Explaining That Diet Does Help Severe “Stomach” Problems

baadsgaard-alfrida-ludovica-vi-opstilling-med-ananas-druer-ogImagine having diarrhea 15 times a day, every day. Add some blood to that. While you try to walk across a university campus. Or coach basketball.  Or serve on a Navy ship in the middle of the vast ocean. Or learn to add, subtract, and multiply.

This is life with Crohn’s disease or ulcerative colitis, collectively called inflammatory bowel disease (IBD). And when I was a medical student on general surgery, I swear it seems like we were digging around every day in some poor patient’s intestines due to his or her inflammatory bowel disease. Many emerged from surgery with bags to collect their liquid bowel movements.

I feel like I’ve heard it a thousand times. “My doctor says it doesn’t matter what I eat for my Crohn’s disease.” Have you heard that? Do you believe that? That’s 100% false. Research since the 1970s shows that patients can go into remission with special “nutritional shakes.” 

Patients are often convinced that food impacts their disease, but they can’t always pinpoint how or which foods. Medical studies weren’t very helpful in the past; they looked at things like fats, amino acids, and vitamin D, finding some correlations, but nothing to hang their hats on. So hard-working doctors just shrugged their shoulders and said, “It doesn’t really matter, dear patient. Just eat.” [Scram. I’ve got 8 patients waiting to see me. I don’t have time to listen to you speculate about whether or not milk gives you diarrhea.]

But fascinatingly, studies have shown for forty years now, plus or minus, that IBD can be controlled with nutrition! Well, more accurately put, researchers and patients controlled IBD with exclusive enteral nutrition. Exclusive enteral nutrition, EEN for short, is basically just a “nutrition” shake kind of like Ensure or PediaSure, only it tastes much worse. The ingredients in the shake have been pre-digested so they can be absorbed completely in the small intestine.

Studies have repeatedly and reproducibly shown great results for IBD patients and EEN, particularly Crohn’s disease. How great? Well how does upward of 100% sound to you for a remission rate? Would you even settle for a 70% rate? Yeah. That good. I’m cherry picking a little; some studies didn’t have such high success rates, but most did. And some studies that didn’t look all that good to begin with looked better after the study results were adjusted for patients who just couldn’t tolerate the special liquids (often quite a few). Also, results were consistently better for pediatric patients [who often heal more quickly and have to be compliant whether they like it or not—and sometimes choose to be compliant because they feel so much better!]. (Kansal, 2013)

But patients and doctors, I guess, weren’t having that. Too yucky. Too restrictive. (Just for interest, I notice that Nestle seems to make many of these nutritional EENs.)

What’s in that shake?

Great minds pontificated about what it was in the EEN drink which could cause these patients to do so well. They played around with the liquid formulas with good success, trying to make them less repulsive and less expensive. Then they pondered, “Well, can we let our patients eat [cake] and take some of this EEN stuff?”

So researchers let patients drink the liquid EEN formula and have free access to table food at the same time. Yum! With free access to table food, despite the nutritional “shake,” the remission rates weren’t as good as when a patient ate only EEN liquid—but they were better than the patients who received no EEN at all. Aha! So it’s starting to look like something in table food perpetuates increased inflammation in inflammatory bowel disease patients. (Triantafillidis, 2015)

Okay. All Mama’s good table food really threw a wrench in the great effects of the EEN shakes. What next?

Well, allowing table food was a step backward, and researchers thought, “We need another twist. What can we do? This is fun.”

So researchers gave patients nutritional “shakes” and they let them eat only certain allowed foods. (NO CAKE this time. Sorry.) Bingo. Success rates held at about 70% of patients showing improvement and or sustained remission. (I know a lot of doctors who made just 70% in class and are successfully practicing. Pass equals MD, baby. Seventy percent is pretty good.) That’s awesome. How happy would you be to be symptom-free and able to eat some real food?  (Sigall-Boneh, 2014)

It’s 2017. Can we ditch the EEN altogether and just eat real food?

Now, we have to cap it off. Could patients get off of the disgusting “shakes” altogether? (Good-bye, Nestle…) Well, the Journal of Clinical Gastroenterology is about to publish a study done by a Dr. Suskind (and his team, of course!) from Seattle Children’s Hospital. Ten pediatric patients followed a diet called the Specific Carbohydrate Diet for three months, and 80% of them had symptoms improve significantly and even resolve and lab markers normalize. Eighty-stinking-percent! Let me repeat: eighty percent success. WITH FOOD.

Way to go Dr. Suskind and team. Way to take medicine back to truly patient-centered, do-no-harm care! And most importantly: WAY TO GO PATIENTS AND PARENTS WHO PARTICIPATED IN THIS STUDY! Changing how you eat is hard work, and most people balk, standing in the corner cowering with too much fear to leave their pizza and bread behind. Not you. Not you. (Suskind, 2017)

[Click here for a readable summary of Suskind’s report and here for an abstract of it.]

