# Sugar Addict and Crohn's



## bjeffrey

A little snippet of research that you may find helpful like I did...


A person with Crohn’s disease might consume more sugar than the average healthy person.1 A high-fiber, low-sugar diet led to a 79% reduction in hospitalizations compared with no dietary change in one group of people with Crohn’s disease.2 Another trial compared the effects of high- and low-sugar diets in people with Crohn’s disease.3 People with a more active disease were reported to fare better on the low-sugar diet than those eating more sugar. Several people on the high-sugar diet had to stop eating sugar because their disease grew worse. While details of how sugar injures the intestine are still being uncovered, doctors often suggest eliminating all sugar (including soft drinks and processed foods with added sugar) from the diets of those with Crohn’s disease.
A diet high in animal protein and fat (from foods other than fish) has been linked to Crohn’s disease in preliminary research.4 As with many other health conditions, it may be beneficial to eat less meat and dairy fat and more fruits and vegetables.
Some people with Crohn’s disease have food allergies and have been reported to do better when they avoid foods to which they are allergic. One study found that people with Crohn’s disease are most likely to react to cereals, dairy, and yeast.5 Increasingly, baker’s yeast (found in bread and other bakery goods) has been implicated as a possible trigger for Crohn’s disease.6 Yeast and some cheeses are high in histamine, which is involved in an allergenic response. People with Crohn’s disease lack the ability to break down histamine at a normal rate,7 so the link between yeast and dairy consumption and Crohn’s disease occurrence may not be coincidental. However, the allergy theory cannot account for all, or even most, cases of Crohn’s disease.
Elemental diets contain amino acids (rather than whole proteins, which can stimulate allergic reactions) and are therefore considered hypoallergenic. They have been used extensively as primary therapy in people with Crohn’s disease,8 9 10 with remission rates comparable to those of steroid drugs. Nevertheless, diets containing intact proteins derived from dairy and wheat have proven equally effective at controlling the symptoms of Crohn’s disease.11 12 13 Until more is known, it is premature to conclude that food allergy plays a significant role in the development of Crohn’s disease or that a hypoallergenic diet is any more likely to help than a diet whose protein is only partially broken down.
In one trial, people with Crohn’s disease were asked which foods aggravated their symptoms.14 Those without ileostomies found nuts, raw fruit, and tomatoes to be most problematic, though responses varied from person to person, and other reports have displayed different lists.15 (Ileostomies are surgical passages through the wall of the abdomen into the intestine that allow the intestinal contents to bypass the rectum and drain into a bag worn on the abdomen.) People with Crohn’s disease wishing to identify and avoid potential allergens should consult a doctor.
There is preliminary evidence that people who eat fast foods at least two times per week more than triple their risk of developing Crohn’s disease.16

Vitamin Dmalabsorption is common in Crohn’s18 and can lead to a deficiency of the vitamin.19 Successful treatment with vitamin D for osteomalacia (bone brittleness caused by vitamin D deficiency) triggered by Crohn’s disease has been reported.20 Another study found 1,000 IU per day of vitamin D prevented bone loss in people with Crohn’s, while an unsupplemented group experienced significant bone loss.21 A doctor should evaluate vitamin D status and suggest the right level of vitamin D supplements.
Inflammation within the gut occurs in people suffering from Crohn’s disease. EPA and DHA, the omega-3 fatty acids found in fish oil, have anti-inflammatory activity. A two-year trial compared the effects of having people with Crohn’s disease eat 3.5 to 7 ounces of fish high in EPA and DHA per day or having them eat a diet low in fish.22 In that trial, the fish-eating group had a 20% relapse rate compared with 58% among those not eating fish. Salmon, herring, mackerel, albacore tuna, and sardines are all high in EPA and DHA.
In a double-blind trial, people with Crohn’s disease who took supplements providing 2.7 g of EPA/DHA per day had a recurrence rate of 26% after one year, compared to a 59% recurrence rate among those taking placebo. 23 Participants in this study used a special enteric-coated, “free-fatty-acid” form of EPA/DHA taken from fish oil. Other blinded trials using other fish oil supplements that were neither enteric-coated nor in the free-fatty-acid form have reported no clinical improvement.24 25 These disparate outcomes suggest that the enteric-coated, free-fatty-acid form may have important advantages, including the reported elimination of gastrointestinal symptoms that often result from taking regular fish oil supplements.26 Unfortunately, enteric-coated “free-fatty-acid” fish oil is not commercially available at this time.
In double-blind research, diarrhea caused by Crohn’s disease has partially responded to supplementation with the beneficial bacterium Saccharomyces boulardii.27 Although the amount used in this trial, 250 mg taken three times per day, was helpful, as much as 500 mg taken four times per day has been administered in research successfully using Saccharomyces boulardii as a supplement with people suffering from other forms of diarrhea.28
Crohn’s disease often leads to malabsorption. As a result, deficiencies of many nutrients are common. For this reason, it makes sense for people with Crohn’s disease to take a high potency multivitamin-mineral supplement. In particular, deficiencies in zinc, folic acid, vitamin B12, vitamin D, and iron have been reported.29 30 31 Zinc, folic acid, and vitamin B12 are all needed to repair intestinal cells damaged by Crohn’s disease. Some doctors recommend 25 to 50 mg of zinc (balanced with 2 to 4 mg of copper), 800 mcg of folic acid, and 800 mcg of vitamin B12. Iron status should be evaluated by a doctor before considering supplementation.
Vitamin A is needed for the growth and repair of cells that line both the small and large intestine.32 At least two case reports describe people with Crohn’s disease who have responded to vitamin A supplementation.33 34 However, in one trial, vitamin A supplementation failed to maintain remission of the disease.35 Therefore, although some doctors recommend 50,000 IU per day for adults with Crohn’s disease, this approach remains unproven. An amount this high should never be taken without qualified guidance, nor should it be given to a woman who is or could become pregnant.
People with Crohn’s disease may be deficient in pancreatic enzymes, including lipase.36 In theory, supplementing with enzymes might improve the nutrient malabsorption that is often associated with Crohn’s disease. However, people with Crohn’s disease considering supplementation with enzymes should consult a doctor.

