Many people have digestive problems that are challenging to diagnose and manage. Commonly, this is due to carbohydrate sensitivity, which has two types:
- Pre-diabetes or diabetes – also known as obesity and blood sugar imbalance
- Specific carbohydrate sensitivity – where you cannot absorb certain carbohydrates in the small intestine
Both forms of carbohydrate sensitivity cause acid or ulcer problems, small intestine or colon problems with abdominal pain, bloating, gas, constipation or loose stools. The foods that contribute to pre-diabetes, diabetes and obesity can be easily found by:
- Counting your calories if you are overweight and then working with us on weight management
- Checking out the glycemic index and then working to consume foods with a lower glycemic index
Blood sugar imbalances and obesity strains or damages the liver, stomach, pancreas and small intestine leading to digestive problems. Losing weight with a medical weight management program and controlling blood sugar better helps relieve digestive symptoms. While diabetic and digestive drugs suppress glucose or digestive symptoms they do not support intestinal organ functioning. Changing your food intake and working together with us with combinations of alternative treatments to support your digestive organs controls symptoms, reduces prescription drug use and side effects and can restore the organs to proper functioning.
Foods that cause specific carbohydrate can be found on low-Fodmaps diet web sites. Fodmaps stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are specific carbohydrates. These specific carbohydrates cannot be absorbed in the intestines of some people, causing symptoms. Often it is just one or two specific carbohydrates, such as sorbitol, mannitol, fructose, corn syrup or certain fruits, vegetables, cereals, grains, milk products or legumes.
The best approach is to obtain the low-Fodmaps lists and eliminate these foods for 6 to 8 weeks and then gradually add back one food group at a time to find which specific carbohydrate is causing trouble. This works best if you keep a journal of symptoms.
Most people should be managed by a clinician familiar with low-Fodmaps foods and guided through the elimination and then reintroduction phases. In many cases, we must also use alternative treatments to support and improve liver, stomach, pancreas, small and large intestine function while working together to improve food intake. It’s worth it because studies show symptoms such as irritable bowel syndrome (IBS) and other digestive problems can improve by 75%.
Often times I’ll use very specific supplements to relieve symptoms and to help digest specific carbohydrates. For some cases, it’s just easier to do this and control symptoms than go through elimination and reintroduction phases.
To determine if you have carbohydrate sensitivity due to obesity and/or blood sugar problems, we can help best if you:
- Write out a food journal over 3 normal weekdays and bring to an appointment for review
- Write out how many calories you consume each day. The Calorie King book or website is good to help you
- Record your weight daily and have us measure your belly size and BMI (basal metabolic index)
- Schedule appointments to balance your blood sugar and start a medical weight management program (if overweight)
To determine if you have specific carbohydrate sensitivity, we can help you best in you:
- Write out a food journal over 7 normal weekdays days and bring to an appointment for review
Food allergy testing is not reliable, especially with specific carbohydrate sensitivity. You have to eliminate specific carbohydrates, and then reintroduce them slowly to determine which is the problem. To determine if you have specific carbohydrate sensitivity requires a process of elimination. If that sounds like too much work or while we are figuring this out, specific supplements can relieve the symptoms or help you digest carbohydrates. Some of the foods containing Fodmaps to eliminate include:
- Fruits: apples, apricots, cherries, pears, watermelon and dried fruit
- Vegetables: asparagus, broccoli, cabbage, eggplant, garlic, mushrooms and onions
- Cereals & Grains: wheat and rye, pasta, bread, cookies
- Milk products: cow’s milk, ice cream yogurt, soft cheeses, custard
- Beans & legumes: chick peas, kidney beans, lentils, soybeans
- Sweeteners: sorbitol, mannitol, isomalt, fructose, corn syrup, lactose, honey
Some foods to continue on a low-Fodmaps program include:
- Fruit: bananas, blueberries, grapefruit, lemons, raspberries
- Vegetables: carrots, celery, green beans, potatoes, pumpkin, zucchini
- Grains: gluten free bread or cereal, rice, oats, polenta, tapioca
- Milk products: lactose free milk and yogurt, hard cheese
- Sweeteners: maple syrup, molasses, sugar (in moderation)
David Overton, PA-C works at Natural Medicines & Family Practice combining conventional and alternative treatments under the supervision of Dr. Richard Faiola, MD, ABFM. Call 360-357-8054 for an appointment or information