The Truth Is In the Timing: What Your Digestive Reaction Time Can Reveal About the Cause of Your Adverse Food Reaction
I’ve been a dietitian working in a gastroenterology practice for almost a decade, where I spend my days listening to the gory details of meals gone awry. Through this experience, I’ve come to realize that many people who suffer from a chronic digestive problem are pretty good at identifying which food(s) seem to trigger their symptoms.
But what they’re less likely to get right is the reason why these foods provoke their symptoms – and how the timing of digestive symptoms can be part of diagnosing the root cause.
- The Truth Is In the Timing: What Your Digestive Reaction Time Can Reveal About the Cause of Your Adverse Food Reaction
- What's To Blame? Seeking Answers.
- REACTION TIMING
- Reaction Time: Zero to Fifteen Minutes
- Reaction Time: Fifteen to Ninety Minutes
- Signs of Potential SIBO
- Reaction Time: Two to Eight Hours
- When The Low FODMAP Diet Can Make Symptoms Worse
- Diagnose The Actual Root Cause
- And The Clock Keeps Ticking
- Read All Of Tamara's Articles:
What’s To Blame? Seeking Answers.
It’s The Dairy! Or Is It?
“Dairy” is a common scapegoat when, say, ice cream provokes diarrhea within minutes of consuming it – but these same patients will also acknowledge that not all dairy foods seem to have this effect.
I Know It’s The Gluten/Corn Allergy/Bacteria/Food Poisoning!
“Gluten” also gets the blame for a lot of digestive system reactions, though patients will admit that some forms of gluten don’t seem to trigger symptoms as much as others…and usually, they still suffer symptoms even when they completely avoid it.
I’ve had patients who see corn in their loose stools assume they’re “allergic” to corn, and I’ve seen patients who experience immediate indigestion upon eating something blame it on bacteria in their intestines.
Some patients prone towards diarrhea and cramping after restaurant meals assume that they just keep getting food poisoning again and again—even though no one else at the table ever gets sick, too.
In this context, my job is often to help people connect the dots between effect and cause so they can eliminate the foods that actually disagree with them, while preventing excessive restriction of foods that don’t.
To do this detective work, I probe for details about the timing of a person’s symptoms relative eating certain foods. As you will see, this relationship offers important clues as to the most likely causes of a symptom – and most importantly for our purposes, provides actionable insights into how to manage those symptoms through diet change.
You May Want To Read: The Low FODMAP Diet Is Not A Gluten-Free Diet
REACTION TIMING
Reaction Time: Zero to Fifteen Minutes
A near instantaneous adverse reaction to food typically signals an immune system or biochemical reaction to a component in that food rather than a food intolerance happening in the intestines.
After all, in this brief time period, your meal has not yet had the chance to empty the stomach and begin its intestinal journey. Therefore, such rapid adverse food reactions cannot be generally be blamed on malabsorption or bacterial fermentation as would be the case from, say lactose intolerance or another FODMAP intolerance.
Such a rapid response to food can be mobilized by the immune system in response to foreign proteins it recognizes as allergens, however. If you have a classic food allergy, in which you have elevated levels of IgE antibodies to a food protein, you could react within minutes of ingesting the trigger food – and that reaction could manifest in gastrointestinal symptoms like acute stomach pain, vomiting or diarrhea.
You May Want to Read: Food Allergy vs. Food Intolerance: Navigating a Complicated Path
We often think of food allergy as a phenomenon of childhood – and one that many kids outgrow to some extent. But adult-onset food allergy seems to be on the rise, and a recent population-based survey published in JAMA Network Open found that close to 11% of American adults have a food allergy.
Another possible cause of quick-onset digestive system reactions to food can be biochemical reactions to components in the food. Examples of this can include:
Sulfite Sensitivity
- Sulfite Sensitivity, in which affected people can experience anything from asthma attacks and hives to sudden onset abdominal cramping and diarrhea when consuming foods or alcoholic drinks preserved with foods additives called sulfites.Avoiding foods that contain sulfites – like dried fruit, red wine and a variety of condiments and frozen foods – is the remedy for this reaction.
