Flare after 3 year remission on SCD

Curious to hear others' experiences of flaring after luck with SCD, Paleo, etc.
What was your next move? - Different dietary choices? Different meds?

I was diagnosed with Crohn's in Nov 2013, started SCD a few months later, and was declared in remission within a month or so of that. I modified slightly once in remission, adding yams and occasional rice and quinoa. I took Apriso, as well as Curcumin. I felt like I had this illness pretty well under control for years...and routine blood work said the same.

And now...I am in a flare. Colonoscopy last week showed inflammation through my entire colon...I am now on prednisone, and switching from Apriso to Pentasa. My doctor is talking about biologics being the likely next step. Feeling a little overwhelmed.

I would love to hear from anyone who has had a similar experience, and how you made your decisions of what to do next. Thanks!

I haven't had a formal remission, but my diet has been evolving over time and its pretty clear that once i've go now eat gluten and some other processed foods, just a short reintroduction causes all sorts of intestinal issues, as well as itchy skin rashes, psoriasis, acne and eczema.

The good news for you is you've shown yourself capable of sustaining a complex food regimen that worked for a long time. The thing is most of these diets have flaws. The SCD diet can end up creating a deficit of important vitamin and minerals in certain individuals (for instance those with SNPs for HTMFR etc).

Then there's the whole issue of microbiome regulation. The role of resistant fibres and butyrates in feeding and balancing the microbiome are now clearly established in research, and so the issue becomes how to get the gut to accept enough fibre/butyrate to begin the job of rebalancing the microbiome, which is an important contributor to gut health.

Personally, during a flare up, I would go to largely plant based diet, testing out what i can eat in terms of fibre, and reducing red meat right down. Staying completely clear of any processed food, anything in a packet with a label. Staying with lots of leafy greens. Intermittent fasting might help, as well as protein fasting.

Thanks!
Yeah diet-wise for now I'm just sticking to super simple foods - veggies cooked well and usually pureed, meat cooked without oils, hard boiled eggs, bananas, gelatin made with 100% juice...Similar to SCD intro. Seems to be working pretty well, but I know the prednisone is also largely responsible for the quick improvement.
Can you point me to resources to learn more about the dietary issues you discussed above? I would love to learn more.

A lot of the best info I get comes from pubmed, but its a time consuming way to get it. Also google scholar has some good papers that are not in pubmed for some reason. There are some less technical websites that might have good information, or it can be (and usually is) biased and one sided. Places like Dr. Axe, Chris Kresser, Marks Daily Apple, the Quantified Body, Green Med Info. But you need to be extra careful and vigilant with these websites that can jump on bandwagons (like the ketogenic diet) which look great from a narrow perspective but have no basis or relationship to how we evolved and how we've actually adapted to eat, so they can be dangerous.

There's one Dr. whose work is worth following closely, and that is Dr. Alessio Fasano at Harvard. You can see him on youtube. He specialises in Celiac disease, but his findings apply to all chronic gastrointestinal conditions, and so very much to Crohns.