Tag: Irritable Bowel Syndrome

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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.

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1612 – 2012 400 years since Lancashire witch trials and Lancashire hot pot.

 

Lancashire has a long tradition of matriarchs – Lancashire women take a no-nonsense attitude to life and are strong characters. This attitude may have been seen as a threat in past times and it’s maybe unsurprising that Lancashire was the scene of witch trials in the early sixteen hundreds, where 10 people (including two men incidentally) were hanged as a result of accusations and a guilty verdict of being witches. This weekend a commemoration of the events four hundred years ago took place around Pendle Hill, Lancashire. My husbands thoughts on this was that it shouldn’t be a celebration, “what’s to celebrate?” he remonstrated, these people were killed. My view is, it’s important that the date is remembered, I was heartened to read that Arthur Studdard a retired barrister, felt that these women should have been pardoned, but this has not happened mainly because of the length of time since it happened and the quality of evidence to review. He felt strong enough to request the Queens support. This weekend’s event did make me think about how far women have come in terms of equality, we have come some considerable way since 1600 I feel, but have some way to go yet perhaps. Another ‘event’ earlier on in the year was the discovery of a cats skeleton bricked up in a wall of a derelict house, found under a mound during a construction project in the area around Pendle Hill. This area is certainly dramatic, bleak and atmospheric, a climb up the hill on the anniversary in the cloud and mist certainly made you feel that there was something in the stories told of these women. The picture below is of a ‘snow witch’ on the side of Pendle hill (a strange coincidence – spooky ;-))

Lancashire hot-pot.

400g Neck or middle neck of lamb

250g Stewing lamb

Potato (waxy potatoes are best such as King Edwards)

2 Carrots

500 mls of water

2 Teaspoons of cornflour mixed in some water

Salt and pepper

Spray oil

Method

Peel carrots and potatoes, add lamb to a strong casserole dish.

Add water, cornflour and sliced carrots to the dish, add salt & pepper.

Slice potatoes to 3-4 mm thick slices and place on the top of the stew, spray with oil,

It is better to use a casserole dish with a well sealed lid if you have one – if not check the dish is not too dry, you may need to add more water during cooking.

Cook for at least 3-4 hours at gas mark 5 (traditionally this hot-pot was left to cook all day.)

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Bilberry and lemon fairy cakes – gluten free, low fodmap, dairy free, lactose free.

Went on the hunt for bilberry again – however a less successful foraging trip. Hiked for two and a half hours up hills, through bramble (will be back for bramble berries later next month!) and over bogs and moorland. I did find some, but less that last time and really only enough to add to cake, or breakfast, or yoghurt. I chose to bake some fairy cakes, as I will take some in to work on Friday and share them (keeps the family from eating them all – a good tip!) The weather was a little cloudy but I did see a little sun, I am glad that I decided to go in the morning as it is raining again now, but this is the reason we have such beautiful plants and wonderful countryside.

Ingredients

175g of wheat free gluten-free self raising flour*

125g dairy free margarine

175g of golden castor sugar

juice and grated peel of 1 lemon

A few bilberries (depends how many you can gather!)

1 cap full of vanilla extract.

2 eggs

Icing sugar and decorations (please ensure these are gluten-free if coeliac and following gluten-free diet, however a small amount of contamination from wheat should not cause a problem if you are following the Low FODMAP diet)

Method

Heat up your oven to gas mark 4.

Add margarine and castor sugar and vanilla essence to a mixing bowel and mix till pale with a hand mixer.

Add 1 egg and a tablespoon of the flour to the mix.

Mix till well incorporated. If the mix curdles slightly (starts to separate) you should add a little more flour.

Add the other egg and another tablespoon of flour and repeat the above process.

Grate the rind off the lemon and add to the bowl and mix well.

Add the flour and fold the mix using a metal spoon till all the flour is incorporated.

Cut the lemon in two and juice on half – add to the mixture and mix well.

Add bilberries and mix.

Spray silicone moulds with spray oil add some mixture to each, this makes about 15 buns.

Cook for 20 minutes or until golden and well risen.

Place on a cooling rack – do not remove the buns from the cases till fully cool, or you may find that they stick.

Juice the other half of the lemon and add to a bowl incorporate icing sugar into lemon juice till you have a runny consistency. Drizzle icing sugar over the buns and add decoration.

These are no higher in fats and sugar than normal buns – but they are high, so have one, don’t eat too many if you have IBS, as fat can cause symptoms if you eat too much. Share the rest with friends and see if they can tell that they have no wheat. *Please watch the flour if you are following a low fodmap diet as some gluten-free wheat free flour contains psyllium husk flour – to keep things moist, this can cause symptoms for some people.

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Low FODMAP Chicken casserole plus low fat processed food and food intolerances, incongruous ideals?

