According to the Mayo Clinic, after you eat, it takes about six to eight hours for food to pass through your stomach and small intestine. It takes a total average time of 43 hours from eating to stool elimination—I like that they call,this “transit time.” Food then enters your large intestine (colon) for further digestion, absorption of water and, finally, elimination of undigested food. After I researched this topic, I thought about how proper digestion is integral to maintaining good health — vital, really. I am interested in hearing from readers about exploring their own relationship to food. Start when you were young, or when you were first diagnosed. I recently discovered the amazing work of Crohn’s patient, Daniel Leighton. He openly explores his disease through his art, and I was blown away—his piece entitled “Tied Up at the Hospital” is superb (heartbreaking to me), and I encourage you to follow his work. So, let’s use ART to share our experiences! I use creative nonfiction, and writing has always been my release—in our book, Jessica and I encourage patients to “keep a food journal,” but now I also want to encourage patients to explore their disease, their relationship to food, their fears and loneliness, humor and love, through making art (photography, poetry, writing prose, painting, video, drawing, etc.). I can’t wait to publish some of these works! (Email me at firstname.lastname@example.org.). Okay, I will start off with a piece of my own creative nonfiction:
How my longing for food — my lifelong love affair with what I could, or could not, eat — began.
I was longing for food, literally desperate for the half-eaten slices of pizza left on the plates at a restaurant off Harvard Square. I was a 26-year-old bulimic, and food was my secret obsession. Who doesn’t love the hot-out-of-the-oven, doughy-crust pizza with fresh-grated mozzarella garnished with chopped basil leaves?
The revelers had straggled out of the room after a private engagement party. I told my boyfriend I had forgotten something, and walked back in through an arched doorway. The jukebox finally playing the Bonnie Raitt song, “Somethin’ to Talk About,” I had selected earlier. I stood there and gazed around the room: it looked a hurricane had breezed through around 60 knots with chairs overturned and crumpled napkins scattered about….
But it was what was on the paper plates that caught my attention: I made my way along the tables and grabbed slices of pizza and—gazing back at the arched doorway to see if anyone was coming — I scarfed them down and pushed the food into my mouth with both my hands like a refuge from war-torn Biafra.
You see, I didn’t know it then, or perhaps that was when I knew something was the matter with me. I was skinny and sick; mentally obsessed with a longing for food that occupied my thoughts much of the time.
A morning run along the Charles River was the usual start to my day—I loved this and felt so light as I jogged the worn paths past the brick buildings of academia. After my run, my reward was half a honeydew melon and a cup of coffee. Then I’d ride my bike to work at the publishing house on Beacon Hill. At lunch, I ate dry salad, and when I came home in the early evening, I ate popcorn with brewer’s yeast with Diet Coke.
Why, you may ask, did this young woman who was outwardly happy—a job in publishing, a boyfriend who had returned after a year hiatus, a loving family in nearby Providence, Rhode Island—resort to eating leftover food from people’s plates in public restaurants?
Having a mother who apparently subsisted on candy bars was one thing, a father who talked obsessively about food and his inability to loose weight, was another. “Am I fat?” plagued me throughout my adolescence.
My family prided themselves on being thin and fit, with tennis, riding, and golf practiced at various clubs—and at school, we played field hockey. Going to an all-girls high school had the added benefit of questions like “You Haven’t Gotten Your Period Yet?”
After high school, I took a year off from attending the non-existent college that my parents pretended I’d been accepted to. I headed to Vienna, where Weiner Schnitzel, Würst, pastries, and beer were to form the main ingredients of my diet, and after a few short months, I weighed 170 pounds.
When I returned from Europe after a year, my father announced that I had gained the “Freshman 15-times-two,” without attending college!
I remember the day I landed at Boston’s Logan Airport. My mother and one of my little sisters, Alex, stood there at the gate. My mother had her kerchief on, covering her wig at the top of her head that gave her that ’70s bouffant look; she was wearing her big Jackie O shades and had one of those purses that look like a small picnic basket with flowers painted around the edges clutched under her arm.
“Guüten Tag, Muttie und meine kleine Schwester!” I called gaily.
I walked toward my mother and sister and watched their mouths drop open. I was around 180 pounds at that point, my hair was cut in an ill-fitting pageboy, and my skin was dark brown from a summer spent sleeping on the edges of fiords after hiking around Scandinavia. They had no idea who I was!
