# The Real Cause of Inflammation/Ulcers In Crohn’s Guts? (SHOCKING)



## Dave Watson

*The Real Cause of Inflammation/Ulcers In Crohn’s Guts? (SHOCKING)*

This is the first of five articles about a completely new way to look at Crohn’s disease.

As I mentioned in my introductory post, the whole idea that Crohn’s is an autoimmune disease is being questioned and even undermined by recent research. For example, the paper below states that CD should be called a chronic inflammatory disorder and instead of an autoimmune disease.

“When a disorder like Crohn's disease responds to anti-inflammatory treatment but does not meet accepted criteria of autoimmunity, we submit that it should preferably be called a chronic inflammatory disorder of unknown cause, in which case nothing is implied and nothing is assumed. Emerging genetic and immunological data suggest that Crohn's disease is not an autoimmune disorder...”
Source: http://www.thelancet.com/journals/la...282-6/fulltext​
Also, more and more evidence proves Crohn’s sufferers have a WEAK immune response instead of aggressive one that would explain the cause of inflammation and ulcers

In Crohn’s disease, a constitutionally weak immune response predisposes to accumulation of intestinal contents that breach the mucosal barrier of the bowel wall.
Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68265-2/abstract​
The cause of Crohn’s disease (CD) remains poorly understood. Counterintuitively, these patients possess an impaired acute inflammatory response, which could result in delayed clearance of bacteria penetrating the lining.
Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737162/​
recent molecular biological and clinical investigations indicate that CD is actually a primary immunodeficiency. 9
Source: http://www.ncbi.nlm.nih.gov/pubmed/20594132​
Given the above research (and there’s more), we have to seriously question the theory that CD is an autoimmune disease and whether an aggressive immune response is really the cause of the inflammation and ulcers in the guts of CD sufferers. If we are objective, there really is NO evidence to support the current theory of Crohn’s. In fact, all the available evidence suggests the exact opposite: Crohn’s is not an autoimmune disease and Crohn’s sufferers have a weak immune response and not an aggressive one.

So, if an aggressive immune response is not causing the inflammation and ulcers, what is?

Before I share with you what I’m certain is causing the inflammation/ulcers, I want you to consider this fact. There are bacteria that ferment sugars to produce acid that can destroy the hardest substance in our body! In our mouth, bacteria (Strep and others) ferment sugars to produce lactic acid that creates holes in teeth or completely destroys them. A colony of Strep, invisible to the naked eye, can create big hole in a tooth exponentially greater than the size of the colony. So, if bacteria can damage teeth via acid production in such a devastating way, under the right conditions, could bacteria in the guts of Crohn’s sufferers cause the inflammation/ulcers? (It's estimated that there are more bacteria in the gut than cells in the body - that's a lot of bacteria!)

This study shows a link between Crohn's and dental disease.

Dental status in CD patients is poor... patients with CD belong to a high-risk group, and preventive measures should be taken early in the course of the disease.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/14571099​
Here’s what I’m certain is causing the inflammation/ulcers in the guts of CD sufferers. This explanation gets a little technical but it’s well worth the effort to understand it.

Normally, immune cells (macrophages) protect the gut lining from damage by bacteria. However, when there’s too much of protein called TNF (tumor necrosis factor-alpha) in the local environment, it affects their normal behavior and the immune cells don’t protect the gut-lining from damage by bacteria.

Certain bacteria ferment carbohydrates (sugars/starches) and produce acid as a by-product. In Crohn’s, the inflammation/ulcers are CAUSED by acid-producing bacteria along the gut lining. The acid produced by the bacteria BURNS the gut-lining causing the inflammation and ulcers. It’s SHOCKING, I know, but there's overwhelming evidence to support it! Let me show you the evidence by asking a series of questions and then answering them.

*If bacteria ferment carbs to produce acid, is there any evidence that sugar/starch consumption is linked to Crohn’s?*

ABSOLUTELY! There’s around 12 independent studies from a number of countries that suggest carbohydrates are somehow linked to the onset and development of CD. Here’s just a few.

A diet high in refined sugar and low in raw fruit and vegetables precedes and may favour the development of Crohn's disease.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/519184

    Sugar consumption was significantly increased in Crohn's disease
    Source: http://www.ncbi.nlm.nih.gov/pubmed/6832625

    A high sucrose consumption was associated with an increased risk for IBD
    Source: http://www.ncbi.nlm.nih.gov/pubmed/9245929

    Our data confirm that patients with Crohn's disease and ulcerative colitis have a high intake of total carbohydrate, starch and refined sugar
    Source: http://www.ncbi.nlm.nih.gov/pubmed/7866810

    consumption of sugars and sweeteners, sweets...were positively associated with CD risk
    Source: http://www.ncbi.nlm.nih.gov/pubmed/15677909​
*Is there any evidence that reducing carb consumption improves Crohn’s?*

Yes, a recent study, using a diet based on SCD, improved ALL CD patients and virtually all were off anti-TNF medication.

