Fructose malabsorption – Page 2 – Clinical Alimentary

Infographics – making statistics in health fun IBS

Statistics for IBS shown as a health infographic – I love this method of sharing information.

December 30, 2012December 30, 2012

When making snow dragons and other mythical creatures, keep your energy up with chestnut biscuits!

These delightful biscuits have a crisp crunchy outside and a cake textured middle. They are so easy to make and do taste very sweet – ideal served with a sweet wine at Christmas, after walking in the snow (doing some exercise to burn off the calories, obviously!) Or after expending energy making snow men/creatures in the cold like the dragon in the picture above, we made him about 3 years ago. I often wondered what people thought of him, we made him along a country walk near to where we live, I think he probably lasted two or three days. The biscuits are wheat, dairy, egg and gluten-free and should be suitable for most people following a low fodmap diet – as long as you tolerate almonds, as almonds can be rather high in fodmaps but obviously, this also depends on how much you add to a recipe and you could always use more gluten/wheat free flour to replace the almonds if you are following the exclusion phase of the Low fodmap diet.

Ingredients

250g dairy free margarine

100g icing sugar

40g soft brown sugar

260g of wheat and gluten-free plain flour

40g of ground almonds

1 x 250g tin of sweet chestnut spread

Icing sugar to dust

Method

It couldn’t be easier – add all ingredients in to a bowl and mix with an electric mixer till all the ingredients have been incorporated into a stiff batter.

Spoon about a tablespoon size drop on a greased baking tray and cook at gas mark 6/200 degrees C, till nicely browned.

Place on a cooling rack and sprinkle with icing sugar, I’m not sure if they are really a cake or a biscuit – I suppose this depends on whether it goes hard or soft on standing (cake goes hard once stale, biscuits go soft.) Will have to let you know.

December 12, 2012December 12, 2012

Jules_GastroRDLeave a comment

Snack time – spicy paprika crackers Low FODMAP, wheat free, dairy free, gluten free

I have been meaning to look into snack ideas for the low FODMAP diet and wondering how to make crackers. I have been reading on the internet and the methods people use seem simple enough. This is my own recipe – but thanks to those whose recipes I have read – too many to mention individually. However special thanks goes to Jonathan Itchon see the link at the bottom of the page – for providing a ratio to make the crackers. Here is the recipe:

200g of plain gluten-free flour mix

150g of water

50g of olive oil

2 tsps of chilli powder (not a blend of spices, chilli ONLY)

1 tsp cumin

1/4 tsp of asafoetida

1 tsp of smoked paprika

1/2 tsp of salt

Add the oil to the water, place the flour in a mixing bowl and add the spices, mix well. Add the water/oil to the flour and mix till it has bound together, too wet and add a little more flour, too dry and add water – although the mix did come together very well. Place dough on a large piece of cling film and add another piece of cling film over the top. Roll the dough till it is VERY thin – thinner dough makes crisper crackers. Cut out with a pastry cutter. This is the most time-consuming bit. the dough is quite brittle so take care – or you can always add 1/2 tsp of xantham gum to make the mix more elastic. Place the crackers on an oiled baking tray and cook on gas mark 7, 220 degrees for ten minutes. Remove from oven and cool on a wire rack.

With 2 teaspoons of chilli powder these crackers are hot hot hot! Reduce the amount or exclude it altogether if you find that chillies don’t agree with your digestive system, or if you are making these for children – use animal cutters! Also the whole house was filled with the smell of asafoetida – just be warned! 😉 Also I don’t tend to use much salt in my cooking so they are perhaps less salty than you may be used to. If you have coeliac disease and are following a gluten free diet you must ensure that the spices you buy have not been contaminated with gluten containing grains – wheat, barley, rye. But these crackers were easy to make and has made me feel like trying different flavours – excellent, since ready-made flavoured gluten free crackers are rather expensive. Make some for your food intolerant friends today!

http://thecanaryfiles.blogspot.co.uk/2012/07/ratio-rally-gluten-free-vegan-grain.html

October 13, 2012

Jules_GastroRD2 Comments

“Read your labels” – retrospectively is no good! A reflection, a survey and slight feeling of dietetic hypocrisy.

