Hoping somebody can help me please

[skybluepinkalien]

I started the Whole 30 plan on the 4th April 2016.

 

I have GERD issues since birth due to my upper sphincter not closing properly.

 

I am currently on a PPI, AND H2 antagonist, and I have been for about 16 years. Without these I cannot even keep down water.

 

My reflux never really bothered me prior to the Whole 30 as long as I took my medication, and didn't eat anything that I knew bothered me, such as spicy food, and excessively acidic foods.

 

Before the Whole 30 I was already dairy, wheat, gluten, mango, avocado, melon, pear, nut, and coconut free due to allergies.

 

Due to other medical issues my Whole 30 is also low histamine, and low FODMAP.

 

I had no GERD issues until the end part of my second week, and going into this week my third week.

 

At times the pain, and nausea have been so bad I have almost been in tears.

 

I have tried adding Gaviscon, which has helped a bit for a short amount of time.

 

It gets really unbearable about 2-3 hrs after eating.

 

In my first week I was having "mini meals" to try and keep the GERD at bay. I have tried to cut back on this as I know it is not strictly Whole 30 advised, unless you are exercising.

 

I have tried to increase the amount of advised good fats in my meals, and that has made it worse, so I have had to cut back again.

 

I have added in digestive enzymes, as of almost a week ago, due to finding I had an upset stomach, as I am eating far more meat, and fat than I would have before the Whole 30.

 

Whether I take the digestive enzymes after every meal or not, I still get the GERD.

 

I have 15 more days to go, minimum, as I had originally planned to do a Whole 45, or 60.

 

I am dreading them.

 

Every part of my being wants to pack the Whole 30 in now, at the moment the only single thing stopping me before Day 31, is the fact I am too blooming stubborn.

 

HELP ME NOT QUIT!

[jmcbn]

Hey there

 

Sorry to hear your GERD symptoms have worsened..... Can you give us an idea of what you have been drinking & eating (with specifics about protein, veg & fat types) over the last lot of days to see if anything jumps out at us?

Hopefully we can help you troubleshoot...

[skybluepinkalien]

I forgot to add to my post I am also nightshade free.

 

I have been working from the Whole 30 shopping lists for nightshade free, low FODMAP, and low histamine, which I have cross matched to find the foods on all lists that comply. I have used this in conjunction with a Whole 30 shopping list which meets all the requirements from a blog called Human in Recovery.

 

I have been eating meat, mainly beef, turkey, chicken, shellfish, and fish, with more of the latter, as since commencing the Whole 30 it looks like I may have an issue with pork, so I am still testing the waters with that, so I am not eating it in abundance.

 

I have a very limited list of fruit and vegetables to work with.

 

I have been eating swede, sweet potato, carrot, butternut squash, green kohlrabi, parsnip, normally boiled, mashed or oven roasted.

 

Alongside this normally Pak choy, green beans, Swiss chard, or courgette, either boiled, steamed, or sautéed.

 

When fat has been low in a meal, say boiled veg, and grilled meat, I have been adding olives, in either olive oil or brine to my meals, but not in abundance.

 

I have been using cold pressed extra virgin olive oil as the main fat source, with the odd bit of duck or goose fat, but not every day, and not in abundance.

 

Fruit wise, I have had blueberries, raspberries, pomegranate, passion fruit and grapes, but again not in abundance, and normally as part of a meal.

 

I have been seasoning my meals with either fresh herbs, basil, parsley rosemary, dill, mint, oregano, and sage, or ginger, or both. This is again not in abundance, and not at every meal.

 

Aside from this I have used Himalayan pink crystal salt, which I have been using for in excess of a year prior to starting the Whole 30.

 

Drinks wise, I have mainly been drinking water, mainly bottled, decanted into a glass. Occasionally I will infuse it with mint, ginger, lemongrass, or rose petals, or a combination using a tea infuser. I have bought no added nasties pressed carrot juice whist travelling, but only the once.

 

I am drinking a minimum of 2 litres of water a day, due to increased fluid intake being needed for medication purposes.

 

When I plate a meal, I am filling half the plate with a combination of starchy vegetables, and compliant "green" vegetables, with a palm sized portion of meat.

[tmhampton1]

So sorry to hear you are struggling. One of the things I found out on my first W30, through trial and error, is that I can't eat more than one serving of starchy veggies otherwise I get very bloated...and other uncomfortable things. I only eat one serving, unless it's pre-workout and then I just have a few bites of a carb. 