Histamine Intolerance
- Histamine Intolerance, in which affected people can experience symptoms throughout the body within minutes of consuming a food that contains high levels of a nitrogen-containing compound called histamine. When consuming high histamine foods – from tomatoes and spinach to aged cheeses and other fermented foods – some of my affected patients may start to experience almost immediate onset abdominal bloating (distension), stomach pain, feelings their throat or chest tightening, and/or heart palpitations. (Other histamine related symptoms may take slightly longer to kick in, but among them are headaches, lightheadedness, fatigue, flushing, hives or itchiness, and/or diarrhea.)
A low histamine diet can help control such food reactions, often with support from a histamine blocking regimen taken under the supervision of a well-credentialed allergist/immunologist or gastroenterologist.
Dyspepsia
Finally, various types of Dyspepsia can lead to rapid onset upper digestive distress after eating, including upper abdominal gas (belching), excessive fullness, heartburn, nausea and even upper stomach pain.
- People prone to Acid Indigestion can experience these symptoms due to acid reflux, which may be triggered by eating larger meals, higher fat meals or foods known to reduce the pressure of the muscle that separates the stomach and the esophagus. These include alcohol, mint, onions, garlic, coffee and chocolate.
- People with Functional Dyspepsia can experience similar symptoms even in the absence of acid reflux. Rather, their discomfort results from the stomach’s impaired ability to stretch adequately in response to eating – possibly worsened by hypersensitive nerve signals in the digestive tract. Eating small, soft textured meals more frequently can help manage symptoms of this condition, and certain over-the counter remedies like FDGard or Iberogast have been shown to be helpful as well.
Reaction Time: Fifteen to Ninety Minutes
While the allergic or biochemical reactions described above can still take place in this 15 to 90-minute window of time, by now food has started emptying into the small intestine.
This opens up other possibilities in terms of the cause of your adverse food reactions.
Accelerated Gastrocolic Reflex (GCR)
People with Irritable Bowel Syndrome (IBS) who find themselves running to the bathroom with crampy diarrhea very soon after eating larger meals, higher fat meals or bulky, high volume foods like salads or popcorn are often experiencing the effects of an accelerated gastrocolic reflex (GCR).
The GCR is a normal digestive system nerve signal between the upstream portion of your digestive tract and the downstream portion of your digestive tract.
In response to greater stretch of the stomach and/or the arrival of fat into the small intestine, a message is sent to the colon that warns it of the meal coming down the pipeline that may need to be accommodated. (This is why we often poop soon after meals rather than spontaneously at random times of the day.)
Larger stretch or more fat can send a stronger signal and therefore a stronger urge to defecate – and for people with IBS, whose digestive system ‘thermostat’ is already extra-sensitive, the gastrocolic reflex can send a pretty forceful message to the colon at even lower thresholds of upstream stimulus.
For people with diarrhea-prone IBS, this may result in urgent, crampy diarrhea very soon after eating, and the notion that “salads run right through me,” though it’s not actually the salad you just ate that you’re pooping out.
For people with constipation, this may result in gas pain, visible distension of the belly and/or excess farting as the intestinal pipeline fills up with more substance and the stool in the colon is moved along…but the body is unable to actually pass a bowel movement and free up space.
People with milder cases of IBS often find that simply watching meal portions, avoiding (or limiting portions of) ‘roughage,’ and avoiding higher fat meals can keep this symptom in check. When diet modification fails, well-timed antispasmodic supplements (such as enteric coated peppermint oil) or prescription medications can be hugely helpful.
Signs of Potential SIBO
People who experience mid-to-lower abdominal gas pain, excess farting, rumbling gas noises and/or bloating that may or may not be accompanied by an urgent bowel movement in this time frame could also be looking at a case of Small Intestinal Bacterial Overgrowth (SIBO).
This is particularly the case if the foods that provoke such symptoms are high in either fat or FODMAPs. One way to differentiate between an accelerated GCR as described above and SIBO is how you react to bulky/fibrous but low-FODMAP foods like popcorn or a basic garden salad: people with classic IBS are more likely to find that these foods provoke their symptoms, whereas those with SIBO may actually find these foods to be relatively well tolerated.
You May Want To Read: SIBO: Get the Facts
Reaction Time: Two to Eight Hours
The onset of intestinal gas (especially foul-smelling gas), gas pain, bloating and/or loose stools—especially lighter colored, malodorous or ‘acidic feeling’ stools – in the 2-to-8 hour window following a meal is more like to be malabsorptive in nature.