Meh. Study needs to be bigger.

Now, I showed someone Suskind’s research summary, and she replied, “But there’s only ten patients. I wish it was bigger.”

Sigh. So do I. But it’s what we’ve got. And it’s so promising. I’m ebullient. Diet alone! Eighty percent remission! With real food. No diarrhea! No bleeding! No stomach cramps! Virtually 100% safe. No injections! No risk of white blood cell counts crashing. Why won’t people try this?

Reminds me of a verse I learned from a big book, although I’ve adapted it. “The fiddle plays and you won’t dance. The singer wails a mournful tune, and you will not cry.” We are hard to please. Impossible nearly. What do we want? A magic bullet pill with no side effects?

I must close now. But you will not want to miss my next post about the amazing stay-at-home mom who made it her life mission to show the world that inflammatory bowel disease can be controlled most of the times with real, whole food. And I’ll explain a little about the diet that saved her 8-year-old daughter’s life and which she spent her life studying and evangelizing.

Terri

Citations:

Kansal, S., et al. “Enteral nutrition in Crohn’s disease: an underused therapy.” Gastroenterology research and practice 2013 (2013).  https://www.hindawi.com/journals/grp/2013/482108/

Triantafillidis, John K., Costas Vagianos, and Apostolos E. Papalois. “The role of enteral nutrition in patients with inflammatory bowel disease: current aspects.” BioMed research international 2015 (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352452/

Sigall-Boneh, Rotem, et al. “Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease.” Inflammatory bowel diseases 20.8 (2014): 1353-1360. https://www.researchgate.net/publication/263548102_Partial_Enteral_Nutrition_with_a_Crohn’s_Disease_Exclusion_Diet_Is_Effective_for_Induction_of_Remission_in_Children_and_Young_Adults_with_Crohn’s_Disease

Suskind, D. L., Cohen, S. A., Brittnacher, M. J., Wahbeh, G., Lee, D., Shaffer, M. L., … & Giefer, M. (2017). Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease. Journal of Clinical Gastroenterology. Abstract only: http://journals.lww.com/jcge/Abstract/publishahead/Clinical_and_Fecal_Microbial_Changes_With_Diet.98120.aspx

33 thoughts on “Explaining That Diet Does Help Severe “Stomach” Problems

  1. Lindsay

    This makes me think of when I first read Breaking the Vicious Cycle. MIND BLOWN. I finally had hope. And resentment toward the medical community. Why does no one know this? Why do the people who do know this not tell anyone?

    And then why does no one listen to those of us who end up knowing and DO try to tell everyone?

    Thanks for putting this out there.

    Reply
    1. thehomeschoolingdoctor Post author

      Thanks, Lindsay! My mind was blown too, you know. I read one IBD article this week that says that when they need to wean their patients off of EEN to real food, they start with white bread. My eyes about bugged out. And another article didn’t do a good job summarizing SCD, and I looked for a correspondence e-mail or address so I could write and correct them—saw none listed! Anyhow, yes. Resentment. Anger. And no one listens to crazy, stay-at-home mothers till they’re dead…ask Elaine Gottschall.

      Reply
      1. EmilyMaine

        How does any educated person choose white bread as the starter food? Do you know baby H is now on solids and the only thing she can’t tolerate is bread (I don’t give her white obviously). We have tried it three times and each time she screams for 3 hours at bedtime. She is fine with pasta but no to bread. Makes me wonder. I don’t eat a lot of it myself but have cut most of that out too now. Anyway, it drives me crazy that the educated often aren’t so educated…

      2. thehomeschoolingdoctor Post author

        As my father, quite a character, would say: educated idiots. Eeks. That’s not nice. We need a nicer way to say that. I mean, I fall into that category, too! 🙂

        Honestly, they did have a reasoning behind the madness about white bread. Studies indicate that IBD flares do better with low residue, low fiber diets. (But not what I call the best kinds of fibers, but more like roughage fiber.) So, by transitioning them to white bread and white rice (rice isn’t a bad choice!), they’re avoiding any “abrasive” kind of fiber. But onto other inflammatory stuff.

        Thanks so much for stopping in! Glad to hear baby can eat pasta! I guess that makes the no-bread route easier. You think it’s the yeast? Or just saying, “whatever” for now and watching and waiting?

  2. Pat

    I have had IBS D for at least 10 years following huge amounts of antibiotics. In desperation I am considering a trip to UK for fecal transplants to be given daily for over 10 days. It is expensive and not exactly a dream trip. However, the food intolerances are becoming, well, intolerable. Joint aches, fatigue, anxieties and brain fog are generally the result of eating something that is a trigger. I have tried to keep this problem under control through diet, but it is very difficult, and I seem to be adding new foods to the bad list every year. As we all know, restricting these foods affects every aspect of life, including social, travel, home life, etc. It is also alarming that I seem to be having neurological issues that appear to be related to food. Long-term damage is a scary thought.
    Before heading off to the UK I wonder if EEN therapy would be effective at restoring my system. Even the possibility seems worth trying. However, I do not see where EEN nutritional shakes for powders are for sale. Is this only available through doctors? I hate to say it, but I have lost faith in the doctors I have seen. It frequently seems I am more informed than they are on these issues.