9 out of 11 patients were able to be managed without anti-TNF therapy, and 100% of the patients had their symptoms reduced.
    Source: http://works.bepress.com/barbara_olendzki/46/​
This study used a sugar-free diet for maintenance of remission.

Sugar-free diet as long-term or interval treatment in the remission phase of Crohn disease--a prospective stud
    Source: http://www.ncbi.nlm.nih.gov/pubmed/6135129​
There's also successful studies based on elemental diets. And there's a very significant amount of anecdotal evidence too.

Although the current medical consensus is that diet is not related to CD, three modern practitioners have independently discovered this perception to be false.

    • Robert C. Atkins, M.D. states in his book, Dr. Atkins’ Vita-Nutrient Solution, that he has a 85 percent success rate of treating CD patients with a sugar-restricted (low carbohydrate) diet and high doses of B-vitamins, including folic acid and pantethine.

    • Wolfgang Lutz, M.D., a medical clinician in Austria has a success rate of over 90 percent when treating his patients with a low carbohydrate diet for at least one year.

    • Elaine Gottschall, M.S. has had remarkable success at healing others suffering from Crohn’s disease and Ulcerative Colitis with a specific carbohydrate diet (SCD), even curing her own daughter.

    • John Yudkin, M.D. states in his book, Sweet and Dangerous, that he has successfully used a low carbohydrate diet to treat a variety of gastrointestinal ailments. In one study he achieved a 70 percent success rate.

    Source: http://pecanbread.com/healingcrow/dietsmain/crohn/crohn.html​
This is a Youtube video of Alex Herring who used a low-carb diet to achieve and maintain long-term remission (8 years plus): http://www.youtube.com/watch?v=o3alTJXEULk

*Is there any evidence that bacteria are penetrating the gut-lining and immune cells (macrophages) not removing bacteria from the gut lining?*

These papers/studies discuss bacteria penetrating the gut-lining.

In Crohn’s disease, a constitutionally weak immune response predisposes to accumulation of intestinal contents that breach the mucosal barrier of the bowel wall.
    Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68265-2/abstract

    The cause of Crohn’s disease (CD) remains poorly understood. Counterintuitively, these patients possess an impaired acute inflammatory response, which could result in delayed clearance of bacteria penetrating the lining.
    Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737162/

    Crohn's disease: Bacterial clearance in Crohn's disease pathogenesis
    Source: http://www.nature.com/nrgastro/journal/v7/n3/full/nrgastro.2010.1.html​This study found that immune cells were less able to remove dead cells in a TNF-rich environment. If they are not removing dead cells, it's quite possible they are not removing bacteria along the gut lining.

Overall, the data suggest that macrophages in a TNF-alpha- and oxidant-rich inflammatory environment are less able to remove apoptotic cells and, thereby, may contribute to the local intensity of the inflammatory response.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/17548650​
*Is there any evidence that acid burn is causing the inflammation/ulcers in the guts of Crohn’s sufferers?*

Diseased sections of Crohn's guts are typically deformed, thickened and/or scared.

This study discusses stricture formation in Crohn's.

Intestinal fibroblasts in CD possess enhanced capacity for collagen reorganization and contractile activity in vitro. This activity may be responsible for stricture formation in CD.
    Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420964/​
This study discusses stricture formation following acid burn.

Acid burns of the upper gastrointestinal tract produce a complex combination of lesions
    Source: http://www.ncbi.nlm.nih.gov/pubmed/8971503​
This paper discusses gut thickening in Crohn's and which is similar to a rat model where acid was used to induce disease.

In areas of gross stricture in CD, the muscularis mucosae comprised almost 10% of total wall thickness. Similar findings were also present in a previously characterized experimental model of CD (trinitrobenzene sulfonic acid-induced colitis in rats), particularly in what appeared to be grossly strictured areas.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/2020666​
Here's some other similarities between Crohn's and acid burn:

Crohn's is linked to vitamin D deficiency low bone mineral density.