This is because the meal is starting to move out of the small intestine – where any nutrients that can be absorbed have been absorbed – and the remaining waste is now entering the colon and encountering a huge community of bacteria.
Two hours is on the earlier side of the typical reaction time and is more likely to occur if you’ve consumed the offending food on an empty stomach or in liquid form; a more typical reaction time for food consumed in a mixed, solid meal is 4 to 8 hours.
Gas, Gas, & More Gas
The more available nutrients that remain in the waste stream – whether undigested sugars like lactose, fructose and sorbitol or undigested fibers like the fructans in onions and garlic or the oligosaccharides in beans and brussels sprouts – the more gas your gut microbiota can generate.
This gas can last for hours as the undigested material makes its way through the colon, and its severity will vary based on how much of that food you consumed. In the biz, we refer to these reactions as carbohydrate intolerances, of which “FODMAP intolerance” is counted among them.
When The Low FODMAP Diet Can Make Symptoms Worse
A rarer – and therefore less commonly recognized – form of carbohydrate intolerance is sucrose isomaltase deficiency (SID); it is an enzyme deficiency that produces digestive symptoms in response to foods that contain sucrose (table sugar) or simple starches like rice, bread, oats, potatoes, bananas and sweet potatoes. Because many of these foods are staples on the low FODMAP diet, people who find themselves experiencing worsening of symptoms after trying out the low FODMAP diet might consider exploring their food/symptom reactions with an experienced GI dietitian and pursuing testing for SID.
Diagnose The Actual Root Cause
In all of these cases, pinpointing the exact nature of the intolerance through breath testing (when available) and/or a FODMAP elimination diet followed by a controlled re-challenge protocol will help steer you toward a precise list of foods to avoid and limit unnecessary dietary restriction.
In some cases, over-the-counter digestive enzymes may be available to help improve absorption of the trigger carbs and eliminate the need to avoid them entirely. For example, lactase enzyme can minimize symptoms associated with lactose intolerance; xylose isomerase can minimize symptoms associated with fructose intolerance, and alpha galactosidase can help with symptoms associated with foods rich in the GOS family of FODMAPs.
While carbohydrate intolerances are the most common form of malabsorption – and malabsorptive symptoms – other types of malabsorption can provoke similar GI symptoms in this time window as well. People who do not produce enough pancreatic digestive enzymes—a condition known as pancreatic insufficiency—can experience malodorous gas, gas pain, diarrhea and often weight loss as well—in the 2-8 hours after consuming anything—but fats in particular. A simple stool test can diagnose pancreatic insufficiency, and prescription enzymes should remedy the situation.
And The Clock Keeps Ticking
It’s dicey to attribute a particular digestive symptom to a food you consumed more than 8 to10 hours prior, as by that time, you’ve presumably consumed at least one if not several other meals and snacks whose contribution to your symptoms cannot be ignored.
While it’s not uncommon for someone to have symptoms in the morning related to something they had for dinner the previous evening, it would be very difficult to find a mechanism by which something you ate a day ago (let alone two or even three) would start wreaking havoc on your digestive tract more than a half a day later.
To be clear: since it can take a full 72 hours total transit time from the time you eat something for its residual waste to be eliminated, it’s possible that a symptom like excess gas and bloating could start within the 10 hour window and last for a few days. But if a symptom suddenly appears, you shouldn’t be looking to what you ate three days ago to account for it.
Because it can take up to 72 hours for a food that has triggered a digestive reaction to completely clear the body, people who are testing tolerance for high FODMAP foods after an initial elimination phase are generally advised to take a three-day break after failing a FODMAP challenge before testing something new. This spacing will help ensure that you don’t confuse the cause of symptoms you experience between a previously-tested food and a new-to-test food.
Please also check out Tamara’s other articles on Gut Microbiome Testing, Are You Full of Sh*t, and also on Bloating.
And if you are struggling with determining the cause of your bloating and how to manage it once and for all, then be sure to grab Tamara’s best-selling book: The Bloated Belly Whisperer available through Amazon US, UK, CA and AU.
Read All Of Tamara’s Articles:
- What Conventional Wisdom Gets Wrong About Bloating
- Timing of Digestive Symptoms: What It Means
- What Is Leaky Gut Syndrome?
