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Post by Deleted on Feb 15, 2012 0:20:39 GMT -5
Sung to the tune of Back to the Shadows Again ... I've been pretty good with my eating, staying away from the known fartogenic foods, but since before my trip back east for 2 weeks, my IBS has been flaring and my mornings have become unmanageable. Multiple partial poops with cramping, taking hours to "finish my business," and no matter what I eat, I am having moderate amounts of stinky gas. My last round of flagyl was in September. So I contacted my doctor yesterday, and got the script filled today. After having my Valentine's drink tonight, I will start on the pills tomorrow. As some of you know, I am pretty anti-Flagyl. Over the years, I've seen people "abuse" it in order to eat crap, and as a scientist, that really pisses me off - people who abuse antibiotics are potentially becoming a breeding ground for antibiotic resistent gut bacteria, including C. diff. I don't want to be one of those people, but sometimes - and as I've been seeing among the longer term vets, perhaps more frequently the further out we are - it becomes necessary to clean out the pipes from time to time. The last time I did this, I did it in conjunction with a switch to a different brand of probiotics, after years on PDUs. The new brand I spent hours searching out and studying was Benebiotics - it had more strains and had S. boulardii (as does PDU), which is particularly good to help keep C. diff under control. I used up both bottles - about 3 months worth, AFTER that last round of Flagyl. It didn't work. I switched back to PDUs. And now I need to do the Flagyl again. The good thing is I KNOW I will feel better by the weekend. The bad thing is (besides not being able to have my nightly half glass of port just before bed for 10 days) that I don't like to need to take it again, and I worry about needing it more and more over time. I also wonder if I need to use it the way I think is a BAD idea, which is to take it in subtherapeutic doses from time to time. So, let me ask those of you who use Flagyl with some regularity - how do you use it? When do you take it, and how much? Is it better to wait until you are pretty miserable, and hope that things will straighten up on their own (which is what I have done, usually to no avail), or to take some at the first signs of problems occurring? I don't like this, but it's better than being uncomfortable.
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Post by majormom on Feb 15, 2012 5:45:06 GMT -5
I've tried it a couple of different ways. 1) 3 - 250mg tablets a week. Normally Monday, Wednesday and Friday. 2) 500mg dose in the evening and another 500mg dose the next morning. I can go without PDU or antibiotics for a week and a few days.
I will start to feel the gassy rumble gut during the workday and figure I'd better take the 500mg dose again that night. I'm trying to stretch out the time when I need to take it but probiotics just don't seem to work long term for me. I've tried over and over again to just take probiotcs (various brands) and 2 weeks is as long as they've ever been effective since about 2 years post-op.
The 3-250mg per week worked for me for a couple of years. I've been up-front with my surgeon about this and he said ok and put it in my file.
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citizenk9
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Surgery Type: DS
Surgery Date: 10/13/2009
Surgeon: Dr, John Rabkin, San Francisco, CA
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Post by citizenk9 on Feb 15, 2012 11:11:52 GMT -5
Wow. I was just thinking about all of this recently. I was put on Augmentin for a sinus infection maybe 4 months ago. I had soooo much recovery from gas and bloating up until recently. I was amazed at the difference I felt. If I really overdid carbs then I paid for it but I could eat them in moderation and be just fine. I felt this was a fair and reasonable way to live. Up until then I have had what I feel is an unreasonable amount of gas and bloating at sometimes the smallest amount of carbs. My stomach will bloat that I look pregnant. I have taken PDU 2-3 times a day and recently added a product recommended by my accupunturist for digestion. I recently got the stomach flu from my husband so I know it was actually the flu. I had also had a very stressful day and ate 2 donuts (which I call Don't Eat Its) because they have always caused me problems. Since then I have been a bloated gassy mess. I feel horrible. I can't sleep and I'm uncomfortable. I feel like it won't go away. I have been thinking about ordering the Fish Zole over the internet since I know my PCP would never prescribe me antibiotics to combat gas. I am so torn up inside over this. I don't want any health problems that you mention from this route but I am uncomfortable. I have also considered doing a complete carb fast clean out protocol but I have a difficult time staying away from bad foods completely as this would require. I feel "weak in will". What to do? !!!!
