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The Great Physician's Rx for Irritable Bowel Syndrome
By Jordan Rubin Joseph Brasco
Nelson BooksCopyright © 2007 Jordan Rubin with Joseph Brasco, M.D.
All right reserved.
Chapter OneKEY #1
Eat to Live
Let's say that thirty minutes after finishing a meal, a thumping headache bounces around the inside of your skull like a leaded Pachinko ball. Your stomach gurgles like Mount St. Helens, and you know what's coming next: a sprint to the nearest throne before the volcano explodes.
Spot a pattern here?
Eating is never any fun if you're sitting on porcelain half the day. In the midst of my digestive troubles during my college years, I dreaded every meal because I knew where I would eventually be heading. Sooner or later, though, I had to eat, so I lived on bland chicken soup, butternut squash, and pureed peas with the skin taken off. Gerber babies had it better than I did.
I tried dozens of diets, some mainstream, some faddish. For instance, I stopped eating meat for a while. Then I drank large amounts of cabbage juice. Another diet called for the consumption of Chinese and Peruvian herbs, Japanese kampo, olive leaf extract, and shark cartilage. I even attempted the ultra-clear detoxification/elimination diet. Talk about a colon cleanse!
Then I heard about the Specific Carbohydrate Diet (SCD), popularized by biochemist Elaine Gottschall, author of Breaking the Vicious Cycle. Without going into many details, the Specific Carbohydrate Diet banned many carbohydrate foods, fluid dairy products, grains and grain products, potatoes, yams, bean sprouts, and soybeans. I contacted Mrs. Gottschall, and for a couple of months, this kind lady and I conversed nearly every day as we tweaked the diet to cure my dreadful digestive problems. I stayed on the SCD diet for nearly six months with fanatical adherence, but it failed to reverse my condition, although thousands of others have said the Specific Carbohydrate Diet made a huge difference in calming their digestive tracts.
My battle with intestinal disorders lasted two years. During that time, I was bedridden with daily bouts of nausea, fever, night sweats, loss of appetite, severe abdominal cramps, and bloody diarrhea. I saw seventy doctors and medical practitioners (both traditional and alternative), including several gastroenterologists. They conducted a battery of tests, including the dreaded upper and lower GI and the unpleasant barium swallow.
The verdict: I had one of the worst cases of Crohn's disease they had ever come across. One of my doctors feared I would have to opt for the surgical removal of virtually all my large intestine and some of my small intestine. In surgical terms, doctors called it a colostomy. In practical terms, it meant I would have to wear bags attached to my abdominal wall to handle my bodily waste.
To a twenty-one-year-old on the cusp of adult life, that sounded like a death sentence. But I had no choice; I had run out of options. I was nothing more than skin and bones, a 104-pound skeleton close to death.
A week before my surgery, an acquaintance of my father called from San Diego. "I know why your son is not well," he began. "He's not following the health plan in the Bible."
Health plan in the Bible? I had read more than three hundred health books in the search for a cure, but not the Bible. I immediately grabbed my concordance and looked up every Scripture that had to do with health, food, and healing. What caught my attention was that God had given us a wonderful array of "natural" foods to eat, but our modern-day culture preferred inexpensive deep-fried, greasy foods high in calories, high in fat, high in sugar, and-in most people's minds-high in taste.
I started feasting on the Word of God and ate what God said to eat. I'll share specifics in a moment, but what I did can be boiled down to a pair of foundational thoughts that you can follow:
1. Eat what God created for food.
2. Eat food in a form that is healthy for the body.
I'm here to tell you that God healed my body in forty days. I gained twenty-nine pounds during that time, and while my healing wasn't instantaneous, it was miraculous nonetheless. To eat without pain and subsequent diarrhea felt like heaven on earth.
I want you-the person suffering from IBS-to experience that same type of miracle. I can't promise you that following Key #1 of The Great Physician's Rx for IBS will chase away your abdominal stress, diarrhea, or constipation entirely, but I am confident that these principles give you the best shot at experiencing a vibrant life.
Besides, hasn't every other approach failed?
An Introduction Is in Order
It's time for me to introduce Dr. Joseph Brasco, a board-certified physician in internal medicine and gastroenterology and my coauthor for this book. I met Dr. Brasco in 1999 at a seminar on clinical nutrition. I had been asked to speak about my digestive tract problems and what I did to get well; sitting in the front row that afternoon was Dr. Brasco.
After my talk, Dr. Brasco introduced himself to me. For a gastroenterologist, he seemed pretty cool: late thirties, dark curly hair, hip clothes, and a calm and dignified persona. He was friendly with a warm bedside manner.
