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Beans, beans are good for your heart…………fill in the rest!

You may have heard the following rhyme,

Beans, beans are good for your heart – well so far this is true they are full of soluble fibre, soluble fibre reduces cholesterol levels and lowers the risk of blood clots preventing heart attacks and strokes.

The more you eat the more you f****, again some real truth here.

The more you f*** the better you feel, well no actually, beans and pulses are known for causing intestinal gas and this can cause havoc with people who have IBS, increasing the level of pain felt and generally making life really miserable. Beans and lentils (pulses) contain a type of carbohydrate called raffinose, this is indigestible by everyone, but with people who have IBS the bloating that results stretches the bowel wall and causes pain. I don’t really need to explain f*** do I? I’m much too polite, I’m afraid.

So let’s have beans for every meal – erm, again possibly not, if you are prone to bloating and pain after eating them.

BUT I MISS BEANS! I’M VEGETARIAN – BEANS ARE MY PROTEIN AND IRON! 😦 HELP!

You should only exclude foods that are actually causing problems, variety in your diet is very important. Good sources of protein for vegetarians are quinoa and quorn and iron can be found in dark green leafy vegetables – ensure you have a SMALL glass of fresh orange to aid the absorption into your body, only if you are not intolerant of fructose. Ask to see a dietitian if you require more personal dietary advice here.

Is there anything I can do to make this food a little more tolerable?

Well possibly.

When buying dried pulses (lentils and beans) please ensure you use them up quickly – leaving them in your cupboard for more than a year really doesn’t help, the longer they are stored the tougher they become. They then require more soaking and boiling to make them more digestible. Ensure the surface is without shriveled skin and the colour is bright. Store your dried beans in a sealed container in a cool dark place.

Soaking is then required, don’t add anything to the beans but water and change this a few times during the soaking process, if you can. Don’t be tempted to add salt or sodium bicarbonate to the beans, salt will inhibit the soaking process. You will need to soak the beans at least eight hours or preferably overnight and rinse the beans after soaking prior to cooking.

Cooking times vary depending on the age and water hardness, again before adding the beans to another dish don’t be tempted to use the water for stock as this does contain more raffinose. See the link at the bottom of the page for a useful information leaflet from Pulse Canada on cooking times for beans. Don’t add acidic foods to the beans whilst cooking such as tomato, vinegar or lemon juice as this makes the cooking process longer.

Tinned beans need to be rinsed before use, again don’t be tempted to use the liquor to add to other dishes – the beans have been cooked in the tin and not given the same treatment. Some of the cheaper tinned versions can be a little tough, necessitating longer cooking time to avoid excessive wind – buying cheaper versions may be false economy if you need to cook them for longer!

A word of warning about kidney beans, cannellini beans and broad beans, they all contain phytohaemagglutanin a protein that if consumed in large amounts is a toxin, it is found in large amounts in kidney beans. It is denatured by correct cooking. Tinned kidney beans are better to avoid the risks, but do rinse them well before using them!

Some information was found about adding a piece of seaweed (Kombu) to the beans during cooking to aid with reducing raffinose content of beans, lots of un-referenced information on the web. Kombu was suggested to contain alpha galactosidase an enzyme that digests raffinose. I have, despite a good hunt on the internet and research sites, been unable to find the source of this information, so I am actually unsure if this does work – any help here from food technologists would be gratefully received! Please reply!

Make your own baked beans!!

Gluten free, dairy free, vegetarian.

500g dried haricot beans

20 sprigs of fresh thyme

2 medium potatoes

400 ml passata

salt (not too much!)

Soak the beans for at least 16 hours with water, change water at least four times.

Peel potatoes and boil till soft, mash.

Cook the beans for 30-40 minutes or until soft in fresh water, then drain.

Add the potato to the beans and the passata, fresh chopped thyme and a small amount of salt. Cook for ten minutes – eat & enjoy!

See link for lots of useful info on pulses!

http://www.pulsecanada.com/food-health/fact-sheets-resources

Jules_GastroRD4 Comments

Paella Low FODMAP, dairy free, gluten free, wheat free – obviously!!

