A Comprehensive Naturopathic Guide for Complete Digestive Wellness

Category Archives: Gluten-Free

IMG_2166It is our hope that our readers have benefitted from the New Year, 3-month, Plan for Wellness. Here are seven painless and simple at-home acupuncture steps you can do to maintain good health and vitality. I recommend acupuncture and we had a wonderful guest blog post a few months ago that a lot of our readers thanked us for.

My naturopath also has me on a total “detox” regimen that includes castor oil packs, meditation (I use Rodney Yee’s “AM Yoga” DVD, or try Jon Kabat-Zinn’s wonderful collection of relaxation CDs), skin “sloughing” before shower (which entails roughing up your skin with a loofah sponge from your extremities toward your heart and encourages new cell growth), drinking plenty of water, regular exercise and daily yoga, counseling with a social worker or psychotherapist, weekly (free) REIKI and monthly massage visits, acupuncture sessions monthly, and physical therapy with integrative manual therapy-healing. A good attitude also helps. I regularly repeat to myself positive messages like:

“Don’t let this disease rule your life and get you down, but when you need to, ‘Ask for Help!’”

This simple YouTube mindfulness video by Jon Kabat-Zinn is wonderful, and Dr. Kabat-Zinn was one of the first to bring mindfulness into medicine!

The suggestions I receive from my naturopath are an attempt to enhance my body’s natural elimination processes through the digestive system, kidneys, skin, liver, and lungs. All are essential to help me optimize elimination with minimal aggravation while also undergoing specific treatment suggestions with my gastroenterologist. I have found this support team and naturopathic/acupuncture treatment to be extremely effective as an aid that can dramatically lessen the physical effects of inflammatory bowel disease.

These seven relaxation techniques are really easy to do at home. I do them before my shower daily! Foot massages are also very beneficial, which I do before bed with some moisturizer (I add a bit of organic apricot or sesame oil to the Pure Essentials moisturizer to thicken it up, and I also put cotton socks over my feet if calluses are bad), as well as candle-lit hot baths with lavender oil drops in the water.

  1. Brush your gums and tongue. Spend at least 5 minutes each time you brush (longer is even better). Set a timer because 5 minutes may seem like a very long time at first. The acupuncture points along the gums match with the entire body system, as does the tongue.
  2. Brush your scalp. Remember when moms insisted that we always brush our hair for 50 strokes? Turns out, there are hundreds of acupuncture points on the scalp itself. For a quick session, massage the governing vessel 20. This point is located at the very top of the head, the point of 100 meeting points, which enables you to access several channels at once. Spend time massaging your scalp with your fingernails and even while you shampoo.
  3. Push back your cuticles on your fingers and toes. Just the act of pushing back your cuticles stimulates acupuncture points that go directly to every muscle and tendon in the body, bringing on relaxation. Need to keep a small child quiet at an event? This works like a charm. Plus you can trace every finger front and back as well.
  4. Loofah your body. This is a hard sponge that softens with use. Loofah plants can be grown, and are much softer than those found at most department stores. (Note: when purchasing a loofah, be sure it says ‘loofah’ on the package.) Use the loofah wherever there is skin. There are thousands of acupuncture points all over the body. If you find a sore or itchy spot, spend extra time there. It is likely that it is an acupuncture point that needs stimulation. Electricity is accumulating there and stimulation via massaging or using a loofah disperses this accumulation. Before showering, use the loofah sponge to aggressively rub from the extremities toward the head, beginning with the arms, then working up from the feet. After you rub all the dead cells off your body, an invigorating shower further energizes you and allows for the stimulation of new cell growth.
  5. Moisten your nasal membranes. When you splash water on your face, keep water on your little fingers. Put your little fingers inside your nose and moisten all around. You do not need to sniff water up into your sinuses. Moistening your nasal membranes increases your chi (your body’s bio-electrical energy).
  6. Breathing exercises. Most of us are chest breathers, rather than abdominal breathers, so we tend to breathe shallow most of the day. On inspiration (breathing in), push your stomach out as far as you can. On expiration (breathing out), let your stomach fall back to neutral. This is very difficult to do at first without thinking about it. When you breathe with your abdomen it forces the diaphragm to drop and thus increases your lung capacity. This is why singers practice breathing so that they are able to sustain notes much longer. Breathing leads to more oxygen, more chi and more energy.
  7. Massage your face, hands, feet, and ears. You can do this yourself, but it is more relaxing and fun if done by someone else. These areas also treat the entire body individually.

(Grateful to Patricia S. Wesley, D.C. for her support

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Daily massage and stimulation will increase blood flow, help improve the effectiveness of your current therapies, improve mood, decrease inflammation, and promote healing.

Remember to think positive, and here is a wonderful quote and photo from the XIV Dalai Lama.

We like to hear from our readers, and thanks for helping spread the word about our book and recommendations!

—Dede, a Crohn’s disease/ulcerative colitis patient perspective—post surgical removal of ileum, large segment of Sigmoid colon, and fistula/granuloma mass—symptom-free for the past eight years, but still a Crohnie/uc-er by definition…


Happy Holidays from Dede & Jessica at Living With Crohn’s & Colitis!

This plan was developed as a guide for generating a treatment regimen. Just as each individual is unique, so too is their road to wellness. This 3-month plan is meant to be used loosely, so you should feel free to adjust each step as needed for your own recovery. Please consult your physician when beginning this program, and continue to visit your established team of specialists (naturopath, gastroenterologist, etc.) so that they can help you monitor your progress and make any necessary adjustments to the program.

As discussed in our book—and is a good idea to read the book before beginning this plan—treatments and lifestyle changes can occur in any order, but here we have provided a plan that will slowly and gently move you through your digestive problems and into wellness. Most patients will feel some positive changes as they progress through this 3-month plan and some patients may even become symptom-free.

The most important aspect of this step-by-step process for building health is that we are creating a foundation for wellness and building upon it, rather than trying to overwhelm the body by incorporating all changes at once. Taking new strides each week helps to keep you focused and motivated through the entire process. We know that change can be overwhelming, which is why we’ve created this program so that it can also be slowed down even further to incorporate new changes every 3 weeks and can be specifically tailored to your individual needs.