The reality of my situation—home after 12 months after living on my own in Vienna and traveling around Europe—was horrifying to me! I was so heavy the buttons on my Indian print button-down shirt were almost popping off.
The whole way home in the car, I only spoke German, trying to explain to my mother that I had “forgotten how to speak English!”
I also liked this “no food/empty stomach” feeling I had in the car that afternoon when I returned, a stranger to my family, back from my year off, and I wanted it to last.
I retreated to my bedroom and unpacked my Kelty backpack, holding back the tears that I knew would never come.
This piece is excerpted from Spin Cycle by Dede Cummings, a creative nonfiction work-in-progress to be published (hopefully!) in 2017.
What About Bowel Surgery?
There are various complicated surgical options available these days which continue to change and develop with the advancement of medical techniques and technology. If you are experiencing significant symptoms, or problems that either warrant immediate attention or have not responded to previous treatments, please consult your physician or gastroenterologist about surgical options that may be right for you.
May 22, 2006, I was hospitalized for three weeks for a dangerous bowel obstruction due to a flareup of Crohn’s disease. My surgeon, the amazing Horace Fuller Henriques, III, removed a large section of my Sigmoid colon along with an attached granuloma, and he removed the terminal ileum and cecum. After a really rough 24 hours with the pain aided by a morphine pump, I began to come back to the world. Horace came to visit me in my hospital room, and while I was in my groggy state, he excitedly told me how he had rebuilt the ileocecal flap. I felt like I was listening to an episode of This Old House on PBS—it was like he was discussing the carpentry job!
It is hard believe that was nine years ago! My quality of life improved after my surgery, so much so that I have remained drug-free and very healthy since then. Sure, I’ve had times of flareups, but I’ve never had to go back to the hospital or stay in bed for more than 12 hours. Since I’m so attuned to my body and keep a food journal, I can notice when flares are coming and I conveniently resort to my dietary and lifestyle regimen in order to stop the flareup before it really knocks me down. I take lots of daily supplements prescribed by my naturopath, too, like VSL#3 Probiotics and Zturmeric, along with Omega 3, Vitamin C, D, and other supplements.
Yesterday, a young mother of two who is a professional singer-songwriter, called me to talk about her case of Crohn’s and her upcoming surgery. I love it when people find me, reach out and email me, and sometimes call me. I feel that the Crohn’s and colitis community is a really tightknit one, and we have the CCFA to help through their efforts as well. But it is the people with Crohn’s, and colitis, the patients themselves, I want to hear from! We have had to endure so much and, in the case of Crohn’s, have had to live with a disease that has no cure. The very active reaching out – whether it’s by email or phone for text message – is a big first step toward healing and taking charge of living with chronic disease.
So back to surgery. . .
Surgery should be a last-resort treatment; but if the need arises, surgery may provide relief for some individuals. About 20% of ulcerative colitis suffers will require surgery at some time in the course of their illness. Approximately 75% of Crohn’s disease patients who have disease in the small bowel will have surgery in the first 10 years after diagnosis. Unfortunately, if no other treatment is done, nearly 50% (or more) of those who have surgery for Crohn’s will still have a reoccurrence of disease symptoms. In colitis that does not respond to medical treatment, surgery is an option that can wipe out the disease. Many people live without the large intestine. In my case, the risk of perforation of the small intestine was very dangerous. If surgery for Crohn’s disease is an option, it is much safer to have elective surgery, rather than be admitted like I was through the ER.
If you have a scheduled surgery for either Crohn’s disease or ulcerative colitis, I highly recommended having a lengthy pre-op appointment with your surgeon so you understand fully the outcomes and what to do and how to prepare. Since I rely heavily on the care of my naturopathic physician, I also scheduled a pre-op appointment with her, where she planned a whole course of preparation for me. This included taking Arnica before my surgery and doing meditations and preparations with diet to lessen the burden on my digestive tract.
After my surgery, the surgical nurses were instructed by my naturopath to place small pellets of Arnica underneath my tongue. It is still amazing to me that this big teaching hospital where I was a patient was so accommodating! Also, the hospital had a wonderful dietitian who helped me slowly introduce foods back into my diet — and made me drink Smooth Move tea! I remember my stepsister went to the local natural foods co-op and smuggled in some organic chicken broth. The wonderful Dr. Henriquez even searched high and low for someone to come in and do acupuncture for me, and there was also a volunteer at the hospital who was able to do Reiki (a form of alternative medicine through “hands-on healing” developed in 1922 in Japan) to aid in my recovery.
