Crohn's and Colitis: What I Wish Your Doctor Would Tell You
Please note that I am not a doctor. The information in this post is for entertainment purposes only and is not intended to constitute medical advice. Always consult with a qualified health professional before implementing any dietary or lifestyle changes.
This month I want to talk about inflammatory bowel conditions and natural approaches to managing them. ‘Inflammatory bowel disease’ is an umbrella term that includes Crohn’s disease, ulcerative colitis and colitis. The reason I want to focus on those conditions this month is because I recently got a call from someone who has been suffering with colitis for thirty years. They are no longer finding relief from their prescribed medication and their specialist has warned them that they may soon need to have a section of their bowel removed. Naturally they are pretty unhappy about taking such a drastic step and have started looking to complementary therapies in the hope of avoiding surgery.
I was stunned to discover during our conversation that in three decades, nobody had ever given the caller any sort of dietary advice or pointed them in the direction of supplements that might help. It left me wondering how many people are in similar predicaments, having no joy with steroids and facing surgery before they’ve even given dietary interventions a chance. Although I don’t have Crohn’s Disease or ulcerative colitis myself, you’ll know from previous posts that I had pretty awful irritable bowel syndrome for many years. It got so bad that I eventually ended up working from home, because I had almost constant diarrhoea and my tummy always felt raw and unsettled. It had a huge impact on my confidence, my social life and my finances, so I have huge sympathy for anyone who suffers with digestive issues.
Before I begin, I want to tell you this: there is PLENTY that you can try that might help your inflammatory bowel condition. You are not bound to have your bowel removed and end up with a colostomy bag. It is not inevitable that you live every day in pain, discomfort, inconvenience and embarrassment. Yes, an unfortunate few of you might find your condition resistant to all dietary changes, natural treatment approaches and medications, but I truly believe that an overwhelming majority of you can experience frequent and extended periods of remission. That is the good news. The bad news is, you’re going to require a hefty amount of self-discipline and you’ll need to be willing to invest a bit of time and money into the cause.
If you’ve been dealing with your bowel condition for a while and have already done lots of research into complementary therapies, there won’t be much new information here for you. However, these are what I consider the top priorities, the absolutely crucial things to do. I took it for granted when I spoke to my caller that because they had been afflicted for such a long time that they would have tried all these things already. I considered them so obvious that I nearly didn’t mention them, but I’m so glad I did, because they turned out to be new information. I want to compile them here, in a list, for anyone else who might not know about them – doctors included!
You need to do this strictly and completely for at least two months. Not reduce it. Not have a couple of days a week without it. Get rid of it! This will include not just the obvious sources like bread, pasta and biscuits, but also hidden sources like sausages, beef burgers, gravy and beer. The good news is that not all sausages and burgers contain gluten, but you’ll need to spend time reading ingredients lists on packets to figure out whether what you’re buying has any gluten in or not. It’s hidden in all sorts of places, so double check everything!
Why do you need to do this? Because gluten is a sticky protein that can cause irritation and inflammation within the gut and beyond. You don’t need to have coeliac disease to react badly to gluten – many people are intolerant to it. If you have digestive symptoms, especially ones involving ulcerations and diarrhoea, you will almost certainly benefit from going gluten free.
Before you rush down the gluten free aisle of your local supermarket, loading your trolley with gluten free bread, croissants, muffins and breakfast cereal, I want to issue a word of warning: ‘gluten free’ does not mean the same as ‘nutritious’. Gluten free or not, an apple is still going to trump a cupcake in the good-for-you stakes. So rather than replace one junk food with its gluten free counterpart, try to actually change the way you eat to rely less heavily on bread, cereals and baked goods.
You need to do this strictly and completely for at least two months. Not reduce it. Not have a couple of days a week without it. Get rid of it! This will include not just obvious sources like milk, cream, cheese and butter, but also hidden sources like milk chocolate, ice cream, many soups and lots of sauces. Like gluten, dairy is hidden in all sorts of places, so you’ll need to spend some time reading the packets of anything you buy.
