Thursday, February 15, 2007

Restrictions

After eight months of waiting for various appointments and results, I finally have an official diagnosis. My biopsy showed damage to the lining of my small intestine, indicative of coeliac disease. Basically this means that I have a problem with gluten, and need to avoid wheat and several other similar grains.

I think I've had the problem for the last eight years. It only became impossible to ignore when I moved from Hong Kong to London a year and a half ago. The change in diet worsened my symptoms and being less busy gave me time to realise that things weren't right.

Coeliac disease is an autoimmune disorder. Gluten acts as a trigger causing my immune system to attack my small intestine, sending my digestive system crazy. In addition, the damage to my intestine prevents it from absorbing nutrients particularly well. Obviously, this can cause any number of nutrition related problems.

The good news is that all the damage and any risk to my long-term health can be eliminated if I follow a gluten free diet. The bad news is that gluten turns up in places you wouldn't necessarily expect. Look at the ingredients list of any processed food and there's a good chance it will contain wheat, malt, modified starch or a vague 'thickener'.

At home eating gluten free shouldn't be too hard. I usually cook from scratch and I'm not upset about avoiding bread, pasta, couscous and other wheat based staples. I've long preferred rice anyway. I can replace flour with cornflour and make sure that I use gluten free brands of soy sauce, stock cubes and salad dressing.

Eating out, however, will be a different story. Even if I could find out exactly what had been put into my food, I would still need to ensure that it hasn't been contaminated by a chopping board, cooking utensil or frying pan that had been used with something else. Just a small amount of gluten would cause damage.

The worst thing is not feeling able to trust other people, even when they have the best of intentions. I bought a slice of gluten free lemon polenta cake at a market last week and the stallholder used the same tongs as he was using with the regular cakes. At that stage, I'd only been off gluten a few days so I ate it anyway. I've since discovered I can make a pretty good version at home.

A while ago, I went to a gluten intolerant friend's house for dinner. She served barbecued chicken that had been marinated in soy sauce, not realising that most soy sauces contain wheat. Even had there been no soy sauce, I would have been concerned about the chicken being cooked on a barbecue that had been used for gluten containing foods like sausages.

I've often been irritated by people who don't eat particular things but now I'm one of them. I had a friend at uni who only ate things that she had cooked herself and I thought she was quite crazy. Particularly as she made an exception for potato crisps. I may have the justification of an actual disease but I'm sure a lot of people will just think that I'm fussy.

Anyway, I'm feeling more relief than anything else at the moment. I'm excited at the prospect of being healthy again and I'm enjoying eating in the knowledge that I'm not doing any harm. I just hope that no one minds accepting repeated invitations to eat at our house! Here's a meal that we did recently to tempt you (all credit to Mogfa for the incredibly arranged salad!).

6 comments:

Jean said...

Good to hear that you're more reliefed :) And repeated invitations to eat at our house...are you serious? with your awesome cooking, bring it on! Btw, what about Japanese cuisine - sashimi sans soya sauce (or BYO soya sauce).

Joe said...

No seriously, I freaked out when I read one woman's blog. She was saying how she doesn't see friends very often because she doesn't eat out and people feel uncomfortable about accepting so many invitations to her house without being able to reciprocate.

You are right about Japanase food. a lot of people with celiac say it is the only food they will eat out. Web forum wisdom says: don't eat any imitation crab or marinated eel and check the wasabi because cheaper ones can have wheat starch.

Still I guess there are a lot of social activities which don't involve eating. Btw - are you going to watch the CNY parade and all on Sunday?

Iqbal Khaldun said...

I know you mentioned all of this to me before, but somehow reading it in print has made me realised the gravity of the situation. All the best for the adaptation, must be a strong sense of relief too!

And, ahem, yay! bring on the free food hehe.

Cal said...

That's so depressing about the woman that never eats out! One of my parents' friends is coeliac and he doesn't seem to have any problems with restaurants and eating at friends. Actually for that generation lots of traditional meals are gluten free anyway: meat, potatoes and two veg (he just watches out for flour in the gravy); stews, cottage pie..... My step mother actually finds it much easier to have him over than a vegetarian!

Joe said...

You're right - traditional English food is actually very coeliac friendly. Without the gravy it's just meat and vegetables.

Knuffy's Owner said...

I recently bought a bread machine to make my own German-style bread : ) There are a some recipes and bread mixes that enable you to make gluten-free bread yourself at home. Just a tip that you needn't avoid bread altogether!