Chicken Enchilada Casserole & Some Non-Standard Symptoms of Celiac

February 3, 2010 · Filed Under Simply Hot Recipes, Slightly Indulgent, Tempt My Tummy, What can I eat ..., chicken, diagnosis, discussion, easy, entree, gluten free, recipe · 66 Comments

I’ve been following the celiac listserv since I went gluten free. My doctor directed me to it as a helpful resource. The information shared was a bit overwhelming at the time (what isn’t when you first go gluten free?), but I especially gravitated towards the personal stories. I also found some product recommendations and the recipes (always the gfe ones) helpful. One member of the listserv who was always generous in all of those areas was a lady named Valerie. This Chicken Enchilada Casserole recipe I’m sharing today for Slightly Indulgent Tuesdays, What can I eat that’s gluten free? (Linda’s casserole edition), Tempt My Tummy Tuesdays, and Simply Hot Recipes, was adapted from a recipe that Valerie posted on the listserv. (She had adapted her version from one in Woman’s World magazine.) But, first, let me tell you a little bit more about Valerie and some information that she shared that has stayed with me and is getting more press these days.

I don’t remember if Valerie was diagnosed celiac herself or gluten intolerant/gluten sensitive, but she reacted to even the tiniest amount of gluten (something many of us can relate to). She was a grandmother and she found that after every visit by her toddler grandchildren, she would get ill. Somehow she had been “glutened” just by the shared hugs and kisses with her sweet grandchildren. She came to the conclusion that this occurrence was not surprising really as she would love on her grandchildren practically nonstop—as all good grandmas do. But her grandchildren always had crumbs on their bodies or clothes as all little ones do from eating tiny bits and pieces with their fingers or being messy with utensils. So she started bathing her grandchildren as soon as they arrived at her house, and, of course, immediately dressing them in clean clothes. Her approach worked! She never got glutened again in this manner and she was able to fully enjoy her grandchildren’s visits.

Valerie was also quick to respond when members queried about the psychological effects of gluten. Her son had suffered from a psychiatric disorder for years and she reported that currently he only demonstrated symptoms when he accidentally ingested gluten. Even the tiniest amount would cause him to behave very bizarrely. It got so his family and friends would immediately know if he’d eaten some gluten.

Most of us know that digestive symptoms get the most press by far when it comes to celiac and gluten intolerance. Yet, most of the folks who actually experience digestive issues as a result of a problem with gluten went years before they received a diagnosis and most remain undiagnosed today. Now, consider the folks with non-digestive symptoms, specifically in this case, neurological and psychiatric symptoms. While there are actually many non-digestive symptoms, this post will focus on just some of the ”non-standard” symptoms of celiac—those addressed in a recent Living Without article. (Also, please remember that it’s estimated that about 40% of those with celiac disease experience no recognizable symptoms.) Dr. Stefano Guandalini, the Medical Director of the University of Chicago Celiac Disease Center, responded to questions on the topic of neurological and psychological celiac symptoms in the August/September 2009 issue of Living Without. He shared the story of his 8-year old celiac patient who had been admitted to the hospital with hallucinations and profound depression. Blood testing showed that her gluten anitibodies were extremely elevated. Further investigation showed that because the child had stopped experiencing digestive symptoms, her parents had been giving her cookies on the weekends. Re-education of the parents led to a truly gluten-free diet for the young girl and she returned to normal.

Neurological issues related to gluten remain some of the most difficult cases to diagnose, largely because of lack of knowledge in the medical community. I doubt very seriously if many doctors, maybe that should be any doctors—other than the fictional Dr. Gregory House on the television medical drama, House—would consider celiac as a possible cause for hallucinations and profound depression. I know many patients who have sought help for such conditions and have never been tested for celiac. Celiac disease hasn’t even entered the picture. Dr. Guandalini stated in the Living Without article that patients can have idiopathic epilepsy (meaning no known cause for the epilepsy), ataxia, peripheral neuropathy, recurrent headaches, and autistic-like behavior (e.g., sadness, failure to socialize, excessive irritability, anxiety) with no accompanying gastrointestinal symptoms. In these cases, the gold standard for a celiac diagnosis simply cannot be applied. Dr. Guandalini states that a positive result on the anti-tissue transglutaminase (tTG) screening test alone is a diagnosis of celiac in such cases, because these patients will have few or no digestive symptoms, and they will show no damage to the small intestine. I truly wonder how often a celiac diagnosis actually gets made under such circumstances. I think far, far less than a celiac diagnosis for someone who has digestive symptoms and we know how underdiagnosed those cases are. So, please spread the word on the neurological and psychological ramifications of celiac disease, so that individuals, their family members, and physicians will look at this other facet of celiac disease. (Note that the symptoms shown here are not all-inclusive; these are simply the particular ones cited by Dr. Guandilini in the article.)