    Reply
    1. thehomeschoolingdoctor Post author

      I see no research at all for inflammatory bowel disease and food sensitivities in the time I just looked now. Has anyone else seen any, by chance?

      I wanted to find a list of enteral formulas. I found a few internet sites that list some. There may be more but for the sake of time, I’ll just link to these. This does not mean that I support what was written or have completely evaluated the material. I have not! But just for the sake of some brand names to be able to read about them!

      http://www.thriverx.net/clinical_care/enteral_formulas.htm
      https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2015/11/MakolaArticle-Dec-05.pdf
      https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2015/11/MaloneArticle-June-05.pdf

      I looked up some of them on Amazon here in the US. We do have access to them without a prescription, but they cost A LOT of money!!!!!! The second and third links are articles. I did notice one explains elemental versus non-elemental and talks about what studies show when one is used over the other. I also noticed one article listed some of the ingredients. The oils in them really made me wince (corn oil!).

      Sensitivities are very hard. And there does seem to be a point at which people gain more and more. I hear that a lot, and for a time I experienced it myself. If you’ve been here much to read over the last year, you may know I’m interested in mind-body and how that can help disease, including food sensitivity (not true allergy). I’m trying it out, but still haven’t made up my mind.

      I wish you much success in whichever path you may follow. Be safe. I know you won’t, but I have to say it, don’t do anything dangerous or health-endangering. If you try the EEN, maybe get a consult with a nutritionist just to make sure you know what to watch for. But I’ve heard they taste BAD, BAD, BAD! And at that cost, keeping up for any length of time would be hard. On the other hand if near complete gut rest and nutritional absorption gave you relief, that’d be a score. Wish I had just a little more to help. But I don’t.

      Take care. Would love to know what eventually “cures” your food sensitivities if you ever care to come back and share.

      PS: I’ve taken the liberty to just edit your comment and spell antibiotics for you. 🙂

      Reply
      1. Aviva

        Hello Pat,
        My daughter has used Modulen by Nestle. I was not so bad. She used to add a banana to it or home made almond milk. Of course when you add things it is not completely enteral… Another EEn I know of is from the site “listen to your gut” by Jinny Pattel (interesting site). I can say nothing about the prices…
        Good luck
        Aviva

  3. Tim Steele

    I’ve never liked the SCD, but if it works, it works. Too restrictive and no fiber. So, obviously then, starving the colonic microbiome is key to treating UC/Crohn’s. I can’t wait to see the full text of the Suskind paper and see what the gut testing reports show.

    Reply
    1. thehomeschoolingdoctor Post author

      I know you’ve said that about not liking SCD/GAPS. But I’m telling you, vegetables are highly encouraged in the GAPS form of SCD. GAPS (Campbell-McBride) touts them highly: carrots, asparagus, squashes, onions, garlic, and so on. And as soon as a person is symptomatic, GAPS says (in my own summarized words): go for the cocoa and almond butter–two good forms of alternative fiber. Go for the navy beans and lentils. Go for the fruits. They are encouraged once a person has been symptom-controlled for a time. The only thing not there is the potato. Which, I was happy to learn this month that Whole 30 has reintroduced. A well-done SCD or GAPS diet is a very good diet. Not that there aren’t plenty of other ways to get a well-done diet too! And not that there isn’t room to add in foods as tolerated. AND both the author of SCD and GAPS sate explicitly: THESE ARE NOT INTENDED TO BE LONG-TERM DIETS. And contrary to what people say, raw foods are not discouraged, only initially until symptoms are controlled. And studies seem to support that roughage is “bad” in IBD flares—so stewing vegetables helps make them more tolerable until a patient’s GI is calmed. (Now that all makes me sound like a SCD/GAPS proponent. I don’t know that I am. I think that people making the change for intensive health need things deeply overhauled. These books delineate how to do that–from broth to ferments to explaining pastured meats. I really appreciate that.)

      Didn’t mean to carry on. Just keep trying to get you to agree with my side. Ha! So I’m pumping your arm!

      If you get the full text of Suskind’s article, I’d like it. My college-aged sister got me the review from Gastroenterology that’s coming out about diet for IBD. Geesh. These articles cost $40 bucks a pop if you don’t have library access! I believe in paying my fair share and I know knowledge comes at an expense, but that’s awful high for these articles. Tips there? I paid to join one of those article catalogs on trial, but they didn’t have half the articles I needed!

