“If you had a giant billboard (metaphorically speaking), what would you put on it?”
“There's something that George Kennan said, which is something I think about a lot. The idea was ..
When you look at everything that goes wrong historically, you can see a deep chain of continuous mistakes that lead up to it. And in a way, that's really discouraging because it makes you think of each step leading to greater consequences. But on the other hand, it's really encouraging. When you think about it, what if you do something, right? Do something right, right now? You're starting a whole other chain that can lead to a positive outcome
Even if things seem like they're going in the wrong direction, or they seem wrong, you can stop, and you can do something small that's right, and that will begin another chain of events” ~ Nick Thompson (Editor-In-Chief at Wired) | The Tim Ferriss Show
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Today, a continuation of a short series about SIBO
Part I covered what SIBO is and highlighted the amazing set of janitors that work overtime to keep our small intestines neat and tidy. They have a big job!
Part II discussed the primary and secondary symptoms of SIBO, along with its ties to other conditions
Part III offered some food for thought about the common causes of SIBO. Everything from faulty ileocecal valves to some bummer news about your favorite nightcap
— —
Signs and Symptoms
In a perfect world, everyone's doctor would order a whole range of tests to get to the bottom of our GI troubles. The reality is, not all of us would be able to afford them. Plus, it's easy to become overwhelmed emotionally when faced with so many tests, all at the same time. Therefore, it's nice to do a bit of investigative work upfront
Start by asking yourself ..
Do you bloat after eating sugar, starches, or fiber?
Am I experiencing either diarrhea or constipation (less than two bowel movements a day)?
If the answer is yes to either of the questions above, the next step would be to take a simple at-home test
Photo Credit: Glasbergen.com
Plantain Flour Test
Mix one heaping tablespoon of plantain flour with 12 oz of water
Drink it on an empty stomach
Pay attention to any bloating or other signs of GI distress
Remember that while this simple test is great for recognition, it isn't something you should use in lieu of formal testing. The biggest reason being, you won't have a baseline. A few months down the road, after following a strict SIBO protocol, if you'd like to retest, you won't have anything to compare to. Instead, you might say
“Dang it all, I still have SIBO” as opposed to “Horray, I'm making progress!”
Expressions of SIBO (A Story of Two Gases)
As we talked about in Part I, when someone has SIBO, there are a large number of bacteria in the small intestine that should instead, be in the colon
Therefore, when we eat certain things (mostly sugars, starches, or fiber), they're being fermented by these misplaced bacteria. This, in turn, causes methane and/or hydrogen gases to form
If methane is dominant, your symptoms will likely include constipation
If hydrogen is dominant? Diarrhea
If both are equally dominant? A person will oscillate back and forth between the two
Photo Credit: The Upturned Microscope
Breath Test
While there are other tests that can be done, the breath test is considered the most valuable, accurate, not to mention (relatively) inexpensive. This is the test I was given
The test itself is non-invasive and really easy to take
When preparing for the test, the goal is to eliminate fermentable foods the day prior. A person will eat a very basic diet (white rice, fish/poultry, eggs, hard cheeses, clear beef or chicken broth, oil, salt, and pepper) for twelve hours, followed by a twelve-hour fast
You're given a drink of that's a blend of lactulose and glucose. After which, a very nice nurse will ask you blow into tester every fifteen minutes for two hours. The data being collected is the amount of methane and/or hydrogen given off by the bacteria
Why both? Glucose has a pretty fast absorption rate; therefore if used alone, the test could miss SIBO that's further down the path of the small intestine. Therefore, the lactulose is added, because its slower transit time will pick up on methane after two hours
Oh, Dear, I've Tested Positive .. Now What?
Can SIBO be overcome with diet alone? What about supplements? Are antibiotics or a natural approach best? What happens if I relapse?
Photo Credit: The Muppet Mindset
During this series, I've been featuring recipes that follow the low FODMAP diet, which is often recommended to someone recovering from SIBO
One of the many things I love about living in a college town is the diversity, not only of the people but the food as well.
