Digestive Health – Page 6 – Clinical Alimentary

Vegetable Pasta – gluten free, Low FODMAP

This recipe is a light roasted vegetable pasta sauce for use with gluten-free pasta. It is a great recipe for a warm summers day to eat alfresco.

Ingredients

1 tablespoon of garlic flavoured olive oil

1 teaspoon of cinnamon

1/2 lemon

1/2 aubergine

1 courgette

2 orange peppers

100 g black olives

Grated parmesan (vegetarian or vegan)

Method

Mix the oil, cinnamon and juice from the lemon and season with salt and pepper.

Chop the courgette and aubergine and then roast.

Roast the peppers separately, remove skin and blend till smooth

Add the roasted vegetables to the peppers and chop, add the olives.

Add to cooked warm gluten-free pasta and serve.

Sprinkle with parmesan cheese.

Updated 22.11.14

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June 8, 2014February 10, 2015

Jules_GastroRD4 Comments

Tapas

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This recipe is inspired by tapas dishes, usually filled with lots of garlic and onion – not great for people who are avoiding these ingredients. I hope you enjoy the recipe and the views of Barcelona!

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1) Spanish omelette.

This is a layered egg and potato omelette – minus the onions, but no worse because of it. It is probably best eaten warm, although if you don’t have a problem with resistant starches you could have it cold with a green leaf salad perhaps.

Ingredients

4 large eggs

4 potatoes

1 teaspoon of paprika

Oil/margarine to grease the dish, to prevent the omelette sticking to it.

Salt + Pepper

Method

Slice the potatoes thinly leaving the skins on for a little extra fibre!

Beat the eggs and add salt + Pepper

Rub margarine around your cooking dish and sprinkle around the paprika.

Par boil the potatoes and cool (don’t allow them to go too cold if you have a problem with resistant starch)

Add layers of potato and egg.

Weight the dish as it cooks so the egg penetrates all the layers.

Cook in a moderate oven till the potatoes and egg are cooked through.

2) Roasted paprika peppers

Ingredients

3 peppers – I like to use yellow and orange peppers as they look so nice but you can use any colour of pepper you feel like.

1 tablespoon of garlic infused olive oil

1 Teaspoon of smoked paprika (I used hot, but you can choose the heat of your paprika depending on your symptoms)

Salt + Pepper to taste

Method

Slice the top off the pepper and remove the stalk, slice the pepper. For the main body of the pepper again slice it but remove any white pithy material from the inside.

Add the oil paprika and seasoning and roast till soft – really couldn’t be simpler!

Low FODMAP, gluten free (check paprika contains no contamination) milk, lactose and fructose free.

January 19, 2014

Jules_GastroRD1 Comment

Taking your IBS on holiday – too scary to contemplate? Or perhaps it might help!

January is a time when we start to think about holidays later in the year. However many people who suffer from IBS don’t travel as a consequence of having symptoms. Travelling can be a daunting prospect if you suffer from symptoms of IBS, sitting for too long can make constipation worse or having dreaded diarrhoea and anxiety of not being able to access toilet facilities quickly, can often put people off travelling too far from home. I often find that people tell me that their symptoms can reduce on holiday so, might it be worth the aggravation of getting to your destination to have the symptoms improve once you are there? Here are some tips that might help and this has been posted in time for you to think about arrangements that you might need to make. This post was originally written for Patient UK last year.

1. Ensure you have plenty of time to get to the airport or to your destination if staying in the UK. Don’t rush, try to use travelling as part of the holiday experience. It doesn’t matter if it takes longer to get to your destination, sometimes using A road routes might be a good alternative to motorway travel, you can drive through some stunning scenery in the UK.

Infographic from Hertz https://www.hertz.co.uk/rentacar/misc/index.jsp?targetPage=scenic-drive-in-uk.jsp

2. Before travelling plan toilet stops along the route if driving in the UK – Patient UK have a very useful new app for this and perhaps more importantly, useful for those unplanned panic stops! See the link at the bottom right hand side of the blog.

Work within your symptoms – if they are worse at a particular time of day, plan to travel outside of those times if you can.

3. If flying or travelling by train book you seat in advance as near to the toilet as you feel comfortable – don’t forget your can’t wait card or translation card* have this in your hand luggage (just about as important as your passport!) Do check the train you are planning to travel on (and the station) has toilet facilities.

Chiltern Railways transformed via Thame Gazette. Lets hope that this is not just a superficial attempt at improving toilet provision.

Get up and move around, if you can, during your flight or train journey – this will also help your risk of blood clots!

4. If you suffer from food intolerances book your in-flight meal in advance contact the airline and discuss your needs with them. If you follow the Low FODMAP diet, or exclude any other foods, avoid foods that result in symptoms at least 48 hours prior to travelling.

5. Take some spare clothing, wet wipes or toilet paper in your hand luggage to freshen up and to use in emergencies. Use a discrete bag to store them in your hand luggage so if your bag needs checking at customs you won’t feel too embarrassed.

