Some days are just hard….

…no matter what you do. No matter how well you eat, how much you rest, sometimes having fibromyalgia and IBS just kicks your butt (and your gut). Your body is at war with itself, and the only way you can survive is to retreat—at least for a while.

For the past few days I’ve been having a hard time getting my GI tract to settle down. I thought I was sticking to low-FODMAP foods, but I was still feeling lousy after every meal. The discomfort wasn’t only lower GI, either—I was nauseated, even by things that I usually tolerate pretty well, like oat cereal and (sadly) my treasured one cup of morning coffee. Then I realized I’d probably been eating out too much—even though I thought I was making good choices from my personally vetted list of menu items at “safe” restaurants. The truth is, no matter how innocuous someone else’s cooking seems, you can never be sure exactly what’s in it. Sigh. So it’s time to go back to basics—home-cooked, reliable, and (again sadly) pretty bland meals—at least until the gut calms down again.

So what are my standbys for days when the tummy is extra temperamental? For breakfast, brown rice with warm almond milk and a pinch of brown sugar and cinnamon. Half a ripe banana. For lunch, a small turkey sandwich with a bit of mayo on gluten-free bread. For dinner, plain grilled chicken breasts and baby potatoes or carrots roasted with a little olive oil. And, to drink, my favorite nausea-reducing beverage, Ginger Green Tea. I keep a jug of this in the fridge most of the time. It couldn’t be simpler to make: just put two tea bags each of 100% ginger tea and decaffeinated green tea in a two-quart/liter pitcher or bottle and fill with cold (preferably filtered) water. Cover the pitcher and refrigerate. The tea is ready to drink in about two hours. (If the brew is too gingery for your taste, use only one ginger tea bag.) I like Traditional Medicinals ginger and Bigelow’s green decaf, but of course any brands will do. 

Fight on.

You Deserve a Cookie!

When you first discover that if you want to stop being in pain all the time, you have to stop eating a bunch of the stuff you like, it can be depressing. I felt pretty sorry for myself for a while, deprived and anxious. How could I be happy without ever again enjoying a ripe peach, or sauteed onions, or a crusty baguette?

Then I decided: the hell with that. If life was giving me the proverbial lemons, I was going to make the best damn lemonade ever. Or at least the best damn cookie.

Sometimes the only cure for deprivation is a sweet treat. Fortunately, recipes for baked goods are pretty easy to modify for low-FODMAP and gluten-free diets, especially once you find an alternative flour blend that suits your needs. As I’ve mentioned in a couple of earlier posts, I’ve had good luck with Pamela’s Artisan Flour Blend.

These cookies are pretty simple, relatively healthy (half the butter of most similar recipes I’ve seen), and astonishingly tasty. My family (none of whom have FODMAPs or gluten issues) love them. They freeze well, too. Give ’em a try, and let me know what you think.

BEST-EVER OATMEAL CHOCOLATE CHIP COOKIES

The Breakfast Chronicles, Part 3: Blueberry Buckwheat Pancakes

I love buckwheat pancakes, but they can be very heavy and dense if you don’t mix the buckwheat with some other kind of flour. Most recipes call for part white or whole-wheat flour, but we IBSers tend not to be able to tolerate the fructans in wheat.

After much research and testing, I’ve found an alternative flour I like that’s not only gluten-free but low in FODMAPs: Pamela’s Artisan Flour Blend. Here are the ingredients: brown rice flour, tapioca starch, white rice flour, potato starch, sorghum flour, arrowroot starch, sweet rice flour, guar gum. I found it at my local Sprouts, but it’s also available online at http://pamelasproducts.com. (One note: Pamela’s offers a lot of different baking mixes, but many of them seem to contain non-FODMAP-friendly ingredients, like honey, molasses, or inulin. So, as usual, be sure to read those labels before you buy.)

Buckwheat pancake recipes also tend to call for buttermilk—again, to help counteract the heaviness of the buckwheat flour. Buttermilk is another high-FODMAP ingredient, though, so I substituted half lactose-free yogurt and half almond milk, and it worked quite well. The cakes came out light and fluffy, but still hearty.

So here’s the recipe. This quantity of batter makes about eight large (five- to six-inch) pancakes, and I find a serving of two completely satisfying. (I made them so big because my blueberries were large and probably wouldn’t have been supported by a smaller cake; you can adjust the size according to the berries you have. I think the recipe would also double well.) If you try them, let me know what you think!