NOTE: All severe conditions and the need for surgery must be ruled out by your physician prior to starting this program. If initial acute symptoms are severe, they must be treated either with natural medicine or pharmaceutical medicines to provide relief while working on the underlying imbalances.

NOTE: Stress is a precursor to disease and flare-ups. If you are a parent of a child with IBD, or a patient or caregiver, try to help keep the holidays as stress-free as possible! (Easy for me to write this, as I woke up at 3:00 a.m. worrying about buying presents …. and planning a party! Yikes. But I am off to walk 4 miles this morning AND DO YOGA AND MEDITATE!!!

 Weeks 1–2: 

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 holidays!

3. Remove major dietary causes of inflammation—keep a food journal, and stay away from trigger foods!

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. I just bought a new supplement—turmeric—because I ran out.

5. Herbal teas: pick one of the teas that best fit your needs and drink daily. I choose Perppermint! Also Chamomile is a good stress reducer. Add honey for sweetening (NO SUGAR AT ALL!)

Weeks 3–4: 

1. Continue previous points.

2. Add an additional supplement or herbal medicine—talk to your doctor or naturopath about Vitamin D, or Omega 3.

foot3. Begin the Tapping for Energy technique (in our book) or daily acupressure. Dede likes to massage her feet before bed, using a nice mix of moisturizer and sesame or apricot oil. It is amazing how much stress in in our feet and the acupressure points relate to organs in the body. It is a great routine to press gently on some of these points — the chart shows you were the bowel area is (also liver point is important to gently press).

4. Experiment with adding more anti-inflammatory foods and spices into your diet.  Last night, I made a fish curry with garnishes of bananas, raisins, chopped apples . . . yum!

Message me if you want the recipe. It was mild, not too spicy, and used Haddock filet.

A macadamia and fish curry.

Weeks 5–6:

1. Continue previous points.

2. Add an additional supplement or herbal medicine. I take grape seed extract when I feel a cold or flu coming on. Try a warm bath at night with lavender oil.

3. Begin to incorporate movement/exercise. Do this at least 3 times per week, but daily possible. This is VERY important…start slowly, but try every day. Begin with your mind—just change the way you think about exercise (like when you get busy at work or with life, don’t eliminate it!).

Weeks 7–8:

1. Continue previous points.

2. Incorporate daily nutritional powders into your diet such as spirulina, kelp, green tea, or acai powder—try these sparingly at first, and make sure nothing irritates (Dede does not use spiraling, but kelp and green tea really help keep inflammation at bay. An excellent overall nutritional supplement, but use the best brand and tell your doctor. Here is a nice article from Dr. Oz on acai powder.  Dede has acupuncture once a month-another great thing to introduce—if it is too expense, find a “community-supported acupuncture” place to go, like a clinic. Dede’s acupuncturist gives her a discount ($55 per 1 hour session!) because she has a sliding scale. Acupuncture really helps!

3. Add an additional supplement, if needed. PROBIOTICS ARE GREAT, according to Dede, who takes 1/4 teaspoon of powder every day. Again, buy from Naturopath, or Metagenics is a good company. Dede uses “Synergy” brand, all flora.

Weeks 9–10: 

1. Continue previous points.

2. Add an additional supplement if needed. Talk to your doctor about your magnesium/calcium levels—Dede takes a mag-citrate because she doesn’t have dairy in her diet. Plus, if you have been on steroids for treatment, you want to be sure your bone health/density is good, so it would be wise to talk to your doctor about having a test.

3. Incorporate mental and emotional support. This may be needed sooner in some individuals suffering from anxiety and depression contributing to their illness. Dede swears by “Talk Therapy,” and goes 2x a month. She tells her therapist everything about dealing with her disease, work, relationships, boundaries, stress, etc. THE BEST!

Weeks 11–12: 

1. Continue previous points.

2. Add an additional supplement if still needing more support.  Talk to your naturopath. Your electrolytes need to be balanced. Dede makes homemade chicken soup broth 2x a month. Dede loves being on a Paleo-like diet! NO SUGAR, NO GRAIN (can use Almond and Coconut flours), NO DAIRY!! This is the best! Use Almond mile, eat eggs and organic animal proteins (local chicken is good, beef—but make sure it is antibiotic-free and free range)

3. Incorporate colon hydrotherapy (castor oil packs 5 days per week or constitutional hydrotherapy treatments — details are in our book, along with tons of other lifestyle information! Dede loves her castor oil pack-when her abdomen is sore, she lies down with the pack and a heating pad, and reads, or meditates, or sleeps. Pain goes away!.

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HAPPY HOLIDAYS!
Enjoy a stress-free New Years, and look forward to 2014! Remember, a positive attitude improves disease outcome, so “THINK POSITIVE!” 


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Since it is almost Thanksgiving, I thought I would write a post to wish everyone a happy, stress-free holiday, and try to help those with IBS, Crohn’s, and UC who may need some encouragement and advice.

We all know holidays can bring on the stress-inducing behaviors and hormones that cause internal signals to flare up in the body. When I was at the Mayo Clinic a few (short) months ago, I learned so much about controlling stress—make stress-reducing activities a priority, starting today, and leading up through the holiday season.

Your lifestyle structure is even more important here: daily exercise, gentle yoga, meditation, sleep, etc. Schedule appointments with professionals to help you lessen stress in your life: a talk therapist, acupuncture, massage (gift cards are good holiday presents for those you love!), etc. Do what makes you feel good about yourself AND relax! (I went to the salon yesterday for hair color!)

Tryptophan is one of the 10 essential amino acids that the body uses to synthesize the proteins it needs. It’s well-known for its role in the production of nervous system messengers, especially those related to relaxation, restfulness, and sleep.

I am now aware why I love turkey so much—I sometimes even crave it. I always feel more relaxed after I eat turkey, and this may explain why….There are many researchers who study the way tryptophan manufactures serotonin, a neurotransmitter that is found—guess where?—in the intestinal tract. Just about 90% of the body’s serotonin is actually found in the gut, so my gut tells me to eat it, and I am not even a biochemist!

