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June 5, 2003

Summer Peach Cobbler

8 Servings

Filling:
4 C peeled, pitted fresh peaches
1/3 C - 2/3 C sugar (to taste)
1 T cornstarch
1 T fresh lemon juice

Biscuits:
2 C sifted white flour
2 t baking powder
3/4 t baking soda
1/2 t salt
2 T granulated sugar
4 T canola oil
1 C soy or rice milk
1 t apple cider vinegar

Preheat oven to 425F.

For Filling: Chop peaches, then stir all filling ingredients except lemon juice together in a medium saucepan, and bring mixture just to a boil. Remove from heat and add lemon juice. Spray an 8" or 9" baking pan or casserole dish with cooking oil spray, and fill pan with fruit mixture.

For Biscuits: In a large bowl, sift then whisk dry ingredients. In a small bowl blend together soy milk and vinegar until mixture thickens slightly, then blend in oil. With a fork blend wet ingredients into dry until well-mixed. Drop dough by tablespoonfuls onto the fruit filling in pan (have spoonfuls lightly touch - this will help them rise). Bake for 18-22 minutes until golden brown, and a toothpick inserted into a biscuit comes out clean.

Hello to everyone -

This newsletter brings a sunny summer recipe and the exciting debut of our IBD board!

To begin, here's a delightfully delicious recipe to welcome the sunshine and glorious fresh fruits of summer - Peach Cobbler! This sweet and luscious dessert is also wonderful with fresh apricots or plums, so choose whichever fruit you love best.

Peach cobbler is an old-fashioned dessert that's traditionally topped with a very high fat butter (or lard!) based biscuit dough. Our version is much healthier, and uses just a small amount of canola oil for richness. The biscuits are especially light and tender from the clabbered soy milk, which is simply soy milk blended with vinegar. This step replaces the traditional buttermilk, so you can avoid the digestive upsets from dairy while keeping the tang and fluffy texture buttermilk lends to baking.

Choose the freshest, ripest fruit you can find for this recipe, and for extra digestive stability peel the fruit to reduce the insoluble fiber level. To peel peaches or apricots, simply drop the whole fruit into a large bowl filled with boiling hot water, and let sit for about 5 minutes. Remove the fruit and the skins should slide right off.

If you're feeling creative, you could add a dash of cinnamon, nutmeg, or cardamom to the fruit filling. Peach cobbler is delicious served warm from the oven, drizzled with a little vanilla soy milk, or served a la mode with vanilla soy ice cream. The cobbler also reheats beautifully the next day...in the unlikely event you have leftovers!

Best Wishes,
Heather Van Vorous

Check out our fabulous new IBS Recipe Index!

Come join the new Crohn's and Colitis Message Board!
If you're dealing with IBD instead of IBS (or suspect you might be), our new inflammatory bowel disease board is the place to ask questions and find support. Crohn's and Ulcerative Colitis can make life very difficult, but having a place to go for friendly help from others who are dealing with the same issues can make a world of difference.

I'm delighted to welcome Jill Sklar, an award-winning author who specializes in medical writing, as our new board moderator. Jill is not just a good friend with a great heart, she's the vice president of the Michigan chapter of the Crohn's and Colitis Foundation of America, the author of The New York Times-reviewed First Year: Crohn's and Colitis, and she's personally dealt with Crohn's disease since childhood.

Jill joins our five current well-informed, empathetic, and excellent board moderators, who are there to help with everything from diet information and recipes to hypnotherapy and yoga. Welcome Jill, and thank you to all of my fantastic moderators!

NOTE: For all article links, please refresh your browser page if the article does not appear when you click on the link. For Medscape and Cardiosource articles you may have to register in order to view articles (registration is free).

A New Drug Approach to Irritable Bowel Syndrome
A drug currently used to treat alcoholics and drug overdoses may also offer relief in a surprising quarter -- to sufferers of irritable bowel syndrome. A small trial of 50 patients with the painful disorder showed that three-quarters of them got relief from the drug, known best as naltrexone. Tiny doses of naltrexone, which is available generically, eased the bloating, pain, constipation and diarrhea that marked irritable bowel syndrome in both men and women. Click here for more information...

Genetic Link in Inflammatory Bowel Disease?
The two most common forms of IBD by far are Crohn's disease and Ulcerative Colitis. In both conditions, there is an immune response that causes the inflammation. Though it is not yet clear what causes the body's immune system to initiate this response, doctors and researchers are now confident that the human genome plays a role in this process.

Pattern-Specific Brain Activation and Personalities in IBS
Patterns of brain activation in patients with irritable bowel syndrome (IBS) suggest an altered perception of pain compared with healthy subjects. Patients with IBS also tend to exhibit a distinct personality profile, which varies according to sex. Research demonstrating these findings was presented the during Digestive Disease Week Conference 2003. Click here for more information...

IBS with Constipation: A New Report for Women
A new report released by the Society for Women's Health Research (SWHR) and reviewed by a panel of experts, finds that the symptoms of IBS with constipation - which include abdominal discomfort or pain, bloating and constipation - significantly impact the physical, social and emotional well-being of sufferers. According to the Report, IBS is under-diagnosed, mistreated and is often misunderstood by both practitioners and the general public.

Use of SSRI Antidepressants & NSAIDs Increases GI Side Effects
This study aimed to investigate the relationship between the use of antidepressants with or without NSAIDs and the risk of gastrointestinal side-effects. It concluded that SSRI antidepressants increase the risk of gastrointestinal adverse effects in first time users as compared with nonselective antidepressants. The combined use of SSRIs and NSAIDs strongly increases the risk of gastrointestinal adverse effects and should be avoided. Click here for more information...