I hope this helps:>
jeffrey


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## kiny

Thanks. Bacteria feed on sugar, that's how they're able to survive in our body, especially harmful ones. I think the two are directly correlated. 

You can't completely avoid sugar though, since glucose is your main source of energy, and not having engouh glucose will make you lightheaded, that's how I landed in the hospital. But normally eating enough healthy foods provides enough sugar without resorting to those filthy sodas pops or candy and you get the potential benefit of not giving the nasty bugger any food to feast on, and many good bacteria are able to survive fine on low sugar intake.


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## kiny

bjeffrey said:


> .
> People with Crohn’s disease may be deficient in pancreatic enzymes, including lipase.36 In theory, supplementing with enzymes might improve the nutrient malabsorption that is often associated with Crohn’s disease.


http://www.ncbi.nlm.nih.gov/pubmed/10201484

contradicts this

"Pancreatic enzymes are elevated in a significant proportion of patients with IBD"

the sample size is pretty big too


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## Marcy

I find the above article very interesting.
I just went to a new GI doctor yesterday and I felt like I was in a diet center instead of a GI office. For the past 5 or so years I have been to a nutritionist,talked several office employees on the whole diet for Crohn's front. Anytime you come across  CD or UC information i.e Crohn's and Colitis foundation they all say the same thing, some can tolerate some things and others will be able to tolerate other things. Also everywhere states that diet per say can not be blamed for CD. So with that being said, this new doctor virtually told me to eliminate all grains,including fresh corn,no beans,no rice or any kind of potato. No tomatoes even in sauce form,absolutely no peppers of any kind,no spices just a little salt and pepper. ALong with the list he stated no dairy or processed dairy. No caffeine or sugar. Then we would gradually reintroduce certain foods. I don't understand because I don't have celiac disease or any of that. I can not eat beef because even the leanest beef causes tummy trouble so I stay pretty much with chicken and turkey. I am allergic to most fish and shellfish of any kind so my protien intake is limited. I am just so confused over all of it. I feel like if I don't get sick from eating something then I will continue to eat it. Maybe I am wrong but gosh I barely eat now if I cut out everything he wants me to just to see if it "helps" I will be loosing even more weight that I really can't afford to loose


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## kiny

Marcy said:


> So with that being said, this new doctor virtually told me to eliminate all grains,including fresh corn,no beans,no rice or any kind of potato. No tomatoes even in sauce form,absolutely no peppers of any kind,no spices just a little salt and pepper. ALong with the list he stated no dairy or processed dairy. No caffeine or sugar. Then we would gradually reintroduce certain foods. I don't understand because I don't have celiac disease or any of that. I can not eat beef because even the leanest beef causes tummy trouble so I stay pretty much with chicken and turkey. I am allergic to most fish and shellfish of any kind so my protien intake is limited. I am just so confused over all of it. I feel like if I don't get sick from eating something then I will continue to eat it. Maybe I am wrong but gosh I barely eat now if I cut out everything he wants me to just to see if it "helps" I will be loosing even more weight that I really can't afford to loose


The things he says to avoid are all full of carbs: rice, potatoes, corn, sugar, etc. It's called the SCD diet (name is pretty confusing, it has the word "carb" in it, but the idea is to avoid all carb), it's pretty much the same as the stone-age diet. Notice that everything you can't eat was also not available in the stone age (even refined sugar wasn't), what was available was fish, meat, fruit vegetables, nothing processed. (mind you, he says you should avoid nuts too, you can eat nuts with the SCD diet)

Protein is the easiest thing to compensate for, just use protein shakes. (or alternatively whey, although remember that whey has lactose unless you buy the really expensive stuff where they have processed it out, some of the companies lie btw, not to mention that unprocesessed whey could potentially be full of MAP, regular protein is also much easier to digest than whey, although I personally never had issues with it)  I don't know why you're worried about protein with this diet though, protein is the last thing you'll be missing out on, you can eat chicken and eggs with this diet, it's the best two natural sources of protein you can get (soy is another, something I wouldn't do).

Although I'm worried that you can't eat most fish, that's a major part of this diet. It's not hard to keep the diet going, but without fish it's going to be a lot harder. Tomatoes is normal, everyone with crohn seems to hate them, there is solanine in them.



Marcy said:


> I feel like if I don't get sick from eating something then I will continue to eat it.


