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StomachWhat Really Causes Acid Reflux and GERD?
About sixty million people in the US report that they suffer from painful symptoms of acid reflux at least once a week. Heartburn, abdominal pain, cough, sour taste in the mouth, sore throat, hoarseness, laryngitis, asthma-like symptoms and sinus irritation are the typical symptoms. Smoking, pregnancy … Read more


Foods pix for FP Calculator by Norm Robillard, Ph.D., Founder of Digestive Health InstituteWhat Foods Can Lead to SIBO? Try FP Calculator
Dr. Robillard’s research on the biochemistry of digestion points to a new way of understanding the connection between dietary malabsorption in your small intestine, small intestinal bacterial overgrowth (SIBO) and its related conditions.  Some SIBO related conditions include acid reflux, GERD … Read more


Digestive Health Institute - Norm Robillard, Ph.D. - SIBO articleSIBO Diets and Digestive Health
Since releasing my first book in the Fast Tract Digestion series on Heartburn which linked chronic acid reflux to Small Intestinal Bacterial Overgrowth (SIBO), I have received several inquiries about using the Fast Tract Diet to treat other SIBO-related conditions such as IBS… Read more


Digestive Health Institute - Norm Robillard, Ph.D. - Antibiotics for IBS ? articleAre Antibiotics Safe for Irritable Bowel Syndrome ?
How doctors treat irritable bowel syndrome (IBS) could change dramatically in the near future. Two years ago, the pharmaceutical company Salix submitted a supplemental new drug application (sNDA) for the treatment for IBS (non-constipation-dependent) with the antibiotic… Read more


PotatoesResistant Starch – Friend, Foe or Lover ?
Since my first article on resistant starch (RS), raw unmodified potato starch, or RUMPS as I like to call it, continues to light up the blogosphere. Like a lot of people, I was caught off guard by the overwhelmingly positive light RUMPS has been cast in. Some people have truly fallen in love with this molecule… Read more


The dark side of fiber by Norm Robillard, Ph.D.The Dark Side of Fiber (Part I of III)
Fiber is the indigestible part of plant-based foods, consisting of structural components such as the cell walls of fruits, vegetables, nuts and legumes, the tough outer layers of grains, as well as any other non-digestible carbohydrates, as well as lignin – a substance found in plants that binds cellulose fibers… Read more



















 



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49 Responses to Home

  1. bandel bezzerides says:

    I am on a candida program designed by Dr. Humiston whose website is CandidaMD.com.

    It focuses on ferments and yeast products and includes a three step process of botanicals along with diet and probiotics. So far it seems to be helping me. Can you comment on the role of candida in digestive ills.

    Bandel Bezzerides, Ph.D.

    • Hi Bandel,
      If you’re doing well on Dr. Humiston’s program, that’s great. I was a bit surprised that his website does not cite a single scientific study to support his ideas. I am always a little concerned when I read about ideas that are not well grounded in current science. His may be, but he should cite the work in my opinion.

      A study by Dr. John Hunter at Addenbrooke’s Hospital in the UK failed to find a connection between IBS, a prevalent SIBO-related condition, and yeast overgrowth (Middleton SJ, Coley A, Hunter JO. The role of faecal Candida albicans in the pathogenesis of food-intolerant irritable bowel syndrome. Postgrad Med J. 1992 Jun;68(800):453-4).

      Yeast are normally present in the gut of roughly 70% of people without causing ill health. A number of factors have been reported to promote yeast overgrowth including antibiotics (key), steroids, chemotherapy, radiation, immune deficiency (key), old age, changes in the gut mucosa (key) or normal microbe population (key), sugars, dairy products and refined carbohydrates. Some of these make sense to me but some don’t. Yeast also feed on carbs (consider beer making ingredients). Refined carbs are typically easier to digest so they would actually be less likely to contribute to yeast overgrowth. The biggest cause seems to be antibiotics, immune or mucosal dysfunction and alterations in normal microbe populations, which is often driven by diet.

