I don't know what to eat anymore

[3slackC]

Pretty much what the title says, not some arbitrary restrictions, but poorly tolerated. I can't have ...
- much fuctose (malabsorbtion)
- histamine or antihistamines
- much fat (indigestion, insomnia and extreme intestinal discomfort)
- much protein (not sure, this might be related to histamine)
- much vegetables or soluble fiber
- gluten and some starches
- most fodmaps
- dinner, but neither fasting (insomnia)
- undereat or work out (I become ravenously hungry, eat poorly tolerated food and suffer the consequences)

So left are starch, milk, non soured quark, some fruit, honey, a little bit of fresh meat or fish or eggs. I also want to also feel good and starch makes me incredibly sleepy to the point of having to take daytime naps, so I won't have that either.

Now how am I supposed to get enough calories (or nutrients for that matter)? I'm thinking about being completely sedentary, so I have to eat less until doctor finds out more. Any advice is appreciated.

 

[Morten]

Pretty much what the title says, not some arbitrary restrictions, but poorly tolerated. I can't have ...
- much fuctose (malabsorbtion)
- histamine or antihistamines
- much fat (indigestion, insomnia and extreme intestinal discomfort)
- much protein (not sure, this might be related to histamine)
- much vegetables or soluble fiber
- gluten and some starches
- dinner, but neither fasting (insomnia)
- undereat or work out (I become ravenously hungry, eat poorly tolerated food and suffer the consequences)

So left are starch, milk, non soured quark, some fruit, honey, a little bit of fresh meat or fish or eggs. I also want to also feel good and starch makes me incredibly sleepy to the point of having to take daytime naps, so I won't have that either.

Now how am I supposed to get enough calories (or nutrients for that matter)? I'm thinking about being completely sedentary, so I have to eat less until doctor finds out more. Any advice is appreciated.

Properly cant give you any golden advice, but sounds like where I were a few years ago, but still fighting with some insomnia. But regarding starch I do eat quite a bit of white rice now, and the best way to cook them(for me), is this way: Soak them for 24 hours, and shifting the water severel times to get the unclear water away. So I shift 3-4 times(removes arsenic). Then start cooking, and when is it boiling, I immediatly turn off the heat. After a few minutes I shift the water for the last times, and add new water to finish them up. They fell very easily disgestible, and I can tolerate a lot. Normally I add quite a bit of coconutoil, Ghee or butter during the last cooking, so the rice will soak in some saturated fats as well. Sorry for your unpleasant journey, best wishes for you.

 

[3slackC]

Properly cant give you any golden advice, but sounds like where I were a few years ago, but still fighting with some insomnia. But regarding starch I do eat quite a bit of white rice now, and the best way to cook them(for me), is this way: Soak them for 24 hours, and shifting the water severel times to get the unclear water away. So I shift 3-4 times(removes arsenic). Then start cooking, and when is it boiling, I immediatly turn off the heat. After a few minutes I shift the water for the last times, and add new water to finish them up. They fell very easily disgestible, and I can tolerate a lot. Normally I add quite a bit of coconutoil, Ghee or butter during the last cooking, so the rice will soak in some saturated fats as well. Sorry for your unpleasant journey, best wishes for you.

Thanks for the advice, might try preparing rice that way, see if I digest it better. I probably got myself to this situtation by not caring and continuing to eat foods I reacted negatively to, messing up my gut further. It's a shame that in addition to histamine, I also can't tolerate the antihistamines my doctor prescribed me. What made you improve?

 

[LucH]

but poorly tolerated. I

Hi,
We need more information if we are supposed to guess why and how.
When do your intolerances begin, with ...
gas and flatulences?
let's put apart what is weakly digested because of a lack of enzymes: lactose.
Ho did you digest protein at midday? Not too long?
How do you go to toilets (faeces): stools once or twice a day or thrice a week?
Did you lack vitamins B (B2) (refined starches) and zinc (few meat)?
How is your tonus / thyroid. Warm or cold hands? (lack of I, Se, Mg). Etc.
The more details you give, the more susceptible we can find a clue.
Try to think about: At the beginning of the process. Not only now.
How is your tong (color)? (suspicion of fungus).

 

[3slackC]

Try to think about: At the beginning of the process. Not only now.

