Low FODMAP Diet--Unusual symptom changes?

Hello all,

I'm curious as to whether anyone has any insight into this:

A few months ago, my Doctor recommended that I try the low FODMAP diet. In general, it has worked wondefully: I've gained weight, no longer have diarrhea, rarely experience pain from inflammation, and in general feel like a normal person (other than the extensive dietary restrictions, of course).

However, about once every 2-4 weeks, I'll suddenly crash--over the course of a day, I'll move from having a stomach ache to having abdominal distension, incredible belching, unbearable pain, and intense nausea. I will be unable to eat, unable to use the restroom, and generally vomit three to four times during the course of the day. The next day, other than being exhausted and slightly inflamed, I feel significantly better, and can resume eating. Usually I will have a few loose BMs, which clear up over the course of 24 hours.

Crohn's has almost never made me vomit before, and now its the primary symptom! My problems are much less frequent but much more intense, and I don't know why. My doctor seems unconcerned, since my day to day symptoms are so much better--however, if your car caught fire once a month, you wouldn't be thrilled with your good gas mileage, right?

Often this happens after some deviation from the diet--I'll admit that I'm weak willed when it comes to sticking with the elimination phase. However, I find it very strange that my symptoms have shifted in such a drastic way. Has anyone else experienced anything like this, or have any idea why the sudden shift? Any idea what I can do about it? As background, I have no surgery, am taking 4.5 grams of Pentasa and 100mg of Imuran a day, and am a 24 year old male. Thanks so much for reading this long post!

What kind of diet deviations are you having? Keep a log and maybe you can pinpoint a specific type of food really aggravating you.

Well, just a guess, but with the occasional throwing up you might have stubbled across a food you are highly sensitive to. With straying from the diet from time to time, a food journal might be helpful.

I've been well a few times to the gut using very limited elimination diets. It was when I began expanding the diet that eventually I would run into troubles. Recall the time when I was the most well using an elimination diet, and decided to add pumpkin seeds to a meal. About three hours later I found myself throwing up a number of times, along with feeling awful overall. I'm similar to you in that I typically have not thrown up from my IBD. This was something new. At the time remember thinking I probably just bought some bad rotten seeds. Later eating some pumpkin seeds the same exact reaction happened, throwing up, gut in a knot, and getting chills. I figure for me, pumpkin is allergen. Thankfully it is something easy to avoid.

Having a probable pumpkin seed and possibly pumpkin allergy gives the spookiness for Halloween additional meaning too.

HungerPains said:

Often this happens after some deviation from the diet--!

Click to expand...

hmmmmm, i think there's a clue there.

Sounds more like an in intolerance to me,
how 'bout every time you slip you make a note of it and match up the food to the pain?
easier than a full on food log.

Thanks for the advice, all!

I've been keeping a log for the past month, and it has been hugely helpful--both in diagnosing problems and in creating an illusion of control (hugely helpful for the emotional management of the disease!)

The past two times I've had sour cream, I've been ill, so that's out--even though its on many fodmap safe lists, and dairy never seems to have bothered me before. I used to eat a lot of ice cream, cereal with milk, etc, so someone suggested to me it might have to do with the cultures which make sour cream, well, sour--I wonder if that's possible?

For those of you with allergies and IBS, did you have the allergies before, or did the development of allergies coincide or follow the onset of IBS? I've never had allergies, but its never too late to try something new, right...?

One strong theory on food intolerances is that 'leaky gut' or intestinal permeability allows undigested food particles (along with bacteria, fungus, parasites and faecal matter) into the bloodstream leading to food intolerance AND immune reactions, so the same cause for crohns and intolerance.

"The lining of the digestive tract can be damaged by overuse of antibiotics, nonsteroidal anti-inflammatory drugs, chemotherapy, alcohol consumption, antacids, too much sugar, stress, bacteria, toxic chemicals, parasites, fungal infection, some foods and various other means. A leaky gut allows food particles to enter the blood stream undigested, thus leading to food intolerances.

Leaky gut and incomplete digestion go hand in hand. Leaky gut allows not only oversized undigested particles to enter the blood stream but also bacteria, viruses, fungi, and parasites. When this happens there is an alarm that goes off in the immune system. The immune system builds antibodies against these foreign molecules. This leads to a vicious cycle of allergic and autoimmune responses. Every time we eat something there is a lot of stress for the body that has a leaky gut. The longer this leaky gut and incomplete digestion exists, the less able the body systems are able to function correctly."
http://transformationalmedicine.com/patient-information/disorders-of-digestion-and-gut/

One of the main causes of leaky gut (not the only one) is gluten in particular and grains in general
http://www.fourhourworkweek.com/blog/2010/09/19/paleo-diet-solution/