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Post by RedSkittles on Feb 15, 2012 11:21:52 GMT -5
When I first tried flagyl, I needed it a long time. I was on it almost constantly for a year, it seemed. After that, I seem to have only needed it 1-2x per year and everything mostly stays under control.
I wonder if you need a longer course and that might help it last longer?
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Post by Gail R on Feb 15, 2012 11:59:55 GMT -5
Does Flagyl help with irritable bowel syndrome? Sometimes I can't tell if it my old IBS acting up or what. Because it happens more when I am stressed, I am thinking that it is IBS when I have upsets. I actually feel better now with the DS most of the time than I did pre-DS, but I would occasionally use Flagyl if it helped IBS.
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Post by Deleted on Feb 15, 2012 12:33:38 GMT -5
Does Flagyl help with irritable bowel syndrome? Sometimes I can't tell if it my old IBS acting up or what. Because it happens more when I am stressed, I am thinking that it is IBS when I have upsets. I actually feel better now with the DS most of the time than I did pre-DS, but I would occasionally use Flagyl if it helped IBS. I can't distinguish the symptoms. I think the IBS is exacerbated by bacterial overgrowth, so the symptoms overlap. Flagyl causes the symptoms to abate significantly. And yes, I'm stressed right now (actually, I'm stressed a lot of the time, so that's kind of a pointless excuse). But as I have said many times, if I had known that my IBS would get so much better post-DS, I would have had it for that reason alone. Lately, the IBS symptoms have been more problematic, and when I take Flagyl, they abate - so it's hard to say whether this is IBS or BOS or both - I actually think it's both, in that the bacterial overgrowth irritates/sets off my hypersensitive guts to give me IBS symptoms. It's worth a round of Flagyl to see if it helps, I think.
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Post by feeder3565 on Feb 15, 2012 23:27:47 GMT -5
Diana you know my story with Mayo and BOS. They put me on a lifetime supply of 3 different kinds of antibiotics. Will look for the directions they gave my pcp on how and when to take them. If you have BOS and you don't take the flagyl your vits., minerals and protein are being effected. They told me this at Mayo and my labs reflect this. Was also told the father out we get the worse it can get and clean eating has nothing to do with it. Short gut=BOS.
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Post by Deleted on Feb 16, 2012 11:36:27 GMT -5
Reporting in:
Started on the flagyl yesterday AM. 500 mg in the AM, 500 at night. This morning, have had a full mug of strong coffee, have been up going on 2 hrs, and can't poop. DISLIKE.
But the stinky gas was gone immediately.
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Post by Deleted on Feb 17, 2012 11:37:52 GMT -5
Morning #2: still not happy.
Did not have a good day yesterday - never felt "finished" and wasn't, based on volume of what I was able to poop. Figured I'd have a good morning today. Notsomuch. Feel like I must have at least 2 lbs of poop still in me. Not constipated, it just doesn't want to completely empty.
Trying to be patient ...
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Post by majormom on Feb 17, 2012 11:48:56 GMT -5
Perhaps the 250mg M, W & F would be better for your system. I don't have a problem with the 2 doses of 500mg. I guess this is more of an art, not a science.
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Post by Deleted on Feb 17, 2012 12:22:00 GMT -5
Perhaps the 250mg M, W & F would be better for your system. I don't have a problem with the 2 doses of 500mg. I guess this is more of an art, not a science. I feel it is important to do a full 10 day course first - but the regular subtherapeutic doses are a further consideration. 500 mg PM one night and the next morning once a week? Or only when you are having symptoms?
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Post by majormom on Feb 17, 2012 13:28:47 GMT -5
This is subtherapeutic and I do it about once a week. That's also about as long as I last without having issues during the workday as well as at night. Once I start having problems during working hours, I take the 2 500 mg doses. I don't like doing this either and have tried and retried every option I hear about.