[madness]

My husband has severe GERD as well and it started acting up before we started the Whole30. It was actually part of the reason we started. Even though it's a mechanical problem, like yours, that simply can't be fixed by diet alone, I was hoping his digestion would greatly improve and at least get him in good health in case he needs surgery. He's been to 3 docs in as many weeks and has an endoscopy (FINALLY) next week and maybe we can figure out what needs to be done.

 

Anyway, I wonder if your medications need to be adjusted? My husbands PPI has been changed several times over the last 5 years. It works for awhile and then his body some how adjusts to it. It might be worth checking in with your doctor. This might not have as much to do with the Whole30 as just your body changing?

[jmcbn]

It's hard to know what an actual meal looks like for you because of the way you have listed your foods. That said a couple of things jump out at me - sweet potato and butternut squash are both fairly moderate as far as FODMAPs go and should be eaten in limited quantities - I'm not sure how often you're eating them...?

You say you're adding primarily EVOO to your meals when they're low on fat - EVERY meal should have a serving of fat over and above that which has been used for cooking. I'm wondering if adding that additional fat might help  in anyway as it slows down digestion.

Your fruit & seasonings look fine.

Your 2litres of water is fine if you weigh around 140 pounds, otherwise you should be drinking more - although I know excess water can also aggravate the issue.

Are you keeping the water until after meals?

I'd agree with madness - if you don't see some improvement in cutting back on the FODMAPs and adding in some fat I'd speak to your Dr about possibly adjusting your meds.

Hope this helps.

[skybluepinkalien]

Ok. This is skybluepinkalien's other half. She's having a hard day of it today.

 

This is the list of veg that we think are allowed which is also easy to get our hands on - please please correct us if it means that we can have more variety:

 

Butternut squash, kale, sweet potatoes, pak choi, carrots, parsnip, swede, green beans, cucumber, spring greens, courgette. - occasionally, we can get our hands on kohlrabi & mooli.

Of those at least one of squash, sweet pots, and swede are in every single meal, sometimes supplemented by carrots & parsnips.  Kale, pak choi & sprin greens are used interchangably.

Cucumber tends to be used as a snack with some cold meat.

The veg is normally boiled, roasted, sauteed and/or fried.

 

In terms of meat, it generally varies between pork, beef, turkey & chicken. Some fish & other more expensive/exotic meats (venison/horse/boar) make it in too.

Fruit is restricted to pomegranate, blackberries, blueberries, raspberries and grapes.  (Melon is out due to allergies)

 

Dinner last night was skewers of sweet potato, parsnip, carrots, kohlrabi & squash with chunks of beef in a herb & oil dressing. 

Dinner tonight will be beef skirt, boiled sweet potato, squash, carrot & swede, with lightly boiled spring greens, kale & green beans.with a handful of olives.

 

Water is mainly taken outside of meals, unless she encounters swallowing issues, or choking.

 

Adjusting meds is fraught with a great deal of difficulty as she's on high doses of lots of things, and can't tolerate the levels of allergens in most pills.

[SugarcubeOD]

What we're looking for as far as meals to help troubleshoot is something more along the lines of this:

 

M1 - 3 fried eggs with an Aidells sausage link, 2cups of roasted brussels sprout and half an avocado

M2 - ground pork burgers (2) with home made mayo and around 2 cups of cut up cold veggies

M3 - steak stuffed bell peppers with coleslaw salad (1 cups) and around a cup of roasted sweet potato.

 

When you list your meals this way, it's easier for us to help trouble shoot.  Listing ingredients doesn't help us in helping you get your meal composition nailed down.

[jmcbn]

Ok. This is skybluepinkalien's other half. She's having a hard day of it today.

 

This is the list of veg that we think are allowed which is also easy to get our hands on - please please correct us if it means that we can have more variety:

 

Butternut squash, kale, sweet potatoes, pak choi, carrots, parsnip, swede, green beans, cucumber, spring greens, courgette. - occasionally, we can get our hands on kohlrabi & mooli.

Of those at least one of squash, sweet pots, and swede are in every single meal, sometimes supplemented by carrots & parsnips.  Kale, pak choi & sprin greens are used interchangably.

Cucumber tends to be used as a snack with some cold meat.

 

Hey there

 

Please see my comment above about sweet potatoe & butternut squash - I eat low FODMAP myself and couldn't tolerate both (or even one of the two) every day...

Take a look at >this list< (about half way down the page) and be sure that she eats from the green section only (excluding any night shades, non compliant foods or allergens obviously) for a few days - it might give her a bit more variety - and definitely think about adding in more fat.

ETA: By 'adjusting meds' I was referring more to the quantity taken rather than the type - it could be that a smaller or larger dose is required...