1 Dessert spoon of garlic infused oil

1/4 teaspoon of asafoetida (check wheat free)

1 teaspoon of Spanish smoked paprika

1 generous pinch of saffron

1/2 teaspoon of turmeric

6 skinned boned chicken thighs

250g of seafood selection (skinned)

4 cups of basmati rice

500 ml chicken stock (ensure you check the label for onion & garlic)

One orange bell pepper

Pinch of salt & pepper

Method

Measure oil into a pan and add spices (except saffron)

Fry chicken, remove from oil and place in an oven at gas mark 6 (admittedly mine were a little over cooked, but I prefer it that way – honest!)

Add rice to oil and fry for 30 seconds and the add chicken stock

Add the pinch of saffron to a small dish and cover with boiling water to leach out the saffron, add this to rice mix.

Cook till rice is softened and add pepper, cook then add back the chicken, add the seafood selection and cook till warmed through.

Serve.

One of my favourite pastimes when I am on holiday is to look around the food markets, here is a market in Barcelona. I love to wander and look at the different foods that are sold and to get some ideas of what to cook when I get home.

Jules_GastroRD1 Comment

Book Review The Complete Idiots Guide to Eating Well with IBS Kate Scarlata RD

This book is a comprehensive guide to eating with irritable bowel syndrome. It is very user-friendly, you can dip in for a quick read or take your time. I liked the summaries at the end of every chapter and the hints and tips are very useful. The book contains lots of recipes all with nutritional breakdown and a gut fact attached to each one! Covering the fact that healthy eating – with foods that are tolerated – is very important.  The foods that can be problematic are covered and Kate does explain, in user-friendly terms, the reasons why these foods can result in symptoms, but also adds that everyone’s symptoms are individual, so it’s advisable to use the advice accordingly. She also explains how to use a food and symptom diary to identify problematic foods, which is extremely useful for those people who are managing their IBS symptoms themselves.

The book is published for the American market, red flag symptoms are discussed, however one area that does differ in the UK is the identification of people with coeliac disease. Please note that everyone (children and adults,) who have IBS should be, or have been, screened by serological testing (blood tests – endomysial antibody (EMA) IgA and/or tissue transglutaminase antibody tTGA) for coeliac disease, in the UK. At the time of the writing of the book, the emphasis on testing IBS patients for coeliac disease was geared more toward those with IBS-D in the US, the author (in her private practice) however, recommends that all of her IBS clients be tested for coeliac prior to altering their diet. These are guidelines from the National Institute of Clinical Health & Excellence (NICE) available here:-

http://guidance.nice.org.uk/CG86

I have seen patients’ whose main symptom of coeliac disease is constipation, so everyone is at risk and should be tested. Ask your GP and eat wheat, barley and rye (bread, pasta, chappatis, some breakfast cereals) before your test, see above guidelines. Read what Coeliac UK have to say here:-

http://www.coeliac.org.uk/coeliac-disease/how-to-get-diagnosed

Other differences I noticed was histamine intolerance was mentioned in the book – this is not well recognised in the UK, but it can be identified by your dietitian by using elimination diets and is likely to be covered somewhat in an additives free diet (benzoate additives for example, but substances that promote a histamine response are also found naturally in some fermented foods.) It is also advised for people on certain antidepressants – the MAOI (Monoamine Oxidase Inhibitor) diet, to help people avoid dangerous rises in blood pressure, this diet is rarely seen now in general dietetic practice.

http://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

Other food intolerances are also mentioned, it is important to see a state registered dietitian if you suspect you have histamine intolerance as identifying these rare intolerances can be challenging.

This book is certainly worth considering if you want to buy a book to help you manage your IBS symptoms, I particularly liked the chapter on travelling and eating out, often areas where it is difficult to acquire advice. The book also discussed lifestyle factors and other areas outside the area of Low FODMAP foods, which is also included, and as such it should contain advice that can help most people with IBS who feel that their diet, or eating in general is problematic.

