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Digestive Health, Stomach & Intestinal Problems

  1. Where can I find a dietitian who works with people who have stomach or intestinal problems? Answer
  2. Several weeks ago, I began having pains in my abdomen. At first I thought I was constipated. Answer
  3. I have searched the Internet for a list of foods which would be on a bland diet. Answer
  4. My girl friend says her doctor told her she had a high level of yeast in her system. Answer
  5. Candida does exist and will continue to exist. Answer
  6. Could you please send information for a woman who has recently had stomach surgery and has been placed on a diet requiring "only soft, non fibrous foods"? Answer
  7. My stomach is quite inflamed and I am still experiencing pain and discomfort. Answer
  8. I couldn't spot one for irritable bowel syndrome. I plan to see a nutritionist in order to develop an eating plan to deal with this disorder. Answer
  9. Can you refresh my memory about what an anti-dumping diet is? Answer

  10. Could you help me track down accurate information about fibromyalgia, candida albicans, leaky gut syndrome and chronic fatigue syndrome? Answer
  11. What is the average volume & concentration of stomach acid produced to digest an average meal? Answer
  12. I have gas all the time. Do you have any suggestions for this problem? Answer
  13. I have irritable bowel syndrome. I have a lot of acid in my system. Answer
  14. I have diverticulitis and my doctor gave me a hgh fiber diet. Do you have a good diet for me? Answer
  15. I have a terrible proble with digesting corn, broccoli, peppers, cauliflower and other favorite veggies that I love. They cause abdominal cramps with burping and gas. Answer
  16. I have Crohn's disease. My fingernails are brittle and peeling. Could this be from a deficiency in a certain vitamin? Answer
  17. I was diagnosed with irritable bowel syndrome as well as lactose intolerance. Are there foods good for IBS suffers? Answer
  18. What type of diet would you recommend for someone who has an ulcer? Answer
  19. An in-law has diverticulitis. My wife was interested in finding recipes and learning how to prepare meals. Answer

  20. My wife has been told by a naturopath / homeopath that she has candiditis in her gut. Is it necessary to cut all sugars or are there other foods? Answer
  21. Could you give me a diet on irritable bowel syndrome? It's for my wife. Answer
  22. I have a GI disorder known as Crohn's disease. What do you recommend to drink on a liquid diet? Answer
  23. My wife is having problems with irritable bowel syndrome. Can you recommend a diet, herbs or something to help? Answer
  24. Why do you say heartburn ins a symptom of hypochlorhydria? Answer
  25. What foods produce acid? Answer
  26. I have a pain in my stomach after I eat. I feel the need to burp for a few hours after a meal. Answer

Where can I find a dietitian who works with people who have stomach or intestinal problems?

The Medical Nutrition and Nutrition Entrepreneurs dietetic practice groups of the Academy of Nutrition and Dietetics provide medical nutrition therapy based on your diagnosis. Dietitians often have their own private practice nutrition counseling services in addition to services provided in a clinic or hospital. You can find a dietitian at the Academy of Nutrition and Dietetics. Include your zip code or city / state, the type of service you want (individual consultation) and expertise in digestive disorders and gastrointestinal diseases / disorders.

I am writing to you because I am at my wits end! Several weeks ago, I began having pains in my abdomen. At first I thought I was constipated and the pain was being caused by the constipation. But my bowel movements became more normal and the pain persisted. I next thought that the pain may be cramps from my period. I went off the birth control pill three months ago and for the past month I have been having my period almost constantly (excepting about 2 days), and it is quite heavy. However, the pain I am having doesn't feel the same as cramps. In the past week, the pain has become far, far worse. I have difficulty moving, breathing deeply, yawning, etc. (The pain is always there, though becomes more intense with the activities mentioned.) I feel it in my lower right side and often up further at my stomach. Just today, I noticed the pain in my back on the right side as well. It is a cramping, stabbing pain. The pain although always present intensifies within an hour of eating. This usually lasts several hours.

Two days ago, after a sleepless and painful night, I checked myself into emergency because I could barely walk. They did blood tests, urine analysis, and both an abdominal and a pelvic ultrasound. They told me to go home because everything seemed normal! The next day, I underwent a gastroscopy (not at all pleasant!) and again nothing was found.

I am so worried and frustrated. The pain is keeping me from work and I even find it painful to walk around the house. The doctors cannot seem to find anything wrong.

Do you have any insight or suggestions? Please, let me know what you think, even if it's already been ruled out, I would like your opinion.

Thank you so much.

First, I am not a doctor and I would highly recommend you aggressively pursue the cause of your pain with one. Pain is your body's way of telling you something is wrong. There are many organs in your abdomen including stomach, gall bladder, pancreas, liver, spleen, intestines including appendix, reproductive organs, kidney and bladder any of which could be the cause of your pain.

