So what can I eat?

If you have a sensitive gut caused by a condition known as the Irritable Bowel Syndrome it will be intolerant rather than allergic to certain foods and food groups. About 20% of women and 10% of men suffer at times from pain, bloating and other gut symptoms. A sensitive gut is not a life sentence and you do not have to avoid foods but adjust your consumption of them according to the nature and severity of your symptoms.

Many people over restrict their diet if they experience gastrointestinal symptoms. There are two problems with this. The first is cutting out whole food groups like, wheat and dairy or meat from the diet can lead to quite serious nutritional deficiencies if replacement foods does not compensate for the nutrients lost by cutting out these major food groups.

Many people find if they simply restrict pulses, wheat, onions and garlic in their diet they will experience a reduction in symptoms.

The second problem is that cutting out too many fruit and vegetables high in FODMAPS (see below) over an extended period of time can deplete the microbiome which can have a profound effect not only on gut health and symptoms but also on overall health and immune function. The microbiome is made up of the 100 trillion bacteria which paly an important role in keeping the body healthy and free from disease.

Instead of completely eliminating a food from the diet (apart from if there is a medical reason to do so as in the case of coeliac disease) we recommend restriction to the level which is comfortable for you. For any given food intolerance this varies between individuals. In our blog we stress the healthy, nutritious foods you can eat rather than those that you can’t.

Many people find just reducing the amount of onions and wheat eaten (both high in fermentable carbohydrates known as FODMAPS) can help their symptoms. Others find that they need to follow a low FODMAP diet for a a short period of time to reduce symptoms and then systematically reintroduce foods so they can identify which foods trigger their gut symptoms.

Either way our blog and book Cooking for the Sensitive Gut provides lots of ideas about what to cook and guides you through the tricky challenge of getting food to taste and look good without the use of key ingredients beloved of cooks.

The biggest adjustment in your diet is going to be to the types of cereals, fruit and vegetables eaten. Meat and fish do not contain fermentable carbohydrates and so moderate portions of low fat meat and fish tend not to trigger symptoms.

Here is a lost of ingredients you can eat and use in your cooking. All the recipes in this blog have been checked against the MONASH University Low FODMAP Diet App and adjusted for the UK diet wherever possible.

 Cereals

• Quinoa
• Rice: red, black and white
• Oatmeal
• Chia seeds
• Millet grains
• Buckwheat flour
• Rice noodles
• 2 slices of gluten free, spelt sourdough bread

Vegetables

These are the vegetables that are low in fermentable carbohydrates and you can eat on a day to day basis. We think this is a great list of vegetables and you can cook a huge range of fabulous dishes with these. For the latest information on which foods are high in FODMAPS and likely to trigger symptoms we recommend using the MONASH University LOW FODMAP Diet app which can be downloaded onto smart phones and tablets here

• Artichoke hearts  (28g)
• Aubergine
• Green beans
• Bok choy
• Broccoli
• Brussels sprouts (2 sprouts)
• Butternut squash (30g)
• Radicchio
• Rocket (arulula)
• Parsnip
• Potato
• Radish
• White cabbage
• Green pepper
• Red pepper
• Carrot
• Celeriac
• Chicory leaves
• Chives
• Courgette
• Cucumber
• Fennel
• Chard
• Spinach
• Kale
• Leek leaves
• Spring onion tops
• Lettuce
• Canned tomatoes
• Fresh tomatoes
• Sundried tomatoes (1 tbsp)
• Turnip
• Water chestnuts
• Seaweed
• Alfalfa sprouts
• Bean sprouts

Fruit

• Firm bananas (not too ripe)
• Blueberries
• Raspberry
• Rhubarb
• Strawberry
• Passion fruit
• Paw paw
• Grapes; black, red & green
• Pineapple
• Black, red and white grapes
• Kiwi fruit
• Lemons & lemon juice
• Canteloupe
• Honeydew melon
• Clementine
• Orange
• Coconut, shredded and dried (18g)

Cheese

Small portions (30g) of hard cheese are fine for most people.  All the great cooking cheese like:

• cheddar
• feta
• mozzarella
• Emmental
• Parmesan
• pecorino

…..are fine for our gut friendly recipes. So too are:

• Camembert
• cottage cheese
• goat’s cheese

These cheeses should be eaten in moderation e.g. no more than 20g

• cream cheese
• haloumi
• ricotta

Some things to watch out for when planning your meals:

Portion size

Your gut is likely to be sensitive to the amount of food you eat regardless of its composition. We advise eating smaller portions and leaving time in between meals for digestion to take place. Being calm and relaxed wen you eat and digest food is very important as stress and worry can trigger gut symptoms.

Onions, garlic, leeks, chives and salad onions

Onions, garlic, leeks and salad onions are members of the allium family. The bulbs of this family of plants all contain large amounts of fructo-oligosaccharides which ferment in the colon. Fructo-oligosaccharides are classified as FODMAPs.

High FODMAP foods are a paradodox because on the one hand they can cause symptoms in people who have a sensitive gut and on the other hand they are very important for gut health as the products of fermentation actually help keep the lining of the gut wall healthy and maintain the gut microbiome (good bugs).

You can still obtain the flavour of onions in the recipes you cook by using the tender green parts of salad onions and leek tops and chives in the dishes you cook. These green parts of the onion are low in FODMAPs and should not cause symptoms in most people.

Garlic flavour

The fructo-oligosaccharides in garlic are soluble in water, whereas the allicin and other volatile  compounds that give garlic its distinctive aroma are soluble in oil.  Thus the gorgeous, aromatic flavour of garlic can be extracted by steeping sliced garlic in oil and then straining the oil before using it in cooking.

You can just make garlic oil as and when you need it. Fry a couple of cloves of sliced garlic in enough olive oil for a recipe and then discard the cooked garlic leaving the flavoured oil.

Fats

Fats are one of the most reactive ingredients in the gut. They interact with receptors in the small intestine to delay the emptying of the stomach, stimulate contraction of the gall bladder, induce secretion from the pancreas and trigger colonic contractions.  The latter is known as the gastro-colonic reflex.  These effects may be mediated by the release of the gut hormone,  cholecystokinin,  in conjunction with activity in the vagus nerve.  People with a sensitive gut are often particularly sensitive to ‘rich’ sauces, fried food, red meat and creamy desserts, all of which may cause nausea, bloating, abdominal pain and diarrhoea.

Coffee

Coffee also releases cholecystokinin and stimulates the gastro-colonic response, triggering abdominal cramping and bowel evacuation in people with a sensitive gut.   Tea may have a similar effect in some people.  It may be the effect of caffeine, but even decaf can have a similar effect.

Chilli

Chilli directly irritates the sensitive gut, causing  abdominal cramping  and diarrhoea.  Most other culinary spices are calming.

Gluten

Many people with IBS find that wheat upsets them and may put themselves on a gluten free diet.  But there is no need to go on a strict gluten free diet unless you have been diagnosed with coeliac disease.   In recent years, some evidence has emerged for a condition known as non-coeliac gluten sensitivity (NCGS), though this is still controversial and may instead be an intolerance to fructo-oligosaccharides11.    While a gluten free diet excludes wheat, rye and barley it still contains many foods containing FODMAPs that can trigger symptoms in people with a sensitive gut; for example onion, legumes, prunes, apples, prunes and pears.