[skybluepinkalien]

Hey there

 

Please see my comment above about sweet potatoe & butternut squash - I eat low FODMAP myself and couldn't tolerate both (or even one of the two) every day...

Take a look at >this list< (about half way down the page) and be sure that she eats from the green section only (excluding any night shades, non compliant foods or allergens obviously) for a few days - it might give her a bit more variety - and definitely think about adding in more fat.

ETA: By 'adjusting meds' I was referring more to the quantity taken rather than the type - it could be that a smaller or larger dose is required...

 

 

Ouch. Matching up that list with the low histamine & the normal shopping list, it looks like sweet potato and squash need to be eliminated, and it doesn't gain any ingredients.

 

I'm not clear on one ingredient. Lettuce. What lettuces are low histamine & low FODmap?

 

 

What we're looking for as far as meals to help troubleshoot is something more along the lines of this:

 

M1 - 3 fried eggs with an Aidells sausage link, 2cups of roasted brussels sprout and half an avocado

M2 - ground pork burgers (2) with home made mayo and around 2 cups of cut up cold veggies

M3 - steak stuffed bell peppers with coleslaw salad (1 cups) and around a cup of roasted sweet potato.

 

When you list your meals this way, it's easier for us to help trouble shoot.  Listing ingredients doesn't help us in helping you get your meal composition nailed down.

 

If I can convince her to put up with her bad stomach for another day, I'll remind her to write down the meals like that.

[jmcbn]

Ouch. Matching up that list with the low histamine & the normal shopping list, it looks like sweet potato and squash need to be eliminated, and it doesn't gain any ingredients.

 

I'm not clear on one ingredient. Lettuce. What lettuces are low histamine & low FODmap?

 

 

 

If I can convince her to put up with her bad stomach for another day, I'll remind her to write down the meals like that.

Romaine should be fine for both purposes. She could also add in fennel for a bit more variety?

I know for me that now that my gut is mostly healed that I've been able to reintroduce small amounts of foods that I couldn't previously tolerate, so this isn't necessarily forever...

[skybluepinkalien]

Thank you guys for all your help, and for being happy to pass information through via my partner.

 

I have followed the list of foods on the Paleo Mom list since making this post, and the GERD seemed to settle in 4-5 days.

 

I have also since found out not eating enough will also cause me symptoms.

 

I am on my last day of my Whole 30, my original plan was to do 45, or 60 days, but I am feeling very frustrated with my lack of food options, so I am feeling I will do a Whole 30 instead.

 

I am guessing as butternut squash, and sweet potato were influencing my GERD I have an issue with FODMAPS.

 

Does anybody know for a hard and fast list so to speak of low FODMAP foods?

 

I thought I had done my research between the Whole 30 shopping lists, and various other sources online, but obviously some lists appear to be including the medium FODMAPS as low.

 

I am also looking for advice on reintroduction of foods.

 

I am guessing I will still need to stick to low FODMAP options initially?

 

I am currently leaning to reintroducing rice first, for a bit more variety, I do not know if this is the correct approach?

 

If I do reintroduce rice it would be made at home, rinsed, and boiled in water, not preprepared packets. 

 

Having gone the whole hog so to speak first time round, with low histamine, low FODMAP, and no nightshades, I have a lot of foods to try an reintroduce.

 

This is made more complicated, by already being gluten, wheat, dairy, nut, coconut, and egg free due to allergies/intolerances.

 

I am finding it a bit overwhelming, and I don't know where to start! Especially as the egg, and nut allergies are more recent, and I kind of want to test my bounds of tolerance with those also.

 

I have prepared myself in advance that it will obviously be a very long process, especially if I am only reintroducing a new food every 4 days or so.

[jmcbn]

Hey there

 

Monash University have an app that can be downloaded listed all types of foods and what they deem to be a safe potrion size going on the research, but the Paleo Mom green list is as close to that as I've found.

I'd stick with low FODMAP for now until such times as you feel the inflammation has gone & then start adding foods form Paleo Mom's amber list.

In the meantime rice would be a good place to start - white, boiled rice tends to cause the least symptoms.

The general rule of thumb for intolerances is to leave them out for 8wks before a retrial so my advice would be to hold off on the eggs & nuts for now, and work your way up to including more veg for variety.

Nightshades & histamines tend to provoke a more skin/joint based reaction - just so as you know what to look out for when you get to those.

Take your time. Rushing will only set you back. Believe me I know.

[skybluepinkalien]

Ok, I have found the Monash app in the Play Store, and that is in the process of downloading. I will look at what it recommends as "safe" portions and it may increase my variety of foods. I just need to cross reference with the histamine content.