Since your periods are abnormal, I would also recommend you see your gynecologist as well. If you are sexually active and off birth control, it is possible you could be pregnant or have a tubal pregnancy. Some women bleed even when pregnant especially when the placenta is laying over the cervix.

It may be your gallbladder since the pain is associated with eating. Gallbladder pain is more at the end of your breast bone and radiates around to your back. Pancreatitis is quite painful as well as kidney stones.

Now go see another doctor and advocate for yourself until you find the cause of your abdominal pain. Don't give up as pain is not normal.

I have searched the Internet for a list of foods which would be on a bland diet. Can you help me? I would greatly appreciate the diet.

Prior to 1991, bland nutrition therapy was used to treat gastritis (inflammation of the stomach lining), ulcers (sores in the stomach or intestines) and reflux esophagitis (inflammation of the throat) or GERD (Gastroesophageal reflux disease). The purpose of a bland nutrition therapy was to eliminate foods which chemically or mechanically irritated the lining of the stomach and throat or those that stimulate gastric acid (stomach hydrochloric acid) secretion. Traditional bland nutrition therapy provided milk and cream frequently throughout the day to coat the stomach and neutralize acids. Only foods mild in flavor and low in fiber were allowed, in order to prevent irritation. Small meals were provided 4 to 6 times a day, so the stomach would never be empty and exposed to undiluted acid.

Small frequent meals have not been found to be more protective than the traditional 3 meals per day. Large meals that distend the stomach are not recommended. Citrus fruits (orange, grapefruit, lemon, lime) may cause some acid reflux.

Caffeine and alcohol were excluded and are still not recommended especially distilled spirits >40% alcohol. Caffeine containing beverages stimulates gastric acid and is not recommended. Decaffeinated coffee stimulates gastric acid as well and is not recommended.

However, research has shown that the traditional bland nutrition therapy neither heals nor prevents recurrent attacks of ulcers or gastritis. Some research has shown that drinking large amounts of milk may actually stimulate the release of acid and has only a transient buffering effect on stomach acid. The fat content of milk has no effect on stomach acid either. In addition, spicy foods were not found to damage stomach lining and people who regularly eat spicy foods are not at any higher risk of developing ulcers. Black pepper, red pepper and chili powder have no detrimental effect on duodenal (intestinal) ulcer healing. Daily pepper use may have a protective effect on cells. People with ulcers should avoid any food that they feel causes them gastric discomfort because there may be some psychological benefit to eating bland foods for short periods of acute pain.

Another major reason for abandoning the traditional bland nutrition therapy is that some of its recommendations oppose dietary recommendations for a healthy eating plan. For example, the traditional bland nutrition therapy recommended a low fiber intake. Eating foods low in fiber is not healthy, as it may increase the chance of colon cancer. High fiber foods are important in maintaining intestinal health, weight control, blood sugar regulation and blood lipid control.

Lastly many stomach ulcers are caused by H-Pylori and are treatable by antibiotics. Because of findings such as these, the traditional bland nutrition therapy has been discontinued.

My girl friend says her doctor told her she had a high level of yeast in her system. She says that has been normal for her. What I would like to know is what kind of food should I prepare for her to help keep her healthy?

We are both 50 years old and active. We are both sales people and on the road a lot. She seems to have a hard time getting healthy meals during the week. On weekends, when we are usually together, I do most of the cooking. She feels she needs to stay away from pasta and bread. Thanks for your help.

If your girlfriend's doctor thinks she has a yeast infection, he / she will treat it with anti-fungal medications. What do you mean by high levels of yeast in your girlfriend's system? How was this measured?

Candida albicans commonly known as yeast is a fungus normally present sometimes on the skin and normally in the digestive tract. Yeast infections can occur in persons with suppressed immune systems and people undergoing chemotherapy. Often urinary tract infections (UTI) are caused by yeast that becomes pathological in the bladder or kidneys.

Living on the road is not always conducive to eating well, so here are a few tips for trying to make the journey healthier.
  • Pack healthy snacks for in the car, such as fruits, vegetables, or a trail mix made of your favorite dried fruits and nuts.
  • Try to choose meals at restaurants that are on the "lighter side" of the menu.
  • When stopping for a coffee or soda on the road, pick up a bottle of water as well.

There is no causal relationship between eating bread and more yeast in your body. Pasta doesn't have yeast as an ingredient so I don't know why your girlfriend grouped it with bread. Why not rice which has the same amount of carbohydrate as pasta? Carbohydrates and fiber in particular feed the normal bacteria in your large intestines. Since your girlfriend is staying away from them, I am concerned that she is not eating enough carbohydrate to maintain her energy needs. Fifty to 60 percent of a person's calories should come from carbohydrate. I encourage you to include bread and pasta in your cooking and meals.

