Brief Answer:
Welcome to HCM. I have reviewed your question

Detailed Answer:
Sir, I am so sorry for your troubles. The first thing that comes to mind is to ask if you have seen a properly trained allergist? For example, lactose intolerance may be so severe you may have to avoid lactose completely as it is in many things, not just milk. You may have to avoid milk completely and replete with calcium/magnesium. It is in pills, processed foods, if you read labels you may be quite shocked. We have also found correlations between the following allergies and irritable bowel: eggs, wheat, gluten, yeast and chocolate. A good allergist can check by skin prick, blood and food challenge to nail down any food allergies.

Let me review other guidelines for dyspepsia and your acidity:

Sleep with an incline pillow, available at most pharmacies or can mail order

Do not eat 3 hours before bed

Stay away from acidic food like orange juice and carbonated beverages

You may have well cooked foods, but raw foods may be too irritating to digestive tract. It is a balancing act. You do not want to become constipated, yet active bouts of IBS may require low fiber while inclusion of fiber promotes bowel regularity. So, I understand your frustration. Polyethylene Glycol (products like Miralax over the counter help with bowel regularity) and are a type of easily absorbed fiber.

Consider omitting gluten and taking B-complex to supplement the nutrients lost from a low gluten diet

Probiotic supplementation may be helpful, pill form if you cannot consume low fat Greek Yogurt. Low fat Greek Yogurt has a lower level of lactose in it, but you still may have to cut out milk. An allergist will be of most help here.

Avoid all gassey vegetables like cabbage, cauliflower, broccoli, nuts, figs, soybeans. Beans must be avoided or soaked overnight, water with gassy stuff in it thrown out and pot refilled with fresh water. This lowers the gas. Using Beano or products similar may lower gas in any dish with legumes in it.

A soft, low fat, no added sugar diet is called for. Small frequent meals are better tolerated. You may find separating liquids from meals is helpful in keeping stomach from becoming overly distended and uncomfortable.

Low fodmaps are not for everyone. Seeing an allergist is a key part of your treatment. Reduction of stress and anxiety is imperative.

I hope I have given you some things to think about. You are dealing with a disease even science does not understand well.

Good luck to you! If there are any further clarifications, please feel free to write back. Thank you for the consult.
Regards, XXXXXXX Shattler, MS,RDN

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Brief Answer:
Sorry for the delay

Detailed Answer:
The pizza has a lot of fat and lactose as does the ghee and butter. We have discussed avoiding high fat foods. Intolerances to foods do not develop immediately necessarily. The back pain you speak of can be caused by the following variables:
1. gas
2. constipation
3. impaction, bezoar or hardened stool pressing on back nerves

"Beano I can get as tablets? can i use it with any sort of food?
I am trying lactose free amul milk. Can i rely on it? any advise ?"

Beano is purchased over the counter for use in decreasing the gas from legumes and I took the XXXXXXX of taking this off their website "Use with the right food: beano® Tablets prevent symptoms caused by a variety of foods including:
Veggies like broccoli, lettuce, peppers and carrots
Proteins like beans and peanuts
Whole grains like whole wheat and oat XXXXXXX
It is Gluten-free product"
I am not promoting Beano, but I don't know of any other proprietary names.

But, Beano will not help if you are using it with a food you are allergic to.

If the milk you are using says lactose free, hopefully it complies with the label.
I don't like the sounds of you popping pills all day to tolerate food. I must stress seeing an allergist. Like eating pizza, theoretically you could take lactaid pills, but you really should not be eating offending foods and taking pills to allow you to digest them, not so many times per day.

Over-eating is a real problem, remember, small meals. Beef is higher in fat. Some are sensitive to it. Stick with the lower cuts of meat like the white meat of chicken or turkey. Eat fresh fruit, not juice and cooked vegies not raw.
A size of a palm of a hand is a serving size of meat or about 21 grams of protein. Average protein need for men your size would be around 45 grams with 8 oz of milk having 8 grams of protein.

If you are bloating with vitamins, I suspect additives. Look for a hypoallergenic B-complex.

Fruits would be anything you can find you can tolerate and is indigenous to your country WELL WASHED.

Flaxseeds are a great source of essential fatty acids.The other seeds, like watermelon, are not well digested.

Sleep. Do not lay down after eating a meal. Melatonin may help re-establish your sleep cycle.I suggest a spray that you can squirt directly under the tongue into the oral blood vessels. Dosage is on bottle. Again, hypoallergenic and pure.

Partially Hydrolyzed Guar Gum 5 gm per day may help relieve your symptoms
PHGG. This is commonly found in Pakistan and XXXXXXX

Enteric coated peppermint oil acts as an antispasmodic .2 ml bid. The other benefit is that it kills candida, a yeast infection that may be at the root of your symptoms.

Other aggravating issues: anger, stress, poor sleep, anxiety. Remedy: Coping skills, meditation, relaxation exercises, exercise in general.

Obtain a list of foods with lactose in it, keep following your FodMap Diet, consider my other suggestions and I wish for your wellness.
Respectfully, XXXXXXX Shattler, MS,RDN

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Brief Answer:
Hi There

Detailed Answer:
I am happy you have found someone to discuss your problems with, they are quite lengthy.

I may not be able to answer all questions, but I will try to address the most important.

Regarding bedtime. Please eat smaller meals and no large meal before bed!

FDA is not in charge of supplements only medications.

Meat. One ounce = 7 grams of protein. The size of the palm of your hand is about 3 oz or 3x7=21 grams. That would be an estimate for a piece of meat.
You need 45 gms protein per day from all sources, dairy (lactose free), meat, all foods should total 45 grams.

Yes, you may have the lactaid pills occasionally.

The bottom line is to find out what is causing all this and seek cure, not just relief. I don't think the doctors have exhausted their testing. I still feel that something such as gluten may be triggering all this. And stress.

I realize taking PPIs is not a good route long term but neither is the damage caused by acid on the lining of your esophagus. Keep taking it until your problems are sorted out and hopefully a cause.

Have you been tested for a yeast infection of the g.i. tract? You might want to ask about this.

Yes, meat at dinner is ok. I see nothing wrong with eating well cooked potatoes.

I am hopeful that these suggestions are helpful and after trying them you are better. If not, please come back with further information and I will try to help you. Regards, XXXXXXX Shattler, MS,RDN

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Brief Answer:
Good Morning

Detailed Answer:
Guar Gum is used as an ingredient in many food products, particularly in baked goods.
This ingredient is often used as a thickener, gelling agent and stabilizer, often in the place of gluten or other congealing ingredients. it is is a low fodmap product having been tested in a lab and declared fodmap friendly.

Ask pharmacist for Polyethylene glycol 3350 instead of Miralax and see if it comes under a different name.

Chia seeds do not have much of a laxative effect and when I mentioned prunes I was not thinking of the stage of fodmap diet you were on.

I hope I have addressed your concerns and it has been nice working with you.

Regards, Kathy Shattler, MS,RDN
5:26 am USA

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