Download Word Version - Andorra Pediatrics

ROBERT M. SELIG, M.D., FAAP
JOANN C. COZZA, D.O., FAAP
DANIEL S. SELIG, M.D., FAAP
ANDORRA PEDIATRICS
8945 RIDGE AVENUE
SUITE 3-4-5
PHILADELPHIA, PA 19128
215-483-8558
Irritable Bowel Syndrome
What Is Irritable Bowel Syndrome?
You may have heard it called "spastic colon" or "nervous bowel." It's an abnormal reaction of the digestive
process to food, stress, or other factors and maybe to a combination of things. No one knows the exact cause.
Normally, gentle contractions of the bowel steadily move food along. During the process, much of the water is
absorbed and the remaining waste is compressed into stool. With irritable bowel syndrome, the process is
disrupted in some way, usually by being speeded up or slowed down.
Are Symptoms Always The Same?
No. Symptoms change, occurring one time and not the next. But problems often include urgent diarrhea or
constipation (sometimes alternating during the same or different bouts), bloating, gas, cramping pains, stomach
gurgling, and white mucus in the stool.
Can I Do Anything To Control The Syndrome?
1. Some people notice that certain foods, such as milk products and sugary, fatty, fried, or spicy foods,
brings on symptoms. If a food seems to disagree with you, try eliminating it from your diet for a while.
2. Caffeine stimulates muscle, including the bowel, so it can contribute to diarrhea. Avoid coffee, tea, cola,
and nicotine. Alcohol also can disturb digestion.
3. Fiber and lots of water help the bowel work normally. Try eating more fruits, vegetables, whole-wheat
bread, and high-fiber cereal. Many people notice that symptoms occur during times of stress, and
certainly, dealing with this unpredictable and embarrassing problem adds to the anxiety.
4. Get plenty of exercise. Walking, for example, is a great way to reduce stress, and it aids digestion.
5. Depending on your specific symptoms, you may want you to try medication, such as something to control
bowel contractions or a preparation to promote bulkier or softer stools.
High Fiber Diet
A high fiber diet speeds the process of food passing through your intestinal tract and promotes regular
bowel movements. The increased ease of stool passage lessens the pain of irritable bowel syndrome and
prevents the sluggishness that leaves stool sitting in the colon for long periods of time.
What Is Fiber And What Foods Contain Fiber?
Increasing fiber in the diet can be accomplished simply by eating more fruits, vegetables, cereals, and
whole grains. (see the fiber and calorie chart).
Foods vary greatly in the amount of fiber they provide. Milk and milk products, fats, meats, poultry, fish, and
eggs contain no fiber at all. The richest source of fiber is grains, such as cereals, but the fiber content varies,
depending on the milling and refining process of the product. Excellent high-fiber cereals (approximately 30
1
grams of fiber per cup) are All-Bran, Bran Bucs, 100% Bran, and Fiber One. Any of these, in addition to Miller's
or unprocessed bran, may be used in cooking and added to many already prepared foods.
How Much Fiber Do I Need Each Day?
Aim for 25-35 grams of fiber daily, but work up to it as your system tolerates it. If you are currently
consuming little or no fiber in your diet, make the change gradually. Don't shock your intestinal tract.
Introducing large amounts of fiber too abruptly may result in cramping, increased gas, or even diarrhea. If any
of these occur, cut back on the portion of cereal you are eating, then gradually increase the amount until you
can tolerate one cup per day, which will provide you with your fiber requirement.
Isn't It Hard To Eat One Cup Of Fiber A Day?
Not really. You don't have to eat one whole cup at one sitting. There is numerous ways to get the fiber you
need enjoyably: Take a half-cup in the morning and the rest at night. Put out a cup of cereal in the morning and
snack on it during the day, or use it as topping on ice cream, custards, and other, more palatable foods. Cook
with recipes that use bran -- baking with bran is an old and familiar culinary technique. Try using bran instead
of breading on chicken and fish, breakfasting with bran cakes instead of pancakes, or making meatballs with
bran filler.
What Foods Should Be Avoided?
1. Foods containing sorbitol: prunes, apples, sugarless gums, candies and pastries. Sorbitol is not well
absorbed by the body and can cause diarrhea.
2. Foods containing fructose (corn syrup) such as certain cola sodas can also cause diarrhea.
3. Foods containing cellulose (cauliflower, asparagus, broccoli, brussel sprouts) can increase gas and cramps
because the cellulose cannot be properly digested by the body.
4. Lactose containing products (milk and milk products) can cause increased gas, cramping and diarrhea.
5. Caffeine containing products can cause increased gas, cramping and diarrhea because of an increase in
stomach acid and propulsion of food through the intestinal system.
General Suggestions
 Increase your fluid intake. Drink fluids (fruit juices and-especially-water) and try to aim for 6-8 glasses of
water daily. Since dietary fiber is somewhat sponge-like, it absorbs water. Additional amounts of water are
helpful in pushing the fiber along its course.
 Exercise: A daily walk or run helps to promote bowel regularity.
 Don't overcook your vegetables: Steaming and stir-frying are excellent in preventing the breakdown of
beneficial fiber.
 Choose healthy snacks: High-fiber snacks include popcorn, peanuts, fruits, and raw vegetables. Snacking
in this manner not only increases your fiber intake -- it also may help cut calories.