As luck would have it, not far from our house are two international restaurants that should be at the top of your must-not-miss list. Near and dear to my heart is Pammel Grocery for gyros, bones for broth, incense and of all things, date paste. Almost right next door is Le's Restaurant, known for its pho soups & banh mi sandwiches
It's also the place, one afternoon last fall, that the group of kids at the laundry mat happened to have gotten carry-out from. The time I was introduced to Cha Ca La Vong
The dish features grilled fish marinated with turmeric, tossed with sautéed scallions and dills, and served with vermicelli noodles, roasted peanuts and dipping sauce. It's beautiful on the plate. A wonderful combination of sweet, salty, sour, and umami. Tumeric not only for color but also it's an earthy flavor. The variety of textures makes it fun to eat
It’s easy to cook Vietnamese turmeric fish at home. You just need to marinate the fish and then pan-sear or broil it in the oven. After that, cook the herbs and throw in the fish, mix and all done. Once the various components are assembled, the cooking is fast, and the payoff is well worth the effort. It is less demanding than a trip to Vietnam (or an afternoon at the laundry mat)
Enjoy!
xoxo
ps: You can read more about SIBO in Part I | Part II | Part III | Part V of the series, along with a list of references used
— — —
~ Adapted from The New York Times
Cha Ca La Vong
Ingredients
- Fish - Prep
- 2 (2" pieces) fresh turmeric, peeled and chopped (see note)
- 1 tsp ground turmeric
- 1" piece fresh ginger, peeled and chopped
- 2" piece fresh galangal, peeled and chopped (or substitute ginger)
- 2 Tbsp neutral oil
- 1 ½ lb skinless cod fillets, cut in 2" squares
- Sauce
- ½ small red or green chile, finely chopped
- 2 Tbsp fish sauce
- 2 Tbsp fresh lime juice
- 1 Tbsp natural sugar
- 2 garlic cloves, minced, divided
- Noodles
- 4-6 oz dried Vietnamese or Thai rice noodles (also called rice sticks)
- Fish - Cook
- 2 Tbsp neutral oil
- 1 tsp salt
- 1 onion, sliced thin vertically
- 1 ½ bunches scallions, trimmed and chopped
- 1 bunch dill, stems discarded, fronds coarsely chopped
- ½ cup each cilantro leaves, mint leaves, and Thai basil
- ¼ cup chopped roasted salted peanuts
- ¼ cup crisp fried shallots (sold in jars in Southeast Asian stores, or canned fried onions)
Instructions
- Fish - Prep
- Place the fresh turmeric, ground turmeric, ginger, oil, and galangal in a food processor or mini-chopper.
- Process until very fine, almost a paste. Transfer to a bowl
- Place the fish in the bowl and rub the mixture all over it (remembering to wear gloves to avoid turmeric stains)
- Season with salt and pepper
- Set aside for 1 hour
- Fish Sauce (Nuoc Cham)
- Mix chile, fish sauce, lime juice, sugar, garlic, and ¼ cup cold water in a small bowl until the sugar has dissolved
- Stir well before refrigerating
- Noodles
- Cook noodles according to package directions. Drain and rinse with cold water
- Fish - Cook
- Heat a couple of Tbsp of the oil in a non-stick skillet over medium-high until simmering
- Add the fish pieces. When seared on one side (1 minute or so), turn to sear the other side
- When seared on one side (1 minute or so), turn to sear the other side
- Sprinkle with salt and remaining chili flakes and cook through, another minute or two. Remove to another platter.
- Add onions and reduce heat to medium.
- When onions start to brown, add remaining garlic, stir, and add scallions. Stir again.
- Tuck fish pieces back into the pan and add the dill. Cook about 1 minute, just enough to warm fish.
- Remove pan from heat
- Serve
- Spread contents of the pan, including all the oil, on noodles
- Scatter herbs on top, then toss on peanuts and fried shallots
- Serve with sauce on the side
65 Comments
I am thankful that you wrote about SIBO. Sometimes we let these symptoms pass and then end up with more discomfort because we did not address the issue when it first started. I am diabetic and sometimes there are symptoms that resemble SIBO. I will have to ask that on my next appointment with my endocrinologist.
Speaking of GI troubles, I am going to be making an appointment for my oldest son. I don’t know what’s up with him, but he’s got some issues going on. Thanks for your info on SIBO, it’s really helpful because I didn’t know about it until I read about it here.
The colors on this dish are gorgeous. Set an extra plate on the table because I am coming over. I experience many of the same symptoms but none of my doctors called it SIBO. I need to ask about that.
After reading the symptoms, etc. of SIBO, I’m going to pass this info on to my daughter. She has so many of the symptoms associated with SIBO and her Dr. can’t figure out what’s going on.
I really want to make this soon! This meal looks so delicious!
Wow your food always looks so beautiful! Almost to good to eat.. almost ? Another great recipe!
I am still learning about this SIBO stuff. Your explanation about what we might feel like after eating is interesting. I don’t have any of this going on but it is good to know and share.
I’ll have to keep these tests in mind. I don’t think I have GI issues, but one never knows down the line.
