Anti-dumping diet is for persons with partial to total gastrectomies (stomach partially or totally removed) or gastric bypass (part of the stomach is bypassed) for morbid obesity. They don't tolerate:

• tough meat, especially beef
  
• milk and dairy products
  
• bread, especially when fresh or fluffy can form a ball
  
• pasta
  
• cirtus juices and fruits
  
• fried foods
  
• concentrated sweets
  
  

Also drinking fluids with meals displaces nutrient dense foods and tends to make the person feel bloated even if flat (fizz gone) carbonated beverages are drank.

What happens is because of the smaller gastric pouch, the simple sugars aren't broken down prior to being dumped into the duodenual intestines. The sugars ferment and cause bloating or often vomiting. Nausea, vomiting, bloating or heartburn can also result from:

• eating or drinking too quickly,
  
• not chewing food adequately especially beef,
  
• eating high fiber foods that can block the stoma,
  
• drinking cold fluids,
  
• eating too much,
  
• drinking with a straw,
  
• eating rich or sweet foods,
  
• eating gas producing foods or drinking carbonated beverages,
  
• eating foods that usually cause gastric discomfort to the individual.
  
  

Nutritional adequacy may be lacking due to decreased volume of food in either gastrectomy or bypass. Consider vitamin or mineral supplements, but only if the intestines have not been surgically shortened.

If you have provided all of the above and the person is still vomiting, consider the stoma may be blocked and talk to the doctor. Don't you have a consulting Registered Dietitian to work with?

I have some friends whose daughter has fibromyalgia and have searched the net for this and chronic fatigue. The medical nutrition therapy for both of these is just a healthy balanced diet. Fibromyalgia is a form of arthritis and chronic fatigue is related to Epstein-Barr which involves the liver.

As to candida, there is lots of misinformation out there with people claiming to have candida in their gastrointestinal tract or blood or other body parts. They have been informed to cut out everything with yeast because they seem to think that eating yeast is the cause of the candida. This practice is not supported by research. In fact, in some parts of the human body, yeast is normally present and a benefit to health as in the colon (large bowel). Candida infections are common in the oral cavity of persons undergoing chemotherapy and is called thrush. It is effectively treated with an antibiotic.

Haven't had anyone ask about leaky gut and am not familiar with such. Sounds kinda funny. From a practical side, if one's gut (stomach or intestines) were "leaking" the abdominal cavity would have a terrible infection and the person would experience extreme pain that would probably need emergency surgery. If you find web sites specific to candida or leaky guy that are supported by current nutrition research and practice, please email those URLs to me and I will share with other dietitians who write.

The pH of the hydrochloric acid in the stomach is about 2.0 to 3.0. The volume is variable among individuals. The sight, smell, taste and presence of food stimulates the secretion of acid into the stomach.

To further search for information about hydrochloric acid secretion, I would suggest you consult a nutritional biochemistry book in your library.

You do not say if you are burping gas via your mouth or passing gas via your rectum. So you will have to choose which answer fits your problem.

If you have a problem with burping, you may be eating too fast and swallowing air. Slow down eating, chew each mouthful at least 10 times. Don't talk with food in your mouth as you need air from your lungs to talk and may be swallowing air if you are chewing at the same time. This practice also increases the risk of choking on food. Don't drink carbonated beverages (soda or beer) with meals as those bubbles probably add to your burping. Stop eating when you are full. If you overeat, you are more likely to burp which in some cultures is considered a required compliment to the host after a meal, but in other cultures is considered rude.

If you have a problem with passing intestinal gas, it may be caused by several factors. Gas forming foods are broccoli, cauliflower, brussel sprouts, cabbage and cooked dried beans. Carbonated beverages especially beer are also gas formers. Often constipation can increase intestinal gas. (Constipated stool looks like irregular round pellets of stool stuck together.) You may want to increase the fiber content of your diet to relieve any constipation you may experience. Certain types of fiber can also cause gas like the above mentioned vegetables and beans. Fiber found in whole cereal grains, fresh vegetables (other than above listed gas formers) and fresh fruits are less likely to cause gas. Remember that some fiber (whole cereal grains) absorbs water from the stomach and intestines as it passes through undigested, so make sure you drink 8 glasses of water per day.

Hope this helps.