It is pathetic and unfortunate that a doctor of your claimed stature instantly diagnoses people over the internet who have valid nutritional deficient diseases. Your intentions, I am sure are humane, yet you (as all your "medical science" brethren do) erroneously lump individual nutritional problems into easy "scientific" categories. Candida does exist and will continue to exist as long as "doctors" like yourself refuse to open your mind and leave the Dark Ages of Medicine.

Sugar, thanks to a lack of attention, has infiltrated every can, package and container of our food supply. IBS (irritable bowel syndrome) is not going away, it is not easing up, nor is medical science curing it. If that was the case, then our nation would have happier bowels, less obesity and spend less time at the doctor's office. Unfortunately, the medical "profession" has turned its back on new ideas and is prescribing everyone with supplements and "cures" with SUGAR in them! Great Job.

Sorry I disagree with your assessment based on current nutrition research and practice. Sugar is not the big bad enemy to our health. Nor is there one simple gunshot solution to our health problems including obesity.

Candida does exist in thrush, a mouth / throat infection that persons with cancer often get after chemo or radiation. Candida does also exist in the vagina or on the penis which can be easily cured with over the counter anti-fungal medications. Candida is also part of the normal flora in our intestinal tract. Beyond that, people don't have candida running rampant in their gut though there is a lot of good healthy bacteria there.

BTW, I am not a doctor, but a registered and licensed dietitian. I don't instantly diagnose people over the Internet, but provide sound nutrition advice and encourage people to see their personal physician or a dietitian for medical care.

Could you please send nutritional information for a woman in her 70's who has recently had stomach surgery and has been placed on a diet requiring "only soft, non fibrous foods"? Thank you

You can check the calories and nutrients for yourself on the Healthy Body Calculator®. Click on the calculator link in the upper left then put in your data and the program will calculate your nutrient needs.

Since surgery is recent, I would suggest you contact the dietitian at the hospital where you had surgery. Recommended foods depend on what surgery was performed i.e. part removed (resection) or bypass (overweight) or enlarged opening to esophagus / intestines.

A soft eating plan omits all fresh fruits and vegetables (vegetable salads), but canned or cooked variations are OK. Fresh bananas are also OK as an exception to the no fresh fruits. Also omitted are whole cereal grains and gas producing foods. Food is not mushy or pureed though. Would recommend you contact the hospital dietitian for nutrition therapy specific for your surgical healing.

I have recently been diagnosed with possible gall bladder disease. This has not been confirmed yet as the blood work and ultra sound has not been completed yet. The doctor has prescribed Prevacid for now and will follow up when the results of the tests are back.

In the mean time he has advised a bland diet as my stomach is quite inflamed and I am still experiencing pain and discomfort. I have been trying to find diet information on the internet and have yet to find it. As I came across your web page I thought perhaps you would be able to help.

So far I am eating oatmeal in the morning and canned chicken broth with a little orzo for my other meals. I also have been eating saltine crackers when I am having pain and that seems to relieve it for a while. I have been craving an ice cold diet coke, but have been told by the doctor to avoid caffeine for the present. Can you please help?

Prevacid blocks acid in the stomach. It is used to treat ulcers, esophagitis and excess acid secretion. The only food that is more acidic than stomach acid is lime juice so any food you put in your stomach will neutralize the acid. Unfortunately, the smell of food will stimulate acid secretion.

A bland nutrition therapy would help an acidic stomach, but do nothing for gall bladder disease. So in the meantime, also don't eat high fat foods. If you have food in your stomach, the acid in your stomach will work on the acid rather than your stomach. So it might make sense for you to eat 6 small meals a day. Foods to include are any cooked or canned foods, but no raw fruits or vegetables or whole grains. You could call it an anti-fiber nutrition therapy in that the foods you would eat for fiber are not recommended for a bland diet. Also, for now, avoid gas forming foods like broccoli, Brussels sprouts, cabbage, cauliflower as well as baked beans or dried beans and peas. This would also work well if you had gall bladder disease instead. Specific foods like coffee, tea or caffeine containing beverages as well as any pepper (black, white, cayenne), chili powder, curry powder, chocolate, caffeine and alcohol are also omitted on a bland diet.

We used to push milk products with people who had ulcers, but have learned not to do that as milk increases acid secretion. Two cups of milk per day is sufficient and supports calcium needs.

If it turns out you do have an ulcer, ask your doctor if it could possibly be caused by an infection. Helicobacter pylori infects the stomach and causes pain. Antibiotics are prescribed rather than drugs to control acid secretion.

Once your doctor diagnoses your problem, ask to talk to a registered dietitian to give you the appropriate nutrition therapy and help you with menu planning to include your food preferences.