Related articles

This book was provided free of charge by the author.

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What not to say to people with IBS – a response – #supportallGUTfolks

2014 update

This post was written in 2012 and since this date the offending comment still exists in Health Magazine and unfortunately the comment facility has been closed. If you feel aggrieved at the comment I suggest you write to them – although both Nina’s comment (IBS Impact) and my requests have fallen on deaf ears, so how successful you would be is debatable.

I was reading an article for help for people diagnosed with inflammatory bowel disease (IBD,) in Health Magazine, really good useful tips actually, on how to be empathetic for those people with IBD. However I did start to see red when I read a comment of you should keep your symptoms of IBS to yourself, when empathizing with people who have IBD. Now, I do get angry really quickly when people make the suggestion that IBS is somewhat insignificant – is this because it is a ‘syndrome’ perhaps? I had a rant and a cup of tea (to gather my thoughts,) then I wrote a response to this article. Not an angry response – quite a nice balanced one, explaining that it is not helpful to people with irritable bowel syndrome (IBS) for the magazine to make this comment, with the reasons why. I also requested that they remove this particular comment from the site – to ensure that it was empathetic to all. My response was deleted from the site by the system administrators, this denies my freedom of speech as an advocate for the UK charity for IBS, and my professional ability to support all those people living with difficult GUT symptoms, despite the diagnosis. I was pleased that IBS Impact still have a well-balanced comment on the site, but they have not asked for it to be moderated – perhaps that was the difference. You can see the article here:-

http://www.health.com/health/gallery/0,,20533275,00.html

I am not in any way suggesting that crohns disease or ulcerative colitis, or any other GUT disorder is not significant, quite the contrary, but people should understand that for some people the symptoms of IBS can be very disabling. Neither am I using this article to promote IBS’s cause, I am just advocating promoting tolerance for all. So how do you empathise with someone with IBS? You can start by not saying the following:

IBS is all in your head.

This is not true, symptoms are very real. Is it the age-old view of society that IBS is ‘all in your head’ and therefore your symptoms cannot surely be real. Irritable bowel syndrome is a functional bowel condition, it is a condition where the digestive tract moves in a disordered way, producing symptoms, also the gut is hypersensitive to bloating causing pain. Yes, tests are negative, but most tests do not measure the speed the GUT moves. These symptoms are not a normal condition for the body, therefore it is difficult to understand how this disorder can be ‘imagined’. Now the gut does have a connection with the brain and the way someone is feeling can affect the way the digestive tract moves, but it certainly does not all start and end in their head. Read more about what Dr Bolen says about the brain GUT connection and five reasons why IBS is not all in someone’s head here:-

http://ibs.about.com/od/symptomsofib1/a/braingut.htm

http://ibs.about.com/od/symptomsofib1/a/notstress.htm

Oh – are you one of ‘those’ people that have a self diagnosed (thinking here – made up) food ‘intolerance’?

This is misguided, we are all aware of the popularity of alternative diets for celebrities, this does not help the cause of individuals who may have intolerance to certain foods. This can result in some level of disdain when a person with intolerances asks for a meal or product free from a certain ingredient. Please accept that not everyone has had access to professional help to identify what is causing symptoms and you should trust them, they know their bodies and what they can tolerate. You can ask them to help you to provide a meal or product that will not make them ill, most people respond very favourably to a request for help.

You are so fussy when it comes to food, you just need to get over it and eat your meal.

Comments like these are really suggesting there is nothing wrong with the person with IBS – therefore I don’t believe food affects you at all – so pull yourself together. Do you really want to tell your friend or family member that you don’t believe what real symptoms they have? This statement reinforces negative feelings and can result in mealtime arguments, really unhelpful for all involved, this will not help anyone’s digestion. Feelings do need to be discussed in a useful way, but choose a suitable time to do so and make it a positive experience by listening to each other to start.

You told me you couldn’t eat what? Oh sorry I forgot, I’ve made a vindaloo, its wheat free, will that do? You can have a large glass of milk to help reduce the heat, if you want.