In the article in Living Without, Dr. Guandalini was also asked about gluten sensitivity. Dr. Guandalini responded that although he used to be skeptical about gluten sensitivity, today he is “respectful” of those who have tested negative for celiac disease, but report true benefits from a gluten-free diet. He added that in the lab at his own center, early data is showing that changes do occur in the small intestine of gluten-sensitive patients. That is a huge finding in my opinion, and I look forward to additional research results being shared.

Valerie, the celiac listserv member who I mentioned earlier, was always so generous with her time and information. She and I even exchanged emails a few times. Valerie hasn’t posted in a few years now. I find myself wondering what is going on with her and hoping she is well (much like my friend, Nance, wonders about her neighbor, Tish). I miss Valerie and I’m grateful for the recipes she shared, including this casserole dish, which I’ve modified a bit.

Chicken Enchilada Casserole

(Click here for a print version of this recipe.)

1 small onion, chopped
2 cloves garlic, minced
1 Tbs. chili powder (I’ve substituted taco seasoning before when I was out of chili powder)
1 tsp. salt
1/2 tsp. black pepper
1 cup diced tomatoes
1 small can tomato sauce
1 Tbs. cilantro, chopped (optional—I add when I have it on hand)
3 cups chicken cooked, boned, shredded
1 tbsp lime juice
1 jar salsa (16 oz) (whatever hotness you prefer—mild worked well for us)
10 corn tortillas (ensure they are gluten free)
8 oz shredded cheese (Monterey Jack, cheddar, or a Mexican blend—your preference; read labels to ensure gluten-free status)

Preheat oven to 350 degrees F. Coat a large, deep skillet with little bit of oil; heat over medium heat. Add onion, garlic, chili powder, salt and pepper; cook, stirring often, until softened, about 3 minutes. Add one cup of tomatoes, tomato sauce, and cilantro (if used). Cook 5 minutes.

Dump shredded chicken over tomato mixture in skillet. Spoon lime juice over chicken. Stir all together in skillet. Heat a few minutes, if necessary. (If chicken is still warm from its cooking method, you will not need to heat more.)

Spread one half of the jar of salsa in an ungreased 9″ x 13” baking dish; top with 5 tortillas (break into pieces as needed to mostly cover salsa).

Top with chicken mixture; sprinkle with half of the cheese.

Top with remaining tortillas. Spread with remaining salsa; sprinkle with remaining cheese.

Bake until cheese is melted and casserole is hot, about 15 to 20 minutes.

Adapted from Valerie and Woman’s World

Shirley’s Notes: I usually use three boneless chicken breasts that I have cooked in my slow cooker in one cup of chicken broth made from bouillon. Slow-cooked chicken breasts shred easily. Leftover chicken or turkey (great way to use leftovers from the special turkey breast), gluten-free rotisserie chicken, etc., may also be used. Like most casseroles, this dish is one that is flexible. You can skip the tomato sauce and add a whole can of diced tomatoes versus just a cup. (You might have to cook the mixture “down” a bit more in the skillet if you do so.) You can spice it up by using diced tomatoes with green chiles, adding more chili powder, adding chipotle powder, and so forth. Some friends like making this dish using ground beef. Personally, I really prefer this dish with chicken or turkey, but feel free to experiment. Eight ounces is not a huge amount of cheese for a casserole this size, but cheddar cheese appears like more than is actually there because of its rich color. That can be a good thing for the cheese fanatics. I often use more cheese for topping (than I do when sprinkling over the chicken mixture), just so I get that visual appeal.

Shirley
Not just gf, but gfe!

Tags: casserole, chicken, GFE, gluten free, recipe

Susie’s Crab Casserole

November 12, 2009 · Filed Under Holiday Food Fest, bread, dairy free, easy, entree, gluten free, recipe · 26 Comments

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Today is week 2 of the Holiday Food Fest. The sweet and talented Alta of Tasty Eats at Home is hosting this week’s theme of Fall Dishes. To me, Fall + Holiday = Thanksgiving. When you set aside the turkey, ham, side dishes, and desserts, Thanksgiving and all the special dinners during the holiday season mean one dish for sure—my sister’s Crab Casserole.

