Food Journaling and Elimination Diets for Gut Disorders
With up to 65% of people with IBS reporting symptoms related to specific foods, identifying food triggers is an important part of managing symptoms and healing the gut. However, because offending foods tend to vary so much between individuals, recommending a one-size-fits-all elimination diet to reduce symptoms is not the answer.
With a little detective work, women who suffer from IBS and chronic constipation can take matters in their own hands to figure out their food triggers, remove them from their diet, and allow their gut to heal.
In this post, I cover how to successfully track food and symptoms, follow an elimination diet, and rechallenge your problematic foods. Let’s dive in!
Food Intolerance, Allergies and Sensitivities:
First, let’s understand the difference between a food intolerance, sensitivity, and allergy. These terms are often used interchangeably but they do not mean the same thing.
An intolerance is an adverse reaction to a food that does not involve the immune system. It can be because of an enzyme deficiency (e.g. lactose intolerance) or due to the effects of a food compound that has a drug-like effect in the body (such as histamine in oranges, or caffeine in coffee).
With intolerance related to an enzyme deficiency, food can go undigested as it passes through the digestive tract. When it arrives in the colon, the gut bugs break it down by fermentation, often causing gas, bloating, cramping, and diarrhea.
Allergies and food sensitivities involve different parts of the immune system. When the body is exposed to the protein component of certain foods, it can react by releasing other proteins called antibodies. Food components that cause antibodies to be released are called antigens or allergens.
There are two types of antibodies that are often produced in response to food triggers: IgE (immunoglobulin E) and IgG (immunoglobulin G).
A true allergy is an immediate reaction to a food antigen or allergen as a result of the release of IgE. Symptoms appear fairly soon after exposure but may take up to two hours. Symptoms can be mild, like an itchy mouth, stuffy nose, or scratchy throat, or severe, in the case of anaphylaxis which can cause swelling in the body tissues and breathing difficulties.
A food sensitivity is a delayed immune reaction that involves IgG. Symptoms can take hours or days to appear. Because of the delay, many people don’t even realize they have a food sensitivity, and it can be difficult to figure out which food is responsible for the problematic symptoms.
How to track your food and symptoms:
Eat typically and record honestly. Many people tend to be on their “best behaviour” when keeping a food diary. Food journaling will not be helpful if you are not eating your typical foods that cause your typical symptoms.
Have columns for: time of day, food, drink, supplements, medication, activity, mood, energy, problematic symptoms, and bowel movements.
Common food triggers include: cow’s milk, lactose, wheat, gluten, eggs, soy, corn, peanuts, nuts, shellfish, coffee, and chocolate. Keeping an eye on these foods is a good place to start, but you can develop a food sensitivity or allergy to just about anything, and food intolerances can be many.
Record for 3-4 days and look for patterns of common triggers for your gut symptoms, and mood or energy crashes after meals or specific foods.
Identify the top 1 to 3 foods that give you the most grief. Even though there may be other foods that are triggers, removing the most offending foods usually gives your gut enough space to heal. (And this way, you don’t end up with a safe foods list of only 10 things.)
How to do an elimination diet
Once you identify your problematic foods, you may want to try an elimination diet. Most people will notice symptom improvement within 4 weeks when removing food triggers, but some folks may need a little longer (up to 8 weeks).
As mentioned above, choose your top 1 to 3 most problematic foods and start here:
During your elimination phase, you should remove all sources of the food trigger(s) from your diet.
Be wary of hidden sources that may be hiding in things like sauces, dressings, processed foods, and when eating out at restaurants. Make sure you read labels. Continue to keep your food and symptom journal during this time.
If your food triggers have been causing digestive issues, it is likely you will see symptom improvement in 3 to 4 weeks on the elimination phase. (For skin, muscle or joint issues, and autoimmune conditions, it may take 2 to 3 months to notice improvements.)
Even though you may be feeling better, in order to give your gut and immune system adequate time to heal and regain strength, plan for your elimination phase to last for 8 weeks. Use your symptom improvements to keep you motivated!
A note about “cheating”…
If you identify the correct problematic food(s) and you are doing the elimination diet correctly, but you cheat or accidentally consume the food trigger during the elimination phase, you will likely feel worse than you would have originally.
By giving your body a break from your food triggers, you allow the gut and immune system time to heal and regain strength. If you reintroduce a problematic food too soon, your immune cells may “attack” a little harder than previous.
If you’re going to do an elimination diet, commit to it. A little bit of a poison is still a poison. It only takes exposure to a problematic food every 5 or 6 days to keep the immune response active and inflammation going.
How to rechallenge your food triggers
After you complete your elimination phase, you can try reintroducing the problematic food(s) to see how you feel.
If you have removed more than one type of food from your diet (e.g. gluten, eggs, dairy), rechallenge one food at a time (e.g. eggs). Otherwise, it can be difficult to figure out which food is causing what symptoms.
To rechallenge a food, consume it 2-3 times a day for 3 days.
For dairy, this might look like:
For wheat or gluten, it might look like:
A few notes about your re-challenge phase:
Stop any gut healing or anti-inflammatory supplements on rechallenge days so you can accurately assess how much inflammation the trigger food is causing.
On rechallenge days, if you are intolerant or have a sensitivity, it may feel like you got hit by a truck, so time your reintroduction when you have space in your schedule to rest if needed.
If you react to a food with rechallenge by the end of Day 1 or 2, there is no need to continue with the rechallenge for the full 3 days as this will give you your answer. Continuing to eat a problematic food will only build inflammation.
If you react to a food “a little bit”, remember that this will likely create issues with inflammation over time, especially if it’s a food you eat regularly.
If you react to a food you are rechallenging, and you still have other foods to reintroduce, wait until you are feeling better before rechallenging the next food. Typically, this will take 3-5 days. (You can restart any gut-healing or anti-inflammatory supplements during this time to help speed up your gut’s recovery time.)
If you do not react to a food by the end of Day 3, that food can become a part of your regular diet.
Troubleshooting your elimination diet
If you complete 4 weeks in an elimination phase, but you still have problematic symptoms or your symptoms have improved a little bit but not enough to make a difference in your quality of life, there are a few considerations:
There are still sources of the identified food trigger in your diet. Examine your food diary and look for hidden sources of your food triggers. Read labels and ingredient lists. For some people, even the tiniest amount of a food trigger can cause symptoms.
The wrong food triggers were identified, or you may have missed additional food triggers. Review your food and symptom diary for additional insights. (Remember how I said to pick your top 1-3 problematic foods? Well, this is where you may want to revisit that food trigger list and consider removing another 1 or 2 food items to see if there is improvement.)
Some food triggers can be sneaky: artificial sweeteners, colours, or flavouring; emulsifiers added to foods; and other food preservatives. If your symptoms have not improved, and you eat a lot of processed foods, you may want to consider these as possible triggers.
There are other factors contributing to your symptoms: stress, inadequate sleep, certain eating behaviours, nutrient-depleted diet, underlaying infection or dysbiosis in the gut, etc.
If you have been unsuccessful with food and symptom journaling, it may be time to seek the help of a trained professional. Have a second set of eyes from an experienced coach can help to identify factors that you may be overlooking.
Gut healing can be a difficult journey if you are doing it alone. Working with a compassionate, caring coach can help you to navigate the maze of information available on the internet so you never have to feel lost, alone, or confused again.
Click here if you’re interested in working together in a 12-week one-on-one coaching container where I can help you decrease bloating, relieve constipation, and heal your gut for good.