      Reply
      1. Tim Steele

        Haha, I’m always on your side, Terri! My problem with this type of diet is when people use them as a long-term way to eat, especially when they are not sick to begin with. Same as the FODMAP diet. I’m all for experimenting and if something works, sticking with it. Once dysbiosis sets in, all bets are off on how to eat.

        The “intro” to SCD is interesting (http://www.breakingtheviciouscycle.info/p/science-behind-the-diet/). Yogurt is a key food item. It almost makes me think that the user of SCD develops a gut flora more like a milk-fed baby than an adult. As long as there is no problem with dairy, it might be the key to the success of SCD. I’m really curious now to see the full text. If bifido blooms, my guess is it’s the yogurt doing it. Is it healthy for an adult to have the gut flora of a baby? Who knows, but if it puts IBD/UC/Crohn’s in remission, who cares?

        It would be interesting to have SCD eaters supplement with Bimuno (ie. http://amzn.to/2iq53qz), this is GOS, or milk fiber, the same stuff found in all baby formula to simulate human milk fiber (HMO). It stimulates bifidobacteria. But I can imagine that anyone who is helped by SCD would be reluctant to mess with success.

        As to Pat’s question about EEN, couldn’t a reasonably suitable smoothie be made at home? I’d use the same yogurt that SCD uses as a base, add some Bimuno, and then a bunch of the SCD-approved fruits and veggies. And eat some scrambled eggs or light servings of the legal SCD meats.

      2. thehomeschoolingdoctor Post author

        “My problem with this type of diet is when people use them as a long-term way to eat…” Yes, well, the authors make it clear this is not the intention. But I do read forums of people banging their heads into these diets for long-term.

        “Once dysbiosis sets in, all bets are off on how to eat.” Yes, how true!!!!

        “Yogurt is a key food item.” I guess I see the yogurt as a way to provide acid-producing bacteria to a system which needs a lower pH. With a lower pH, I think the butyrate producing bacteria are more effective. It’s all running together, though. And you know there are people, like me, who seem to test for VERY low lactobacilli! But, personally, at first I couldn’t do dairy like this. I apologize for any gap in knowledge here, but why do you think it would promote Bifido? Elaine Gottschall discouraged Bifido. She didn’t like it. Now, I don’t know what I think about that, but sometimes this stuff later comes to light.

        Would the yogurt have GOS?

        The EEN formulas most often used are elemental, broken down to the amino acids and more simple sugars. The best IBD remission rates seem to come from this. Then, they looked at polymeric, which keeps the peptides intact. So if I was going after it, I’d “micro-manage” and choose the elemental for best success because it requires virtually no digestive work. Then, if cost was an issue, I’d do the polymeric. But as her question was about IBS/food sensitivities and not IBD, I guess there’s just no trail to follow that I’ve seen! I wonder if any practitioner has used EEN or polymeric enteral nutrition for IBS. I just don’t know. And I’ll bet Pat is sensitive to eggs—-but that’s just a guess from talking to people and myself.

        Adios!

  4. Tim Steele

    Me again…

    I was just looking at tube feeding solutions that can be bought OTC. Did you see Nestle’s Compleat (http://amzn.to/2jGKGqq)? It costs $75 for 24 8oz containers, about $3 ea. But each unit is only 265 calories, so you’d need 5 or 6 per day. Still not overly expensive @ ~$15/day.

    Not sure what to think about the ingredient list, looks pretty damn “processed”:

    Water, Chicken Puree (Water, Dehydrated Chicken Meat), Cranberry Juice Cocktail (From Concentrate), Corn Syrup, Maltodextrin, Sodium Caseinate (Milk), Canola Oil, Pea Puree (Water, Pea Powder), Carrot Puree (Water, Carrot Powder), Contains less than 1% of Tomato Paste, Partially Hydrolyzed Guar Gum, Potassium Citrate, Calcium Phosphate Tribasic, Potassium Sorbate, Sodium Chloride, Hydroxylated Soy Lecithin, Magnesium Phosphate Tribasic, Choline Chloride, Carrageenan, Sodium Benzoate , Sodium Ascorbate, Magnesium Oxide, Alpha Tocopheryl Acetate, Ferrous Sulfate, Zinc Sulfate, Niacinamide, Calcium Pantothenate, Copper Gluconate, BHA/BHT (To Preserve Freshness), Vitamin A Palmitate, Manganese Sulfate, Pyridoxine Hydrochloride, Thiamine Hydrochloride, Riboflavin, Chromium Chloride, Folic Acid, Biotin, Potassium Iodide, Sodium Molybdate, Sodium Selenite, Phytonadione (Vitamin K1), Cholecalciferol (Vitamin D3), Cyanocobalamin (Vitamin B12)

    To me, if it meant eating this, or the SCD diet, I’d choose real food every time. And the more I look at the list, the more I think that if someone wanted to try an EEN approach, they should look at the SCD ‘legal’ list and make a smoothie with a yogurt base.

