A diet for a normal life
When dietitian Sarah Elliott was told she had Crohn's disease as a teenager, she felt as though she'd been handed a life sentence.
But, despite many highs and lows over the past 14 years, she has the inflammatory bowel disease to thank for shaping her career instead.
It all started when she was diagnosed with the condition as a 19-year-old. She was told by her specialist she had an incurable disease, that she would have to be under a specialist and on medication for the rest of her life and that not even changes to her diet could help.
"At 19, being told you have an incurable disease and that you'll have to be under medication for the rest of your life is really a sense of doom," says Ms Elliott.
"To feel that you have no control over it or no options on how to help yourself rather than take medication, which can have side effects, was all very scary."
Determined to better control her condition alongside the medications, she began playing with her diet in an attempt to identify the foods that made her symptoms worse.
"It was all through trial and error. There was no-one out there who could help diet- wise, it was a matter of identifying foods that made me feel uncomfortable."
Today, with the help of medications and through careful manipulation of her diet, the 33-year-old has Crohn's well under control. In fact she's been in remission for seven years.
Not only has she gotten to the other side of Crohn's, Ms Elliott has also discovered a career path to help others like herself along the way.
At the time of diagnosis she was studying for a Bachelor of Education, wanting to become a teacher, but once she developed Crohn's she changed her mind.
"Being told a flat out 'no', that diet wouldn't help my condition, and then finding that manipulating my diet did impact quite significantly on how I felt on a day-to-day basis made me realise I wanted to become a dietician. It was out of frustration really, and it just made such sense."
After 4 1/2 years of study, in 2002 she became a qualified dietitian. These days she splits her time between her job as an immunology dietitian at Wellington Hospital, in private practice trading under the Food Savvy banner and as a mum.
While she focuses on food allergies, food intolerances and eating disorders, she specialises particularly in diets for people with bowel disorders.
"It's become my niche because of my own condition. People pick up the compassion and understanding that I have for it, and I know the implications of the diet because I live it as well."
Whatever the diagnosis, Ms Elliott develops individual eating plans for her patients and works hard to educate them on how to eat to manage their conditions.
"When it comes to food allergy, it's about making sure people understand where the foods they're allergic to are found, that food groups are often labelled in different ways, and teaching them about cross- contamination, such as bulk bins and delis."
Nine times out of 10, through allergy tests, education and the right eating plans, patients can effectively manage food allergies.
In more severe cases, food intolerances in particular, patients will be put on liquid-only diets, where foods are slowly reintroduced to determine the cause of their problems.
"These conditions can affect people's quality of life so significantly that they are willing to try anything.
"We're talking people who can't sleep because of their eczema, who can't breathe because of their asthma, who can't go out because they've got such bad diarrhoea. You don't realise how much some people suffer silently.
"Making people feel empowered about the way that they eat and being able to have more control over their symptoms rather than their symptoms controlling them, and being able to switch that balance is really liberating for people and I love being part of it."
One diet Ms Elliott is particularly passionate about is the low FODMAP diet, which reduces poorly absorbed sugars in the diet and can be useful to control symptoms of irritable bowel in some people.
She's currently working with fellow dietitians and the gastroenterology department at Wellington Hospital to use the FODMAP diet with patients with irritable bowel syndrome (IBS) - with or without inflammatory bowel disease.
She's also working on a specific information sheet that GPs can use to help identify people who might benefit from the diet.
She says the FODMAP diet will benefit a proportion of people with bowel problems, and claims it has been the secret to her own success in managing IBS associated with her Crohn's.
"When I gave it a try I was able to become less restrictive with my diet. I had been gluten and dairy-free, but FODMAP made me realise it wasn't all gluten and dairy, which meant I could refine my eating and eat more foods like cheese and spelt." Ironically, her husband, Shepherd, is a chef, and these days, thanks to FODMAP, she has a huge enjoyment of food and a great appetite.
"I don't have any issues so long as I stick to the foods I know my body can tolerate. I'm not held back by anything."
It's a far cry from the days when Crohn's took control of her life, the lowest point at the age of 23 when she was extremely unwell, having also developed osteoporosis and anaemia, which can be the unfortunate effects of having Crohn's disease.
"I was underweight, I'd lost about six to seven kilograms, it would take me half an hour to eat a sausage, I had to take painkillers before I could even get out of bed and I couldn't walk very fast because the motion of walking would cause intense pain. I remember being very upset at not knowing if I'd ever get better, wondering why me, why did I have to get something like this?
"Now I'm healthy. My condition is well managed. I don't have osteoporosis anymore. I have lots of energy. I exercise without pain. I'm able to work, and, best of all, I've married my partner of 14 years and we have a 23-month-old daughter, Neiva."
Ms Elliott advises anyone with bowel problems to first enlist the help of their GP, dietitian and gastroenterologist to help manage their condition.
Most of all, she says, don't give up hope.
"People don't realise that Crohn's disease, when it's not well managed, has a huge impact on your quality of life - you worry about where you can go out, where are the toilets. You don't want to go to friends houses because the toilet might be too close to the living areas. It really can cause a lot of anxiety on a day-to-day basis.
"I don't feel any of that anymore. I don't worry when I go out. I'm living proof that Crohn's can be well managed and that you can have a very, very normal life."
Ms Elliott is part of a new national support group for sufferers of Crohn's disease and ulcerative colitis. Crohn's and Colitis New Zealand (CCNZ) was launched at Parliament in July.
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