      In (rare?) instances where yeast overgrowth is a problem, one of Dr. Humiston’s ideas – probiotics, has some support in the literature. The idea is to out compete the yeast with healthy bacteria. As more complete (more closely resemble a fecal transplant) probiotic preparations come to market, this approach will likely get even better.

      You can be tested for yeast in a stool sample, but just the presence of yeast might not be significant or an indication that yeast overgrowth was causing your symptoms. The good news is that while yeast and bacteria respond to completely different types of drugs (antifungal vs. antibiotic), they both respond to limiting difficult-to-digest carbohydrates. Denying both yeast and bacterial overgrowth excess carbohydrate fuel is the best overall approach that should be tried first for either condition. That is what the Fast Tract Digestion approach is all about.

      The most serious problem with yeast is blood infections from the more invasive yeast species resulting in 80,000 blood infections per year, which are often hospital acquired and often lethal.

      Here is an excellent review article on yeast you might be interested in:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803610/

  2. Kate says:

    When will the new book on ibs/ibd be out?

    • We are pushing for the end of this month, at least for the ebook. It could be a little longer for printing as hiccups generally arise. I am excited to release this one!

      • Kate says:

        Awesome! Can’t wait! How is the new one different from the gerd one (besides the obvious, of course lol)?

  3. All the FTD books are based on the same underlying approach. They look at the conventional ideas about the cause and the treatments of each condition along with the side effects and health risks of the conventional treatments. Then, the evidence for a connection to SIBO is examined to determine the extent for which the Fast Tract Diet will be effective. In the case of IBS, there is also a chapter on antibiotics. Also, each book will introduce new recipes.

  4. Angela says:

    Hello, I have severe digestive disorders and am trying to find the answers. I restrict all Fodmaps and am gluten-free. I live best on rice and meat and coconut oil. It seems nonfodmap fruits and veggies cooked or pureed give me a flare. Even small quantities (a few tablespoons). Pro-biotics do nothing and pre-biotics kill me. I need help!
    Angela

    • Hi Angela,
      I am not surprised that you are having some persistent symptoms. It doesn’t take much of the wrong foods to trigger symptoms. The Fast Tact approach uses the Fermentation Potential to determine how much of each food is safe amount to consume. If you have not read Fast Tract Digestion Heartburn, I would recommend you do so as there are significant limitations with some diet strategies that do not limit all difficult to digest carbs. We also have the second volume on IBS coming out by the end of March. The Digestive Health Institute offers counseling to deal with individual needs as well as a coaching program. You can email me at normjr1@gmail.com if you are interested.

  5. Lucia Gracia says:

    Hello Dr. Robillard,

    I have been suffering from IBS for 15 years and since 2 years ago from GERD as well. My main symptoms are nausea and indigestion. My symptoms got worse about 5 years ago. Around that time, I was tested for SIBO but all came negative. Since my symptoms kept getting worst, last year I visited the Dr. again and after getting many tests done, I found out I had gastritis and H.Pylori and was given two course of antibiotics. The H.Pylori was supposedly gone but GERD has stayed with me since then. I learned about your first book on Mark’s Daily Apple blog and I was very interested on it. However, when I read here on your website that your approach is specifically for SIBO I worried it might not work for me since I was already tested for that and all came back negative. Do you think your Fast Tract approach could still give me relief even if I don’t have SIBO? Have you had any cases of people without SIBO that have found relief of symptoms with your approach?

    Thanks a lot!

    Lucia

    • Hi Lucia,
      You raise a qood question. When you had the test, can you remember what sugar was used in the test (lactulose, glucose, etc)? Also did you have symptoms at the time of the test?

      If you have GERD symptoms, you likely have some degree of SIBO (small intestine) or dysbiosis (not limited to small intestine). SIBO is not necessarily a static, positive/negative situation. Your body is constantly working to clear the overgrowth but acid reducing drugs, meals with certain hard to digest carbs or just too many carbs and other factors work against your body in promoting SIBO. I think the book and diet will help your situation, but your answers are relevant to this recommendation. The institute offers individual consultation if needed.