    Speaking of smoothies, I know lots of you don’t like them, ie. “Eat your food, don’t drink it!” But we are talking about a special situation here where we want to feed quickly digested foods that starve the gut flora of most food fiber, but deliver whatever prebiotics are found in the yogurt or whatever magic is occurring in the SCD trials.

    Oh, and did you know that the mesentery is implicated in Crohn’s as well?

    (2016) https://www.ncbi.nlm.nih.gov/pubmed/27167572
    (2007) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856873/

    Reply
    1. thehomeschoolingdoctor Post author

      Yes, the list is atrocious! AND studies indicate that in IBD, gums (like guar gum and other emulsifiers) are on the list of things implicated as worsening disease. Yet it’s added to an enteral feed which is going to be used by people with gut issues for sure.

      I don’t think this is a hyrolyzed formula (where it’s broken down as completely as it can be) that would have been used in the EEN studies or polymeric nutritional (with peptides rather than full proteins) studies which came after the EEN studies. So if someone is bad off to the point that their digestion is so broken that it needs near complete rest, I see the need for EEN. But even the EEN used has detrimental food products, which shows that the body can do good things with bad things.

      I sure would like a couple of acquaintances of mine to at least try SCD. I don’t care if they blend it or bake it, just try it.

      I’ll check out the mesentery links. Got to get off this black box for now.

      Reply
      1. Pat

        Thanks so much for all the research, suggestions and thoughts regarding my food intolerances. I also appreciate the spell chk/editing. I love dictation but….
        After reading the articles you sent on EEN I am concerned about several aspects, some of which you and Tim have addressed. I really really don’t love the idea of a feeding tube. Even for six or eight weeks that sounds absolutely awful. So I would like to rule out that delivery method right off the bat. The list of ingredients you listed are also scary. I think I got to this point through a combination of lots of antibiotics and poor diet choices. I have to wonder about drinking a product that really doesn’t seem to be all that healthy. I went on the Adkins diet for several months before my first food intolerance, peanuts, and I wonder if excluding healthy fruits, vegetables and grains harmed my biome. The antibiotics definitely finished me off after that with an immediate correlation. However, the Taymount Clinic in UK ( where they provide the fecal transplant) interviewed me over the phone and indicated they believe the biome is frequently already weak due to the mother’s insufficiency and/or deliveryproblems when you when you were born. I have no idea if that is true in my case.
        http://taymount.com/
        Since I had very little in the refrigerator to work with yesterday, I decided to try a homemade shake made of almond milk, (yes, I know I’m not supposed to use that until six months, but that’s what I put in my coffee every day without, I think, issues), half of a small avocado, frozen blueberries, and a ripe banana. I paid for that all day long. My stomach was just torn up. I ended up cheating with a small cup of rice before a dinner of salad and pork loin. The rice seemed to do the trick and my stomach settled. I think the meal helped too. But all of that is counter to the diet. Too many fruits and vegetables just kill me, but I can’t just eat primarily meat all day.
        I have no idea which ingredient was the culprit in the smoothie. It seems as though one day I can tolerate a certain food and the next day it causes problems. As you know, it’s hard to tell which food is actually the culprit– the one you ate hours ago or the one you just ate.
        I may try the goat yogurt, because predictably I am intolerant of dairy and soy. I have heard that goat milk is much less of a problem.
        I would love to rebuild my microbiology with fresh fruits vegetables and lean meat. That is definitely preferable to drinking a nasty shake with questionable ingredients. But is that actually possible? Or am I just cutting out the foods that I’m intolerant of in my diet and waiting for the next shoe to drop?

      2. thehomeschoolingdoctor Post author

        I’m no expert in dealing with people with this. Just want to put that out there for sure, no matter what titles I may carry behind my name. Don’t trust anything you read on the internet. 🙂

        I’m just going to throw a bunch of stuff out there that your comment made me think of, not necessarily specific to you, Pat. I know lurkers read comments (I’m a lurker in many places) to generate ideas.

        1. What I liked about GAPS opposed to SCD was that it starts people off with stewed meats and vegetables. (GAPS evolved from SCD.) It has a rigorous introduction diet which I think can drive conscientious insane and unfortunately to obsession, but the basic tenets are actually pretty good when compared to what they know about IBD. So to start off, a person should try non-fibrous vegetables (so at first avoid celery), like carrots, butternut squash and slow and long cook them with meats, like a whole chicken or cut of a roast. Stewed meats and veggies are much easier to absorb than fried or roasted ones. Think of all the traditional stews! She suggests a person eat this only until symptoms abate. Then, add in some more. And she has a list. And slowly, the patient is eating more and more. Fruits don’t come in for a little bit after a patient is symptom-free/much improved. And then, they also need to be stewed/boiled/cooked—not fresh yet. That comes.

        So that’s interesting, I think.