If you have an inflammatory bowel condition, I would include yoghurt, probiotic yoghurt drinks, and kefir in this category and would avoid them too. I would also avoid butter and ghee, just to be on the safe side. Most people have heard of lactose, but dairy also contains casein, alpha-lactalbumin and beta-lactoglobulin which can be problematic for some people too. You might want to get a food intolerance test done by Cambridge Nutritional Sciences to ascertain which bits of dairy you are intolerant to, if any. Having a blood test done to check for this straight of the gate will save you a lot of trial and error, and hence a lot of time and expense, further down the line. I wish I had heard of Cambridge Nutritional Sciences years ago! Unless and until you get tested, I’d eliminate ALL dairy, not just cow’s dairy – i.e. goat dairy, sheep dairy, buffalo dairy, etc.
Eliminate sugary foods
You need to do this strictly and completely for at least two months. Not reduce them. Not have a couple of days a week without them. Get rid of them! Sugary foods are appalling for gut health and for health in general. They promote inflammation and disrupt the gut microbiome, allowing conditions like leaky gut and candida overgrowths to take hold. Given the state your digestive tract will already be in if you have an inflammatory bowel condition, the last thing you need is to be aggravating the environment with lots of sugar.
I know it’s difficult, because sweet foods are always the nicest. Who doesn’t love cakes, biscuits, chocolates, soft drinks and ice creams? Unfortunately they don’t love us and however we might wish it were different, junk confectionery items are not conducive with good health. You should eliminate them entirely for a while to give your digestive tract a chance to recover and to allow yourself an opportunity to change your tastes. You will be really surprised after several weeks with no sugary foods at how artificially sweet they taste when you next try them.
Ideally, you are going to be using the strict couple of months to create permanent changes to your diet, so you won’t be going back to eating sugary foods on a regular basis. I know you’ll probably still want to have them occasionally as treats and you will be able to, but please forget the idea that you can go back to eating them daily without consequences. You can’t. Hardly anyone can – even if they don’t have gut problems, it tends to catch up with them somehow further down the line.
Note: you also need to eliminate artificial sweeteners, which are also bad for the gut and your overall health. So you can’t just replace all your favourite sugary foods with their ‘diet’ or sugar free equivalents, sorry!
You need to do this strictly and completely for at least two months. Not reduce it. Not have a couple of days a week without it. Get rid of it! Like sugar, regular drinking and binge drinking are detrimental to the gut microbiome. Besides wiping out good gut bacteria, alcohol can also cause inflammation to the GI tract, which is the last thing you want if you already have damage there. It can weaken your immune system leading to further inflammation and many alcoholic drinks are high in yeast, which itself is a trigger for lots of people with compromised digestive systems.
I know people can find the idea of life without alcohol somewhat bleak, so after a strict couple of months by all means see how you go with an occasional drink again, but please do your best to stay off it completely for a while. I know all too well how a little taste of this on a Monday and a little slice of that on a Wednesday and then a glass of that on a Friday can all add up so that by the end of the week, you’ve consumed something irritating to the GI tract almost every day! And then you’ll bemoan the fact that your dietary changes haven’t made any difference and you’ll have wasted all the rest of your hard work. Take it from someone who learned the hard way: it really is better (and easier in the long run) to just give the whole lot up entirely for a few weeks and allow your inflamed bowels chance to recover.
If you can afford it, get a food intolerance test from Cambridge Nutritional Sciences
I had recently an extremely positive experience with Cambridge Nutritional Sciences – far more so than with the market leaders of food intolerance testing a few years prior. I wish I had heard of CNS much earlier in my health journey because they were a real game-changer for me, but better late than never! Finding out your own specific intolerances will enable you to eliminate things in a strategic way instead of blindly guessing and having to monitor your symptoms. For example, lots of people are intolerant to eggs, nuts or legumes, but these are nutritious foods. It would be rather extreme to give them up for three months on the off-chance they don’t agree with you, but then if you don’t give them up when you should have done, your symptoms might not improve as much as you’d like. And after you’ve gone to all the effort of giving up gluten, dairy, sugary foods and alcohol, you’re going to want to see some big improvements, I imagine!