Intolerances started merely with bloating and the inability to digest lactose (for which I now take lactase). Following a stressful period of my life, I ate poorly and not much, after which I began to bloat. I then had bloody diarrhea for 3 weeks (suspecting a food borne illness from a raw, mold ripened soft cheese) and digestion has not been the same since.

gas and flatulences?

I'm always bloated. Fruits and vegetables give me extreme (words can't describe how bad it is) flatulence, pain on both sides of my lower abdomen and debilitating fatigue, sometimes I digest them well though. Whenever my digestion worsens, I have to pee a lot, up to 15 times a night. Sometimes I have brain fog that makes me feel as if I'm demented.

Ho did you digest protein at midday? Not too long?

Protein digestion is a little slow with no gas. Didn't eat much protein before this started, so couldn't tell you how it was in the past. Digestion overall is poor and when I'm hungry (Have not had the physical sense of hunger for quite a while, for me, hunger means lack of focus and symptoms of low blood sugar), I'm still feeling full from the last meal. The only way I can eat enough are refined starches (though whenever I switch to mostly starches, I get rather uncomfortable joint pain).
Fat makes me extremely nauseous. A fatty breakfast lingers in my stomach until midnight and I get insomnia.

How do you go to toilets (faeces): stools once or twice a day or thrice a week?

Bowel movements are irregular. I'm never able to empty myself completely, sometimes go 4 times a day, sometimes once, sometimes skip 2-3 days. Sometimes solid, sometimes thin, sometimes liquid.

Did you lack vitamins B (B2) (refined starches) and zinc (few meat)?

After recently taking B vitamins, I felt normal again for about a week, continuing to take them, I went back to feeling sluggish and stopped.
Ate a lot of meat, lost my taste for it and didn't eat it much anymore. Recently, after developing severe acne, I started craving it again.

How is your tonus / thyroid. Warm or cold hands? (lack of I, Se, Mg). Etc.

Hands, feet and nose always cold, but not as bad as it once was. Ferritin and serum iron are low normal. Poor libido.
Sometimes have this itchiness in my throat (where my thyroid is), that goes away immediately after eating. When I pull my hair, it falls out. After explaining to my doctor that TSH (Had 1.0 undereating, 3.7 eating barely enough) alone is not a good measure for thyroid function, he tested fT3, fT4 and antibodies (awaiting result).

How is your tong (color)? (suspicion of fungus).

I'm extremely sensitive to the smell of mold and yeast and had something growing on my tongue a while ago. My environment probably has mold in it, I notice a slight odor in some rooms, that I don't stay in much and have frequent nasal congestion. When I eat some vegetables, I buy them frozen. I vacuum seal most food.
Couldn't tolerate bread when I last tested, made me feel extremely cold (it was frozen and re-heated, suspecting resistant starches).

At night, I have horrible flatulence and RLS that wakes me up and then I'm extremely hot, drenched in sweat and overstimulated.
I had pretty bad anxiety and some panic attacks, but not anymore. Doctor tested DAO, currently waiting for the result. I suspect lack of stomach acid and recurring SIBO, but doctor wants me to do an endoscopy to test this (pancreatic enzymes are fine). Thanks for your help.

 

[LucH]

3slackC says :

Intolerances started merely with bloating and the inability to digest lactose (for which I now take lactase). Following a stressful period of my life, I ate poorly and not much, after which I began to bloat. I then had bloody diarrhea for 3 weeks (suspecting a food borne illness from a raw, mold ripened soft cheese) and digestion has not been the same since.

=> severe lack of Mg B2 with an impact on neurone.
Weak digestion: Need HCL betaine and protease at dinner (not at midday).

I'm always bloated. Fruits and vegetables give me extreme (words can't describe how bad it is) flatulence, pain on both sides of my lower abdomen and debilitating fatigue, sometimes I digest them well though. Whenever my digestion worsens, I have to pee a lot, up to 15 times a night. Sometimes I have brain fog that makes me feel as if I'm demented.

=> Fruits must be eaten separately. Not at the beginning if fermentation dysbiosis.
Food order: vegetables, meat and last carbs.

Note: If starch present when stools aren’t evacuated twice a day, it feeds bacteria in the second part of the colon. You need to inform on MMC (Migrant Motor Complex) if you want to have better transit. Resolor could help. 0.5 mg at night time.
But before taking a prokinetic (resolor), you have to calm irritation of the stomach and weaken proliferation of intestinal bacteria with use of essential oils (EO) (only if entero-coated, otherwise you won’t tolerate it) and / or with anti-infectious plants or antibiotics. You need the advice of a wealth practician.