The best way around this is to understand what your friend or relative is sensitive too and then perhaps you can hold some store cupboard items, that can be relied upon in an emergency. It is better to plan so that everyone can eat the same meal, but perhaps you can have an alternative in case of unannounced visits, or if you forget. Basic examples would be eggs (omelettes, poached) plain chicken or fish, boiled rice, fresh boiled warm potato, frozen carrots, salad leaves and you could also put a loaf of sliced wheat free bread in the freezer.

What do you mean you can’t come out?

Some people with IBS do not want to travel without preplanned toilet facilities and they may not wish to discuss their personal symptoms with you. Please try not to be offended. What is useful to say is that you are sorry that the person cannot come on the trip, and if you are a real friend you can offer help, if it is wanted – no questions asked, please! Wait for the person to discuss their symptoms, they will, if they feel happy and comfortable to do so. If they ask for help then the IBS Network makes a can’t wait card for trips out, it can be used in shops and stores. You could plan the trip together or wait to go till the persons symptoms are a little better controlled before you go. Arranging to visit the person in their own home is always an option, to make them feel less excluded, if the trip cannot be cancelled.

HA,HA,HA, lol,  those are Dave’s symptoms????? Really?? OMG! Just wait till I tell……..

If this person you are talking about is a friend or work colleague or even an acquaintance, then imagine how you would feel if someone were to say those things about you. Your ‘friend’ does not deserve this sort of treatment, behaviour like this causes stress and could be viewed as very hurtful – please think before you speak. Les Floyd who writes a cool blog wrote a blog about Socrates and the triple filter test, ask yourself these questions before you speak – 1. Have you made sure what you are going to tell is true? 2. Is what you are going to tell something good? 3. Is what you are going to tell something useful? If what you are going to say does not fulfil the truth, goodness or usefulness filter then simply don’t open your mouth – end of. The blog, which is really worth reading can be found here

http://lesism.blogspot.co.uk/2012_05_01_archive.html

We don’t have a special fussy eaters menu.

Remember the fact that the customer is king, the best retort you can give is to say that you may not have a good understanding of the persons requirements BUT YOU ARE WILLING TO LEARN (this is the most important part.) “What can we get for you to eat?” Then listen carefully and try to avoid contamination of their food – prepare it separately. This will make the person comfortable in what you are going to provide, it will also keep you a customer – and never forget, people with food intolerances always eat with others. If the person has had a good visit they are more likely to return and spread the good word with friends and family. Web sites that can help are

http://www.coeliac.org.uk/food-industry/caterers-and-restaurateurs

http://allergytraining.food.gov.uk/

(for ‘allergy’ also read intolerance, plenty of information about how to cater for food intolerances on the site.)

Everybody gets tired.

Tiredness is a symptom of IBS, it is not known what the cause is, but it is a symptom. Yes everyone does get tired at times but some people with IBS can have the added complication of tiredness to cope with as well as the hustle and bustle of life. The person with IBS will have some idea of how much they can cope with, please be empathetic and listen.

Some of the comments or questions discussed here are a little bit exaggerated, but I am sure that everyone has had similar comments made to them at some point. I was also a little disappointed with some of the comments on the Health Magazine site – but each to their own I suppose, all I ask is please be sensitive when speaking to someone with IBS. You know what, though? Some of the answers will also help others with GUT symptoms to eat well, so people with GUT conditions really do have very similar experiences and should be able to support each other.

Jules_GastroRD5 Comments

Nothing makes something good!

http://vimeo.com/24975340

I watched this video some time ago but I keep coming back to it. It is uncomfortable viewing initially, but it is beautifully filmed and makes you feel warm inside once you have watched it. I do think you need to persevere with watching it, it has nearly 7000 likes on Vimeo. Let me know what you think. If you decide to watch it on YouTube you might get lucky and have the additional joy of watching the advert of the cats with opposable thumbs too!

http://www.youtube.com/watch?v=LOMbySJTKpg

Enjoy!

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