Never heard of succinium and don't know what electro dermal screening is.

Are you referring to succinic acid or succinate? If so, this is an intermediate compound formed during the transfer of energy from blood sugar (glucose) which happens in every cell of the body. Since every cell in your body produces succinate, it would be impossible and probably lethal to stop the production of this intermediary compound.

Have you read my fiber topic as it contains much info about high fiber foods. The current medical nutrition therapy for diverticulosis (no symptoms) is a high fiber diet including nuts, but no seeds (berries, tomatoes, etc.) that can get caught in the diverticuli (pockets in the intestinal wall).

However, you say that you have diverticulitis (symptoms which may include pain and inflammation). The current medical nutrition therapy is a low fiber diet, which eliminates all raw fruits and vegetables and whole grains or cereals while you have symptoms.

Sounds like you could use some guidance. I would suggest you call your doctor's office and ask to talk to a dietitian. It is more than just following a printed list of allowed and omitted foods.

First I would suggest talking to your doctor to rule out any changes in your digestive tract health. There are several possible causes for your symptoms and I am not a doctor. Until the cause is found for the abdominal cramps, I would suggest not eating these foods.

Second, most of the foods you mention are gas forming (broccoli and cauliflower). Corn sometimes is not digested well by the intestinal tract and the hull can pass through intact. Green peppers can cause burping as the skin needs bile from the gall bladder to be digested. It may be that you just overdid the amounts of these foods at the same meal.

After your doctor has ruled out any physical cause for your cramps, burping and gas, I would suggest you slowly add these foods back into your diet, one per meal and in small quantities (1/2 cup). You can increase the quantities slowly (1-cup), then try mixing two at the same meal. You will find your individual tolerance to these fresh vegetables.

TPN (total parenteral nutrition) is administered through an IV into a vein. The mixed solutions provide calories through glucose (dextrose) and fatty acids in addition to essential amino acids to build and repair muscles and organs. Usually an MVI (multivitamin intravenous) plus minerals is added as you did to the TPN solution.

The state of your nails may be due to the fact that you have been ill with Chron's rather than a nutritional deficiency. Chron's involves malabsorption of nutrients including protein and the resulting diarrhea is evidence that your body was not absorbing the food that you were eating. The amino acids (protein) in the TPN solution was needed to heal your intestinal tract.

Nails and hair are rigid protein structures and generally reflect the overall health status of a person not a vitamin deficiency. It is not unusual for the nails to become ridged or brittle during an acute illness, especially those involving fevers. Other nail changes like white lines in the nail occur because of damage to the nail bed when pushing back the nail cuticle. Until your nails become stronger, cut them even with the end of your fingers, don't wear nail polish and wear gloves when your hands are in water for extended periods of time (dish washing).

Given a nutrient dense, balanced, healthy diet with adequate protein, your nails will probably return to normal, but it will take 6 to 12 months for the nail to grow out from the cuticle to the end of your finger.

When you are without symptoms, you should eat a diet with adequate fiber which is 20 to 35 grams per day or approximately 1 gram of fiber per 100 calories eaten per day (i.e. 1800 calories would suggest 18 grams of fiber). Foods high in fiber are whole grains, fruits, vegetables, legumes, (soybeans, peanuts), beans and peas. Read the Fiber topic for more information.

Since you do not use milk products, I would suggest you read the Milk and Calcium topics. To meet your calcium requirement, try soy milk (check the label to see that 1 cup contains at least 302 mg of calcium. The calcium RDA for adult women and men is 800 mg per day. Other nutritional supplements like Ensure and Sustacal are lactose free milk based products that contain calcium. Your other choice can be to take 800-mg calcium supplements. There are various forms of calcium, some more absorbable than others. Talk to your pharmacist for their recommendations. Also, Vitamin C increases calcium absorption so take the supplements with orange or grapefruit juice.

It depends on whether you are having symptoms or not. If you are having symptoms, eat only cooked foods, limit your intake of milk to 2 cups per day and avoid gas forming foods (broccoli, cauliflower, brussel sprouts, cabbage, baked beans) caffeine containing foods (coffee, tea, cola and chocolate) and alcohol. Some spices like garlic, pepper, curry, chili powder and cayenne also stimulate the production of acid in the stomach. Also, you should eat 3 meals per day. The acid will work on the food rather than your stomach or intestinal wall. Any food other than lime juice will neutralize the acid because food is less acidic than the acid your stomach produces.