        2. Something else I remember reading in GAPS (And I don’t think GAPS is “the best” diet; I actually believe in a patient-tailored diet, picking one diet to start from and modifying it. I believe in extensive logging of symptoms, fastidious self-observation, and hopefully a nutritionist or doctor to guide with a few select tests and diet instructions.) is how Dr. Campbell-McBride notes that a patient could eliminate foods “till the cow’s come home” (my summary). She was implying that the patients she sees have tons of sensitivities, but she had to move them forward eating somehow and couldn’t eliminate everything.

        3. EEN can be taken orally rather than my feeding tube. But most patients can’t stand it and aren’t able to take it that way, thus the tube. I guess polymeric is a little bit easier to “stomach.”

        4. I kind of think people with SIBO/FODMAPS/Candida/dysbiosis/irritable bowel/food sensitivities all overlap. Are all a continuum.

        5. When it comes to milk, I agree with you. If a person want’s dairy back in, I go for the goat and sheep milk products. I also think that the 24 hour fermentation process does help make things even more digestible. The bacteria break down some of the proteins in the milk so the body doesn’t have to. You won’t be absorbing so many bigger peptides that way.

        6. Hypnosis actually has a good track record for IBS! I was impressed by that in my reading over the last few days. We’re looking at about, mmm, probably 70% improvement across all patients! Plus or minus, depending on the study. But hypnosis has a huge stigma which I don’t know what I think about. But I think it deserves some advertisement, so I’ll put it out there. Here’s a list of studies from an IBS site:

        http://www.ibshypnosis.com/IBSresearch.html

        I’m reading a book now summarizing mind-body stuff, and there’s a chapter in there on hypsosis. Whorwell, one of the early researchers of IBS and hypnosis, is about to retire. The book makes him sound disappointed and jaded, because he knows this therapy will work for nearly 70% of sufferers, but he can’t get legitimacy in the medical arena. (Imagine that.)

        Someone actually sent me a while back a sample of a professional IBS hypnosis series. Nothing in it sounds scary to me.

        7. When I can eat eggs again freely, I’ll be sure to write a post on how I did it. 🙂 I’ve banged my head into every single wall with diet and supplements and even using one of those people who do coaching that you see advertised all over the place (one that I really have enjoyed). No go. Someone said, “It’s eggs. Maybe you’ll never get over it.” Perhaps. Perhaps.

        8. I try to take note of what makes my sensitivities better: sleep for sure, exercise, sunshine, going to the sea, carving out 20 minutes of only-me quiet time every day.

        And I’m stopping talking now!

  5. gabriella

    Ah yeah, you know, the Plant Based Diet Doctor Gurus, the ones with the sunken eyeballs, claim that the vegan diet is a cure all for everything that ails a human and prevents ailing in the future. Especially the no added oil, no added salt diet. The gurus claim that plant based diets solve all gut problems, even Crohn’s disease. There’s mixed reporting by individuals though. I did a brief google search to see if there’s any report out there of any one coming down with Crohn’s after years of eating a plant based diet. Nothing yet. I shall continue to venture forth into the belly of the Google beast. There must be someone lurking out there perhaps on the 60th page of ‘hits’. Or perhaps these poor people are shame facedly hiding in a dark corner somewhere avoiding castigation from The Dedicated Ones.

    Looking forward to your next installment, Terri.

    🙂

    Reply
    1. thehomeschoolingdoctor Post author

      Hey! My blog is on the 60th page of hits! (Hee! Haw!)

      No. Vegan does not seem physiologically compatible with life without modern supplements. To have a primary diet that requires supplements off the bat doesn’t seem right and defies my common sense. However, you know I do love plant matter to eat! Cooked, raw, heck, even flambeed. And I’m well aware that you like them cooked. Good by me.

      If you do find something, let me know. I’ve comprised a couple of eating plans for specific diseases, one being a kind of cancer, and none were vegan. Very plant-based, yes, but not vegan.

      Reply
      1. gabriella

        I cruised the Crohn’s forums. There was one person who claimed to have kept a vegetarian (not vegan) diet for 7 years prior to developing Crohn’s disease. But we don’t know, do what, how this person practiced a vegetarian diet. Some people tried vegan without success. Some people reported success and flare ups when they ‘cheated’.

        I agree with you totally. Vegan diets do not provide the nutrition required by human beings, namely vitamin B12 and probably zinc. Selenium is not required by plants so that is also a hit and miss. Saskatchewan lentils and probably other pulses are rich in selenium because it’s in the soil. Lentils more so because for some reason botanists don’t understand, the plant takes it up at a higher level than other pulses.

        I subscribe to plant based with some animal/ocean material. Doesn’t have to be huge amounts but focusing on kidney and liver which provide a concentrated source of vitamins and minerals means not needing to nosh on large quantities of animal ‘bits and pieces’. Also some seafoods like oysters and even sea urchin roe will provide valuable nutrition without concomitant ocean pollution.