6. Do some research about the food in the country you are travelling to, sometimes patient organisations available in the country you are travelling to can be helpful if you are intolerant of gluten for example – https://www.coeliac.org.uk/gluten-free-diet-and-lifestyle/holidays-and-travel/

Don’t plan to do too much during your vacation – less is more! You are more likely to enjoy the experience if you choose one or two visits rather than a very packed itinerary.

7. Contact the hotel to discuss food requirements before you travel – or you may wish to go self catering if you have more than one food intolerance and would find it difficult to manage. Often plain food such as rice, chicken & fish are abundant so do think about your dietary needs when planning your holiday.

8. Be aware that toilet facilities abroad may be very different to what we are used too at home, again being prepared for this can help.

How to use a toilet demonstrated in 2012 by Bryce McGowan – Solomon Islands

9. Take some rehydration salts in your first aid pack as you can become dehydrated very quickly in hot climates especially if you experience diarrhoea. Ensure you have plenty of fluids to drink, 8-10 glasses are usually adequate but you may need more, dark coloured urine (wee) is usually a good indication that you are not having enough.

10 Be very aware and follow travel food hygiene advice at your destination, as the last thing you would want is a case of travellers diarrhoea during your holiday http://www.nhs.uk/conditions/Diarrhoea/Pages/Introduction.aspx More information on food safety abroad can be found at http://www.nhs.uk/livewell/travelhealth/pages/travellersillnesses.aspx

*Can’t wait and translation cards are available with the membership package for The IBS Network.

January 12, 2014

Jules_GastroRD1 Comment

Toasted quinoa and buckwheat salad – gluten free, dairy free, vegan

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It is a little more of a challenge to follow a free from diet if you are vegan and rely on pulses in your diet – I am going to attempt to produce more recipes to facilitate a good variety of foods for you to choose, during the exclusion phase, here is one recipe – but check out the links below for others.

Ingredients

25 g Mixed sunflower and pumpkin seeds

25 g Walnuts

25 g Pine nuts

1/2 Teaspoon of smoked paprika

1/2 Teaspoon of cinnamon

1/4 Teaspoon of ginger

1 dessert spoon of garlic infused oil

1/2 Lemon

2 Carrots

1 Red pepper

150 g Red quinoa

80 g Buckwheat

Spray oil

Method

Add the spices to the garlic infused oil and mix into the chopped nuts and mixed seeds.

Toast for 5-10 minutes in an oven – watch this closely as it can easily burn.

Remove from the oven and cool.

Add the buckwheat and quinoa to a pan and add some water to cover and simmer till soft.

Cool.

Chop the pepper and carrot into medium pieces and spay with oil and roast in the oven.

Mix ingredients together and add lemon juice.

Check the labels of the spices to ensure they are free of contamination with gluten if you have coeliac disease

Serves 4-6

https://clinicalalimentary.wordpress.com/2012/12/16/dippy-over-hummus-oh-sigh-to-find-a-low-fodmap-alternative

https://clinicalalimentary.wordpress.com/2012/10/13/snack-time-spicy-paprika-crackers-low-fodmap-wheat-free-dairy-free-gluten-free/

https://clinicalalimentary.wordpress.com/2012/10/04/midweek-low-fodmap-special-veggie-chilli-a-warming-meal-for-chilly-nights/

updated 22.11.14

December 28, 2013November 22, 2014

Jules_GastroRD2 Comments

Grains galore! Super? Or perhaps not……………

It appears that we have some grains that are ‘super’ according to the blogosphere, now I am not necessarily a fan of super foods which are proposed to be better for you than standard foods, but it is great for people with food intolerances, allergies or autoimmune conditions to have more of a choice in grains. So an increase in the range of these foods might be a good idea. So what is the low down on these newly promoted grains compared with standard grains?

Freekeh (contains wheat, gluten and likely contains FODMAPs and resistant starches)

This grain is essentially toasted wheat using early harvested green grain. The grain is harvested early before it has fully ripened. This results in a higher protein content than wheat and the grain has a really nice texture and a nutty flavour it is based on durum wheat species. The grain has been produced in the middle east for some considerable time, it is an ancient grain! Therefore we are being sold a product, likely at a premium, that has been cultivated for many years. It is not the choice that anyone with a wheat allergy, wheat or gluten intolerance or people with coeliac disease should consider, therefore perhaps it isn’t as ‘super’ as you might first imagine! It is higher in protein therefore may be higher in gliadin (gluten type protein found in wheat.) It might also be higher in resistant starches, good for those people who want to have a high fibre product to improve gut transit, but certainly not a perfect choice for those with digestive problems.

Quinoa (gluten-free, wheat free and Low FODMAP)

Could this grain be the answer, a true super grain? Actually quinoa is not a grain as such. It has all the essential amino acids (building blocks for protein) that are required for health, so it is an excellent choice for vegans to ensure that the proteins needed in the diet are consumed. It is also good for people who have coeliac disease and irritable bowel syndrome and those who have a wheat allergy (labels still need to be checked for contamination unfortunately) Getting more interested? I certainly am, however the only drawback is the expense of the flour – a whopping £5.75 per kilo, wow. As a grain it can also be challenging to produce recipes using the product, but it does taste nice when done well. I have not yet tried cooking with the flour, I can’t get over how much it costs. If anyone can find a cheaper UK source I might be tempted to send for some and give it a try for you.