I'll make this quick: I was browsing through your FAQs and couldn't spot one for irritable bowel syndrome. I plan to see a nutritionist in order to develop an eating plan to deal with this disorder. I usually eat 3 meals a day, but I find that I can't predict "when" I'm going to be "sick". Sometimes my stomach can tolerate the food, other times, it can't! It makes eating out virtually impossible - and I refuse to become a slave to this condition! Just wanted to know if you could recommend a link or some quick advice on this subject. I realize that you're quite busy and would appreciate any response. Thanks for your time!

Inadequate and inconsistent fiber seems to be a trigger for people with irritable bowel disease (IBD). Start out with a moderate amount of fiber (15 grams) and gradually build up to your RDA for fiber around 25 (women ages 19 to 50) 38 (men ages 19 to 50) grams per day.

Eat 3 average sized meals per day and don't over eat or skip meals. Some foods containing caffeine (coffee, tea, some carbonated beverages and many energy drinks), lactose (sugar found in milk, yogurt, ice cream and cheese), fructose found in fruit and alcoholic beverages may cause food intolerance. Sorbitol, manitol and xylitol are artificial sweeteners that can cause gas and diarrhea especially if eaten to excess. Avoid gas producing foods like broccoli, cauliflower, Brussels sprouts, cabbage, baked and dried beans. You should tolerate decaffeinated coffee, tea and carbonated beverages. Try lactase reduced dairy products like milk so you get the calcium and vitamin D you need.

Definitely keep a food diary to help you identify what, how much and when you eat as well as the time of any negative reactions such as bloating, gas and diarrhea. You may want to record what you are feeling as well as any activity you are doing when you experience symptoms of IBD.

Consider the use of prebiotics and probiotics. Probiotics are good bacteria in active yogurt cultures found in yogurt and kefir. Prebiotics are ingredients like inulin that help increase the good bacteria in your large bowel.

I would recommend seeing a registered dietitian who would take your eating history, food preferences and design a nutrition therapy appropriate to your medical diagnosis. A nutritionist may not have a nutrition degree or experience working in healthcare with diseases like IBD.

I am a diet technician in a convalescent hospital. An anti-dumping diet has been prescribed and it has been a long while since I have worked with one. Can you refresh my memory for me? Thank you in advance.

Anti-dumping nutrition therapy is for persons with partial to total gastrectomies (stomach partially or totally removed) or gastric bypass (part of the stomach is bypassed) for morbid obesity. They don't tolerate:
  • tough meat, especially beef
  • milk and dairy products
  • bread, especially when fresh or fluffy can form a ball
  • pasta
  • cirtus juices and fruits
  • fried foods
  • concentrated sweets

Also drinking fluids with meals displaces nutrient rich foods and tends to make the person feel bloated even if flat (fizz gone) carbonated beverages are drank.

What happens is because of the smaller gastric pouch, the simple sugars aren't broken down prior to being dumped into the duodenual intestines. The sugars ferment and cause bloating or often vomiting. Nausea, vomiting, bloating or heartburn can also result from:
  • eating or drinking too quickly,
  • not chewing food adequately especially beef,
  • eating high fiber foods that can block the stoma,
  • drinking cold fluids,
  • eating too much,
  • drinking with a straw,
  • eating rich or sweet foods,
  • eating gas producing foods or drinking carbonated beverages,
  • eating foods that usually cause gastric discomfort to the individual.

Nutritional adequacy may be lacking due to decreased volume of food in either gastrectomy or bypass. Consider vitamin or mineral supplements, but only if the intestines have not been surgically shortened.

If you have provided all of the above and the person is still vomiting, consider the stoma may be blocked and talk to the doctor. Don't you have a consulting registered dietitian to work with?

I am a clinical dietitian and wonder if you could help me track down accurate information on fibromyalgia, candida albicans, leaky gut syndrome and chronic fatigue syndrome. I find there are any increasing number of outpatient consults referring to these conditions. Thank you

I have some friends whose daughter has fibromyalgia and have searched the net for this and chronic fatigue. The medical nutrition therapy for both of these is just a healthy balanced diet. Fibromyalgia is a form of arthritis and chronic fatigue is related to Epstein-Barr which involves the liver.

As to candida, there is lots of misinformation out there with people claiming to have candida in their gastrointestinal tract, blood or other body parts. They have been informed to cut out everything with yeast because they seem to think that eating yeast is the cause of the candida. This practice is not supported by research. In fact, in some parts of the human body, yeast is normally present and a benefit to health as in the colon (large bowel). Candida infections are common in the oral cavity of persons undergoing chemotherapy and is called thrush. It is effectively treated with an antibiotic.

