Special Considerations

Of course we would love to speak with you on an individual basis regarding any specific diet restrictions or concerns you may have. Some special diets are more “common” and we are able to pass along information that may have been helpful to other clients. As always, these are suggestions only and are not meant to contradict any information given by a personal physician. Information should be verified with your physician. We welcome your feedback on any special diets as well!

Diverticulosis / Diverticulitis Diet
Please note: though indiviuals safely receive Colon Hydrotherapy with Diverticiulosis, when diverticulitis flares up it is best to wait.

Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber keeps stool soft and lowers pressure inside the colon so that bowel contents can move through easily. The American Dietetic Association recommends 20 to 35 grams of fiber each day. The table below shows the amount of fiber in some foods that you can easily add to your diet.

Amount of Fiber in Some Foods

Fruits
Apple, raw, with skin 1 medium = 3.3 grams
Peach, raw 1 medium = 1.5 grams
Pear, raw 1 medium = 5.1 grams
Tangerine, raw 1 medium = 1.9 grams
Vegetables
Asparagus, fresh, cooked 4 spears = 1.2 grams
Broccoli, fresh, cooked 1/2 cup = 2.6 grams
Brussels sprouts, fresh, cooked 1/2 cup = 2 grams
Cabbage, fresh, cooked 1/2 cup = 1.5 grams
Carrot, fresh, cooked 1/2 cup = 2.3 grams
Cauliflower, fresh, cooked 1/2 cup = 1.7 grams
Romaine lettuce 1 cup = 1.2 grams
Spinach, fresh, cooked 1/2 cup = 2.2 grams
Summer squash, cooked 1 cup = 2.5 grams
Tomato, raw 1 = 1 gram
Winter squash, cooked 1 cup = 5.7 grams
Starchy Vegetables
Baked beans, canned, plain 1/2 cup = 6.3 grams
Kidney beans, fresh, cooked 1/2 cup = 5.7 grams
Lima beans, fresh, cooked 1/2 cup = 6.6 grams
Potato, fresh, cooked 1 = 2.3 grams
Grains
Bread, whole-wheat 1 slice = 1.9 grams
Brown rice, cooked 1 cup = 3.5 grams
Cereal, bran flake 3/4 cup = 5.3 grams
Oatmeal, plain, cooked 3/4 cup = 3 grams
White rice, cooked 1 cup = 0.6 grams

Source: United States Department of Agriculture (USDA). USDA Nutrient Database for Standard Reference Release 15. Available at www.nal.usda.gov/fnic/cgi-bin/nut_search.pl. Accessed April 5, 2004.

The doctor may also recommend taking a fiber product once a day. These products are mixed with water and provide about 2 to 3.5 grams of fiber per tablespoon, mixed with 8 ounces of water.

Avoidance of nuts, popcorn, and sunflower, pumpkin, caraway, and sesame seeds has been recommended by physicians out of fear that food particles could enter, block, or irritate the diverticula. However, no scientific data support this treatment measure. Eating a high-fiber diet is the only requirement highly emphasized across the literature and eliminating specific foods is not necessary. The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are generally considered harmless. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify individual items in one’s diet.

If cramps, bloating, and constipation are problems, the doctor may prescribe a short course of pain medication. However, many medications affect emptying of the colon, an undesirable side effect for people with diverticulosis.

Diverticulitis

Treatment for diverticulitis focuses on clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications. An attack of diverticulitis without complications may respond to antibiotics within a few days if treated early.

To help the colon rest, the doctor may recommend bed rest and a liquid diet, along with a pain reliever.

An acute attack with severe pain or severe infection may require a hospital stay. Most acute cases of diverticulitis are treated with antibiotics and a liquid diet. The antibiotics are given by injection into a vein. In some cases, however, surgery may be necessary

Source: National Digestive Diseases Information Clearinghouse

GLUTEN-FREE DIET

What is gluten?

In terms of the medical definition of Celiac Disease, or Gluten Intolerance, “gluten” is defined as the mixture of many protein fragments (called peptide chains or polypeptides) found in common cereal grains — wheat, rye, barley and sometimes oats (oats don’t naturally contain gluten, but are often subject to contamination with small amounts). Wheat is the only grain considered to contain true “gluten” and the peptides that predominate in wheat gluten are gliadin and glutenin.