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Post by bearmom on Feb 17, 2012 13:46:51 GMT -5
Morning #2: still not happy. Did not have a good day yesterday - never felt "finished" and wasn't, based on volume of what I was able to poop. Figured I'd have a good morning today. Notsomuch. Feel like I must have at least 2 lbs of poop still in me. Not constipated, it just doesn't want to completely empty. Trying to be patient ... I do the occasional clean out with Flagyl, and commit to eating stuff like salad and soups for a day or two, which may make things clean out a little TOO well, but I prefer that to the "not quite empty" thing.
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Post by KathyF on Feb 17, 2012 16:25:33 GMT -5
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Post by mooney on Feb 17, 2012 17:46:41 GMT -5
I dont know ur story but im interetsed. can you share the 3 kinds of atnibiotics and the directions? Diana you know my story with Mayo and BOS. They put me on a lifetime supply of 3 different kinds of antibiotics. Will look for the directions they gave my pcp on how and when to take them. If you have BOS and you don't take the flagyl your vits., minerals and protein are being effected. They told me this at Mayo and my labs reflect this. Was also told the father out we get the worse it can get and clean eating has nothing to do with it. Short gut=BOS.
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Post by Deleted on Feb 17, 2012 18:13:43 GMT -5
Perhaps the 250mg M, W & F would be better for your system. I don't have a problem with the 2 doses of 500mg. I guess this is more of an art, not a science. I can take 250, once a day for about three days max.
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Post by Deleted on Feb 17, 2012 21:23:57 GMT -5
Guts finally cut loose early this afternoon. And again. And again.
Now, let's see how they settle down. And if my mornings improve.
On a somewhat related note, I took the cats to the vet today for check ups, nail trims, and belly and sanitary shaves (both have long black hair; Isis is dying of a liver tumor and isn't grooming herself very well, and when she does, she pukes up hairballs; Onyx, although he is losing weight, is a huge beast and has "issues" keeping his nether regions clean).
We were told by the adoption group Maine Coon Rescue that Onyx had been locked in a crate for 12-18 hrs/day by his previous owner, and then was punished for pooping in the crate. HE HATES THE CRATE - and often poops when he is put in it. We bought him a new larger crate a few months ago, and the last time I took him to the vet in it, he didn't poop.
No such luck today. By the time I got to the vet's office, about 3 minutes from our house, there was a REEKING STENCH from the bigger crate. And you know what it smelled like? MY poop. OMG - I felt obliged to keep mentioning to the other lady in the waiting room, the vet techs and the vet that ONYX POOPED in his crate.
They took him back in the crate, and brought him back in the cleaned out crate, all shaved, clipped, and rabies vaccinated - and he DID IT AGAIN.
Stinky stinky boy! But I must say, I have a new appreciation for the cat litter we buy from Costco in the big green jug - it really absorbs his stench, because I was unaware of how gross his poop smells.
He is so funny - once he gets over being butthurt by the whole experience, he comes over for belly rubs - he LOVES having his nekkid belly rubbed (maybe because his nipples are exposed??). Such a sensuous fatboy.
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Post by JostDreams on Feb 17, 2012 21:32:09 GMT -5
Diana,
You mentioned the abuse of antibiotics increasing the chance of antibiotic resistent gut bacteria, including C. diff. Fifteen years ago I was very ill with Cushings Disease which caused a host of other problems. I had a transphenoidal resection of a pituitary adenoma followed three weeks later by a colon resection. Prior to that I was on and off flagyl for multiple perirectal abcesses/fistulas/fissures. After the resection I was on vancomyacin (sp?) for 6 weeks because of a nasty hospital infection.
After both my lap band removal and gastric bypass, I came down with nasty cases of C Diff. When you mentioned prior antiobiotics, I thought of the high dosages from so many years ago. In your opinion could that have contributed to the recent C Diff? Thanks!