I think it's incredibly hard to know, outside of stuff that irritates (alcohol, tomatoes), outside of those I don't think I can personally decide what helps and what doesn't. Sometimes I ate things and thought "hey, this is why I got sick", and 2 months later I ate it again and I felt nothing. How do you know what got you sick, how do you know it was even the food, it's hard to tell I think. Some people make lists, while it sounds great in theory, how can you possibly know which food it was, it can take days or weeks before some foods have an impact on the body, there are hundreds of things in each thing we eat, how do you know what it was or even what was it in the food that triggered it. Was it the carb, the fat, the spices, the lactose, how do you know it wasn't something else, how do you even know it was the food to begin with.


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## Marcy

Thank you for the insight. The diet is the Paleo diet. As for carbs, at this point in my journey I need those carbs to help maintain my weight as to my pcp. Tomatoes and I are ok what I mean is I don't have problems digesting them. I am not a refined sugar person I do not drink colas,unsweet tea on occasion with a little lemon, I don't eat chips or candy or forget about baked goods they send me running to the potty. Most of my diet is veggies and I do like an apple from time to time w/o the skin of course. My biggest downfall is pasta and brown rice. When I cook my meat is always broiled, as I said before beef is a no no for me as I can't digest it. I did try some poached snook the other night without any issues from the allergies. They are lower if fat and supposed to not have as strong of an allergy factor as say cod or trout. 

I do understand what this doctor was saying, but i still felt at 101 pounds he was putting me on a diet I know I will fail at. Some things in life I know we have to grin and bear it but I eat very little as is and yes my pasta may be a comfort food but I don't sit and eat a full box of the stuff. 1 cup is all I allow myself without it I would probably be like a ticking time bomb. lol..My husband says I am like a druggie with my pasta 1 meal a day I like to have pasta. Would it help if I went to a glueten free version?


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## kiny

Gluten free pasta would still be very high in carbs.  If you're worried about your weight, the Paleo / SCD diets are very high in protein, and any unused protein gets transferred into fats. You could always try building down your reliance on pasta and see how far you get, as long as you eat enough you shouldn't be losing weight because of the diet really. Only time I lose weight is if I simply don't eat enough.


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## mario

Just to highlight the fact that we are all different, if I didn't eat copious amounts of sugar I'd fall down the nearest drain!!! I am in remission (with the help of meds) and the only food I avoid is dairy. It has taken over 2 years to find my perfect diet and during my 'no sugar' experiment I became dangerously thin. It would be so cool if we could pool ideas and come up with the perfect diet but sadly we are all on an individual journey. Good luck to all who are still finding their way.
Hugs
Marie x


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## Kev

I lowered my sugar intake (and having a sweet tooth the size of the rock of Gilbralter made it a challenge) but I didn't want to switch out sugar for artificial sweeteners (I've heard horror stories about artificial sweeteners and any inflammatory illness). Solution? I use honey.  Use the same amount of honey as you would sugar, and you can have your cake (Angel Food) and eat it too.  No frosting/icing though.  Substitute some yogurt.


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## kiny

Kev said:


> I lowered my sugar intake (and having a sweet tooth the size of the rock of Gilbralter made it a challenge) but I didn't want to switch out sugar for artificial sweeteners (I've heard horror stories about artificial sweeteners and any inflammatory illness). Solution? I use honey.  Use the same amount of honey as you would sugar, and you can have your cake (Angel Food) and eat it too.  No frosting/icing though.  Substitute some yogurt.


The SCD book also recommends honey for those people who still want some sugar. The idea she says, is that honey is a monosaccharide, and since it gets absorbed much quicker than disaccharide or polysaccharide, there is less chance that it will remain in your gut as waist, so bacteria have less chance to exploit it.

I have also stopped drinking pop with artificial sweeteners, I don't think people in the stone age had diet soda either.


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## Irishtarheel

*SIBO, REFLUX GERD and SUGAR CRAVINGS!!*

Hi there, as if it all doesn't get confusing enough, I'd like to add something that is new to the research, as I am one of the people who has it = SIBO.  SIBO is common to Crohnnys, especially those who have had resection(s),  and it was finally given a name in the last few years.  It is gaining a lot of awareness in the past 2 years or so.  Here is a link from UVa for some reading.
http://uvahealth.com/services/digestive-health-1/images-and-docs/low_FODMAP_diet.pdf

I bring this up because intense sugar cravings go along with it and honey is an absolute no-no when you have SIBO.  Many Crohnnys who have SIBO have been treated for GERD, reflux, and all kinds of stomach issues when they actually have a bacterial problem that requires an antibiotic and a specific diet to control it: Low FODMAPS to starve out the overgrowth of bacteria.  It typically returns in 6-12 months, but can be controlled with diet.  I was thinking that perhaps I should ask Dave if we can open a sub-forum on it to generate better awareness in this community.  The condition comes about, generally, for Crohnnys (more so with resections) because the Ileo-cecal valve is gone and then, literally, the floodgates are open for the lower bacteria to swim upward and multiply in the food filled small intestine as far as the lower stomach and have a great big party with all that additional food.  They make gas and a host of noisy, uncomfortable symptoms that make you want to be the adult who says, "OK, you guys, party's over, go home!"

The symptoms are this:  burping (sometimes tooting too!), no matter what you eat or how little, intense bloating that gets worse by the day, lots of tummy gurgling, relux galore, (this combined with the bloating makes it really uncomfortable to bend over--Gee, is that $10 bill on the ground worth the discomfort?!!), nausea, and I felt very fatigued and foggy brained as well.  Not to mention an intense craving for sugars (which I'm not a fan of) and sweet starches.  My cravings went entirely away, with treatment. 