Where I live in Virginia—in King George county, which borders the Potomac River—we are lovers of all things crab. Specifically, we love the Maryland blue crab. We eat our first steamed crabs usually in April or May and we don’t stop eating them until late October. We have many fond memories of Indian summers spent eating steamed crabs on the picnic table on the porch or under a shade tree, spectacular in its fall foliage. Mr. GFE fondly refers to the blue crab as the elusive crustacean. It’s not uncommon for folks to have one or two crab pots set out in the Potomac or one of its tributaries. They steam a bushel of crabs every weekend during the summer. If you’re lucky, these crabbers are either your family or your friends. Others are sure to visit their local waterman and/or seafood dealer for a bushel of crabs hot off the cooker for Memorial Day, Father’s Day, 4th of July, Labor Day, and just about any celebration that occurs during crab season. Crabs are meant for both celebrating and socializing—so crabs equal good times.

So what do we do when colder weather arrives and crab picking season ends? Do we give up crabmeat for 6 months? Heavens, no. We make dishes that contain crabmeat that we’ve picked and frozen during the summer, or we head back to our local waterman/seafood dealer and buy a pound or two of crabmeat that he’s picked and frozen for the winter. I’m in that latter category, although I do remember one winter when we feasted on flounder stuffed with crabmeat several times. We’d caught the flounder while fishing in the Chesapeake Bay off my parents’ summer home. We always caught and ate crabs when visting there, too. That particular occasion, I had picked enough crabmeat to stuff the flounder before freezing. Those stuffed flounder made for an exceptional meal in January when the cold north wind was howling.

My sister found this crab casserole recipe many years ago now that’s become a winter season favorite. She makes it gluten free for me by just replacing wheat bread with gluten-free bread. I started making it myself for those holiday meals with Mr. GFE’s side of the family. I’ve made it with all kinds of gluten-free bread, both store-bought loaf bread and from “bread” I’ve made, like cornbread or corn muffins. It was in this dish that I originally used Van’s frozen gluten-free waffles as a substitute for gluten-free bread. One Thanksgiving morning when I went to put together my casserole, I realized I hadn’t bought any gluten-free bread in preparation. I remembered that I had the waffles in the freezer, toasted two, crumbled them, and then threw them in with the other ingredients. I was worried how the casserole would turn out, but everyone said it was the best crab casserole ever. So, you really can’t go wrong with whatever gluten-free bread you use in this recipe.

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Susie’s Crab Casserole
( Click here for a print version of this recipe. )

Serves 8
Preparation Time: 5 minutes
Baking time: 40 minutes
Oven temperature: 350 degrees Fahrenheit

1 pound crab meat (Susie says to use backfin, but I use the “special,” which is a mix of backfin, and leg and claw meat—it’s much more reasonably priced, although crabmeat is pricey)

½ cup milk (or non-dairy equivalent)

3 slices of bread (I use gluten-free bread, like tapioca loaf, or 1 ½ to 2 Van’s gluten-free waffles; you need about one cup of your fresh bread “crumbs.”)

1 ½ – 2 tbsp prepared mustard (I use Dijon)

1 tsp Worcestershire sauce (I use Lea & Perrins)

¼ cup (1/2 stick) butter or non-dairy equivalent, melted (this is half the original amount and you might even cut back a little more)

3 eggs, slightly beaten

½ tsp salt

½ tsp pepper

1 ½ tsp – 1 tbsp Old Bay seasoning (or similar, to taste)

Paprika (for sprinkling on top)

Beat eggs slightly in bowl.

Crumble bread into pieces; add to eggs in bowl.

Pour milk over bread, and gently stir all together.

Add and mix all ingredients (except paprika).

Pour into a lightly greased casserole dish (about 1 ½ qts).

Sprinkle with paprika.

Bake until knifes comes out clean, about 40 minutes.

Adapted from the V.I.P. Cookbook: A Potpourri of Virginia Cooking, Vol. 7

Don’t forget to check out all the Fall Dishes over at Alta’s Tasty Eats At Home! The giveaway this week is a really fun apron from Flirty Aprons. Too late to get in on this week’s roundup? No worries … next week is another theme, and one you won’t want to miss—Gifts of Good Taste! This event is hosted by Phoebe at Cents to Get Debt Free, so please share your favorite edible gifts. Phoebe will be giving away a Digital Precision Pro Kitchen Scale—nice!

By the way, Mr. GFE is loving this Holiday Food Fest event … he usually doesn’t get to enjoy Susie’s Crab Casserole this early in the fall! He was practically following me around the kitchen waiting for it to be ready! I have to admit that it was also nice to get out my very special handmade pottery that my dear friend, Cindi, gave me years ago. It’s really too pretty and special to only use one time each year … it’s a fir tree after all—aren’t fir trees around all year long?

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