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Resources2016-12-12T10:04:22+00:00

22 Comments

  1. Ralph Flores March 3, 2013 at 3:01 am

    Norm Robillard, as a Gerd sufferer for 6 months, I was pleased to come across your books. After only 10 days or so, my symptoms have markedly diminished. A manometry has shown my LES to be weak, and I am 72. Up to now I’ve been trying anti-acids, switched thereafter to Betain HCl and enzyme supplements (based on Dr. Wright’s book), which I am still using, though they’ve not helped so far. Now that a low carb diet seems to be working, I might abandon them, and wonder what your take is on using these supplements, which you mention briefly in one of your books?

    • Norm Robillard March 3, 2013 at 4:42 am

      Hi Ralph,
      Happy to hear you’re feeling better. That’s excellent news! I expect that if you were to get another manometry, it would show that your LES is much stronger. I believe this test is actually measuring increased intraabdominal pressure from SIBO, not decreased LES pressure.

      Antacids are fine for breakthrough symptoms. Betain is fine if you have been tested and have low acid. Otherwise, it’s one more medicine you don’t need. I will leave that call to you and your doctor.

      Also, if you read Heartburn Cured, you might be interested in Fast Tract Digestion Heartburn describing a different approach aimed at the same goal – controlling SIBO.

  2. Dana August 6, 2013 at 7:47 pm

    Hi Dr. Robillard,
    I have gastritis and GERD.I just finished reading your book and I am already starting the Fast Track diet. I’ve already calculated the FP for a few of my staples and while doing so, I thought “Now, there should be an app for this!”. I hope one becomes available. Also, I am SHOCKED to say the least that we can have BBQ sauce, hot wing sauce, onions, tomatoes, etc. on this diet (although I believe it–it’s just shocking in a good way!). However, since I have gastritis (mild–I only feel pain when I get stressed) shouldn’t I stay away from these things or would it make sense that if they don’t cause pain then they aren’t irritating my stomach? Thanks for all the research you’ve done and thinking outside the box on GERD!

    • Norm Robillard August 6, 2013 at 8:04 pm

      Hi Dana,
      I appreciate your feedback, thanks! As long as you are considering the FP of the foods you eat, you should be fine. If you find that certain foods bother you (i.e., cause symptoms) you can limit those. You may find for instance that you are OK with cooked onions, but want to avoid raw onions, etc. In regard to the BQ sauce, most brands contain a good amount of sugar (includes fructose), so do the calculation and use less if needed. I make my own with less sugar. Other than that, have fun with this new paradigm and keep me posted.

  3. Alexandra August 22, 2013 at 3:24 pm

    I love your Acid Reflux book and think it all makes sense. I was on Dexilant for 3 years for acid reflux and while on it developed IBS-C, bloating, cramps and weight gain. I also have anemia the last year which I found out after I caught pneumonia. I am in my 40s and in great health (otherwise) and not overweight! About a year ago, I switched to low-FODMAPS which helped the IBS (other than bloating) but the acid reflux is persistent. Due to my FODMAPs experience, I really think you are onto something.

    However, since my gastro health is getting worse, I switched off the Dexilant and moved to high doses of H2 blockers and decided to change my diet even more! Eating very low carb paleo has gotten rid of the bloating and constipation. I lost the weight I’d gained and feel like my IBS is much improved. That said, the acid is BAD. Also, I’m dizzy often from lack of food and no matter what I eat (or not – if I fast) I cannot get off the Pepcid and honestly it doesn’t even work that well. It’s been 3 months since I moved off Dexilant. I’ve heard about acid rebound from PPIs but at 3 months is it still a possibility? I take a probiotic, mastic gum and DGL (sugar free one) and have to supplement the Pepcid with ant-acid often because I have breakthrough symptoms almost every day. I started eating a diet of only animal protein and STILL have symptoms. Is this just part of the transition? Like I said, I love the ideas behind your diet and given my success with FODMAPS it sounds like it should work but I’m really worried I’m damaging myself with so many symptoms at 3 months out (incidentally my symptoms were NEVER like this pre-Dexilant. They were consistent but far less bad.) I’m willing to stick it out if someone can tell me this isn’t a lost cause. I’m very hungry LOL. Any input you have would be great.

    I’ve also tried HCL supplements (but my stomach is hot after I eat to begin with with HCL it felt like I had a knife in my stomach), aloe vera juice (jury’s out on this one), apple cider vinegar (extreme nausea inducing) and stomach enzymes. I tried tapering off the Pepcid – disaster. Everything makes the reflux worse. I cannot figure it out. Anything in your research point to ideas about this?