Haven't had anyone ask about leaky gut and am not familiar with such. From a practical side, if one's gut (stomach or intestines) were "leaking" the abdominal cavity would have a terrible infection and the person would experience extreme pain that would probably need emergency surgery. If you find web sites specific to candida or leaky guy that are supported by current nutrition research and practice, please email those URLs to me.

I am a student at the University of Virginia and I was looking for an answer to a question when I came upon your web page. Do you know what is the average volume and concentration of stomach HCl produced to digest an average meal? Thank you for your time.

The pH of the hydrochloric acid in the stomach is about 2.0 to 3.0. The volume is variable among individuals. The sight, smell, taste and presence of food stimulates the secretion of acid into the stomach.

To further search for information about hydrochloric acid secretion, I would suggest you consult a nutritional biochemistry book in your library.

I have gas all the time. No matter what or when I eat. This is very sad and very embarrassing (at work, church, with friends). Do you have any suggestions for this problem?

I do not want people to start calling me "ms odor but". Please reply. Thanks.

You do not say if you are burping gas via your mouth or passing gas via your rectum. So you will have to choose which answer fits your problem.

If you have a problem with burping, you may be eating too fast and swallowing air. Slow down eating, chew each mouthful at least 10 times. Don't talk with food in your mouth as you need air from your lungs to talk and may be swallowing air if you are chewing at the same time. This practice also increases the risk of choking on food. Don't drink carbonated beverages (soda or beer) with meals as those bubbles probably add to your burping. Stop eating when you are full. If you overeat, you are more likely to burp which in some cultures is considered a required compliment to the host after a meal, but in other cultures is considered rude.

If you have a problem with passing intestinal gas, it may be caused by several factors. Gas forming foods are broccoli, cauliflower, brussel sprouts, cabbage and cooked dried beans. Carbonated beverages especially beer are also gas formers. Often constipation can increase intestinal gas. (Constipated stool looks like irregular round pellets of stool stuck together.) You may want to increase the fiber content in your meals to relieve any constipation you may experience. Certain types of fiber can also cause gas like the above mentioned vegetables and beans. Fiber found in whole cereal grains, fresh vegetables (other than above listed gas formers) and fresh fruits are less likely to cause gas. Remember that some fiber (whole cereal grains) absorbs water from the stomach and intestines as it passes through undigested, so make sure you drink 8 glasses of water per day.

Hope this helps.

I came across your web site while doing a search for acid Succininum. I have irritable bowel syndrome. I recently went through "eloctro dermal screening" and this acid came up as being too high in my system. I understand this acid may be a product of the digestive system. What I'm wondering is if certain foods yield more of this acid. Are you able to give me any information on it or suggestions where to search? Thank You.

Never heard of succinium and don't know what electro dermal screening is.

Are you referring to succinic acid or succinate? If so, this is an intermediate compound formed during the transfer of energy from blood sugar (glucose) which happens in every cell of the body. Since every cell in your body produces succinate, it would be impossible and probably lethal to stop the production of this intermediary compound.

I have been undergoing treatment for diverticulitis and my doctors office gave me a "high fiber diet" (a list of eight food categories) in which it stated to include a cup of nuts a day. Even I know better than that. I have checked around with several bookstores, etc. and I can't seem to find a good high fiber diet for this particular problem. Do you have a resource or can I obtain a "good" diet. I certainly don't mind and would be more than happy to pay the cost. Please let me know. Thank you.

Have you read my fiber topic as it contains much info about high fiber foods. The current medical nutrition therapy for diverticulosis (no symptoms) is a high fiber nutrition therapy including nuts, but no seeds (berries, tomatoes, etc.) that can get caught in the diverticuli (pockets in the intestinal wall).

However, you say that you have diverticulitis (symptoms which may include pain and inflammation). The current medical nutrition therapy is a low fiber diet, which eliminates all raw fruits and vegetables and whole grains or cereals while you have symptoms.

Sounds like you could use some guidance. I would suggest you call your doctor's office and ask to talk to a dietitian. It is more than just following a printed list of allowed and omitted foods.

I have a terrible problem with digesting corn, broccoli, peppers, cauliflower and other favorite veggies that I love. Recently I had an attack where I had severe lower abdominal cramps all across my lower abdomen and shooting underneath to my rear. It was awful, also for the next few days I had excessive burping and flatus. Does this mean I should just stay away from my favorite veggies or could there be a medical problem I should be tested for. I am a young female who eats a lot of veggies, fruit, grains and not a lot of meat. Please help. Thanks.

First I would suggest talking to your doctor to rule out any changes in your digestive tract health. There are several possible causes for your symptoms and I am not a doctor. Until the cause is found for the abdominal cramps, I would suggest not eating these foods.

Second, most of the foods you mention are gas forming (broccoli and cauliflower). Corn sometimes is not digested well by the intestinal tract and the hull can pass through intact. Green peppers can cause burping as the skin needs bile from the gall bladder to be digested. It may be that you just overdid the amounts of these foods at the same meal.