Tryptophan has the ability to raise serotonin levels, too! Wow, who knew this? I love the fact that I can eat turkey and sample other holiday foods like nuts, seeds, bananas, pumpkins, squash, sweet potatoes, green beans with almonds, pearl onions (those sweet little ones, not the canned and creamed kind!) WITHOUT having a flare up. Also (again, who knew?!), Tryptophan also boosts the production of B3, and since I had a partial bowel resection in 2006, I need to keep track of my B vitamins (especially since my terminal ileum is completely gone, I have lost the capacity to fully absorb vitamin B12).

Everything I eat is sourced, and mostly bought from local farms. It is not that hard to do. For instance, our turkey is a Vermont-raised, free running turkey, and I picked it up yesterday from our local food coop. Potatoes are from here, also butternut squash, apples, pumpkins—are all from Vermont; cranberries are organic and from Cape Cod. I will be baking apples, too—delicious and easy. Some of us cannot eat nuts or cranberries, so avoid, but there is plenty to choose from!

Here are some tips: drink water before your meal to fill you up so you don’t overeat, take small portions, walk after the meal. If you have an ostomy, take extra supplies and a change of clothes to your hosts’ party. If you avoid sugar and alcohol, you will be less likely to flare up; also don’t try ANY food that is not on your list (remember the food journal from the book!).

On Wednesday/tomorrow, I will make some pies to drop off at our local Thanksgiving Day dinner for those less fortunate in our area—Don’t forget to do something to help someone else in need this week, and after. With all the holidays upon us, plan some special time each week to volunteer (soup kitchen, helping those who have been in a house fire, helping veterans, etc.). Thanksgiving was set as the fourth Thursday in November. This year, something amazing and historic has happened: After sundown on the second of Hanukkah’s eight days, we will also celebrate Thanksgiving. If you are Jewish, there is an even busier holiday!

I will post some recipes on my Facebook page! Be well, and breathe … A bit of dietary research unravels mysteries of cravings from this writer with uc/Crohn’s disease….Happy Thanksgiving & holidays everyone!


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Good day to my fellow Crohnnie’s and UC-ers,

Holidays are fun—remember that!!! In the spirit of our favorite holiday when you have IBD, we are gearing up for a gluten-free, dairy-free, sugar-free, AND grain-free Thanksgiving!!! Yahoo! Can’t wait. Here is what we can eat: TURKEY!!! The best comfort food on earth (with lots of tryptophan in it that makes us feel good), sweet potatoes (yams) that are steamed and mashed with olive oil and a bit of melted canola butter on top, small sweet onions with canola butter, steamed carrots, cranberry sauce (unsweetened), as long as you can tolerate cranberries. Don’t try ANY new food over any holiday. If you go to a potluck, don’t eat, or bring your own food …. Remember to stay positive, get a lot of rest and exercise every day to clear your head. Start meditation, and volunteer at a local Thanksgiving Day dinner (I’ll be making some gluten-free dishes to bring to my town’s open dinner as a donation)….

Take care of yourself! Give back to others, and you will have a perfect holiday!

Here are some more of Dede’s “Living-with-Crohn’s & Colitis” TIPS—

Probiotic & Diet
For PROBIOTICS, look for a pure brand with a 50/50 blend of bifidobacterium and lactobacillus acidophilus. Perhaps you can find this brand: Metagenics, Ultra Flora “Synergy.” Take once a day, with or without food (depends on how you tolerate it). Keep that food journal, and note down any stress in your life, daily exercise, everything you eat. Don’t eat fried or spicy food—keep track, and eat small frequent meals. I have a really OCD technique: breakfast begins with tea and a dash of milk (the ONLY dairy I eat, and my ONE treat ;)), then add a bit of honey (again, buy in bulk and a pure brand). Cold cereal of almond milk mixed with bananas and cut-up melon (add nuts and raisins IF you can tolerate). Snack is peanut butter on carrots.
CHEW EVERYTHING really well!
Drink TONS of water with fresh lemon squeezed into it.
Drink TONS of herbal teas…I like peppermint

Lunch is tuna or chicken salad (use pure fresh, virgin, olive oil!), maybe chick pea humus and a handful of almonds on the side; snack is applesauce and peanut butter. Dinner is a grilled local beef/organic hamburger with steamed zucchini. No grain, no sugar, no dairy. I eat ALL the time and feel great on this diet. I don’t even crave sugar!

Good luck and stay positive. YOU CAN DO THIS!

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It is amazing how much a positive attitude can help. In our book, there is a section when I am despairing and a doctor comes and sits with me and holds my hand—no kidding! He said, “Think positive.” Well, on that note, I want to write a post today about that and helping the body adjust to the changing season and of course living with IBD in general. I also want to share the news that I am writing a cookbook, called Living with Crohn’s & Colitis Cookbook (good title, too!)…my publisher is the wonderful Hatherleigh Press, which is distributed by Random House. I couldn’t ask for a better team! Publisher, Andrew Flach believed in this book from the very start, associate publisher, Ryan Tumanbing is always there when I need things, and my editor, Anna Krusinski is da Bomb!

My book with Jessie is a good overview and a way to understand how the body chemistry and immune response works. I am not denying the benefits of medication, but we do offer an alternative, and if you are someone who has to stay on meds, you can do both—no matter what, it is important to keep the body tuned and in a balanced state of homeostasis.

Getting a full work up from a medical professional is the first step—go to a specialist at a GI clinic (Dartmouth is the best in my area), and have a colonoscopy, blood work (really important as many patients are anemic due to blood loss, or low in B-12 as in my case), a physical exam (a patient will no doubt be embarrassed by this like I was, but this is a very important exam because the doctors can determine a lot when they examine the anus and rectum, and palpitate the abdomen—they could feel the mass in my case), and what is called enterography: a MRI or CAT scan (I don’t recommend CAT scans too frequently for younger people) will reveal areas of disease inflammation.