- Are You Full of Sh*t? Stool Burden and the Low FODMAP Diet
- Everything You Want to Know About Farting*
- 5 Reasons to Skip Gut Microbiome Testing – For Now
- Exclusive Interview with Dietitian Tamara Duker Freuman
- Q & A With The Author Of “Regular, The Ultimate Guide to Taming Unruly Bowels and Achieving Inner Peace”
Looking for a dietitian?
We always recommend working with a low FODMAP experienced Registered Dietitian. You can check out our directory to find one near you. Many of them will work online and remotely with you so be sure to reach out to anyone within your area.
You need to add one other case, with an alpha-gal allergy, there is a delayed food allergy reaction of 3-6 hours. Diarrhea is a common symptom. Alpha-gal is present in any non-primate mammal (beef, pork, lamb, bison, dairy, etc.).
Hi, Sheila,
Fair enough! It’s true that alpha-gal allergy will kick in 3-6 hours after ingestion unlike a traditional food allergy whose reaction is much faster. However, most patients experience this reaction as far more severe than diarrhea– it’s commonly anaphylaxis– and it requires urgent medical attention in a way that standard diarrhea typically doesn’t. I haven’t yet had a patient with alpha-gal who confused this reaction as a digestive food intolerance because the symptoms seem to present so differently. But your point is well taken– this piece certainly doesn’t cover every possible adverse food reaction under the sun, and there are certainly some rarer–and more serious–conditions that merit medical diagnosis rather than internet self diagnosis! Thanks for the feedback!
I just wanted to say thank you for this article – symptom timing is something that I’ve confused by for awhile and this has been the best summary I’ve found so far!
Alanna, we are so happy that this was helpful. Tamara is an amazing RD and we knew she was the perfect person to write this article. It IS very confusing and I think most people think that when a reaction happens very quickly, that it must be due to a FODMAP, when that isn’t the case. That was the impetus for the article. Please share with others! We think there are many people who would benefit from the info.
Thank you for this information. You’ve given me new insight I to symptoms I’ve had for years. Can you provide more information regarding which part of the abdomen is bloated? Sometimes the bloat and pressure is focuses at the top of my abdomen, and usually soon after eating. Other times, the bloat and pressure is in the lower abdomen. I think this tends toward 1-2 hours after eating. I think your timing explanation may cover it, but does location matter. I often have both upper abdomen bloating and pressure at first, then lower abdomen bloating and pressure later. Nearly always after trigger food consumption. Fun times.
We are glad you found this informative article. Tamara is really good at what she does – and obviously has a way with words. IBS can be complex and each and every one of us can have a unique presentation of symptoms, which is why it is imperative that your work with a GI and a RD. You have a great question and obviously are very connected to what is going on for you and are able to describe it. Tamara is available for consult and we could not recommend her more highly. Maybe reach out to her?
Thank you so much! All of this information is so helpful! What do you think about FODMAP for Short Bowel Syndrome? I’ve had Crohn’s for 19 years and had a resection that removed my Ileocecal Valve. Ever since then I have been even worse. What I thought was another Crohn’s flare was actually Short Bowel Syndrome which I was recently Dx with. So I am trying everything possible to keep food in me and to gain back weight and stay nourished and hydrated.
I have a lot of patients with short bowel syndrome and I typically restrict the more “osmotic” FODMAPs– these are the ones that can draw more water into the bowel due to their small size: lactose and high amounts of polyols for sure (e.g., as in a soft drink)… and concentrated sources of fructose often as well (soft drinks). I am careful NOT to restrict all dairy, as many/most of my short bowel patients do well with hard cheese and it’s a great source of calories/protein for them. Lower levels of polyols– like those in avocado– seem not to bother my short bowel patients… and guacamole/crackers is a great high calorie snack for them! I often use a bulking fiber supplement–like Fibercon– to help slow down their GI transit time so that they can digest/absorb the maximum amount of nutrition. Hope this helps!
Absolutely valuable information. Thank you so much.
Thank you, Linda. We see people questioning timing of symptoms every day, and knew that an article should be written addressing the various timing and reasons – and we knew that Tamara was the perfect person to write the article! Share far and wide with anyone who you think might benefit!
This is best article I have read in years on IBS! Still trying to find a groove with symptoms and am jumping onto low fodmap diet for now.