"Our data suggests, for the first time, that Vitamin D deficiency can contribute to Crohn's disease,"
    Source: http://www.sciencedaily.com/releases/2010/01/100127104904.htm

    Low bone mineral density is frequently associated with Crohn's disease. Supplementation with daily calcium and vitamin D is associated with increases in bone mineral density. The addition of oral etidronate does not further enhance bone mineral density.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/15704046​
Acid burns are linked to calcium wasting and vitamin D deficiency.

Thus, burn injury gives rise to calcium wasting, failure of bone to take up excessive calcium, and vitamin D insufficiency to frank deficiency.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/22332088​
Type V collagen is increased in Crohn’s.

In strictured intestine both collagen content and the relative amount of type V collagen were significantly increased compared with control intestine.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/3335305​
Type V collagen in increased in burn tissues.
Our data demonstrate that type V collagen in preparations from human post-burn granulation tissues consists of 3 alpha chains and can be resolved into 2 distinct heterotrimers.
    Source: http://www.nature.com/jid/journal/v87/n4/abs/5614183a.html​
Proteolytic activity is increased in Crohn's.

Proteolytic and leucine aminopeptidase activity levels in faeces from patients with Crohn’s disease and healthy subjects were compared and were found to be 2.5 and 6 times higher, respectively, in patients with Crohn’s disease.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/3069527​
Proteolytic activity is increased in burns.

This increased proteolysis may play a role in wound repair and scar formation.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/16984440​
The inflammatory response in Crohn's has been studied for several decades. The inflammatory response in burns has been extensively studied too. Both involve iNOS, PGE2, IL-6, IFN-y expression and much more. I spent a considerable amount of time comparing them and they are the SAME! Here's some specific examples.

IL-22/3 & IL-17 pro-inflammatory cytokines are “fundamentally connected” to Crohn’s.

Our findings suggest that activation of the IL-23/IL-17 axis is fundamentally connected to the etiology of CD and may represent the basis for the relapsing nature of the disease by increasing the sensitivity of epithelium to microbial LPS.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/18512248​
The Th17 cytokine IL-22 is expressed at high levels in CD and correlates with disease activity
    Source: http://www.ncbi.nlm.nih.gov/pubme/18022867​
IL-17 and IL-22 are also found following a deliberate burn.

Recently, a novel class of T-helper cells, termed Th-17 cells, has been found to secrete the pro-inflammatory cytokines IL-17 and IL-22.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/21353393​
Th1/Th17 cells are considered characteristic of Crohn's

Th1 and Th17 pathways are implicated in Crohn's disease (CD).
    Source: http://gut.bmj.com/content/60/Suppl_1/A212.1.abstract​
Th1/Th17 cells can be generated following a burn injury.

Th17 cells critical mediators of host responses to burn injury and sepsis.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/22753950​
    Thus, burn injury primed native T cells for an enhanced Th1-type response.
    Source: http://www.ncbi.nlm.nih.gov/pubmed/9706148​
This year I intend to have analyzed resections from multiple Crohn's sufferers by experts in the field of burns. I'm sure they will conclude that the thickening, deformation and scaring is caused by acid burn.

*So, If Crohn’s sufferers eat a low-carb diet will the inflammation/ulcers  heal quickly?*

Unfortunately, probably not! Normal gut bacteria cause the inflammation/ulcers but something else prevents them from healing or delays the healing process. I will cover this in my next article.

Here's a simple diagram that sums up this article.





This is a potentially a huge breakthrough in Crohn's so let's debate it in an intelligent manner :thumright:


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## Ihurt

I absolutely agree with this theory. I also think Bacteria are the cause of A lot of these chronic diseases. I have not been dx yet, but I have a lot of digestive pain and issues. I also have a disease of the bladder called interstitial cystits in which "they" say is autoimmune. But oddly enough, I only get relief while on certain antibiotics! I have had to be on low dose antibitoics for over 4 years now as that is the ONLY thing that brings me relief. 

It took them forever to find out that bleeding stomach ulcers are caused by the bacterium helicobator pylori. I know that a friend of mine see's a osteopathic doctor who treats a lady who had severe crohns disease. She was told by her gastro surgeon that  she had to have her colon removed it was so bad. Well she decided to work with this osteopath doc and he put her on a strict diet, I mean mainly just juicing and a whole food diet. Within a year she no longer suffers at all. I mean can you imagine if she had let that surgeon take out her colon?? I know everyone is different and everyone's disease is different in how it will effect them. But I do think that bacteria and low immune system does play a role in it. When the immune system is low, then nothing in your body is going to run right and that can lead to all sorts of issues. I Hate when they say that these autoimmune diseases are caused by an over-active immune system. There is NO proof of that . I rather like to call it a malfunctioning immune system as opposed to a over active immune system. 