After five days, I was ready to go home. It wasn’t easy, and transferring from morphine to other pain meds was really difficult. I also got really depressed and cried a lot as I tapered off Prednisone (tapering should be done with great care, and slowly, so as not to cause a flare-up). But, I let my body gradually heal and realized that crying and being depressed is part of having major surgery, too. But I didn’t just pick up my life the way it was: my recovery lasted about six weeks and I took it day by day, and very slowly, and I asked friends to help with care for my kids and help with house cleaning. I kept a food journal and gradually added exercise every day, along with yoga and meditation.
So, don’t despair if you have a surgery coming up. Instead, take control of the situation and keep a positive attitude!
A recent study from Georgia State University published in Nature, points to emulsifiers leading to changes in the intestinal track that eventually lead to inflammation. Food addivitives are being suspected, and research will move forward from mice to human studies.
The intestinal tract is inhabited by a large and diverse community of microbes collectively referred to as the gut microbiota. While the gut microbiota provides important benefits to its host, especially in metabolism and immune development, disturbance of the microbiota–host relationship is associated with numerous chronic inflammatory diseases, including inflammatory bowel disease and the group of obesity-associated diseases collectively referred to as metabolic syndrome. A primary means by which the intestine is protected from its microbiota is via multi-layered mucus structures that cover the intestinal surface, thereby allowing the vast majority of gut bacteria to be kept at a safe distance from epithelial cells that line the intestine1. Thus, agents that disrupt mucus–bacterial interactions might have the potential to promote diseases associated with gut inflammation. Consequently, it has been hypothesized that emulsifiers, detergent-like molecules that are a ubiquitous component of processed foods and that can increase bacterial translocation across epithelia in vitro2, might be promoting the increase in inflammatory bowel disease observed since the mid-twentieth century3.
This study is good news for those of use who have a diagnosis of Crohn’s or colitis, collectively know as IBD.
I was diagnosed with Crohn’s disease in 2001, officially, and managed the disease with antibiotics, Prednisone, naturopathic doctor visits and supplements. No one else in my family suffers from Crohn’s. However, in 2006, I developed fistulas and a granuloma, and I was extremely sick when admitted to the hospital with a blockage in my small intestine (there terminal ileum is the most common place Crohn’s develops). I didn’t eat solid food for one month leading up to, and after, my surgery— I weighed only 119 lbs on my 5 foot 8 frame (now I am up to 145 lbs.!)
After returning home, I began to search for a book that would aid in my recovery and help me establish a “new lease on life.” Surprisingly, I couldn’t find this book anywhere—so I began to write a proposal to write the book that I was looking for: a book that would be predominantly a wellness guide about living with an incurable disease. Here is what my teacher/editor had to say about this book:
“Dede is an amazing woman! In this book you will find not only helpful advice but real inspiration.”
—Julie Silver, M.D., assistant professor, Harvard Medical School, author of What Helped Get MeThrough: Cancer Survivors Share Wisdom and Hope
At that time, I had had a moderate case of Crohn’s for eight years and had been in and out of the ER four times for treatment of flare-ups (usually fluids and bowel rest did the trick). I was ready to learn how to manage my condition and take a proactive role in my own health so that I could avoid more hospital stays and enjoy life and doing the things I loved again, like hiking, cross-country skiing, running, and especially traveling.
Now that the book is out, and my new cookbook just came out, I can say with confidence that Jessica Black, ND (my co-author) and I were certainly on the right track in terms of our research into gut microbiota! Jessica was already a forerunner with her wonderful book, The Anti-Inflammation Diet and Recipe Book. I really have Jessie to thank, for not only being my coauthor, my far-flung naturopath (I am on the east coast and she is in Portland, Oregon), but my inspiration for taking charge of my own health.
In our book, Living With Crohn’s & Colitis, Dr. Black and I frequently stress the need for an additive/preservative-free diet, a diet that focuses on natural, organic foods. (Note: Even when additives are derived from plant sources they can still be harmful.)
My perspective—that is, the patient’s perspective—makes this book unique and personal. Through my story, you will learn how I became an advocate for myself upon receiving a Crohn’s diagnosis. As the years went by and I developed a better understanding of my body and its healing, I became a resource for alternative therapies, and I want to further the mission of helping people balance their clinic treatments with Eastern medicine and healthy eating habits.
