Monday, April 12, 2010

A Gut Feeling

If your bowels aren’t happy, you aren't either. And ulcerative colitis and Crohn's disease—collectively known as inflammatory bowel disease or IBD—can make you very unhappy. In my Boca Raton functional medicine practice, inflammatory bowel disease is one of the main disorders we treat.

IBD is a chronic, relapsing and debilitating condition affecting a patient’s lifestyle and mental state, often causing social embarrassment and isolation. No one knows what causes it or how to prevent it, but at its most basic, IBD involves inflammation of the intestines because of abnormal activation of the immune system. And that can have wide-ranging ramifications throughout the body.

The most common conventional treatments for IBD involve heavy-hitting drugs that include steroids and immunosuppressants. Accompanying these are side effects including anemia, easy bruising, frequent infections and mood swings. Because of the frequency and severity of these side effects, many patients prefer the symptoms of the disease to the problems that accompany treatment.

But if you have IBD, the symptoms—which can include rectal bleeding and diarrhea—aren’t the only thing you have to worry about. When your gut is damaged, your body can’t absorb the critical nutrients it needs to function properly, especially protein, unrefined carbohydrates, healthy fats, water, and many vitamins and minerals. This is especially true if you’ve had surgery to remove part of the bowel.

Because of this, many doctors recommend a multivitamin-mineral supplement for anyone with IBD but if you are taking a standard vitamin pill you might as well flush your money down the toilet! Vitamins made with fillers and binders take too long to break down and become absorbed into your bloodstream. This is especially true if you already suffer from absorption problems. What you need is a comprehensive high-potency liquid multi that is rapidly absorbed by the body.

You also want a multi that contains iron. Most don’t, so check the label. Often, iron absorption is limited if you suffer from IBD and that can compromise the production of the red blood cells that carry oxygen to your body’s tissues. You should have your iron levels checked every year during your annual checkup.

While everyone with IBD is a little bit different, certain foods tend to make symptoms worse. Here are my recommendations for anyone with either ulcerative colitis or Crohn's disease:

  • Avoid clothing that is tight around the waist.
  • Drink plenty of purified water.
  • Eat more natural foods in smaller portions more frequently during the day. Just be aware that fruit may cause problems on an empty stomach
  • Avoid high-fat foods. These foods speed up the time it takes food to travel through your intestine. This can cause diarrhea and further prevent proper nutrient absorption.
  • Do not eat foods containing artificial fats and sweeteners. Artificial fats (like Olestra) and sweeteners (like sorbitol and aspartame) often cause diarrhea.
  • Steer clear of caffeine and soft drinks. Like fat, caffeine also speeds up the movement of food through your intestines and can promote diarrhea.
  • Avoid spicy foods since they can cause a flare up. Specific spices to watch out for are black and red pepper, chili peppers and powders, nutmeg and mustard.
  • Avoid foods known to cause problems, either through your own experience or through lab testing.
  • Avoid the chronic use of prescription and over-the-counter gut-altering medications like NSAID’s, proton pump inhibitors or acid blockers. This can cause mineral deficiencies.
  • Feed the gut what it needs (after testing). Initial regimens usually consist of pre and probiotics, colon cell nutrition (glutamine and short chain fatty acids and omega 3 fatty acids.
  • Find ways to consistently reduce stress. Stress suppresses good gut bacteria and necessary serum immunoglobulin A.

It’s also important to mention enzymes. It isn’t uncommon for people with IBD to be deficient in pancreatic enzymes. Taking digestive enzymes may not only reverse this deficiency, it will also enhance nutrient absorption. While most multivitamins don’t include critical enzymes, I’ve included an array of important digestive enzymes in my liquid multivitamin-mineral.

IBD is a serious, chronic, perplexing disease. As with so many chronic diseases, it’s a combination of genetics and environment—the persistent stimulus in an individual who has a genetic predisposition to this disease. Managing IBD symptoms, while challenging, requires a proactive nutritional approach—starting with the tips I’ve outlined above. And, ultimately, you should always trust what your gut is telling you so that the “gut feeling” you get is the best you can have.

To your good health,

Dr. David Blyweiss