No doubt that this disease and many other chronic diseases are very complex. Another thing I thought about is that could it be that our cortisol levels have something to do with the bodies ability to heal. I mean when a person has crohns, right away the doctors answer is to treat with prednisone. Well prednisone messes with the cortisol levels. I kind of think prednisone is like a bandaid. It takes down inflammation due to it's anti-inflammatory effects, but at the same time it lowers ones immunity leaving the body wide open for other things to attack.  I mean it is only good for very short term and temporary. I mean it seems like when one stops the prednisone, symptoms return quickly which would make sense if crohns was caused by a bacteria. I mean when you are on steroids, yeah it is keeping the inflammtion down for the moment, but when you get off of them your immune system is so low from being on steroids and vunerable that symptoms will come back that quicker, it is easier for bacteria to take hold again. It is just a theory, but it makes sense.


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## Beach

Interesting, and thanks for writing up.  It is interesting how many diseases seem to have a connection to dental health.  Have you read some of Weston Price's writings about how he was able to prevent cavities in most patients?  I remember some of his writings mentioning that he found after patients avoided modern processed grains, plus took vitamin D3, butter oil (vitamin K2?), and cod liver oil "harmful" bacteria levels in their saliva dropped significantly.  

I don't have Crohn's but found after I followed similar ideas mentioned by Dr. Price that my gut condition improved greatly, and cavity formation all but stopped.  I used to develop cavities very easily.  I used to joke with the dentist that he should place a plaque on a wall with my name, dedicating a room to me.   

Just saw this sight and thought it look interesting also.  

www.healthymouthsummit.com


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## Hope345

thanks so much for these posts.


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## Sarah50

Wow, thanks Dave, for the compelling information on Crohn's and its possible causes.  It makes total sense so far!  I, for one, have had problems with my teeth over the years.  I actually had a lot of dental work last year, took antibiotics (amoxycillin) 3 times last year, started having crohn's symptoms around October and was diagnosed with crohn's by the end of November.  

I also had vitmain D deficiency about a year ago or so.

I've been put on a low residue diet (doc says for life because of stricturing), Asacol and have been 'in remission' - no symptoms for the past month.  I've been *craving* sugar like crazy, I don't know why... maybe from the lack of fresh fruits and veggies??  There are lots of carbs on the low residue diet.  I looked at the SCD diet and that is way too restrictive for me.  But maybe, in time, I can try a low carb diet and see what happens.  I'm just afraid of the stricturing and want to avoid surgery.    

Anyway, thank you for all of the work and research you've done and sharing it with us!!  I look forward to reading through the links and look forward to your other articles.


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## D Bergy

Interesting information. 

Has any of this research identified specific pathogens?

I have personally dealt with E-Coli, MAP, H-Pylori and Mycoplasma Pnuemonia
I am not sure these are always present with all cases of Crohn's but they were all factors in mine. 

Dan


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## Dave Watson

That's coming in a later article Dan where I explain how AIEC and MAP are *indirectly* responsible for the inflammation and ulcers.

Recent research has found 92% of CD sufferers infected with MAP, and up to 36% of sufferers infected with AIEC. If this research is fairly representative, it's quite possible all Crohn's sufferers are infected with either MAP, AIEC or both.



D Bergy said:


> Interesting information.
> 
> Has any of this research identified specific pathogens?
> 
> I have personally dealt with E-Coli, MAP, H-Pylori and Mycoplasma Pnuemonia
> I am not sure these are always present with all cases of Crohn's but they were all factors in mine.
> 
> Dan


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## Polaris

Thank you so much for this article (and the ones to come). Very interesting to read. I completely agree that Crohn's is not an autoimmune disorder.


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## superzeeman

Fantastic information! I truly beleive that this is not an autoimmune disorder. I just cant figure out what to eat that never has processed grains and sugars.


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## PollyH

I agree that the production of D-lactic acid by the intestinal bacteria is quite detrimental. I also agree that the exposure to LPS from gram negative bacteria is very inflammatory. Those two problems --- excess D-lactic acid and exposure to LPS --- are at the heart of the intestinal problems suffered by people with Small Bowel Bacterial Overgrowth (SIBO).  (I'm a moderator on a SIBO group. We are talking about Crohn's, right now, so I stopped by your group to see what the connection was to Crohn's.)   

