FediMan

Like many autistic people, I struggle with my digestion. I thought I'd jot down some things that I've found helpful. I'm not a medical professional and I can't give medical advice; before making big changes, please talk to someone who is, and who can. If you're worried, see a doctor. If the behaviour of your digestion changes or you lose weight unexpectedly, you should definitely see a doctor. If a doctor has given you instructions, follow those and ignore me.

My symptoms are diarrhoea, urgency, cramps (which, to me, feel like being squeezed in the nuts), and venomous farting. Even if your symptoms are different, there may be something below that will help you.

Keep a diet and symptom diary

Everyone's triggers will be different. (Mine include chocolate, ginger, tea and coffee (even decaffeinated), mushrooms, beans, leeks, and numerous other fruits and vegatables.) Work out what yours are. One good way that doesn't involve living on melon for a month is to keep a food and symptom diary: jot down what you ate, how much you had, and how your digestion reacted. After a few weeks, go back over it and see if you can spot any patterns. It helps if you have a healthy, varied diet.

Interpreting a food and symptom diary is hard, because * Symptoms can be delayed: for example, chocolate affects me within minutes, but beer doesn't cause problems until the next morning. * Different foods can affect you in different ways, but they can overlap. * There's a dose–response curve. * We don't eat individual ingredients: we eat meals. * Two or three foods that you might have tolerated in moderate quantities can gang up to cause problems if you eat them together. * You don't always know what's in a meal if you didn't prepare it yourself or if you used lots of processed ingredients. * Your digestion can be affected by other factors, such as stress, sleep and hormones. * Your triggers can change over time as your health changes

It's a long, time-consuming, frustrating process, but it's worthwhile.

When trying new foods, try to pick a time when you're alone in the house, or at least alone with a sympathetic partner. It takes the stress out of things.

Manage stress and sleep

Books have been written and courses of therapy given on these points, so I won't belabour this point, except to say that I find small doses of CBD (cannabidiol), taken at night, make life easier. If you shy away from CBD because it's derived from cannabis, or if you can't get it where you are, I've found brewer's yeast or a good B-vitamin complex to be helpful.

As always with supplements, don't overdo it. More is not always better. If you don't see an obvious improvement, stop taking them.

Fibre

Learn the difference between soluble and insoluble fibre, because they have very different effects on your gut. At least in the UK, nutrition labelling is inadequate in that it doesn't distinguish between the two. Spend time with a search engine (I can't find one good page that has all the information you need), and then use trial and error. You will make mistakes, but every one is a learning opportunity.

Loperamide

I've been prescribed Loperamide for my diarrhoea. It doesn't solve everything, but it certainly helps. Loperamide is a drug of abuse, and so, to avoid dependence, I don't usually take it when I'm staying at home.

At the doses I take, Loperamide doesn't cause euphoria or stop me from thinking clearly enough to do my job as a software engineer.

It shouldn't be used for IBS without a doctor's prescription, so don't self-medicate: see a doctor if you think it might help.

Probiotics

I find that probiotics help, especially with farting. Everyone's gut is different, so the brand I take may not help you. If you want to explore this option, you'll want to try several brands, one at a time, for a month or two each, until you find one that helps you. You may need to take the maximum dose for a while in order to get the colony established in your gut, and then find you can cut down a bit to save money, because probiotics aren't cheap.

Curcumin

I find that taking curcumin daily not only eases my sore joints but also helps my digestion. If you want to try it, choose a modern preparation, such as Meriva, BCM-95, CircuWin or Theracumin. Not only will your body absorb these products much better than whole turmeric, but, unlike whole turmeric, they're not contaminated with lead. (I've deliberately linked to a page that contradicts me on this point, because I want you to make up your own mind. I'm not your doctor. I'm not anyone's doctor.)

Curcumin lengthens clotting time (“thins the blood”), so talk to a doctor before trying it, and then take as little as you can get away with. Never take curcumin or turmeric if you're on blood-thinning medication.

Fasting

I use the 5:2 diet to control my weight. For me, that means 24 hours without food, twice a week. When I don't eat, I don't have digestive problems. (Ta-daa!) I'd rather not have to fast to be healthy, but having a day off my IBS is a nice compensation for doing it.

Fasting is natural: for millions of years, we've fasted at night and whenever food was scarce. Constant availability of high-calorie food via electrical refrigeration and jet aircraft is unnatural, and contributes to the obesity epidemic. We evolved to feast in summer and fast in winter; now, for most people in the West, winter never comes.

Nevertheless, there are some people who shouldn't fast: * Children * Women of childbearing age * Anyone who's ever had an eating disorder * Anyone who's been told by a doctor not to fast, or who has a medical condition that could make fasting dangerous

Vitamin D

Like many autists, I'm short of vitamin D. I find that topping it up with supplements takes the edge off my bad digestion. However, I'm in the minority: a study run by Sheffield University found that most IBS sufferers don't benefit from Vitamin D.

If you try it, don't overdose. If you're considering large doses, get your vitamin D levels checked first, maybe at the end of the summer (when they should be high) and again at the end of the winter (when they'll be lower).