Prunes – natures laxative.

“I hope my tongue in prune juice smothers, If I belittle dogs and mothers”

Ogden Nash

Ogden Nash was an American poet who suffered from crohn’s disease according to Wikipedia, his unfortunate demise was after a lactobacillus infection after eating poorly prepared coleslaw as the Wikipedia site states. Interesting quote about prune juice, do you get the feeling he detested prunes? Prunes might have resulted in symptoms for him – depending on his crohn’s disease. I can only speculate, but what do these dried fruits do for us? Should we in fact include them in our diet? The following post by Compound Interest explains the chemistry behind the prune – or dried plum.

Prunes do in fact improve constipation – but for some people at a cost – the reason they do is down, in part to the large amount of sorbitol and fructans they contain, these FODMAPs or fermentable sugars draw fluid into the small bowel and rapidly ferments in the large bowel. Sorbitol is also found in sugar free mints and gum – often a warning is given on these to avoid eating too much as a laxative effect may be the result. Not great if you have IBS and bloating and are intolerant to sorbitol. Prunes could also result in symptoms for people with active crohn’s disease too – perhaps that is the reason they are suggested by Nash to be a treatment to instill an avoidance of denigrating your mother! Or alternatively it might be just down to taste or personal preference. But to help constipation if you don’t suffer from IBS, bloating and excessive wind – they are worth a try – introduce them in your diet slowly so your bowel adjusts to the extra fibre they contain. These sugars can also have a pre-biotic (food for bacteria) action, so it is worth including some in your diet if you tolerate their effects!


Low FODMAP fishcakes

fish fridayIngredients

1) Tartar Sauce

50 g Gherkin (check ingredients for Fodmaps)

2 teaspoons of capers

3 tablespoons low-fat mayonnaise

5 g flat leaf parsley

2) 300 g white fish

650 g new potatoes

9 g fresh turmeric

2 teaspoons of cumin

1 tablespoon garlic flavoured oil

2 eggs

150 g of wheat free breadcrumbs



Tartar sauce

Chop gherkins, capers and parsley and mix with mayonnaise, salt and pepper to taste.

Mix and chill.

Fish cakes

Peel half of the potatoes and leave the others with peel on to add more fibre.

Boil in salted water till soft, mash with pepper.

Peel and chop turmeric and cook in the garlic flavoured oil with cumin.

Add the chopped fish, cook very lightly.

Combine fish and potato – mix gently to ensure large pieces of fish remain

Using a ring fill with fish and potato mix.

Beat the egg.

Coat each fish cake in egg then roll in breadcrumbs.

Lightly fry with spray oil and then finish cooking in the oven.



Happy New Year! Clinical Alimentary blog awards 2012

Will you sing this tonight on the strike of midnight, to being in the new year?

Should auld acquaintance be forgot

And never brought to mind

Should auld acquaintance be forgot

For the sake of auld lang syne.

For auld lang syne my dear

For auld lang syne

We’ll take a cup of kindness dear

For the sake of auld lang syne – Robert Burns

So as not to forget times long past and new friendships found – with a special thanks to all my followers – in particular (in no order of preference)

Dr Gary Lum author of Yummy Lummy, who consistently likes my posts and has so far provided my only reblog

John Thompson (not a relation!) author of Sybaritica, for comments

Alex Gazzola author of Food Allergy and Intolerance, for support and always making me think ‘out of the box’

Dr Barbara B. Bolen author of About IBS, and Patsy Catsos author of IBS free – for driving the most views to my site

Nina and all at IBS Impact for supporting the IBS community and driving some very interesting discussions.

I hope the New Year brings all of my followers good luck, new opportunities and most of all a calm gut.

My most popular posts of 2012

The stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 6,900 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 12 years to get that many views.

Click here to see the complete report.

LOFFLEX how to manage a #crohn’s flare up during the festive season

It probably isn’t very good to be following the LOFFLEX diet during the festive season but crohn’s is no respecter of holidays and it may be that you have had to return to a very bland diet during the festive season. You can eat food during this time – here are some recipes I developed to help you to have at least a Christmas lunch, or you could use this recipe for thanksgiving too.

Turkey is suitable for stage one of the lofflex diet, so are carrots and boiled potatoes (no skins.)

Roast potato

Peel potato and wash with clean water.

Cut into pieces and par boil in salted water for five minutes.

Drain off cooking liquor

Shake the pan to roughen the edges of the potato

Spray with a small amount of vegetable oil.

Cook in the oven for minutes at gas mark 7/220°C

Have 1-2 pieces.


3oz/75g Rice crumbs

1 teaspoon of sage

1 teaspoon of mixed herbs

100mls/4 fluid ounces of boiling water

Spray with rapeseed oil

Salt to taste


Add sage and herbs to a cup; pour on water and leave to brew.

Sieve herb liquor to remove solids and retain liquor.

Weigh out rice crumbs and add herb liquor till a consistency of stuffing is achieved, add salt to taste.

Place stuffing into a ramekins and flatten the surface, spray oil on the top.