Renee, Thank you for writing and we are so happy to be able to help. Make sure you are working with a RD who knows the diet for the best chances of success. Resources like ours can work wonders in conjunction with your medical team. Be aware that this diet is a process and does take time. We will be here for you during your healing journey.
Thank you so much for this article! I am glad to realize that something negative I ate would not START to cause symptoms 3 days down the road! This helps me, and I appreciate the info.
YES this is a nuance that is very important to note! So glad this was helpful. Tamara is AMAZING! if you haven’t read her book, the Bloated Belly Whisperer, we Highly recommend it.
Thank you for this interesting article. I have had an unresolved issue for about 10 years now. After eating most, though not all foods, after 3-4 hours I start to burb. I can then burb continuously for around 2-3 hours. The timing is usually around midnight to 3 am. I don’t have diarrhoea, bloating or stomach pains. It is so bad that without Ranitidine I can only eat oats, chicken and plain rice. Does this fit in with any or your diagnosis? Thank you.
From Tamara:
Hi, there,
Anytime post-meal symptoms resolve with ranitidine, it suggests acid reflux/indigestion, not a lower GI issue like IBS. The middle of the night timing is especially common among people with acid reflux. Also, since this happens with pretty much all food, it’s not suggestive of a specific food intolerance so much as an issue with the digestive process overall. I might consider having your stomach emptying time checked; experiencing reflux so many hours after a meal can sometimes be a clue that your stomach empties on the slower side.
Thank you. Very interesting.
This was so helpful – great information that acts like a road map for me in my digestive issues. Thank you!
Anita, so glad you found this article. We agree it is incredibly helpful and Tamara did a great job of breaking it down.
Thank you, this info is very helpful! Still trying to figure out why I can eat the same breakfast 2 days in a row with different digestive results…
As a side note, in the beginning of the diet, for me, when my system had not completely calmed down, I found that I could eat a low FODMAP amount of oats one day, but not two days in a row. After a few months, as my IBS stabilized, that changed. Now I can eat them subsequent days in a row. Just adding this as a personal experience.
A post-breakfast reaction may have to do with what you ate the night before, not the breakfast itself.
Thanks for the info, but I am still not sure what causes my gas problem.
I had all physical tests done to rule out any problems but all tests came back negative.
Since many years now, I start to have lots of gas and bloating every day, in the evening that lasts for 4 or more hours till the night. I don’t know if this is the breakfast or the afternoon meal or dinner I ate.
It’s so bothersome that I cannot go to any friend for dinner because I know, my smelly gas and abdominal bloating, will start in the evening/night.
Any suggestions?
Sonia, you are not alone! So sorry you are going through this. Definitely check out Tamara’s book The Bloated Belly Whisperer. I would also consult a RD. Even when a GIs work is done, the real work – and RESULTS – usually start when you work with a RD.
Hi, Sonia,
I’d start with Chapter 7 of my book–“The Backed Up Bloat.” Your symptom pattern sounds a lot like someone with a high stool burden, which is a polite way of saying very backed up with a colon full of stool. May not be specific to any individual food(s) so much as a case of more fiber coming in than you are able to move out.
Hope this helps get you on the right track toward a solution!
Tamara
This article is incredibly helpful. Thank you. I’m trying a histamine-tyramine restricted diet to see if those are factors in my headaches and fibromyalgia pain, with a RD of course. I’ve noticed that I seem to have some issues with some FODMAP foods and not others. I was curious about non-digestive reactions, like headache or body pain in the timeline of things. Can those occur and be delayed? Last week, I had a horrible reaction with heartburn, tummy pain, body aches and headache, and then next day had a bad headache and body aches as well. Then they resolved later. I’m suspecting possible gluten, tyramine (beef), raw onions. The food link to the body aches is the one that is most difficult to pin down and the one I’m most concerned with. Any advice of things to look into? I’m cutting out gluten for a while and then will challenge it again.
Hi, Becky,
Reactions to the “amines”– histamine, tyramine– or other food compounds like salicylates– can often manifest outside the GI tract (skin rashes, headaches, racing heart, dizziness, fogginess) in addition to producing GI symptoms like nausea, rapid onset bloating/pain, diarrhea, heartburn, etc. Often, these onset rapidly.. within seconds to minutes.