      • Lucia Gracia says:

        Hello,

        First, thanks so much for your reply Dr! I really appreciate it.

        The test was done with 10 grams of Lactulose and I was having a lot of symptoms at the time (especially a lot of nausea). For several years I was told I had IBS and that this was causing my nausea. However last year after having an endoscopy, it was found that I also had gastritis and H.Pylori. After following the FODMAPS diet and taking antibiotics and acid reducing drugs I felt better but after some months I started feeling sick again. It’s been a couple of months since I started taking Prilosec every night to manage my symptoms and although it sometimes help, I am not symptom free. What’s more, I really do not want to spend the rest of my life taking drugs.

        Thanks again!

        Lucia

        • Thanks for the details. I would agree that taking PPIs for the rest of your life is not a great option. Your situation is interesting as nausea and gastritis can have many causes (and may not be related to SIBO). Hopefully the H.pylori is gone now and no longer an issue. And H.pylori is not tightly linked to acid reflux and is independent of SIBO. To make a long story short, there could be something else going on other than SIBO in your case. Sorry that I can’t offer more without talking to you in more detail. But it certainly can’t hurt to try the diet an see if you get benefit.

          • Lucia Gracia says:

            Hi Dr. Robillard,

            Although I know it will be very hard for me since a big part of my diet is based on carbohydrates, I will definitely give your approach a try (I actually just bought your book in Amazon.)

            Thanks a lot for your response!

            Lucia

          • Ok Lucia. Good luck. There are lots of acceptable carbs in the book. Just limit the five carbs listed as high FP. Later, you can test each type individually as most people are not intolerant of all five.

  6. penny norley says:

    hi i was wondering where i can purchase the book in the uk , having a terrible
    time at the moment with lpr doc does not seem to be able to treat this condition
    waiting to see specialist, can this diet help with lpr thanks penny

    • Hi Penny,
      You can purchase the book on this site on the buy books page. Use the drop down menu for shipping outside the Unites States.

      • penny norley says:

        hi thanks for your reply will this diet help with my lpr
        desperate to find a solution as i dont want to be on ppis
        thanks penny

        • The Fast Tract Diet will absolutely help LPR. People with LPR report that, unlike heartburn or basic IBS symptoms, improvements in LPR take a month or more. This may be due to how sensitive the vocal cords are to stomach acid and possibly digestive enzymes and bile which can also be present in reflux.

  7. Diane Mancuso says:

    Question: If I eat 1/2 serving of a particular food from your chart in your book “Fast Track Digestion Heartburn” does that mean the fermentation potential is also cut in half?
    Or if I eat double the serving size, will the fermentation potential be doubled, too?
    Thank you. I am hopeful your book will relieve my daily suffering from acid reflux. It has seriously degraded my quality of life. The reflux began after a large dose of antibiotics.

    • Well put Diane. That’s correct for both Fast Digestion Heartburn and IBS. The FP is exactly proportional to serving size so you can increase or decrease FP as you indicated.

  8. Stephanie says:

    Hey.
    I have recieved and read your book Fast Tract Digestion IBS. I would highly recommend it to everyone. Its helped me put together why all those other diets weren’t working and why I kept having to modify each one I went on. My question is with SIBO being in close occurrence with yeast overgrowth, I understand they both feed off mainly the carbohydrates but do the fungus feed on other foods that perhaps bacteria wouldn’t eg strong cheese?

    Thanks,
    Steph

    • Hi Steph,
      Good question. Bacteria and yeast both break down carbohydrates and protein to get the nutrients they need to survive and reproduce with carbohydrates serving as the main fuel source. The idea of the Fast Tract Diet is to limit fermentable carbs that persist in the intestine and therefore should be beneficial for controlling both yeast and bacterial overgrowth.