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Post by Deleted on Feb 17, 2012 22:34:37 GMT -5
Diana, You mentioned the abuse of antibiotics increasing the chance of antibiotic resistent gut bacteria, including C. diff. Fifteen years ago I was very ill with Cushings Disease which caused a host of other problems. I had a transphenoidal resection of a pituitary adenoma followed three weeks later by a colon resection. Prior to that I was on and off flagyl for multiple perirectal abcesses/fistulas/fissures. After the resection I was on vancomyacin (sp?) for 6 weeks because of a nasty hospital infection. After both my lap band removal and gastric bypass, I came down with nasty cases of C Diff. When you mentioned prior antiobiotics, I thought of the high dosages from so many years ago. In your opinion could that have contributed to the recent C Diff? Thanks! Could have, might have - but the hospital-acquired flavor is probably worse than anything that was already lurking in your guts. Clostridium is a spore-former, so a resistant strain could have been hanging around your gut at low levels and have bloomed when the other bacteria that were suppressing it were killed off, but it is probably much more likely you acquired a bad antibiotic resistant bug in the hospital. Here is a recent article about C. diff.: www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0019993You might find this reassuring, however (Flagyl = metronidazole): Clin Infect Dis. 2011 Jul 1;53(1):42-8. Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Stevens V, Dumyati G, Fine LS, Fisher SG, van Wijngaarden E. Center for Health Outcomes, Pharmacoinformatics, and Epidemiology, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, New York 14260, USA. vstevens@buffalo.edu AbstractBACKGROUND: Clostridium difficile infection (CDI) is a major cause of hospital-acquired diarrhea and is most commonly associated with changes in normal intestinal flora caused by administration of antibiotics. Few studies have examined the risk of CDI associated with total dose, duration, or number of antibiotics while taking into account the complex changes in exposures over time. METHODS: A retrospective cohort study conducted from 1 January to 31 December 2005 among hospitalized patients 18 years or older receiving 2 or more days of antibiotics. RESULTS: The study identified 10,154 hospitalizations for 7,792 unique patients and 241 cases of CDI, defined as the detection of C. difficile toxin in a diarrheal stool sample within 60 days of discharge. We observed dose-dependent increases in the risk of CDI associated with increasing cumulative dose, number of antibiotics, and days of antibiotic exposure. Compared to patients who received only 1 antibiotic, the adjusted hazard ratios (HRs) for those who received 2, 3 or 4, or 5 or more antibiotics were 2.5 (95% confidence interval [CI] 1.6-4.0), 3.3 (CI 2.2-5.2), and 9.6 (CI 6.1-15.1), respectively. The receipt of fluoroquinolones was associated with an increased risk of CDI, while metronidazole was associated with reduced risk.CONCLUSIONS: Cumulative antibiotic exposures appear to be associated with the risk of CDI. Antimicrobial stewardship programs that focus on the overall reduction of total dose as well as number and days of antibiotic exposure and the substitution of high-risk antibiotic classes for lower-risk alternatives may reduce the incidence of hospital-acquired CDI.
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Post by JostDreams on Feb 18, 2012 0:39:38 GMT -5
Thank you ma'am!
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Post by beemerbeeper on Feb 18, 2012 9:52:02 GMT -5
I eat very clean. I found that the whey in my protein shakes was a culprit and I even gave those up. I eat no gluten and no lactose at all. I don't know what of the foods I do eat could be my problem. I'm wondering if there is something in my Walmart brand Crystal Light?
Subtherapeutic doses used to help me but don't any more. I hate to take it so I haven't done a full round in a long time but I guess it is time.
I don't use a probiotic as those never seemed to help at all but I guess I will go on one when I finish this round of flagyl.
My biggest problem is the smell of the farts. I'm going to try devrom for that. Somebody asked me this week if one of my dogs had just pooped. It was a silent little fart. Gag.
Wishing you success.
~Becky
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Post by beemerbeeper on Feb 18, 2012 9:56:01 GMT -5
It seems that Align is the only product out there containing that particular strain.[/quote]
Thanks Kathleen. I need to buy a probiotic and will try that one.