Make a search with “Dr mark Pimentel + SIBO”.

I’ve used EO with a shake in which I put some useful nutrients:
Mg bisglycinate, PCa, K citrates, salt (Electrolytes) + L-glutamine, collagen (glycine) and taurine.
Drink every 3 hours (120 ml). No other liquid, except occasionally.

Note: glutamine for tight junctions’ integrity. Glycine is gaba-like (mood) and collagen could be taken into account for protein intake. Easier to digest.
You lack B2 (brain). 3 times a week a multi-B. Must be co-enzymed. But only after having dampened the dysbiosis. Otherwise lost.

For thyroid: I Se Zn Mg. Iodine from a supplement once a week. 150 - 250 mg. Important to take on a regular basis. Afterwards I’d take selenium. 100 mcg Se, 2 or 3 times a week. No more. Too much of a good thing is bad!
Zinc 2 x 15 mg. bisglycinate Zn. Not to take with a calcium supplement.

You’ll need some Cu for SOD enzyme if histamine problem. First dampen excess production (thanks to DAO enzyme brought). I’ve taken 1 000 000 Units, 5’ before meal. But not now. First weaken bacteria and fungus overgrowth.

I'm still feeling full from the last meal. The only way I can eat enough are refined starches (though whenever I switch to mostly starches, I get rather uncomfortable joint pain). Pasta and bread contains gluten, not well assimilated. Rheumatism by some people.

=> Perhaps too much lectins. Nightshade vegetables: tomatoes, eggplant, zucchini, green beans, cucumbers, squash, peppers, potatoes.
Refined carbohydrates (white rice, potatoes, bread and crackers) can worsen arthritis symptoms. => More inflammation. + Need B1 B2 B3 to process carbs.

Bowel movements are irregular. I'm never able to empty myself completely, sometimes go 4 times a day, sometimes once, sometimes skip 2-3 days. Sometimes solid, sometimes thin, sometimes liquid.

=> Problem of digestion / combination + lack of enzymes.
I take enzymedica lipo gold when eating too much fat.

I would simplify my meals: 3 ingredients. + Weak protein when high carbs (rice / potato / pasta). Or weak carbs whenever high protein (150 gr meat). That’s a question of enzymes and pH. Not the same pH for starch and protein.
Mind legumes: there’re anti-proteases. Snap beans and lentils might work.

After recently taking B vitamins, I felt normal again for about a week, continuing to take them, I went back to feeling sluggish and stopped.
Ate a lot of meat, lost my taste for it and didn't eat it much anymore. Recently, after developing severe acne, I started craving it again.

=> Eat according to taste, but first correct the ground. If you can’t digest macro-nutrients, you’ll feel sluggish. 80 % of our energy is taken / stolen by digestion.
Mind dairy if acne.

I'm extremely sensitive to the smell of mold and yeast and had something growing on my tongue a while ago.

=> Probably candidiasis (candida albicans = fungus). Fungus steals the nutrients and direct food needs.

Summary:
Clean up the land (dysbiosis). Contribution of enzymes to digest and assimilate macronutrients. Electrolytes for cellular communication and acid-base balance. Need to pamper first intestinal walls (inflammation). Need for anti-oxidants against low-grade inflammation and optimize immunity. Useful nutrients for morale... Be careful not to do it randomly otherwise the bacteria will take refuge behind a biofilm and it will be even more difficult to get out. A doctor who is knowledgeable in herbal medicine would be useful as a guide...

 

[Morten]

Thanks for the advice, might try preparing rice that way, see if I tolerate it better. I probably got myself to this situtation by not caring and continuing to eat foods I didn't tolerate, messing up my gut further. It's a shame that in addition to histamine, I also can't tolerate the antihistamines my doctor prescribed me. What made you improve?

Thanks for the advice, might try preparing rice that way, see if I digest it better. I probably got myself to this situtation by not caring and continuing to eat foods I reacted negatively to, messing up my gut further. It's a shame that in addition to histamine, I also can't tolerate the antihistamines my doctor prescribed me. What made you improve?