I’ve never had Cha Ca La Vong, so I’m intrigued now. It looks tasty, that’s for sure. So colorful!
I’m happy that you shared this information about SIBO. Looking forward to trying these tests and also trying the yummy recipe you’ve shared.
These are questions I can not answer yes to even though there are a lot of things that happen to me. I will share this important information withthe people I know.
I really wonder if I have this! I have a lot of G.I. issues and I am trying different things to see what works for me. I did not know they were tests for this contest. I am definitely going to look into that.
It is so hard when you have things going on and no one knows what on earth the matter might be so just does test after test in hope.
This looks like a delicious meal I can’t say i’ve ever had Cha Ca La Vong before.
I don’t think I have SIBO but I will definitely share these posts with people who are having stomach or GI disturbances. The fish recipe looks good and I will try and make it.
The colors in that dish are so bright and bold! Isn’t it something how so many folks have gastro problems but they manifest themselves so differently.
This looks like a tasty chicken recipe. I like using turmeric in my recipes too.
I am with you on this, doesn’t it look absolutely delicious. I need to try and use turmeric in more I think!
I’ve heard of that plantain flour test. Curious though how long do you have to wait until you feel results or did you notice immediately?
This is the first time I read Cha Ca La Vong, but when I saw it has noodles, oh, this is a must try and easy to cook. Now I’ve learned something about “SIBO”. Thanks for sharing the test, at least they can be on our household items especially the Plantain Flour Test.
I have never heard of SIBO before. I will have to d a little research on it. Also- the fish looks super yummy!!
I didn’t know about SIBO until I read your posts. Vibrant colors of this Vietnamese turmeric fish makes it so inviting. I am going to get all the ingredients together and try to make this recipe. I love turmeric!
What a darling fresh Spring dish. As well as it being perfect for those that suffer with SIBO, it has certainly brightened up my grey day here in the UK>
I didn’t even know that there is a plantain flour, I’ll have to check that out. I am enjoying the Sibo series, I am learning so much.
This looks delicious. It has a lot of things in it I’ve never tried so I’d love to give this whole dish a try. Looks so good.
I will have to show some of these things to my ex. They never really determined what she had, but I had never heard of SIBO before. And the tests do seem pretty non-invasive, which is good. Considering all the other tests they put her through. The dish looks pretty amazing as well. Although you pretty much have me at seafood I admit.
Oh my this recipe looks AMAZING. The benefits of turmeric are incredible so this dish sounds so yummy and healthy. I want to try it!
Great information about SIBO. This is indeed a must shared information and I love the recipe as well. Definitely will try this out as well.
Thank you for investing time and sacrifice to share these pieces of your heart and the things you’ve learned. So many of your recipes have become showstopper staples in my life and I have you to thank. I am slow to try new recipes for fear of not liking them and too much effort, but your break those fears with your delightful writing. Seriously, thank you. I am looking forward to making this one. So far my favorites of yours are the Drip Beef, Greek Yogurt Pancakes, Vegetable Risotto, and Fig Tart. Your oatmeal and rice pudding recipes are also on my list to make.
Healthy eating is so important for everyone these days. You recipe looks so tempting and beautiful. I cannot wait to try it out.
I feel like I’ve been living under a rock, I have never heard of SIBO before. But this is some really great info!
The colors on this dish are gorgeous. The fish recipe looks good and I will try and make it.
I like the idea of using a plantain test to determine as to whether or not someone has symptoms of SIBO although your right in saying that it should not be in lieu of an official test. What is interesting though is this recipe of cha ca la vong which while I have not heard of before is in fact right up my street. I like the sound of the turmeric used which is great for the body but also the fresh ingredients used as well.
Yeah, I’ve had tons of GI issues in the past, and thankfully I’ve been able to overcome them in some sense. That’s largely been because I’ve been conscious of my diet, and I can confirm that both turmeric and ginger have been instrumental in my recovery!
This was very insightful! Gut health is so important, glad you are sharing a light on SIBO, this will help many.
Wow Ill be honest and say I didnt have any information on SIBO prior to your post but it sounds like such a troublesome thing to go through. Ive been hearing the fantastic things about tummeric and have actually just bough a bottle of it today to take in the mornings. Will definitely be making this dish with it.
I am still not sure if what I am experiencing is SIBO. However, I found relief in ginger with turmeric tea. It’s store-bought but made with natural ingredients. I take it twice a day, or after I have eaten a meal. The first few days, I would burp so much. Now, I don’t burp as much anymore and my tummy is lighter. 😀
I love that you used both ginger and turmeric with this recipe. I have acquired the love for the taste of both of these ingredients. 😀
I’ve never heard of SIBO but it’s really good to be aware of different ailments because you never know. I love the look of this dish and as a huge fan of turmeric I would certainly make this.