~Becky
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Post by bigmanz on Feb 18, 2012 10:34:40 GMT -5
Diana, I'm new to the board and a former patient of Slimshadie's. I have been having major heartburn that has been coming in waves. After reading your post on IBS,I realized that I was exhibiting symptoms of it that I had had years earlier. TRhe only difference now from then is the heartburn. Since the surgery I don't know if this could also be a symptom of IBS or not. Your thoughts? (Dr. Stewart, 12/12/11 down 60 lbs.)
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Post by Deleted on Feb 18, 2012 11:04:10 GMT -5
I don't think of heartburn as being related to IBS, but I suppose it could be. I have both, but I think of them as being separate issues.
I am on PPIs for the GERD. My stomach issues are pretty much nil when I take them, but symptoms rebound within less than a day if I don't (a couple of times, I have forgotten to refill my prescription in time, and very quickly figured out that was a no-go).
I'd try treating the heartburn with a PPI first and see if that helps.
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Post by Deleted on Feb 18, 2012 11:20:00 GMT -5
AHA!! I've been up for less than an hour, and have had two large, pudding-y, easy-to-pass poops that feel like I'm pretty close to "done" - and I haven't even eaten yet, just had coffee.
And I'm down nearly 3 pounds from earlier this week.
Gawd I hope this means I'm back to whatever passes as acceptably "normal" in my world!
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Post by Deleted on Feb 18, 2012 11:21:28 GMT -5
I eat very clean. I found that the whey in my protein shakes was a culprit and I even gave those up. I eat no gluten and no lactose at all. I don't know what of the foods I do eat could be my problem. I'm wondering if there is something in my Walmart brand Crystal Light? Subtherapeutic doses used to help me but don't any more. I hate to take it so I haven't done a full round in a long time but I guess it is time. I don't use a probiotic as those never seemed to help at all but I guess I will go on one when I finish this round of flagyl. My biggest problem is the smell of the farts. I'm going to try devrom for that. Somebody asked me this week if one of my dogs had just pooped. It was a silent little fart. Gag. Wishing you success. ~Becky Becky, what's the sweetener in the fake Crystal Lite? I cannot do any "itols" AT-ALL. Horrible gas and bloating.
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Post by bigmanz on Feb 18, 2012 13:07:05 GMT -5
I'm on Dexilant 60mg and nexium 40 mg each once a day, Dexilant morning and Nexium at night and still having problems. i notice that it has gotten worse since the IBS symptoms have come up though. My Gastro put me on the Dexilant and started me on metronidazole 500 mg 3 a day today to see if it helps. Took one earlier and already am getting some relief of the IBS. As for the sugar substitutes that end in "itol, (xylitol and sorbitol) they are both dirrivatives of HFCS and I have a horrible time with anything from HFCS 's. Thanks for your answer.
