Posted 7/14/2013 4:19 PM (GMT 0)
http://www.drhoffman.com/page.cfm/http://www.drhoffman.com/page.cfm/170 http://www.drhoffman.com/page.cfm/171 TESTING: IgG RAST food panel, Candida antibodies, anti-gliadin antibodies, Vitamin D, B12, folic acid, homocysteine, zinc, iron, ferritin, testosterone (healing in men), and DHEA (healing in both sexes) DIET: Specific Carbohydrate Diet (tailored to reflect results of IgG RAST) SUPPLEMENTS: SCD-Compliant Probiotics, Vitamin D, Enteric-coated Fish Oil, EGCG, Curcumin, Zinc, L-glutamine, Methylcobalamin, Methylfolate, DHEA OTHER THERAPIES: Low-dose Naltrexone, Chrohn's/Colitis intravenous "drips", antifungal medication (Nystatin, Diflucan, etc.), bio-identical testosterone Of greatest interest is Omega-3 fish oil , recently demonstrated to be helpful in both ulcerative colitis and Crohn's disease. Italian researchers have recently demonstrated that a year's use of nine fish oil capsules resulted in a doubling of the remission rate of patients with Crohn's disease. The capsules are enterically-coated and not yet commonly available in health food stores. The use of essential fatty acids in the treatment of these inflammatory conditions is supported by favorable results in trials with other inflammatory conditions like rheumatoid arthritis and psoriasis. Specific benefit can be obtained from oral dosing with the amino acid L-glutamine . One study showed that seriously ill patients requiring intravenous feeding were more likely to wean themselves from dependency on nutritional supplementation by vein when given relatively high oral doses of L-glutamine on the order of one tablespoon three times daily, equivalent to 50 grams. L-glutamine may work as a direct "food" for intestinal cells in need of repair, as well as by virtue of the fact that it is a precursor for synthesis of the premier antioxidant glutathione. Indeed, antioxidants appeared to play a special role in protection of the intestinal cells from inflammation. It is believed that highly reactive free radicals literally disrupt cell membranes and cause inflammation in the gut. Several studies point to critical depletion of vitamin C , selenium , zinc , and vitamin E in patients with inflammatory bowel disease. Vitamin C and zinc must be supplemented carefully, particularly because of their potential to cause gastrointestinal upset. Of course, probiotics such as acidophilus
and bifidobacteria
play a role in the management of inflammatory bowel disease. The problem is
that despite heavy supplementation with probiotic products, often the
conditions are not right for restoration of normal bacterial balance.
Redeployment of beneficial bacteria in the intestine can only occur in the
context of elimination of harmful bacteria and yeasts and the proper nutrient
environment that favors the reestablishment of healthy flora. Hence the desirability
of dietary strategies such as the Specific Carbohydrate Diet which "breaks
the vicious cycle" of bacterial and fungal overgrowth. In a "vicious cycle," harmful bugs
proliferate, irritate the intestine, disrupt digestion, impair immunity, and
foster fermentive degradation of certain hard-to-digest foods. The main dietary
culprits: two-sugar and other enzymatically-resistant carbohydrates found in
grains, certain starchy vegetables, certain fruits, table sugar, and
lactose-rich dairy products.
Gottschall's Specific Carbohydrate Diet is a
balanced, varied program consisting of meat, fish, eggs and poultry with most
vegetables, nuts, and some fruits and sugars allowed. Lactose-free dairy
products are permitted, as are certain ingeniously-formulated grain-free
breads, cookies and pastries consisting of nut-meal. Beans are usually able to
be reintroduced within three months.
Patients with IBD often note significant
improvement in their symptoms within three weeks of starting the Gottschall
diet. By twelve weeks, the majority are recovering definitively. One
twenty-year-old patient of mine with ulcerative colitis took a full year to
become symptom-free. She now maintains her remission with a modified version of
the SCD that allows her occasional rice-based grain products. Another patient
with ulcerative proctitis affecting the rectum had daily bloody diarrhea
despite medications for years until initiating the Gottschall diet. After 18
months, he is completely symptom-free without the aid of medications. Elaine
Gottschall herself is a frequent recipient of letters of gratitude from
patients relieved of devastating symptoms.
While the SCD is the best-kept secret of IBD
management, adjunctive therapies help speed resolution of symptoms and improve
the margin of success. It has long been noted in the conventional management of
IBD that antibiotics like Flagyl have value in ameliorating pain, diarrhea, and
bleeding. For the same reason, herbs with natural antimicrobial
effects are used to advantage in Crohn's Disease and ulcerative colitis. These
include grapefruit seed extract, golden seal, artemisia , sanguinaria,
gentian, uva ursi and garlic . These
substances can be used to reduce proliferation of harmful intestinal bugs like
Staph and Klebsiella and Proteus. Progress
of therapy can be monitored with stool tests like the Comprehensive Digestive
Stool Analysis from Great Smokies Diagnostic Laboratories.
Some studies suggest that IBD is a form of
exaggerated allergic response to the presence of intestinal bugs that healthier
individuals--or those less genetically susceptible--tolerate with ease.
Innovative modern allergy desensitization techniques are being pioneered in
colitis and Crohn's. They are aimed at rapidly reducing hyper-sensitivity to
bad bugs and candida--an intestinal fungus that may wreak havoc in the GI
tract.
Indeed ,
the yeast connection is an important one in IBD. Some studies have shown
increased sensitivity to Brewer's and Baker's yeast in colitis and Crohn's
sufferers. Avoidance of yeast and sugars with the Candida Diet, as well as the
use of anti-fungal herbs and medications, often speeds resolution of IBD.
Certain herbs and nutrients have
anti-inflammatory effects in the intestines. Ginkgo biloba , known for its
circulatory-enhancing effects, has demonstrated anti-disease activity in some
studies of IBD. Herbs like licorice
and the bioflavonoid quercitin
have soothing effects on the intestinal wall. Aloe vera can help to heal
ulceration. Chinese herb formulations containing, among other things, extract
of cinnamon and angelica, relieve spasm and inflammation and dissipate
pathological heat.
The amino acid L-Glutamine has been shown to
possess healing affects on gastrointestinal mucosa. Fish oil , containing the vital
Omega 3 polyunsaturated fatty acid EPA, can help break the inflammatory cycle
in colitis as it does in rheumatoid arthritis and psoriasis. Shark cartilage too has been touted in IBD. Some
studies support the use of bromelain
as an anti-inflammatory, and surprisingly, certain properties of red-hot
capsacin from cayenne peppers have led to research in its application to IBD.
Certain short-chain fatty acids, especially butyrate, work well in colitis when
administered orally or via enema.
Many vitamins and minerals play a supportive
role in GI tissue repair, but since IBD impairs digestion and absorption, a
vicious cycle of nutritional decline can easily perpetuate itself. A very high
percentage of IBD sufferers are malnourished. Statistics show many to be
protein-calorie deficient. Many have fat-intolerance which results in essential
fatty acid and fat-soluble vitamin deficiency. Many suffer from bleeding which
leaves them iron-deficient. Diarrhea promotes depletion of water-soluble
vitamins and essential minerals like zinc and magnesium .