Introduction by Raman Prasad (Excerpt)

This book came into being because of a toothbrush innocently swished in the Rio Grande River during a high school canoe trip, and a resulting case of Montezuma's revenge. This incident led to months of antibiotics and antiparasitic medication, bloody diarrhea, cramping, and a diagnosis of ulcerative colitis at age seventeen.

During a five-minute, post-sigmoidoscopy meeting, a gastroenterologist quickly told me: "Do not eat raw vegetables, fruit, popcorn, or nuts ever again." I was given a prescription for prednisone, and life veered off for a while. Years eighteen through twenty-three passed by in a surreal blur. I could never count on feeling well the next day.

At age twenty-four, after a hospital stay, with drugs having little effect on the disease, the doctor described my intestines as resembling "bloody hamburger." Surgery was the next option, and hope waned.

Another Chance

However, in 1996, I was lucky enough to find Elaine Gottschall's book Breaking the Vicious Cycle through the soon-to-be-popular Internet. This book proposed treating inflammatory bowel disease (IBD), diverticulitis, celiac disease, cystic fibrosis, and chronic diarrhea through a "specific carbohydrate diet (SCD)." After reading it twice, the premise behind the diet made sense.

The author describes a "vicious cycle" in which injury to the surface of the small intestine leads to the inability to properly digest the carbohydrates in many foods, including bread, pasta, rice, and milk. When the body cannot digest these foods, the undigested carbohydrates become energy that fuels bacterial overgrowth in the intestinal tract. The small intestine becomes injured further and responds to the increase of bacterial by-products by creating more mucus. In turn, the mucus leads to impaired digestion and the cycle escalates, resulting in symptoms such as diarrhea and eventually IBD.

The diet attempts to break this cycle by avoiding carbohydrates that cannot be properly digested, thereby depriving harmful bacteria of energy. In addition, it includes acidophilus, through homemade yogurt, which restores the intestine's bacterial balance.

However, the diet seemed tough: no rice, no bread, no potatoes, no to many things. But as IBD symptoms (diarrhea, blood, and cramping) subside, the diet included fruits and vegetables—foods I rarely ate with ulcerative colitis. Many years had passed since I had dared to eat a salad. I decided to give the diet a try. I emptied out my apartment of "illegal" foods and stocked up on SCD "legal" ones at the grocery store. (See the chart below for examples of "legal" and "illegal" foods.)

At first it was difficult to tell whether the diet was working. I was on the steroid prednisone, which hid any pain and stopped diarrhea, but I also felt numb and confused on the drug. After six weeks, a notable change came in that an abnormally high blood test for the liver returned to normal—and a liver biopsy was cancelled. Weaning off the steroids took nearly six months, but my bowel movements had become normal, and the pain in my abdomen was gone. As the months passed and my energy returned, I felt strong again, and best of all, I dared to look ahead and make future plans.

These plans included going back to school for graduate studies and then finding a job in New York City. During this time I continued to read postings on an online SCD mailing list. I was able to use a lull at work to organize recipes from the SCD mailings and post them at www.scdrecipe.com.

Meeting Elaine Gottschall

In the fall of 2001, Elaine Gottschall visited the New York area to make presentations in Brooklyn and on Long Island. Eager to meet the woman responsible for giving me my life back, I took the Long Island Railroad out to a restaurant in Port Jefferson, New York, to attend a twenty-person brunch in Elaine's honor.

From the picture in Breaking the Vicious Cycle, I imagined Elaine, then eighty years old, as warm and soft-spoken. At 5-foot 8-inches, she was warm and kind, but she exuded the energy of someone half her age. (For the record, she wasn't soft-spoken, but had a strong, clear voice.) Her knowledge, as well as her humor, impressed us all that afternoon.

Over the years, I saw Elaine a number of times, helping at her SCD table during several conferences. The last time I saw Elaine was a few weeks before she passed away in September 2005. She was struck by serious cancer. (Mere months earlier, at age eighty-four, she had accompanied her young granddaughter on a transatlantic flight to Paris.) I visited her near her home in Canada, a short trip outside of Toronto.

Indeed, she had helped so many people with the SCD along the way, that now there were people looking out for her. During my visit, people I had never met, but whose lives had been changed by the diet, warmly took me into their homes and fed me SCD meals. One woman prepared a vegetable-laden chicken soup to nourish Elaine in the small, comfortable Canadian hospital where she was staying. Walking toward her hospital room, we were all filled with great sadness. Even in pain, she was in good humor; however, on the subject of the diet, she became grave and concerned. She did not want her work to fall into disuse—she knew that for each person she had helped, there were hundreds more suffering. She simply asked us to keep the SCD alive.

All of us who have been helped by her work and who met her in person have done what we can—from opening clinics and consulting on the diet to simply passing along the name of her book. For me, what stands out the most is her selflessness, commitment, and perseverance. Even while she was in the hospital, I remember her taking a phone call so that she could help someone else who was ill.

This book is a small contribution to keep her work going. Realizing all that has been cooked for me over the past years, I feel increasingly appreciative of all the people around me—family, friends, and other fellow SCDers. I hope that in sharing these recipes, these feelings and good health are passed on to others.