IBS – Page 20 – Clinical Alimentary

Gluten Free, Low FODMAP, Low Fibre, tea scones

Afternoon tea is an English tradition that is now only consumed for a birthday or other celebrations and one of my favourites for a treat. It should contain sliced sandwiches, a scone with jam and small cakes. The following is a recipe for plain scones.

Ingredients

250g of gluten-free self-raising flour

50g of olive oil based spread

50g of castor sugar

1 pinch of salt

40mls of milk

1 egg

(1 egg to use for an egg wash and sugar for coating the scone.)

Method

1. Weigh out the flour and add the olive oil based spread, sugar and salt to the bowl

2. Rub the margarine into the flour until you have a small crumb

3. Add the egg and milk and bring the mix together – remember the more work you put into this the better the mix will stay together, it really is not like working with wheat flour!

4. Roll out to a 1.5 cm thickness and cut out scones.

5. Wash with egg and sprinkle with sugar and bake in an oven for 15-20 minutes at gas mark 6 22o°C.

You could add a teaspoon of gluten-free baking powder to increase the rise of the scone – I didn’t – as I tend to feel that you can taste baking powder in scones if you use too much.

February 15, 2014

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Haddock Florentine with mustard roasted carrots (gluten free, low lactose, Low FODMAP)

It’s grim ‘up north’ today, the weather is grey and dismal at February’s threshold, still winter then? Few frosty mornings have occurred to evidence winters grasp on the landscape, just sodden foliage and waterlogged boggy moor – a relentless morass. The trees are coated in a thin layer of moss and everything is damp and dismal – great weather for ducks, but pretty uninspiring to everyone else! The ‘mood’ of the woods brings to mind one of my favourite poems by Rudyard Kipling, evoking feelings of nostalgia at its reading. It’s haunting theme I feel is more about sadness and loss, and I am often reminded of it whilst wandering in the woods around West Yorkshire –

The Way Through the Woods

They shut the road through the woods
Seventy years ago.
Weather and rain have undone it again,
And now you would never know
There was once a road through the woods
Before they planted the trees.
It is underneath the coppice and heath
And the thin anemones.
Only the keeper sees
That, where the ring-dove broods,
And the badgers roll at ease,
There was once a road through the woods.

Yet, if you enter the woods
Of a summer evening late,
When the night-air cools on the trout-ringed pools
Where the otter whistles his mate,
(They fear not men in the woods,
Because they see so few.)
You will hear the beat of a horse’s feet,
And the swish of a skirt in the dew,
Steadily cantering through
The misty solitudes,
As though they perfectly knew
The old lost road through the woods …
But there is no road through the woods.

http://www.kiplingsociety.co.uk/bookmart_fra.htm

Summer is some way off – need something warm and tasty bring comfort and lift the mood? This is a really nice fish recipe for using up any stale or spare gluten-free bread (if you have any that is!) Otherwise you could use shop bought gluten-free or rice crumbs, which is more easily available to you. It is warm and filling and not too hard on delicate malfunctioning digestive systems. Fish is not cheap these days but this dish works well with smoked river cobbler too which will help with the cost, tinned spinach is also a useful standby to use. If you suffer from bloating from resistant starches you could make the dish without the breadcrumbs if you wish.

Ingredients

1/2 packet of gluten-free/wheat free bread crumbs

2 smoked haddock or river cobbler fillets

1/2 pint of lactose free skimmed milk

3 teaspoons of corn flour

10 g of margarine

1 teaspoon of freshly grated nutmeg

25 g Gruyère

12 g of parmesan

1 tin of spinach

Method

Make the sauce, melt the margarine and add cornflour mix to a paste and slowly add milk till all the flour has been incorporated and add grated nutmeg, Gruyère and salt to taste. Mix till thickened, cool.

Wash the spinach and layer in the bottom of an oven proof dish, cut the skin off the fish and add a layer on the top of the spinach. Coat the fisn layer with the cooled sauce. Add salt and pepper to the dish.

Sprinkle breadcrumbs on the top of the sauce and cover with the grated parmesan.

Cook in a preheated oven at gas mark 5 or 180ºC. Serve with mustard carrots (roast carrots with a small amount of garlic infused oil and grained mustard.)

February 1, 2014February 1, 2014

Jules_GastroRD

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

Tomato free moussaka – low FODMAP

Moussaka is one of my favourite dishes, in my humble view it has to have cinnamon included – and lot’s of it. You might feel that adding a spice used in sweet dishes in the UK sounds strange, but it rounds off the flavour really well. It can be a high calorie dish particularly when lamb is the main component but it is possible to reduce the high fat load. I may be performing moussaka sacrilege by suggesting that it can be made without tomatoes, but I feel the essential flavours are included, so the dish doesn’t miss much by not using them.

Ingredients

2 medium aubergines

1 tablespoon of garlic infused olive oil

4 potatoes

500 g lean lamb mince

2 teaspoons of cinnamon

1 teaspoon of asafoetida

2 teaspoons of dried oregano

1 pint of skimmed lactose free milk (Yes you can get it now!!!)

75 g grated strong mature cheddar

2 eggs

200 ml of red wine

1/2 teaspoon of gravy browning

100 ml of water

4 teaspoons of cornflour

Salt & pepper to taste

Method

The method is time-consuming but I don’t eat this dish regularly, I usually have it on special occasions so it is worth making an effort to make it well.

1) Dry fry the mince and add cinnamon, asafoetida, oregano and gravy browning. Drain off the cooking juices and allow the mince to cool. Put the cooking juices in the refrigerator till the drained lamb fat has gone solid, scoop off the fat and throw it away.

2) Pour the remaining cooking juices in a frying pan, add red wine, water and cook. Mix 2 teaspoons of the cornflour with a little water then add to the gravy, cook till thickened.

3) Slice the aubergines into 4-5 mm circular slices, sprinkle with olive oil and roast in the oven till brown. Cool.

4) Slice the potato to the same thickness as the aubergine and par boil for 10 minutes – do this just before you are ready to assemble the dish, you don’t want them to go cold.

5) Grate the cheese, pour the milk into a pan and add the cheese and the rest of the cornflour (mixed with a little water.) Cook till thickened, cool and add the eggs – mix well.

6) Add a layer of aubergine, potato, meat – add gravy. Continue to build up the layers till the ingredients are used up. Pour the cheese sauce on the top.

7) Cook for 1 hour at gas mark 6 (200°C), or until the potatoes are soft and the top has browned.

Serves 6

January 18, 2014

Jules_GastroRD4 Comments

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