I believe the inflammation characteristic of Crohn's can initiate a case of SIBO. Also, I think SIBO can alter hormones and the immune system in such a way as to make a case of Crohn's more serious. Yet, there must be something else unique going on with Crohn's, or all the people with SIBO would be showing up with Crohn's and colitis.  

From what I've read, it is the way the immune system deals with yeast / fungus that is unique to Crohn's and colitis. There is an increased load of yeast / fungus in those with Crohn's and colitis, partly because the immune system is having a difficult time removing it. For instance, the MAP bacteria interfere with the removal of yeast by macrophages. This interference increases inflammation. 

A lack of Dectin-1 has been associated with increased severity of colitis in humans and mice. A lack of Dectin-1 can be genetic, and a lack of this has been shown to interfere with the removal of yeast by macrophages. This immune weakness increases inflammation. When you induce colitis in dectin-1 deficient mice, the colitis isn't as severe if you give an anti-fungal. 

The AIEC bacteria replicates within macrophages. I would assume that this would also interfere with the removal of yeast by macrophages. 

There is a full text article available for free that talks about colitis and an impairment in the ability of the macrophages to remove yeast/fungus. Here is the link and a quote.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432565/ 

"Fungi are recognized by a number of immune receptors among which Dectin-1 has emerged as key for phagocytosis and killing by myeloid phagocytes. Dectin-1 is a C-type lectin receptor that recognizes β-1,3-glucans found in the cell walls of nearly all fungi. Dectin-1 activates intracellular signals through CARD9 leading to inflammatory cytokine production and induction of T helper 17 (Th17) immune responses (10-13). Deficiencies in either Dectin-1 or CARD9 result in enhanced susceptibility to pathogenic fungal infections in humans and mice (14-16). Polymorphic variants in the gene for CARD9 are strongly associated with Crohn’s disease and ulcerative colitis in humans (17, 18). Furthermore, anti-Saccharomyces cerevisiae antibodies (ASCA) against yeast mannan have been strongly associated with Crohn’s disease (19, 20). Together, these later findings suggest a possible link between immune responses to commensal fungi and intestinal disease."


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## wildbill_52280

I believe the term you are using, this "acid burn" is pretty non-scientific, and doesn't represent any specific concept related to ibd nor can be found in the scientific literature used in the same way that you use it. There are many types of acids in nature, like lactic acid which is produced under natural fermentation of dietary fibers by probiotic bacteria in the intestine which are anti-inflammatory, or even butyric acid(butyrate), which is highly anti-inflammatory, http://gut.bmj.com/content/47/3/397.full  and resolves inflammation in IBD. So there is no justification to say all acids cause IBD inflammation, if any acids do, which specific acid's are you talking about? 

So i am wondering how you know or reason that an "acid burn" is responsible for inflammation of the colon? my guess is, you do not know this but may have simply made this up or from poorly interpreting(umm manipulating) the scientific literature. 



Dave Watson said:


> *Is there any evidence that acid burn is causing the inflammation/ulcers in the guts of Crohn’s sufferers?*
> 
> Diseased sections of Crohn's guts are typically deformed, thickened and/or scared.
> 
> This study discusses stricture formation in Crohn's.
> 
> Intestinal fibroblasts in CD possess enhanced capacity for collagen reorganization and contractile activity in vitro. This activity may be responsible for stricture formation in CD.
> Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420964/​


this reference does not support the claim that acid burn causes ibd inflammation. they were comparing fibrolasts from uc to crohns to get new information about how strictures form. No mention of any sort of acids causing inflammation.




> This study discusses stricture formation following acid burn.
> 
> Acid burns of the upper gastrointestinal tract produce a complex combination of lesions
> Source: http://www.ncbi.nlm.nih.gov/pubmed/8971503​


the acid burns they are talking about in the above study you posted are from common household cleaners (muriatic  acid) that people are using to attempt suicide, and are NOT the same as what is going on in IBD, therefore the reference you provided does not support nor prove the claim "acid burns cause crohns disease" the study above has no mention or anything to do with any form of IBD.

here is the full version of your reference, everyone feel free to read it yourself.
http://ejcts.oxfordjournals.org/content/10/11/934.full.pdf 