After your doctor has ruled out any physical cause for your cramps, burping and gas, I would suggest you slowly add these foods back into your diet, one per meal and in small quantities (1/2 cup). You can increase the quantities slowly (1-cup), then try mixing two at the same meal. You will find your individual tolerance to these fresh vegetables.

I spoke with you awhile back about different diets for Crohn's disease. I have another question for you. My fingernails are brittle and peeling. Could this be from a deficiency in a certain vitamin? I am currently having a flare up with Crohn's and I am at home on a TPN. I add iron and a multivitamin to my TPN. The doctor decreased the amount of TPN yesterday and he will be taking me off of it soon. As long as I am able to eat without vomiting or pain. How can I get my nails back to normal?

TPN (total parenteral nutrition) is administered through an IV into a vein. The mixed solutions provide calories through glucose (dextrose) and fatty acids in addition to essential amino acids to build and repair muscles and organs. Usually an MVI (multivitamin intravenous) plus minerals is added as you did to the TPN solution.

The state of your nails may be due to the fact that you have been ill with Chron's rather than a nutritional deficiency. Chron's involves malabsorption of nutrients including protein and the resulting diarrhea is evidence that your body was not absorbing the food that you were eating. The amino acids (protein) in the TPN solution was needed to heal your intestinal tract.

Nails and hair are rigid protein structures and generally reflect the overall health status of a person not a vitamin deficiency. It is not unusual for the nails to become ridged or brittle during an acute illness, especially those involving fevers. Other nail changes like white lines in the nail occur because of damage to the nail bed when pushing back the nail cuticle. Until your nails become stronger, cut them even with the end of your fingers, don't wear nail polish and wear gloves when your hands are in water for extended periods of time (dish washing).

Given a nutrient rich, balanced, healthy nutrition therapy with adequate protein, your nails will probably return to normal, but it will take 6 to 12 months for the nail to grow out from the cuticle to the end of your finger.

I was diagnosed with Irritable Bowel Syndrome (IBS) as well as lactose intolerance four years ago. I have cut out all forms of milk (including casein, whey and milk fat), caffeine, carbonation and alcohol and am taking a doctor-recommended daily fiber drink to keep regular. I still don't feel all that great. Are there foods that are especially good for IBS sufferers?

My second question is, now that I don't "do milk" what is the best way for me to get calcium? I'm 31 and concerned about osteoporosis.

When you are without symptoms, you should eat adequate fiber which is 20 to 35 grams per day or approximately 1 gram of fiber per 100 calories eaten per day (i.e. 1800 calories would suggest 18 grams of fiber). Foods high in fiber are whole grains, fruits, vegetables, legumes, (soybeans, peanuts), beans and peas. Read the fiber topic for more information.

Since you do not use milk products, I would suggest you read the milk and calcium topics. To meet your calcium requirement, try soy milk (check the label to see that 1 cup contains at least 302 mg of calcium. The calcium RDA for adult women and men is 800 mg per day. Other nutritional supplements like Ensure and Sustacal are lactose free milk based products that contain calcium. Your other choice can be to take 800-mg calcium supplements. There are various forms of calcium, some more absorbable than others. Talk to your pharmacist for their recommendations. Also, Vitamin C increases calcium absorption so take the supplements with orange or grapefruit juice.

What type of diet would you recommend for someone who has an ulcer?

Thank you for your input.

It depends on whether you are having symptoms or not. If you are having symptoms, eat only cooked foods, limit your intake of milk to 2 cups per day and avoid gas forming foods (broccoli, cauliflower, brussel sprouts, cabbage, baked beans) caffeine containing foods (coffee, tea, cola and chocolate) and alcohol. Some spices like garlic, pepper, curry, chili powder and cayenne also stimulate the production of acid in the stomach. Also, you should eat 3 meals per day. The acid will work on the food rather than your stomach or intestinal wall. Any food other than lime juice will neutralize the acid because food is less acidic than the acid your stomach produces.

Prescribed drugs and antacids are effective at healing and preventing ulcers both gastric and duodenal (intestinal).

If you aren't having symptoms, you can eat whatever you want except caffeine, alcohol and the above spices. Milk has been found to stimulate the production of acid so limit to 2 cups per day.

There is some new research that ulcers may be caused by an infection and treatment with antibiotics has been suggested. Talk to your doctor about this.

An in-law has diverticulitis. My wife was interested in finding recipes and learning how to prepare meals. Do you have any recommendations or know of how to best prepare meals? Since I'm only the middle man, what foods/spices should be excluded from the diet?

