My Trigger Foods
Disclaimer: If you are reading this and dealing with ANY health related problems I am NOT recommending you take the same unconventional approach as I have in my battle with Crohn’s disease. Any changes you wish to make in your care plans should be done in partnership with the team of qualified healthcare providers who treat you.
What are my trigger ingredients?
In a previous post, I talked about some of my worst trigger foods - fish, shrimp, egg, and corn. Because of the severity of these reactions I avoid these entirely. But in addition to these after testing over 100 ingredients during a four year elimination diet and through trial and error I’ve found over 20 ingredients that impact me in other ways.
Here is a list of ingredients that give me problems:
Severe reactions - these are more immediate and stronger reactions in me:
Fish - nausea / vomiting
Shrimp - puss/blood filled welts on legs
Egg - GI bleeding, diarrhea, breakouts, brain fog, low energy, pale
Corn/corn products - GI bleeding, breakouts, low energy, dry peeling lips, mouth sores
Lesser reactions - all can cause diarrhea in me when eaten frequently in large quantities:
Milk/cream/whey (as a protein supplement / in very large quantities whey protein flairs up my abscess and rosacea - so I avoid)
Cauliflower
Broccoli
Carrots - also gives me bad breath
Avocado oil
Bell Pepper
Serrano pepper
Cilantro
Basil
Lentils
Minor Impacts - these don’t give me diarrhea but can drop my consistency:
Avocado
Coffee (can cause diarrhea in me if system is already wreaked - otherwise ok)
Tapioca
Peas - can also contribute to body pimples
Butternut squash
Quinoa
Garbanzo beans
Rapeseed oil - mucus + GI discomfort
Other Impacts - these ingredients cause me various symptoms:
MTC Oil - GI discomfort / diarrhea
Sunflower Oil - GI discomfort / pain
Tomatoes and Sweet Potatoes - an increase of pimples (likely something within both)
Wheat - increased water weight
Green onion and garlic - gives me bad breath
Casein - Emotional impacts
I’ve seen many lists on the internet that tell IBD patients to avoid specific foods but these don’t normally line up with my specific triggers. Not everyone has an allergic reaction to peanuts for instance - this is why prescribing a set diet for IBD is impossible - because everyone’s triggers are different.
I assume there are things in the lists above that could affect a larger population however (multiple sources have pointed fingers at “The Big 8” allergens). I also assume that not everything in the list above is an allergy but instead just the result of how specific foods (when eaten in larger quantities) affect me (and possibly others) as we age - yes, getting older is fun.
Do I ever eat any of my triggers?
Some of the ingredients in the lists above I still eat on occasion but others I avoid completely. How do I determine this? There are a three main factors that come into play in my decision making:
1) How severe the reaction is:
If a reaction is immediate or severe then I choose avoid those ingredients completely - it’s not worth it.
Fish and shrimp are two things I do not eat at all. When I was a kid I didn’t have any problems with them but now that I’ve developed a visible and immediate reaction to them (even in small quantities) I avoid them at all costs. Thankfully these reactions for me are not as severe as someone with a life threatening peanut allergy so I’ve never had to worry about cross contamination or coming in contact with someone who has recently eaten these foods. (my wife is also vegetarian so that helps)
Egg and corn both trigger severe Crohn’s symptoms in me (GI bleeding) but these reactions are not as immediate as salmon. I do everything I can to avoid these as well however I generally don’t worry too much if I eat a single cookie that might have a little egg mixed into the batter.
I do however avoid cooking with both egg and corn products (95% of the food I eat is something I’ve cooked). I will no longer eat an omelet for breakfast or corn on the cob for dinner. I also will no longer cook with any derivative of these products for example: egg whites; corn meal; corn oil; corn syrup; etc. I didn’t always strictly remove these from my diet and had two hospitalizations because of it. You live and you learn…
Now what about those ingredients that don’t trigger a severe reaction but still trigger a “lesser reaction” - do I eat those? Well, that depends on the next two points…
2) How much of an ingredient I have eaten recently:
The concept I use when talking with others about my experiences is a tolerance bar - a simple bar chart showing how the negative effects of eating an minor trigger builds over time until it hits a threshold - which then results in my body being unable to tolerate it any longer - purging it from my system immediately.
Let’s say I take some basil (a minor trigger of mine) and mix it with potatoes for breakfast. As an example let’s say this one meal takes up 30% of my body’s tolerance towards basil. At this point I haven’t seen any symptoms from the basil and if I waited several days/weeks before eating basil again then I probably wouldn’t see any negative effects. But let’s say I also add a little basil to a grilled cheese sandwich for lunch - my tolerance bar might fill up to 65% of my limit - still no symptoms. Now let’s say I’m really pushing my luck and I make a basil pesto sauce for dinner… At this point in time my tolerance bar could very well go beyond the limits my body can handle (the 100% red line in the graph below) - causing the very unpleasant reaction of diarrhea in me. Not great!
Example:
This idea should not be new to anyone as we are all aware that if we have one glass of wine with dinner then we generally won’t feel the intoxicating effects of the alcohol but if we have a few more glasses we might stumble around a bit before throwing up and have a painful hangover the next morning (maybe I’m just a lightweight! ha!). Not fun!
