Because It's Never 'Just' IBS

Hi again Fodmappers

It seems that most weeks I find myself talking to someone who has been diagnosed with IBS but who is sure their doctor has got it wrong. They are genuinely suffering and feel sure something has been missed. They wonder whether they may have Coeliac disease or Crohns or worse.

And it seems to me that they are sure it can't be 'just' IBS because we've all been led to believe that IBS is a trivial illness.

IBS is the kind of thing that comedians like to poke fun at. Sean Lock is one comedian who jokes about IBS, but he also says ".. IBS isn’t that bad, is it? I’ve got a sister-in-law who has it." Some people have even had their doctors tell them it's 'just' IBS. For the record, I once saw a doctor who told me it would 'pass'. It seems doctors are comedians too. Just.

So let's get this straight. There is no 'just' about IBS.

IBS is a nasty illness which affects every part of your life. It's not 'just' the bloating and the way that, over a few hours, you can appear to have become several months pregnant. Neither is it 'just' the way your bowels develop a life of their own, apparently rebelling against you at every opportunity. It's certainly not 'just' the intense pain which the pain killers don't seem to touch. It's an awful lot more.

It's the way you begin to fear for your job as you are taking more and more time off work.

It's the way you're surviving on very little sleep as finding a comfortable position at night seems impossible.

It's the look on your friend's faces when you make another excuse not to go out for food.

It's the way you've had to give up on that yoga class as you can't trust your belly to stay silent for that long.

It's not being able to remember the last time you did anything spontaneously.

It's having to cancel that trip at the last minute.

It's being scared to eat.

It's the way you lack the energy to carry out the simplest tasks.

It's the way your whole life seems to revolve around knowing where the nearest loo is.

It's the way your friends and family don't quite understand.

It's the embarrassment of it all.

It's the way it knocks your confidence.

It's the way it drags you down. 

And yes, much of that is true for others who suffer with chronic conditions, but we wouldn't (I hope) trivialise those. Having said that, I have a lot of sympathy for people with M.E which, until fairly recently, was referred to as 'yuppie flu'. Talk about trivialising!

So this week I was pleased to discover a petition started by the IBS Network to 'recognise it's not 'just' IBS'. (You can find out more about the IBS Network here.) It strikes me that this is exactly what is needed. But because IBS is embarrassing I do wonder how much publicity this campaign will get.

So, if this is something you feel strongly about, please add your name to the petition and let's stop trivialising this awful condition. It's a small step but you never know, it might 'just' make a difference.

'Til next time Fodmappers - Stay Fabulous. x

Can A Gluten Free Diet Help IBS?

And how is that different from a low-fodmap diet?

Hi again Fodmappers

I've noticed that there seems to be a lot of confusion surrounding gluten and whether going gluten-free can help reduce the symptoms of IBS, so that's what I want to talk about today. I also want to look at why you need to avoid wheat, barley and rye as part of a low-fodmap diet, and, finally, why some gluten-free products are not suitable for a low-fodmap diet. But first lets look at the difference between gluten and FODMAPs.

Gluten vs FODMAPs

Gluten is a protein (or more accurately a combination of two proteins) found in grains, particularly so in wheat but also in rye and barley, and it is this which gives dough it's stretchy quality. If you have bought flour for baking bread you will probably have bought a 'strong flour' as this type contains more gluten than the flour you might use for cakes or biscuits as bread making needs the elasticity that gluten provides. It's gluten that is a factor in coeliac disease.

Approximately 1 in 100 people in the U.K have coeliac disease. 'Coeliac disease is not a food allergy or intolerance, it is an autoimmune disease. In coeliac disease, eating gluten causes the lining of the small intestine to become damaged.' (1) People who have coeliac disease need to avoid ingesting even the smallest amount of gluten as to do so can cause further damage to the lining of the gut.