Another reason I recommend the test is because you might also be intolerant to some of the ingredients commonly used in gluten free products. I, for example, am hugely intolerant to rice (hence rice flour), potatoes (hence potato flour) and corn (hence cornflour). I’m also intolerant to peas, pears and celery, which means all those celery sticks I forced down thinking I was being virtuous were a waste of time! Because I had so many food intolerances, it was proving impossible to track them down using trial and error, so having a blood test done was incredibly helpful. If you strictly avoid your trigger foods for an extended period of time and concentrate on healing your gut, you may be able to safely eat those foods again at a later date. I plan to get another test done in the near future to see whether I can reintroduce any foods back into my life, because it turns out that in the long run, you miss peas and sweetcorn way more than you’d imagine!
Take gut-healing supplements
If you have an inflammatory bowel condition, your bowel, as the name suggests, will be literally inflamed and often ulcerated. While eliminating aggravating and pro-inflammatory foods is a crucial step, it is also important to do something to actually heal this damage.
- If I could only use one product to do this, my absolute number one choice would be L-glutamine. Within two weeks of cleaning up my diet and taking L-glutamine, my digestion was unrecognisable. The horrible raw feelings inside my tummy had subsided, I no longer had as much urgency, and my stools became more formed for the first time in years. I have come off L-glutamine a few times over the years, but ever since I got the results of my food intolerance test I have taken it twice daily and I don’t think I’ll be dropping it from my regime anytime soon. It is wonderful for healing leaky gut, strengthening the tight junctions that have become loose, and for generally calming bowel inflammation. I would recommend getting loose powder rather than capsules so that you can take high doses more easily (and more cheaply!). Make sure it’s pure – nothing should be added.
- Aloe vera is another excellent thing to use, but you MUST choose a product that has had the anthraquinones removed. Anthraquinones are found in the latex layer of the aloe vera leaf and it is these that are irritating to the digestive tract and produce laxative effects. They may even be carcinogenic when taken in the long term. If you choose an aloe vera product that has had these anthraquinones removed, it will be gentle on the stomach. Aloe is naturally anti-inflammatory and is high in glycosaminoglycans, which help to soothe irritation and heal wounds. I’ve had a few people who use high-potency aloe vera capsules for interstitial cystitis tell me that they had the unexpected happy side effect of being very soothing for their digestion too. If you're not keen on capsules, you might be interested to know that I actually created Tiny Pioneer Simply Aloe Powder, Tiny Pioneer Aloe Mallow Powder and Tiny Pioneer Blend No. 3 with Crohn's disease and ulcerative colitis patients in mind. They are made with a specially processed powder that has been used in a small sample of Crohn's patients where it showed good results. Aloe vera has also been studied in a double-blind, randomised, placebo-controlled trial of 44 ulcerative colitis hospital out-patients where it was found to produce a clinical response more often than placebo when taken for four weeks.
- Slippery elm is a demulcent herb that protects and heals irritated tissues. It can be bought in a powdered form and added to water (vile) or mixed with fruit puree (much nicer!). I’m fairly brave when it comes to taking medicine, so if I tell you that something is vile, it really is. Because slippery elm is very mucilaginous, it goes slimy as soon as it is mixed with water. It is this slimy property that makes it so good for the gut, but I much prefer to mix it with some Biona Apple and Banana puree! It doesn’t affect the efficacy and it makes it much easier to take. I don’t take slippery elm for my bowels – I actually take it for stomach ulcers. In recent years I’ve developed a propensity to get a stomach ulcer whenever I’m stressed, but a few doses of slippery elm soon sees me right.
- Make bone broth or take bone marrow or collagen. If you have the time and inclination, making bone broth out of organic bones and drinking it a few times a day is very healing for the digestive system. You might have heard of the GAPS diet, often used in children with autism. This advocates the drinking of bone broth to sooth and heal the gut. To learn more about this, you can read ‘Gut and Psychology Syndrome’ by Natasha Campbell-McBride. Her regime is far too extreme for me to follow, but if you continue to experience bowel inflammation even after applying all the other steps here, it is something for you to consider. If you don’t fancy making bone broth, you could try taking a bone marrow or collagen supplement instead. I have just started taking Ancestral Supplements ‘Living’ Collagen, which is not made from hides and hooves like many collagen supplements, but instead uses trachea and scapula that is processed using natural enzymes instead of heat. I’m interested in the gut healing properties of course, but I’ve also just had yet another birthday and I’m rather hoping that the anti-aging properties will keep me looking young!
