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Old 10-23-2007, 08:21 AM   #1
Chris Longley
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Default Ulcerative Colitis

Hi,

I have the mis-fortune of suffering from UC and despite my best efforts, it seems to be pretty persistent.

I was hoping that some of you might have some insight into this - I'd be particularly interested in Dr Garrett Smith's views.

I'm currently taking fish oil - approx 10g EPA/DHA, Probiotics (Udo's choice Super 8) and ZMA. This is in addition to the Pentasa prescribed by my Dr.
With regards to food, I aim for zone ratios with higher fat, but I'm not sure this is the best approach.

Any advice would be greatly appreciated.

Chris
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Old 10-23-2007, 05:27 PM   #2
JW Luckett
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My daughter was diagnosed with Crohn's Disease last year in August at the age of 18. She's on Pentasa and gets Remicade once every two months. Here in Japan they also have the patients sit down with a nutritionist, so diet also plays a very important role in managing the disease.

The approach here is to limit fat intake to 25-30 grams per day. That's not much. She is supposed to avoid fatty food, especially fatty meat like beef and pork. Fish is all good and she also takes an Omega-3 supplement. For some reason lamb seems to be OK, too (maybe cause it's grass-fed?). NG foods are things like all processed food, ramen noodles, cakes, ice cream, etc.

Her experience seems to support this approach. She was recently in Vietnam and had to just eat what was there, and that was mostly oily food. When she got back she was having a minor flare up. When she splurges and eats her favorite goodies, she gets abdominal pain and has to stop eating and just drink her nutritional supplement. I wish she would manage her diet better, but she's a 20-year-old college student away from home.

Anyway, you wrote that you go for zone ratios with higher fat, so I guess I'm saying you might want to experiment with that and really pay attention to the quality of the fat.

joe
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Old 10-24-2007, 05:49 AM   #3
Garrett Smith
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Chris,
You didn't mention much on diet at all. What do you strictly avoid?

If you wanted to go the cheapest route, my first advice would be to go on a STRICT gluten-free, nightshade-free, Paleo diet (no peas or green beans either) for a month and see how your symptoms fare. Also, you must get 9+ hours of sleep a night. I had a patient with suspected UC "fix" the problem simply by doing the above diet, getting more sleep, and taking my heavy-duty probiotics.

If you need to see proof in the form of tests, here we go:

First thing I'd say to do is the "Stool Test for Gluten Sensitivity" at www.enterolab.com . $100

Next, an Intestinal Permeability test through my office (a urine test).

If you were ever concerned or had hunches about parasites playing a role, get the stool test done through www.parasitetesting.com and list me as your physician (they won't do the test unless they have a doctor to send the results to, but you can order it). You can get my address and other info from my website for the forms.

Then, if nothing showed up yet, we'd talk about food allergy testing. Again, that won't be necessary if you really do the diet above. Make sure you are gluten-free, and I'd highly suggest the book from www.noarthritis.com on how to exactly avoid the nightshades (they are hidden in as many places as gluten).

Yes, it sounds like it will be tough. It is tough. So is UC.

Also, 10g total of EPA+DHA sounds like a bit much to me, but that's another story.
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Old 10-24-2007, 06:26 AM   #4
Greg Davis
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I don't know too much about the condition, but for what its worth I have an aunt who struggled for years with Chrohn's.. like really sick- in/out of hospital.

Finally she now eats a paleo diet and she's perfectly healthy (she does include nightshades, the odd tuber, some cheese/yogurt without problems). No more digestive problems, she's physically active, keeping a good bodyweight etc.

Funny thing is I stumbled on the same diet from reading pmenu, devany, etc. just to improve athletic performance. And she had to use trial and error for many years to come to the same conclusions about diet. When I stayed at her cottage this summer she was like "wow someone who actually eats the same way I do!".

So from what I know from her experience I wouldn't focus so much on the supplements, just don't deviate from paleo foods (absolutely no gluten or sugar- these are the number 1&2 no-no's for my aunt.)
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Old 10-24-2007, 09:42 AM   #5
Chris Longley
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Thanks for the replies so far.

My diet is by no means paleo, but is gluten free. I do eat nightshades - potatoes and tomato products ranking pretty highly.

So, is an elimination diet the most important factor in your opinion Dr Smith? How do macronutrient ratios factor in?

I'm in the UK so I would assume the tests suggested would be difficult to paticipate in...?

