When I was nineteen I was diagnosed with ulcerative proctitis, a diagnosis soon changed to ulcerative colitis because, I suppose, my gastroenterologist felt my disease’s chronic nature and severity warranted this more serious diagnosis. At that point I felt pretty dejected. I’d always prided myself on being a good athlete, and now that I was grown I wanted to take my fitness further, but I would frequently go through periods of unavoidable weight loss, and the fact I had a stomach ache at least once almost every day, and almost never went two days without a stomach ache, gas, and bloating following a meal, checked my love of food and often left me not wanting to eat again till I was really hungry. Then there were the sporadic “flare-ups” of the disease. I won’t go into the details of those painful periods; suffice it to say I was so stubborn and distraught with the idea that one of these flare-ups would kill me without intervention with steroids and anti-inflammatories, that once, when I had run out of meds., I didn’t eat for more than four days to try to naturally wrest myself from the episode. It didn’t work though. In the end only steroids worked.
All this for a nineteen year old who’d always been in the peak of health, and my doctor said it would be this way for the rest of my life, if I was lucky and it didn’t get worse – that there was no cure and that people didn’t recover from colitis once it became chronic. So I was pretty dejected. I asked him repeatedly if there was anything I could do about my diet, or if quitting drinking would help. He said there was no evidence that was the case, except of course that I should, like anyone, only drink in moderation. My medical records from this time all said I was asthenic but seemingly in excellent health otherwise. I felt that this was how I looked in the mirror, but that something very wrong was going on inside me. But I figured there was little I could do, so for about six years things went on like this.
Both Ulcerative Colitis and Crohn’s Disease are characterized by causing ulcers and general inflammation in the digestive tract. But whereas Ulcerative Colitis, as its name suggests, is confined to the colon, Crohn’s Disease can manifest as inflammation anywhere from the esophagus to the colon and rectum, yet almost always includes inflammation and ulcers in the small intestine (that’s really how they diagnose it). The presence of severe inflammation and ulcers in the small intestine generally makes Crohn’s Disease the bleaker prognosis to get, because while both are considered incurable, the small intestine is where the vast majority of nutrient absorption occurs, and while ulcers in the relatively thicker, more muscular large intestine (colon) usually remain superficial, ulcers in the small intestine can at times eat right through the intestinal wall. And that’s not good. For this reason about fifty percent of Crohn’s patients have to get part(s) of their small intestine removed at some point in their lives.
During my initial six years with Ulcerative Colitis, I did at least find solace in the fact that my disease, while it seemed to be slowly getting worse, was chiefly a disease of (sometimes terrible) discomfort, and not one of lasting internal damage, except that I had a much greater chance of getting colon cancer than most people. Then, two and a half years ago, while on a trip to my friend’s farm in Tennessee, I got really sick. My medication didn’t work and I ended up in the emergency room twice and was laid up for several days. They gave me a different anti-inflammatory. It worked. And when I got home I received a colonoscopy. Severe inflammation and ulcers were found in my large and small intestines, and I was diagnosed in short order with probable Ileocolic Crohn’s disease. You see, when I was nineteen I’d only had a sigmoidoscopy, which doesn’t look at the small intestine. A cheaper option because it’s a quicker ‘periscope up yours’ maneuver and they don’t need to put you to sleep or use anesthetics for it. Lucky me. So who knows if my disease was already manifesting as Crohn’s back then. It’s likely I’d had Crohn’s for six years without knowing it.
So I asked my new gastroenterologist if there was anything I could do. – Diet? Drinking? And got the same answer: “I know how it is to be young, but if you drink, only drink in moderation. As for Crohn’s though, there’s no conclusive evidence diet or alcohol play a role.” One thing I simply had to do though was take a new medication four times a day, because Crohn’s was a serious diagnosis, but if I stayed on top of my treatment there was a good chance I’d never have to move to stronger, more side-effect prone anti-inflammatories, or more serious interventions (i.e. surgery). So again, dejection. I took the pills. They helped the symptoms. But I’d been considering leaving my job of three years, and when I asked how much my single medication would be without my employer-provided insurance, the pharmacist said $725 per month. To put that in perspective, now I’m paying $350 per month, for rent. So I demurred. But after several months of this, I said, “Fuck this. I’m not living my life this way, unable to digest food properly, stuck at a dead-end job or saving to move to another one, and just waiting for the other shoe to drop with this disease.” Most everyone I’d spoken to who either had Crohn’s or knew somebody with Crohn’s said they were in terrible shape. If that was going to happen to me, I was damned sure going to go down in flames trying to make myself better, so I started looking for a cure.
Everything I read about intestinal candida overgrowth resonated with how I remembered having felt in the six months previous to my first ulcerative proctitis diagnosis, so I decided to start there. I found what seemed to be a really good anti-fungal diet book and started it. After a bit I knew I had to quit my medication because it was masking my symptoms, so I quit cold turkey and—my colon stopped working. After less than six months on this drug, the least side-effect prone/detrimental drug of its kind, quitting it was like turning off my plumbing, so I had to go back on it and slowly wean myself from it over the course of a month.