Crohn’s typically presents in the lower right abdominal quadrant (often confused with the appendix!) of the small intestine, but it can strike anywhere from the mouth to the anus. Colitis presents throughout the large intestine only. Crohn’s really cannot be cured, and has a tendency to skip to infect the next section of the bowel even after the diseased section has been removed (as in my case). Colitis can be cured through surgery if nothing else (drug therapy or naturopathic-holistic-alternative) works. They take out the large colon, and connect the stomach-duodenum-small bowel through a J-pouch internally, or an external ostomy bag. Not a great thing for anyone to have an ostomy bag; however I have met many people with colitis who don’t mind the bag at all, and love the fact that they are pain-free.

The Crohn’s & Colitis Foundation of America is the best organization! I love everyone there, and run in their half marathons with Team Challenge to help raise money for research; plus it is a community of fellow patients, young and old, and we are a surprisingly close-knit group. Join, and sign up for a walk and a support group (they even have a new college group!) as soon as you can.

The other thing to do, is have a poop sample tested (this is no fun, but can tell a lot—bacterial infections, or something called C-Diff). In addition to going to a GI clinic, make an appointment for a work-up with a recommended naturopath, a trained naturopathic physician with a four-year degree from a well-known college (Bastyr University, for example) and get right in there for a checkup and a plan of action. My naturopath did allergy testing to see if there were specific foods (most common culprits are wheat and dairy), that I needed to eliminate, and she ordered an endocrine hormone test to see if I may have had a hormone imbalance.

I also give a lot of credit to my acupuncturist who is trained in Chinese medicine, and I go once a month. It is all in our book, but make sure you stay on top of the disease and get regular check ups with your medical doctor to rule out any other complications. I had a dangerous abdominal fistula, that didn’t show up on the CAT scan and was attaching itself to another organ—sorry to bring in the drama, but IBD (Inflammatory Bowel Disease) can be life threatening. No question, it is vitally important to be proactive, especially as a parent.

My weight was so low, I was dangerously thin—ironic, because our society places such status on being thin! I am now a healthy 140 pounds, and I work hard every day to stay healthy. Once I get busy with work, and let things slide, I start to feel run down… I can tell right away! Being in tune with your body is very helpful—keeping a food and daily journal, getting some good private counseling, and doing stress reduction exercises (Tai Chi or yoga) daily is also a big part of managing the disease.

I think I have covered the basic tenets of my book with Dr. Jessie. Oh, one more thing, join the online groups— http://www.ihaveuc.com, and The Crohn’s Journey Foundation for starters, also Intense Intestines, Girls With Guts, the Crohn’s Forum, Healing Well, and others. We are a strong and awesome group—always there to support each other! Let’s face it, the doctors are so busy, they can’t spend and hour with each patient, and it is the patients themselves who are doing great research and offering support. If a doctor tells you stress or diet have nothing to do with IBD, find another doctor! Oh, and second opinions are a good plan as well.

I have eliminated SUGAR, and ALL grains from my diet and ALL dairy. It is awesome! I feel so much better… I eat baked chicken or grilled fish, locally-raised, antibiotic-free, grass-fed hamburger steak once in a while when my body craves red meat, all served with yummy vegetables on the side and tons of fruit and nuts and eggs… I take extra calcium-magnesium, along with daily probiotics, turmeric, Omega 3, Vitamin D, herbal adrenal support, extra vitamin C, and a good multi-vitamin (I buy only organic food and supplements—it’s more expensive, but then I don’t spend a lot of money on clothes and makeup!).

So that is the basic overview—I am always there for my readers, and want to offer as much support as possible!

Oh, this just in, Dede will be on The Doctor Oz show this coming Monday, October 14th, in a spot on how common bloating is. They found me through the Crohn’s-Colitis book on “Help a Reporter Ou”t (HARO), and asked me to show how hard it is to buckle my jeans when I am bloated, which is what “used to happen” when I ate too much dairy or wheat…now, I don’t have bloating much AT ALL! Watch the segment if you want a laugh 😉 as “laughter is the best medicine.” I don’t mind embarrassing myself to help others…

Be well, and take care of yourself… don’t be afraid to ask for help!
Dede

Below, you can see some recent dinners… My husband and I have a grill we use a lot, and here you can see grilled marinated swordfish (fresh ginger root, white wine, wheat-free tamari, lime, and a dash of brown sugar for the marinade and let sit for a half hour before grilling) with grilled garden-fresh small eggplants (some people may have trouble with seeds…always introduce new foods slowly and note the reaction by your body in your journal right away….like I tried polenta this summer….noooooo! Not good for me, but may not bother someone else—we are all different!), and baked chicken with a sesame glaze (it was so good!) and steamed broccoli.

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20130626-080451.jpgA New Diet…. Begun just over four weeks ago, is really helping! I am inspired by my friend, and fellow Crohnie, Katy Haldiman, RN, MS, The Paleo Nurse, and my consultants, Jordon Reasoner, and Steve Wright of SCD Lifestyle, to try a simplified diet to help my recent recurrence of Crohn’s from spreading.

Crohn’s is not easily deterred. I was so lucky to have seven years of clinical remission. It was only in the last year, that my disease spread. My last seven years have been filled with hope and health, and it is easy to fall into despair when the doctors tell you that your disease has gone from nonexistent to “severe.”

~

Rather than saying “Woe is me,” and spending time feeling sad and useless (I did a lot of that, believe me), I decided to take action, and try to live the words of the Dalai Lama:

“Scientists say that a healthy mind is a major factor for a healthy body,” His Holiness said. “If you’re serious about your health, think and take most concern for your peace of mind. That’s very, very important.”

That said, I am on my way to health, for sure—no time to sit on my cushion meditating (I do that daily for a few minutes still); rather, I need to stay focused and take care of my body: better food, sleep, stress relief, education, awareness, team building, satisfying work, making money enough to live on, giving back to my community and the world…working for peace, justice, and environmental sustainability. According to His Holiness the XIV Dalai Lama, peace of mind is essential for health—words to live by.

This new diet, very much like The Paleo, is giving me strength and vitality. It is not for everyone—and I always tell people you must proceed with a doctor’s knowledge, for Crohn’s and UC can be serious, even fatal, if not managed correctly. I have worked really hard to form a collaborative team—my own book’s co-author, Jessica Black, ND, is my stalwart supporter and her book, The Anti-Inflammation Diet and Recipe Book has just come it in a second edition and has sold almost 100,000 copies! Jessie is an amazing health practitioner.

