Bloating, excessive flatulence, abdominal distension, constipation and diarrhoea are all possible signs of an irritable bowel.
The impact on lifestyle for people living with these problems can be immense. Some of our clients tell us they won't go out in public, including shopping, unless they know where the closest toilet is. Others starve themselves before going out to avoid the embarrassment of flatulence they have no control over.
Many people try all sorts of food exclusions in an effort to figure out what is affecting them, often leading to a very restrictive diet and impacting on their social life. If someone invites you out for tea and you ask them to cook something without onion, you may get a strange look and not be invited again - that's a reality for these clients!
Dietitians have helped people over the years by managing and adapting their fibre intake, along with other food substrates. Some people require more fibre, for others less fibre is required. During the past 10 years, there has been better research clarifying just what foods can be part of the irritable bowel picture. Much of this research has been done by Dr Sue Shepherd, an Australian dietitian, who specialises in gut disorders and nutrition. My colleague and I had the pleasure of attending a seminar in Wellington recently, where we had a whole day with Sue to update and upskill ourselves in this area.
The offending food components in these cases are a group of carbohydrates, including simple sugars like milk sugar, lactose, and fruit sugar, fructose. On a dietitian's advice, breakfast might change from cereal and milk to an oat-based cereal and low lactose milk. Many artificial sweeteners are out, and many fruit juices.
A diet of foods with low- fermenting carbs is not healthy for everyone, just for those with this over-sensitive gut or irritable bowel. It provides good relief from symptoms for 75 per cent of people who try it. It is still not clear who will benefit and why some people don't, but being able to help three out of four people is certainly worth a try.
People who may never have had a problem with food can quite suddenly start developing symptoms. Although there isn't conclusive evidence, it is suspected the factors that can trigger these problems include recent overseas travel (particularly in Asia), gastroenteritis, heavy antibiotic use and psychological stress. Symptoms can often be temporary - for example, many of us know our bowels play up around exam times. For these temporary situations, dietary change is not necessarily required but, if the problems persist, low-fermenting carbs may be the answer.
It is very important that anyone with gut symptoms is first seen by a doctor or gastroenterologist to exclude other medical conditions like inflammatory bowel disease or coeliac disease. The diet is fairly complex and needs a lot of time sorting out substitutes for the foods avoided to maintain a nutritionally balanced, appealing diet. Dietitians are pleased we can now offer a proven nutrition solution for these clients.
2/3 cup basmati rice
250g skinless smoked chicken breast, diced
2/3 cup semi-dried tomatoes, roughly chopped
1-2 Tbsp chives chopped
1 1/3 cups grated mozzarella cheese
1/4 cup basil leaves, finely shredded
3 eggs, lightly beaten
Optional extra flavour: olives, capsicum, spinach, zucchini
Preheat oven to 200 degrees Celsius.
Grease a loaf tin or make in eight 2/3-cup capacity mini loaf tins. Line bases with baking paper.
Cook rice, following absorption method on packet. Rinse. Set aside to cool.
Place rice, chicken, tomatoes, chives, 1 cup of cheese, basil, eggs, and extras into a large bowl. Mix well to combine.
Spoon mixture into prepared tin. Sprinkle with remaining cheese.
Bake for 15 to 20 minutes or until cakes are firm to the touch and light golden.
Stand in pan for 5 minutes.
Run a flat-edged knife around edges of cakes. Turn onto a wire rack.
Serve as is or allow to cool. Can be placed in an airtight container and refrigerated. Rosemary Law, a NZ Registered Dietitian
- © Fairfax NZ News
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