After doing so I felt somewhat better some of the time, but still something wasn’t right. I felt bloated and still had stomach aches, though maybe not as frequently. Part of me wanted to give it more time, but part of me believed that if this was the answer I’d be feeling more linear progress, and more quickly, so I continued to look for answers.
I seriously considered going vegan, and began to move in that direction, after reading Self Healing Colitis and Crohns by David Klein. I wasn’t very convinced by the author’s arguments as they pertained to me, yet I’d much rather have tried veganism than go back to the pills. Then I found a book online called “Breaking the Viscous Cycle” by Elaine Gottschall via “Crohn’s Boy’s” site (Praise be to Crohn’s boy!) which has become the first step toward my new, healthy life. Gottschall got a M.S. in microbiology studying digestive processes and bacteria of the digestive tract, and her interpretation of the cause of Crohn’s, colitis, and several other diseases is brilliant.
Briefly put, people with diseases like mine (of similar origin but perhaps involving different, pernicious bacterial and fungal species at different loci of interaction with our digestive tracts) get an infection. In response to the infection, our bodies mount an inflammatory response. The inflammatory response is not fully effective in purging the system of bad bacteria, and the assault from the bacteria, the inflammatory response, and the mucosal discharge that’s a part of it, all combine to disable the tips of little microscopic protuberances (a bit like taste buds) called villi, which line our small intestine. This is significant because it’s at the tips of these villi that our bodies break down complex carbohydrates into simple carbohydrates so they can be absorbed, so we who have a chronic infection of the digestive tract become increasingly impaired in digesting carbohydrates. What’s more, complex carbs are one of the favorite foods of bacteria – harmful bacteria included – so what happens to all the free-floating complex carbohydrates that we crohnies eat but can’t digest? The bacteria that caused the initial infection puts it to good use: the infection becomes stronger; we get sicker. This is what Gottschall calls “the vicious cycle,” and it’s broken simply by not eating the complex carbs we can’t effectively digest and thus starving our gut flora and with them, the infection.
Perhaps because I had already gone a ways in cleansing my system of fungus, my results from adopting this book’s suggested diet, called the Specific Carbohydrate Diet, or SCD, were sudden and dramatic. Within forty-eight hours, my Crohn’s symptoms were gone. I don’t mean relieved; I mean gone. In fact, staying religiously within the parameters of this diet (though certainly not on the healthiest version of this diet I could have devised for myself) kept me totally without any digestive discomfort whatsoever for many months. Only when I picked up another chronic bug while in Ecuador (whoops) did I again start having some digestive problems. This last advent was partly just due to my own hubris in healthful glee (e.g. drinking Ecuadorian tap water and eating too much street food), but the fact that my infection persisted despite antibiotics before slowly subsiding over months (but probably didn’t go away entirely) points to a potential problem with the Specific Carbohydrate Diet and with my imperfect health.
Our bodies’ first, most massive line of defense against disease, along with one of its most crucial components for keeping toxins out of our body and bloodstream, is our gut flora. You have more bacterium in your colon than you have cells in the rest of your body. If you’re healthy, this little ecosystem of yeast and bacteria is composed of nearly a thousand species (mine’s probably composed of significantly less than that). “Good” bacteria and yeast are like good housekeepers. You got them initially through your mother’s milk, and by and large they can’t live outside you for long, so they want to keep everything functioning well. They eat what you eat, and some things you can’t digest (like vegetable fiber) they can, and they poo fatty acids, which are good, salubrious fare for us.
“Bad” bacteria and yeast just have a different life strategy. They don’t care so much for their host, at least not in the long-term. In their different life cycles they can be both more transient and more rooted than their “good” adversaries. When they literally put down roots in your intestines, this can open up fissures contributing to what’s called “leaky gut syndrome.” Then things like toxins, undigested proteins, viruses, and these goddamned bad bacteria can slip right into your blood stream, and that’s very bad.
It’s important to remember that the good bacteria which have come to unobtrusively protect us and assist us in digesting the indigestible have been evolving within us for hundreds of thousands of years, at a minimum. Like us, they’ve adapted to certain environmental conditions, which for them mostly consist of what we eat and drink – a diet which throughout most of our species’ history was probably pretty consistent (at least in terms of the basic types of foods we were eating, though the proportions of these probably varied considerably). However, about ten thousand years ago we added cereal grains and dairy to our diets; a couple hundred years ago we added sugar; and in the last hundred years or so we’ve added a slew of seed and legume oils, trans fats, chemicals, pesticides, and a whole lot more sugar. Today, by far the bulk of an average American’s calories come from foods our species never even ate previous to the Neolithic revolution 12,000 years ago, so recently our gut flora have been living through times of change, to say the least.