      Individual species and strains of both yeast and bacteria vary significantly in the types carbohydrates they prefer but in general, but yeast prefer simpler carbohydrates and don’t break down starch well. So starch would be less likely to promote yeast overgrowth. Cheese, though a good source of protein, is a fermented food and thus has almost no carbohydrates left and should not pose a risk for yeast of bacterial overgrowth.

  9. ann says:

    hello- i have a severe case of candida thus much of what you wrote is not clear . refined carbs are better? cheese is not a problem? i am on dr. humiston’s protocol now and am having serious problems with step one, the liver cleanse. i was doing better on colloidal silver but then i hit the wall. i think it was because i was not replenishing with enough good bacteria. do you think that the above referenced dr. is on the right track? i have tried just about everything . in the beginning things work and then they don’t. very frustrated. thanks much!

    • Hi Ann,
      Sorry to hear that the diet you’re on is not working. I actually don’t know enough to comment on Dr. Humiston’s protocol or liver cleanse. If it doesn’t work, give the Fast Tract Diet a try. You are correct that I think that “refined carbs are better” and “cheese is not a problem”.

  10. DINA says:

    HI NORM , ME AGAIN, I BOUGHT THE BOOKS YESTERDAY ON AMAZON AND HAD THE 1 DAY DELIVERY SO THEY WILL BE HERE TODAY AND I AM SURE WILL ANSWER ALL OF MY QUESTIONS BUT FOR TODAY I AM WONDERING WHAT ABOUT COFFEE AND TEA ARE THEY OK AMD WHAT CAN I PUT IN COFFEE. I LOOKED AT UNSWEET COCONUT MILK AND IT HAS VERY LITTLE CARB AND IS LACTOSE FREE OR WOULD CREAM BE BETTER. I GATHER FROM THE BLOG SPLENDA IS OK AND WHAT ABOUT PEANUT BUTTER ? I HAVE BEEN EATING LETTUCE AND CHICKEN AND EGGS FOR THE PAST 2 DAYS AND IT IS REALLY GETTING BORING. I CAN NOT WAIT TO GET MY HANDS ON THE BOOKS. THANKS SO MUCH!

    • HI NORM , ME AGAIN, I BOUGHT THE BOOKS YESTERDAY ON AMAZON AND HAD THE 1 DAY DELIVERY SO THEY WILL BE HERE TODAY AND I AM SURE WILL ANSWER ALL OF MY QUESTIONS BUT FOR TODAY I AM WONDERING WHAT ABOUT COFFEE AND TEA ARE THEY OK AMD WHAT CAN I PUT IN COFFEE. I LOOKED AT UNSWEET COCONUT MILK AND IT HAS VERY LITTLE CARB AND IS LACTOSE FREE OR WOULD CREAM BE BETTER. I GATHER FROM THE BLOG SPLENDA IS OK AND WHAT ABOUT PEANUT BUTTER ? I HAVE BEEN EATING LETTUCE AND CHICKEN AND EGGS FOR THE PAST 2 DAYS AND IT IS REALLY GETTING BORING. I CAN NOT WAIT TO GET MY HANDS ON THE BOOKS. THANKS SO MUCH!

      HI Dina,
      Coffee and tea are fine. You can add cream, Splenda, dextrose, lactose-free milk or unsweetened coconut milk. Peanut butter if OK too. Just don’t over do it. Enjoy the book.

  11. DINA says:

    ALSO NORM JUST WONDERING IF YOU KNOW ANY DOCTORS IN ST.LOUIS MISSOURI THAT TREAT FOR SIBO IN ACCORDANCE WITH YOUR BOOK OR WITHOUT THE ANTIBIOTICS ? THANKS AGAIN .

    • Hi Dina,
      We are working on collaborative studies that will one day provide to support for doctors an hospitals to use the Fast Tract Diet as a first line treatment for IBS and GERD. For now, the Digestive Health Institute is the only place to receive counseling on the diet.