Diverticulitis is grouped with inflammatory bowel diseases. Pockets develop in the large intestines and become inflamed. During acute symptoms, your in-law should see their doctor. Depending on severity of symptoms, one of the following diets may be recommended: not eat anything by mouth (NPO); just liquids (clear or full); low fiber nutrition therapy (only cooked, refined foods, no seeds or skins). Any of these diets would prevent further irritation and allows the intestines to heal. Your in-law should also see a registered dietitian who can read her medical chart and prescribe the appropriate nutritional therapy.

Diverticulosis on the other hand describes the chronic disease where inflammation is not present. A high fiber (20 - 35 gm fiber per day or 1 gram fiber per 100 calories), low particulate nutrition therapy is recommended. Whole grains (bread, cereal, pasta, brown rice), legumes (soybeans, lentils, dried beans and peas) fresh fruits and vegetables are recommended. Your in-law should also drink enough water (8 cups per day minimum) as fiber absorbs water in the gut and swells, thereby increasing stool bulk. However, foods with small seeds (particulate) like berries (strawberries, raspberries, blueberries cranberries, etc.) are not recommended as they can become lodged in the intestinal pockets. This can lead to an inflammation and diverticulitis. Any spices as long as they are not seeds (dill, celery, etc.) are allowed.

The real key to health in diverticulosis is maintaining increased fiber that helps clean out the pockets that have already formed in the intestines. Any recipe that includes whole grains, fresh fruits and fresh vegetables would be desirable. For instance, if tomato sauce with noodles were on the menu, switch to whole-wheat pasta. A healthy eating plan would also include reducing fats and fried foods.

Thanks for your excellent resource.

Could you answer a question I have about my wife? She has been told by a naturopath/homeopath that she has Candiditis (too much Candida virus in her gut, which has become a yeast and crossed through her gut wall and into her body).

On his advice, she's cut out caffeine, alcohol, any pickles or fermented products, milk with lactose and most sugar. Her symptoms are vastly improved, however cutting out sugar is very difficult to do in this day and age. (She still has fructose from fruit.)

Is it necessary to cut all sugars or are there other foods which may still need to be considered as causes of her fatigue, bloated belly (after eating sugar), "hangover" feeling, etc.?

Sorry, but there isn't any current nutritional therapy for Candida you describe. However, the foods she has eliminated usually cause gastrointestinal problems or irritable bowel syndrome.

Eliminating caffeine, alcohol, pickles and sugar pose no nutritional harm and most are not included in a balanced or healthy eating plan anyway. So if your wife's symptoms have improved, congratulations.

Dairy products, including milk and fruit are sources of sugar as well as desserts and sweets made with sugar. Other sources of carbohydrates are complex starches and fibers, which aren't sugars. Diabetic desserts, candy and sugar free gums are usually sugar free and would be a good choice if your wife wants to eliminate sugar. However, there are two sugars derived from alcohol - manitol and sorbitol - which can ferment in the gut. Does your wife chew sugar free gum or breath mints with either of these two nutritive sweeteners? If so, eliminate them for one week to see if symptoms disappear.

Lactose may be the biggest problem. Most dairy products (milk, cheese and frozen desserts like ice cream) contain lactose. Check out the milk topic for more information about lactose and food sources. Try soymilk as it is lactose free.

Fiber may be another irritant to her intestinal tract, given the bloating symptoms you describe. Next try reducing fiber by switching to refined grains and white bread, cooked vegetables (no gas forming like broccoli, cauliflower, cabbage, brussel sprouts or baked beans), canned fruits or juices (no prune) to see if her symptoms improve after one week. If not, switch back to whole grain cereals and breads, raw vegetables and fruits. If her symptoms improve, you have more information to provide her doctor.

Fructose is absorbed through the intestinal wall and further broken down to glucose in the blood. It usually doesn't cause fatigue, bloating or a hangover problem. Besides, fruits and juices are excellent sources of Vitamins A and C, potassium and fiber.

Only make one change in her food choices at a time to pinpoint the food irritant. If her symptoms continue, I would suggest she see a doctor.

Could you give me a diet on irritable bowel syndrome? Its for my wife. She needs to eat better.

Please see second answer below.

In addition, the My Plate is helpful in planning a balanced diet.

I have a GI disorder known as Crohn's disease. I am currently having a flare up and am on a liquid diet. What do you recommend to drink? I can handle soup, Ensure tastes terrible. Also, any tips on how to eat to prevent a flare up?

During acute symptoms, you should avoid raw vegetables and fruit, milk and dairy products and whole grain cereals. You may need to follow a clear liquid nutrition therapy or even nothing by mouth to give your GI tract a complete rest. (This may require hospitalization with IV's with added vitamins and minerals, which can be achieved with total parenteral nutrition - TPN.) A clear liquid nutrition therapy is strained fruit or vegetable juices (apple juice, cranberry juice), broth (chicken or beef), plain gelatin, fruit ices, carbonated beverages, coffee and tea. Besides Ensure, you can try Citrotein or Sustacal. That's it.