Still problems but better of now. It has taken 5 - 6 years. Has focused on living so anti stressfully as possible. Kind of meditation 0,5 hour every day, just to cool down. Keep on noticing what works and when. Eat clean and organic. I try not to be to full at night.
This forum has opened my eyes to a lot of new stuff. Started to take aspirin with K2 and supplements without fillers(silicone dioxine), which can irritate the gut. But my best advise is to try to have moments of antistress, whatever that means for you. I think it could be a part of a anti inflammatory lifestyle.

 

[3slackC]

3slackC says :

=> severe lack of Mg B2 with an impact on neurone.
Weak digestion: Need HCL betaine and protease at dinner (not at midday).



=> Fruits must be eaten separately. Not at the beginning if fermentation dysbiosis.
Food order: vegetables, meat and last carbs.

Note: If starch present when stools aren’t evacuated twice a day, it feeds bacteria in the second part of the colon. You need to inform on MMC (Migrant Motor Complex) if you want to have better transit. Resolor could help. 0.5 mg at night time.
But before taking a prokinetic (resolor), you have to calm irritation of the stomach and weaken proliferation of intestinal bacteria with use of essential oils (EO) (only if entero-coated, otherwise you won’t tolerate it) and / or with anti-infectious plants or antibiotics. You need the advice of a wealth practician.

Make a search with “Dr mark Pimentel + SIBO”.

I’ve used EO with a shake in which I put some useful nutrients:
Mg bisglycinate, PCa, K citrates, salt (Electrolytes) + L-glutamine, collagen (glycine) and taurine.
Drink every 3 hours (120 ml). No other liquid, except occasionally.

Note: glutamine for tight junctions’ integrity. Glycine is gaba-like (mood) and collagen could be taken into account for protein intake. Easier to digest.
You lack B2 (brain). 3 times a week a multi-B. Must be co-enzymed. But only after having dampened the dysbiosis. Otherwise lost.

For thyroid: I Se Zn Mg. Iodine from a supplement once a week. 150 - 250 mg. Important to take on a regular basis. Afterwards I’d take selenium. 100 mcg Se, 2 or 3 times a week. No more. Too much of a good thing is bad!
Zinc 2 x 15 mg. bisglycinate Zn. Not to take with a calcium supplement.

You’ll need some Cu for SOD enzyme if histamine problem. First dampen excess production (thanks to DAO enzyme brought). I’ve taken 1 000 000 Units, 5’ before meal. But not now. First weaken bacteria and fungus overgrowth.



=> Perhaps too much lectins. Nightshade vegetables: tomatoes, eggplant, zucchini, green beans, cucumbers, squash, peppers, potatoes.
Refined carbohydrates (white rice, potatoes, bread and crackers) can worsen arthritis symptoms. => More inflammation. + Need B1 B2 B3 to process carbs.


=> Problem of digestion / combination + lack of enzymes.
I take enzymedica lipo gold when eating too much fat.

I would simplify my meals: 3 ingredients. + Weak protein when high carbs (rice / potato / pasta). Or weak carbs whenever high protein (150 gr meat). That’s a question of enzymes and pH. Not the same pH for starch and protein.
Mind legumes: there’re anti-proteases. Snap beans and lentils might work.



=> Eat according to taste, but first correct the ground. If you can’t digest macro-nutrients, you’ll feel sluggish. 80 % of our energy is taken / stolen by digestion.
Mind dairy if acne.


=> Probably candidiasis (candida albicans = fungus). Fungus steals the nutrients and direct food needs.

Summary:
Clean up the land (dysbiosis). Contribution of enzymes to digest and assimilate macronutrients. Electrolytes for cellular communication and acid-base balance. Need to pamper first intestinal walls (inflammation). Need for anti-oxidants against low-grade inflammation and optimize immunity. Useful nutrients for morale... Be careful not to do it randomly otherwise the bacteria will take refuge behind a biofilm and it will be even more difficult to get out. A doctor who is knowledgeable in herbal medicine would be useful as a guide...

Thanks for the suggestions. I'll to try make homemade bone broth, should contain the amino acids and nutrients you mentioned. Digestive enzymes might also help. My constipation might actually be due to histamine. Since I stopped taking the antihistamines, it came back. I did eat quite a bit of lectins.

