what to do after unsuccessfull elination diet?

positivenote

Hi all,
positing on behalf of my other half. To get straight to the point my other have has been passing a mucous substance when she goes to the toilet for approx 7-8 months and the irritation is proving unbearable. Salted baths give some relief to the irritation but nothing for the cause of the causes for the irritation.After numerous visits to GP and having a colonoscopy all results came back as non-conclusive. So we spoke to a nutritional therapist, who recommended an elimination diet which she has tried for the past 23 days but there has been no change, apart from weight loss which she is delighted with. All she has been eating is water with lemon, fruit, sweet pot and other veg, with turkey/chicken breasts. However, she still passes this mucous substance when she goes to the toilet.
I wouldn't usually go online looking for advice on issues this personal, but our GP has said that there is nothing more she can recommend and her advice would have been an elimination test.
ANY recommendations would be more than welcomed
Thanks

El_Dangeroso

It's unacceptable for the GP to say there's nothing more that can be done. I'd insist on being referred to a specialist who has more knowledge in the area.

I know of people who had to go to 4 specialists before getting a diagnosis. Don't take 'I don't know' for an answer.

positivenote

I know what your saying... Problem is the GP, after 3 visits, recommended colonoscopy which we had to get done privately as we were given a time frame of another 6 months publicly. This proved that the issue was not related to that specific area and biopsies were taken and checked with nothing of significance to report. (thankfully) GP then suggested nutritional therapist consultation, which resulted in elimination test suggestion, which after 25days hasn't improved the situation.
Im not sure what else the GP can recommend, or what type of specialist we should try and talk to? If its not food and its not a problem that a colonoscopy could diagnose we're at a loss as to what it could be?
A friend has suggested that stress can manifest itself in really strange ways and that possibly acupuncture could be something to consider... but this is the physical excretion of a mucous type substance rather than anything like a pain or a anxiety.
anyway, thanks for the feedback, anymore from anyone would be really appreciated.

Irishcrx

I'd be looking into a specialist for sure, I had an issue with my stomach a few years back and I wasn't getting any answers either. The pain was intense at times and pretty much had me couch bound. I ended up in A & E bleeding from the rectum and they still didn't know what was causing it , they sent me for a colonoscopy which came back inconclusive as well, incredibly frustrating..but the bleeding did stop and in time the pain went away although I never found out the route cause so I always worry it will return.

You need answers.

El_Dangeroso

positivenote wrote: »

I know what your saying... Problem is the GP, after 3 visits, recommended colonoscopy which we had to get done privately as we were given a time frame of another 6 months publicly. This proved that the issue was not related to that specific area and biopsies were taken and checked with nothing of significance to report. (thankfully) GP then suggested nutritional therapist consultation, which resulted in elimination test suggestion, which after 25days hasn't improved the situation.
Im not sure what else the GP can recommend, or what type of specialist we should try and talk to? If its not food and its not a problem that a colonoscopy could diagnose we're at a loss as to what it could be?
A friend has suggested that stress can manifest itself in really strange ways and that possibly acupuncture could be something to consider... but this is the physical excretion of a mucous type substance rather than anything like a pain or a anxiety.
anyway, thanks for the feedback, anymore from anyone would be really appreciated.

A colonoscopy can't show everything and I find it really annoying when GPs say 'Oh well there's nothing obvious on the scope so there's nothing wrong with you.' You're wife would beg to differ I'm sure!

It could be a bowel infection or parasites or malabsorption or loads of other things that don't show on a scope. Definitely worth shelling out another 150 to see a consultant.

flyingsnail

When your OH had the colonoscopy did they have a consult or followup with a gastroenterologist?

Zillah

positivenote wrote: »

rather than anything like a pain or a anxiety

Stress isn't an entirely psychological phenomenon. It manifests with measurable hormone changes, blood pressure, sleep quality - all manner of things. I've no idea if it could be at fault but I wouldn't dismiss it based on the notion that her problems aren't just pain or anxiety.

fussyonion

Strange how they didn't diagnose IBS as I have IBS and I have the same mucus problem as your girlfriend.

Since I started eating healthier, though, it doesn't happen all the time.
Usually when I eat white bread/doughy rolls/fast food.

positivenote

flyingsnail wrote: »

When your OH had the colonoscopy did they have a consult or followup with a gastroenterologist?

Not as such. We went private and the surgeon cam out to us after the proceedure and told us that there were no signs of anything to worry about but he took a fe biopsies anyway and he would be in touch when the results returned. We asked for the results to be forwarded to our GP. This was done and the GP rang us and told us that the biopsies came back clear.