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Post by Deleted on Feb 18, 2012 13:56:52 GMT -5
I'm on Dexilant 60mg and nexium 40 mg each once a day, Dexilant morning and Nexium at night and still having problems. i notice that it has gotten worse since the IBS symptoms have come up though. My Gastro put me on the Dexilant and started me on metronidazole 500 mg 3 a day today to see if it helps. Took one earlier and already am getting some relief of the IBS. As for the sugar substitutes that end in "itol, (xylitol and sorbitol) they are both dirrivatives of HFCS and I have a horrible time with anything from HFCS 's. Thanks for your answer. Not sure I understand what you mean by this. HFCS is simply a sugar syrup that has a SLIGHTLY higher concentration of free fructose than a similar syrup made from pure sucrose (which is a disaccharide made up of one molecule of glucose and one molecule of fructose), after hydrolysis to the monosaccharides as a 50:50 mixture. HFCS55, which is used in sweetening sodas, is about approximately 55% fructose and 42% glucose, made by enzymatically converting a bit of the glucose to fructose. Fructose tastes somewhat sweeter than glucose. SO HFCS IS PRACTICALLY THE SAME THING AS CANE SUGAR IN COMPOSITION (except that it is the individual sugars - monosaccharides - while cane sugar is a disaccharide that is quickly broken down in your stomach acid to the monosaccharides, so it is only your tongue that notices the difference). "High-fructose corn syrup is produced by milling corn to produce corn starch, then processing that starch to yield corn syrup, which is almost entirely glucose, and then adding enzymes that change some of the glucose into fructose. The resulting syrup (after enzyme conversion) contains approximately 42% fructose and is HFCS 42. Some of the 42% fructose is then purified to 90% fructose, HFCS 90. To make HFCS 55, the HFCS 90 is mixed with HFCS 42 in the appropriate ratios to form the desired HFCS 55." So in fact, HFCS55 is practically the same thing as cane sugar (sucrose). While I believe the HFCS has a very slightly different taste and mouthfeel than sucrose, which is still a disaccharide until it hits our guts and is broken down to 50:50 glucose and fructose, it makes no scientific sense that it is processed in our guts differently after that. I think there is too much HFCS in our diets, because it is cheap, and artificially supported by corn subsidies and sugar tariffs, but that is a political complaint, not a scientific one; my other complaint is that too many foods - especially foods marketed at kids - are overly sweetened to make them (surprise!) taste better, and the more sweet crap you eat, the more you want. But the reason to complain about HFCS should be parsed into the accurate components - government support for its cheapness, and overuse in overprocessed foods designed to make us want to eat more of it. In the absence of the subsidies and tariffs, the food manufacturers would be using cane sugar to do the same damned thing. It does NOT make scientific sense to demonize HFCS because of its chemical nature as being different from sucrose/cane sugar. Xylitol is made by hydrogenating xylose, a plant sugar we can't digest. The xylose comes from corn - or HARDWOOD - cellulose is made up of xylose sugars. I don't think (it was not clear) it is made from corn STARCH (which is made of glucose), but probably from the plant cellulose itself. Sorbitol is made by reduction of glucose (hence it is also sourced from corn starch, but NOT from fructose). Xylitol has a laxative effect because sugar alcohols are not fully broken down during digestion; albeit one-tenth the strength of sorbitol. Both can cause gas, bloating, cramping and other laxative effects. And BOTH of them are not zero calorie: * Xylitol has 2/3 the calories of sugar (One teaspoon (5 g) of xylitol contains 9.6 Kcal, as compared to one teaspoon of sugar, which has 15 Kcal . * Sorbitol has 2.6 Kcal per gram versus the average 4 Kcal for sugar (not sure why the numbers for sugar are different on the two Wikipedia pages, but for both, the Kcal are about 2/3 of sugar, NOT ZERO) For me, the reduction in calories is SO not worth the trade off for the laxative effect.
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Post by bigmanz on Feb 18, 2012 15:26:44 GMT -5
For the last 15 years, until I had my DS, anytime i ate or drank anything with HFCS I would suffer a reaction very simular to "Dumping Syndrome" yet I could eat anything made with cane sugar. i can tolerate Splenda and Stevia, even nutrasweet but if it is an "alchol"type sweetner it does the same as the HFCs did me.
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Post by Deleted on Feb 18, 2012 16:52:36 GMT -5
For the last 15 years, until I had my DS, anytime i ate or drank anything with HFCS I would suffer a reaction very simular to "Dumping Syndrome" yet I could eat anything made with cane sugar. i can tolerate Splenda and Stevia, even nutrasweet but if it is an "alchol"type sweetner it does the same as the HFCs did me. I can't argue with how you experience foods with HFCS or xylitol or sorbitol, but scientifically, there is little connection - xylitol is not even made from corn starch, it is made from bagasse (the undigestible cellulosic part of the corn plant), and sorbitol is reduced glucose, made from corn starch that has been hydrolyzed to glucose but NOT converted to fructose - so there should be no fructose in it at all. Now, whether you are allergic to something ELSE in corn is a different question.
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