Blueberry Buckwheat Pancakes

The Breakfast Chronicles, Part 2

Polenta: would coarse corn grits by any other name taste as sweet? Oh, probably—but I think their Italian name makes them even more appealing.

I love polenta. You can put anything on it that you can put on pasta, but it’s way more versatile. For instance, you can eat it for breakfast—and not just as mush in a bowl.

I made polenta last night to go with a pan-roasted pork tenderloin and some red Swiss chard sauteed in garlic-infused oil. After cooking the polenta (following the recipe on the Bob’s Red Mill bag), I poured it into a loaf pan and let it set up while I made everything else. Just before we were ready to eat, I turned the polenta out of the pan, cut it into 1/2-inch slices, topped it with a little grated Parmesan, and popped it into the toaster oven (on a piece of heavy-duty foil) for about 10 minutes. It had a slightly crispy crust, but was still creamy inside—the perfect foil to the peppery pork and bitter greens.

Best of all, there was some left over. I warmed up a couple of slices in a skillet with a bit of butter, topped them with warm maple syrup and blueberries, and bingo: a weekend-quality breakfast on Thursday. SO much better than oatmeal, and equally easy on a grumpy gut.

Speaking of blueberries, the stores are finally getting some tasty U.S.-grown ones in, so I’m planning to make my very favorite blueberry-buckwheat pancakes this weekend. Stay tuned for pix and the recipe.

The Breakfast Chronicles, Part 1

Ever since I was a little kid, breakfast has been my favorite meal. Not so much the standard American eggs and bacon, but the sweet, starchy, Sunday-morning-special kind of breakfast: pancakes, waffles, coffee cake….mmmm. When I grew up and discovered good coffee, the bliss was complete.

One of the first things I learned to cook was French toast. It was as yummy as pancakes, but you didn’t have to follow a recipe—just beat up those eggs, splash in a little milk, some vanilla and cinnamon, dunk the bread, fry it up in butter, drizzle on the syrup—heaven! I went through a low-carb period some years back (didn’t everyone?), and while the initial weight loss was nice, the diet was doomed when I realized I’d never again eat real French toast. Yes, I did try making it with low-carb bread, but frankly, I’d rather eat a fried sponge. And it turned out that the low-carb syrups I’d been buying were sweetened with sugar alcohols, some of the biggest, baddest FODMAPs around. Ugh–once again I’d been unwittingly making myself sicker in the name of “health.” Thankfully, real maple syrup is one of the sweeteners IBSers can safely eat.

So, given the necessity of French toast in my life, one big challenge has been finding bread that doesn’t contain FODMAPs. I didn’t expect this to be so difficult, given that there are dozens of alternative-grain breads on the market. But most of them are intended for gluten-free diets, and gluten-free isn’t necessarily FODMAPs-free. Most breads I’ve found have at least one ingredient—honey, molasses, fruit juice concentrate—that isn’t good for those of us who are sensitive to fermentable sugar molecules. For a while, I thought I’d hit the jackpot with Udi’s white sandwich bread, which had the added benefit of being readily available at Trader Joe’s; but close label reading revealed that it contains inulin. Sigh. The search continued.

Then I came across Glutino white sandwich bread, made in Canada by the Genius bakery. Here’s the ingredient list: water, potato starch, corn starch, canola oil, tapioca starch, dried egg whites, rice bran, cellulose powder, yeast, inverted sugar, sugar, salt, modified cellulose, xanthan gum, calcium sulfate, enzymes. Nothing bad! Unlike some of those gluten-free breads, it has a nice light texture and a normal taste, sort of like old-fashioned homemade white bread. It makes a decent sandwich, but, more importantly, it makes great French toast.

The down side is that it’s a little hard to find, and it’s kind of pricey (but no worse than the gluten-free stuff). I came across it at Sprouts (in the freezer section, with the other weird breads), a “ranch market” grocery chain that’s appeared in Southern California in the past couple of years. I haven’t yet checked Whole Foods, but I wouldn’t be surprised if they carried it too. As far as I can tell, you can’t order it online from the manufacturer (www.glutino.com), but their website does have a “find a retailer” link that might help you track it down. If you try it, let me know what you think!