        Recently I decided to try psyllium. Fabulous. Then I went without for a couple of weeks. Despite major ingestion of vegetables and pulses like lentils, (oodles of plant fibre) the Quality of product was not as good at all. So back on the two rounded teaspoons of psyllium per day. Less is more. The recommendation of 2 to 4 tablespoons per day is probably overdoing things and maybe even creating problems. I finally got the CD of the MRI of my back (from summer 2015… yeah I’m slow). There’s a herniated disc distorting the spinal cord at L4/L5. I already knew about the one at T10/11. The report stated ‘spinal stenosis’ but I didn’t really know what that meant. And now that I DO know, I’m not taking it lying down. If this has anything to do with lack of fecal propulsion in the rectal region, I’m not sure. Or if it has anything to do with a bit of lack of bladder control, again I do not know for sure. I do know that getting the muscles supporting the spine as strong as they can be is important. Way back many years ago I had sciatica but eventually it went away. When did all this happen? No idea. But I am getting the old back stronger and stronger and not giving up. Nice to see the picture though. Better to know than to not know.

      2. thehomeschoolingdoctor Post author

        Hi! Your comment got me thinking about selenium in South Dakota, as we’re really just there under Saskatchewan! Wondering if South Dakota would have pockets of high selenium! We do! But we don’t grow lentils. (I wonder if we could grow lentils…) Anyhow, not that you care much about SD, but I did find this.

        “The Western Plains of the Dakotas are underlaid by a geographic formation that contains high concentrations of Se (Rosenfeld and Beath, 1964). This geological formation results in high concentrations of Se in the soil of parts of North and South Dakota, and consequently, the beef raised in this region may contain high concentrations of Se.”

        Cool, eh!? I like geology a little bit. Not enough time to learn it.

        You should read Sarno’s book on the back. Interesting. Not meaning that a person should ever, ever ignore back pain and symptoms of constipation and bladder issues (I’ll toss in another ever, ever) and defer medical evaluation!!! But it’s definitely an interesting take. I think his theories could use some updating pathophysiology-wise, but a real winner none-the-less.

  6. Aviva

    Hello Terri,
    Haven’t read your posts for a while and my eyes just fell on this one about Dr. Suskind and Crohn’s remission, for a reason, I suppose. My daughter’s Crohn was very bad for a while and she did an enteral diet with Modulen (Nestle…). She did go on a remission and then went on with Gaps. To my disappointment, since being so sick before, on finishing the enteral diet, she submitted to the doctors’ recomendation and she receives the biological medicine Remicade I.V every two months. I am sure she could be well without the medication.
    Of course I was happy to see Dr. Suskind’s small study. Dr. Hunter from England got remission with enteral feeding for some years now and then a list of foods, kind of resemblins SCD.
    You have gone so far away from your Medical School knowledge. Chapeau!

    Reply
  7. Wilbur

    I wrote a long response that got deleted by my iPad. A reboot of my browser. I hope this one makes it through!

    Foremost, I cured myself of IBS-D. Lots of food intolerances. I knew all of the bathrooms on my route. My diet was geared to avoiding problems. It was awful. I was a C-section baby, bottle-fed, and took lots of antibiotics. I eat anything I want now.

    Regarding what you say about hypnotism. It has a bad rep because of what people see about theatrical stage hypnosis. Hypnosis as a general subject is nothing like that. I’m studying hypnosis. Pure and simple, hypnosis is benign, a concentration of mind. Focus. Hyper-awareness.

    What most do not realize is that we go through much of our day in a state of hypnosis. That we have a set of beliefs and we interpret normal everyday happenings to confirm our beliefs. Confirmation bias. The beliefs and confirmation bias provide a feedback loop that create our reality.

    So, one must create their own reality. Study after study shows that eating vegetables is good. It fixes lots of stuff, including IBS-D. I’m far from vegan, but I believe in vegetables. Cooked, raw, whatever. You know that; I know that. So reinterpret the rumblings and diarrhea and other things after eating vegetables as good things. A start to healing. A friend, not a foe. Yes, it looks the same as being IBS-D,but is it any worse? If it’s the same, what have you lost? You know vegetables are good. It must be better even if it feels the same.

    And damn, we see that, while not large, small improvements happen. We have an urgent poop, but it’s not as runny as before (a consequence of eating more veggies). And we concentrate on the small improvements. That’s positive hypnosis. Using minor and only slightly positive cues as triggers to produce larger positive behavior. The feedback loop done right.

    I also want to add that some of the IBS patients not helped by hypnosis seemed to have had surgeries that might have damaged nerves near their colons.

    Reply
    1. thehomeschoolingdoctor Post author

      Well, we’ll take the shortened version since the long one got lost in space. Thanks. That is a great point about the very small improvements being things to allow your mind to focus on rather than the feeling that this all isn’t working. “Using the minor and slightly positive cues as triggers to produce larger positive behavior.”