 

[Gawdawg]

Pretty much what the title says, not some arbitrary restrictions, but poorly tolerated. I can't have ...
- much fuctose (malabsorbtion)
- histamine or antihistamines
- much fat (indigestion, insomnia and extreme intestinal discomfort)
- much protein (not sure, this might be related to histamine)
- much vegetables or soluble fiber
- gluten and some starches
- most fodmaps
- dinner, but neither fasting (insomnia)
- undereat or work out (I become ravenously hungry, eat poorly tolerated food and suffer the consequences)

So left are starch, milk, non soured quark, some fruit, honey, a little bit of fresh meat or fish or eggs. I also want to also feel good and starch makes me incredibly sleepy to the point of having to take daytime naps, so I won't have that either.

Now how am I supposed to get enough calories (or nutrients for that matter)? I'm thinking about being completely sedentary, so I have to eat less until doctor finds out more. Any advice is appreciated.

Maybe a carrot salad would digestions issues.

 

[LucH]

I'll to try make homemade bone broth, should contain the amino acids and nutrients you mentioned.

yes for proteins and glycine + fibers. Not enough for electrolytes. Lack of glutamine for tight junctions of stomach. I'd take both: bone broth at midday and a shake with nutrients at 5 PM.

Digestive enzymes might also help.

Sure, with the board given.

My constipation might actually be due to histamine. Since I stopped taking the antihistamines, it came back. I did eat quite a bit of lectins.

if lectins are present too high, all methylation process is cancelled. No life without methylation.
I repeat: If you don't handle MMC in the good way, you won't recover (dysbiosis). Try to inform correctly.
Hope it can help.

 

[3slackC]

Test results came back, I have a severe DAO deficiency (histamine intolerance). I basically don't produce it at all, he hasn't ever seen it that low.

Maybe a carrot salad would digestions issues.

Already having it daily.

But in the meantime, the main the problem persists: I have fructose malabsorbtion + lactose malabsorbtion + histamine intolerance + gluten sensitivity + problems with fodmaps (and possibly others) and I don't know whats left to eat anymore.

 

[LucH]

I don't know whats left to eat anymore.

1. I repeat because you didn't catch or realize.
“Fermentation dysbiosis can be a sign of MMC dysfunction, which can have consequences on general metabolism and communication between the gut and the brain. To restore the balance of the intestinal microbiota, it is necessary to act on digestion, diet and MMC at the same time. »
2. We must first clean up the land. What do you suggest to alleviate excess bacteria in the stomach and intestines? How to proceed when the intestines have become lazy and the MMC needs to be re-educated. The transit is random. Yes, you need ballast and soft fibers, but you also need to be able to ingest them in case of irritation...
3. Intestinal spasms are involuntary and painful contractions of the smooth muscles of the intestine. They can be caused by inflammation, infection, irritation or an imbalance in the gut microbiota.
4. To restore the balance of the intestinal flora, it is first necessary to eliminate the possible causes of dysbiosis, such as a bacterial or fungal infection, antibiotic treatment, chronic stress, etc. You must then re-seed the microbiota with beneficial bacteria, by taking probiotics adapted to your situation. But not now; only on quiet ground.
5. Be careful, if certain molecules are not entero-protected, they will be irritating to the stomach walls and they will not adequately target bacterial proliferation in the 2nd part of the colon.

 

[Morten]

Thanks for the suggestions. I'll to try make homemade bone broth, should contain the amino acids and nutrients you mentioned. Digestive enzymes might also help. My constipation might actually be due to histamine. Since I stopped taking the antihistamines, it came back. I did eat quite a bit of lectins.

I take 1/2 of benadryl antihistamine every night, gives me better sleep and more calm system. I shifted my b complex to a vendor without fillers. You could also try one capsules charcoal with coconut oil before bed, to help coconut oil not to be metabolised by the liver, and reach the colon

 

[3slackC]

I take 1/2 of benadryl antihistamine every night, gives me better sleep and more calm system. I shifted my b complex to a vendor without fillers. You could also try one capsules charcoal with coconut oil before bed, to help coconut oil not to be metabolised by the liver, and reach the colon

Thanks for both of the tips, but I really didn't tolerate the antihistamine drugs my doctor prescribed well at all. First time I took them, I had 13 hours of uninterrupted sleep (which alone would be great), but was fatigued the entire day following. I assume coconut oil with activated charcoal is supposed to yield an antibiotic effect. Have you actually noticed a positive effect?

