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New to crohn's and need to find food triggers but need help

Hi All,

It was confirmed yesterday that i have a mild case of crohn's and was told that while i am waiting to see the specialist in a few weeks, that i need to start filling out a food diary to see if i can find my food triggers.

So my question is how do i know? just say i get my stomach pain this afternoon how far back would the food be that i ate to cause it?? (if that's how it even works)

I am just so confused and google gives me different answers and my GP wasn't much help either
 
Hi! Welcome to the forum.

I would just jot down what you eat each day and note when you have pain or worsened symptoms. That will help you narrow it down a bit. Then you can cut out the food you think was the issue. It really is trial and error. I usually get pain fairly quickly (within a couple of hours) of eating something that my gut is not ok with. The journal will help you to remember what you ate and make it easier to compare from day to day.
 
Who's asked you to complete a food diary? If you're seeing a dietician, he/she will help you interpret.

My experience has been that working out triggers is much more complicated than you think. I react to aspects of my diet other than specific foods, especially the overall volume of food I consume and the overall fibre content. For me, it can take several days or more to induce changes in symptoms, e.g. a week on a low fibre diet to see the difference from a high fibre diet.

I'd keep a record and look at obvious candidates for triggers and see how much of them you're eating. You can get an idea of common triggers from reading online guides to diet and Crohn's, or threads like this one on the forum: http://www.crohnsforum.com/showthread.php?t=17707
Or start a new thread asking people what their trigger foods are. Then when you've filled out a few days of a diary of your typical diet and symptoms, look for relationships between foods and symptoms, but use your knowledge of other peoples' safe and trigger foods to guide you and help you see what you may be looking for.

For example, high fibre foods are hard for many people, so high fibre foods are one thing you could look out for when assessing your own food diary. Other common triggers are spicy foods, dairy and alcohol. You won't necessarily find you react to these common triggers, but they can help you narrow down where to start looking.

I recommend: look for consistent reactions (same reaction to a food every time you eat it)
Look out for common triggers and common safe foods
Look at your overall diet as well as at specific foods (e.g. think about whether you eat a lot, whether your diet is high in fat, high in fibre)
Remember the amount of a food you eat can make a difference
Remember you are almost certainly getting symptoms unrelated to food, or symptoms that occur after eating regardless of what you ate, so if you get symptoms after eating, it doesn't necessarily mean the food caused it
Once you think you have some idea of what your trigger foods are, try eliminating one for at least several days, preferably a couple of weeks, and see if you're feeling any better without it. Change one element of your diet at a time so you know which is making any differences you observe

And importantly - don't stress about it or overthink things. If you get confused, just keep the record and let the specialist try interpreting them, or see a dietician.
 
It's a long road so try to enjoy the walk,
Some spend years struggling and others quickly stumble onto something that works for them
...... that i need to start filling out a food diary to see if i can find my food triggers.
Alongside the food you eat keep a note of how you feel, tired, happy, pain, gas, everything you can be bothered with.
It is a useful tool as patterns may become obvious
If every time you see the same symptoms after the same food then you can begin to form assumptions that you can test. (Exclude that food for a while and see if it happens when you reintroduce it).

So my question is how do i know? just say i get my stomach pain this afternoon how far back would the food be that i ate to cause it?? (if that's how it even works)
There are some things that will cause an instant (or pretty damn quick) reaction, these will be the easiest to see. Like dairy causing cramps or diarrhoea after coffee, you will pick these up pretty quickly.....
There are others that take a few days/weeks to filter through like rhinitis, depression, eczema, arthritis, fatigue, boils, general worsening of symptoms.
These take a bit longer and is where the diary really becomes useful.
And then there are the things that you might think of as your friends (toast, pasta, easy to digest processed foods) that might be feeding the disbiosis that is causing (or contributing to) an immune reaction that is causing (or contributing to) the disease (just saying maybe, the science is not without controversy)

You can spend years chipping away at the symptoms (this food make me gassy, this food causes cramps). This is a good thing to do as it improves quality of life and reduces symptoms but these are all the end-product of a severely disrupted gut microbiome

I am just so confused and google gives me different answers and my GP wasn't much help either
Don't stress,, spend some time reading and sorting out which ones sound like they are worth investigating. There are some themes that will turn up repeatedly (like disbiosis) There are some measures that have worked for many but also failed for many (or in an unknown percentage some have failed to understand the subtleties of the course they were following).

I'm just one of the many voices and you will decide which ones to listen to (as you get better at listening to yourself)

The following just for you to consider as you wonder where to go next, and if you do your own research and call bullshit on any or all of it, i'm quite happy with that......

My own belief is that the main factor is disbiosis[1], (whether is is caused by stress, antibiotics, preservatives, infections, chemicals, processed foods, or excessive (acellular) carbs[2] or a combination of some or all of these and more besides is irrelevant).
For most of our existence we would have eaten all the carbs we could find (because they are a great source of energy) but they were locked up inside cells and were digested lower in the intestine, now most carb sources are virtually pre-digested. One of the things this causes is a massive overgrowth of bacteria in the small intestine, and leads to our immune system attacking the bacteria, and then you have a disease.