Fiber Contents Of Foods
Goal: 25 to 35 grams per day
1. Common servings of foods containing dietary fiber are shown below.
2. Increase your intake by including fiber from all sources.
3. Foods from meat and dairy groups are not good sources.
4. Foods that are good sources of fiber are also typically low in fat.
Food
Serving Size Fiber (gm)
Cereals
All-Bran
1/3 cup
8.5
Bran Buds
1/3 cup
7.9
Bran Chex
2/3 cup
4.6
Cheerios
1 1/4 cup
1.1
Corn Bran
2/3 cup
5.4
2
1 1/4 cup
0.3
3/4 cup
4.0
4 biscuits
2.1
Graham Crackos
3/4 cup
1.7
Grape Nuts
1/4 cup
1.4
Honey Bran
7/8 cup
3.1
Nutri-Grain, barley
3/4 cup
1.7
Nutri-Grain, corn
3/4 cup
1.8
Nutri-Grain, rye
3/4 cup
1.8
Nutri-Grain, wheat
3/4 cup
1.8
100% Bran
1/2 cup
8.4
100% Natural Cereal
1/4 cup
1.0
Oatmeal, (cooked regular, quick, or instant)
3/4 cup
1.6
Raisin Bran-type
3/4 cup
4.0
1 cup
0.1
2/3 cup
2.6
1 1/3 cup
0.2
3/4 cup
0.4
1 cup
2.0
2/3 cup
2.1
1 cup
2.0
1/4 cup
3.4
Corn Flakes
40% Bran
Frosted Mini-Wheats
Rice Krispies
Shredded Wheat
Special K
Sugar Smacks
Total
Wheat Chex
Wheaties
Wheat germ
Vegetables (cooked)
Asparagus, cut
1/2 cup
1.0
Beans (string, green)
1/2 cup
1.6
Broccoli
1/2 cup
2.2
Brussels sprouts
1/2 cup
2.3
Cabbage (red, white)
1/2 cup
1.4
Carrots
1/2 cup
2.3
Cauliflower
1/2 cup
1.1
Corn, canned
1/2 cup
2.9
Kale leaves
1/2 cup
1.4
Peas
1/2 cup
3.6
Potato (with skin)
1
2.5
Potato (without skin)
1
1.4
Spinach
1/2 cup
2.1
Squash, summer
1/2 cup
1.4
Sweet potatoes
1/2
1.7
3
1/2 cup
Zucchini
1.8
Vegetables (raw):
Bean sprouts
1/2 cup
1.5
Celery, diced
1/2 cup
1.1
Cucumber
1/2 cup
0.4
1 cup
0.9
Mushrooms, sliced
1/2 cup
0.9
Onions, sliced
1/2 cup
0.9
Pepper, green, sliced
1/2 cup
0.5
Spinach
1 cup
1.2
Tomato
1
1.5
Lettuce, sliced
Fruits
Apple (with skin)
1
3.5
Apple (without skin)
1
2.7
Apricot
3
1.8
5 halves
1.4
1
2.4
Blueberries
1/2 cup
2.0
Cantaloupe
1/4 melon
1.0
Cherries, sweet
10
1.2
Grapefruit
1/2
1.6
Grapes
20
0.6
Orange
1
2.6
Peach (with skin)
1
1.9
Peach (without skin)
1
1.2
Pear (with skin)
1/2 large
3.1
Pear (without skin)
1/2 large
2.5
1/2 cup
1.1
Plums, damson
5
0.9
Prunes
3
3.0
Raisins
1/4 cup
3.1
Raspberries
1/2 cup
3.1
Strawberries
1 cup
3.0
Watermelon
1 cup
0.4
Apricot, dried
Banana
Pineapple
Legumes
Baked beans/tomato sauce
1/2 cup
8.9
Dried beans, cooked
1/2 cup
4.7
4
Kidney beans, cooked
1/2 cup
7.3
Lentils, cooked
1/2 cup
7.3
Lima beans, cooked
1/2 cup
4.5
Breads
Bagels
1
0.6
Bran muffins
1
2.5
1 slice
1.0
Crisp rye bread
2 crackers
2.0
Crisp wheat bread
2 crackers
1.8
French bread
1 slice
0.7
Italian bread
1 slice
0.3
Mixed grain bread
1 slice
0.9
Oatmeal bread
1 slice
0.5
Pita bread
1 piece
0.4
Pumpernickel bread
1 slice
1.0
Raisin bread
1 slice
0.6
White bread
1 slice
0.4
Whole wheat bread
1 slice
1.4
1 cup
1.0
Rice, brown
1/2 cup
1.0
Rice, polished
1/2 cup
0.2
Spaghetti, regular
1 cup
1.1
Spaghetti, wheat
1 cup
3.9
Cracked wheat bread
Pasta and Rice
Macaroni
Juices
1/2 cup
Apple
0.4
Grapefruit
1/2 cup
0.5
Grape
1/2 cup
0.6
Orange
1/2 cup
0.5
Nuts
Almonds
10 nuts
1.1
Filberts
10 nuts
0.8
Peanuts
10 nuts
1.4
Lentils, cooked
1/2 cup
7.3
Lima beans, cooked
1/2 cup
4.5
Navy beans, cooked
1/2 cup
6.0
5