The End of Elimination and Reintroduction.

It’s been quite some time since I last wrote a blog post about how I was getting on in the reintroduction phase and there are a lot of reasons for that, but from my bare notes the crux of today’s message is:

  • The elimination phase is hard.
  • The reintroduction phase will challenge you in ways you didn’t think of beforehand.
  • You will f**k up and possibly more than once.
  • But it’s definitely worth it in the long run.

Let me go into more depth.

I entered the elimination phase thinking that the only time I would need to dedicate to it would probably be a couple/few weeks before my gut had quietened down enough so that I could start the reintroduction phase. This was not the case. It took five weeks of elimination in total.

That’s five weeks of eating only very low FODMAP foods. Now don’t get me wrong, I created a lot of very delicious low FODMAP meals in that time and ate very well, but as a self-confessed ‘foodie’ I found myself missing a lot of higher FODMAP foods. However, I got through the elimination phase eventually (and was a low FODMAP saint the whole time) and began the reintroduction phase.

I have to say that by the time five weeks of elimination had passed I was like a kid in a sweet shop when reintroduction came around, so I struggled to decide between bread and dairy as my first re-challenge. (Although you’d normally only cut out lactose-containing products during elimination, I’d completely cut out dairy because I have a mild milk allergy and Lesley, the dietitian who was helping me through the process had suggested that I omit it from my diet so that we could eliminate it from my symptoms and help us to gain a more accurate result.)

Dairy won the coin toss, so I began week six challenging lactose. It went okay to start with and I wasn’t seeing any massive ill-effects, but it must have had a cumulative effect because I ended up having an IBS attack later that week. The lesson I took from that week was to stay on non-dairy milks (which I don’t mind because hemp milk’s delicious), but have the occasional piece of cheese when I fancy it, such as in a tomato, basil and mozzarella salad or a griddled halloumi burger or good brie on top of a cracker. You get the drift.

Week seven I chose to reintroduce bread. When it comes to reintroducing fructans you need to challenge each food that you want to reintroduce separately because the way the digestive system processes fructans differs for each food. In essence, you might find that you can tolerate some fructans, but not others.

So, you would follow a structure of:

  • Week 1: try reintroducing bread
  • Week 2: try reintroducing pasta
  • Week 3: try reintroducing cereal
  • Week 4: try reintroducing onion
  • Week 5: try reintroducing garlic.

I miss wheat bread a lot on the low FODMAP diet and don’t find gluten-free bread very tasty, so I was really excited, but nervous too, to try its reintroduction. I thoroughly enjoyed eating wheat bread again and I’m pleased to say that apart from a bit of bloating I had no real ill-effects, such as painful spasms. However, on Thursday that dramatically changed, but not because of the bread.

The Thursday of that week was my youngest step-son’s birthday, so we ordered a takeaway from his favourite Indian restaurant in Stirling. I love Indian food and this restaurant’s food is the best I’ve ever tasted, but’s also extremely heavy on the onion and garlic, so I’d resigned myself to having something low FODMAP from the fridge instead. This was not to be. When the food arrived it smelled out of this world and my little FODMAP-sensitive tummy (and brain) went out of the window. Let me tell you what I had:

  • Vegetable pakora (crisply fried on the outside and soft inside, filled with such vegetables as potato, ONION and CAULIFLOWER) that were dipped in ONION and GARLIC-laden pakora sauce.
  • Lamb dansac (a delicious slow cooked lamb curry that’s simmered in an ONION, GARLIC and LENTIL curry sauce).
  • Crispy poppadums (formed from CHICKPEA flour) that came with a delicious fresh ONION chutney.
  • And finally, Naan bread (made from WHEAT flour).

My mouth’s watering just typing this menu out, but in the early hours of the next morning it was watering for a very different reason as waves of nausea swept over me and I spent hours going back and forth to the bathroom. I felt like such a fool, but my dietitian, Lesley, was really understanding about it and just advised me at the time to eat entirely low FODMAP and allow my gut to completely quieten down before I tried re-challenging again. It took around five days for my gut to finally re-settle into normality.

Do I regret it? Yes, of course I do – I was in a great amount of discomfort. However, it also forced me to remind myself that I’m only human and it’s okay to f**k up with FODMAPs occasionally.

It’s now week ten of reintroduction and I’ve so far I’ve re-challenged polyols (fine), sorbitol (fine) and fructose (fine), but I’ve yet to try re-challenging galacto-oligosaccharides (GOS) and some fructans. I’ll get there eventually.

As you can see, the elimination and reintroduction phases are time-intensive and can be very taxing, but I would wholeheartedly recommend that anyone who has been officially diagnosed with IBS goes through them because it really does help you to identify your own personal FODMAP triggers and it may enable you to incorporate some higher FODMAP foods into your diet. Apart from enabling you to eat a bigger range of tasty food, this wider variety of foods will in turn also help support the growth of your good gut bacteria.

During this process I’ve built up a large collection of elimination phase-suitable recipes that I’m thinking of turning into a new cookbook and I would love to hear your thoughts on this, so please get in touch with your opinion.

I’d like to take this opportunity to wholeheartedly thank FODMAP-trained dietitian, Lesley Reid, for helping me through the elimination and reintroduction phases. Her support was incredible and she made the whole process achievable. Needless to say, if you’re looking for a FODMAP-trained dietitian to help take you through the experience I would highly recommend Lesley. (You can find her details below.)

And finally, I’d like to thank all of you who have followed my journey through the elimination and reintroduction phases. Your support and encouragement have been invaluable!

Lesley Reid, King’s College Professional FODMAP Qualified Dietitian

Lesley’s details are:

Telephone:
07777640035

Email: info@lesleyreiddietitian.co.uk

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One thought on “The End of Elimination and Reintroduction.

  1. Marilyn says:

    Well done, I would be very interested, I am currently on phase 1 going into my 4th week , I struggle for meal and snack choices as I am normally a very plain fussy eater anyway, so therefore my allowed choices are limited even more, I do know I am lactose intolerant so I am fine with eating & drinking Arla Lactofree milk, & yogurts, my bloating has reduced slightly, but still having lots of motions during the day ranging from med to small soft to normal and suffer from lots of wind.
    I have been diagnosed with Diverticular disease, and acute diverticulitis, hyitis hernia, duedonial ulcer,and gastritis, maybe you could offer some advice .
    Thanking you
    Marilyn

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