~

I have eliminated ALL grains and dairy from my diet—woohoo! What a difference. I found this great site, and I can use almond meal flour (also coconut flour), and I eat fruits and veggies, nuts and animal protein pretty much non-stop. I had an adjustment for the first week, as I really missed my oatmeal in the morning, but as you can see from the photo, my morning meal is wonderful and tasty, too.

I hope this post inspires people to look at their own diets, and proceed with caution (this diet is not recommended if you have flare-up symptoms of Crohn’s or ulcerative colitis). I began this diet with no symptoms, and after the first week, I started to feel like I had more energy, and my stress levels are kept low by walking 4 miles a day and sleeping 8 hours per night.

I’ll post some more photos of my wonderful meals… Summer is the best time to do this diet: only organic fruits and veggies and meat must be antibiotic-free, grass-fed…that whole thing! I buy all local meat, eggs, fruits and veggies… And I plan on putting up and preserving a lot of them this summer so I can continue summer’s bounty from my freezer (and canning room) during the cold Vermont winter!

I also have a nice little garden growing…. Kale, and more kale! Plus, tomatoes, green beans, lettuce, spinach, onions, asparagus, etc. growing your own food is another way to reduce stress and get physically fit—gardening is good for upper body strength!

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I have been taking probiotic powder for many years. The new research on gut bacteria recently, and hype around probiotics, makes it imperative for consumers — and those of us with IBS or IBD, — to know why and how we should take the supplements.

Here is an excellent article by Michael Pollen from the NYTimes. (Photo above by Hannah Whitaker for the New York Times. And styled by Emily Mullin.)

I am a big proponent of getting vitamins and minerals from diet, and vitamin D from the sun, but sometimes we may be compromised (like missing the most important segment of small bowel, the terminal ileum, as in my/Dede’s case), and need to supplement. Probiotics are found everywhere in our diet — fermented food is a great source — wheat, coffee, bananas, onions, garlic, honey, and of course, yogurt and kefir.

The grocery stores and markets are rife with disclaimers of “Probiotics! Added to Everything!” So, what do we do? How do we know what is best?

I asked my co-author, Jessica Black, ND, to come up with a simple description I can pass along to our followers and readers…. Here is what she wrote, and I hope it is helpful:

Probiotics are essential to proper GI function. Probiotics help maintain a healthy barrier between what we ingest and what gets through to our blood stream. Probiotics play a large regulatory role in the GI lining immune system, which sets the stage for the immune system balance throughout the rest of the body.

Probiotics restore proper gut ecology – the proper balance of all important microorganisms lining the GI tract.

I also excerpted the section in our book on probiotics, and feel free to send an email to request a PDF of the full article (dede@livingwithcrohnsandcolitisbook.com).

Last, but not least, my brand is called UltraFlora “Synergy” probiotics made by Metagenics (I buy from the naturopath, but here is link: http://www.metadocs.com/products/detail.asp?pid=86

It is a 50-50 blend of Lactobacillus acidophilus and Bifidobacterium lactis, a highly viable and pure strain, also dairy-free and gluten-free. It has 15 billion live organisms, and needs to be refrigerated in order to retain its efficacy.

Good luck! Questions or comments welcome, of course.


Inflammatory Bowel Disease (Crohn’s & Ulcerative Colitis)

By Drew Nystrom L.Ac., CMT

Our first-ever “guest post” on Dede’s blog! Drew and I “met” through Dede and Jessica Black, ND’s Facebook page, and Dede invited him to educate our readers and followers about the benefits of accupuncture. WTG, Drew! This is like a new book we should publish! A very thorough examination of signs and symptoms of Crohn’s and ulcerative colitis, along with specific treatment plans for acupuncture. Since Dede (seriously) is a wimp when it comes to needles (also, working on this using Ayurvedic treatment to help with this possible symptomatic “sensitivity” on the skin, which is very likely bowel, related, since the skin and the bowel ARE related!~)…Please welcome Drew, and share this, and come visit him if you live in the Southern California region—like our friends at the CrohnsJourneyFoundation.

This happy woman is like Dede, who hates needles, but has monthly acupuncture treatment—it really helps alleviate symptoms and detoxify the overworked liver, etc. when you have an auto-immune disease

This happy woman is like Dede, who hates needles, but has monthly acupuncture treatment—it really helps alleviate symptoms and detoxify the overworked liver, etc. when you have an auto-immune disease

Inflammatory Bowel Disease is a heading/umbrella that has other diseases underneath it. You may have heard of Crohns Disease, Ulcerative Colitis and Irritable Bowel Disease. You may know someone who’s been diagnosed with one of these or you may have had one of these unfortunate afflictions. In any case these can be serious debilitating conditions that sometimes require extreme care for severe cases but all require long term care. In this article I will discuss the differences and similarities between the three.

Crohn’s Disease: A chronic inflammatory condition of the intestinal tract was first described by Dr. Burrill B. Crohn in 1932, along with Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer. Mostly affects the end of the small intestine called the “Ileum” and the beginning of the colon/large intestine “Cecum” but can affect the entire length of the GI tract. Crohn’s disease can affect the entire thickness of the bowel wall leaving “skip lesions;” whereas, Ulcerative Colitis only affects the superficial layer of the large intestine.

Ulcerative Colitis: A chronic inflammatory disease that affects only the Large Intestine (aka: colon). The lining of the colon becomes inflamed, and ulcerations occur which bleed and produce pus.The inflammation and the ulceration lead to spasms, cramping/pain and frequent bowel movements.

Like Crohn’s Disease Ulcerative Colitis is an autoimmune disorder where your body attacks itself.