  12. DINA says:

    Hi Norm, got both, books last night started reading fast tract digestion IBS first since SIBO is mty primary concern, I did not see anything in the book about herbs like oregano oil peppermint oil or garlic or ginger and I have read from other sources that those herbs are antibacterial and will help kill the overgrowth of bacteria and hopefully move the healing prcess along a little faster. Also the book says spenda is OK but some diet information I received from my doctor says no spenda ? Thanks again and thanks for always replying back so quickly I really appreciate it . Thanks again.

  13. DINA says:

    ALSO NORM INTHE BOOK IT GIVES FERMENTATION POTENTIAL FOR VEGETABLES ARE THESE COOKED OR RAW AND I AM ASSUMING WHEN IT GIVES WT ON FOODS IT IS IN ACTUAL WT NOT VOLUME. THANKS AGAIN DINA

  14. Hi Dina,
    Good question. The FP was calculated based on the “as tested” glycemic index data or based on an assumed GI of 50 for lower carb veggies which have not been tested for GI (in these cases, its not critical since there are so few carbs). The best rule of thumb for the veggies in bold (tested for GI) is to assume that if the food is generally consumed cooked, the GI was determined using the food cooked. It’s easy for most veggies. Potatoes, rice, squash, etc. assume cooked. Of course there will be a few that fit both categories, carrots for example. Again, since non-starchy vegetables don’t have too many carbs, it won’t matter that much.

    And you are correct. The weight is actual weight given in both ounces and grams.

  15. DINA says:

    Hi Norm , thanks for the quick response , I have been reading the book and so happy to see I can have a little bit of grain I have been missing it terribly. I did have a previous question that was not answered about the peppermint oil oregano oil, garlic and ginger wondering what your thought are ? Also so pleased to say that I started really avoiding the carbs on Monday ( my SIBO is along with costipation and pain and as predicticted in your book I had high methane levels on the breathtest) since Tuesday constipation has been less of a problem and I am so hopeful and 100 % compliant . your book is WONDERFUL. THANKS

  16. Great to hear things are going in a positive direction Dina. Peppermint oil has a bad reputation for GERD some suggesting it might relax the LES. I would avoid it. Oregano oil supposedly has anti-fungal properties, but it’s hard to believe just a drop or two (the usual dose) would be effective. Also, some people have allergic reactions to it. In general, I don’t promote any form of antibiotic or anti-fungal, but rather support a diet approach as a first line of defense. Ginger has a good reputation and anecdotal reports support it’s use for heartburn. I love the taste it adds to stir fry dishes and use it a lot. I also like garlic for cooking and it’s reported to have a variety of positive health benefits, but I wouldn’t overdue it as it does contain some FODMAPs.

  17. DINA says:

    Hi Norm, one more question in the book a cup of milk has a FP of 8 and I was wondering if it would be the same for lactose free milk ?

    Thanks

  18. Lactose-free milk would be lower, but I don’t have an actual value for it. Assume it’s in the range of about 3-4 for the same serving size. That is to account for other oligosaccharides in milk.

  19. DINA says:

    The glycemic index is such a small list, I understand why with a person having to get stuck so many times to test a food, is there any other method to calculate a foods FP I have a feeling this will be a lifestyle I will have to adopt and it would be nice to have more variety . Thanks.

  20. Dina,

    Keep in mind that the Fast Tract Diet approach is a completely new idea – still the books list the FP of over 300 foods. And the glycemic index data base itself covers over 2000 different foods and continues to grow. But many foods are not tested for GI because they have so few carbs, it’s hard to test them (subjects can’t eat enough to consume the 50 grams of carbs needed for the test). In those cases, the foods (including most vegetables) will have a low FP and you can consume them without much worry.

    Also, I don’t include many foods from the GI data base in the FTD books either because they are mixed meals (very specific if you are not eating that exact meal), rarely used foods, or they are specific to other countries and not consumed in the US. But the FP calculation can be done pretty easily in an excel spread sheet so you can plug in any of the foods from the entire GI database. There is no other way to calculate FP, because by definition, it is based on the glycemic index.