Thank you for the information on SIBO. I have never heard of this before. This dish looks really good, and I love how it’s filled with healing spices and herbs.
I maybe the only person who doesn’t like turmeric on the planet, lol! Maybe I just haven’t tried it the right way, I don’t know. I bet it tastes great on your recipes!
My husband isn’t a huge fan of turmeric either. However, he loves it in some Vietnamese dishes. Guess it just depends on the dish.
You did a stunning job, not just in the photography but in the cooking of that fish! Wow! Wish I could taste through my phone!
That looks like such a lovely meal to eat. I love the colors too, it really helps remind me of warmer days for sure. I will try to make this!
This recipe has some really great ingredients! SIBO sounds like you have to be careful to avoid episodes!
I haven’t heard of SIBO before but suffer from a lot of GI problems daily. These ways of testing sound really interesting.
I am pretty familiar with SIBO as someone with Ulcerative Colitis, this is something I have researched and talked with my doctors about a lot. It is pretty amazing how you can never hear about something for years and then when it comes into your life you know everything about it while it seems weird that nobody else does. I love that you are sharing the info!
Thank you for the details on the symptoms. Now I will be cautious if I ever have those symptoms. I’ve never had of Cha Ca La Vong, so I’m fascinated now. It looks yummy, can I replace fish sauce with anything vegetarian?
Thank you for this information! It’s so helpful. I also can’t wait to try this recipe. Yum!
It’s good that he breathe test is more efficient in diagnosis especially as it is is expensive. The fish sounds nice and healthy and with those ingredients very tasty too.
I’d like to start by saying your pictures are truly stunning. You are so talented at cooking and photography. This looks delicious and I would love to try this recipe. I also enjoy learning about SIBO because it’s not a topic I’m educated on but do have a friend who is affected. Your blog is one of the best I’ve ever seen
Looks so authentic! I love asian recipes, especially Vietnamese! I love fish too!
This Cha Ca La Vong recipe sounds yum. The prep time is quite long though. Not sure I would be able to pull it off.
I have been reading up on SIBO since you first mentioned it and I am convinced that this is part of my issue. This dish looks amazing, the colours look great too!
Oh wow! I’m definitely going to try that test. Sugar is a culprit for just about every bad disease! This is so interesting and something I never would have ever considered!
BTW, this dish looks lovely. I will definitely have to try it!
I swear I have been meaning to eat healthier for a while now. Since giving birth I have been eating whatever. I agree on the rise of disease from sweeteners. I love how beautiful and bright your photos are. It is convincing me to start sooner. Thank you for this.
I stumbled upon your blog while looking for random recipes. I love the way you write and I am looking forward to trying your recipes. Definitely a blog I’ll be following when I’m hungry… which is all the time!!
Now that looks wonderful!
I would skip the green chile but other than that, I like all the ingredients. I love almost anything with fish as long as it’s not too spicy.
Love the colors from the turmeric. My hubby will have fish occasionally. Seems like he might like this one as the ingredient list of full of flavors.
This looks delicious, we love fish and yet we get bored of having it in the same way. I have been researching a lot about SIBO since you mentioned it!
Great recipe – a fun, light dish that’s quite easy: marinate fish, make sauce, cook noodles, cook fish, flash cook veg and then toss everything together BAM! Done. However, the recipe for the sauce is way too large, netting a cup of dressing for this delicate Asian salad of sorts. Therefore, cut that part of the recipe in half, or use as a marinade for another dish/time.
We cook with turmeric all the time, usually together with garlic and ginger, so this recipe is right up my alley. Looking forward to trying it!
Ali, I’ve been lurking here for a long, long time, so I’m finally going to leave a comment. All your posts are so inspiring and ever fail to make me want to cook. Thank you.
I had to share that reading your archives, has been the best way to spend two days home sick in bed. Your advice is thoughtful, sensible, truthful and respectful. I’m a 50 something woman, and I’m learning so much from you and your readers. This blog is a wonderful use of the Interwebs. Thank you!
This is my first comment but I have been steadily working my way through your blog and I have to say that I love your style of food. It’s really interesting, original and simple. xo
Hi! I just started following your blog so I wanted to say hello. I love your recipes and your posts are so fun to read! I especially enjoyed the photos of this one 😉
I tried it and it was delicious! Let it marinade overnight. 🙂 kisses from the Netherlands