 

I have literally just had a quick look at the app, and prior to the Whole 30 being dairy free, I was having rice, or soy milk, which apparently are high FODMAP.

 

I don't know if anybody has any experience of using the app, and can tell me how accurate they have found it?

 

This may sound really stupid, I have encountered that people suffer inflammation as a result of FODMAPS. My reason for going low FODMAP whilst doing the Whole 30 was to see if it helped my stomach issues that I have had for years, obviously not thinking about inflammation. 

 

What signs do inflammation give, and how do I know when it is gone?

 

The eggs, nuts, and coconut were diagnosed as a mild/moderate allergy. I have discontinued both since mid-February, but obviously as it limits my diet so much I kind of wanted to test my limits with them so to speak.

 

I think histamines may play a part in  my skin issues, as I suffer with chronic urticaria, along with dermatographia, which I understand is caused by MAST cell activation, which can be aggravated by high histamine levels.

 

My nightshade avoidance whilst doing the Whole 30 was due to a reaction to chilli in foods, which had only developed over the past couple of years or so.

 

Basically I was clutching at straws and hoping for results! Lol.

 

I worry that I will lose patience and try and introduce too much at once, but I know I am only doing myself a disservice if I do that.

[jmcbn]

What signs do inflammation give, and how do I know when it is gone?

All foods that we are sensitive to cause inflammation. The type & location of the inflammation usually varies according to the food:

Dairy usually effects the respiratory system (asthma like symptoms aren't uncommon) & encourages the production of mucous, and can cause dark circles under the eyes (think eyes, nose & throat)

Histamines tend to cause a skin reaction

Nightshades can also cause a skin reaction and/or joint pain

 

FODMAPs tend to result in gastrointestinal inflammation - so bloating, gas, cramps, excessive wind/belching, diarrhoea/constipation

 

Nuts tend to also be respiratory, or something like oral allergy syndrome (burning on the lips/tongue)

Eggs can cause bloating & joint pain

[skybluepinkalien]

Thank you.

 

I know it sounds stupid asking, and I feel stupid asking, as normally I am very switched on, and do my research etc, but I think when I hear the word inflammation, I automatically think obvious symptoms that would indicate swelling/inflammation, as you mention stomach bloating, sinus pain, swelling around joints, urticaria,  swollen mouth/lips/inner mouth etc.

[praxisproject]

Nuts/eggs and a number of other ingredients can also trigger anaphylaxis (extreme swelling which can impact breathing) where an epipen is required.

 

Inflammation is quite complex, almost every autoimmune condition relates to inflammation. Chronic inflammation itself can cause other medical issues, at it puts the body in a kind of overload/redline status. Once in this state, the body can struggle to cope with more things as it just has no more resilience left in the tank. Leaky gut can do this too, once the gut is leaky, lots of things are entering the blood stream that aren't supposed to be there.

 

Before my first Whole30 I had terrible inflammation. Arthritis, lots of pains, swelling, bloating (mine is whole body rather than just stomach), puffy eyes, sore teeth, sinus problems, breathing problems, skin damage. 

 

Most inflammation will show in blood tests, if doctors are looking for it. There's a number of different biomarkers associated with different kinds of inflammation.

 

Dairy & Wheat/Gluten are both big triggers of inflammation for me, no gluten, no arthritis! Gone! Iritis, gone! Random pains, gone!

Some more surprising ones were vegetable oils, including soybean oil, canola oil and artificial sweeteners.

As bad as sugar is for me, my body now copes with sugar far better than it can sweeteners (I have the odd bit of stevia with no reaction, but the volume is very small), Splenda which was my favourite in my low carb days is actually the worst for me in inflammation.

I'm in the morbidly obese category (for weight context) but I have put on 10 kilos of inflammation overnight from gluten, it hurts, your skin can feel like it's going to pop open, but sometimes you just feel terrible and you have no idea why (your organs can get it too). It's not "real weight" but that doesn't mean it doesn't feel like or that it's not harmful. I had always thought this was "water weight" and none of my doctors ever thought it was important before my first Whole30.

 

https://en.wikipedia.org/wiki/Inflammation (this is worth reading through for the crazy long list of all things that are related, but the chronic section is the one to talk to doctors about. Somewhere there's a great picture with arrows linking different inflammation conditions.

 

Personally I struggle with my homocysteine levels and it's something which is easily measured in blood tests.

http://drbenkim.com/articles-homocysteine.html (this isn't a source I'm familiar with, but the list is very similar to the one from my naturopath, which is just for me and I have MTHFR too and "probable" celiac)