Tuesday, November 15, 2011

The Elimination Diet

So you feel relieved that you now have a diagnosis and you know that you have FM, but then you turn to the computer to get a list of foods you can and cannot eat and you discover that every list says something different.  Talk about confusing and discouraging.  If you’re lactose intolerant you remove milk from your diet and after a time slowly reintroduce foods on the list that are low in lactose, if you’re gluten intolerant you look at the list of grains/flours that have gluten in them and remove them from you diet.  If you’re fructose intolerant (malabsorbant) you can’t find a list … or you can find lots of lists, but they’re all different and you have no idea what you can and cannot eat. 

It’s a bit overwhelming at first, overwhelming and frustrating.  It is a constant battle of evaluating everything you eat and every symptom you have, small or big, to try piece together what may have cause that, what did you miss or what did you accidently eat when you thought you were doing so good.  This is usually one of the biggest challenges of FM, trying to understand the diet and what works for you.  And in the end, even if you’re with a support group that can help to guide you, it all comes down to trial and error and what works for you.  There is no magic list, you have to trial the foods yourself to figure out what you can handle and what you cannot, you have to stay focused on the long task of reintroducing foods.  Depending on your level of sensitivity you may find this a challenging process or it may go okay if you are not extremely sensitive. 

One of the purposes of the Elimination Diet is to help you determine how sensitive you are and to give yourself a clear indication of what foods are okay, but the main purpose of the elimination diet is to get yourself to a point of feeling well again, to rid yourself of those symptoms that sent you searching for an answer in the first place.  This process usually takes about 5-7 days.  It is recommended to stay on the elimination diet for at least one week, preferably two weeks, this gives you system a chance to clean out as well as some time to recuperate, the more recuperation time the better the reintroduction of foods will go.  Some people have spent more time on the very basics because they just feel better that way.  The problem I encountered with the elimination diet is the lack of variety.  The lack of variety makes it hard to stick to, but it also means lack of nutrition.  I suffer from IBS-C and was left wondering if the constipation was still there because of the lack of fiber, fruits and veggies in the diet.  Unfortunately I was unable to reach a stage of feeling well as I could not get rid of the constipation (later I discovered this was a side-effect from my medication) but after a couple weeks on the elimination diet I decided I had to move forward to try and get more food into the diet.  There is no clear cut answer on how to go about it, you have to go on how you feel and what you think is best for your body, but it is definitely recommended to aim for at least one week on the very basics to get your system cleaned out.

After you have given your system a chance to clean out and hopefully feel better then it’s time to start trialing food.  This is where it almost gets more difficult.  You feel like you made it through those first days of eating nothing and now you’re ready to go, but the battle has only begun.  It is recommended to only introduce ONE new food every 4-5 days.  Reactions times can vary from immediately to up to 3 or 4 days after you have eaten a offensive food.  With time you will learn what your reaction time usually is and you may be able to adjust your reintroduction times, but as much as you want to rush things it is best to take it slow.  The next big battle is against cheating … oh it’s so tempting to just have a little bit of something bad … but that means you’ve messed up your system and have to clean it out again.  That means you have to go back to the basics for 5 days or so to give your body a chance to be recuperate otherwise you will not truly know if it’s the new food you introduce that is the problem or the food you ate when you cheated.   As you can imagine adding one new food every 5 days means it takes a LONG time to build up your food list … and that’s if things go well.  If you introduce a food that you react to you need to make sure you give 4-5 days of healing time before you try something new. 

I give credit to anyone who is able to stick out the elimination diet without cheating or getting sidetracked.  It is a difficult journey and I will admit that there were many times where I just “had to have” that “bad snack”.  Only to regret it shortly after I ate it, realizing that I was never going to get ahead if I kept picking at those things I missed so much.  It’s hard, and it’s frustrating, but it does get better.  It is also very much a mental battle.  You have to WANT to get better and WANT to go through the process.   There will be discouraging times where you can’t figure out what’s effecting you or you feel like you will never feel better, but you need to keep at it.  You need to also come to a point of accepting that this is a permanent change.  I think that was one of my biggest problems, I thought our FM issues were mild enough that we could get away with just removing the worst items and still being “normal”.  I had to come to terms with the fact that if we truly wanted to feel better then we had to change how we eat.  Many people find it useful to keep a record of the foods they eat and any symptoms they have each day so that they can better evaluation what is happening and be able to look back over time to see if there is a consistent pattern.

I know what the next question is … “what can I eat on the elimination diet?”

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