The Whole Food Guide to Overcoming Irritable Bowel

Syndrome Strategies and Recipes for Eating Well With IBS,

Indigestion, and Other Digestive Disorders

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 Contents
Acknowledgments and Dedication
Introduction
Chapter 1 Name It and Claim It
Chapter 2 A Functional Problem with Many Causes
Chapter 3 One Person’s Food Is Another’s Poison
Chapter 4 Back to the Basics
Chapter 5 What You Can Do to Help Your Gut
Chapter 6 Kitchen Setup for Simplified Cooking
Chapter 7 What Do I Eat?
Chapter 8 Try It, You’ll Like It
Beverages
Morning Cleanser
Lemon Liver Flush
Chia Fresca
Vegetable Juice
Nut Milks
Almond Milk
Creamy Cashew Milk
Cashew-Flaxseed Milk
Smoothies
Berry-Coconut Smoothie
Fruit Smoothie
Green Smoothie
Energy Smoothie
Breakfast
Perfect Soft- or Hard-Boiled Eggs
Poached Eggs Florentino
Green Eggs
Breakfast Patties
Golden Carrot Pancakes
Flaxseed Pudding
Porridge
Nutty Porridge
Snacks
Soaked, Dried Nuts or Seeds
Flaxseed Crackers
Rose-Hip Spread
Fabulous Flaxseed and Pumpkin Seed Spread
Sesame Seed Cheese
Nori Snack Roll
Toasted Sea Palm
Baked Corn Chips
Easy, Fresh Salsa
Guacamole
Mango Salsa
Liver Pâté
Salads and Dressings
Mustard Dressing
Miso Dressing
Lemon-Garlic Dressing
Sweet Cucumber Salad
Confetti Coleslaw
Sauerkraut
Bean and Whole-Grain Salad
Sprouted Hummus
Sardine Salad
Vegetable Dishes
Baked Winter Squash
Roasted Root Vegetables
Laura’s Fantastic Greens
Mashed Garlic Cauliflower
Collard Noodles
Gluten-Free Grain Side Dishes
Millet-Amaranth Pilaf
Kasha
Polenta
Simple Fried Rice
Soups
Mineral-Rich Bone Broth
Vegetable Stock
Chicken-Vegetable Soup
Japanese-Style Fish Soup
Thai Chicken Soup
 Beet Soup
Winter Squash Soup
Entrees
Fast Beans and Corn
Spaghetti-Squash Frittata
Shrimp Curry
Shrimp Stir-Fry
Baked Fish
Slow-Cooked Turkey Thigh
Turkey Meat Loaf
Chicken Italiano
Lamb-Fennel Stew
Leek-Beef Burgers
Desserts
Flax Icing
Banana-Almond Bread (or Muffins)
Coconut-Carob Candies
Banana-Cashew Pudding
Fruit Compote
Nutty Carrot Cake
Sweet Potato Pie
Pumpkin Pie
Blueberry Pie
Cashew Cream
Resources
References
 Acknowledgments and Dedication
I wish to thank my parents for nurturing my curiosity and problem-­solving
abilities, my editors, mentors, teachers, clients, and students who are also
my teachers. I especially want to thank my Diana, who has supplied
unwavering support in so many ways.
 Introduction
In the United States alone, 10 to 15 percent of the population—45.5 million
people—suffers from irritable bowel syndrome (IBS) (Saito, Schoenfeld,
and Locke 2002). If you are among them, I wrote this book to help you take
charge of your life and work toward regaining your health. I want to
provide you with some tools to help you find the best diet for you, and I’d
like to share what worked for me in my healing process, so you and others
can learn from my experience of overcoming IBS without drugs or surgery.
Through careful observation and alternative testing, I was able to discover
what foods, environmental factors, pathogens (such as harmful bacteria,
viruses, and fungi), activities, and emotions contributed to my IBS
symptoms. I was able to address the pathogens and change my eating and
lifestyle habits. Once I changed my diet, my digestion improved in two
weeks. As I continued incorporating lifestyle changes and repairing my gut,
the symptoms slowly and consistently subsided. Today my digestion is
healed, and if I have a minor upset, I can identify the source and recover in
hours instead of months. I don’t take any drugs, and I take only a few
specific supplements, which I’ll identify for you.
After healing my own digestion with whole foods, relaxation, massage,
gentle exercise, herbs, and supplements, I became a certified nutrition
consultant, and I have helped many others improve their overall digestion
and overcome IBS. I hope this book will give you the tools to help you find
the solution to your own IBS.
With the information in this book, I hope to help you answer these
questions:

What is IBS, and how do I know if I have it?