 

Crohn’s Disease

Symptoms related to inflammation of the GI tract:

• Persistent Diarrhea

• Rectal bleeding

• Urgent need to move bowels

• Abdominal cramps and pain

• Sensation of incomplete evacuation

• Constipation (can lead to bowel obstruction)

More severe symptoms:

• Fissures in the lining of the anus (tears)

• Fistulas (tunnel from one loop of intestine to another or connects the intestine to the: bladder, vagina or skin)

Ulcerative Colitis

Symptoms related to inflammation of the Colon:

• Bowel movements become looser and more urgent

• Persistent diarrhea accompanied by abdominal pain and blood in the stool

• Stool is generally bloody

• Crampy abdominal pain

General symptoms that may also be associated with IBD:

• Fever

• Loss of appetite

• Weight Loss

• Fatigue

• Night sweats

• Loss of normal menstrual cycle

Types of Crohn’s Disease:

Ileocolitis: The most common form of Crohn’s, ileocolitis affects the end of the small intestine (the ileum) and the large intestine (the colon). Symptoms include diarrhea and cramping or pain in the right lower part or middle of the abdomen. This type is often accompanied by significant weight loss.

Ileitis: This type affects only the ileum. Symptoms are the same as ileocolitis. In severe cases, complications may include fistulas or inflammatory abscess in right lower quadrant of abdomen.

Gastroduodenal Crohn’s disease: This type affects the stomach and the beginning of the small intestine (the duodenum). Symptoms include loss of appetite, weight loss, nausea, and vomiting.

Jejunoileitis: This type is characterized by patchy areas of inflammation in the upper half of the small intestine (the jejunum). Symptoms include mild to intense abdominal pain and cramps following meals, as well as diarrhea. In severe cases or after prolonged periods, fistulas may form.

Crohn’s (granulomatous) colitis: This type affects the colon only. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers). Skin lesions and joint pains are more common in this form of Crohn’s than in others.

Types of Ulcerative Colitis:

Ulcerative Proctitis: For approximately 30% of all patients with ulcerative colitis, the illness begins as ulcerative proctitis. In this form of the disease, bowel inflammation is limited to the rectum. Because of its limited extent (usually less than the six inches of the rectum), ulcerative proctitis tends to be a milder form of ulcerative colitis. It is associated with fewer complications and offers a better outlook than more widespread disease.

Proctosigmoiditis: Colitis affecting the rectum and the sigmoid colon, the lower segment of colon located right above the rectum. Symptoms include bloody diarrhea, cramps, and a constant feeling of the need to pass stool, known as tenesmus. Moderate pain on the lower left side of the abdomen may occur in active disease.

Left-sided Colitis: Continuous inflammation that begins at the rectum and extends as far as a bend in the colon near the spleen called the splenic flexure. Symptoms include loss of appetite, weight loss, diarrhea, severe pain on the left side of the abdomen, and bleeding.

Pan-ulcerative (total) Colitis: Affects the entire colon. Symptoms include diarrhea, severe abdominal pain, cramps, and extensive weight loss. Potentially serious complications include massive bleeding and acute dilation of the colon (toxic megacolon), which may lead to an opening in the bowel wall. Serious complications may require surgery.

Causes and who’s affected:

As many as 700,000 Americans may be affected by Crohn’s Disease and Ulcerative Colitis. It is equally common in men and women and while it can affect a person at any age there is a higher risk during the years from 18-35. The cause of IBD is not fully understood but there is a connection between diet and stress; as well as hereditary, genetics and/or environmental factors that play a role in the development of IBD. Studies have shown a greater risk of 5-20% increase in someone acquiring this disease if a “first-degree” relative (parent, child, sibling) has it and an even greater chance if both parents have an IBD. Crohn’s is most common among people with Eastern European backgrounds and it is increasing in number for African Americans. Ulcerative Colitis is more common among Europeans with a Jewish background heritage.

The environment that you put yourself in plays an important role as well. The occurrence is higher in “developed” countries than in “underdeveloped countries, higher in urban areas rather than rural, and in northern versus southern climates.

Treatment with Chinese Medicine:

acupuncture-lakewood-ca-269x300Due to the differential diagnosis that is applied in Chinese Medicine there are different “patterns” that exist when dealing with a disease. This is a similar idea to the different types of Crohn’s Disease and Ulcerative Colitis described above. However, with Chinese Medicine, the patterns are based off of the symptoms the patient is currently experiencing as well as their history, their facial color, body odor, general demeanor, abdominal diagnostic, pulse diagnostic and tongue diagnostic. All of this information is compiled which leads to one of many “diagnostic patterns” to which the according acupuncture points, herbal formula, diet and lifestyle is prescribed. Chinese Medicine is a powerful therapy that can help treat severe cases and help keep mild cases and patients who are in remission stay in remission.

Before we discuss the differential diagnosis, there are a few terms that need to be explained. First one is the “Organ” system. In Chinese Medicine each organ is attributed to specific functions that don’t necessarily match a scientific viewpoint. For example the “Spleen” and “Stomach” are considered to be in charge of the digestive functions and water metabolism in Chinese Medicine. The “Spleen” actually handles some of the function of the “Western” spleen, pancreas and small intestine. The “Liver” has to do with the free flow of qi, which is easily obstructed by stress, emotions, diet and lifestyle. The “Kidney” can be attributed to water metabolism, as well as genetics and our “reserves.” The term “burning the candle at both ends” is a great way to describe how stress and lifestyle can damage the Kidneys. The “Heart” has to do with our emotions and deals with blood. When the digestive system isn’t absorbing food properly we cannot produce the nutrients and blood needed to support these organs. “Heat” refers to inflammation and “Dampness” refers to water metabolism malfunction. Both of these can manifest in numerous ways, as you will see below.

Below are examples of some different patterns that could be “diagnosed” as Crohn’s Disease or Ulcerative Colitis and what the treatment principle should be.

• Spleen Qi Deficiency: Intermittent dull abdominal pain that is alleviated with pressure, abdominal distention, early satiety, nausea, loose stools or diarrhea, loss of appetite, waxy pale or sallow complexion, fatigue, weakness, shortness of breath with exertion, spontaneous sweating, dizziness, and light headedness. Might have mild bleeding of dark, purplish blood, or less commonly, red blood preceding or following a bowel movement; or black, tarry, sticky, unformed stools; or occult blood in the stool discovered upon routine testing. There may be other signs of bleeding, such as heavy menstrual periods or easy bruising.

