Carbonated Beverage Intolerance

A week or so ago, I sent out a Tweet asking people what foods/drinks they have trouble with due to Crohn's, Colitis, IBD in general, ostomies, etc. I got several responses, so this will be the first of several posts, talking about the various foods that you guys Tweeted me back. I will address every food Tweet I received, but please be patient while I do my research and put together the best response/recommendation/recipe for you. This new segment on the blog will be called "Food Fiends".

The first problem food (or drink, in this case) I'm doing to discuss is carbonated beverages. There are several reasons why soda or carbonated drinks could cause issues for someone. Many of them contain caffeine, which is a stimulant; it can stimulate your gut resulting in more frequent or loose stools, for example. This is obviously not something anyone wants, let alone someone with CD or any form of GI problems.

Secondly, the sugar content. These drinks frequently contain a high amount of sugar, which can throw off the good bacteria in your gut, as well as cause a suppressed immune system due to the high level of blood sugar. I personally notice that I have an increase in output with my ileostomy when I drink a sugary beverage, and I have wondered (though not yet fully researched) if excess sugar in people with ostomies can result in a sort of "dumping syndrome" similar to what post-op bariatric patients experience.

Finally, carbonation. Many, many people have trouble with the carbonation in soft drinks, though often the symptoms are benign, like excess burping or passing of gas. Gross, but not exactly harmful. People that already have a troublesome gut, however, aren't always so lucky. The carbonation in soft drinks can create a bloated stomach/bowel, causing pressure in the abdomen, resulting in pain in even someone with a healthy gut; the cramping and pain can be even more severe in people with GI issues. People with ostomies can experience this as well, but instead of the normal passing of gas that might occur, the gas/air is released into the ostomy pouch, causing "ballooning", which is quite uncomfortable, not to mention the added risk of rupture to the ostomy appliance (leaks are no fun!).

In most cases, the carbonation itself is the primary problem for discomfort, but that's not always the issue. Try to determine which aspect/s of the soda is aggravating for your body. Keeping a food diary and trying different beverages is a good way to figure it out. For example, to determine if it's the sugar content getting to you, try a non-carbonated, caffeine-free drink, like a fruit punch. Be careful using juices with high levels of acidity, though, because those can be irritating as well, and that could just throw another variable in the mix. Fruit punch, grape flavored drink mixes (like Kool-Aid), or sports drinks like Gatorade are safe bets, because they're lower in acidity, caffeine free, and non-carbonated. If you drink this variety of beverage and still have discomfort or digestive issues, then it could be the high sugar content causing your problem.

If you eliminate the sugar content as the issue, next try to eliminate the caffeine as the culprit. Drink a carbonated, but caffeine free, beverage. Many brands of root beer, grape, lemon-lime, and orange sodas are caffeine-free, but read the label to make sure. If you drink it and don't have any issues, then you know it's the caffeine that is wreaking havoc on you. If you experience the same negative symptoms, however, then it's likely the carbonation.

Ok, so now you know which aspect of the drink causes you distress. It may even be more than one variable; perhaps both the caffeine and carbonation bother you. Now what? Now you have to find alternatives. Think of this as a compromise.

If caffeine is the problem, drink only caffeine-free soft drinks. Avoid coffee and tea, unless it's decaf. Avoid sodas like cola, citrus (like Mt. Dew), etc. Sprite, 7up, Mug's Root Beer, Orange Crush, and Grape Crush are examples of sodas that don't contain caffeine. You can also mix fruit juice with carbonated water for a yummy, fizzy drink.

On the other hand, carbonation may be what you need to avoid. If that's the case, go to "flat" soft drinks. As I mentioned before, sports drinks are great non-carbonated options. There are also bottled flat drinks like Hawaiian Punch, and other fruit-flavored drinks. Tea and coffee are also good options if you're not avoiding caffeine. If you're craving the flavor of a certain carbonated drink (and the carbonation doesn't matter to you), then maybe consider defizzing your favorite soft drink. This would make the soda flat, and remove the carbonation. There are a couple ways to do this:

- Break the seal on a bottle of soda and leave the cap loose; wait for the carbonation to die off on it's own. This could take as long as a week, so you'd need to plan ahead and then stay ahead of your beverage needs.

- Pour half of the soda into another empty bottle or container with lid. Then shake both and release the fizz periodically until there's no more fizz.

- Stir a teaspoon of table sugar into a glass of soda, This eliminates the fizz, but does also add additional sweetness.

If the fizz is what you're craving, finding an alternative can be tough. In this case, my personal suggestion would be for you to test out your tolerance level. A standard can of soda is 12 ounces. Maybe you can tolerate 6 ounces, and that's enough to satisfy your need for carbonation? If you can't tolerate ANY carbonation, then the only alternative is to wing yourself off of it all together. Ask yourself which is more important: your health, or the fleeting enjoyment of a carbonated drink? I understand, though, that's easier said than done. Quitting soda is tough, I know. But the only time you can really fail is when you stop trying, so keep that in mind and do your best. Unless you have very severe consequences, the occasional soda is probably ok. You can even consider taking an anti-gas/anti-bloating medication for the times that you do need to enjoy a carbonated drink, which may reduce any discomfort. Otherwise, drink lots of water, fruit juice, fruit or herbal teas, etc. Play around until you find something you like. When my CD flares, I have a lot of eating restrictions. But I use those times as an opportunity to get creative with my meals and explore new territory! It can really be fun experience if that's what you try to make of it.

If carbonation and caffeine are fine, but sugar is troublesome (this is quite unlikely, but still possible; everyone is different), then your options are trickier still. Do not try drinking diet beverages, because they contain artificial sweeteners which can cause far worse consequences to your health. Instead, try reduced sugar beverages that you make yourself. This gives you very precise control on how much sugar you're consuming. Unsweetened teas with a splash of fruit juice, water or unsweetened tea with lemon/lime, unsweetened herbal or fruit teas, or water with flavor drops (sold in stores) can be good options. Also consider less processed, unrefined, natural sweeteners. A little bit of honey goes a long way in your tea or coffee! Sweetening your own drinks with a natural sugar is pretty much always going to result in a beverage that is better for you and lower in sugar. There are approximately 10 teaspoons of table sugar in one can of soda! That's way more than you need.

This has been quite a long post, but I hope you've learned a little something! Check out my accompanying post with recipe suggestions for the caffeine-intolerant, sugar-intolerant, or carbonation-intolerant! The first two recipe posts are already up. The first has recipe alternatives to carbonated drinks. Go here to read it! The second contains recipes that are lower in sugar and alternatives to sugary store-bought drinks, located here.

Thanks for reading and check back for my next Food Fiend: garlic!