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Posted 7/5/2008 9:39 PM (GMT 0)
I was wondering about experiences with using fiber. I have seen a bunch of references that say that fiber is bad and I think that I know why, but I was wondering if there is anyone who has used fiber without problems. I saw one post where a contributor said that they had used Prodiem for 4 years without problems. That fits my understanding of the problem since it is a methylcellulose based fiber. If my understanding is correct, all fiber will cause problems except non-fermentable fiber. That basically leaves only corn bran, oat hull fiber (NOT oat bran), lignin, cellulose and cellulose derivatives. I was surprised at all the things that are considered fiber that I would not have expected. For instance, vegetable gums (guar gum, carrageenan, xanthan gum, and some bean gums) are all really bad for Crohn's. I saw another post where someone said that they could not eat salad. I thought that was strange until I realized that all those gums are used freely in commercial salad dressings (also other sauces). I have also seen information that most of the natural fiber used in things like Metamucil will cause problems for Crohn's. Since there seems to be some difference between theory and reality where Crohn's is concerned, I was wondering if there is real experience out there.
Posted 7/5/2008 9:59 PM (GMT 0)
Hi I eat corn flakes for fibre and white rice. I seem to do alright on that. lol gail
Posted 7/5/2008 10:35 PM (GMT 0)
Hi Keeper. Fibre is a complex issue for crohnies and the theories are evolving.

If you have stricturing crohn's, fibre is a major concern for obvious reasons, especially insoluable fibres, like that found in most fruits and vegetables. Soluable fibre (fibre that soaks up liquid like oatmeal) can actually help regulate diarrhea because it bulks up the stool, but for people with significant strictures it's always a balancing act as to how much is too much. You have to be governed by your symptoms. If you eat oatmeal in the morning and have bad cramps the next day then it's probably too much. If it regulates you great. The reasons salads are bad for people with crohn's is not necessarily the dressings. Salads contain lots of insuluable fibre in the form of seeds, skins, strings etc and can wreck havoc on the gut if there is inflammation and can get stuck if there are strictures.

My basic advice is to eat as much fibre as you can comfortably tolerate. I use my tolerance for fibre as a barometer for how things are doing inside. As inflammation increases, my tolerance decreases. So I know if, after a period of tolerating salads, whole grain breads etc, I start experiencing an increase in symptoms it's time to cut back on the fibre and increase my medications.

If you are only eating fibre that is not fermentable, then it is not a food source at all it is a dietary supplement. There are lots of micro nutrients in a dish of oatmeal, or a piece of whole grain bread.

However, there are some who do benefit from eliminating all grains (SCD diets) but I believe they do allow beans which is a major source of dietary fibre.
Posted 7/5/2008 10:45 PM (GMT 0)
HI Keeper :)

I'm the poster that's been using Prodiem for about 4ish yrs now on the recommendation from my GI, best advice I've ever gotten from a doc.

I no longer have mush or D, just nicely formed BM's, sometimes they come out so formed that when I wipe the TP is even clean and it cut down the rest of the mucus issues I was having (bee propolis initially cut the mucus back and in conjunction with fibre supplements no more mucus only trips to the can.

It's important that you're not a "stricturing crohnie" and you must always start with a small amount of fibre and increase very slowly and only if necessary and drink plenty of water with it.

I take it at night before I go to bed.

:)
Posted 7/6/2008 4:05 AM (GMT 0)

in review… the digestion of a long chain of glucose, (like starch or cellulose) our enzymes are acting on the polymer chain…the ultimate goal is to get the energy from each one of the glucoses through fermentation (namely, glycolysis). If you ingest simple glucose, rather than a chain of glucoses you bypass the enzyme process to break the chain.

Alternatively, energy can be achieved by oxidative phosphorylation. Involves exchanging phosphate groups and oxygen. Reactions are influenced by pH, ions, and transport availability, membrane potential, gradients, etc. significant for the sodim-potassium pump (ATP processing).

 

Fiber can help present molecules for a longer period of time based on rheology. And polymers such as thickeners (cellulose chains of glucose) can alter rheology: If its thicker, the idea being the molecules are available to be processed for a longer period of time. Any nutrients then as well.

For the specific chain, cellulose versus psyllium versus starch for that matter, check your product, as even prodiem has both products (cellulose or psyllium). if there is a problem, it would seem to me you are suggesting the individual molecule of the chain is contributing. The approach though to use a thickener to slow the system to get and benefit from the energy and nutrients.

Now as far as experience, I noticed that a carboxymethylcellulose based ice cream (soft serve for example) may be better tolerated than regular ice cream (all lactose, milk, and glucose problems aside for a second). Suggesting an emulsion benefits processing. You can make your own emulsion simply by mixing starch (boiled potatoes) in a blender and adding other nutrients. As opposed to purchasing metamucil which I always felt bloated.

The bottom line however is that somewhere the good bacteria and the glycolysis has gone awry. Or something within oxidative phosphorylation.