      Hypnosis for select things seems to have some good results. It’s on the reading list here.

      Reply
      1. Pat

        Thank you Terri, and to everyone else who has replied to my post.

        I have been thinking about a number of comments that were made. It does appear to me that I am able to eat certain foods sometimes, but not other times. Reading through what you were saying, it occurs to me that perhaps sometimes I’m eating too much of those foods at one time, and I am not able to digest them due to overload. Sometimes I will have black beans with a meal of salmon and vegetables. Afterword, I will feel so good as if I have received some nutrient that I really needed. I thought that might be the black beans (fiber?). Although to be honest salmon does settle very well with me. However other times I will have soup with black beans and really have a digestive upset. So I wonder is it combinations? Is it that I was already in “the mode” and sensitive to almost anything I would eat, or some other reason. After reading your posts, I think I will try small portions of those healthy foods that can cause problems and cook the vegetables to make them less fibrous. The question is why do we want to starve the microbiome with EEN? Are we starving out the bad bacteria.before replacing it with good?

        The other problem is just that sometimes I narrow down my list of things I can eat to a degree that I’m starving and I just eat something that I know is not the right thing. At that point, I’m definitely my worst enemy. The idea of eating small portions of well cooked food may help me from getting into that state.

        As far as hypnosis goes, I actually think that is very very successful. I have a lot of headaches that I think are linked to the food in tolerances. I use hypnosis tapes, meditation and other forms of mind over body techniques for the headaches as well as sleep problems. I also jog. It came to me one time that I was having a very difficult time jogging, my legs felt like lead, I was breathing hard, etc. I’m 60, so I have to admit things are getting a little tougher out there on the pavement. But when I start thinking about something else, I completely forget the physical discomfort and find myself further down the road. Essentially, my brain is sipping a piña colada on the beach while my body is jogging. A brain expert I once read said that the brain is not capable of thinking of two things at one time. So if I think about the pain in my big toe, it becomes impossible for me to think about the pain in my head–or gut. I have been trying that technique during meditation, creating a distance between the symptom as if the symptom is a separate entity from me. At the end of the sessions both my gut and my headache are better, although not necessarily gone. Of course that works well for symptoms that are not so painful that it would be extremely hard to block them. It has helped reduce my symptoms and giving me an attitude adjustment. 🙂 Sometimes that’s half the battle.

      2. thehomeschoolingdoctor Post author

        Food sensitivities are weird, and everyone has to admit, even allergists, that they are so shifting and unpredictable! Even true allergies can be so shifting!

        That is the million dollar question. Do we want to starve the microbiota? For how long? I look at it as not necessarily starving the microbiota, but more as allowing restoration of the proper environment for the microbiota. Yes, you are taking away their external food source but by doing so the body can probably restore itself without dealing with digestion. EEN will be nearly completely absorbed before it hits the distal small intestine. When starches, fats, and proteins make it to the ileum (the last part) of the small intestine, changes are put in place that shouldn’t be. For example, if these nutrients reach the ileum, then it feeds back to the pancreas and shuts off production of pancreatic enzymes. So a person with malabsoprtion, who needs those enzymes, may not be getting them the way they should.

        Another change that occurs would be the change in pH of the small intestine and intestine with unabsorbed sugars, starches, proteins, and fats. Proper pH is VERY important for the action of our enzymes and also for certain bacteria to grow (or to keep other ones from growing) or to keep bacteria from growing in wrong spots! So by using EEN or a diet which alleviates some of the delivery of nutrients more distally than it should be, the distal small intestine, cecum, and colon may be allowed rest. Give the body a rest, and it can restore. It can do a better job at eliminating damaged cells and new cells aren’t being inflicted with digestive turmoil. I’ve often wondered if a long water fast could cure many GI issues. PLEASE NO ONE TRY THIS. DUH! We are finding out a lot currently about fasting, which is so very interesting and insightful. Maybe feeding overgrown, negative quality bacteria is worse than starving good ones. I’ve read the good ones dig down deep in the crypts and so even though we think we’ve killed them off, there are still colonies deep in there. So get the environment (pH, mucous layer, motility) back the way it should be, and the beneficial bacteria can get back to living well again.

        Also, I do want to point out that changes in the cecum that occur with bacterial overgrowth and delivery of nutrients also feeds back and slows peristalsis. So that’s another change that occurs in all this which makes things worse.

        So my thought with the EEN and the SCD is that less makes it down to the ileum and cecum, which isn’t necessarily a bad thing. But if the studies keep working, I’ll be super excited for lots of medical minds to think on it and finally give us their final conclusion!

        I liked your information on hypnsosis. It was very interesting. Thanks!

        Have a great weekend! May all be well!

  8. Pingback: A Stay-At-Home Mom’s Diet Enters Medical Research | The HSD

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