    Most foods that don’t have a GI, but still have appreciable carbs, can still be generally assessed (the books cover this) by relating them to other foods that to have a GI. And as a last resort there is testing them by consuming them. This approach works best after you have reached a symptom-free baseline on the diet using known low FP foods. Keep in mind, there was a time this was the only way to know if a food gave you problems. Now it’s a minor technique for foods that you can’t otherwise assess.

    As this approach continues to catch on, the FP data base continues to expand based on my efforts and those of people reading the books and applying the approach.

  21. Lauren B. says:

    Dr. Robillard,

    I have enjoyed the benefits that come from following your diet, and am excited to spread the good news as soon as I can thoroughly re-read the book again. I’d like to be able to review the book over at my website with a complete understanding of the science of SIBO, and the sources you cited.

    I did have a question about erythritol. I have used it in my lower carbohydrate, sugar-free recipes for years, and found that it is the one sugar alcohol that does not cause GI distress. Here are a couple journal articles I’ve found that claim it is NOT fermentable:

    Human gut microbiota does not ferment erythritol.
    http://www.ncbi.nlm.nih.gov/m/pubmed/16277764/

    Metabolism of erythritol in humans: comparison with glucose and lactitol.
    http://www.ncbi.nlm.nih.gov/m/pubmed/8457525/?i=3&from=/16277764/related

    It might be an alternative to Splenda for follows the low FP plan. You might want to update your book if you find this to be true as well. Erythritol is a natural sweetener that the diabetic community who follows my blog has embraced. It in the only sweetener that can adequately sweeten desserts made with chocolate. Splenda alone tends to taste bitter in chocolate desserts.

    How can I email you directly, Dr. Robillard? I tried to connect with you on LinkedIn. Thanks again for a

    • Hi Lauren,
      Thank you for writing me. I had read that erythritol was absorbed more efficiently than the other sugar alcohols, but I had not seen the references you supplied detailing in-vivo and in-vitro fermentation studies. Fascinating! Kudos to you for researching this and generously pointing it out to me. I will indeed look into this further and include in my next book as well as any revisions to my existing Fast Tract books. I would like to give you credit for pointing this out to me – if you don’t mind. I would be glad to mention your book and excellent web site as well. I just may have to try a recipe with erythritol and will surely be ordering your book!

  22. DINA says:

    I HAVE A FRIEND WITH IBS-C SAME AS ME AND SHE FINDS THAT CHIA SEEDS THAT HAVE BEEN SOAKED FOR 30 MINUTES REALLY HELP HER AND CAUSE NO PROBLEMS I DO NOT KNOW THE GI FOR THEM AND WOULD ASSUME THEY WOULD BE OFF LIMITS BECAUSE THEY ARE A SEED AND A SOURCE OF FIBER BUT SHE SWEARS BY THEM , WHAT O YOU THINK. I HAVE SUGGESTED THE BOOK TO HER AND SHE HAS BEEN FOLLOWING THE FODMAPS FOR 6 MONTHS WITH GREAT SUCCESS. WHAT DO YOU THINK ?

    THANKS SO MUCH

    ALSO AS FAR AS MAINTENANCE ARE YOU EVER ABLE TO HAVE A SPLURGE MEAL OR GO OFF THE DIET FOR A SPECIAL OCCASION AND IF SO HOW LONG DOES IT TAKE TO UNDO ANY DAMAGE , I GUESS IT WOULD DEPEND ON ANY VARIABLES BUT JUST THOUGT I WOULD ASK.

    THANKS

    • Hi Dina,
      I don’t like to fix something that isn’t broken. If the chia seeds and FODMAP diet is working for her, why do anything?

      Chia seeds have 13 grams of fiber for a 1.1 ounce serving – FP in this case is 13 g. But the fiber from Chia is less fermentable than say fiber from legumes. Depending on serving size, it might not be a big problem.