Prescribed drugs and antacids are effective at healing and preventing ulcers both gastric and duodenal (intestinal).

If you aren't having symptoms, you can eat whatever you want except caffeine, alcohol and the above spices. Milk has been found to stimulate the production of acid so limit to 2 cups per day.

There is some new research that ulcers may be caused by an infection and treatment with antibiotics has been suggested. Talk to your doctor about this.

Diverticulitis is grouped with inflammatory bowel diseases. Pockets develop in the large intestines and become inflamed. During acute symptoms, your in-law should see their doctor. Depending on severity of symptoms, one of the following diets may be recommended: not eat anything (NPO); just liquids (clear or full); low fiber diet (only cooked, refined foods, no seeds or skins). Any of these diets would prevent further irritation and allows the intestines to heal. Your in-law should also see a Registered Dietitian who can read her medical chart and prescribe the appropriate nutritional therapy.

Diverticulosis on the other hand describes the chronic disease where inflammation is not present. A high fiber (20 - 35 gm fiber per day or 1 gram fiber per 100 calories), low particulate diet is recommended. Whole grains (bread, cereal, pasta, brown rice), legumes (soybeans, lentils, dried beans and peas) fresh fruits and vegetables are recommended. Your in-law should also drink enough water (8 cups per day minimum) as fiber absorbs water in the gut and swells, thereby increasing stool bulk. However, foods with small seeds (particulate) like berries (strawberries, raspberries, blueberries cranberries, etc.) are not recommended as they can become lodged in the intestinal pockets. This can lead to an inflammation and diverticulitis. Any spices as long as they are not seeds (dill, celery, etc.) are allowed.

The real key to health in diverticulosis is maintaining increased fiber that helps clean out the pockets that have already formed in the intestines. Any recipe that includes whole grains, fresh fruits and fresh vegetables would be desirable. For instance, if tomato sauce with noodles were on the menu, switch to whole-wheat pasta. A healthy diet would also include reducing fats and fried foods.

Sorry, but there isn't any current nutritional therapy for Candida you describe. However, the foods she has eliminated usually cause gastrointestinal problems or irritable bowel syndrome.

Eliminating caffeine, alcohol, pickles and sugar pose no nutritional harm and most are not included in a balanced or healthy diet anyway. So if your wife's symptoms have improved, congratulations.

Dairy products, including milk and fruit are sources of sugar as well as desserts and sweets made with sugar. Other sources of carbohydrates are complex starches and fibers, which aren't sugars. Diabetic desserts, candy and sugar free gums are usually sugar free and would be a good choice if your wife wants to eliminate sugar. However, there are two sugars derived from alcohol - manitol and sorbitol - which can ferment in the gut. Does your wife chew sugar free gum or breath mints with either of these two nutritive sweeteners? If so, eliminate them for one week to see if symptoms disappear.

Lactose may be the biggest problem. Most dairy products (milk, cheese and frozen desserts like ice cream) contain lactose. Check out the Milk topic for more information about lactose and food sources. Try soymilk as it is lactose free.

Fiber may be another irritant to her intestinal tract, given the bloating symptoms you describe. Next try reducing fiber by switching to refined grains and white bread, cooked vegetables (no gas forming like broccoli, cauliflower, cabbage, brussel sprouts or baked beans), canned fruits or juices (no prune) to see if her symptoms improve after one week. If not, switch back to whole grain cereals and breads, raw vegetables and fruits. If her symptoms improve, you have more information to provide her doctor.

Fructose is absorbed through the intestinal wall and further broken down to glucose in the blood. It usually doesn't cause fatigue, bloating or a hangover problem. Besides, fruits and juices are excellent sources of Vitamins A and C, potassium and fiber.

Only make one change in her diet at a time to pinpoint the food irritant. If her symptoms continue, I would suggest she see a doctor.

Please see second answer below.

In addition, the Food Guide Pyramid is helpful in planning a balanced diet.