- Bovine colostrum is something I have mixed feelings about. It is used to good effect in many people with inflammatory bowel diseases, but it also contains casein. It’s something that might be best used only after you’ve had a food intolerance test. Colostrum has been found to strengthen gut barrier function and restore epithelial tissue, but if you’re intolerant to other constituents of dairy besides lactose, you might be better avoiding it. I’ve spoken to people who noticed a real improvement with it though, so if you’ve no intolerances to anything in it, then it might be well worth a try! Be sure to get it from an ethical supplier who ensures the needs of the calves are met first and who takes good care of the cattle.
Your gut microbiome is likely to be in a bit of a state with all the inflammation and ulceration you’ve had going on, not to mention the medication you’ve likely been taking. A good probiotic will help to restore a healthy balance of good and bad bacteria. There are so many probiotics out there that I can’t recommend one particular brand and I’m sure there will be products that are manufactured especially with inflammatory bowel diseases in mind in any case. You want a count of at least one billion and you want the label to tell you exactly what strains are in there and in what amounts. Stay away from any brands that vaguely talk of ‘proprietary blends’ without giving any specifics.
You can also eat probiotic foods, but I’d avoid the dairy based ones at least for a few months. Sauerkraut, kimchi, kombucha and jun are all good sources, though be sure to buy raw, organic, unpasteurised versions. I am a regular customer at Loving Foods and I highly recommend them! Given that I don’t drink alcohol or any soft drinks, their kombucha and jun are lovely treats, especially on a hot day.
Take prebiotics or eat prebiotic foods
Probiotics are living bacteria. They too need food to survive and prebiotics are what they eat! Bananas, onions, leafy greens and artichokes are good sources, but sometimes they are added to probiotics or you can purchase them as separate supplements. If you take them in supplement form, they can make you a bit windy to begin with.
If you are able to implement all of the dietary changes listed and incorporate one or more of the gut healing supplements, along with a good quality probiotic, I am fairly confident that you will see significant improvements in your symptoms. These should become apparent quite quickly, which should spur you on to keep up the regime for several more weeks. If after several weeks of the regime you are still not improving, you might want to book a consultation with a nutritionist or a medical herbalist for some more personalised advice. My mum is a medical herbalist and she has had some excellent results with Crohn’s and ulcerative colitis patients, so there is definitely hope for you!
Do be aware that when you first start taking gut healing agents and probiotics, it can be a bit of a shock to your digestive system and you might feel a bit rubbish for a few days. This phenomenon of feeling worse before you feel better is known as a healing crisis, a Herxheimer reaction or a die off reaction. You might want to Google these terms before you begin your regime to learn more about them. When I first gave my diet a huge overhaul and started to address my gut health, I had die off reactions on and off for a few weeks, but I was also taking lots of antimicrobial agents to address a candida overgrowth. It wasn’t too bad – certainly no worse than the years of stomach irritation and diarrhoea that had preceded things – but it’s just something I wanted to warn you about!
Further down the line, if and when your guts are a little more robust, you might also want to use some antimicrobial agents to address any yeast or bacterial overgrowths. However, for the first couple of months when everything is very inflamed and raw, particularly if you experience ulcers and bleeding, I would focus on just eliminating aggravating foods and healing the irritation. There will be plenty of time to address things like candida and SIBO at a later date when your digestive tissues are less delicate.
I know that for some people surgery will be the only option, but for those whose condition has not yet reached that stage, hopefully some of the things here will be helpful. You might want to head over to the website Empowered Sustenance to learn more – Lauren, the owner, was diagnosed with severe ulcerative colitis at 14 years old and at 18 was told that surgery was her only option. She made some strict dietary changes and used supplements to return her gut to good health and she is now a nutrition consultant, committed to helping others in similar predicaments. She is far more disciplined and knowledgeable than me and she has a recipes section that I have turned to many times for inspiration!
Okay, I really hope someone out there will find this post useful. I know some of the dietary changes seem very draconian, but surely not more so than having sections of bowel removed or spending a lifetime worrying about toilet issues. If you do implement some of the suggestions and see improvements, please consider letting your doctor or specialist know so that they can spread the word to others. It isn’t because they’re neglectful that they didn’t tell you any of this – they just don’t know it either. Help them to learn so they can help others in your position.
Wishing you the best of health,
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