The test for it is the Hydrogen Breath Test, although it is not perfect, and strong anecdotal presentation is considered enough to go on.  In my case, after two days on Xifaxan I was markedly better, which my doc considered confirmation.  I was on two 30-day courses, and am now on the LFM diet for life, plus homemade SCD yogurt, to keep it under control.  I take a multivitamin, Calcium w/ D/Mag., Omega 3, B-12 sublingual, vegan iron tab. I'm investigating oregano & cinnamon for antibiotic (garlic not an option)and anti-inflamm supp.   I eat lots of fish/salmon, some poultry, certain fruits and veggies, pureed carrot/veggie dressings on baby (soft) lettuces w/ olive oil, hard cheeses (swiss or havarti mainly), SCD yogurt, and occasionally/rarely nut flours for a baked bread.   Everyone's diet will be the culmination of what works best for them, but omitting FODMAPS is the key here for SIBO.  

There are so many meds we can all be on.  I'm just hopeful that perhaps some patients who have SIBO symptoms will be able to feel better and get off any stomach meds if SIBO is, in fact, the underlying problem vs. acid pump, etc. issue.

My doc is at UNC-CH where the research is topnotch.  They confer with Duke Univ. and it all makes for good information.  Best wishes and I hope this sheds more light for lots of people in discomfort.


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## Irishtarheel

*P.s.*

I forgot to mention that, of course, SIBO is suspected as long as other things have been ruled out.  For example, Crohns in the esophagus or stomach, which I would imagine would be painful, etc.


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## Marcy

Awesome read and information Thank you for posting


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## Irishtarheel

*Honey substitution*

Your welcome, Marcy!  I neglected to add that although honey is not allowed (Boooo), maple syrup is, so I use that in moderation.  For anyone on the SCD diet, further research shows that because (pure) maple syrup has an equal amount of fructose to glucose (which helps metabolize fructose) it is digested better/faster/higher in the digestive tract than honey and does not ferment and cause increased bacterial growth as honey would.  So, I use a little in my cooking or in a lemon-dijon vinaigrette.  

Have a great day!


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## kiny

I've been thinking and reading a bit. I have been on the SCD diet for a while now and went off it without any real change to be honest.

Well, the theory is that bacteria would be less populous if there is a shortage of carbs, especially dissacharide and polysacharrides since they would reside in the colon and any that aren't absorbed could be exploited by bacteria residing in the colon.

I think the correlation between diet and bacterial infections is of course there, we were not born with mycobacteria and we got them from somwhere.

But the idea that we could control a bacteria by changing our diet seems a little weird to me now considering:

*it's not a mild bacteria, we are talking about MAP & / or E.coli or even C diff in some cases, could a diet change really impact a bacteria this strong?

*many people who say the SCD diet work are not just on the SCD diet but are also taking medication, it makes claims unreliable since we don't know if the diet is controlling the disease, the medication or something else

*other bacterial diseases closest related to crohn are not affected by changes in diet, leprosy or tuberculosis are not cured or changed because you change your diet (changes in vitamins do affect these diseases)

*the SCD diet is very high in lactose like yoghurts and cheese, the main source of MAP and studies point out a relationship between lactose intolerance and crohn. Further restricting the SCD diet by taking out lactose leaves you with very little food choices. Taking out lactose on a diet which does allow a reasonable amount of carbs is so much easier.

*we know crohn is not just limited to the mucosa, it can affect the whole colon, not just the local bacterial ecosystem in the gut

*short chain fatty acids are needed to repair the colon, the SCD can be severly lacking in those

*the diet is very high in egg protein (in pure and not powder form), fermentation results in H2S which is harmful to the gut mucosa 

*people who have crohn often become underweight because they eat less and less, I have never seen this have a positive effect, on the contrary, people become underweight and it tends to get worse before it gets better

*the SCD diet is very very restrictive, it's quite hard to stick to non carb foods

*the diet is very low calorie, unless you eat a lot, which goes against the idea of going easy on your colon by splitting meals into smaller portions during the day, it's very very hard to control your weight, no fats and lots of fruits and vegetables result in very low calorie choices of food, and since vegetables are often very hard to digest and ferment really late in the colon, it's a question if we even absorb some at all

Just some questions in my mind, it's very one-sided, I could have easily pointed out a lot of positive things, but that wasn't on my mind atm.

I think if there is to be a diet for crohn it should be a diet for crohn and not some diet that might possibly in some areas be good for crohn and in others be completely wrong for crohn. I think for me personally a diet that is low in lactose, but very high in calories but still restricting too high sugars whenever able and making sure I have all I need to repair mucosa damage like SCFA would be much better. I mean why should we settle for a diet that was never made for crohn, why not simply make a diet that could work best for crohn, why can't we just pick all the data and make a healthy diet that is not overly restrictive an still beneficial to us.


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## Irene3

*Thank you Bjeffrey*

This is a great thread, thank you for posting all that info. I already knew my bacterial overgrowth, is related (candida), to my sugar intake, and that sugars in milk also seem to make my crohns worse, though I have a lot of milk while on Pred, and crave sugar, have headaches, and heximers seems to come at times, as I am taking an antifungal daily. I think as they die off, release toxins, cravings worse, and just generally SO unwell some days. Add in Pred moods and at times I feel like a complete mess. 
  There's research to indicate that these bacterial overgrowths, can cause mental issues, from depression to Paranoya, as well as major mood swings.
  Most people put symptoms like these, on this forum, down to Pred and other med side effects, but more and more I'm convinced, that at least in me personally, sugar is the main cause for the overgrowth, then the flares come, then Pred just makes things infinetally worse, for not only added physical/mental side effects, but it encourages bacterial over growth.

