots of You Tube videos you can watch for free.

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Thank you.

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@cindychesler

My primary care physician referred me to a dietitian. The dietitian suggested I try FODMAP to determine my triggers. The dietitian also referred me to a gastroenterologist who recommended I NOT try FODMAP. She (Gastroenteroligist) said it was a last resort and to delay following up with the dietitian. She did a colonoscopy which turned up nothing of note. After the colonoscopy I followed up with the Gastro's nurse practitioner who had ZERO eating guidance. Color me frustrated.

Thanks for the links above, I will check them out.

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I know what you mean. Low FODMAP should not be last resort but part of a healing regimen that includes medication, nutrition and medical guidance. I started with Low FODMAP and have now moved to the Specific Carbohydrate Diet. I had been doing pretty well for two weeks (minus a setback caused by eating raisins), but today I introduced homemade yogurt which was probably a mistake because I have been bloated all afternoon. So I am sort of depressed again, thinking I am back to square one. It shall pass.

For a simple case of diarrhea no special diet is needed usually, for the rest of us with chronic diarrhea following a diet that avoids irritation to the gut is a must. I don’t have a specific diagnosis. We started out with CDiff (two different tests were negative), then we moved to SIBO, but that is not clear. GI doc does not think I have Chrons or UC because he thinks I am too old to develop those and a CT scan of my digestive track looked totally normal, but I may have something called microscopic colitis, which is more typical to develop for someone in their sixties like me. Had a normal colonoscopy last year but will likely have another before end of year if I don’t improve on diet. This is all crazy making because we hear such disparate advice and it takes a long time to arrive at anything definitive. Very frustrating and lonely process. This is why I post. You feel like the only person with these problems who can’t eat anything and is always worrying about having a bad reaction to food and running to bathroom. Thank you to everyone who reads and responds to these posts.

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@guthealth

I know what you mean. Low FODMAP should not be last resort but part of a healing regimen that includes medication, nutrition and medical guidance. I started with Low FODMAP and have now moved to the Specific Carbohydrate Diet. I had been doing pretty well for two weeks (minus a setback caused by eating raisins), but today I introduced homemade yogurt which was probably a mistake because I have been bloated all afternoon. So I am sort of depressed again, thinking I am back to square one. It shall pass.

For a simple case of diarrhea no special diet is needed usually, for the rest of us with chronic diarrhea following a diet that avoids irritation to the gut is a must. I don’t have a specific diagnosis. We started out with CDiff (two different tests were negative), then we moved to SIBO, but that is not clear. GI doc does not think I have Chrons or UC because he thinks I am too old to develop those and a CT scan of my digestive track looked totally normal, but I may have something called microscopic colitis, which is more typical to develop for someone in their sixties like me. Had a normal colonoscopy last year but will likely have another before end of year if I don’t improve on diet. This is all crazy making because we hear such disparate advice and it takes a long time to arrive at anything definitive. Very frustrating and lonely process. This is why I post. You feel like the only person with these problems who can’t eat anything and is always worrying about having a bad reaction to food and running to bathroom. Thank you to everyone who reads and responds to these posts.

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Hi there, were you ever able to find out what was causing your symptoms? I am in similar boat and have my first visit with Mayo on 3/29 in Rochester.

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About 1-1/2 months ago as I was leaving a store, I suddenly felt nauseated. After that I just didn't feel good for several days and I realized I had not had a bowel movement for about 4 days - I've always been a "constipated one." So I started my usual Metamucil, which seemed to do nothing but make me feel sicker. So I went to my doctor, and having just had a colonoscopy about 2 months before, and since the whole hospital system is connected, my family doctor was able to go into it and see what it showed. Sure enough, there were a good many polyps and I was dealing with diverticulosis .... not diverticulitis which is when infection sets in. So, he started me on Miralax, and we went through all the foods I should no longer eat. OH MY! So many are foods I really love .... fresh raspberries, nuts ... anything that could get stuck behind one of those polyps; and of course I had to add a whole lot more fiber. Well, that is working and I have discovered that there are acually foods that I do really like that are high fiber. I'm doing better, but really need on concentrate on drinking plenty of water also. My question was, if the doctor that did the colonoscopy saw several polyps, why didn't he clip them out? Hmmmm ..... I'm thinking of calling him and just asking. I'm curious about that.
Barb

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@amberpep

About 1-1/2 months ago as I was leaving a store, I suddenly felt nauseated. After that I just didn't feel good for several days and I realized I had not had a bowel movement for about 4 days - I've always been a "constipated one." So I started my usual Metamucil, which seemed to do nothing but make me feel sicker. So I went to my doctor, and having just had a colonoscopy about 2 months before, and since the whole hospital system is connected, my family doctor was able to go into it and see what it showed. Sure enough, there were a good many polyps and I was dealing with diverticulosis .... not diverticulitis which is when infection sets in. So, he started me on Miralax, and we went through all the foods I should no longer eat. OH MY! So many are foods I really love .... fresh raspberries, nuts ... anything that could get stuck behind one of those polyps; and of course I had to add a whole lot more fiber. Well, that is working and I have discovered that there are acually foods that I do really like that are high fiber. I'm doing better, but really need on concentrate on drinking plenty of water also. My question was, if the doctor that did the colonoscopy saw several polyps, why didn't he clip them out? Hmmmm ..... I'm thinking of calling him and just asking. I'm curious about that.
Barb

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I have that too Diverticulosis besides 6 other major digestive disorders diagnoses.
I’ve had 3 colonoscopy’s in my life . I’m not sure if they saw polyps, but if I were you .. I would def call Dr. And Ask why they weren’t removed . I have lot of flat polyps on my stomach lining but they didn’t remove them during last endoscopy either .
I’m a mess 8 years in.
Best wishes to you …

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@amberpep

About 1-1/2 months ago as I was leaving a store, I suddenly felt nauseated. After that I just didn't feel good for several days and I realized I had not had a bowel movement for about 4 days - I've always been a "constipated one." So I started my usual Metamucil, which seemed to do nothing but make me feel sicker. So I went to my doctor, and having just had a colonoscopy about 2 months before, and since the whole hospital system is connected, my family doctor was able to go into it and see what it showed. Sure enough, there were a good many polyps and I was dealing with diverticulosis .... not diverticulitis which is when infection sets in. So, he started me on Miralax, and we went through all the foods I should no longer eat. OH MY! So many are foods I really love .... fresh raspberries, nuts ... anything that could get stuck behind one of those polyps; and of course I had to add a whole lot more fiber. Well, that is working and I have discovered that there are acually foods that I do really like that are high fiber. I'm doing better, but really need on concentrate on drinking plenty of water also. My question was, if the doctor that did the colonoscopy saw several polyps, why didn't he clip them out? Hmmmm ..... I'm thinking of calling him and just asking. I'm curious about that.
Barb

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I would have the same question. Good luck!

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