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Crohn's Disease Forum » Books, Multimedia, Research & News » Avoidance of fiber associated with greater risk of flare


02-25-2017, 05:47 AM   #1
ebarker2
 
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Avoidance of fiber associated with greater risk of flare

Avoidance of Fiber Is Associated With Greater Risk of Crohn's Disease Flare in a 6-Month Period.
Brotherton CS1, Martin CA2, Long MD2, Kappelman MD3, Sandler RS2.
Author information

Abstract
BACKGROUND & AIMS:
Chronic inflammatory bowel diseases (IBDs) have been associated with an abnormal mucosal response to the gastrointestinal microbiota. Although dietary fiber affects the gastrointestinal microbiota, there is limited information on the role of fiber on IBD activity. We investigated factors associated with fiber consumption and whether it was associated with flares in patients with IBD.
METHODS:
We collected a completed 26-item dietary survey from 1619 participants in the Crohn's and Colitis Foundation of America Partners Internet cohort (Crohn's disease, 1130; ulcerative colitis/indeterminate colitis, 489). Eligible individuals were in remission based on disease activity index at baseline and completed a follow-up survey 6 months later. Fiber and whole grain consumption were categorized into quartiles and deciles. Disease flare at 6 months was defined as a disease activity index score exceeding remission cutoff values, and/or an IBD-related surgical procedure or hospitalization since baseline.
RESULTS:
Participants with longer duration of disease, past history of surgery, and past IBD hospitalization ate less fiber. The risks for disease flare differed by disease type. Compared with those in the lowest quartile of fiber consumption, participants with Crohn's disease in the highest quartile were less likely to have a flare (adjusted odds ratios [OR], 0.58; 95% confidence interval [CI], 0.37-0.90). Participants with Crohn's disease who reported that they did not avoid high-fiber foods were ∼40% less likely to have a disease flare than those who avoided high-fiber foods (adjusted OR, 0.59; 95% CI, 0.43-0.81). There was no association between fiber intake and flares in patients with ulcerative colitis (adjusted OR, 1.82; 95% CI, 0.92-3.60).
CONCLUSIONS:
Intake of dietary fiber is associated with reduced disease flares in patients with Crohn's disease, but not UC. Recommendations to limit dietary fiber should be re-evaluated.
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Diagnosed Crohn's 2007. Pentasa and several other drugs. Began exercising and taking better care of body in 2008. Lost 45 pounds, gradually reduced junk food, alcohol and tobacco. Stopped meds 2009. Went Gluten free, lactose free. Finally tobacco and alcohol free in 2013. Biopsies and internal camera since then come back with 'no trace of disease'.
02-25-2017, 12:30 PM   #2
crohns4ever
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Awesome news ebarker2 I eat a lot of gluten free bread so maybe I won't have to many flair up with my Crohn 's it would be nice.
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Diagnosed: With crohns July 4th 1999
Current Meds: 6MP 100mg a day, Remicade every 3 weeks
Surgery: Had 3 1/2 feet of colon removed due to very active crohns on july 4th 2000:
03-22-2017, 07:18 AM   #3
IrritableBob
I have found for myself that I can eat fiber, but it is the type of fiber that I'm eating that has a defining influence on my crohn's. I eat lots of fruit--mainly mangos, bananas, pears, and peaches. It is the fiber from grains (and somtimes nuts) such as oats, rice, and coconut that really mess me up. Soaking these grains helps somewhat, but I've found that it is just best for me to get my fiber through fruits and vegetables.

Just my two cents worth.


Diagnosed June 2014
Azythroprine (Imuran), Vitamin D3, Mulitvitamin, Probiotics, Essential Oils, DIET!

Previously on Remicade, Prednisone, Ondansetron (Zofran), Promethazine (Phenergan), Omeprazole (Prilosec)
03-24-2017, 09:50 PM   #4
chrohnotrigger
 
Join Date: Dec 2013
Participants with longer duration of disease, past history of surgery, and past IBD hospitalization ate less fiber ... participants with Crohn's disease in the highest quartile [of fiber consumption] were less likely to have a flare

CONCLUSIONS:
Intake of dietary fiber is associated with reduced disease flares in patients with Crohn's disease, but not UC. Recommendations to limit dietary fiber should be re-evaluated.
There is some seriously bad mix-up of correlation and causation in this article. Their conclusion is unfounded without a proper studied performed with controls and blinds. You can easily argue that those people with milder Crohns were much more likely to not have problems eating fiber, which simultaneously explains their unavoidance of it and their lack of CD complications. This is fake science- sad!
03-25-2017, 03:11 AM   #5
ebarker2
 
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There is some seriously bad mix-up of correlation and causation in this article. Their conclusion is unfounded without a proper studied performed with controls and blinds. You can easily argue that those people with milder Crohns were much more likely to not have problems eating fiber, which simultaneously explains their unavoidance of it and their lack of CD complications. This is fake science- sad!
Without debating the merits of this study, I agree many studies leave much to be desired. But this is one of many papers all of which evidence the same thing: the vital role of fermentable fiber & resistant starch in creating the health of the intestinal wall. In particular the role of the microbiome using f/f & r. starches to make butyrate which is used as the key energy source by colonycytes in the epethelial wall to make the mucosa and repair/regenerate the epethelial wall every 6 days. It it clear this is one of the most important processes in the digestive system and it doesn't happen without fermentable fiber & r.s.
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