Thanks for the replies, but any suggestions upon where to go next or what type of specialist to try and get in touch with?

flyingsnail

Personally I would have thought the next port of call would be a proper consult with a gastroenterologist, that tends to be their area.

joeprivate

positivenote wrote: »

Hi all,
positing on behalf of my other half. To get straight to the point my other have has been passing a mucous substance when she goes to the toilet for approx 7-8 months and the irritation is proving unbearable. Salted baths give some relief to the irritation but nothing for the cause of the causes for the irritation.After numerous visits to GP and having a colonoscopy all results came back as non-conclusive. So we spoke to a nutritional therapist, who recommended an elimination diet which she has tried for the past 23 days but there has been no change, apart from weight loss which she is delighted with. All she has been eating is water with lemon, fruit, sweet pot and other veg, with turkey/chicken breasts. However, she still passes this mucous substance when she goes to the toilet.
I wouldn't usually go online looking for advice on issues this personal, but our GP has said that there is nothing more she can recommend and her advice would have been an elimination test.
ANY recommendations would be more than welcomed
Thanks

What did the nutritional therapist ask you eliminate from the diet?,
It would seem obvious to me that meat in particular chicken meat be eliminated form the diet as it is a well known source of bladder infections in women.
So my advice would be to not to handle any raw chicken for the whole family to see if this would help.
What I would suggest would be no processed food and no meat or chicken for your other half for a few weeks and you may wish to get some advice so as you are happy this vegan type diet is balanced as you may not be used eating a plant based diet .
Also no uncooked chicken to be brought into the house to see if this is the cause perhaps you might get away if you buy your chicken in M&S .
M&S will seal each of its chickens in a special bag that can be roasted
The supermarket said it will reduce the risk of transmitting campylobacter
The bacteria causes 280,000 food poisoning cases a year and 100 deaths in the UK

I have a few more links to share so I will update post later

positivenote

joeprivate wrote: »

What did the nutritional therapist ask you eliminate from the diet?,

Hi, thanks for the advice. elimination of the usual food stuffs dairy, eggs, sugar, wheat etc...
Her diet has consisted of:
Fruit for breakfast (apples/banana/berries) with lemon water

Lunch: either veg (roasted) or rice-cake with salmon

dinner: Roast veg and turkey or chicken breast.

Its interesting that you say chicken as she has eaten chicken 4-5 nights a week for dinner for as long as I have known her which is over 20 years... this could be something to try, but what can she introduce to replace the absence of chicken? and for how long should she avoid it to see if there's a change?

Mellor

joeprivate wrote: »

It would seem obvious to me that meat in particular chicken meat be eliminated form the diet as it is a well known source of bladder infections in women.

The issue sounds like it's colon not bladder, but none the less. Should definitely check any foods that are eaten regularly.

positivenote wrote: »

Hi, thanks for the advice. elimination of the usual food stuffs dairy, eggs, sugar, wheat etc...
Her diet has consisted of:
Fruit for breakfast (apples/banana/berries) with lemon water

Lunch: either veg (roasted) or rice-cake with salmon

dinner: Roast veg and turkey or chicken breast.

TBH, that sounds like a half arsed effort from the nutritional therapist tbh.

Dairy, eggs, wheat, etc are possible cause but they aren't the only possible offenders. She should really look at every individual food that she eat regularly. It could easily be chicken, salmon/fish, even certain vegetable etc

joeprivate

Mellor wrote: »

TBH, that sounds like a half arsed effort from the nutritional therapist tbh.

Here is some information from Drmcdougall website https://www.drmcdougall.com not sure if it 100% relevant but I think it might point you in the right direction.

One step further in effective therapy is to avoid the foods that most often cause allergies–dairy products, eggs, chocolate, wheat, and citrus fruits, as well as fats of all kinds. (he includes all oils eg olive oil ) If this approach is not successful, the final step toward diagnosis is to use an elimination diet.


A person with a functioning healthy small intestine re-absorbs the bile secretes from the liver in the last part of the small intestine, called the ileum. In patients with Crohn’s disease this portion of the ileum often is damaged and unable to absorb the bile. Bile continues to flow along the ileum into the large intestine, where it causes irritation and discharge of mucus and water. In these patients the immediate benefit from a change in diet is the decrease in bile acids produced by the liver as a response to lowering the fat content of the foods eaten. In addition, the fibers introduced in a plant based diet bind and neutralize many of the bile acids and absorb free water present in the stool.