 

[Morten]

So there might be other antihistamin drug you could tolerante.
I dont Know that many names of vendors.
I agree sleeping too long/much tend to make one unable to be present.
About the coconut trick, it was haidut on a podcast mentioned it.
Actually taken one pill with coconut before sleeping tends to upset my stomach a bit.
I think I would try as first thing in the morning, and wait hours a few before eating....

 

[LucH]

I really didn't tolerate the antihistamine drugs my doctor prescribed well at all.

another solution would be to inform on what brings histamine (H1 to H3) and what liberates histamine (L1 to L3). H3 and L3 should be avoided.
And to to reset the counters I'd take DAO enzymes in order to help to get rid of excess histamine. 1 000 000 Unit at least.

 

[3slackC]

Update on this: After having extreme nausea for multiple days last week and suspecting my constipation to be the cause, I decided to do an enema.
Turns out, I had over 3 kilograms of stool stuck in my colon (not an exaggeration, I weighed myself before and after). It smelled extremely foul and contained tons of fully undigested vegetables. I'm no longer bloated or passing excessive gas and digestion seems to be much faster now.

Not entirely in line with your suggestion, I changed the order I'm eating to fat, protein, carbs and lastly vegetables (= carrots), hoping the fat has a protective effect on the intestines when eating starch. I also dropped oats and most vegetables (Eating less variety should decrease the chance of indigestion). The DAO enzymes alleviated the symptoms of histamine intolerance and digestive enzymes help tremendously with fat digestion.

As a first step for MMC, I'll be trying to eat 2-3 fixed meals a day, spaced roughly 5-6 hours apart (8-9 AM, 1-2 PM, 6-7 PM). I'll also be sipping on warm water with electrolytes throughout the day instead of drinking a lot at once and try holding fluids back until 1-2 hours after a meal.

Thyroid results also came back, TSH = 1.7 uU/ml, fT4 = 1.9 ng/dl, fT3 = 2.9 pg/ml. Does this look like slightly suppressed T4 -> T3?

Since histamine is no longer a problem, I'll be eating the following until my digestion works a little better (supplementing selenium, iodine and low dose thiamine + niacin + riboflavin for now):
Fat:
- Coconut (oil) (perhaps also MCT oil)
- Dark Chocolate
- Butter

Protein (and fat):
- Pastured Eggs
- Pastured Pork and Beef
- Milk
- Shrimp
- Bone broth (homemade bone broth is quite delicious)
- Liver once a week

Carbs:
- Carrots (To clear out the land)
- Oranges
- Rice (Trying with supplementation of B vitamins)
- Sweet potato (Although high in soluble fiber, they do not seem to cause my any problems)

I'll be eating primarily starch for carbohydrates, as compared to sugar (fruits), it raises my body temperature and actually satisfies me. Thanks for the advice, lets see how it goes.

 

[LucH]

Thyroid results also came back, TSH = 1.7 uU/ml, fT4 = 1.9 ng/dl, fT3 = 2.9 pg/ml.

Does this look like slightly suppressed T4 -> T3?

TSH is ok but that doesn't mean all is OK (communication)
T3 lacks.
T3 ratio = free T3: rT3 = 20 minimum.
Max 5% rT3. The lower this number, the better. www.stopthethyroidmadness.com/rt3-ratio.
Note 1;: ok for starches but only with fluent faeces. 2x/day minimum. And preferably when flatulences under control.
Note 2. Ok for carrot with oil at the beginning of the meal but only once a day (chelation), or then whenever on crisis. Better choice for digestion if taken at first. Carrot will only amalgame toxins and excess histamine. Fine but acts as a fireman. Not as a nurse => healing needed.
But if it's under control, it'll be easier to go forwards.

 

[3slackC]

So DAO enzymes (when taken orally) only work for foods high in histamine (histamine in the gut), not for foods that act as histamine liberators. I was puzzled by my symptoms and chocolate and citrus fruit seem to be the problem.

 

[LucH]

So DAO enzymes (when taken orally) only work for foods high in histamine (histamine in the gut), not for foods that act as histamine liberators.

I didn't say that. Orally taken DAO enzymes work for both: histamine brought and liberated. 1 000 000 units at least, at each meal, 5 - 10 minutes before meal.
And you need to care for what you eat (moderation).
It supposes you have microflora under control.