So what are these FODMAPs you speak of?

I know, it’s kind of a weird acronym….in the beginning my eye insisted on seeing it as FOODMAPs.

For the best and most complete explanation, I strongly recommend you buy Patsy Catsos’s book, or at least check out her website (there’s a link on this page). She’s the scientist; I’m just a grateful fan who thinks her work ought to be more widely known. That said, however, I can offer a brief summary, just to get you started.

FODMAPs stands for Fermentable Oligo-, Di-, and Mono-saccharides And Polyols. These are carbohydrate molecules (several different kinds of sugars and fiber) that “may be poorly absorbed in the small intestine, and…are the favorite foods of the bacteria that live in the large intestine. When bacteria eat FODMAPs, a lot of gas is produced. FODMAPs can act like a sponge to draw and hold excess fluid in the large intestine….People with IBS experience this as a painful bloating sensation. They may pass an excessive amount of gas or have watery diarrhea, constipation, or both. Chaos! I would have liked to name this group of carbs ‘Chaos Carbohydrates'” (IBS—Free at Last, p. 5).

So, for those of us with very sensitive guts, FODMAPs are little better than poison; yet they occur in the some of the “healthiest” foods around: apples, peaches, pears. Broccoli, cauliflower, kale, asparagus. Whole wheat, lentils, black beans. Pistachios. They’re also in things some of us can’t imagine cooking without, like onions and garlic, and in things we’re barely conscious of sticking in our mouths, like sugarless gum.

Not every sensitive person is sensitive to all FODMAPs, however. Everyone has slightly different tolerances. So the bulk of Patsy’s book focuses on the FODMAPs elimination diet, whereby you find out which of the many suspect molecules are your particular triggers. Basically, you eliminate all of them from your diet for two weeks, then add them back one at a time and note which ones give you symptoms. You then construct a personalized eating plan that encompasses the widest variety of foods you can tolerate.

One caveat: as Patsy emphasizes in her book, you should first be sure you actually have IBS and not some other GI disorder (celiac disease, for instance) before attempting any do-it-yourself diet modification. And beware of confusing gluten-free and FODMAPs diets. There’s some overlap, because by avoiding wheat (a FODMAP) you’ll also avoid gluten; but gluten is a protein, and FODMAPs are carbs, so the two diets address quite different issues. And finally, again, I’m not a biochemist, a physician, or a dietitian, and none of what I say here should be taken as medical advice. I’m just reporting what’s worked for me and might work for you.

More to come….

Eating for IBS: everything I thought I knew was wrong

Freud is supposed to have said, “Anatomy is destiny.”  Close, but no ciggie, Siggie: physiology is destiny.

Or at least that’s what I think after living with fibromyalgia syndrome (FMS) and concomitant IBS for the past decade. As anyone with either of these conditions knows, they can’t be cured; the best we can hope for is to “manage” them so as to minimize our pain and maximize our functionality.

Problem is, there’s a lot of bad, or at least contradictory, advice out there about what constitutes said management. This is certainly true for FMS, but it’s even truer for IBS. The only guidance MDs have ever given me on controlling my IBS symptoms is to “eat a healthy, balanced diet”—the current definition of which includes lots of vegetables, fruits, whole grains, beans/legumes, and non- or low-fat dairy. Dutiful patient that I was, I did my best to follow this prescription. And I got sicker and sicker.

Then, almost by accident, I discovered the FODMAPs elimination diet. After reading dietitian Patsy Catsos’s book IBS—Free at Last, I started eating in a way that suits my particular physiology, and my gut is happier than it’s been in years. Amazingly, though, I have yet to talk to a single person (including doctors and fellow sufferers) who’s heard of this approach to treating IBS. Except for Patsy and a few others, there don’t seem to be many folks writing about FODMAPs on the Internet either. The literature I’ve found is pretty good at explaining the science behind the diet and providing lists of foods to eat and avoid; but it doesn’t address practical concerns very well. Which alternative pastas are closest to the real thing? Does ANYONE make bread I can eat? And please, can’t someone give me a recipe for decent spaghetti sauce that doesn’t have garlic or onions??

That’s where I come in. I want to share here what I’m learning about shopping, cooking, and eating the low-FODMAPs way. I hope you (and your gut) find it helpful.