      In general, I don’t recommend fiber for constipation. Here a link to a study published in 2012 that showed that the best relief for constipation was eliminating fiber. More fiber resulted in more constipation.
      http://1.usa.gov/1eNkzH0

      You must feel better if you’re already taking about splurging. The longer you give your system to heal and your microbiome to come to a homeostasis, the more forgiving your digestive system will become to occasional cheating. Still, by three days or so, most people will see some symptoms return.

  23. DINA says:

    I AM FEELING BETTER, I HAVE HAVE AFEW TIMES WHERE I REALLY BLEW IT THOUGH, I THINK I WAS SO RESTICTIVE THAT WHEN I BLEW IT I REALLY BLEW IT. I WAS ALSO WONDERING ABOUT THE NU- THIN CRACKERS THAT YOU REFER TO IN THE OTHER BOOK FOR REFLUX I BOUGHT BOTH BOOKS AND I ONLY SEE THE CRACKERS ON THE LIST IN ONE OF THE BOOKS ARE THEY ALLOWED WITH SIBO AND IN THE BOOK IT IS MENTIONED THAT THERE IS A GI FOR OVER 1000 FOODS BUT I HAVE LOOKED ON LINE AND ONLY FIND A LIST THAT PRETTY MUCH HAS ALL THE SAME FOODS IN THE BOOK. I WOULD LOVE ANOTHER LIST SO I COULD FIGURE THE FP FOR MORE FOODS. ALSO IF SOMETHING HAS THE SAME FP SAY A PIECE OF FRUIT VERSUS A PIECE OF CAKE WILL ONE DO MORE DAMAGE THAN THE OTHER OR WILL IT BE THE SAME SINCE FP IS THE SAME. CHEESE PIZZA IS LISTED TOO AND I WONDER IS IT THIN OR THICK , FROZEN OR RESTAURANT ? IS CHEWING GUM NOT SUGAR FREE BUT REGULAR JUICYFRUIT 10 CALORIES PER STICK OK ? CANT WAIT FOR THE NEXT BOOK ALSO I HAVE FOUND A REAL TREAT THAT I MAKE FOR MYSELF OTHERS MIGHT ENJOY. I PUT UNSWEET ALMOND MILK IN ICE CUBE TRAYS AND FREEZE AND THEN I PUT THEM IN THE BLENDER WITH ADDITIONAL ALMOND MILK AND EITHER SPLENDA OR DEXTROSE AND SOMETIMES ADD PLAIN COCOA IF I WANT CHOCOLATE FLAVOR AND I ZAP IT IN THE BLENDER AND IT IS REALLY GOOD AND THICK JUSTLIKE A SHAKE. A FEW BERRIES COULD BE ADDED AS WELL WITHIN FP LIMITS OF COURSE

    • Hi Dina and great news that you are feeling better! Any foods that you see in one book (including the crackers) can be used in the other book. There are actually well over 2000 foods with GI values, though some may not be available in the US or refer to mixed meals. Do your best to find the GIs for foods that interest you but are not in the book (so you can calculate the FP). If you can’t find a GI, estimate FP by either using the GI for a similar food or substituting a GI = 50 to get a ballpark FP value which will essentially be 50% of the net carbs plus grams of fiber and sugar alcohols if they are present in a given serving.

      Since this is a completely new diet system, I continue to expand the foods list, but interested readers and others can help by posting more GI values they find for foods not listed in the tables. I plan on updating the FP tables in the FTD Heartburn ebook and second printing of the paperback this year.

      There will obviously be some variability between one type of pizza and another. You would be best served by going with thin crust and not too much tomato sauce since those (and not the meat, cheese or veggie toppings) are the main source of FP grams.

      As for cake vs fruit and other comparisons, you should initially treat all FP the same for convenience, but as you get better, you may find that the sucrose, resistance starch and fiber from chocolate in cake trigger your symptoms worse than the fructose and pectin fiber in fruit (or the opposite) even though the FP is equivalent. These are different molecules that will evoke different responses depending on the types of microbes in your gut triggering symptoms.