Buckwheat (gluten-free and wheat free)

Despite it’s very confusing name this grain is not a wheat grain, it is related to rhubarb. Again this grain has a similar level protein to wheat at 12% and contains 90% of the amino acids needed for health. This grain makes great pancakes but I have not had the experience of using it to cook other recipes. Buckwheat can cause allergies in its own right and single cases of anaphylaxis have been reported in literature, but it is likely a rare occurence, more prevalent in countries that use it as a staple food. It is a great choice for those with coeliac conditions and wheat allergy.

Spelt (contains wheat, contains gluten but Low FODMAP)

Again this is an ancient wheat grain containing a lower level of fermentable carbohydrate however spelt pasta is not lower in FODMAPs – just the flour. This needs to be 100% spelt and it is better to choose bread made from spelt that has been made using the sourdough process. I have cooked with spelt flour and dishes produced have a nice texture and I have not had any failures with this flour. It could be a choice for those who have problems with fermentable carbohydrates but those with wheat allergy, gluten intolerance or coeliac disease should avoid this grain. Unfortunately there is a lot of misinformation about this grain, in general by people who do not understand the requirements of the gluten-free diet. People can believe it is suitable for those with coeliac disease because it has a lower level of gluten, however it is NOT gluten-free. I am not aware of any published information on what level of gluten needs to be avoided for those with gluten intolerance, therefore this flour may need to be avoided by those people with non coeliac gluten intolerance also.

Codex wheat (contains wheat, possibly FODMAPs but very very low gluten, therefore essentially gluten-free)

Codex wheat has been developed to replace wheat flour for people suffering from coeliac conditions, it is used in the UK by manufacturers of gluten free foods and generally for foods available on prescription, although its use in foods generally available to all is growing. The gluten content of wheat is processed by washing to remove the gluten and the wheat is then tested to ensure the content of gluten does not exceed guidelines. The benefit of codex wheat is that the texture of foods using the flour is a close approximation to those of normal wheat and therefore palatability is improved. It could contain fermentable carbohydrates, although what effect the washing process has on fermentable carbohydrates is not known for all available supply, the amount of fructans it contains depends on the type & processing of the bread, so it might not be a good choice for those with fructans intolerance. A recent research report by Whelan (2011) tested the fructans content of codex wheat and found variable amounts. It does contain wheat therefore it is not suitable for those who have wheat allergy.

Teff

Teff is an ancient Ethiopian grain that is gluten-free. It is widely used in gluten-free flour mixes and is a good choice, contains 13% protein and again an excellent amino acid profile, containing all the essential amino acids. The fructans and fodmap content of Teff is not known, but it is generally used in flour blends and gluten-free breads are generally tolerated by most people following the Low FODMAP diet although it has not be tested for FODMAP content.

Tricale

Tricale is a mixture or hybrid of wheat and rye grain. It is therefore not suitable for people with coeliac disease. The amount of fructans it contains is unknown, therefore it’s suitability for the low fodmap diet is unknown, however rye has high levels of fructans so it is probably best to avoid this grain. A Wiki article suggests the protein content is higher than wheat but the glutenin content is lower, but this does not mean it is suitable for use for those who have problems with wheat.

Kamut

Similar to Freekah, this is a middle eastern ancient grain, it’s true name is Khorasan, Kamut is a brand name. The grain manufacturers website suggests that this grain is high in selenium, this depends very much on the soil the grain is grown in. It contains wheat and gluten. It has a protein range of 12-18%. The companies nutritional analysis data can be found here:

Kamut nutritional information

Again fructans content is not available for this grain.

Updated 22.11.14

October 13, 2013December 15, 2014

Jules_GastroRD2 Comments

Bonsoir mes amis voules-vous des Madeleines sans gluten? Milk free, low FODMAP.

These little plump cakes are easy to make and are just the ticket if you want to have a little something sweet but don’t want to go overboard on calories, they are gluten-free, low fodmap and milk free. The secret is to eat one! I love France, particularly Paris I have been twice and still would love to go back. Here is the recipe:

Ingredients

130 g Castor sugar

2 medium eggs

Grated rind of 1 lemon + juice of 1/2 lemon

225 g of gluten-free self-raising flour

120 g of dairy free margarine

Method

Add the castor sugar, lemon juice and eggs to a bowl. Whisk over a pan of warm water until at least double the volume.

Melt the margarine and add the grated lemon rind, pour into a measuring jug.

Drizzle the margarine slowly into the batter and continue to whisk, then add the flour and mix slowly with a metal spoon until it is fully incorporated.

Allow the batter to cool and put a heaped teaspoon of batter into a Madeleine tray. Cook at gas mark 6 until risen and golden.

Remove from the tray and cool – makes about 18.