As I recall, he thanked me for my transparency and wondered if we could have lunch together to discuss the topic further. I replied, "By all means," but I couldn't get over how a specialist in gastroenterology was seeking my opinions on how diet affected digestive diseases and irritable bowel syndrome. In 1999, I was a fresh-faced twenty-three-year-old studying naturopathic medicine, not a medical school graduate like him, but I had life experiences and triumph in an area of medicine where he didn't often come across successful outcomes.
Most of his patients, he said over our meal, came into his office feeling miserable. They didn't have a serious disease like cancer or inflammatory bowel disease-just a bad case of bloating, periods of passing gas, alternating constipation, and diarrhea. They felt that life dealt them a raw hand.
There wasn't much he could do in a ten-minute office visit, Dr. Brasco explained. He would listen to his patients describe the ailment, then he usually suggested a certain medication. That's what medical physicians like himself had been trained to do: make the diagnosis, fill out the prescription form, and send patients on their way.
Except that they kept returning to his examination room, complaining about the same symptoms and wanting more than a bottle of pills. That's when he would prescribe an antispasmodic or make arrangements for an upper or lower GI. When the patients returned complaining of more abdominal pain, he would order a CT scan. While good for his billing department, the patient (or the insurance company) would spend several thousand dollars on tests, but would be no closer to feeling better than on the first day he or she walked into his clinic.
Dr. Brasco had been fascinated by nutrition in med school, but his residency at a big city hospital was an eye-opener: the people walking into the emergency room lived in gritty neighborhoods dotted with fried-chicken drive-thrus, chili hamburger stands, tacquerias, waffle shops, and every fast-food purveyor in the country. His patient load lived on junk food-and paid a high price with their health.
He tried to explain basic nutrition to his ailing patients. Stay away from fast food. Eat more vegetables. Snack on an apple a day. He had been influenced by Enter the Zone, authored by Barry Sears, which set forth the idea that restricting carbohydrates may reduce bloating and other gastrointestinal problems for those with IBS. Dr. Brasco became an evangelist for the low-carbohydrate gospel with his patients. I wouldn't say that he got in their faces, but he was rather direct.
"Listen," he would say to his patients after hearing a litany of symptoms, "I'm convinced that you have irritable bowel syndrome. We have two ways of looking at this. I can prescribe a medicine for you, which will help a little bit, but you're going to be right back in this examination room one month from now complaining that your stomach hurts. Or, if you're interested, we can change your diet, but you will have to work with me. I don't want to waste my time or yours if you're not interested in making a major lifestyle change in what you choose to eat."
Dr. Brasco said that only a third of his patients were willing to say good-bye to deep-fried crispy chicken and hush puppies. The rest preferred to take their prescription in hand and wash down pills with water, even though prescription drugs-everything from Amitriptyline to Zantac-rarely calmed things down in the digestive tract. They weren't willing to make the hard choices that a lifestyle change involves.
Dr. Brasco knew what hard choices entailed since he had digestive issues of his own. He practiced what he preached, though, by shopping at health food stores and eating a diet heavy in whole grains while eschewing meat. He believed that a high-fiber diet-bananas, oatmeal, bran cereal-would make him feel better. A funny thing happened, however: the physician wasn't able to heal himself.
So Dr. Brasco continued his search, and that's the main reason he took me aside after I spoke at the seminar on clinical nutrition. He was eager to learn more about the diet that eventually healed me of my painful digestive ailments-a diet that's part of the Great Physician's prescription for health and wellness.
Are you willing to make big changes in what you eat? I believe you'll have to, but I see nothing but upside. Aren't you enormously interested in eating without experiencing excruciating pain? Haven't there been times when you said you'd do anything to feel better? Well, your chance has come. Dr. Brasco and I are in agreement that the most important thing you can do is make changes in your eating habits, because a poor diet plays a huge role with IBS.
What you're about to read in this chapter are principles for eating that have been adopted by both Dr. Brasco and myself to ease our own digestive problems. A book that we coauthored earlier together, Restoring Your Digestive Health, laid the foundation for the 7 Keys and The Great Physician's Rx for Irritable Bowel Syndrome. If you stick with us, you'll learn why Key #1, "Eat to Live," may be your best weapon against the scourges of irritable bowel syndrome.