FODMAPs should not cause systemic symptoms unless you have SIBO, but even so, headache and joint pain is not a common systemic symptom of SIBO (‘brain fog’ can be, and occasionally we see rashes.). In fact, many high FODMAP foods are among the lowest histamine/tyramine.
While the set of symptoms you describe do sound consistent with amine-type reactions, the foods you suspect are not really common triggers of these reactions. “Gluten”/wheat do not fall into any of these categories unless perhaps we’re talking about bleached flour products loaded with preservatives, and unless the beef is dry aged/very old/leftover, it is not a high tyramine, histamine or salicylate food, either. Onions are a high salicylate food, but with salicylate sensitivity, you’d be reacting to a wide variety of fruits, veg and especially spices/herbs… not just onions.
Rather than try to guess at it, keep a detailed food/symptom diary for 2 weeks. The data should help you/your RD see patterns between common ingredients/foods and types of reactions.
Thank you, very helpful indeed!!! I still find it very difficult to identify which foods I do not tolerate because sometimes it is a combination (coffee and fruit), sometines it is when you passed a certain treshold of a sugar throughout a day and the treshhold seems to vary.
What about the timing of nausea?
What about the timing of stool inconsistencies. For me, this is the most hard one to interpret. You would see an effect on stool consistency after 72h? When trying to find ways to relieve constipation or when you are alternating between soft and hard and would like to find a way to get more stable, one also looks at the Stool symptoms. Also I find it very hard to rate the extent of bloating on a scale (like my therapist sometimes asks) as there are different types of bloating that may either sit there stuck and don’t leave as farts. Also how to distinguish those from oedema? Sorry, for making things complicated again 😉 What you describe is very useful, looking at the timing helped me a lot to identify fructose vs. wheat (I am reacting to both but totally different).
Glad to have found your site.
We are happy to have you here. Of course we all wish it were under different circumstances! I will let Tamara respond to the more technical questions.
Hi, Juliane,
Your questions are starting to expand beyond the topics covered in this article– e.g., how to manage irregular bowel movements, how to decipher bloating from water retention, etc. While these are all important questions, they cannot be properly addressed in the comments section of an online article. It sounds to me like you would really benefit from personalized medical nutrition counseling from an RD who can look at your diet, your bowel patterns and symptoms and give you tailored advice.
Thank you for this article! I’m curious if you have any ideas about why someone would get gas/bloating/diarrhea around the same time each day, regardless of what was eaten. In this case, usually between 3-6 pm with symptoms lasting through the night and improving after a couple morning bowel movements. This happens daily for the past 3 weeks no matter what I eat (follow loose paleo diet with occasional gf grains and have for many years).
I’d look to see what you are eating/drinking/supplementing at breakfast or mid-morning snack, which I’m assuming is 6-8 hours before the onset of symptoms. A supplement with high dose Vitamin C or magnesium? A “sugar alcohol” sweetener in your summer morning beverage? Anything new food-wise, drink wise or suppelment-wise in the 9am-12pm time frame?
I have SIBO and bad acid reflux. Waiting on a GI appointment. What has been happening lately is that after I eat (I am reintroducing whole grain bread, and resistant starch), I get dizzy and lightheaded. It subsides after an hour or so, but it is scary. Also, my acid reflux has gone into my middle ear drum, which doesn’t help. I will be seeing an ENT for that. Does anyone else have this happen?
Hi Melissa, good to hear that you have a GI appointment coming up. You are absolutely not alone when it comes to dizziness. Many folks with various degrees of gluten-intolerance (and possibly allergies) describe the same experiences as you. I do not have any experience with the ear issues. The fact that you are pursuing meetings with specialists is putting you on the right track. I would say even with “just” SIBO and GERD it would behoove you to also work with a Registered Dietitian after your meetings. We are assuming you are also working with the low FODMAP diet and while it is actually typical for folks to be dealing with more than IBS, it certainly cements the fact that your personal situation is nuanced and complex and lining up the right help could make the difference between a successful outcome and not getting the results you hope for. I don’t know how far off your meetings are, but many doctors have enhanced their virtual connections with patients. Perhaps reach out in that manner sooner than later. If something is scaring you, listen to your “gut”, as the saying goes. Better to be safe than sorry.
