Elimination Diets are Now an Accepted Part of IBD Treatment (Crohn’s and Ulcerative Colitis)

Autoimmunity & Healing Diets

Jan 11

I have finally seen the day when elimination diets are now an accepted part of IBD treatment (Crohn’s and ulcerative colitis).

When I started helping patients with their Inflammatory Bowel Disease (IBD), gastroenterologists categorically denied that food or diet had anything to do with the disease. They claimed there was no science that showed that what a person put into their mouth affected their digestive disease.

Laughing out loud.

Science is great, but who would fund a study about food? Not a pharmaceutical company. They are interested in the grossly expensive (and dangerous) biologic treatments for IBD.

However, common sense and plenty of anecdotal evidence existed. I helped many patients gain control over their disease through diet. For some, it was trial and error until they started to follow the Specific Carbohydrate Diet, the GAPS Diet, or the Autoimmune Paleo Diet, and tweeked them for their individual differences.

These diets are fantastic blueprints for healing the gut.

Back then, doctors refused to discuss diet. They didn’t know much about what to recommend. However, over the years they have had enough patients eager to talk about diet and getting results with diet, they had to start to recognize the importance and impact it has on disease and certainly on digestive disease.

Now We Have Science – With Conflicting Findings

In a short clip I received from ibdnewstoday.com, a doctor goes over past studies which showed that people who went off cow’s milk improved in their IBD scores. That makes sense.

There was also mention of eliminating gluten to improve IBD. I’m all for eliminating gluten.

There was mention of a study that showed that eliminating meat and alcohol improved IBD. I can agree with this because the meat they use in research is from factory farm animals and clearly alcohol has no place in a healing diet.

However, there are several studies that conclude that people with IBD improve when eliminating animal products in general and sulfur containing amino acids in particular.

The mechanism here is that hydrogen sulfide results from the fermentation of animal proteins in the colon. This interferes with processing of fiber. Processing of fiber generates butyrate, which is food for the colonic cells. Thus, the conclusions are drawn that animal products – particularly meat – are bad for people with IBD.

This controversy has been around for years and vegans jump on this bandwagon and recommend vegan diets for every ailment. In fact, there are reports of some people doing very well on vegan diets (it’s just not clear how long one can be on a vegan diet and not develop health issues).

However, other, more recent studies show that diets that include animal products are very good for people with IBD.

Pilot Study Using SCD as a Basis for an Anti-inflammatory Diet

In 2011, at the University of Massachusetts, there was a small pilot study using the SCD as the basis for an anti-inflammatory diet. There were 11 subjects with either Crohn’s or ulcerative colitis.

The diet was based on the principles of the SCD, with some other allowable foods.

The researchers found that out of the 11 patients in the pilot, 9 did not have to use anti-TNF therapy and all 11 had symptom reduction while on the diet.

A win.

Another Small Pilot Study with SCD

Published in the Journal of Gastroenterology in December of 2016, this study’s goal was to determine the effect of the SCD on active IBD, in children. There were 12 subjects aged 10 to 17 years. Two patients were unable to maintain the diet and for another two it was ineffective.

However, the the 8 remaining, there was a significant decrease in the bio-marker for inflammation, C-Reative Protein and the Crohn’s disease activity index (PCDAI) decreased significantly.

… stool microbiome analysis showed a distinctive dysbiosis for each individual in most prediet microbiomes with significant changes in microbial composition after dietary change.

The authors conclude,

SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD. (source)

Another win, hopefully causing gastroenterologists to listen when their patients tell them about diet.

$2.5 Million to Study the Specific Carbohydrate Diet for Crohn’s

This headline appeared in the March 24, 2016, Crohn’s and Colitis Foundation of America Newsletter.

NEW YORK, NY – For the first time ever, dietary intervention will be the focus of a major national research study of patients with Crohn’s disease. The Crohn’s & Colitis Foundation of America (CCFA) announced today that it was awarded $2.5 million from the Patient-Centered Outcomes Research Institute (PCORI) to study the effectiveness of the specific carbohydrate diet and Mediterranean-style diet to induce remission in patients with Crohn’s disease. (my emphasis)

Interestingly, the study idea evolved out of a patient-generated research question posed through CCFA’s patient-powered research network (PPRN). I love that the idea came from the patients themselves, because they know that food and diet has a huge affect on how they feel and how they can manage the disease.

I can’t wait to see the results, but I expect them to be positive – probably for both diets, but better with SCD for Crohn’s.

It’s exciting to finally see the SCD given the attention it deserves. While there are still naysayers, there are clearly enough patients telling their doctors they want more from them then dangerous drugs.

Do you have (or know someone who has) IBD? Have you tried the SCD, GAPS or AIP? How has it worked for you? Leave a comment and let me know!

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Elimination Diets are Now an Accepted Part of IBD Treatment (Crohn's and Ulcerative Colitis)) https://goo.gl/WVb8tB

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