    • Norm Robillard August 22, 2013 at 3:59 pm

      Hi Alexandra,
      At least you are off the strongest acid blocker medicine. Many people report the same problem – symptoms worse after stopping PPIs than before they went on them, but I can’t help wonder if continued use of the H2 blocker in your case has postponed the full rebound effect of going off Dexilant (usually two months should be plenty of time for that to pass). Have you had any GI diagnostic work done (SIBO test, endoscopy, etc.)? Given your history and use of several supplements, I would need to review your diet and supplementation in detail along with your history. You might consider making an appointment for a consultation. I would also be interested in knowing the ratio of protein and fat in your diet as protein is the more fermentable of the two.

  4. Patrik September 13, 2013 at 7:14 am

    Just a few questions if that’s Ok?
    What would you consider beeing the easiest to digest veggie, rootvegetable, berrie, and nut?
    I’m also wondering if you think that goats milk/yoghurt is easier to digest than that of cows?
    // Patrik

    • Norm Robillard September 13, 2013 at 1:40 pm

      Hi Patrik, Interesting question. Each of the foods you mention present unique challenges for our digestive system. Veggies contain some tough fiber, root vegetables contain some low GI carbs and in some cases resistant starch, berries are high in fiber, and nuts also have some low GI carbs and fiber. The Fast Tract Diet uses the Fermentation Potential (FP) system to answer your question more specifically for each food type. The answer depends not only on the food, but the serving size.

      As for goat milk/yogurt vs cows milk, let me first say I advocate cream or fermented milk products over whole or skim milk to limit the amount of lactose. Both types of milk have similar amounts of lactose. There are reports that goat’s milk has smaller sized proteins and fats that could ease digestion. In a quick search, I could not validate those claims. There is also the idea that allergies to one product might be reduced by using the other product – because they each have “unique” protein profiles.

  5. Patrik September 14, 2013 at 10:55 am

    Thank you, Norm.
    There’s just no easy answers, is there!? 🙂
    The reason I’m asking is that if you read up on what you’re saying, and compare with for example SCD, phd, Paleo, Gaps, anti-histamine,and Fodmaps, and so on,, you end up with very different ideas on what is best for digestion, and combating SIBO, healing Leaky gut, repoulating Healthy gut flora, and so on.
    I’m trying hard to pin down what’s the similarities, and what’s the differences. I’m having a really hard time getting my digestive issues under control. Feeling more and more limited in what i can, and can’t eat.
    So that’s why I was asking that question above. I interperate your answer as “if you eat small enough quantities, you can eat whatever..?” And that is pretty much what I’m doing, but I’m getting pretty tired of it.
    I wanna be able to eat helthy foods like vegetables, tubers, berrys, and maybe some nuts, rice, quinoa, and some yoghurt/cream, and stuff like that. I’m not talking about cramming down lot’s of pasta, french fries, bagels, and crap like that. Just some healthy gluten-free carbs. Maybe 50-75 g a/day. That’s all..
    I have one more question to. I’ve read about gluten-intolerance cross-reactions. Have you heard about this? To narrow it down the bodies can react with anti-bodies against gluten to some proteins similar to gluten, and some of these proteins can be found in for example, rice, milk, and potatoes. This schould then lead to an never ending, vicious circle, of Leaky gut, even though gluten has been removed from the diet. What is your oppinion om this,
    // Patrik

    • Norm Robillard September 14, 2013 at 11:52 am

      Yes, there are several diets out there. I review them here and make a case in the blog and in my books why I believe the Fast Tract Diet is the best choice for SIBO-related conditions. In making your food choices, assessing the fermentation potential is a must if you want results. There’s not much difference between Quinoa and pasta IMO, at least in terms of resistant starch. Many tubers also have significant amounts of resistant starch. Eating a one pound sweet potato, for example, is the last thing someone with IBS, GERD, etc. should do. A smaller serving of jasmine rice or a well cooked low FP variety of potato would be a better choice.

      On the issue of gluten cross-reactions, it is certainly possible that antibodies to gluten could cross react with similar proteins in other foods. But an alternative explanation for why many gluten-sensitive people or people with celiac disease don’t fully recover on gluten-free diets, has to do with resistant starch. Many gluten free foods, for instance some rice and tuber varieties corn, bananas, etc, have significant amounts of resistant starch. Bacterial overgrowth, linked to celiac and gluten-intolerance, can be hard to control with so much fermentable material in the diet.