How is the digestive system supposed to work?

What’s likely to contribute to IBS?

How do I figure out what’s making my gut hurt and what to do

about it?
 How do I choose foods that won’t give me pain, and why do some
whole foods help?

What does stress have to do with it?

What about fiber?

Are there herbs or supplements that will help?

What do I eat?

Can I ever eat out again?

You can find the answers to these questions by following this book step
by step. If you use the forms this book provides to document your own
reactions to foods and activities, you’ll begin to notice what affects your
digestion and overall health. Follow the simple recipes and use them as
starting points to fine-tune your diet. Be patient with yourself. Regaining
proper bowel function and healing yourself can take time. Do the best you
can and realize that no one’s perfect. If you have a relapse, don’t agonize;
instead, analyze and learn what you need to do differently next time. Even
slow progress is beneficial and indicates healing. I’m living proof that
healing is not only possible but also likely, if you give yourself the attention
and care you deserve. Your body wants to be whole and healthy, and if you
give it the opportunity, that’s what you can expect.
The most effective approach to any health challenge is to look at the
entire body, lifestyle, and attitude in order to change the process of
degeneration to one of regeneration. Everything affects everything else. Our
digestive system is a continuous unit that is attached to, and interacts with,
the rest of the body. Each part of the digestive system depends on all the
other parts. Gulping our food without thoroughly chewing it results in an
irritated intestine. The chemicals we encounter in our food and environment
as part of our modern life can irritate the entire gut tube, not just the area of
entry. This is because we can eat chemicals, inhale them, or absorb them
through the skin. Also, spending excess energy worrying can deplete energy
needed to repair or maintain our digestive process, potentially resulting in
IBS. The key is to proceed with awareness and attention to the food you eat
and how you eat it, and to simplify your overall environment. This holistic
approach can help you regain a healthy life, free of IBS.
 Chapter 1

Name It and Claim It

Irritable bowel syndrome (IBS), sometimes called spastic colon or nervous
indigestion, is one of twenty-five functional gastrointestinal disorders
(Olden 1996). It can be severe enough to prevent you from working or
leaving home, lest a toilet be too far away. Defined by its symptoms after
other possible causes are eliminated, IBS is characterized as: abdominal
pain or cramping relieved by a bowel movement; changes in bowel habits;
stool urgency; diarrhea, constipation, or both; and gas and bloating in the
absence of detectable structural abnormalities or other causes (Bolen 2009).
Many of the symptoms of IBS also apply to inflammatory bowel disease
(IBD), celiac disease, and cancer, so it’s important to consult a medical
doctor to rule out these serious diseases (Collins 1994).