At my usual supermarket shop this morning I was very pleased to find a low dairy, low lactose own brand cream cheese. Wow – I thought – will have to give this a try, but as I always do out of habit I had a look at the nutritional information on the side of the carton. The amount of fat and saturated fat in the product was staggering 26.6g/100g of fat, 23.0g/100g of saturated fats, from coconut oil. Why is it that food that is meant for individuals who have to modify their diet as a result of allergies, intolerances or as a result of autoimmune conditions are higher in fat and calorie dense? You could argue that cream cheese is usually high in fat and you would be correct at 24g/100g of fat and 16g/100g of saturated fat but the free from brand is higher. It’s often the additional specially manufactured foods in a ‘free from’ diet that can be higher in calories than the standard alternative version, that means if you need to follow a specific diet you may be exposed to more calories as a result. Yes I do see people who are underweight and would really benefit from the extra, but I also see those who have problems in maintaining a healthy weight. For example some gluten-free bread is quite high in fat. Adding fat improves the taste and texture of free from food and you don’t often find a low-fat variety, it’s technically challenging I suppose. Yes, foods higher in fats and sugar are a treat – see recipe for chocolate covered coconut ice cream for an example, but when staples such as wheat free bread can be higher in fat this becomes more difficult to manage, if you need to control your calorie intake. Try and include plenty of alternatives such as rice, potatoes, lean meats, fish, vegetables and fruit in your diet (when tolerated) – those foods that are not processed are lower in calories, and often cheaper. This doesn’t mean you can’t have manufactured alternatives, as they are important to incorporate, to feel you are not being excluded too much, increase variety and help you to follow your diet, but try to keep these foods to a minimum of you are able. For the staples, such as bread, which is important if you need to take packed lunches, check the food labels of free from items and choose the ones that are lower in fats, sugar and calories when you can.

Check the label for nutritional information as well as the allergen labelling. Look at the following links:

http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling.aspx

http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling-terms.aspx

The following recipe is a low FODMAP chicken casserole.

700g Chicken Thighs (skins removed, trim off any visible fat – use thigh meat as it imparts a stronger flavour to the dish.)

3 celery sticks including leaves.

200 mls dry white wine

5 g Fresh thyme

1 dessert spoon of garlic infused olive oil

1/2 teaspoon of asafoetida

Juice of 1/2 a lemon

freshly ground pepper and dash of salt

Measure out wine in a measuring jug and add chopped thyme, olive oil, lemon, asafoetida, pepper and salt mix well.

Cut celery sticks and place in a casserole dish with the chicken thighs.

Pour over the mix and leave to marinade for 2 hours.

Cook for 1 hour gas mark 6/200 C remove from oven and allow to relax for five minutes.

This dish was served with low-fat roast potatoes made by par boiling for five minutes, drain off water and replace pan lid. Shake the pan to roughen the edges of the potatoes and use spray olive oil to reduce the amount of fat used. Roast till golden.

If wished you can pour off the liquid when the chicken is cooked to make a sauce, drain off the fat and discard and using a small pan pour in liquid and add cornflour mixed with a little water, to thicken.

Serves 4-6 people (but not my husband, who ate considerably more! This dish prompted a five-minute face wash from my cat after having a taste – a rare occurrence.)

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Paprika Meatballs – Low FODMAP

Ingredients

400 g lean beef meatballs (ensure no onion in ingredients)

400 g tin of chopped tomato

2 teaspoons of Spanish Smoked Paprika

2 teaspoons cornflour

1 teaspoon of cinnamon

1 teaspoon of granulated sugar

1/4 – 1/2 teaspoon of asafoetida

1 teaspoon of garlic infused oil

Method

Place meatballs in a casserole dish.

Pour the tomato into a measuring jug, add to this the paprika, cinnamon, sugar, garlic infused oil and asafoetida (take care to ensure that you place your asafoetida in a tightly sealed container – it smells very strong but adds a real depth of onion flavour to the dish.)

Then add this mix to the casserole dish.

Measure out the cornflour into a small dish and then add water to form a paste (cornflour is really great to use to thicken dishes – its wheat free and mixes very well with cold water – therefore NO LUMPS 🙂 yay!)

Add this to the dish and mix well.

Cook in a preheated over at gas mark 6, 200 C, for at least 1 hour (more if you can stand to wait to try it!)

Serves 4 – served here with freshly boiled rice and roasted marrow.

Low FODMAP, wheat free (ensure that asafoetida is pure if you have coeliac disease or a wheat allergy – it can sometimes be diluted with wheat flour) gluten-free, egg free, dairy free. Check spice labels for allergens.

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Violet and Chocolate Biscuits – egg free/wheat free/gluten free/low fat/Low FODMAP

150g Rice Flour

100g Soft Brown Sugar

50g dairy free low-fat margarine

125g pot of dark chocolate soya dessert (made from hulled soya beans)*

2 teaspoons cocoa powder (ensure gluten + Wheat free)

1 tsp of gluten-free baking powder

Crystallised violets.

Weigh all ingredients into a mixing bowl and mix using a hand mixer till the batter is smooth.

Draw heart shapes onto grease-proof paper and shape mixture, makes about 12 biscuits.

Cook for 5 minutes gas mark 170, then add one crystallised violet decoration to each biscuit, cook for further 10 minutes at the same temperature.

Cool and sprinkle with icing sugar

These biscuits are suitable for wheat free, gluten-free, egg free, dairy free.

Suitable for LOFFLEX when chocolate has been introduced with no problems and Low FODMAP – nb contains soya products check for other FODMAP ingredients and use products made from hulled soya beans – do not consume if soya intolerant.

updated 22.11.14

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