Mario- I too loose so much weight when I have no sugar at all, and I became more ill. I believe, part in part because of the overgrowth, I have to reduce, before completely scd diet, with no carbs and starches.

Irish... I too had a resection, and it makes sence that bacteria can move up into the small intestine more freely. :/

Also, I checked which fish oil I'm using, half way through this thread, and thankfully it's the right one. But on a whole, I think diet changes, detoxing these bacterias properly, is important, or at first we just feel more unwell. If I'm having a recsection, it will be a while, but if I get to have dilation of my stricturing, then I'll be on the scd, at least for the most part, regardless of supplements and medications( anti-inflammatory hopefully rather then imunosuppresants again). 

  I can see the point about not naturally having produced these bad bacterias, but their in everything, chicken is what most people with crohns tolerate best, and the smallest amount of bacteria in chicken, can reak havoc in the small intestine. 
  But, each to their own. Thanks again 


Mario

Irishtarheel


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## Irishtarheel

*Follow-up to Kiny*

I definitely agree with the premise that each person has to do whatever works best for him/her personally, as to their own experience/tolerances over time.  Those tolerances are also in flux, in the same way that seasonal allergies are of any kind.  Our autoimmune responses change over time and only each person knows what is best at any given time in a personal Crohn's journey.  I only speak to my own.  However, SIBO is a diagnosis and a situation that is similar from one person to the next, so low-FODMAPS would be helpful "on some level" "to some degree", to anyone who has SIBO, whether they have Crohn's/IBD, IBS, or whatever underlying situation.  Because SIBO (which can commonly occur with Candida (yeast) infection) is merely a radical _overgrowth_ of all bacteria, in the wrong places.  That is different than trying to balance out proportions of particular and specific types of bacteria.  That can certainly be a long-term goal for better health with probiotics, etc., but it is a seriously trickier one, of course.

Kiny, your points are interesting.  However, I don't know where any of them came from, or how legit. any of them are, so I would just request that when you quote lots of broad sweeping statements, you footnote them so that we can all "consider the source," so to speak and take it from there.  Your curiosity, reading and effort are certainly commendable. It's just that there is so much info out there--lots of it really bad--so it's tremendously helpful to know where it comes from.  You'll find both Dave and GStar are tremendously knowledgeable and have great resources on all of this in the food and supplements/SCD subforum, as well as the "Wiki" resources Dave has put together from very trusted and reliable sources if you do a search here.

There are some quick points I'd like to follow up on per your post:  1)As I mentioned, with SIBO, the goal is to limit and slow down the overall _overgrowth_ of bacteria.  2)  I believe (read in my baby books long ago!) we rec'd our natal bacteria from travelling down and out the birth canal (a virtual bacterial carnival  down there, mother's milk immunity, and early food, since you were curious on that note. 3) I, personally, have not been on any maintenance meds since I was diagnosed in 2001, with the exception of Entocort for a month in 2009, so I am a great "guinea pig" for diet recommendations and how they fare.  SCD did work well for me, and now, low-FODMAPS is keeping my SIBO totally at bay, as well as significantly calming my bi-monthly hormone-induced flare-ups.  This may encourage those who wonder how food and drug reactions interconnect and play out 4) Lastly, the SCD and low-FODMAPS has tons of healthy (lactose-free) fats--if you are able to tolerate them, such as SCD yogurt made with whole milk or cream; hard cheeses, such as cheddar, nuts and nut butters/flours, olive oil, etc.  Perhaps you can't have these for some reason?  That is where the whole diet discussion goes off in different directions.  With SCD, you may not be able to tolerate certain foods AT FIRST, but as you heal over time, with patience, you can begin introducing small amounts and testing them.  

Elimination diets of any kind are, no doubt, tedious and require a lot of time, effort, patience, and persistenc...over a long period of time.  We become individual test tubes in a sense!  They are worth the pay off, no matter what kind/type you decide is right for you at the moment.  I know it's a really tough struggle and I want to lend you my support in finding what works best for you, individually, as you take your journey.  It's a long journey.  You should think about looking at the SCD subforum, as it's about food in general, too.  Best of luck and hang in there, Kiny!  It sounds to me like you have great persistence.


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## Josephine

I have sugar and salt addict.