Gliadin is thought to be the peptide chain that instigates the toxic immune response and subsequent intestinal damage in celiacs. However, other protein fragments thought to be toxic to celiacs occur in rye, barley, and oats. They are secalins, hordeins, and avenins, respectively. Even though some research suggests that the avenins are not toxic, most celiacs still avoid oats just to be safe. Minute amounts of any of these protein fragments can cause intestinal damage in people with celiac disease. Because the disease is not fully understood, it is thought there may be other peptide chains including some derived from glutenin, that are also toxic. Because of the lack of definitive research on the disease, celiacs must often live by the saying, “when in doubt, leave it out.”

Safe grains for celiacs

Current scientific consensus is that rice and corn (maize) are considered safe for celiacs. In addition, millet, sorghum, Job’s Tears, teff, and ragi are thought to be close enough to corn in their genetic make-up to be safe. More research is needed to substantiate this. Other grains suspected, but not proven, to be safe for celiacs include buckwheat, amaranth, quinoa and rape. Although their safety is debated, they are only very distantly related to wheat. Thus, it is unlikely their peptide chains are the same as the problematic chains found in wheat, rye and barley.

Sources of gluten

Primary sources:

  • wheat (including semolina, durum, spelt, triticale, and Kamut® grain)
  • rye
  • barley
  • oats (oats don’t naturally contain gluten, but are often subject to contamination with small amounts and many gluten intolerant people avoid oats).

Hidden sources: (ingredients/additives which may contain gluten)
The source of many of these ingredients must be carefully scrutinized to ascertain whether or not any gluten is present. For example, modified food starch from corn is acceptable, as long as no wheat starch is included. Apple cider vinegar is acceptable, but distilled vinegars may contain gluten. Pure buckwheat or buckwheat flour is acceptable, but many buckwheat flours are contaminated with or have wheat flour added.

  • Binders
  • Bleu cheese
  • Brown Rice syrup (if barley malt enzyme is used)
  • Caramel coloring (made from barley malt enzymes)
  • Coatings
  • Colorings
  • Dextrins
  • Dispersing agents
  • Emulsifiers
  • Excipients (added to prescription medications to achieve desired consistency)
  • Extracts (in grain alcohol)
  • Fillers
  • Flavorings (in grain alcohol)
  • Flours, Breads, Cereals, Crackers, Pasta, Sauces & Condiments made with the above listed grains or their derivatives.
  • Grain alcohol (beer, ale, rye, scotch, bourbon, grain vodka)
  • Homeopathic remedies
  • Hydrolyzed protein, hydrolyzed plant protein (HPP) hydrolyzed vegetable protein (HVP)
  • Malt or Malt Flavoring (Barley malt)
  • Modified starch, modified food starch (when derived from wheat)
  • Mono- and di-glycerides (made using a wheat starch carrier)
  • Oils (wheat germ oil & any oil with gluten additives)
  • Preservatives
  • Soy Sauce (when fermented using wheat)
  • Spices (if containing anti-caking agents)
  • Starch (made from grains listed above)
  • Vegetable gum (when made from oats)
  • Vegetable protein
  • Vinegars (distilled clear and white or with a mash starter)
  • Vitamin E oil

Gluten contamination

When gluten-free grains are milled or processed, they may be contaminated with other grains processed on the same machinery. Gluten contamination may occur via baking pans, grills, utensils, cutting boards, toasters, etc., when foods are baked, cooked, or otherwise processed. Deep frying foods in oils or fats that have been used for gluten containing foods may also lead to gluten contamination. Many fast food chains fry french fries in the same oil as wheat battered onion rings.

Additional considerations

Many over the counter and prescription medications may contain gluten. Pills may be dusted with flour during manufacturing and capsules may have gluten present in the oil inside.

Non-food products such as toothpaste and lipstick may also contain gluten. Other non-ingested products such as skin lotion may contain gluten and may be accidentally ingested when fingers come into contact with the mouth. Ingredients in packaged foods can change without warning. Celiacs must be constantly vigilant even with foods that have been previously deemed safe.

Source: Whole Foods Market

Irritable Bowel Syndrome

For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. Increasing fiber intake by 2 to 3 grams per day will help reduce the risk of increased gas and bloating.

Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help