Managing IBS with Diet

Hey everyone! Dr. Dale here.

Irritable bowel syndrome, or IBS, is one of the most common conditions that I see in my gastroenterology practice.  In fact, it’s estimated that about 15% of the world’s population struggles with IBS and the unpleasant symptoms that go along with it—including gas, bloating, constipation, and diarrhea.

Patients should know that diet alone may not effectively treat IBS.  Plus, IBS symptoms can sometimes be very similar to those found with more dangerous health conditions, such as colon cancer or Crohn’s disease.  For these reasons, it’s important to call the office and schedule an appointment if you believe you may have IBS. However, many patients do find that they are able to manage their symptoms and find some relief through an IBS-appropriate diet.

There are a number of specialized diets available for patients with IBS and other GI issues.  These include diets that eliminate or restrict common “trigger foods”, such as gluten, dairy, sugar, and high amounts of fiber.  Every patient is unique, so trigger foods may not be the same for everyone, and you may need to trial a few different diets before you find the right fit.

If you’d like to try an IBS diet, the “low FODMAP” diet is a great place to start.  This diet was developed by researchers at Monash University in Australia, specifically for patients with IBS.  FODMAP stands for Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols. While the name may seem long and confusing, the important thing to know is that it refers to specific types of carbohydrates that are difficult for people with IBS to digest.  The low FODMAP diet focuses on eliminating these types of carbohydrates, while including a variety of foods that are easier to digest.

In general, a patient following the low FODMAP diet would avoid cow’s milk, certain types of fruits and veggies, most legumes, gluten-containing grains (wheat, barley, and rye), and high-fructose corn syrup.  Instead, this patient might consume almond milk, low-FODMAP fruits and veggies, animal proteins, rice, and sugars that are lower in fructose. There are hundreds of foods that have been tested at Monash University and certified as safe for people with IBS.

One caveat: the low FODMAP diet is quite specific.  Rather than just avoiding one group of foods, such as meat or fats, the low FODMAP diet restricts certain foods from many different food groups.  For this reason, it can be a little challenging to get the hang of, so please call the office at 310-360-6807 and make an appointment if you think you’d like to give it a try.  We can schedule some time to discuss your IBS symptoms and specific nutrition needs, and give you some pointers on getting started with the diet.

The Monash University website also has some great information on this diet, including recipes and a list of high and low FODMAP foods. You can view these resources at: https://www.monashfodmap.com/about-fodmap-and-ibs/

Achieving Your Weight Loss Goals

With January and February complete, many of my patients are still working towards achieving their New Year’s resolutions.  Often, this means a renewed focus on health and physical fitness, and particularly on losing weight. In addition to its aesthetic aspects, weight loss has so many positive benefits for health—decreased risk of chronic diseases, increased self-esteem, improved energy levels—but this resolution can certainly be challenging to accomplish.

First and foremost, it’s always a smart idea to meet with your healthcare provider prior to beginning any weight loss program.  I can help you to identify an appropriate target weight and physical activity level, and help you develop a personalized weight loss plan that complements your lifestyle.

Patients sometimes struggle to lose weight through diet and exercise alone.  If this sounds familiar, I may have some strategies that can help you meet or maintain your weight loss goals.  Orbera® is a comprehensive, managed weight loss system that has been shown to help patients lose more than three times the weight of diet and exercise alone.  I’m excited to now offer Orbera at my Beverly Hills office.

For most patients, Orbera is a year-long program.  We begin by placing a temporary gastric balloon in your stomach, which stays in place for about six months.  During these six months, you’ll learn portion control, retraining your brain to understand what it means to eat healthy.  The balloon placement is a simple, outpatient procedure that is done in-office.

After the balloon is removed (again, through a simple, in-office procedure), you’ll continue working through the Orbera program for an additional six months.  During this time, you’ll follow a specialized diet and exercise program, receive personalized support from my office, and further develop your healthy eating habits—making it far more likely that you’ll be able to maintain your weight loss.

CoolSculpting® is another in-office option that can help you achieve your weight loss goals.  Unlike Orbera, which focuses on overall weight loss, CoolSculpting targets fat in specific areas.  It’s great for contouring stubborn areas that may be resistant to diet and exercise, such as the chin, upper arms, or love handles.

Using a specialized applicator, the CoolSculpting system delivers targeted cooling to trouble areas, essentially freezing off the fat cells.  Over the next four to six months, your body will naturally flush out these fat cells, leaving a contoured, sculpted physique. CoolSculpting is a safe procedure with no downtime, so many patients even return to work after their appointment.

Because Orbera and CoolSculpting may not be right for every patient, you’ll need to schedule a consultation to ensure you achieve the best weight loss results.  You can contact my office at 310-360-6807 if you have any questions about these procedures, or to schedule a consultation.

What Are Hemorrhoids?

https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-basics#2

Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop.

Swollen hemorrhoids are also called piles.

Hemorrhoids are one of the most common causes of rectal bleeding. They're rarely dangerous and usually clear up in a couple of weeks. But you should see your doctor to make sure it's not a more serious condition. He can also remove hemorrhoids that won't go away or are very painful.

Internal and External Hemorrhoids

Internal hemorrhoids are far enough inside the rectum that you can't usually see or feel them. They don't generally hurt because you have few pain-sensing nerves there. Bleeding may be the only sign of them.

External hemorrhoids are under the skin around the anus, where there are many more pain-sensing nerves, so they tend to hurt as well as bleed.

Sometimes hemorrhoids prolapse, or get bigger and bulge outside the anal sphincter. Then you may be able to see them as moist bumps that are pinker than the surrounding area. And they're more likely to hurt, often when you poop.

Prolapsed hemorrhoids usually go back inside on their own. Even if they don't, they can often be gently pushed back into place.

A blood clot can form in an external hemorrhoid, turning it purple or blue. This is called a thrombosis. It can hurt and itch a lot and could bleed. When the clot dissolves, you may still have a bit of skin left over, which could get irritated.

What Causes Them?

Some people may be more likely to get hemorrhoids if other family members, like their parents, had them.

A buildup of pressure in your lower rectum can affect blood flow and make the veins there swell. That may happen from extra weight, when you're obese or pregnant. Or it could come from:

• Pushing during bowel movements

• Straining when you do something that's physically hard, like lifting something heavy

People who stand or sit for long stretches of time are at greater risk, too.

You may get them when you have constipation or diarrhea that doesn't clear up. Coughing, sneezing, and vomiting could make them worse.

How to Prevent Them

Eat fiber. A good way to get it is from plant foods -- vegetables, fruits, whole grains, nuts, seeds, beans, and legumes.

Drink water. It will help you avoid hard stools and constipation, so you strain less during bowel movements. Fruits and vegetables, which have fiber, also have water in them.

Exercise. Physical activity, like walking a half-hour every day, is another way to keep your blood and your bowels moving.

Don't wait to go. Use the toilet as soon as you feel the urge.