To take this idea a step further, in 2021 and 2022 I completed several experiments trying to determine where my threshold limit was for a minor trigger (in this case bell pepper) and I also wanted to know if eating my minor trigger repeatedly in smaller quantiles would actually cause a stronger reaction than if I just ate it only once but in a very large quantity. Now there could have also been seasonal factors at play but here were my results:
Test 1 (eaten for lunch and dinner each day):
Day 1: 10 strips of bell pepper
Day 2: 20 strips
Day 3: 20 strips - diarrhea (50 total strips | 17 strip average a day)
Test 2 (eaten for lunch and dinner each day):
Day 1: 6 strips of bell pepper
Day 2: 12 strips
Day 3: 15 strips - no diarrhea (33 total strips | 11 strip average a day)
Test 3 (eaten for lunch and dinner each day):
Day 1: 15 strips of bell pepper
Day 2: 35 strips
Day 3: 5 strips - diarrhea (55 total strips | 18 strip average a day)
Test 4 (only eaten at dinner one day):
Day 1: 25 strips of bell pepper - no diarrhea (25 strip average a day)
Test 5 (only eaten at dinner one day):
Day 1: 42 strips of bell pepper - no diarrhea (42 strip average a day)
What I gathered from these experiments was that a smaller amount eaten over a period of a few days caused a stronger reaction than just flooding my system all at once - i.e. 40 strips of bell pepper over a 48 hour period gave me diarrhea but 40 strips all in one meal did not. From my experiences once you start eating something your body doesn’t like it primes itself for it’s next encounter - it knows it wants to flush it out of your body and will react stronger the next time.
So to summarize: the second point I consider is how much of an ingredient have I eaten recently… while the third point I consider is…
3) How my overall health is in that moment:
Let’s build upon the idea that a single minor trigger ingredient can build over time. How would the tolerance graph begin to look when eating several meals across several days each with a variety of ingredients?
Let’s say in addition to basil I’ve eaten avocado, cilantro, egg, milk, and bell pepper - all in different amounts - all of which cause different reactions in me and also hit my tolerance limit at different rates. (Note that some reactions are more immediate and severe than others - a good example of this from my personal experience is 1 gram of salmon can cause a reaction (vomiting) in me very quickly while it takes dozens of eggs over a period of several days to trigger a reaction (bloody diarrhea)).
In the example below you can see that both bell pepper and basil have surpassed my tolerance threshold (100%) and I’m experiencing reactions from each - however I’ve not yet eaten enough avocado, cilantro, egg, or milk to trigger reactions from those. If I’m already having an issue with diarrhea from bell pepper and basil I probably shouldn’t eat any cilantro (which also can contribute to diarrhea in me) and I should also immediately remove the basil and bell pepper from my diet.
Listening to my body is a huge part of maintaining good balance. If I’m currently experiencing diarrhea I’m NOT going to eat ANYTHING that I know triggers additional diarrhea - it’s not worth it.
But if my symptoms are under control and I’ve done really good with my food choices over the past few days then I might just have a little cream in my coffee or a little cilantro or bell pepper in my quesadilla - but I consider these as “cheat” meals and I never cook any of my trigger foods at home.
You can also see from the graph above when you compare the length of meal 2 for avocado and cilantro that your tolerance limit can fill up faster depending on the amount of an ingredient you eat combined with the strength of the reaction in you (or how much your body doesn’t like the ingredient).
Additional thoughts:
One final area that should be mentioned here is that your body only has only so much capacity (nutrients, cell, etc.) to flush triggers out of your body. Over the years I’ve seen my symptoms largely worsen during specific times of the year. What I think could be happening is that my body is prioritizing the removal specific triggers over others which then actually lowers my overall tolerance to things I eat - meaning that I see symptoms sooner with lower quantities eaten. Here is a visual representation of that idea:
In this example since seasonal factors are consuming 40% of my body’s overall tolerance then my tolerance to specific ingredients is lowered to 60% instead of my normal threshold of 100%.
In the fall of 2021 during a period of increased GI distress it seemed like I was more sensitive to my triggers than usual. Prior to the fall of 2021 I had documented some minor discomfort in my abdomen (just below the sternum) when I eat something with sunflower oil but I would only see the symptom present when I ate it in very large quantities. However, over these two months of increased GI distress I noticed a similar discomfort even when eating very small quantities of sunflower oil. After ragweed tapered that fall my GI quickly recovered and I was able to eat sunflower oil again without symptoms. I saw a similar pattern with coffee lowering my consistency faster during ragweed season. Could it have been that since my immune system was in a compromised state that my triggers became more visible?
It’s a theory that I’ll keep testing but it is a concept that I have seen occur in my life over the years. You can read more of my thoughts on seasonal factors here.
Update: October 2023
I just added some major new additions to this post based on the last two years of continued experimentation. I hope the things I'm continuing to learn about my own body help you as well.
Original note:
According to the ~4,000 Crohn's Disease contributors on the popular crowdsourcing platform www.stuffthatworks.health here are the most indicative factors that contribute to a Crohn's flare:
- Trigger Foods (General)
- Dairy
- Spicy Food
- Food (General)
- Fiber Food
- Fatty Food
- Stress
- Diet (General)
- Fried Food
- Alcohol
You can clearly see that a majority of the triggers that are most indicative of a flare are diet related. Stress is the only exception here.
More often than not I tend to be conservative in my food choices. I've seen too many times where I make bad decisions and pay for it greatly. But having tested as many ingredients as I have now, I have a very high confidence level and comfort with that even if I ate something that caused me to flare it would be resolved immediately by reverting back to those ingredients that I know work well for me.
