Inflammatory Bowel Disease

Inflammatory bowel disease describes disorders involving chronic inflammation in your digestive tract. Types of IBD include Crohn’s and Ulcerative Colitis. Crohn’s disease affects approximately one million people in Europe, and the causes of this disease remain unclear. Currently there is no cure for Crohn’s although pharmaceutical medication including steroids can alleviate symptoms. Crohn’s Disease may cause ulcers and inflammation. This can lead to deficiences and malabsorption, leading to fatigue.

If you have been given a diagnosis of Crohn’s  or Ulcerative Colitis and are looking for an understanding of how to improve this  condition, there are several areas you may wish to look into that your Gastroenterologist may not have explored. These include:

Candida and yeast overgrowth

Small intestinal bacterial overgrowth

Food intolerances

Many of the patients we see complain of having multiple bowel and stomach symptoms – constant discomfort -sometimes getting up in the night, or gritting their teeth through meetings, or worrying about travel.

Many of them have benefited from professional advice as regards dietary changes, supplements to improve nutrient deficiencies and supplements to alleviate inflammation.

Is there a link between Candida and Crohn’s disease?

Studies have found a possible link between the commensal yeast Candida albicans and the development of Crohn’s disease making a yeast overgrowth a possible initiator of the inflammatory process observed in this IBD. Source PubMed

If you have a history of repeated use of antibiotics and have a sweet tooth or love of bread and yeast or a lowered immune response, you could consider getting a Candida test.

If the test does reveal that you are suffering from an overgrowth of yeast we will recommend you follow a low sugar diet and take anti-fungals if appropriate.

Candida Diet for Crohn’s Disease

The diet will involve the exclusion of all yeast and all sugar and fermented foods. We may also recommend anti-fungals to kill off the yeast and probiotics to replenish your gut with friendly bacteria. Our gut microbiome test is also very helpful in revealing the correct  strain of probiotics if needed.

Typically the low sugar diet is followed for four to six weeks.

Most patients report feeling better and eating better during this period. You may rediscover what it was like to cook and to have a varied diet rather than relying on one thing all the time. And, of course, you will need to read labels. Snacks are often the most difficult part because all the things many of us reach for were will be out of bounds.

If yeast is linked to your inflammation, most patients are surprised how rapidly they see the beneficial effects on their digestive system. And it was only then that they realise how much they had been suffering.

Your energy levels may also improve markedly. Many patients report that the afternoon dips in energy and the flaking out in the early evening tend to disappear. You may feel hungry and unsatisfied for a lot of the time at first, but this is after all, a period of adjustment. This sensation of I emptiness is not ‘genuine’ but more a function of withdrawal. Your skin condition may also improve.

The answer to Crohn’s and other symptoms is not always easy. Many patients continue to take anti-inflammatory medication, however the whole constellation of unpleasant symptoms has been eliminated by mere attention to diet.

Changing your diet can be an initially traumatic process, and thereafter not easy to maintain. We are surrounded by debased and degraded foods laden with sugar, and we tend to rely on a single substance – wheat /sugar- day in and day out.  Breaking free from this is, in practical, social and even cultural terms not easy, but the rewards in terms of health may be extraordinary.

Food Intolerances and Crohn’s

Diet provides a further therapeutic strategy in active Crohn’s disease. Some patients have underlying food intolerances to wheat dairy products, and yeast. Changing your diet can be challenging so we always recommend booking a consultation with a nutritionist that can help you with Crohn’s and also ensure you do not develop nutrient deficiences.

Is there a link with Crohn’s and Small Intestinal Bacterial overgrowth?

Research does indicate that Small intestinal bacterial overgrowth (SIBO) is common in patients with Crohn’s disease and the two may be correlated. Studies in Europe and North America have estimated that SIBO is prevalent in 25%-88%  of cases of CD. Source PubMed

What are the symptoms of Crohn’s disease?

• Blood and Mucus in stool

• Loose stools and urgency

• Needing to have frequent bowel movements

• Weight loss

• Loss of appetite

• Pain and inflammation

• Malaise

In some studies diet has been shown to trigger symptoms in patients with Crohn’s disease.

We will help you with an elimination diet and where necessary provide food intolerance testing to see if any foods are causing your symptoms. By avoiding offending foods, inflammation may be reduced and hopefully induce remission.

Tests- Sometimes underlying pathogens and intolerances may be exacerbating your symptoms. We may use candida stool tests, tests for small intestinal bacterial overgrowth and food intolerance testing.

Anti-inflammatory diets- we will provide guidance on the best anti-inflammatory diets used to dampen inflammation. Some diets we may use include SCD – Specific Carbohydrate diet, low fodmap diet, low sugar diet.

Anti-Inflammatory Supplements- we provide guidance on anti-inflammatory supplements to help reduce inflammation. In some cases, Curcumin, Omega 3 and Aloe Vera may be of benefit.

Restoring nutritional status- Many patients have underlying nutrient deficiences- we will provide the highest quality supplements to tackle deficiences such as iron, folic acid, selenium.

We  work with your Gastroenterologist and ensure that the Nutritional Therapy approach works alongside your medication.

Booking an appointment for Inflammatory Bowel Disease

If you are looking for a Crohn’s nutritionist and UC specialist please contact us and we would be pleased to book you in for a consultation in our clinic in London or via Zoom.

References

Diet as an Optional Treatment in Adults With Inflammatory Bowel Disease: A Systematic Review of the Literature 2023 Jul 18;15(7):

Jones, Workman, Freeman, et al.
Crohn’s disease: maintenance of remission by diet
Lancet, Vol 2 (1985), pp 177-80t

Riordan, Cowan, Crampton, et al.
Treatment of active Crohn’s disease by exclusion diet
Lancet, Vol 342 (1993), pp 1131-34

Katz et al.
Intestinal permeability in patients with Crohn’s disease and their healthy relatives
Gastroenterology, Vol 97 (1989), pp 927-31

 An immunological link between Candida albicans colonization and Crohn’s disease Source PubMED