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Crohn's Disease Forum » Diet, Fitness, and Supplements » Treatment of Crohn's disease with an unrefinedcarbohydrate, fibre-rich diet.


12-14-2015, 06:55 PM   #1
wildbill_52280
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Treatment of Crohn's disease with an unrefinedcarbohydrate, fibre-rich diet.

Just thought this study would help someone. I have been following a diet similar to this for 7 years and have never had an obstruction, almost always have had diarrhea under control with little to no medications except lialda and pentasa on occasion.

The diet in this study is kind of like the Specific Carbohydrate Diet because simple sugars are removed, but SCD advises removing starches and complex carbs which also contain the most soluble fiber which have shown benefit for the GI system, so I never agreed with all the SCD guidelines. Oats are probably the best grain for IBD I believe, they contain beta glucan which is also found in medicinal mushrooms. Soluble fiber is preferred food for the good bacteria in the gut.

Thirty-two patients with Crohn's disease were treated with a fibre-rich, unrefined-carbohydrate diet in addition to conventional management and followed for a mean of four years and four months. Their clinical course was
compared retrospectively with that of 32 matched patients who had received no dietary instruction. Hospital admissions were significantly fewer and shorter in the diet-treated patients, who spent a total of 111 days in
hospital compared with 533 days in the non-diet-treated control group. Whereas five of the controls required intestinal operation, only one diet-treated patient needed surgery. This is in strong contrast to general
experience with this disease. Treatment with a fibre-rich, unrefined-carbohydrate diet appears to have a favourable effect on the course of
Crohn's disease and does not lead to intestinal obstruction.
In a mean follow-up of 52 months only one of the 32 diet treated
patients required major surgery (and in him the indication was present before starting the diet), which contrasts with the usual tendency for patients with Crohn's disease to need operations. In a large American study with a mean follow-up of 42 months5 operations were needed by over half the patients.
The risk of reoperation varies in different series between 5-5 and 16-50' per year.7 12-14 In the nine diet-treated patients who had had a resection, no reoperations were required during a mean follow-up period of 55 months.
It is unlikely that the controls had unusually severe disease since only 1600 underwent surgery (40 per year). Nevertheless, they received five times as much hospital treatment as the diet treated patients. The latter seldom needed treatment in hospital, spending on average less than one day per year in hospital. Our data challenge the traditional recommendation of a low residue diet in the treatment of Crohn's disease.
http://www.ncbi.nlm.nih.gov/pmc/arti...00093-0016.pdf
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12-15-2015, 11:35 PM   #2
wildbill_52280
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Psyllium(a type of soluble fiber) plus probiotics induced remission in crohn's patients.
I also used psyllium at a dose of 8-24 grams for the first three years, and may soon go back to it.

http://www.ncbi.nlm.nih.gov/pubmed/17688660
12-16-2015, 01:30 PM   #3
wildbill_52280
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sorry for the typo's in the second paragraph!!Id correct them but the edit button is not available, so ill post the paragraph again with corrections in bold.

In a mean follow-up of 52 months only one of the 32 diet treated
patients required major surgery (and in him the indication was present before starting the diet), which contrasts with the usual tendency for patients with Crohn's disease to need operations. In a large American study with a mean follow-up of 42 months 5 operations were needed by over half the patients.
The risk of reoperation varies in different series between 5.5 and 16.5% per year. In the nine diet-treated patients who had had a resection, no reoperations were required during a mean follow-up period of 55 months.
It is unlikely that the controls had unusually severe disease since only 16% underwent surgery (4% per year). Nevertheless, they received five times as much hospital treatment as the diet treated patients. The latter seldom needed treatment in hospital, spending on average less than one day per year in hospital. Our data challenge the traditional recommendation of a low residue diet in the treatment of Crohn's disease.
ill also add another excerpt from the study.
On the unrefined-carbohydrate diet the mean intake of dietary fibre was
61% more than the estimated national average of 20.4 g/day. In our experience with this diet, which totals 150 patient-years, no patient has suffered intestinal obstruction, though many already had intestinal strictures.
12-17-2015, 02:57 PM   #4
wildbill_52280
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Just an observation on the two studies above, the first attempted to increase total fiber by about 10 grams, which includes insoluble and soluble.

While the second study specifically increased the intake of soluble fiber. Theoretically the soluble fiber should have a greater beneficial impact considering it's known role in creating short chain fatty acids. It seems this may have been the case because the psyllium study reported induction and maintenance of remissions, and considering the severity of the patients in the psyllium study. Also the psyllium study didn't exclude sugars like table sugar or corn syrup. So soluble fiber really does seem to carry the most benefits, but i think a combination of increasing total fiber and soluble fiber perhaps through a supplement like psyllium would be a good decision. Basically applying a combination of both studies to your own dietary choices, should give a good benefit.
12-17-2015, 11:45 PM   #5
Lady Organic
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thanks. It makes me so sad that the diet study with very interesting result was done and forgotten in ... 1979!!! how can so possible easy solution can be forgotten or ridiculed? unbelievable.

regarding prebiotic fibers, I do not take psyllium, but I take inulin chicoree root. I really feel this work super for me. I take about 8 to 10 g a day
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minor hands/wrists chronic arthritis since 01/2013

Diet: ''IBD-AID'' : http://www.nutritionj.com/content/13/1/5+ organic food only
suppl Curcuminoid extract, Inulin,psyllium, apple pectin, Vitamin D

past meds:
pred 50mg, 5-ASA, cortifoam, Imuran (failed) Purinethol (success) methotrexate (failed CD and arthritis).
12-25-2015, 02:38 AM   #6
wildbill_52280
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Another study on psyllium fiber, a.k.a. plantago ovata seed, for maintaining remission for patients with UC who were already in remission and comparing it to mesalamine. this is great, but not quite as good as the previous study i posted which INDUCED remission in patients with crohn's who failed other meds, but it does say something about this natural over counter fiber treatment, something to consider adding to your arsenal for sure.