Hi…I have an internal shaking on my left side and it usually happens around 7 hours after eating. It seems more intense with wheat and some spices. I cannot have dairy at all now. It seems to cause a buildup of gas as well. The trembling feeling keeps me awake at night. Do you think a Fodmap diet might be helpful for me. I have just ordered some probiotics in hopes of getting some relief. Should also mention that I do not have a gallbladder.
Hi Debbie, I will chime in here. We do not offer individual medical advice, but I will suggest a few things for you to think about. First of all, I haven’t had my gallbladder for decades and follow the low FODMAP diet quite successfully. Secondly, Monash actually cautions against adding probiotics during a structured Elimination and Challenge Phase as they can cloud your FODMAP reactions, which is what you are trying to assess at that time. Your complex and unique situation is a perfect example of why working one-on-one with a Registered Dietitian is so important – and more likely to bring you to a successful place. One of understanding your triggers and having a positive relationship with food. Perhaps check our RD Directory and find someone to work with.
Hi Tamara, thank you for this very informative article. I have a question, and need your expertise.
I have suffered from mild IBS D for about 12 years, after my gallbladder removal. I took probiotocs that kept it under except control, could eat anything except watermelon and avocados .
Fast forward to late 2020, I was prescribed a statin that created what I believe is a strong IBS flareup. Now, after I eat, within 30-60 minutes the cramping and rumbling starts. I now have severe constipation, gas, pain, strong cramping and stomach rumbling, flatulence, pain/discomfort under my ribs that comes and goes, undigested food, etc. I tried to follow a low fodmap diet as best I could, but noticed in my bowel movement some undigested seeds and skins from egglant I was consuming. I now remove the seeds and skin prior to cooking. I noticed cramping and rumbling have decreased, together with the pain, but I continue to have discomfort/bloat under my ribs. I am hoping that this discomfort will go away as I continue on my low fodmap diet. Do you believe I am on the right track?
Sorry for the long message and thank you again.
Hi, Ruth,
If FODMAPs are your triggers, then you should be feeling notably better within 2 weeks on a low FODMAP diet. If you do, then you are on the right track. If you don’t, then you’re not. Given your prior issues with watermelon/avocado, sounds like sorbitol has always been an issue, and maybe there were other sorbitol rich foods in your diet that were more of a culprit than others.
If insoluble fiber reduction improves your symptoms (peeling eggplants), then fiber modification seems like a possible remedy for you, either instead of or in addition to FODMAP modification.
It’s also common for people to start having diarrhea after gallbladder removal that is caused by Bile Acid Malabsorption and misdiagnosed as IBS.
A registered dietitian can work with you to help sort out the combination of factors above and figure out a personalized plan.
just started the FODMAP diet. My stomach hurts all the time, is there anything I can take like a digestive enzymes to help stop the pain so I can eat? I feel like I am skin and bones right now. Had teleconference with A GI doctor this past Thursday, suggested I start FODMAP. Will have another appointment with different GI doctor as soon as they can schedule. I need help now with stomach pain so I can eat. Stomach gurgles similar to volcano erupting, belching as soon as I drink a few sips of water, not excessive gas, but do feel better if I do pass gas. No diarrhea, try stretching out my body while lying on side and gently massaging my entire stomach gently. Hope you have some suggestions, scared to ear or drink. Thank you.
Hi, Teresa,
I’m sorry to hear you are dealing with so much pain and weight loss. Unfortunately, I/we cannot offer individualized medical/nutrition advice to people in the comments section of our articles, not can we offer diagnoses. Digestive enzymes are not generally helpful for gas pain, but Gas X can be. I’m glad you are under the care of a GI doctor, as that is the person who is best positioned to advise you appropriately, and a low FODMAP trial certainly seems reasonable for someone with so much gas and gas pain. If the low FODMAP diet does not improve your symptoms within a week or two of following it, you should let the MD know and see what else s/he has to offer by way of recommendations.
82 yo Have tried to keep food diary. Uncertain still. Dairy is high suspect. Avoid. Also have alpha gal. Very often excruciating pain in lower bowel near bladder, followed by loose stool or diarrhea. Have had 3 episodes passed out momentarily because of pain. What causes this?
Hi, Mary,
Unfortunately, we can’t offer medical diagnoses or personalized assessment in this venue, and your situation sounds more severe than your average food intolerance. To answer this kind of question, I’d need to do a much more detailed assessment, learn a lot more about your medical history, previous testing etc. before offering an informed opinion. This kind of conversation needs to take place via a proper patient consultation.