Fodmaps, on the other hand, are a group of carbohydrates found, not only in grains, but also in fruit, vegetables, nuts, pulses and dairy produce. 'Current research strongly suggests that this group of carbohydrates contributes to IBS...' (2)

IBS is much more common than coeliac disease, affecting between 1 in 4 and 1 in 10 people at any given time. (3) Though it is a chronic condition, it is a functional disorder. That is to say, the problem is in the way the gut functions, rather than in any damage to the gut itself.

Though wheat, barley and rye contain gluten they are also high-fodmap, and this seems to be where the confusion arises.

If you have IBS you may have discovered that you feel better if you eat gluten free products rather than wheat-based breads, biscuits, cakes, pastas and cereals. However, this is likely to be because, by choosing gluten free, you are also removing high-fodmap grains (such as wheat, rye and barley) from your diet.

A Gluten Free Caution

But if you have IBS, you do not need to avoid gluten, you need to avoid fodmaps. In fact fodmappers need to be careful when choosing 'gluten-free' as these products are designed for people with coeliac disease not IBS. Just because they are gluten-free doesn't mean they are necessarily low-fodmap. Remember fodmaps are found in more than just grains, and gluten-free products may also contain soya flour, apple fibre or inulin (from chicory) all of which are high-fodmap.

So the short answer to the question, 'can a gluten free diet help IBS?', is yes. But it has nothing to do with gluten. I hope that's cleared things up a bit?

'Til next time Fodmappers - Stay Fabulous. x

1. https://www.coeliac.org.uk/coeliac-disease/myths-about-coeliac-disease/
2. http://www.med.monash.edu/cecs/gastro/fodmap/
3. http://www.aboutibs.org/site/what-is-ibs/facts/

Chachouka

 

Hi there Fodmappers - Well as promised here's another yummy vegetarian low-fodmap recipe for you. My lovely man made this for our supper last night - aren't I the lucky one? It's adapted from a recipe in Hugh Fearnley-Whittingstall's book 'River Cottage Veg Every Day' where it is described as a 'spicy North African pepper and tomato stew' which makes a 'lovely, lazy supper'. It would also make a rather tasty breakfast!

The instructions below are pretty much true to the original recipe except with a few low-fodmap changes. Of course you can adjust the spices according to your preference. Personally I like a bit of spice - it makes up for all the things us fodmappers go without.

3 tablespoons garlic infused olive oil

1 teaspoon cumin seeds

The green part of some spring onions

1 red and 1 yellow pepper (seeded, cored and sliced)

Half teaspoon hot smoked paprika

A pinch of Saffron

Half carton of Passata

4 eggs

Salt and pepper 

Heat the oil in a large pan over a medium heat. Add cumin seeds and spring onion greens and fry until soft. Add the peppers and continue to cook over a medium heat until these have softened. Add paprika, saffron, passata and salt and pepper. Simmer for approx 15 minutes, stirring as needed. Meanwhile heat the oven to 180C/gas mark 4. After 15 minutes, transfer the contents of your pan into an ovenproof dish. Make 4 little indentations in the top of the mixture and crack an egg into each. Bake for 10 to 15 minutes.

Serve with some salad or wheat-free bread. Enjoy.

Low-FODMAP Veggie Summer Salad

This salad has become a firm favourite in our house this summer. I don't think it needs a recipe as such as I'm sure you can see most of the ingredients (sweet peppers, cucumber, tomatoes, radishes, olives, salad leaves and feta) and it's fun to adapt it to your own tastes. The one thing you can't see from this pic is the Quinoa base.

Quinoa is still a bit of a recent discover for me. It's low-FODMAP (of course) and gluten free so it can be eaten by people with IBS and also those with Coeliac disease. It is a complete protein and high in magnesium and iron and contains both soluble and insoluble fibre for good digestion. It also contains calcium so is a great addition to a vegan diet. I'm vegetarian, rather than vegan, so I get to enjoy a bit of both the feta and the quinoa.

The salad is dressed with a splash of olive oil and a sprinkle of sea-salt - but a squeeze of lemon juice could work well instead.

Enjoy.