I remain quite healthy now, though not in full remission. I am dealing with active Crohn’s disease and ulcerative colitis by balancing a Western medical plan with a naturopathic treatment plan, an additive-free diet, along with acupuncture, massage, yoga and exercise (don’t forget getting enough sleep!).
I know what it is like to suffer from illness and want to help our readers and their caregivers regain wellness. We love to hear from readers, so please comment and let us know who you are doing and what works for you so we can share!
Our new cookbook is out and Dede would like to give away a free copy to the first two people who comment on this post — tell us a bit about yourself, are you a caregiver, do you have Crohn’s, or colitis, or IBS, or some other autoimmune disease? When you receive your book (send email in PM to email@example.com), please post a review on Amazon for us and we will be eternally grateful!
We are excited to share these gut-friendly recipes from the book and there is a long introduction about how to live with IBD and tips to help.
For the millions of people afflicted with irritable bowel disease (IBD), including Crohn’s and colitis, it can be a daily struggle to find nutritious meals that won’t aggravate symptoms or cause a flare-up. The Living with Crohn’s & Colitis Cookbook is your essential nutrition guide with over 100 recipes and meal plans expertly designed to improve daily functioning and help relieve symptoms of Crohn’s and colitis.
The Living with Crohn’s & Colitis Cookbook contains everything you need to plan your meals, balance your diet, and manage your symptoms, including:
• A guide to keeping a food journal
• Sample meal plans
• Tips for shopping for an IBD diet
• Gentle and nutritious recipes to help soothe flare-ups
…and much more!
The Living with Crohn’s & Colitis Cookbook features over 100 recipes, including Zucchini Buckwheat Banana Bread, Homemade Almond Milk, Dr. Lang’s Healing Soup, Garlic-Herbed Scallops, Coconut Curry Chicken over Brown Rice, Mushroom Risotto with Cashews and Parmesan, Crabapple Walnut Cake, and many more. The book also features Paleo recipes.
Enjoy these photos from our book!
In some human diseases, the wrong mix of bacteria seems to be the trouble.
I recently discovered a new blog that is specifically for Chronic Fatigue Syndrome and Fibromyalgia. It is called Health Rising and the link is below.
There are articles that explore gut health and microbiota by Ken Lassesen, that really explain the importance on overall homeostasis for everyone, whether you have Crohn’s, colitis, IBS, IBD, Celiac, etc.
I am on a strict diet of no dairy, no grains, no sugar. Supplements include probiotics and turmeric. I am really healthy and haven’t had symptoms for almost eight years! I did have a partial bowel resection, in 2006, that changed my life and set me on a path toward wellness— that is when I wrote my book because I was disillusioned by the recommendations of my GI doctors who said I should take heavy-duty, autoimmune-suppressing drugs.
Read more: Bacterial Resistance, Infection and Chronic Fatigue Syndrome: Fighting Infections Pt. I http://www.cortjohnson.org/blog/2014/03/26/bacterial-resistance-infection-chronic-fatigue-syndrome-fighting-infections-pt-1/
In some human diseases, the wrong mix of bacteria seems to be the trouble, Part 2.
A recent NPR story on gut bacteria and Crohn’s disease really impressed me, so I want to share it in its entirety here on my blog!
Mix Of Gut Microbes May Play Role In Crohn’s Disease
The particular assortment of microbes in the digestive system may be an important factor in the inflammatory bowel condition known as Crohn’s disease.
Research involving more than 1,500 patients found that people with Crohn’s disease had less diverse populations of gut microbes.
“[This] basically for the first time identifies what might be the bacterial changes in patients with Crohn’s disease,” says Ramnik Xavier, of Masssachusetts General Hospital in Boston, who led the work.
More than a million Americans suffer from Crohn’s, which seems to start when an overreactive immune system causes abdominal pain, diarrhea, bleeding, weight loss and other symptoms. Many patients have to take powerful steroids (which can have serious side-effects), and some have parts of the digestive tract surgically removed.
Mounting evidence has suggested that microbes living in the gut might contribute to the problem. So Xavier and his colleagues compared the species of bacteria in more than 447 Crohn’s patients to the mix of microbes in more than 221 healthy people.