Recently studies have begun to show that different types of food support the growth of different species of gut flora…Duh. For example, one study showed that soluble vegetable fiber tended to promote the growth of beneficial gut flora, while insoluble fiber from cereal grains tended more to promote the growth of potentially harmful species. And when you consider that the “good” nature of beneficial bacteria is that they clean house well, fighting tooth and nail for us, while avoiding putting down roots, it seems plausible to me that if we flood our bodies chronically with toxins and toxic foods, this lack of roots could prove a liability for our little allies. They could be disproportionately swept away, while the nasty guys trying to set up colonies rooted in our intestinal walls are disproportionately left behind, to flourish. This is just my speculation, but it makes sense to me.
Anyway, I think this is what happened to me in my childhood and adolescent years, when I thought my sole preventable health risks were getting fat or having a heart-attack, and my chief guide to nutrition was a food pyramid on the back of a Rice Crispies box. I’m infinitely grateful to Elaine Gottschall and the SCD, but wiping out the majority of the bacteria that was causing my Crohn’s Disease was only the beginning of my road to complete health. The SCD is a wonderful first step for anyone who has Crohn’s (from what I’ve heard, it hasn’t proven as consistently effective for people with Colitis or other gastrointestinal diseases, but has had some amazing effects for some autistic children, to give you an idea of gut flora’s range of influence), but it does have potential weaknesses. Our bodies do need some glucose, especially to fuel certain aspects of our immune system. And the mucous forming polysaccharides which the SCD warns against may worsen one’s already heightened, mucous forming inflammatory response in the case of a chronic intestinal infection, thus further impairing digestion, but they are also vital for a healthy person’s immune system in protecting against and purging infection, as anyone who’s ever had a runny nose can testify to. I think this is why, several months after starting the SCD, I got a sinus infection for the first time. And what’s worse, a year and a half and two rounds of antibiotics later, I still have it.
It’s for this reason that I now believe the SCD diet, while a wonderful long-term intervention, especially if one regularly eats the carbohydrate rich vegetables like squash permitted on it (sadly I did not), is probably best to transition away from eventually, to a diet that is designed to maintain exceptional health. The best such diet I’ve come across was in the book Perfect Health Diet by Jaminet and Jaminet. The Jaminets take the “Paleo” approach to interpreting nutrition, which I alluded to earlier in my Neolithic Revolution comments, and find very compelling. But they do so in a way that isn’t overly speculative, as some Paleo literature I’ve read, but rather rely chiefly on a wealth of cutting-edge, nutritional research.
But what about those of us who feel our digestive immune systems have been greatly depleted and thrown out of balance by years of abuse from eating the wrong foods followed by handing the stewardship of our health over to the pharmaceutical industry? Is regaining truly excellent health in the cards for us? Maybe. There are a host of fermented foods which can be very helpful, and there are probiotics in supplement form. And with a great diet including these, in foods like kim chee, kambucha, and kefir, who knows how far we’ll get. But studies have shown that people with chronic digestive diseases usually have significantly fewer species of gut flora, and it’s not likely that a little of several species here and there will bring these people back to full recovery. There is one treatment though that’s consistently had amazing, curative results, but I’m not sure if you can stomach it – or colon it, I should say. It’s a fecal transplant, and it’s just what it sounds like.
You may think it sounds gross, but a fecal transplant is hardly invasive compared to a colonoscopy or getting part of your intestine cut out (standard practice for Crohn’s today). And rather than a relatively small amount of a handful of bacterial species, you take a sample from a donor with a healthy digestive system, and basically get an enema (a significantly larger dose than from probiotic pills or fermented food; crap is 60% gut flora by volume) of nearly a thousand species of bacteria and yeast –an entire eco-system – which then takes to its new environment, killing pathogens and setting up shop unbelievably well.
Right now fecal transplants are only used to treat one especially anti-biotic resistant and potentially deadly bacteria, called Clostridium difficile (which the treatment generally cures almost immediately!), but to my knowledge this is the only application it has been tried in (probably as a last resort due to this bacterium’s antibiotic resistant nature), and there’s no reason this treatment shouldn’t be tried more broadly. Of course, such a potential cure is anathema to the pharmaceutical industry’s paradigm of ‘treatment unto death,’ and maybe that’s why it’s not being used more broadly, but we sufferers of chronic digestive problems and immune dysfunction of all kinds should really be pressing our physicians and specialists for this. It could truly be a revolutionary treatment, and a way to significantly strengthen a large segment of the population’s immune systems cheaply!
You may think I’m being too optimistic about it, but consider what cow herders and dairy farmers have been doing with this technique pretty much since they’ve had means to do so, and to amazing effect. When a cow is sick, farmers often don’t even bother trying to diagnose the problem. Instead, they simply extract some gut flora from the rumen (where a cow’s gut flora live) of a healthy cow, and inject it into the rumen of the sick cow, and voila – much of the time this does the trick. Our good gut flora are like the first and strongest gatekeepers protecting our health, and the proper function of numerous physiological processes, from nutrient absorption to neurological function, depend upon their health. Restore that, and it’s like setting in place a solid cornerstone to build your health upon. I know I’m still presently without this cornerstone, so I’m trying to slowly build one, and am confident I can. And even if it proves a lengthy process, and the medical community never comes around to help, at least I’m pretty sure I’ve cured my Crohn’s disease.