A Simple & Cost-Effective Approach to Inflammatory Bowel Disease

Let’s address what’s “bugging” you.

Photo by Windows on Unsplash

It is your father’s big birthday dinner, and the spot of choice is meat paradise, otherwise known as a Brazilian steakhouse. You love filet mignon, bacon-wrapped chicken, and all-you-can-eat sides, so you could say you’re pretty stoked. Only to realize, your bowels are talking to you… a little too much. You haven’t had a diarrhea flare for a couple of weeks, but this time is bad. You haven’t been able to get off the toilet for over an hour, and it looks like you won’t be able to make it to the birthday dinner.

I get how frustrating this can be. You shouldn’t have to live your life wondering where the next bathroom is, if your gut can make it through the 4-hour flight on vacation, or if you’ll be able to enjoy a nice dinner out with family. You should be able to live your life on your own terms, and trust in your gut to get you through any situation. Is there any hope for resolving these flares? Are there any tools outside of medications that can keep me off the toilet and with the people I love?

What’s with the leak?

Inflammatory Bowel Disease (IBD, featuring ulcerative colitis and Crohn’s disease), exactly as it says, is a condition where there is inflammation of your bowels. But you’re not as concerned about the fancy medical jargon, you care about how you feel! For you, the symptoms of pain, diarrhea, and even the occasional and concerning blood in the stool, are a result of the inflammation. You’re a logical person, so I bet your next question is, why is there inflammation there in the first place?

You see, some healthcare providers, are more interested in covering up the symptoms you have (diarrhea, pain) than actually figuring out what the root cause of your symptoms is. But that sounds good to you right! You don’t want to feel those things anymore, so you’re willing to do anything to get your normal life back. Herein lies the problem with that approach; if you’re just covering up symptoms and not addressing the root cause, what happens when the symptoms come back? Do you just alter the dosage or increase the number of pills you’re taking until the symptoms are gone again? How long are you going to stay on that path of chasing symptoms?

Don’t get me wrong, there is 100% a time and a place for taking medications. If someone has been having a lot of bloody diarrhea or has lost more than 15 pounds in the last week, that needs to be addressed quickly. That’s a perfect opportunity to use all your available tools to improve your gut, however, that isn’t always the case.

Let’s Go To The Tool Shed

Back to your earlier question, why is the inflammation there in the first place? A new idea is emerging, that your body, and specifically your immune system, is attacking your own gut microbiome (Click HERE to learn what the gut microbiome is). Ah, yes you’re highly intelligent, and you’re now thinking why is my immune system attacking my microbiome? That’s where the answer is less clear-cut. It could be one particular bad bug, it could be too many bad bugs or even a shortage of good bugs, but gut dysbiosis is definitely playing a role. I like to think of gut dysbiosis as an “unhealthy microbiome” or the microbiome you have when you’re not feeling healthy.

If gut dysbiosis is part of it, let’s get into our tool belt and see what things we can use to support a healthy microbiome.

Diet

I’m sure many of you have tried a plethora of diets to try to support your gut, but maybe you feel like you’re spinning your wheels and don’t really know which one(s) to stick with. The simple answer: whatever diet you can be consistent with.

To find a more nuanced answer, I like to look to research. A study from 2017 took a group of adults with active IBD and put them on what’s called an Autoimmune Paleo Diet (AIP, a more advanced version of a traditional paleo diet). The results here were pretty incredible: Clinical remission was achieved by week 6 on the AIP diet in 73% of individuals (1). Clinical remission means your symptoms are near absent or completely gone, not necessarily that the disease itself is gone. Nearly ¾ of people seeing improvement by a tool that’s within your control has to feel empowering!

Another layer further than AIP is called an Elemental Diet. This includes a semi- or entirely liquid diet, hopefully making calories and nutrients easier to absorb for those with IBD. Some evidence shows as high as 71% of individuals have achieved clinical remission from 4 weeks of an elemental diet (2).