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## Marcy

I am finding with myself I am not withdrawing from sugars but I too find myself craving salt. My PCP says it is because 1. I have gallbladder removed 2. my resect. and 3. my continual diarrhea. He says once that is controlled my salt cravings should lesson. Hope that helps


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## jjk308

Marcy said:


> I find the above article very interesting.
> I just went to a new GI doctor yesterday and I felt like I was in a diet center instead of a GI office. For the past 5 or so years I have been to a nutritionist,talked several office employees on the whole diet for Crohn's front. Anytime you come across  CD or UC information i.e Crohn's and Colitis foundation they all say the same thing, some can tolerate some things and others will be able to tolerate other things. Also everywhere states that diet per say can not be blamed for CD. So with that being said, this new doctor virtually told me to eliminate all grains,including fresh corn,no beans,no rice or any kind of potato. No tomatoes even in sauce form,absolutely no peppers of any kind,no spices just a little salt and pepper. ALong with the list he stated no dairy or processed dairy. No caffeine or sugar. Then we would gradually reintroduce certain foods. I don't understand because I don't have celiac disease or any of that. I can not eat beef because even the leanest beef causes tummy trouble so I stay pretty much with chicken and turkey. I am allergic to most fish and shellfish of any kind so my protien intake is limited. I am just so confused over all of it. I feel like if I don't get sick from eating something then I will continue to eat it. Maybe I am wrong but gosh I barely eat now if I cut out everything he wants me to just to see if it "helps" I will be loosing even more weight that I really can't afford to loose


Your doctor is probably a bit wierd about food, a common American affliction and taking away all those foods is over the top.  You should be able to tell what you can tolerate a food or not by your reaction within 12 to 24 hours after eating it, the beef for example.  Your intolerance of beef may be because of strictures in the bowel, since beef has a lot of connective tissue, lean or fat, that is hard to digest and clumps up.  I have that problem too, while other finer meat, poultry, even pork, and venison, is OK.  

Likewise for anything high fiber.  Vegetables high in fiber are really bad for me, especially uncooked, as in salads, since I suppose they are indigestible and clog up the strictures.  So are any that produce gas.  Tomatoes, peppers, spices have no effect.

So aside from fish I'm restricted to a diet that will make any health nut scream in horror!

My first gastroenterologist was similar to yours, except that he was making quite a bit of money selling his special canned nutrition drink.  It had some real bad effects on me, because a lot of it was nonfat milk, and I get lactose intolerant in a flare-up.  Of course he kept insisting that I drink it and I dropped him pretty soon.

Anyway it sounds like you need a gastroenterologist who is an expert in Crohn's, not one who goes in for dietary fads.


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## Marcy

I am really beginning to wonder how right you are jjk308. I did however follow his Paleo diet for almost 2 months and my family is glad I have just limited the inflammation causing foods. Tomatoes,potatoes and the like. Peppers was a no brainer for me since they tend to give me indigestion anyway. My son said it was worse than when I quit smoking. lol..poor kid said, "Mama, you are worse than I am when I don't get my daily soda." 
I have come to realize I know my gut better than anyone else and if I just avoid certain things I tend to feel much better in the long run. When you are allergic to seafood and shellfish, have a hard time digesting beef, you are left with very little. I have found eating 2 hard boiled eggs from my free range chickens a day helps with the whole protein issue.

Thank you so much for helping me see the light. I think like you I will continue to listen to my gut more than the off the wall food fad...

Nothing is worse than a hungry menopausal woman, lmao..That comes from a hubby who has been through it all with me and this disease. Lord Thank You for this man of mine. Without the humor we would have split years ago.


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## kiny

I wanted to follow up on this, I avoided all sugar intake for a while, honestly more as a test than anything to see what the effects would be, and it really was not a good idea. Even though my iron, B12 and B6 levels were not that low, if you lack sugar, you start to feel dizzy, you don't have enough energy and it's really rough until you resume normal sugar intake. 

I think the diet is slightly too strict at times, since it basically avoids all intake of sugar and since crohn patients often lack iron, having iron deficiency on top of sugar deficiency feels like getting hit with a sledgehammer every 5 seconds. 

I think there is a middle ground where you take enough sugar but don't overdo it.


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## Irishtarheel

Hi Gals!  Remember, too, that "sugar," takes on many forms, so on something like the low-FODMAPS for SIBO/Crohns patients and other IBD patients (there is a test to confirm SIBO presence & diagnosis), there are distinctions between types of sugars.  That's what FODMAPS stand for...the variety of specific sugars.  So, you are not really avoiding all sugars if you just avoid, say, refined sugar.  You get lots of energy from a variety of sugars and carbs, so you won't get dizzy, etc.  

Short answer is that I'm agreeing with both of you.  SCD was never really embraced by the medical community, and now, low-FODMAPS is a much revised and more live-able version of same with a ton more research behind it.  It is fully embraced by respected and reputable teaching hospitals around the world, Australia, London, and recently UVa medical school in the US.  If a Crohnnie has had an ileo-resection removing the valve, then the likelihood of developing SIBO is just a matter of time...not if....it's actually when. So many Crohns patients (have intense sugar cravings) have been diagnosed with GERD, who actually have SIBO and could avoid meds for GERD by just following a very reasonable food plan. One thing to also keep in mind with LFMs that would correlate with what you both are saying, is that it is an elimination diet which each person tailors to his/her own intolerances...As you are saying this makes so much more sense for IBD patients.  

There is a introduction period where one avoids the "usual suspects" for most patients, and then over time you re-introduce one food after another and see how you, personally, do with it.  That way, it's not a one-size-fits-all like the SCD and some other food plans are.  It is just as you both are saying.  It is, however, is a more scientific way of approaching it where you can really figure out what you can have (which is sometimes portion-based, i.e. you can't have a whole sweet potato, but you've realized through trial and error, that you can have a 1/2 of one with no symptoms whatsoever, because it's a tolerance issue). 