In their paper published in the journal Cell, Host and Microbe, the researchers detailed the clear difference they discovered: The patients with Crohn’s seemed to have too many of the sorts of bacteria that rile immune systems.
In addition to having less diversity in their gut microbes, Xavier says, the Crohn’s patients had fewer bacteria that have been associated with reduced inflammation and more bacteria associated with increased inflammation. (The findings were confirmed in 800 Crohn’s patients from other studies.)
Interestingly, children whose doctors had tried to treat their Crohn’s symptoms with antibiotics before they were properly diagnosed had a mix of microbes that was the most out of whack.
“We may have to revisit the use of antibiotics in [these] patients with early-onset Crohn’s disease,” Xavier says.
Instead, doctors might eventually do better to identify and prescribe treatments that mimic the helpful bacteria, he says, along with foods or other pharmaceutical agents that reduce or counteract the harmful bacteria.
“There’s the possibility that we might be able to identify [some] sort of super-probiotics that might be able to correct the gut back to the healthy state,” Xavier says.
UCLA pathologist Jonathan Braun, who studies microbial ecology, says the paper offers important first insights into illnesses beyond Crohn’s. “Other diseases are thought to be driven at least in part by bacteria,” he says, such as some inflammatory and autoimmune disorders. Bacteria may also be involved in obesity.
Humans should work harder to understand bacteria, Braun says, “and live with them when they’re helping us, or get them to serve us better when they are causing harm.”
Good for the media to pick up in the importance of balance in the flora and fauna of the gut—remember, everyone is different and there is no know cure for Crohn’s (for UC, the large colon can be removed, putting the patient in remission, but that is not the case for Crohn’s unfortunately).
So, with Spring on the way, now is the time to set some goals for health: sign up for Team Challenge with the Crohn’s and Colitis Foundation of America, walk 3 miles a day (get your heart rate up by walking up hills), do yoga/meditate, get lots of sleep, make an appointment with a naturopath, too. Spring brings with it hope for new life (and here in Vermont, lots of mud!).
Dear Fellow UC-ers and Crohnnie’s, Happy New Year!
One of the best resolutions for the new year that is underway, is to have a positive outlook!
I know, I know, sometimes it is really HARD to have that when you feel lousy, but our community that has grown around the book, and the online network of Crohn’s, colitis, IBS/IBD, and other autoimmune disease is a supportive one. With that in mind, I propose a three-month guide to wellness. It isn’t a medical guide, and you should always consult your GI about doing anything dietary or herbal, or even lifestyle changes.
As usual, start with moderation, and keep a daily journal — not just about the food you eat, but what you do, how much you exercise and for how long, when you have acupuncture or massage, or have your period, or if you are exposed to anything potentially toxic in your environment—keep track of it all! Dede swears by this, and Jessie says she has patients that immediately start making connections (like, for example, maybe that whole bag of chips you ate the other day wasn’t such a good idea….). That said, here is the First Two Week GOAL. Take it slow, and modify as necessary.
1. See the change and believe in the change! Visualize optimal colon health daily. See yourself happy, active, and vibrant in your mind.
2. Proper Mealtime Habits—eat slowly, and take your time preparing, shopping, and don’t overeat, or try new foods during the plan.
3. Remove major dietary causes of inflammation—keep a food journal, and stay away from trigger foods! (For Dede it is wheat, sugar, and dairy—I know, hard to imagine life without dairy? Then switch to almond milk which is so good!)
4. Add only one supplement or herbal medicine, whichever best suits you. This may be an acute remedy for diarrhea, acidophilus, or any other supportive medicine—for example, Dede started a new supplement, turmeric, which is a natural anti-inflammatory. She takes two capsules daily, and tries to cook a curry dish once a week or so.
5. Herbal teas: pick one of the teas that best fit your needs and drink daily. Dede drinks Peppermint! Also Chamomile is a good stress reducer. Add honey for sweetening, as you like.
6. Take it slow and easy. Be kind to yourself, and ask for help!
Happy New Year!
From Dede and Jessica, and the LWCC group—we are here for you!
Email with questions to firstname.lastname@example.org
Or to Jessica Black, ND at
Sam, Sherri, Dede, and Saskia at the end of the CCFA’s Nape to Sonoma Half Marathon last summer—we were all tired but elated to have finished, and raised almost 2 million dollars for IBD research for the CCFA.org.
Follow Saskia’s blog—she is an inspiration to us all!