It’s Saturday, I wake and stumble down the stairs bleary eyed, hairdo that wouldn’t look amiss on Edward Scissorhands. Cat’s breakfast is made first and then I make my morning cup of tea. First mistake of the day, I use cows milk – damn, now my inner consciousness devil voice starts to say “it’s only a splash of milk can this make a difference?, go on drink it” I think for a couple of seconds and decide that I will make another cup of tea with lactose free milk, then I make my porridge, again with lactose free milk. First critical lapse incident managed, cool!

Now for the confession. On Saturday I like to go for a coffee at a cafe and have my weekly treat a small biscuit or cake with my coffee. Now I asked for lactose free milk coffee – ok so far, and then chose a coconut macaroon, wheat free – I did enquire if this was the only wheat free choice and I was told it was. Now, I’m not that fond of macaroons but it was the only choice, so I bought it and sat down to drink my coffee and read the paper. The more savvy of you here will be shouting at the screen “DID YOU READ THE LABEL?”, did I? Well, err, (feeling REALLY sheepish) not before I had bought it and certainly not before I had eaten a good portion of the biscuit :-(. I then decided unconsciously to take a peek at the ingredients list. This is where I was totally disappointed with myself because guess what? Yes!! Someone had added a FODMAP to my biscuit. SORBITOL of all

I don’t go this far! No finger wagging in my clinic.

things, in my biscuit, I felt so disappointed and really guilty of hypocrisy. You may be wondering why I feel hypocritical, well, in my clinic when I see people who have to use special diets reading labels is very important. When it gets to this part I furrow my brow and look quite serious and say “reading your labels is very important to following your diet and here is a list of what to look for”. People often say when I see them again that they have made mistakes and a good proportion of those are through not looking at the label. I suggest to them that this is part of the learning experience and then the advice is then reiterated, read the labels FIRST, before you buy and certainly before you eat.

So, I have joined the ranks of people who make retrospective label reading mistakes, perhaps this is a normal part of changing your diet and maybe everyone does this? At least I suppose you read it to see and are then aware of your mistake, but the damage is already done. It really makes you consider human behaviour in this, why would I do this now, when I was successful earlier on in the day? Was it because earlier I had another choice available, do you think? How many of you make this mistake – perhaps we could do a survey?

Survey is anonymous and will close in 1 month – if you wish to know more check this out http://polldaddy.com/privacy/ or contact Polldaddy directly http://polldaddy.com/about/

October 6, 2012October 7, 2012

Jules_GastroRD2 Comments

Book Review IBS Free at Last – Second edition Patsy Catsos

This recently published book is based on the FODMAPs diet for irritable bowel syndrome. It’s a guide for those wishing to trial a low FODMAPs diet to alleviate symptoms; as such it is comprehensive, explains the diet fully and includes information about who should use this diet. It is safe, explanations about possible other conditions such as coeliac disease, which may be masked by going on wheat free diets, for example, are discussed fully. Dietetic treatment is vital to help with following the exclusion and reintroduction phases to ensure the diet is nutritionally complete and to give advice about eating out and shopping, finding onion and garlic free processed foods can be problematic, for example. Patsy has included common questions that patients have and answers these very well, useful for those following the diet and those who treat them. For USA patients this book does give examples of food plans and recipes – for those outside the US information about converting cups to grams may be useful for following the recipes and some of the medications and supplements mentioned may not be available in all countries. It is important to include information for those who do not get resolution of symptoms using this diet and this is mentioned. The book does not clearly detail other factors for consideration such as stress, anxiety and other areas such as behaviour around mealtimes, as it was intentionally written as a book about diet. Although written for the United States, this book is certainly useful for those who wish to know more about this new treatment for IBS, and would be a good accompaniment to those who are treated with by their dietitian. Healthcare professionals wishing to know more will also find it useful and it is fully referenced, it is available on Kindle and hardcopy from good book suppliers.