After 12 months, treatment failure rate was 40% (14 of 35 patients) in the Plantago ovata seed group, 35% (13 of 37) in the mesalamine group, and 30% (nine of 30) in the Plantago ovata plus mesalamine group
http://www.ncbi.nlm.nih.gov/pubmed/10022641
12-29-2015, 12:00 AM   #7
Lady Organic
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thx Wildbill, interesting indeed.
01-13-2016, 03:14 PM   #8
wildbill_52280
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A new article on the importance of fiber to the microbiome or in other words all the bacteria that inhabit your gut.

http://www.theatlantic.com/science/a...obiome/423903/
01-15-2016, 09:00 AM   #9
InstantCoffee
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Fiber has been the key to my recovery.
I started off with psyllium and moved to Fitness Fiber by ON and FiberSmart fiber.

It's not full remission but I'm gaining weight, and I'm good as long as I avoid my usual trigger foods.

I've also gone from having bile-filled diarrhea every time I have sugar to being able to consume large amounts of sugar as long as I continue to buffer it with fiber rich foods.

Fiber is SO important and I can't emphasize that enough, it's terrible that many patients have been scared away from it because certain fibers have made them sick, I was victim to this myself.

I now snack on pumpkin seeds and roast edamame which I can't imagine doing 2 or so years ago. They're very good for protein and fiber, but obviously I had to work up to it, I don't recommend it for someone with severe symptoms.

Right now I continue to take fiber supplements on occasion, I rarely if ever take psyllium. I take in way more sugar than I should but it doesn't hurt me like it used to.

If you check out my log I recently posted up what I believe to be the most effective parts of my recovery experiments, and I highly advise plantains and green bananas for their fiber content.
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01-15-2016, 05:49 PM   #10
wildbill_52280
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Fiber has been the key to my recovery.
I started off with psyllium and moved to Fitness Fiber by ON and FiberSmart fiber.

fitness fiber has psyllium in it and ill have to warn you about maltodextrin which is also in it. MD has been shown to feed Adherent Invasive Escherichia Coli bacteria which is suspected to play a large role in crohn's disease.

Maltodextrin (MDX), a polysaccharide derived from starch hydrolysis, markedly enhanced LF82 specific biofilm formation. Biofilm formation of multiple other E. coli strains was also promoted by MDX. MDX-induced E. coli biofilm formation was independent of polysaccharide chain length indicating a requirement for MDX metabolism.
http://journals.plos.org/plosone/art...l.pone.0052132

http://www.bodybuilding.com/store/op...FYMDaQodax8LQw

I've always wanted to try plantains, but supposedly they also contain lots of sugar when I looked up nutrition info.you can also try inulin and apple pectin in addition to psyllium, a blend of fibers is probably better then relying on just one. I see nothing wrong with the fiber smart fiber though. At one time i was using 26 grams of psyllium and 5 grams of inulin fiber so a total of about 31 gram sin fiber supplements, in many ways i was doing good during very good during that time, taking probiotic too. But for whatever reason i changed my regimen, I'm much more methodical these days when i make changes I make them very slow and take notes so I know exactly how something is effecting me.
07-29-2016, 03:59 PM   #11
Lady Organic
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Fighting mild disease activity in my rectum right now, I have just started psyllium and will increase my probiotics intake as well.
I intend to take 10g/day of psyllium. I will reduce my inulin to 4g/day.
Combining different prebiotics is a good idea imo.

I also started to take quercetine and curcuminoid again. I feel im just ready to try anything at this point, so affraid of whats coming next if I cant get things under control...

WildBill, you mention apple pectine, which is in clinical trials if I remember correct. Can we buy this product?
what is apple pectine exactly? thx.
08-01-2016, 11:15 AM   #12
wildbill_52280
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Join Date: Sep 2009
Fighting mild disease activity in my rectum right now, I have just started psyllium and will increase my probiotics intake as well.
I intend to take 10g/day of psyllium. I will reduce my inulin to 4g/day.
Combining different prebiotics is a good idea imo.

I also started to take quercetine and curcuminoid again. I feel im just ready to try anything at this point, so affraid of whats coming next if I cant get things under control...

WildBill, you mention apple pectine, which is in clinical trials if I remember correct. Can we buy this product?
what is apple pectine exactly? thx.
Apple pectin is a type of fiber from apples you can buy it. http://www.iherb.com/search?kw=apple+pectin

Take psyllium by dissolving it fully in water other wise it could cause a blockage. I would recommend taking vsl#3 probiotic with these supplements as a synbiotic.
08-25-2016, 10:15 PM   #13
wildbill_52280
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I did a strict experiment on psyllium with probiotics and had slight benefits but started to decline on this. I believe too many pathogens can access psyllium it is not selective enough to favor the good bacteria. but these recent results is in contrast to an earlier experiment which i had no side effects the biggest difference was a supplement i was taking which i believe inhibited inflammation, which changed the nature of dysbiosis allowing for better fermentation of psyllium. And also in contrast to the 3 years I took psyllium so i conclude either the carotenoid supplement i was taking or high amount of oats (600-900 cal per day) to be of greater benefits then psyllium husk, but these are just my opinions of course, make of them what you will. I suspect apple petcin also to possibly be a better choice then psyllium because its from a human food, not some woody flavorless herb or whatever psyllium is.

Just tagging! Lady Organic
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