So, since it is not really a fad diet, and you can tailor it very personally (in the same way that a registered dietitian would) by using a thoughtfully designed medical approach, you have a plan for eliminating just the items that don't agree with you individually.  You may want to consider it, because being a Crohnnie and having intense sugar cravings--at other times than your monthly cycle  -- is a strong indicator of SIBO,  especially if you have GERD symptoms, as well.  This food plan has seemed to help those who do not have SIBO, too.  Those with severe IBS (who frequently end up becoming IBD eventually.)  That was my scenario...IBS for almost 20 years, and then Crohns.  It's an interesting dynamic this whole thing between sugars & carbs that ferment in the intestine & create IBS/IBD symptoms. 

I took the scenic route to say that you don't have to eliminate all sugars, or carbs...there are many different kinds and this food plan distinguishes between them, and each person's intolerances with particular one(s).  Hope that helps.


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## Irishtarheel

Welcome aboard, Abel124!  Great article.  I have felt so much better for avoiding all processed foods, refined grains/sugars.  My favorite snack is a ripe banana with homemade almond butter and my only, rare sweet is a little bit of maple syrup in my baking or my homemade yogurt.  I feel the best I have in years...and the cool thing is that over the past 7 months my husband and 3 kids have joined in, of their own choice.  We've cleaned out our pantry to make room for only healthy, whole foods, and our freezer of anything other than frozen fruit, veggies, & fish.  My three 17+ age kids have always been very active (lacrosse, soccer, the gym, jogging outdoors) and feel great, too.  Over the years, we were quasi-involved, but not totally committed to optimum eating habits as we are now.  

Overall, it makes me so happy to see my family in their best health and enjoying this lifestyle.  We are sharing recipes, good blog/resource info., and having fun with it! 

I will always be concerned that one of our kids will develop Crohns at some point.  If they have this foundation, I'm hoping it will keep it at bay, perhaps, ...or at least help them cope if they need to.  We've discussed their risk and what they can do for their best total health.

Best wishes to you on your journey!


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## wildbill_52280

its absolutly true, and this is one thing i have luckily understood since day 1 of having crohns, partly with the information that is provided in the Specific Carbohydrate diet. This has allowed my to stay relatively complication free and have no need for surgery for 3 years since being diagnosed with crohn's disease, without any use of drugs. but i still have a hard time, though not as hard as most people.

i have looked at the scientific data about deficiency in digestive enzymes, it seems were are not deficient, it is the bacteria that ferment the sugar to produce toxins. but certain starches also create toxins which intensify inflammation and symptoms of constipation as well, like corn, rice and barley. wheat oats and beans are the only grains/starches that are relatively tolerable and do not lead to severe constipation or intense inflammation.


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## Irishtarheel

I rarely hear this on Crohn's forums, but I appreciate the constipation mention  as that was my main problem for decades.  Who would've thunk, right?!!!  Now I am "regular," no bloating, etc. since this food plan.  It's nice to feel comfortable and more predictable, in my own body, finally.


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## NiceCupOfTea

So basically I'm responsible for my Crohn's because I ate every wrong thing going for it and, even now, am not prepared to change my diet?

Feel like I may as well get hit by a bus, really.

But before I do so, I'll make sure to eat a highly sugary, refined snack, so I can try to make the Crohn's that teensy little bit worse.


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## NiceCupOfTea

Before I get hit by that bus, I might as well ask: if sugar is the universal villain, why are there clinical studies showing that liquid diets are nearly as effective as Pred in getting Crohn's into remission - and by 'liquid diets' I'm talking about Ensure, or Ensure-type drinks, which are about as sugary and full of processed ingredients as you can get?

Doesn't it ever occur to anyone that simply cutting out 99% of "normal" food is probably what gets you into remission, not cutting out sugar or processed foods?

If you want to get into the business of being 'virtuous' and 'pure' about diet, then there is as much clinical evidence in favour of a virtually all-vegetarian diet as there is of the meat-heavy SCD/Paleo - which is, not much in either case. 

But at least vegetarianism isn't correlated with an increased risk of getting IBD, unlike animal protein. 

If it isn't obvious yet, yes I am crazy and no I don't have any respect for your diets, I can't be bothered pretending I do.


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## David

NiceCupOfTea said:


> If it isn't obvious yet, yes I am crazy and no I don't have any respect for your diets, I can't be bothered pretending I do.


Then don't respond in anymore dietary related threads please.

Thank you.


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## crohnsguy057

NiceCupOfTea said:


> Before I get hit by that bus, I might as well ask: if sugar is the universal villain, why are there clinical studies showing that liquid diets are nearly as effective as Pred in getting Crohn's into remission - and by 'liquid diets' I'm talking about Ensure, or Ensure-type drinks, which are about as sugary and full of processed ingredients as you can get?
> 
> Doesn't it ever occur to anyone that simply cutting out 99% of "normal" food is probably what gets you into remission, not cutting out sugar or processed foods?
> 
> If you want to get into the business of being 'virtuous' and 'pure' about diet, then there is as much clinical evidence in favour of a virtually all-vegetarian diet as there is of the meat-heavy SCD/Paleo - which is, not much in either case.
> 
> But at least vegetarianism isn't correlated with an increased risk of getting IBD, unlike animal protein.
> 
> If it isn't obvious yet, yes I am crazy and no I don't have any respect for your diets, I can't be bothered pretending I do.


I think there's a name for the fallacy you've just given.


Dietary effects are observed by patients with IBD worldwide. If you've never observed it, go eat some nuts, tomatoes, coffee and beer. You cannot say that diet has no effect.