Possible Causes and Missed Diagnoses

The most often overlooked cause of IBS, celiac disease is an inherited
sensitivity to gluten, the protein in wheat and other cereal grains. Celiac
disease is an extreme enough autoimmune disease to potentially destroy the
intestinal lining. Two studies showed that 10 percent of participants with
IBS had celiac disease (Shahbazkhani et al. 2003; Sanders et al. 2001).
Doctors use antibody testing of blood and saliva samples to diagnose celiac
disease, and genetic testing (by mouth swab) can determine if you are
predisposed to it, even if you no longer consume gluten.
Doctors’ gold standard for diagnosing celiac disease is to use a biopsy to
look for damage to the small intestine. But since the intestine can heal itself
in a matter of months, if you didn’t consume gluten at all for several weeks
prior to the biopsy, you could get false-negative results. A false negative
means that little or no damage was found. Some doctors still believe there
must be total destruction of the villi of the small intestine to diagnose celiac
disease, but newer data shows that even partial villi destruction indicates
celiac disease (O’Bryan 2008).
When you are trying to overcome IBS, you need to ask what’s irritating
your gut. The answer could be nearly anything, from various food allergens
or chemicals to an imbalance of gut flora to hormone and neurotransmitter
imbalances (Talley 2006). The same substances that cause the intestine to
spasm and quickly eliminate the bowel’s contents can sometimes lead to
more serious conditions if the cause is not addressed, or if drugs or
laxatives, which thwart the body’s protective and self-healing mechanisms,
are used.
The problem with IBS is that the actual cause of the symptoms may be
overlooked or downplayed as stress, or you might even hear your doctor say
something like, “It’s all in your head.” Many people with real but
undetected causes of abdominal discomfort have been given antidepressants
or tranquilizers to reduce their pain (Waxman 1988). The key word is
“undetected.” As we get better at finding a cause for this type of irritation,
it’s likely that there will be fewer IBS diagnoses. In many of my clients, a
specialized stool test not only shows the presence of pathogenic or
imbalanced bacteria in the gut (also known as dysbiosis), but also indicates
how well the digestive system is working (Goldberg, Trivieri, and Anderson
2002). Specialized laboratories test for antibodies to specific pathogens and
can indicate which treatments are most effective (see the resources for a list
of laboratories). Colonoscopy, or endoscopic examination of the colon,
shows only structural issues, not microscopic changes or bacterial infection.
Once the pathogen is eliminated or the imbalance corrected, the gut can
heal, and IBS symptoms can disappear.
It’s becoming well known that people with IBD, such as Crohn’s
disease or ulcerative colitis, often also have IBS. The difference between
IBS and IBD is that people with IBD have detectable structural
abnormalities (Collins 1994). I think of IBS as one of the first steps on the
continuum of dysfunctional digestion. IBS may also be just one symptom of
a life out of balance. IBS affects the whole body and mind, and vice versa.
Not knowing when they will need a toilet can cause many IBS sufferers
to restrict their activities considerably. The inability to feel comfortable in
your own body can be depressing and anxiety producing. When you can’t
rely on your digestion, what can you rely on? Food can become the enemy.
You may find it easier to eat little, since many symptoms are reduced or
eliminated when the digestive system isn’t called on to do any work. Some
foods may not cause symptoms for a while, but, due to overconsumption,
may start triggering symptoms later, further narrowing the variety of foods
you can eat.
When something irritates another part of our body, we avoid it. We can
physically move away from and avoid a skin irritant. We can wash away
bacteria and irritating chemicals, such as paint or poison oak sap. We can
avoid insects or swat them away to protect our skin. Similarly, we can
eliminate an irritant from the digestive tract; the body uses sudden diarrhea
(and sometimes vomiting) to get rid of the toxic irritants excreted by some
pathogenic bacteria, such as those involved in food poisoning. Some other
microbial toxins (like those produced by Clostridium difficile) directly alter
the rate of bowel movement less violently (Joneja 2004). If the body
succeeds at eliminating the pathogen, there’s no resulting infection, since
the intestinal contents are actually part of the exterior environment, not part
of our tissues.
Unfortunately, though, we may not be able to directly identify the
digestive tract irritant, because it may be from something we consumed
days before, or it may relate to something we breathe (chemical exposure)
or even to the hormones we produce during stress, monthly cycles, or both.
We can’t avoid an irritant we can’t identify, so we keep coming in contact
with it. And just as a continuous skin irritation can lead to inflammation and
disease of the skin, the same applies to an ongoing irritation of the internal
“skin” of the digestive system. Continuing to eat foods or substances that
cause reactions, and that our bowels then try to reject, may eventually make
us tolerate those foods—but damage continues to occur. If we ignore the
warning signs, the unchecked causes can eventually lead to damage and a
more severe diagnosis.
The key to keeping food from becoming the enemy, it turns out, is to
vary your diet every day on a four-day rotation plan. I’ll show you how to
identify and avoid your trigger foods, and help you set up a rotation diet to
prevent your body from reacting to replacement foods.

How Do I Know If I Have IBS?

No specific test exists for IBS, so ruling out other diseases and physical
causes is the first step. The primary symptom is chronic abdominal pain,
often very severe, possibly accompanied by a bowel movement or relieved
after a bowel movement. The Rome Foundation is a nonprofit organization
that helps those with functional gastrointestinal disorders. They use the
following criteria to diagnose IBS. If you have two of the following
symptoms, your abdominal pain may be associated with IBS (Longstreth et
al. 2006):

Pain relief with defecation

Onset of pain or discomfort associated with change in frequency of

stool

Onset of pain or discomfort associated with change in form of stool

Several variations (subtypes) of IBS exist, and though they are not
absolute, one or more of the symptoms of a subtype must be present to
identify that specific subtype (Mearin et al. 2003):