During acute symptoms, you should avoid raw vegetables and fruit, milk and dairy products and whole grain cereals. You may need to follow a clear liquid diet or even nothing by mouth to give your GI tract a complete rest. (This may require hospitalization with IV's with added vitamins and minerals, which can be achieved with total parenteral nutrition - TPN.) A clear liquid diet is strained fruit or vegetable juices (apple juice, cranberry juice), broth (chicken or beef), plain gelatin, fruit ices, carbonated beverages, coffee and tea. Besides Ensure, you can try Citrotein or Sustacal. That's it.

When you no longer have acute symptoms, you can start a full liquid diet by adding cream soups, cooked refined cereals, custard, tapioca or pudding, but milk products like yogurt, ice cream and pudding may still cause you symptoms due to lactose intolerance.

Crohn's disease has symptoms similar to colitis, but can occur anywhere along the GI tract. The cause for the symptoms is unknown. Various nutrient deficiencies can develop because of malabsorption during acute phases, which include diarrhea. Initially, loses of sodium, potassium and water are of concern. Long term symptoms can cause protein/calorie malnutrition along with deficiencies of Vitamins A, B 12, C, D, E and K, folic acid, calcium, iron, zinc and magnesium. Oral vitamin supplements probably will not resolve these deficiencies during acute diarrhea phases. Weight loss and limited food intake during acute phases adds to the decrease in your nutritional status.

I would suggest that when you are not experiencing symptoms that you should follow a nutrient dense balanced diet including a daily multivitamin, with adequate fiber to maintain intestinal elimination. You will have to vary the fiber content of your diet to find the level that works for you. If you are prone to GI obstructions, a high fiber diet is not recommended. For persons without Crohn's disease 1 gram of fiber per 100 calories of food is recommended and would be a good fiber level to start.

First, I would suggest she continue to see a doctor so that the cause may be found and treated.

As to a diet, until active symptoms subside either a low or high fiber diet would help. Which diet she should use depends on her symptoms. If constipation is the problem, eat high fiber foods. If diarrhea is the problem, eliminate high fiber foods, milk and lactose containing dairy foods (See Milk topic). High fiber foods are raw vegetables and fruit, whole wheat breads and cereal grains. These foods would stimulate the intestinal peristalsis (rhythmic movement). Caffeine may also contribute to symptoms and should be limited for a short term.

Heartburn is a symptom of both hypohydrochlorhydria (too little stomach acid) and hyperhydrochlorhydria (too much stomach acid). The dietary treatment is the same, a bland diet. However in hypochlorhydria (ahydrochlochloria - without stomach acid), acid pills may be prescribed to aid digestion of food.

Lower esophageal sphincter pressure or hiatal hernia can both cause reflux esophagitis. (Stomach acid that flows back up the esophagus which causes an inflammation of the lining in the esophagus. The esophagus lacks the thick mucous lining found in the stomach and therefore is more susceptible to the stomach acid.)

No food actually produces acid in your body. Actually, no food is more acidic than the acid that your stomach produces.

However, any food or beverage eaten stimulates the secretion of hydrochloric acid by your stomach. Some foods cause a greater secretion of acid than others do. For instance, alcohol, caffeine containing foods (coffee, tea, cola, cocoa and chocolate) and spices (pepper, cayenne, curry or chili powder) all cause a greater secretion of acid by your stomach.

Hydrochloric acid is used by the body to start the chemical digestion of food. Acid is mixed with the food in your stomach before it is passed on to the intestines for more digestion and absorption. People with ulcers who produce too much acid must omit at least the caffeine, alcohol and spices. They should also discuss any medications they take with their doctor. Aspirin compounds do irritate the stomach and there are other pills that could be substituted for aspirin.

If you notice a food bothers you, eat less of it at a time or omit it for a short time (1-week) to see if you feel better. Don't omit whole groups of food. Remember to consult your doctor for any persistent illness.

Persons with hypohydrochloria (lesser amount of acid) or ahydrochloria (no acid), will experience an intolerance to some foods because they lack enough acid to chemically digest their food. Also, persons lacking acid, may experience symptoms similar to ulcers or gall bladder disease. Common symptoms are heartburn or a pain at the bottom of your breastbone. Persons with ahydrochloria have the opposite problem a person with ulcers has, too little acid.

The acid pills your doctor prescribed will help you digest your food and you will notice an improvement in the way you feel after meals. If the pain continues, by all means, go see your doctor.