Looking for the latest IBS research and news?
Click here for the IBS Newsletter Archive

"Soluble fiber supplements - help!"

"I'm really confused about how much and how often I should take a soluble fiber supplement for my IBS. The product labels say these are laxatives, and have warnings not to use them for more than a week. But my doctor told me to take them everyday and didn't mention any risks!"

Soluble fiber supplements (such as Equalactin, Citrucel, Fibercon, Benefiber, Fybogel, Normacol, Regulan, Metamucil) are marketed as over-the-counter laxative and anti-diarrheal products, so they are bound by the FDA prescribing guidelines for those products. This means that the supplements must have the dosage limitations on their packaging that apply to OTC anti-diarrheal and laxative drugs, even though they are not drugs but fiber supplements. The FDA packaging guidelines for this category do not discriminate between the drugs and the fibers. This explains why the dosages for these products that your doctor recommends for IBS may conflict with the package information.

The dosage information for IBS that I have been given by doctors and fiber supplement manufacturers, and that I believe works best for preventing IBS symptoms, is as follows: For the powders (Citrucel, Benefiber, non sugar-free Metamucil) start at 1 teaspoon twice a day and over the next week or two (or three or four) work up to 2 tablespoons twice a day. If you're using pills (Equalactin, Citrucel, Fibercon) start at 2 pills twice daily and work up to 2 pills four times daily. You can also mix and match the powders and pills (for example, take the powders at home but keep the pills on you at work or for taking before restaurant meals). If you're combining powder and pill supplements, I think it's definitely best to make sure that your total daily dosage is equal to what it should be for just the pills or fibers alone. You don't want to take the maximum dose for the pills and then take the maximum dose for the powders on top of this.

If you do not see a measurable improvement in your symptoms within one week of using the maximum dosage of a soluble fiber supplement, this could certainly point to a problem other than IBS, and you should see your doctor again. If you have any questions or concerns about the dose and frequency of taking soluble fiber supplements, check with your own physician.

For all fiber supplements, make sure you have a large glass of water with each dose, and drink fresh water frequently throughout the day as well. Soluble fiber needs water to work - this is essential. I believe you can take soluble fiber supplements every day for the rest of your life, and this should really help your IBS.

If you're at all prone to bloating or gas avoid Metamucil (psyllium) and try Equalactin, Citrucel, Fibercon, or Benefiber instead. Also, be aware that the sugar-free versions of the supplements can contain artificial sweeteners, which can trigger IBS attacks. In addition, citric acid is often added to orange-flavored supplements, and this can cause acid reflux in some people. If these are concerns for you, choose a sugar-sweetened or unsweetened, unflavored variety of supplement. Aside from the concerns about psyllium, there doesn't seem to be one type of soluble fiber supplement that is more or less likely to be well-tolerated by people in general. There is a great deal of individual variation here in how someone responds to any particular supplement. So if you have gas or bloating from starting a supplement that doesn't disappear after a week or so, don't be discouraged, just try a different brand and perhaps a different formulation (the pills instead of powder, or vice versa). It may take several different tries to find the supplement that works best for you, but the results can be well worth the effort.

The USDA recommended minimum fiber intake for adults is 25 to 35 grams daily, and soluble fiber should account for one third of this amount. Some scientists actually recommend up to 60 grams of fiber a day, so the USDA recommendations are not maximum dosage limitations. The typical American eats only a meager 10-15 grams of fiber daily. For comparison, the average fiber intake in China is 33 grams of fiber a day, and it ranges as high as 77 grams per day in some regions.

Dosages and fiber content for common soluble fiber supplements:

Benefiber provides 3 grams of soluble fiber per tablespoon dose.

One tablespoon of Metamucil smooth texture orange and original texture orange (these are not the sugar-free varieties) contains 2 grams of soluble fiber and 1 gram of insoluble fiber.

Two Metamucil wafers provide 2 grams soluble fiber and 1 gram insoluble fiber.

Two Fibercon tablets contain 1 gram soluble fiber.

Two Equalactin tablets contain 1 gram soluble fiber.

One tablespoon of Citrucel provides 2 grams of soluble fiber.

Two Citrucel caplets provide 1 gram of soluble fiber.

Fiber supplements have health benefits in addition to controlling IBS symptoms. Soluble fiber (both foods and supplements) not only normalizes bowel function, it also helps stabilize blood glycemic levels, slows the rate of carbohydrate absorption, improves regulation of blood sugar, and lowers insulin requirements. Soluble fiber also decreases LDL ("bad") blood cholesterol levels, and therefore reduces the risk of heart disease. Studies have also shown that fiber helps prevent colon cancer.

Heather & Company is dedicated to serving people with IBS. Our mission is to offer education, services, and products that allow people with IBS to successfully manage their symptoms through lifestyle modifications. We currently offer the books
Eating for IBS and First Year IBS, web site resources, seminars and classes, and Heather Cooks!, a healthy cooking show on the internet and television. We also host the only patient-expert moderated IBS Bulletin & Message Board on the internet with forums for diet, recipes, hypnotherapy, and yoga. We will soon have other IBS services available. Heather Van Vorous, an IBS sufferer since age 9, is the company founder and president.

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LEGAL DISCLAIMER - This email is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Any application of the recommendations in this email is at the reader's discretion. Heather Van Vorous and Heather & Company are not liable for any direct or indirect claim, loss or damage resulting from use of this email and/or any web site(s) linked to/from it. Readers should consult their own physicians concerning the recommendations in this email.