      Chewing gum has about one FP gram per stick.

      Thanks for your great idea for a quick smoothie. I might just have to try it!

  24. EER says:

    Hello,

    I wondered if you have any thoughts on the newly emerging theories/evidence regarding the role of cell bound pepsin in laryngopharyngeal reflux / silent reflux. Do you believe your ideas allow for this or contradict it.

    Thanks

    • Hi E, Pepsin is most active in the acidic environment of the stomach – pH 1 to 3.5, but does retain some activity up to pH 6 and it’s good at attacking protein so yes, I think this enzyme can do damage if it contacts the vocal cords. Caustic bile and stomach acid as well as gut bacteria (with their full complement of digestive exo-enzymes) are also refluxed and likely play a significant role in damage to the esophagus, lungs, sinuses and vocal cords. The solution, in my view is to stop the reflux. I don’t see how a low acid diet would accomplish if the cause is gas pressure from SIBO / dysbiosis which I believe to be the ultimate cause. Perhaps this type of diet could minimize the pepsin-mediated damage to the vocal cords and esophagus by keeping the pH higher, but what about the damage from acid, bile and bacterial enzymes?

  25. EER says:

    Hi Norm,

    Thanks for your thoughts. Based on the research I was reading it was pepsin that is thought to be the main problem in EER rather than acid, as pepsin – stable up to ph7 becomes cell bound and is re-activated with reacidification. This paper goes into some detail on all this; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216344/
    It also mentions a probable aerosol explanation for why pepsin is found in the sinus, middle ear and lungs. I know that Jamie Koufman has researched this also and advocates the same. These theories don’t offer an explanation as to why reflux is happening, why it happens to some people who have healthy diets and not to others who don’t. Which is why your ideas were of interest. On a separate note I’m curious about the biochemical stress response in all this and would wonder if anyone has had any reflux resolutions with anxiety meds, stress reduction techniques. Thanks again.

  26. Robert Steigerwalt says:

    I am a 72 year old man who has had gastro problems since age 17. Started Tagamet, then Zantac, than Prilosec as they were invented and they did the job until 4 months ago I had an episode after my evening dinner that put me in the worst gas pain I have ever had and tremendous belching this lasted for 12 hours and I was up the entire night walking and belching this ended in a bout of diarrhea, then I was over it. My primary doc was on vacation so a PA tested me for H. Pylori, positive and I did the antibiotic treatment. I have had the same episode 3 more times since then (about once a month) I can’t tie it to specific food.
    My gastro doc breath tested for fructose, lactose & SIBO and found SIBO and some lactose intolerance. He also did an endoscopy and upper GI (barium) and I had a Colonoscopy a few months ago, these showed no serious problems. He put me on 1650mg per day of XIFAXAN for 10 days, by day 5 they had made me so sick with horrible cramping & diarrhea that I was unable to sleep for 3 days, I was ready to go to the ER. Against his advice I quit the pill and improved almost immediately. Not knowing where to turn I purchased your book and have started the diet, I’m on day 3 & so far symptom free. What is your opinion of these sporadic episodes and the severe Xifaxan drug reaction? I was told this drug has very few side effect and none like I had.

    • Hi Robert,
      Sorry to hear about your abrupt symptoms. That would cause anyone to become concerned. I am glad to see you are under the care of your doctor and did address the H. pylori issue. H. pylori can have serious consequences down the road. You can read the article on antibiotics for IBS on this site, and I am glad you are trying the Fast Tract Diet. I can’t say for sure what caused your dramatic reaction to the Xifaxin, but you can expect a rapid die off of gut bacteria on this antibiotic. Perhaps that’s what caused your symptoms. I recommend you discuss the book with your doctor, who may support you in weaning off the acid reducing drugs while you implement the diet, since these drugs actually promote SIBO. Some people take simple antacids as rescue meds as they wean off the hard core acid-reducing drugs.

  27. Thanks for all the great comments. Going forward, please use either the forum or blog pages for your comments.

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