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Inflammatory Bowel Disease: Does Diet Play A Role?


written by Dr. Christine Bishara - May 16, 2022
medically reviewed by Dr. Christine Bishara, MD - May 16, 2022

Photo Credit: by Kat Smith, Pexels.com
Photo Credit: by Kat Smith, Pexels.com

Want to see real change happen? Tell a mother there’s nothing she can do for her sick child.

This is what happened when Elaine Gottschall, back in the 1950's, was told her 4-year-old daughter, Judy, was suffering from severe ulcerative colitis. Judy’s condition was unresponsive to medications, and causing significant malnutrition and growth delays. Elaine and her husband were told that surgery was the only remaining option for their very ill daughter. Elaine was desperate to help her daughter, but did not want her to have surgery that would remove part of her colon and leave her with a colostomy bag for the rest of her life. Just when she had been resigned to her fate of surgery, A friend introduced Elaine to Dr. Sidney Haas, MD, a 90-year-old physician who had spent a large portion of his medical career developing a nutritional approach to intestinal healing. He had even written a textbook about this approach that was present in almost every medical library in the world. His colleagues however, unschooled in nutrition and dismissive of its importance in one’s health maintenance, had abandoned his findings in pursuit of new and emerging medications and surgical options. What was this nutritional approach that Dr. Haas developed and did it help Judy? More on that later but let's talk a little about what inflammatory bowel disease is and its causes and symptoms.

Inflammatory Bowel Disease (IBD) comprises the conditions Ulcerative Colitis and Crohn’s disease. Both are characterized as such due to the inflammation they cause in the gastrointestinal tract. While ulcerative colitis is usually limited to the mucosa (innermost layer of the colon), Crohn’s disease can affect any part of the GI tract and the inflammation usually extends through several layers of the intestinal lining. Both are considered autoimmune diseases and can frequently cause other symptoms outside the GI Tract. Peak incidence of diagnosis is adolescence and young adulthood.

Because IBD causes active intestinal inflammation, accompanying symptoms include:

● Abdominal pain and cramping

● Abdominal bloating and gas

● Poor appetite

● Intestinal bleeding and diarrhea

● In severe cases dehydration and subsequent malnutrition result from an inability to absorb any nutrients.

What is the cause of inflammatory bowel disease?

While no specific causes have been definitively identified, there are several theories.

Causes:

1- Genetic. Inflammatory bowel disease does tend to run in families.

2- A Westernized diet has been proposed as a major risk factor since IBD is more common in industrialized nations with the incidence increasing in individuals who emigrated to a westernized nation, pointing to an environmental or dietary factor playing a possible role.

3- Gut dysbiosis: this means there has been a disturbance in the equilibrium of the microorgan-isms living in the gut, leading to the production of certain harmful toxins called lipopolysaccha-rides. Presence of a bacteria called Mycobacterium avium, which causes intestinal infections in cows has also been purported as a possible cause. The infected cow can pass the bacteria to humans through infected milk, leading to damage to the intestinal lining. Emerging data has linked this to be a strong risk factor for IBD, especially Crohn’s disease. Is Mycobacterium avium subspecies paratuberculosis (MAP) associated with Crohn's Disease? | medRxiv

Although there is no current cure for IBD, many people go into remission with certain treatments and diet modification.

Pharmacological Treatments have been successful in putting many patients in remission. They include:

● Oral 5-aminosalicylates such as sulfasalazine or mesalamine.

● Steroid medications such as prednisone, budesonide

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● Immunomodulators such as azathioprine and methotrexate

● Biologic therapies such as infliximab

Diet:

Now back to diet and Elaine Gottschall. Desperate to avoid surgery and to help her daughter, Elaine started Judy on Dr. Haas’s nutritional protocol “The Specific Carbohydrate diet.” Within a few months, Judy’s symptoms began to improve and within two years, she was completely symptom free. Judy is now in her 60’s and in remission from her Ulcerative Colitis, never requiring surgery. What is the science behind this diet which limits all refined carbohydrates such as those found in bread, pasta, etc?

1- Bacterial overgrowth: Since they have little fiber, carbohydrate rich foods remain in the intestine longer. These carbohydrates become energy sources for harmful bacteria lead-ing to bacterial overgrowth. These bacteria release the harmful lipopolysaccharides which start to cause injury to the intestinal lining.

2- To protect itself, the intestine secretes mucus to form a barrier in an effort to block the harmful substances. This however, prevents digestive enzymes from further breaking down undigested carbohydrate molecules leading to more bacterial overgrowth and more toxic lipopolysaccharides.

3- Due to the intestinal inflammation from the above processes, the intestine cannot properly absorb nutrients leading to malabsorption and malnutrition.

4- With all the chaos going on in the intestine, the immune system reacts by releasing in-flammatory responders which trigger more inflammation and further damage to the intes-tinal lining.

By eliminating certain carbohydrates from the diet, “The Specific Carbohydrate Diet” has helped many people with Inflammatory bowel disease. It is explained in a book written by Elaine Gottschall called “Breaking The Vicious Cycle.”

Do you suspect that you may have inflammatory bowel disease? If so, speak to your doctor about getting a diagnosis and before starting any diet or treatment option.

Since many of the medications used to treat Inflammatory bowel disease can be costly, Canada Pharmacy Online can be an option for obtaining these medications at a fraction of the cost.

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