Put into an oven at gas mark 6/200 degree celsius for approximately 20 minutes or until the surface has browned.


Use turkey stock – drain off the fat from the surface and thicken with rice flour.

Cranberry sauce with no alcohol added – sieve out skin and seeds.

  1. Pear or apricot crumble with soya custard

Serves two

50g/2 oz Rice crumbs

12g/½ oz granulated sugar

2 tablespoons sieved, or skin free apricot jam

2 pears

Spray rapeseed oil

Peel and remove the stalk and core from the pears

Slice the pear and add to two ramekins.

Add one tablespoon of sieved apricot jam to each one, (warm the jam in a pan till the jam is runny and sieve off skins, or purchase skin free apricot jam, available for Christmas cake decorating.)

Mix rice crumbs and sugar and sprinkle on the top of the apricot and pear

Spray surface with spray oil

Cook in the oven for 15 minutes gas mark 6/200°C – take care when serving as it can be very hot! Serve with soya custard.

Christmas can be a difficult time if you have restrictions on your diet, so try to keep focused and think of some treats that are not food related, such as going to see a movie at the cinema, watching your local football team on boxing day, going to see a play or pantomime or inviting friends round to watch a Christmas DVD.

Keep well hydrated and if you experience severe symptoms seek help from your healthcare provider. Everyones intolerances can be different so if you have noticed that some of the ingredients in the above recipes make your symptoms worse it’s probably best to avoid them, discuss this with your dietitian.

Peppermint creams LOFFLEX (Low FODMAP)

Peppermint creams, easy to make and good as an occasional treat for people with food intolerances


270g of icing sugar (extra if mix too runny)

2 teaspoons of peppermint oil

1 teaspoon glycerine

2 tablespoons of water


Add peppermint, glycerine and water to icing sugar and mix till fully amalgamated.

Roll into a sausage shape and cut into equal parts, roll into a ball then flatten with a fork.

LOFFLEX recipes Third Edition

Ground rice pudding Annette Sharp RD

50g Ground rice

25g Sugar

600ml rice milk (plain or vanilla – try to get one with added calcium)

1 tsp vanilla extract (optional)

Flavouring tinned pears, pineapple juice honey/cinnamon/cardamom to taste


Place ground rice, sugar and milk in a small non stick saucepan and whisk until smooth. Gently bring to the boil, stirring whilst cooking – the mixture should quickly thicken into a custard consistency.Continue to simmer over a very low heat for 5-6 minutes, stirring occasionally. Transfer to a bowl, cover and leave to cool of can be eaten whilst warm. Can blend cold pudding to achieve a very smooth consistency.

Rice Flour Pancakes

1/2 cup of rice flour

300mls of milk

2 tbsp caster sugar

oil for frying

Whisk ingredients together and fry small pancakes (approx 2 inch in diameter) in a small amount of oil until dark golden, serve with jam made from allowed fruit or honey.  Alternatively omit the sugar and add herbs and serve with meat or fish from allowed list.

Chicken Noodle Stir Fry My Le Lac RD

100g Chicken Breast

50g Courgette (skinned and sliced thinly)

50g Mushrooms (chopped)

Dried Rice Noodles

1 tbsp Vinegar

1 tsp sunflower oil/olive oil

Salt to taste

NB this counts as one portion of vegetables

Bring a pan of water to boil, place noodles in the pan

Cook the noodles till softened, drain and rinse in cold water to prevent them sticking together

In a non stick pan heat the oil, add the chicken

When the chicken has browned add the courgettes and mushrooms

When the vegetables have cooked add the noodles and stir fry, them add the vinegar, salt to taste and serve.

Moroccan Lamb Tangine Layla Brown RD

Serves 4

2 tsp black pepper

11/2 tsp paprika

11/2 tsp ground ginger

1 tbsp turmeric

2 tsp ground cinnamon

1x shoulder of lamb, trimmed and cut into 5cm/2 inch chunks

2 large carrots, peeled and grated

2 tbsp of garlic infused oil

3 peppers

115g canned apricots

55g stewed plums

1 tsp powdered saffron

brown rice miso

1 tbsp clear honey

2 tbsp coriander

2 tbsp flat leaf parsley

Place the black pepper, paprika, ginger, turmeric and cinnamon into a small bowl and mix to combine. Place the lamb in a large bowl and toss together with the spice mix. Cover and leave overnight in the fridge.

Preheat the oven to 150C/300F/gas 2

Cut the remaining food into small pieces/chunks and place in a slow cook oven or casserole dish along with the other ingredients and brown rice miso, water and cook for approx 21/2 hours till meat is very tender.

Place in a serving dish with fresh herbs.

Serve with boiled rice.

Please note: Everyone’s dietary tolerance of foods, with crohns disease, is individual. If you suspect you have problems with these ingredients please check with your dietitian if the ingredient is OK for you, before trying the recipe. The recipes are designed for stage 1 of the LOFFLEX diet, but occasionally people can have reactions to foods in stage 1, so it is very important to keep in touch with your dietitian, when following the treatment.