1. Diarrhea-predominant IBS (IBS-D)

three or more bowel movements a day

loose, watery stools

fecal urgency

2. Constipation-predominant IBS (IBS-C)

fewer than three bowel movements a week

hard or lumpy stools

straining during bowel movements

3. Mixed-type IBS (IBS-M)

both hard and loose stools over a period of hours

or days

4. Alternating-type IBS (IBS-A)

 change from one subtype to another over periods
of weeks or months
Other symptoms you may experience with IBS include:

whitish mucus in the stool

swollen or bloated abdomen

incomplete evacuation (the feeling that you haven’t

finished a bowel movement)

Women with IBS often have more symptoms during the menstrual
period. According to the American College of Gastroenterology, 80 percent
of people with IBS are women (American College of Gastroenterology
Functional Gastrointestinal Disorders Task Force 2002). About half of
people with fibromyalgia or chronic fatigue syndrome are likely to have
IBS (Blanchard and Abrams Brill 2004). Having an autoimmune condition
also increases the risk of IBS, and vice versa (Ibid.). Interestingly,
temporomandibular joint (TMJ) dysfunction is another common condition
among IBS sufferers (Whitehead, Palsson, and Jones 2002). Muscle tension
in the jaw may indicate stress, which also affects digestion and elimination,
and TMJ may also affect chewing, which, as we’ll see, is critical for good
digestion.

I’ve created the following questionnaire for you to use in assessing your
symptoms to see if you have IBS. Look back at your symptoms over the
past six months (including your toilet habits). Rate the frequency of your
symptoms and place the corresponding number in the table. When you’ve
finished, add up the columns. Don’t worry if you can’t figure exactly how
often you have the symptom; approximate. All of these symptoms are signs
of disordered digestion, but some are more serious than others.
Scoring Key:
Never = 0
Less than once a week = 1
Once a week = 2
Many times a week = 3
Every day = 5
Many times a day = 7
*If you have this symptom, see your health care provider immediately.
Interpreting Your Score:
1 to 10 IBS is unlikely, but your digestion is not optimal.
11 to 25 IBS is possible. Simple changes may improve your symptoms
within a short period.
26 to 50 IBS is probable. Follow this book’s recommendations.
51 to 198 Consult a doctor. If disease is ruled out, you will likely be
diagnosed with IBS. Following this book’s suggestions will help you.
If you score over 50 and have been diagnosed with any of the conditions
in the next table, you may need to seek help from a specialist in digestive
disorders. If you hear “there’s no cause” and you will “have to live with it,”
read on and follow this book’s suggestions. There are causes and you don’t
have to live with the debilitating symptoms of IBS. You can do a lot to
change your life for the better.
Check (✓) all the following diagnoses that apply to you:

***

How Is the Digestive System Supposed to Work?

We all eat. We think little about our digestion unless it’s not working
properly. Even as infants, we knew when we were hungry. As children, we
learned what it felt like when we needed to poop and to control that need
until we could get to a toilet. We also knew if our tummy hurt or if we
didn’t feel well, though as children, we may have had difficulty expressing
that information. Beyond hunger or the need to defecate, most of us have no
idea how our digestion should function. Improperly working digestion may
result in IBS.

I Think, Therefore I Eat

Let’s start at the beginning—with the brain, because it controls much of
our digestive response, and it can enhance or reduce our ability to digest
properly. We respond to thinking of, seeing, or smelling food by secreting
saliva and other digestive juices. The food industry is well aware of this
response and takes advantage of it, using advertising to entice people to
consume its products as often as possible. Constantly being surrounded by
food affects the digestive system’s functionality. Digestion may
overrespond or underrespond. People who are incessantly exposed to food
or its images may succumb to overeating, or may consciously ignore urges
to eat. Continuous consumption can tire your digestive process, cause
excessive weight gain, or both. From my clinical experience with food-
service workers, chefs, and waitpersons, ignoring hunger signals can
confuse your natural digestive responses, reducing appetite and hunger
awareness.
Aside from having a role in appetite, the brain plays a part in controlling
blood flow, and thus digestive maintenance and repair. When we are calm,
relaxed, and unrushed, the digestive system can easily provide the chemical
secretions and muscular movements required to take food apart and extract
what we need, as well as easily eliminate wastes, because blood circulation
to the digestive system is properly maintained when we are relaxed. When
we are stressed, circulation is partially diverted away from the digestive
organs to the large muscles, heart, and lungs (Selye 1956).