> This paper discusses gut thickening in Crohn's and which is similar to a rat model where acid was used to induce disease.
> 
> In areas of gross stricture in CD, the muscularis mucosae comprised almost 10% of total wall thickness. Similar findings were also present in a previously characterized experimental model of CD (trinitrobenzene sulfonic acid-induced colitis in rats), particularly in what appeared to be grossly strictured areas.
> Source: http://www.ncbi.nlm.nih.gov/pubmed/2020666​



the acid they use for this disease model of colitis is not naturally found in the intestine, and does not, nor is not meant to fully replicate what is going on in IBD. its used to artificially induce inflammation for general studies and observations, and does not accurately represent what is happening in IBD, scientists know it is only a model of the the inflammation they have created themselves and not the real thing. Therefore, this provides no evidence that "all or any acids cause IBD or inflammation"

QUOTE-The 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced murine colitis represents an experimental model for human Inflammatory Bowel Disease (IBD).  In this model, mice receive an enema containing the contact 
sensitizing allergen TNBS in ethanol; the latter of which is given to break the mucosal barrier and allow penetration of TNBS into the bowel wall.  This acute model rapidly induces colonic inflammation in a reproducible manner and represents a low-cost, high throughput model.

this quote and link is from a company that provides scientific services and genetic resources to laboratories around the world.
http://jaxmice.jax.org/literature/f...Services_Sample_TNBS_Induced_IBD_Protocol.pdf
http://www.jax.org/





>


do you have any references to what this computer generated diagram is supposed to represent? its not a real photo so i suppose it could represent anything right? it could even represent nothing at all.




IN CLOSING:
Hopefully the readers of this thread can now see some of the flaws in Dave Watson's theory and reasoning, and that the term "acid burns" has no solid foundation in the scientific literature.

Otherwise butyric acid(butyrate) has been shown to be antiinflammatory.
http://gut.bmj.com/content/47/3/397.full

Again, Dave Watson has provided no justification for the claim that all acids or any acids in general cause IBD inflammation. It is a very broad, general, ambiguous and inaccurate claim, with no scientific basis.It is a poor interpretation of scientific studies. IT is made up, and fictional.


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## Dave Watson

Your comment is *complete rubbish* and you've ignored the detailed argument and the flow of logic. You need to re-read the whole article!

I show that the idea that CD is an autoimmune disease is very unlikely, and also unlikely is an aggressive immune response considering there are numerous studies that demonstrate that CD sufferers have a weak immune response, unless you intend to twist that somehow.

*I've demonstrated a carb link to Crohn's. I've demonstrated that reducing carb comsumption improves Crohn's. That in itself suggests carbs are being used by bacteria.*

I have shown bacteria are penetrating the gut lining. Now, connect the dots!

If bacteria in the mouth can produce acid to cause dental disease, could bacteria in the gut produce acid to cause the inflammation/ulcers? Of course they could! I do not know the specific acid being produced, more research will identify that!

I have shown the numerous links between acid burn and Crohn's, including the similarity between CD inflammatory response and a burn inflammatory response.

The diseased tissue in Crohn's can thicken, deform and scar - this is exactly what happens with tissue burns!

All the science is there.

As I mentioned above, I intend to have resections from Crohn's sufferers analyzed by experts in the field of burns, whom I'm sure will confirm that acid burn is responsible for the deformation, scarring and thickening.

Next time before commenting, drop your silly ego! The science above is OVERWHELMING!




wildbill_52280 said:


> So there is no justification for claiming all acids in general cause IBD inflammation. It is a very broad, general, ambiguous and inaccurate claim, with no scientific basis. IT is simply, made up, and fictional.


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## kiny

You are saying if you remove the TNF-alpha the crohn's disease improves, the main issue is too much TNF-alpha which is behind tissue damage etc?


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## Dave Watson

Yes, kiny! In my next article I will explain how excess TNF prevents the inflammation/ulcers from healing!



kiny said:


> You are saying if you remove the TNF-alpha the crohn's disease improves, the main issue is too much TNF-alpha which is behind tissue damage etc?


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## kiny

Dave Watson said:


> Yes, kiny! In my next article I will explain how excess TNF prevents the inflammation/ulcers from healing!


Right, can you explain why etanercept, which is just as effective as infliximab for neutralizing TNF-alpha does not help for crohn's disease at all but infliximab does?

http://www.ncbi.nlm.nih.gov/pubmed/12806611


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## Dave Watson

I will cover it in my next article. But, it’s simple matter of digging to connect the dots. For example, if CD is all about TNF, then why would Stelara help when it blocks two proteins called IL-12 and IL-23? TNF is considered the master regulator, so is TNF and IL-12 and IL-23 connected? If you dig deep enough you’ll find they are

So, what is it about etanercept that makes it ineffective for CD? Here's a start kiny: http://www.ncbi.nlm.nih.gov/pubmed/12806611 but I'll cover it in the next article.



kiny said:


> Right, can you explain why etanercept, which is just as effective as infliximab for neutralizing TNF-alpha does not help for crohn's disease at all but infliximab does?
> 
> http://www.ncbi.nlm.nih.gov/pubmed/12806611


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## Dave Watson

NO! It will be covered in my next article. It's quite rude to demand answers considering I'm the author of this thread!