I think the main driver of the improvements seen in these studies was the changes in the microbiome. We know dramatic diet changes (such as AIP), can shift the microbiome in as little as 7 days (3). I do not recommend you follow the AIP or the Elemental diet on your own, rather you should seek the guidance of a functional medicine practitioner or an experienced dietitian.

Supplements

Let’s address the obvious supplement first: probiotics. The research on probiotics for IBD is fairly mixed (4). Specifically, multi-strain probiotics (featuring various strains of lactobacillus and bifidobacterium) tend to show greater improvement in disease activity compared to a placebo. The trial that had no effect on the probiotic group featured just one strain of lactobacillus. Think about it this way, there are trillions of bacteria and tens of thousands of different species of bacteria within our gut, do you think taking just one would move the needle that much?

Many of the pharmaceuticals for IBD are designed to work on the immune response, specifically to up-regulate the anti-inflammatory response and down-regulate the inflammatory response. There are several supplements that have also shown great benefits for IBD, including turmeric, fish oil, and Vitamin D (5)(6). Again, I believe much of why these supplements show benefit has to do with alterations of the microbiome.

Lifestyle

Lifestyle includes factors such as sleep, stress management, and life purpose. Look, sleep can be the most simple, yet also the most complex factor to deal with. Let me ask this, do you think IBD will be improved by sleeping less than 6 hours a night? Or that not being able to fall asleep for 3 hours will help your gut feel more relaxed? Sleep is where much of the “repair processes” happen from all the inflammation we’ve accumulated over the day. If you don’t sleep great, repair can’t happen, and your IBD likely doesn’t improve.

The last two, stress management and life purpose, are the least sexy things to address. Stress is one of the biggest buzzwords in the health and wellness space right now. However, I can imagine that constantly scanning places for the nearest bathroom is not a relaxing situation. These stressful situations continue in a vicious cycle as stress makes your inflammation worse and vice versa.

Lastly, life's purpose can also have an impact on your inflammatory disorders. I’ve seen inflammatory conditions (including IBD) worsen as individuals lose their sense of purpose, as well as improvement in those who seem to find it. While you can’t take a supplement to find your purpose or diet your way to perceiving your environment as less stressful, these tools yield great results when it comes to managing the status of your microbiome.

In terms of research, the microbiome is only in its infancy and our understanding of its connections with various diseases is just a small piece of the pie. If you’re looking to live your life on your terms again, and want a healthcare provider who understands the microbiome and its implication for IBD, check out The HIVE Natural Health Center. You don’t have to live with the “bathroom map” for the rest of your life.

As always, Trust in Your Gut.

Disclaimer: The contents of this article are for educational purposes only, and are not intended to diagnose or treat any condition. Do not apply any of the information in this article without first speaking with your doctor.

References

1. Konijeti GG, Kim N, Lewis JD, et al. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017;23(11):2054–2060. doi:10.1097/MIB.0000000000001221
2. Wellens J, Vermeire S, Sabino J. Let Food Be Thy Medicine-Its Role in Crohn’s Disease. Nutrients. 2021;13(3):832. Published 2021 Mar 3. doi:10.3390/nu13030832
3. David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559–563. doi:10.1038/nature12820
4. Malinowski B, Wiciński M, Sokołowska MM, Hill NA, Szambelan M. The Rundown of Dietary Supplements and Their Effects on Inflammatory Bowel Disease-A Review. Nutrients. 2020;12(5):1423. Published 2020 May 14. doi:10.3390/nu12051423
5. Raman M, Milestone AN, Walters JR, Hart AL, Ghosh S. Vitamin D and gastrointestinal diseases: inflammatory bowel disease and colorectal cancer. Therap Adv Gastroenterol. 2011;4(1):49–62. doi:10.1177/1756283X10377820
6. Marton LT, Goulart RA, Carvalho ACA, Barbalho SM. Omega Fatty Acids and Inflammatory Bowel Diseases: An Overview. Int J Mol Sci. 2019;20(19):4851. Published 2019 Sep 30. doi:10.3390/ijms20194851