Some of the most popular diets to bring this under control are SCD[3], GAPS[4] and (old school cordainian) paleo[5],
These rely on severely restricting the carb intake to bring any bacterial overgrowth under control, and for many it works, but i do not see them as sensible long term diets (I see them as a sensible step towards a long term diet (like "Perfect Health Diet"[6] or Pegan[7]))

Perhaps the most interesting one i've seen is the Paleo AI[8] protocol, unlike old school paleo it does allow carbs like tubers, plantain (those similar to what out forebears would have eaten) but severely restrict everything likely to cause a problem and gradually reintroduces them in a staged manner starting with those least likely to cause issues so as to enrich the (severely restricted) diet as quickly as possible (SCD and GAPS also do this but both rely on older science and philosophy, and include more potentially problematic foods earlier on)

I'm NOT saying you should try them, but you may wish to read up so you can decide if it makes sense and incorporate what works for you , (for instance, i have found i am much better off without (especially) wheat and all grains except rice, which is fine, but i did go through a period of very low carb before reintroducing it)

[1] “Inflammatory bowel diseases (IBDs), including Crohn's disease (CD), are genetically linked to host pathways that implicate an underlying role for aberrant immune responses to intestinal microbiota.”
http://www.ncbi.nlm.nih.gov/pubmed/24629344
“Microbe profiles identify the ileum as the primary inductive site for all forms of CD and may direct prognostic and therapeutic approaches,”
http://www.medicaldaily.com/crohns-...acteristics-expressed-small-intestines-292008
“This study provides the first evidence that quantifiable bacterial protein signals are associated with CD, which can have a profound impact on future molecular diagnosis.”
http://gut.bmj.com/content/early/2014/01/16/gutjnl-2012-303786.long
“A more useful and relevant paradigm for the etiology of CD might be based on the idea of a pathogenic microbial community profile and might emphasize the role of interactive sets of microbes, rather than the role of individual organisms. “
“Several lines of evidence implicate microorganisms or the intestinal microbiota in the pathogenesis of CD. “

http://cid.oxfordjournals.org/content/44/2/256.full
+ hundreds of of similar studies

[2]my current favourite.......(ask me again next week and it may be different)
Carb related inflammation
http://www.crohnsforum.com/showthread.php?t=72911

[3] I don't think SCD is necessarily the best diet, but it is the best supported
SCDlifestyle.com is a great resource, but only one of many SCD websites
http://scdlifestyle.com/scd-quick-s...WmES93-MC61w4Or12cTlAEAK6WCa9H75jbxoCsTHw_wcB
scd starts with the intro diet
http://pecanbread.com/f/how/introdiet.html
then the stages of reintroduction
these stages are what makes it an elimination diet, you don't eat many foods and gradually reintroduce foods to check there tolerance. This is also the step most people don't follow....
“Introduce ONE new food at a time- a two to four day interval is a great (but not mandatory) guideline for introducing new foods. This will make it possible determine whether each new food can be tolerated. “
http://pecanbread.com/p/how/stages.html

[4] An updated version of SCD (SCD being 40 or more years old)
THE GAPS DIET
http://gapsdiet.com/

[5] talks on paleo and IBD by Dr. Joseph Brasco of the Huntsville Center for Colon and Digestive Disease
http://www.crohnsforum.com/showthread.php?t=48559

[6] The Perfect Health Diet
http://perfecthealthdiet.com/the-diet/
and his take on IBD (in four parts)
Bowel Disorders, Part I: About Gut Disease
“If we prioritize these in terms of damage caused, then ulcerative colitis is an infectious and autoimmune disease, since these two factors do the most severe damage. It is generally unclear which is doing the most damage. Food toxins and malnutrition continue to be secondary sources of damage.
On the other hand, if we prioritize chronologically in terms of the original causes, the disease is originally caused by food toxins and malnutrition and sometimes antibiotics, which cause intestinal damage and infections, followed by autoimmunity.“

http://perfecthealthdiet.com/2010/07/ulcerative-colitis-a-devastating-gut-disease/

[7] Why I am a Pegan – or Paleo-Vegan – and Why You Should Be Too!
http://drhyman.com/blog/2014/11/07/pegan-paleo-vegan/

- Perfect Health Diet is at the upper meat end and Pegan is at the lower meat end, whatever works for you

[8] The Autoimmune Protocol
http://www.thepaleomom.com/autoimmunity/the-autoimmune-protocol


There is plenty online to research all these ideas, and only spend money if you need to, most books will be available through libraries.......
 
My 2 cents
Keep a food log with symptoms
But at least for Ds right after dx everything was so inflamed it didn't really matter what he ate ( including een -formula only ) he felt horrid until the inflammation went down by meds .

I will say the residual "stuff" -abdominal pain bm frequency etc has been extremely reduced by adding diet restrictions to his meds
He is 11 now and has been dx for almost 4 years

Two diets we looked at with his Gi are
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896778/?report=classic

Ibd -aid diet ( ibd-anti inflammtory diet)
And
Partial enteral nutrition crohns exclusive diet
http://www.ncbi.nlm.nih.gov/m/pubmed/24983973/

Even though both have lists of foods that were "safe" for the folks in the study
Ds doesn't always follow those same rules
We use those as a guide of things to try
And then retry to determine if we get the same response
So it still is very individual
 
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