Hi Tamara, that’s an interesting read re timings as I’ve been trying to use the same logic to work out whats causing my issues. I believe i have IBS D.
Also i was wondering if you or anyone knows if the Bloated Belly book would cover my issues of numerous visits when I’m having a bad day?
I don’t really suffer from bloating but more repeated loo visits for IBS D
Thank you
Hi, Dédé here…You say you believe you have IBS D. I assume this is from frequent visits to the bathroom with loose stools? The first step would be to have a full workup with a GI to get an accurate diagnosis. We also have an article for you on Diarrhea, that might be of help.
Hi there. In the event that people do actually know what caused their reaction 10 to 12 hours later, what would that imply? I have histamine intolerance, very aware of my body and what I eat, when I eat it. I have tried two things recently as I try to reintroduce a few things back into my diet. I am salicylate intolerant at this time in my life and I eat my last meal at 6pm. Both times I tried reintroducing something back in that had minimal amounts of sals, I woke up between 1 and 2 with the same old anxiety and vertigo I used to get when I was consuming them regularly. The big difference is, I used to get the reactions within an hour of consuming them. My thought process is that all of the healing I’ve done has been doing great for my small intestine and now working it’s way down the system? Would love your thoughts!
Thank you! Your time and efforts are appreciated 😁
I imagine this has something to do with how salicylates are metabolized and the implications for when their effects hit your system. I honestly don’t know enough about the mechanics of salicylate sensitivity pathways to confirm or refute your hypothesis!
So, this info totally changed how I was interpreting symptoms and I thank you for that! But I feel like one thing needs clarification. To illustrate what I’m getting at, here’s my typical experience: I wake up in the morning feeling fine. Have breakfast. If it’s a “good day” (GI-wise), 45-60 minutes later I’ll have a “normal” BM. Then about 30-45 minutes after that, I start getting lower GI bloating that’ll last hours. The conclusion I draw is that my breakfast has nothing to do with the bloating. It’s something I ate yesterday that’s creating gas, and the breakfast just prompted the GCR that moved it into my colon.
However, if it’s a “bad day,” I’ll have no morning BM; instead, 45-60 minutes after LUNCH, I’ll have crampy diarrhea. But still, neither the breakfast nor lunch caused the diarrhea, right? It was something I ate yesterday. Does that sound about right?
Hi Rebecca,
Tamara sent this answer to your question: “Not every GI symptom represents a food intolerance or adverse food reaction.
Sometimes the post-breakfast bloating can result from a high stool burden (incomplete pooping/being backed up) and the crampy diarrhea after lunch is a ‘dam breaking” diarrhea caused by skipping the morning BM.
This case s a good example of why articles can offer generalized advice, but consulting with a skilled GI RD will provide individualized advice based on your specific symptom patterns.”
Thank you for all of this information. This is really helpful! I am confused about symptom timing for quite a while now and I would say that this is the best summary I’ve found.
Thank you! It is one of our most popular – and helpful – articles for sure! Check out Tamara’s articles on farting!
Thank you, Tamara, this was very helpful as I’m working through an elimination diet.
I’m wondering about foods that cause itching in the mouth within the first few minutes, but not bloating or other digestive issues. For example, avocado can sometimes make my throat itch, but not always, and otherwise digests fine. The first time I ate egg white again I had an itchy throat and sneezed, but I tried it again later that day and didn’t have the same reaction, and I had no digestive issues. What’s going on with that? Is it ok to continue eating these foods that sometimes make my mouth itchy but are healthy?
Hi Maya, while we wait for Tamara, in the meantime, you can take a look at this. Of course, please speak with your allergist.
From Tamara, “The itchy mouth w/ avocado sounds like oral allergy syndrome (OAS), possibly to foods that cross react with latex seeing as avocado triggered it. It’s basically like an environmental allergy masquerading as food allergy– certain food proteins resemble pollens or latex and the body mistakes them for the environmental protein… sort of like as if you ate a mouthful of pollen/latex. It is typically triggered by raw fruits/veg/nuts rather than cooked ones. In all but rare cases, it is perfectly safe to eat the foods as the reaction remains mild and localized to the mouth/throat.
The egg thing sounds weird since it was not reproduced later in the day. Not sure what that’s all about!”