Making a List and Checking It Twice
When it comes to eating (1) foods that God created and (2) in a form healthy for the body, God declared in Genesis that He was giving Adam and Eve every seed-bearing plant and every tree with fruit for food (1:29) and plants of the field (3:18). In Deuteronomy, God presented the animals that people could eat: the ox, the sheep, the goat, the deer, the gazelle, the roe deer, the wild goat, the ibex, the antelope, and the mountain sheep. Elsewhere in Scripture God's people ate foods such as almonds, barley, beans, bread, cakes, cheese, cucumbers, onions, leeks, melons, curds of cow's milk, figs, fish fowl, fruit, game, goat's milk, grain, grapes, grasshoppers, herbs, honey, lentils, meal, pistachio nuts, oil, olives, quail, raisins, sheep, veal, and vegetables.
These foods I just listed are nutritional gold mines and contain no refined or processed carbohydrates and no artificial sweeteners. I'm convinced that a diet based on consuming whole and natural foods fits within the bull's-eye of "eating to live" and gives you the best chance to overcome IBS. Yet too many of the so-called foods sold in our nation's supermarkets are not created by God but are produced by employees in hairnets on an assembly line at some far-flung factory. Like sheep following the next one off a cliff, we fill our shopping carts with processed foods that do a number on our stomachs and provoke diarrhea and constipation problems. Processed foods strain the gut because the digestive tract must toil harder to extract nutrients from foods whose nutritional ingredients were raided before and during the manufacturing process.
But Jordan, if you're telling me to eat a bunch of natural foods for my IBS, it can't be this simple.
You're right. It's not that simple. You must consume your foods carefully, especially carbohydrates, which play a big part in IBS flare-ups. Every bite you take, whether it's a protein, fat, or carbohydrate, impacts your digestion-and therefore your symptoms. Let's take a closer look at these macronutrients.
Proteins Are Practically Perfect
Proteins, one of the basic components of nutrition, are the essential building blocks of the body. All proteins are combinations of twenty-two amino acids, which build body organs, muscles, and nerves, to name a few important duties. Among other things, proteins provide for the transport of nutrients, oxygen, and waste throughout the body and are required for the structure, function, and regulation of the body's cells, tissues, and organs.
Our bodies, however, cannot produce all twenty-two amino acids that we need to live a robust life. Scientists have discovered that eight essential amino acids are missing, meaning that they must come from other sources outside the body. Since we need those eight amino acids badly, it just so happens that animal protein-chicken, beef, lamb, dairy, eggs, etc.-is the only complete protein source providing the Big Eight amino acids.
That's why vegetarianism, which Dr. Brasco and I tried in our desperation to feel better, was doomed for failure.
Low Fat Equals Low Health
Before we began collaborating on Restoring Your Digestive Health, Dr. Brasco urged his patients to switch to low-fat foods, which are part of the mantra for by-the-medical-book advice: increase fiber and embrace a low-fat diet.
The problem with reduced-fat chips and fat-free cookies is more than their poor taste: chemically altered foods make things worse for the body, not better. Ron Rosedale, M.D., author of The Rosedale Diet, pointed out that laboratory animals, which live traumatic lives inside small cages, suffer from stress disorders and premature death. Yet, when these laboratory animals were fed a high-fat diet, the life-shortening effects of stress were alleviated. "The same appears to be true for humans," Dr. Rosedale writes. "Eating a low-fat diet can promote depression and anxiety in humans." And we all know that stress and anxiety are not an IBS sufferer's best friend.
What type of fats in foods should those with IBS eat? The fat found in grass-fed animals, lamb, dairy products from grainfed animals, wild-caught fish, free-range poultry, nuts, seeds, and nut and seed butters are great sources of fats. People are often shocked to hear me say this, but this is why I say butter is healthier for you than margarine. Butter, when organically produced, is loaded with healthy fatty acids such as short-chain saturated fatty acids, which supply energy to the body and aid in the regeneration of the digestive tract. Margarine, on the other hand, is a man-made, congealed conglomeration of chemicals and hydrogenated liquid vegetable oils.
Fats and oils created by God, as you would expect, are fats you want to include in your diet. The top two on my list are extra virgin coconut and olive oils, which are beneficial to the body and aid metabolism. I urge you to cook with extra virgin coconut oil, which is a near-miracle food that few people have ever heard of.
The Truth About Carbohydrates
Now comes the moment of truth about carbohydrates: those with IBS should restrict the consumption of carbohydrates and wisely choose the carbs they eat. One of the benefits of reducing carbohydrates is an improvement in intestinal flora, or bacterial microorganisms. Few people have heard of intestinal flora or are aware that there are trillions of cells in the human body but even more microbial cells in the large intestine in the form of intestinal flora. The body permits these friendly bacteria and yeasts to live in the intestinal tract because they are the first line of defense against disease-causing bacteria, viruses, toxins, and parasites.
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