  6. Doug September 16, 2013 at 1:46 pm

    Hi Dr. Robillard, I got your latest Fast Tract Digestion book and was wondering if there was a more extensive list of FP values for food available as a resource. It’s tricky to determine whether different varieties of foods (rice, potatoes) are going to be a problem or not when I’m buying them. A more comprehensive list would be most helpful. Also, would taking digestive enzymes reduce the need to be as strict with the consumption of foods like tubers and other resistant starches? Or would that likely down-regulate the body’s natural production of those enzymes over time?

    Thanks!

    Doug

    • Norm Robillard September 16, 2013 at 2:29 pm

      Hi Doug,
      Fast Tract Digestion lists the FP for 350 foods while there are slightly fewer in FTD Heartburn. Sorry I don’t have additional lists of foods available currently. In the future, time permitting, I may be able to post some updates on this site.

      In the mean time, there are over two thousand glycemcic index values available so some of the foods you are interested in may be represented. Some people add the formula to an excel spread sheet for easy FP determination of foods not in the tables but which have a GI available. There are other strategies that may also help such as avoiding long grain rices other than jasmine, consuming white potatoes over sweet potatoes or yams, choosing foods that are most similar to low FP foods in the tables, estimating the amounts of the five difficult-to-digest carb types in new foods, or experimenting with new foods after your symptoms are under control to see if they cause new symptoms.

      Interesting question about adding digestive enzymes. These would include amylase for starches, beta galactosidase (beano) for legumes and lactase for lactose intolerant individuals. I have not read anything suggesting that taking these supplements will down regulate natural production of of these enzymes. In the case of beano (the human body doesn’t make it) and lactase (already deficient for lactose intolerant people), there is not downside. Likely taking extra amylase would not be a problem either, but I am not 100 % sure.

      • Doug September 17, 2013 at 5:08 pm

        Thanks for your reply Dr. Robillard. As a follow-up in a totally different direction – what about attacking the bacteria problem from a different angle by taking natural antibiotic alternatives such as Olive Leaf Extract, garlic, lemon juice, etc. in addition to reducing hi FP foods in order to both kill and starve out the “bad” bacteria over time? I’m concerned that bacteria are actually eating my proverbial lunch as I’ve been on antibiotics/acid-suppressants/steriods for years on and off. As a consequence I’ve lost an awful lot of weight while probably not making much of a dent in the bacteria count until recently, having read your book and implemented some changes (symptoms have improved already). However, I’m discovering limiting many of these carbs that I used to eat, while surely helping to lower the bacteria load on my digestive system, also tends to cut into the overall calories that I’m looking for in order to gain that weight back. So I’m looking for those high calorie “good” (low-FP) alternatives to help with that. Any recommendations?

        Thanks!

        Doug

        • Norm Robillard September 17, 2013 at 5:58 pm

          Hi Doug,

          Glad to see you are seeing some symptoms improvements already! The weight loss should begin to subside as you get any bacterial overgowth under control and your normal digestive process is restored.

          You could certainly try some natural antibiotics. Lemon juice has been reported to potentially increase the acidity of the small intestine which may be helpful for curtailing bacterial overgrowth there. I don’t have experience with garlic or olive leave extract. You might also look at my response to Carolyn in the comments under the Book reviews tab on some positive results with Peppermint oil.

          As for keeping/gaining weight, I agree that increasing some higher carb but low FP foods like jasmine rice, parsnips, squash and lychee fruit, etc. could help. I also recommend making sure you have ample fat in you diet. Good fat sources include olive oil, salmon or tuna, cheeses and steak cuts with marbled fat.

  7. Marianne Ablitt October 7, 2013 at 11:10 am

    Hi Norm,
    I have your new “Fast Tract Digestion” book. A few things confuse me in the tables and to me seem to be contradictions that perhaps you can explain. e.g
    For Relative Symptom Risk values and FP : chick peas are moderate but hummus ( primarily chickpeas) is low ; buckwheat is moderate but buckwheat gluten free pancakes are low ; rice noodles are moderate but brown rice pasta is low.
    Also Middle Eastern flatbread is low but Pita bread is moderate. In Australia these two breads are exactly the same thing – maybe they are different in the US ?
    And shredded coconut is moderate, and yet it is used in one of your recipes – Pineapple Macaroons. Is this a contradiction ?
    A different question ; you nominate sugar polyols as potential problems. The FODMAP diet also limits polyols, some of which are found in fruits and vegetables, but you do not highlight any of these as problems e.g. mushrooms, cauliflower, snow peas, stone fruit. Are these different from what you are referring to ?
    One last question ! you say it is not good to eat pre-cooked rice because it changes as it cools, and that if it is to be eaten, it must be thoroughly re-heated. But it sounds like it will still have greater resistant starch then warm freshly cooked rice – how much of a problem is to eat reheated rice ( Jasmine, or sticky ) ?
    Thanks, your patience is much appreciated 🙂
    Marianne

    • Norm Robillard October 7, 2013 at 1:49 pm

      Hi Marianne,
      Thanks for reading the book and coming up with some good questions.
      On hummus, here is an excerpt as this question has been asked before: Notice in the FP tables that the serving size referenced for chick peas is 5 times larger than the serving size for the hummus. That accounts for the difference in FP.