With regards to supplements - what doseages would seem sensible? The 10g EPA/DHA has come about through reading Dr Sears work. Also, what should I be looking for in a probiotic?

I really appreciate all the help on this.
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Old 10-25-2007, 08:16 AM   #6
Garrett Smith
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Chris,
I will be covering this topic more in depth in a future PMenu article, meanwhile, here's some info to look at:

Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease.

Quote:
CONCLUSION: Concentrations of glycoalkaloids normally available while eating potatoes can adversely affect the mammalian intestine and can aggravate IBD.
Pathology in hamsters administered Solanum plant species that contain steroidal alkaloids.

Quote:
Syrian hamsters were orally administered ground plant material from either Solanum sarrachoides, S. melongena, S. eleagnifolium, or S. dulcamara. Six of eight hamsters administered S. eleagnifolium and eight of 10 hamsters administered S. dulcamara died following administration of plant material and had gastric glandular mucosal necrosis and small intestinal mucosal necrosis with little inflammation.
Mechanism of death in Syrian hamsters gavaged potato sprout material.

Quote:
To determine the cause of death in animals ingesting potato sprout material, 40 Syrian hamsters were divided into 4 equal groups and gavaged once on day 0 either water, 300 mg of potato sprout material, 400 mg of potato sprout material, or 500 mg of potato sprout material. Tissues were examined grossly and microscopically at 72 hr post-gavaging and brain acetylcholinesterase activity of each hamster was measured. The 300-mg dose group had increased mean acetylcholinesterase activity compared with control hamster mean activity, and the 400-mg and 500-mg dose groups had 90% and 84% of the mean acetylcholinesterase activity of the control hamster mean activity. There was severe gastric and proximal small intestinal mucosal necrosis in those hamsters which died prior to euthanasia.
Lesions of potato sprout and extracted potato sprout alkaloid toxicity in Syrian hamsters.

Quote:
Nine of 10 hamsters receiving dried potato sprout material and 3 of 5 hamsters receiving alkaloid extract had severe gastric and intestinal mucosal necrosis which was most severe in the glandular stomach, duodenum and proximal jejunum. All control hamsters gavaged with water and all hamsters gavaged with the potato sprout marc survived to the time of euthanasia and did not have gross or microscopic lesions.
Seriously, after seeing the documented evidence of GI lesions from multiple species of nightshades in both humans and animals, not eliminating them from the diet of someone with a GI disease is just plain wrong. I have to go, but take this seriously. I'm going to tell you that tomatoes do the same thing, potatoes are just MUCH worse for the GI tract.

Take them out of your diet completely. The evidence for induced pathology with peppers is even stronger, and eggplant contains the same alkaloids as potatoes do.

Sweet potatoes, yams, parsnips, and other root vegetables. It's an easy substitution.
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Old 10-25-2007, 10:12 AM   #7
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Didn't want to leave out tomato, since you said that was a large part of your diet:

Influence of saponins on gut permeability and active nutrient transport in vitro.

Saponaria saponin and alpha-tomatine also reduced transmural potential difference, but soya saponins were much less effective. The results indicate that some saponins readily increase the permeability of the small intestinal mucosal cells, thereby inhibiting active nutrient transport, and facilitating the uptake of materials to which the gut would normally be impermeable.

I'm going to save the rest for my article, just wanted to give you a taste of the research showing that GI tracts don't like the nightshades at all...

Just wait for the article on peppers, that one will be brutal.
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Old 10-25-2007, 05:14 PM   #8
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2nd what Dr. G said. it may be a simple solution to a nasty situation.
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Old 10-26-2007, 11:59 AM   #9
Chris Longley
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Wow, thanks for the info. Consider nightshades gone. I'd pretty much subbed in potatoes for the grains i'd taken out out of my diet - no more though...

So are there any supplements that you'd recommend alongside the elimination diet or am I just wasting my money looking for a shortcut?

Thanks again everyone.
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Old 10-26-2007, 01:53 PM   #10
Garrett Smith
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Chris,
I think that one big imbalance the nightshades cause is a magnesium deficiency (and/or ratio of too much calcium to magnesium, causing calcium deposition).

As far as gut damage, the best thing you can do is avoid them completely. Read all your spices, avoid ingredient labels with "spices" or "natural flavors".

Glutamine may be of some help at this point.
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