  • Tongue: pale and swollen, with tooth marks (or pale and thin with significant blood deficiency).
  • Pulse: Thready and weak or moderate.
  • Treatment Principle: Strengthen Spleen, supplement and elevate qi. Nourish Blood and stop bleeding.

• Liver Qi invading the Spleen: Recurrent Diarrhea which may be urgent and preceded by cramping abdominal pain. The pain is relieved following defecation. The diarrhea may alternate with constipation. Symptoms become worse with stress and tension or eating. There is a possibility of mucus and blood in the stool. Other signs and symptoms include abdominal distention, poor appetite, nausea, heartburn, indigestion, borborygmus, flatulence and belching, which relieve abdominal discomfort, hypochondriac discomfort, ache and tightness generally worse on the right side, irritability, depression, moodiness, shoulder and neck tension, temporal or tension headaches, cold fingers and toes, premenstrual syndrome and breast tenderness.

  • Tongue: normal or darkish body, or pale, or with slightly red edges: greasy coat especially over the root (depending on the degree of heat, deficiency and Dampness.
  • Pulse: Wiry
  • Treatment Principle: Harmonize the Liver and Spleen, regulate Liver qi, Support and strengthen Spleen, Alleviate spasm and pain, and stop diarrhea.

• Blood Stagnation: Chronic Diarrhea with a feeling of incomplete evacuation or tenesmus. The stools may be purple or black, sticky or tarry. The diarrhea may alternate with constipation.Fixed and localized, sharp or stabbing abdominal pain (usually in the lower left quadrant) which is worse with pressure. Dark complexion, dark rings around the eyes and purple nails. Spider naevi or vascular abnormalities over the abdomen, face and legs (particularly the inner knee and ankle).

  • Tongue: purple or with brown or purple stasis spots; sublingual veins dark and distended
  • Pulse: wiry, choppy or thready.
  • Treatment Principle: Transform and eliminate stagnant Blood from the Intestines.

• Damp Heat dysenteric disorder: Frequent, foul smelling, explosive diarrhea with blood, mucus and pus: the mixture of mucus and blood will vary depending on the balance of Heat and Damp.Burning anus, tenesmus, colicky abdominal pain, abdominal distention, scanty concentrated urine, red complexion, red eyes, dry mouth, and thirst (maybe with little desire to drink). In the early stages there may be fever and chills, headache and a floating pulse.

  • Tongue: greasy yellow coat; with more Heat a red tongue body and a dry coat; with more Dampness, a thick greasy tongue coat
  • Pulse: slippery and rapid.
  • Treatment Principle: Clear Damp Heat from the Intestines and Regulate Qi and Blood, stop pain.

• Spleen and Kidney Yang Deficiency: Chronic and relentless diarrhea which is thin, watery and mucoid, and may contain pus and blood. In severe cases there may be incontinence of stools and rectal prolapse. The diarrhea is worse from exposure to cold and cold foods. Mild tenesmus or a dragging sensation in the lower abdomen, not relieved by diarrhea. Mild persistent abdominal pain, which is better with warmth and pressure. Loss of appetite, listlessness, fatigue exhaustion, depression. A waxy pale or sallow complexion, cold extremities, cold intolerance, weakness and soreness of the lower back and legs.

  • Tongue: Pale and swollen with a thin white coat.
  • Pulse: deep, thready, weak and slow.
  • Treatment Principle: Warm and Strengthen the Spleen and Kidney Yang. Disperse Cold, transform Dampness. Astringe diarrhea and elevate qi.

• Yin Deficiency with Residual Damp Heat : Chronic diarrhea with small quantities of sticky mucus and blood. Frequent urge to defecate but often in vain. Mild lower abdominal pain, tenesmus, loss of appetite, nausea, dry mouth and lips, thirst worse at night, afternoon or tidal fever that’s worse at night. Heat in the palms and soles, nightsweats, flushing , emaciation, weight loss.

  • Tongue: red or scarlet and dry, with a greasy or peeled coat.
  • Pulse: thready and rapid.
  • Treatment Principle: Nourish and supplement yin and clear residual Damp Heat. Nourish and regulate Blood and stop dysentery.

• Heart and Kidney Yin Deficiency: Recurrent mouth ulcers, which appear in clusters and tend to aggregate on the tongue or tongue tip. The ulcers are painful and hot, with a narrow, slightly swollen, mildly red margin. They frequently recur and persist for up to several weeks before resolving. Often of many years duration, the ulcers tend to be provoked or aggravated when the patient is stressed, anxious or upset. Nervous, anxious individual, insomnia, vivid dreaming, panic attacks, palpitations, forgetfulness, dizziness, tinnitus, lumbar ache, sensation of heat in the palms and soles, dry mouth and throat, night sweats.

  • Tongue: red with little or no coat, redder at the tip.
  • Pulse: Thready and rapid.
  • Treatment Principles: Nourish Heart and Kidney yin. Clear Heat, calm the (spiritual) Shen.

Forms of treatment include acupuncture, herbal formulas (which can be taken internal or external), Massage/tuina, dietary therapy, exercise and lifestyle consultation. When we utilize and multiple forms of therapy results are seen at a rapid rate.

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*Disclaimer: The information offered in this paper is not intended to diagnose but rather to inform the public about IBD and give a brief look at how Chinese Medicine looks at and treats IBD.
References:
http://www.ccfa.org /
• Will Maclean and Jane Lyttleton, (2003), Clinical Handbook of Internal Medicine “The
Treatment Of Disease with Traditional Chinese Medicine” Volume 2 Spleen and Stomach, University of Western Sydney


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Having returned from Mayo, I want to post a quick update…. I’m good, under the circumstances—not going to let having this disease change things too much. I saw my GI at Dartmouth yesterday. He was surprised I went to the Mayo Clinic, but understands how seriously I consider taking DNA-altering drugs, and drugs that affect my immune system, etc. His colleague, Corey Siegel, is doing a study of using a different kind of Tumor Necrosis Factor (Alpha) inhibitor (big fancy words I am loving to say, but suffice it to say it is human and not mouse-tissue based); the results of which will be available in a few weeks. They want me to wait since I have no symptoms, and waiting is what I do best!