Posted 7/6/2008 5:04 AM (GMT 0)
I have an idea that may or may not be real. It is that Crohn's arises from too much undigested food reaching the colon/ileum. That could arise from eating too much fiber or other indigestible food stuff that the gut bacteria can then feed on, or from a digestive lack in the individual (low enzymes or the like). The gut bacteria produce, as a byproduct of breaking down fiber and resistive starches, a molecule referred to as butyrate. This by-product has the effect of providing the gut lining cells with a source of energy, a regulator of cell transport and an anti-inflammatory. The anti-inflammatory effect of butyrate inhibits production of many immune system cytokines including TNF, IL-1, IL-12 and a long list of others. It basically shuts down the immune response. In fact, enemas using butyrate were once used to treat Crohn's. The problem arises when there is an overabundance of butyrate produced. It is not produced uniformly throughout the gut, but mostly at locations where there are higher concentrations of bacteria. In those locations, with the immune response damped, it is easy for any infectious bacteria to get a foothold on the gut lining. Moreover, the immune response is damped at the site of infection, so the immune response has to come from cells distant from the infection. This means that the inflammation has to work its way back to the site of infection before any reduction of the infection can occur. The usual macrophage response does not work due to TNF and IL-1 inhibition and so inflammation is the main immune response and the damage is indiscriminate. There is journal evidence to support this idea, but I would be interested in hearing anyone's thoughts about it.
Posted 7/6/2008 5:23 AM (GMT 0)

Keeper said...
I have an idea that may or may not be real. It is that Crohn's arises from too much undigested food reaching the colon/ileum. That could arise from eating too much fiber or other indigestible food stuff that the gut bacteria can then feed on, or from a digestive lack in the individual (low enzymes or the like). The gut bacteria produce, as a byproduct of breaking down fiber and resistive starches, a molecule referred to as butyrate.

Except that fibre actually helps sweep the bowels of bad bacteria...

crohn's is actually a 2 part disease, 1) genetics (being predisposed to getting IBD) and 2) trigger(s), smoking is one KNOWN trigger for crohn's specifically and this includes second-hand smoke, there are also many other suspected environmental triggers, for example, it's known that fast-foods, processed foods, caffiene, refined sugar, animal fat can all exacerbate IBD symptoms.

Fibre is important (even for those with stricturing crohn's should still be on a low-fibre diet), it aids with D or C, helps sweep the bowels of bacteria and helps the bowels function properly.

:)

Posted 7/6/2008 5:41 AM (GMT 0)
Yes, I agree that fiber is important for many functions. Even butyrate has so many valuable functions, I can't remember them all. The problem arises when excess butyrate is maintained by oversupplying the gut bacteria with food. If the gut were "swept" periodically by using a non-fermentable fiber or fasting for a period of time, it would break the cycle of immune suppression and inflammation and allow the normal immune response to eliminate the problem. My idea is that a routine of such sweeping of the gut would prevent outbreaks. I should say that gut bacteria can also use any undigested carbohydrate, so a period of low carb and low fiber and a medicinal dosing of fiber like methylcellulose which is not digested by gut bacteria might do the trick. Fasting also has the charm of simplicity, but it's not everyone's cup of tea. I recently had a flare and I was going for a colonoscopy. The day of fasting prior had me feeling almost normal. (BTW, fasting is mentioned as a way of allowing the gut to rest and recover from inflammation in some of the medical references I have been looking at, so it's not just a new-agey thing).
Posted 7/6/2008 5:55 AM (GMT 0)
Yes, I do fasting from time to time, more of a liquid diet togive the bowels somewhat of a rest, it's hard to get through but it can be beneficial to some degree, possibly some have more sucessful results than others...like with pretty much anything, what works for some doesn't work for all as IBD is a fairly individualistic disease.

:)
Posted 7/6/2008 6:27 AM (GMT 0)
agree. Keeper, whats the correction?, to eliminate the "gas", i think its worse because the acid byproduct isnt buffered, as in a pH issue,
http://www.nda.ox.ac.uk/wfsa/html/u13/u1312_03.htm
Posted 7/6/2008 6:30 AM (GMT 0)
i was told bicarbs werent suggested, i guess becuse then you get the stones...i need a break good dicussion though
Posted 7/6/2008 9:26 PM (GMT 0)
Hi Medchrt - I don't know how much of the butyrate enters the bloodstream. It is taken up fairly quickly by the gut epithelial cells and used to generate energy anaerobically. I don't know what the by-products of that process are though. It is only in spots in the gut where bacteria congregate that you get production of butyrate in excess of what is needed for local epithelial cell consumption. This might be another explanation of why some people have more trouble. They might have a gut that forms kinks or other places where bacteria can accumulate and not get swept away by peristalsis. There was some mention in my reading of lesions occurring where there are natural accumulations of bacteria. For anyone interested in some of the background to this, have a look at some of the following:
Effect of butyrate on immune cells:
http://www.fasebj.org/cgi/content/full/14/15/2380
More on the action of butyrate:
http://ajpgi.physiology.org/cgi/content/full/279/5/G918
Discussion of the production of butyrate by gut bacteria:
http://aem.asm.org/cgi/content/abstract/73/4/1073
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