      On buckwheat, I just go by the published glycemic index values for the foods or grains. Check the amounts listed to see if they are the same. It could also be the way the pancakes were prepared that resulted in a higher GI/lower FP.

      Middle Eastern flatbread vs. Pita bread. These are different in the states as far as I know. You should use caution in adding either to your diet and limit the amount and chew well until you know you can tolerate them.

      As for shredded coconut FP vs FP for Pineapple Macaroons, in each case, I calculated the FP based on the amounts of net carbs (7 g for 2.1 ounces) and fiber 8 g for same amount. The biggest contribution is from the fiber. There is no contradiction I am aware of. The answer could be the serving size – the recipe serves 5 people, so the total FP for the entire amount would be 5 X 6 or 30 grams.

      On the FODMAP diet limiting mushrooms, cauliflower, snow peas, stone fruit: I limit these foods based on the FP calculation with an estimated GI of 50% (they have not been tested likely because they are relatively low carb). Depending on how the total carbs and fiber for foods are tested (there are different test methods), polyols may or may contribute to the fiber content. If they are in the fiber determination, they would be added directly to the FP. If included in total carbs, but not fiber, they would contribute 50% to the FP. Given the relatively low amount of total carbs (half of which are being added to the FP) for these foods, I don’t think the FP would change much either way – maybe by one gram or so. Clearly better test methods are needed to we can accurately quantitate polyols.

      Cooled and reheated rice does have more resistant starch than freshly prepared rice. Some of the resistant starch formed by cooling is not gelatinized upon reheating. Freshly cooked rice made with enough water so it’s light and fluffy is the best bet.

  8. Frederick Wilson December 27, 2013 at 2:31 am

    Norm – Your approach to GERD and LPR has totally amazed me. After decades, I’m finally healing up. While I wait the month or so for my LPR to completely resolve, here are 2 tips that have been working for me in dealing with pain:

    1) Cough lozenges. Even though they sometimes have some non-Fast Tract substances in them, they help with pain if used in moderation.

    2) Sodium Carbonate: I bake a box of Arm & Hammer baking soda at 400 F for 60 minutes. This turns a lot of the sodium bicarbonate into sodium carbonate. Then I use 1/2 teaspoon of the powder in an 8 oz glass of water. This makes a soothing solution at pH 9.5 or so that can be sipped to bathe the upper esophagus and larynx. The theory, as I understand it, is to raise the pH and irreversibly denature the pepsin in the damaged areas.

    Both of these have been temporary remedies for me, and over the few weeks I’ve been on Fast Tract, I need them less and less each day. Just thought someone else might benefit…

    • Norm Robillard December 27, 2013 at 4:13 am

      Thanks Frederick, Happy to hear it. Thanks for the suggestions. I don’t know enough about the NaBicarb to Nacarb chemistry to comment, but since NaCarb is used in cooking, it should be Ok in limited amounts.

    • David Rager January 6, 2014 at 9:09 pm

      Frederick,

      I am also suffering with LPR and I would love to speak with you regarding your experience with the Fast Track Diet. My email is bigcoop20@hotmail. Please email me if you have a chance.

  9. Ann January 25, 2014 at 2:34 am

    Hi, I left a message somewhere just now but can’t find it anywhere. Anyway I think the the Patrick Timpone mentioned are here http://symbiopharm.de/en/products/symbioflor-1.html and would appreciate your thoughts on them if poss. I do have a label of COPD (don’t/wont take anything) the same company has a product for bronchitis – http://symbiopharm.de/en/areas-of-application/chronic-bronchitis.html. Understand if you are unable to give feedback on products. Thxs Ann

    • Norm Robillard January 25, 2014 at 3:20 am

      Hi Ann, Thanks for the link to the probiotic Patrick was talking about. Correct, I don’t typically endorse products up or down on this site. But I can comment on the bacteria in this supplement, Enterococcus faecalis. In the gut, this organism is naturally present, non gas producing and healthy. Its also used in cheese making. It’s also what’s called an opportunistic pathogen. That means outside the gut, it can cause a whole variety of infections – but that’s not unusual for gut microorganisms. Just make sure you take it with plenty of water.

  10. Norm Robillard February 2, 2014 at 6:11 pm

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