Here is an example of an elimination diet from the same website.
You could use this or adapt it with your doctors advice If your other half is on medication you really need to be careful when changing your diet as a plant based diet often brings blood pressure back to normal and if you were taking blood pressure tablets you could end up with blood pressure that is to low.

Portion control (based on a visual estimate) should result in about 80% of the food coming from starches; the remainder will be from vegetables and fruits. Cook all foods thoroughly. Heat breaks down and deactivates proteins and other troublesome components of the food. Boiling and steaming are the healthiest ways to cook.
Starches (all cooked), include:
Brown rice (or white rice)
Sweet potatoes
Winter squash (Acorn, Butternut, Pumpkin, etc.)
Taro (or poi)

Non-starchy green and yellow vegetables (all cooked) include:
Asparagus
Artichoke
Beets
Beet greens
Celery
Chard
Kale
Lettuce
Spinach
String Beans
Summer squash

Almost all other non-starchy yellow, orange, red, green, and purple vegetables are allowed (cooked). Avoid onions, green pepper, cucumbers, and radishes, especially when raw because they can be very troublesome for the stomach, causing indigestion.
Fruits (all cooked) include:
Apricots
Bananas
Berries
Cherries
Papaya
Peaches
Plums

Avoid all citrus fruits, including oranges, grapefruits, tangerines, lemons, limes, etc. and also tomatoes.
Condiments include:
Salt
Sugar
Only common table salt and table sugar are allowed, if not restricted for other health reasons. This means no salad dressings, mustard, lemon juice, vinegar, pepper or other condiments.
Beverages:
Water (sparkling water is OK)
Managing the Elimination Diet:
After one week of being strictly on the new diet, food-caused problems should be ending and the dieter should be feeling much improved. If this is the case, then the dieter can begin adding other foods (those not listed above) back to his or her diet, but only one at a time, in order to determine if any of these cause unpleasant reactions. For testing purposes, each "new" food should be eaten in large amounts three times a day for two days. If the food does not cause a reaction, then the dieter can conclude that this food is not a troublemaker. Most reactions occur within a few hours, but some may not show up for several days. Each food must be tested individually; do not introduce two new foods at once. When there is a reaction to a specific food, the dieter must wait for four to seven days before testing the next item. This interval gives the time required to clear the intestines and to rest the system from that allergy-causing food.
The foods added back during the elimination diet should not be from animal products of any kind or from vegetable oils for general health reasons.


Best of luck and keep in touch with your doctors about any changes you are thinking of making but don't be afraid to question them about what they are telling you as they often get it wrong.

Alf Veedersane

The OP has used an elimination diet.

El_Dangeroso

joeprivate wrote: »

What did the nutritional therapist ask you eliminate from the diet?,
It would seem obvious to me that meat in particular chicken meat be eliminated form the diet as it is a well known source of bladder infections in women.
So my advice would be to not to handle any raw chicken for the whole family to see if this would help.
What I would suggest would be no processed food and no meat or chicken for your other half for a few weeks and you may wish to get some advice so as you are happy this vegan type diet is balanced as you may not be used eating a plant based diet .
Also no uncooked chicken to be brought into the house to see if this is the cause perhaps you might get away if you buy your chicken in M&S .
M&S will seal each of its chickens in a special bag that can be roasted
The supermarket said it will reduce the risk of transmitting campylobacter
The bacteria causes 280,000 food poisoning cases a year and 100 deaths in the UK

I have a few more links to share so I will update post later

You can get food poisoning quite easily from vegetables too. In fact several of the most notable outbreaks recently were caused by organic vegetables. Another was frozen berries contaminated with hepatitis.

I don't see anything helpful for the above for the OP. If they have an infection, then that needs to be treated medically. Not by avoiding certain foods which will do nothing.

doireannod

Hi there. It's very reassuring that the colonoscopy was inconclusive and no disease process was detected. Has your doctor suggested a possible diagnosis of Irritable Bowel Syndrome (IBS)? If you think IBS may be the problem, the most successful diet to relieve symptoms is the FODMAP diet. Without getting too technical, FODMAPs are molecules found in foods that cause irritation to the gut and can cause pain and passing mucous. A lot of fruit and veg are high in FODMAPs. Adopting a low FODMAP diet can help some people with IBS. It should be done under the guidance of a dietician to help you identify the high FODMAP foods and avoid them.
Examples of high FODMAP foods that can cause irritation to the gut wall are apples, pears, grapes, broccoli, cauliflower and green beans.