When you no longer have acute symptoms, you can start a full liquid nutrition therapy by adding cream soups, cooked refined cereals, custard, tapioca or pudding, but milk products like yogurt, ice cream and pudding may still cause you symptoms due to lactose intolerance.

Crohn's disease has symptoms similar to colitis, but can occur anywhere along the GI tract. The cause for the symptoms is unknown. Various nutrient deficiencies can develop because of malabsorption during acute phases, which include diarrhea. Initially, loses of sodium, potassium and water are of concern. Long term symptoms can cause protein/calorie malnutrition along with deficiencies of Vitamins A, B 12, C, D, E and K, folic acid, calcium, iron, zinc and magnesium. Oral vitamin supplements probably will not resolve these deficiencies during acute diarrhea phases. Weight loss and limited food intake during acute phases adds to the decrease in your nutritional status.

I would suggest that when you are not experiencing symptoms that you should follow a nutrient rich balanced eating plan including a daily multivitamin, with adequate fiber to maintain intestinal elimination. You will have to vary the fiber content of the foods you eat to find the level that works for you. If you are prone to GI obstructions, a high fiber nutrition therapy is not recommended. For persons without Crohn's disease 1 gram of fiber per 100 calories of food is recommended and would be a good fiber level to start.

My wife is having problems with irritable bowel syndrome and has been tested for everything and nothing is helping. Could you recommend a diet, herbs or something to help?

First, I would suggest she continue to see a doctor so that the cause may be found and treated.

As to a diet, until active symptoms subside either a low or high fiber nutrition therapy would help. Which nutrition therapy she should use depends on her symptoms. If constipation is the problem, eat high fiber foods. If diarrhea is the problem, eliminate high fiber foods, milk and lactose containing dairy foods (See milk topic). High fiber foods are raw vegetables and fruit, whole wheat breads and cereal grains. These foods would stimulate the intestinal peristalsis (rhythmic movement). Caffeine may also contribute to symptoms and should be limited for a short term.

Why do you say heartburn is a symptom of hypochlorhydria? Heartburn is usually associated with lowered, lower esophagus sphincter pressure and increased acid reflux into the esophagus. See Castell work on reflux, heartburn and diet.

Heartburn is a symptom of both hypohydrochlorhydria (too little stomach acid) and hyperhydrochlorhydria (too much stomach acid). The dietary treatment is the same, a bland nutrition therapy. However in hypochlorhydria (ahydrochlochloria - without stomach acid), acid pills may be prescribed to aid digestion of food.

Lower esophageal sphincter pressure or hiatal hernia can both cause reflux esophagitis. (Stomach acid that flows back up the esophagus which causes an inflammation of the lining in the esophagus. The esophagus lacks the thick mucous lining found in the stomach and therefore is more susceptible to the stomach acid.)

What foods produce acid? I notice milk, ice cream and red meat bother me and I feel sick for a few weeks after I eat them. I think I need some help.

No food actually produces acid in your body. Actually, no food is more acidic than the acid that your stomach produces.

However, any food or beverage eaten stimulates the secretion of hydrochloric acid by your stomach. Some foods cause a greater secretion of acid than others do. For instance, alcohol, caffeine containing foods (coffee, tea, cola, cocoa and chocolate) and spices (pepper, cayenne, curry or chili powder) all cause a greater secretion of acid by your stomach.

Hydrochloric acid is used by the body to start the chemical digestion of food. Acid is mixed with the food in your stomach before it is passed on to the intestines for more digestion and absorption. People with ulcers who produce too much acid must omit at least the caffeine, alcohol and spices. They should also discuss any medications they take with their doctor. Aspirin compounds do irritate the stomach and there are other pills that could be substituted for aspirin.

If you notice a food bothers you, eat less of it at a time or omit it for a short time (1-week) to see if you feel better. Don't omit whole groups of food. Remember to consult your doctor for any persistent illness.

I have pain in my stomach after I eat. I also feel the need to burp for a few hours after a meal. I went to see my doctor and he gave me some acid pills to take. Why do I need them?

Persons with hypohydrochloria (lesser amount of acid) or ahydrochloria (no acid), will experience an intolerance to some foods because they lack enough acid to chemically digest their food. Also, persons lacking acid, may experience symptoms similar to ulcers or gall bladder disease. Common symptoms are heartburn or a pain at the bottom of your breastbone. Persons with ahydrochloria have the opposite problem a person with ulcers has, too little acid.

The acid pills your doctor prescribed will help you digest your food and you will notice an improvement in the way you feel after meals. If the pain continues, by all means, go see your doctor.

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