Dr. Bensen said if I take the drugs, they are seeing the best results with the TNF(A) Biologic (he mentioned Humira) (also Remicade and Cimzia), combined WITH the immunomodulator, 6MP, for the best results for full remission, at 40-60%. He said if I take the Imuran alone, my chances of getting results are not as efficacious. This, I do understand. He feels the Mayo Clinic’s recommendations are not fully in line with his, and Corey Siegel’s, “front-line” offense approach.

~

In the meantime, I am (seriously!) looking into taking whipworms….you know how much I love creepy crawly things! Seriously, there is a new study, and you can read about it here.

It is nice to be back home in Vermont…. The day I left Rochester, Minnesota, there was a blizzard and they got around 13 inches of snow in MAY!

I am working on a longer post about the stress reduction class I tool, the Eastern medicine and work of Amit Sood, MD, and the integrative medicine at the Mayo Clinic.

Here are a few more photos from Mayo (top, Fish, by Gordon Gund a patient; bottom statue study for the “Les Bourgeois de Calais,” by Aguste Rodin…a huge statue that is very powerful and stands in the middle of a busy atrium cafeteria looking anguished; and last but not least, the dancers I really fell in love with in the hallway near the blood work laboratories!)…

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Happy Spring! Time for “a second opinion”
for this Crohnie patient….

20130106-081800.jpgOh, not to worry . . . well, kind of. In November, I was told my Crohn’s had spread alarmingly. Another 20cm along my ileum (end of small intestine), from the previous surgery’s incision.

The Dartmouth GI team, headed by one of the top IBD doctor’s in the country, Corey Siegel, MD, wants me to take two heavy-hitter drug combos—an immuno-modulator approach that I don’t feel comfortable with taking. Here is my (layperson, granted!) reasoning: since my quality of life is so good, and my symptoms are episodic and stress-induced, mainly (the docs don’t really like talking about stress as a disease-trigger, as it is so hard to quantify I think), my gut is telling me to wait and continue with my naturopathic treatment; and, quite frankly, I almost prefer surgery to the idea of taking such life-affecting medications…

I want to add, that many of my Crohnie and uc-er friends are successfully being treated on these drugs, I have nothing AGAINST the drugs, and if they help and the symptoms are minimal, that is fantastic! Since many of you have asked (!), here is what they want me to take…. Not one, but TWO drugs, given the severity of my disease….. Read on:

According to WebMD, Remicade (or infliximab) is used to treat certain types of arthritis (rheumatoid arthritis, arthritis of the spine, psoriatic arthritis), certain bowel diseases (Crohn’s disease, ulcerative colitis), and a certain severe skin disease (chronic plaque psoriasis). In these conditions, the body’s defense system (immune system) attacks healthy tissues. Infliximab works by blocking the actions of a certain natural substance (tumor necrosis factor alpha) in the body. This helps to decrease swelling (inflammation) and weaken your immune system, thereby slowing or stopping the damage from the disease. Remicade is given by infusions, through the vein (it usually takes 2 hours) every 6-8 weeks.

The other drug they want me to take is commonly called 6MP. It is taken In pill form. This medication is used with other drugs to treat a certain type of cancer (acute lymphocytic leukemia). Mercaptopurine belongs to a class of drugs known as purine antagonists. It works by slowing or stopping the growth of cancer cells. This drug may also be used to treat Crohn’s disease, ulcerative colitis, and lymphoblastic lymphoma.

In patients using infliximab along with azathioprine or 6-mercaptopurine for the treatment of Crohn’s disease, there have been rare reports of an extremely rare, often fatal cancer (hepatosplenic T-cell lymphoma).

Sounds pretty scary, huh?

Infliximab works by binding to tumor necrosis factor alpha. TNF-α is a chemical messenger (cytokine) and a key part of the autoimmune reaction. Cytokines are proteins that are produced by cells. Cytokines interact with cells of the immune system in order to regulate the body’s response to disease and infection. Cytokines also mediate normal cellular processes in the body.

In our book, Jessica Black, ND, my co-author, discusses the cellular balance in the body to achieve and maintain a balance of homeostasis. In patients with IBD, the need for hormone balance and regulation is also important. In our book, she says,

“Every organ in the body depends on, and influences, other organs—everything is interconnected in the body. This is why whole body approaches to healing often work better than treating just one system, or one symptom.”

This naturopathic approach to whole body, and more holistic/lifestyle, healing is what I aspire to. Since I do not want to take the aforementioned drugs, and my overall health is so good, I feel better able to exlore other options. Emeran Mayer, MD, who wrote the Preface to our “Living With Crohn’s & Colitis” book, recommends a second opinion. (Here is the link LWC_Pages_EmeranMayer to his inspiring write-up.)

I am leaving for the Mayo Clinic in Rochester, Minnesota next Sunday, and I will be there for almost a week. It will be interesting, to say the least (!), to hear what the GI team has to say about my case. i will be seen there at 8:00 a.m. on Monday, April 29th by William Tremaine, MD.

Let the adventure begin. I am not scared, or alarmed—just looking for a more integrative approach to my personal patient care. My gluten-free, sugar-free, diet has been going really well—I feel healthier overall, and my research shows that sugar can create problems in the gut, and may even be linked to leaky gut syndrome, so it has been a great practice to switch to only using honey for sweetener. Here is a great video by Mark Hyman, MD, about why “functional medicine is different than conventional medicine” … it is VERY inspiring, not to mention PRACTICAL!

A group of supportive friends and family . . .

One thing I have going for me, and encourage my IBD-friends to be part of, is the online community of Crohnie and uc-ers that I am privileged to know and appreciate. Sometimes we make each other laugh! Take my Crohnie-friend, Christina . . .she is an awesome survivor of many surgeries and health problems, but when I read her interview with Sarah Chouiery of The Crohn’s Journey Foundation, I laughed out loud at the “embarrassing moments” section! Christina’s blog is a great resource for some welcome humor! I will have it on my iPad as I travel to Minnesota next week….

This photo, below, was taken in my hometown of Brattleboro, Vermont…. Is it a real dog behind the statue of the Buddha you may ask?

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