Liquid diets are just that - liquid. Much easier for the body to digest. It's for that same reason that people puree carrots before they eat them. However, liquid diets DO NOT cure Crohn's. They're just easy enough for our bowels to digest, so we don't feel uncomfortable.

Yes, it occurs to most of us. But you know what happens when you cut out 99% of "normal food"?? You only have 1% of normal food available for you to eat. GOOD LUCK GETTING A BALANCED DIET. "Normal food" isn't a scientific term: it isn't "normal" food that hurts CD patients, it's SPECIFIC food. The purpose of the diets is to FIND what specific foods.

"which is, not much in either case". I disagree. We've got many people here who abide by one or the other, and they work perfectly. They don't work for everyone. This suggests that either a) people suck at following diets, so we have no real good evidence, or b) people's digestive abilities differ, depending on their specific IBD-related DNA. or c) it's all in our heads, and we can cure ourselves by eating our food "with a grateful, loving heart", etc. etc. (I dare you to say it's this one)

"But at least vegetarianism isn't correlated with an increased risk of getting IBD, unlike animal protein. "

Source? Please list more than one, so I can actually trust it. Not that it matters to your failing argument.

"If it isn't obvious yet, yes I am crazy and no I don't have any respect for your diets, I can't be bothered pretending I do."

But you can be bothered to post paragraphs of unscientific logical fallacies on an internet forum? You glorious keyboard warrior, you. 

xoxo


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## wildbill_52280

NiceCupOfTea said:


> Before I get hit by that bus, I might as well ask: if sugar is the universal villain, why are there clinical studies showing that liquid diets are nearly as effective as Pred in getting Crohn's into remission - and by 'liquid diets' I'm talking about Ensure, or Ensure-type drinks, which are about as sugary and full of processed ingredients as you can get?
> 
> Doesn't it ever occur to anyone that simply cutting out 99% of "normal" food is probably what gets you into remission, not cutting out sugar or processed foods?
> 
> If you want to get into the business of being 'virtuous' and 'pure' about diet, then there is as much clinical evidence in favour of a virtually all-vegetarian diet as there is of the meat-heavy SCD/Paleo - which is, not much in either case.
> 
> But at least vegetarianism isn't correlated with an increased risk of getting IBD, unlike animal protein.
> 
> If it isn't obvious yet, yes I am crazy and no I don't have any respect for your diets, I can't be bothered pretending I do.



These dietary studies arent necessarily implying that high sugar diet absolutely causes crohn's, but there may be a relationship. 

maltodextrin i think is the only carbohydrate usually used in the "liquid" diets, it is the absence of lactose, sucrose and polysacharrides that may induce a remission by altering the intestinal flora. my memory of this may not completly accurate though about which carb is in the liquid diets  they use for inducing remissions, if you really want to know more tho look it up.


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## pieman

NiceCupOf Tea is quite correct in his/her assessment (though has a rough way of saying it!). So is Kiny and one or two others. They get rough treatment, or are ignored, but the original poster gets applauded, even though there are no links or references given there - seems a little unbalanced. Not to worry.

The elemental and polymeric feeds that give so many IBD patients relief contain a significant amount of sugar products. (So does TPN.) The question begged by this fact is very real! 
Note: Only undigested residue reaching the colon can effect the gut microbiota there. 

Heavy protein diets (animal protein) are in fact correlated with increased rates of IBD.
nature.com/ajg/journal/vaop/ncurrent/full/ajg2010192a.html

"High total protein intake, specifically animal protein, was associated with a significantly increased risk of IBD.."
nutritionmd.org/consumers/gastrointestinal/ibd_nutrition.html

".....animal protein intake emerged as the strongest independent risk factor. "

There are numerous studies such as these. There are many sides to any discussion. Trumpeting one side without looking at the other is dangerous at best. I can see why people get frustrated.
Anecdotal evidence is not the same as scientific data.
Perhaps there may be too many unscientific folk on here for me. Shame.


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## NiceCupOfTea

@crohnguy - There's loads of studies on pubmed. I could actually find an old post of mine (on another forum) in two minutes and repost them: but guess what, I can't be bothered. You search for the evidence - like I did.

Here, because I'm so nice, I'll give you at least one hint: Japanese semi-vegetarian diet. Go, you Paleo warriors, you.

***Administrator edit - Member was banned for this post.  We welcome debate, but it needs to be done in a respectful manner.  This member was warned previously.  We are a SUPPORT forum first and foremost.*


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## crohnsguy057

NiceCupOfTea said:


> @crohnguy - There's loads of studies on pubmed. I could actually find an old post of mine (on another forum) in two minutes and repost them: but guess what, I can't be bothered. You search for the evidence - like I did.
> 
> Here, because I'm so nice, I'll give you at least one hint: Japanese semi-vegetarian diet. Go, you Paleo warriors, you.
> 
> ***Administrator edit - Member was banned for this post.  We welcome debate, but it needs to be done in a respectful manner.  This member was warned previously.  We are a SUPPORT forum first and foremost.*


oh, another post of yours? You're going to cite another post that you made? 

I'm not a paleo warrior. I just think we should approach all diets with respect, and the idea that IBD is linked to a bacterial issues would mean that a reduction in sugar is a good idea.



> JAPAN


that may be true, but we're talking about people's health here. We can't really afford to gamble on people's health, regardless of whether or not Japan is the best country in the world.


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