Finding Relief for Inflammatory Bowel Disease (IBD)
It is believed that as many as 1.4 million Americans suffer with inflammatory bowel disease (IBD). Symptoms can include diarrhea, constipation, bowel urgency, stomach pain, cramping, bloating, bloody stools, fatigue, loss of appetite, weight loss, skin problems, fever, and anemia. The disease typically has times of remission where people with IBD experience a near normal life and periods of flare up when conditions suddenly worsen. During a flare up, people with IBD may not be able to leave their homes easily because they need to stay close to a bathroom. When they do go out, people with IBD may be constantly on the alert, scanning stores, office buildings, and restaurants for the fastest route to the public restroom. Inflammatory bowel disease typically occurs as either ulcerative colitis or Crohn's disease, either of which can feel socially or professionally limiting when the disease is flaring up.
Control Requires Change
For those who suffer with IBD, the first simple step to taming the colon and taking back control is to change what is put into the colon. Whatever we eat ends up in our intestines, either irritating of soothing the colon. John McDougall, MD, says this obvious fact is missed by many physicians:
The main reason chronic colitis is rarely healed is because almost all practicing doctors believe that the foods we eat have little or nothing to do with the health of our intestine (or for that matter our entire body). They cannot imagine that what remains for hours and sometimes days in contact with the lining of our intestinal tract could have a thing to do with its health. This misunderstanding is as preposterous as a doctor believing that what people breathed had no effect on their lung health or that substances that contact a patient’s skins rarely caused skin disease.
Fiber is Your Friend
A diet high in fiber has been demonstrated to benefit those suffering with IBD, particularly with Crohn's disease. Fiber is only found in plant foods. The authors of a recent study on the effects of fiber on Crohn's disease conclude that "a plant-based diet not only is effective for gut inflammation but also promotes the general health of IBD patients. ... . A high amount of dietary fiber is not harmful and seems to be favorable for CD." Another study showed that a low-fiber diet did not improve Crohn's symptoms but rather that those patients with the highest dietary fiber intake were "significantly less likely to experience a flare." For those suffering with ulcerative colitis, research continues on the benefits of resistant starch. So far, researchers have demonstrated that fiber in the form of resistant starch and wheat bran normalize gut transit time.
Fat is Not So Friendy
Dr. McDougall explains that lowering fat intake is another important step in reducing the symptoms of IBD. When we eat fats — whether from animals or derived from plants such as olives — our liver produces bile to help digest the oil. If our small intestine is healthy, the lower part of it (called the ileum) reabsorbs the bile. People with Crohn's disease often have a damaged ileum and are thus unable to reabsorb the bile. When the naturally acidic bile reaches the colon, the colon tries to dilute it by releasing mucus and water. The result is diarrhea. By eliminating excess fat in the diet, the liver doesn't need to pour large amounts of bile into the intestinal track. Further, if we are eating plants, the fiber will absorb much of the bile that is present and absorb any excess water in the colon.
Allergens are Aggravating
Any discussion of IBD must acknowledge the effect of allergens. Dairy products, wheat, and eggs are all likely to cause irritation to the intestines. A plant-based diet removes two of these three irritants and is often enough to provide relief of symptoms. If symptoms do not resolve, wheat should be dropped from the diet; if symptoms persist, I would recommend that my patients proceed with an elimination diet to discover any other foods that are irritating the system.
Being Bothered by Bacteria?
But are allergens the cause of IBD, or do they merely aggravate a compromised intestinal track? Interesting research is pointing towards a bacterium, Mycobacterium avium, subspecies paratuberculosis (MAP), as the cause of IBD. This bacterium causes a chronic disease of the intestine in dairy cows and many other animals, including non-human primates. MAP has a thick, waxy cell wall that survives the pasteurization process. Humans can be infected by consuming contaminated meat, dairy products, or even water that contains the bacterium. The researchers refer to the transition process as "from farm to fork" and indicate that susceptible individuals go on to develop intestinal disease.
MAP seems to be just one more reason to be an early adopter of a plant-based diet. The average age of onset for Crohn's disease is 15 to 35. By avoiding animal products, we not only lower our risk of developing chronic diseases like IBD, but we simultaneously lower our risk for lifestyle diseases such as hypertension, type 2 diabetes, cardiovascular disease, obesity, and some cancers. But maybe best of all, a low-fat, whole-food plant-based diet can halt and often reverse the damage we did to our bodies before we knew about the power of plant foods.
Return to Running
Read about how my patient Susie adopted the Starch-Smart® System and conquered Crohn's disease and high cholesterol. She says, "Although this lifestyle takes a lot of self-discipline, ... it beats spending all your time in the doctor's office as a result of eating the Western diet. I prefer to be outside training for my next triathlon!"
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