We either debate my article in a friendly and intelligent manner, or DO NOT comment in this thread. 



kiny said:


> You can cover it now we can wait.


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## wildbill_52280

Dave Watson said:


> Your comment is *complete rubbish* and you've ignored the detailed argument and the flow of logic. You need to re-read the whole article!
> 
> I shown that the idea that CD is an autoimmune disease is very unlikely, and also unlikely is an aggressive immune response considering there are numerous studies that demonstrate that CD sufferers have a weak immune response, unless you intend to twist that somehow.
> 
> *I've demonstrated a carb link to Crohn's. I've demonstrated that reducing carb comsumption improves Crohn's. That in itself suggests carbs are being used by bacteria.*
> 
> I have shown bacteria are penetrating the gut lining. Now, connect the dots!
> 
> If bacteria in the mouth can produce acid to cause dental disease, could bacteria in the gut produce acid to cause the inflammation/ulcers? Of course they could! I do not know the specific acid being produced, more research will identify that!
> 
> I have shown the numerous links between acid burn and Crohn's, including the similarity between CD inflammatory response and a burn inflammatory response.
> 
> The diseased tissue in Crohn's can thicken, deform and scar - this is exactly what happens with tissue burns!
> 
> All the science is there.
> 
> As I mentioned above, I intend to have resections from Crohn's sufferers analyzed by experts in the field of burns, whom I'm sure will confirm that acid burn is responsible for the deformation, scarring and thickening.
> 
> Next time before commenting, drop your silly ego! The science above is OVERWHELMING!


Dear Mr. Watson,
I am asking politely if you could please explain what you mean by saying my comment is "complete rubbish"? Please, be specific, which parts are "complete rubbish".

Thank you kind sir.


----------



## Dave Watson

It's quite obvious you are not interested in debating this article in an intelligent and friendly manner. In fact, I think your goal is to undermine it.

I will PM David now and ask him to remove your posts and prevent you from commenting in my threads any further.



> Hopefully the readers of this thread can now see some of the flaws in Dave Watson's theory and reasoning, and that the term "acid burns" has no solid foundation in the scientific literature.
> 
> Otherwise butyric acid(butyrate) has been shown to be antiinflammatory.
> http://gut.bmj.com/content/47/3/397.full
> 
> Again, Dave Watson has provided no justification for the claim that all acids or any acids in general cause IBD inflammation. It is a very broad, general, ambiguous and inaccurate claim, with no scientific basis.It is a poor interpretation of scientific studies. IT is made up, and fictional.





wildbill_52280 said:


> Dear Mr. Watson,
> I am asking politely if you could please explain what you mean by saying my comment is "complete rubbish"? Please, be specific.
> 
> Thank you kind sir.


----------



## Dave Watson

Let me do a quick summary of my article.

We do not know the cause of CD, so we have to *completely open-minded*. Decades ago Barry Marshall suggested bacteria could cause stomach inflammation and ulcers and he was laughed at. But, with persistence he was proven right.

Today, I’m suggesting bacteria ferment sugars to produce acid that cause the inflammation/ulcers in Crohn’s. Initially, it’s hard to believe but my article makes a compelling argument.

There’s no evidence that Crohn’s is an autoimmune disease or CD sufferers have an aggressive immune response. In fact, the available evidence suggests the exact opposite. So, what is causing the tissue damage?

Sugars and starches are linked to Crohn’s.

Sugar/starch reduction can improve Crohn’s

Bacteria penetrating the gut lining is proven in Crohn’s.

We know dental disease is caused by bacteria in the mouth fermenting sugars to produce acid, so could this occur in the gut? Of course it’s possible.

I’ve shown all the evidence linking Crohn’s and an acid burn.

The diseased tissue in Crohn’s can be deformed, thickened and scarred! Deformity, thickening and scarring occur in acid burns!

My goal now is to have experts in the field of burns analyse the deformed, thickened and scarred tissue from Crohn’s sufferers to see if there’s evidence of acid burning, and I’m confident they will find it.This potentially a huge breakthrough in Crohn’s! 

In my next article I show overwhelming evidence why the inflammation/ulcers don't heal or heal very slowly, again this is potentially, another huge breakthrough in Crohn's.


----------



## rollinstone

Dave Watson said:


> Let me do a quick summary of my article.
> 
> We do not know the cause of CD, so we have to *completely open-minded*. Decades ago Barry Marshall suggested bacteria could cause stomach inflammation and ulcers and he was laughed at. But, with persistence he was proven right.
> 
> Today, I’m suggesting bacteria ferment sugars to produce acid that cause the inflammation/ulcers in Crohn’s. Initially, it’s hard to believe but my article makes a compelling argument.
> 
> There’s no evidence that Crohn’s is an autoimmune disease or CD sufferers have an aggressive immune response. In fact, the available evidence suggests the exact opposite. So, what is causing the tissue damage?
> 
> Sugars and starches are linked to Crohn’s.
> 
> Sugar/starch reduction can improve Crohn’s
> 
> Bacteria penetrating the gut lining is proven in Crohn’s.
> 
> We know dental disease is caused by bacteria in the mouth fermenting sugars to produce acid, so could this occur in the gut? Of course it’s possible.
> 
> I’ve shown all the evidence linking Crohn’s and an acid burn.
> 
> The diseased tissue in Crohn’s can be deformed, thickened and scarred! Deformity, thickening and scarring occur in acid burns!
> 
> My goal now is to have experts in the field of burns analyse the deformed, thickened and scarred tissue from Crohn’s sufferers to see if there’s evidence of acid burning, and I’m confident they will find it.This potentially a huge breakthrough in Crohn’s!
> 
> In my next article I show overwhelming evidence why the inflammation/ulcers don't heal or heal very slowly, again this is potentially, another huge breakthrough in Crohn's.


Dave, I appreciate the research you have done, but you use the word "evidence" too much and I think that's what frustrates wildbill and kiny, because the fact is its not evidence, it is however an interesting hypothesis, and there could certainly be a link to fermented carbs and acid development in the gut when one considers dental issues, but the pH of the gut and mouth are so vastly different not to mention other acids used in some of the links in which researchers purposely used to induce acid burn. In summary, I am glad you are looking into this as I think all leads need to be followed in regards to Crohn's. But it's not evidence until its been proven, and even then, giving the nature of science there's always a chance of variance.


----------



## Dave Watson

Thanks for your comment Joshuaaa.

Although, I do believe I've used the term 'evidence' accurately. For example:

There is significant evidence that carbs are somehow linked to Crohn's. The most recent study showed that reducing carbs improved Crohn's, and this is supported by other studies.

There is evidence of bacteria penetrating the gut lining, as mentioned in the above studies.

There is evidence that diseased tissue is thickened, scarred and deformed.

There is no evidence that Crohn's is an autoimmune disease or CD sufferers have an aggressive immune response.



Joshuaaa said:


> Dave, I appreciate the research you have done, but you use the word "evidence" too much and I think that's what frustrates wildbill and kiny, because the fact is its not evidence, it is however an interesting hypothesis, and there could certainly be a link to fermented carbs and acid development in the gut when one considers dental issues, but the pH of the gut and mouth are so vastly different not to mention other acids used in some of the links in which researchers purposely used to induce acid burn. In summary, I am glad you are looking into this as I think all leads need to be followed in regards to Crohn's. But it's not evidence until its been proven, and even then, giving the nature of science there's always a chance of variance.


----------



## rollinstone

When you state it simply and concisely like that one can certainly see why your hypothesis should be tested. But how would one get evidence that it is infact those same fermented carbs that are causing the burning, for instance, say we get the resected pieces of human gut, you would need healthy gut as well as a control, I don't see how it could happen, how will they be able to determine whether or not the acid indeed caused the inflammation and ulceration, also how come the ulceration in Crohn's seems to be patchy through out the infected region. (I'm not asking you directly, just saying there are other variables to consider)


----------



## Dave Watson

Thanks Josh, that's the whole point in posting the article. There's enough evidence to seriously pursue this.

At the end of my next article I will do a quick summary to simplify the points I'm making.

Give me some time and I'll respond to your main question.



Joshuaaa said:


> When you state it simply and concisely like that one can certainly see why your hypothesis should be tested. But how would one get evidence that it is infact those same fermented carbs that are causing the burning, for instance, say we get the resected pieces of human gut, you would need healthy gut as well as a control, I don't see how it could happen, how will they be able to determine whether or not the acid indeed caused the inflammation and ulceration, also how come the ulceration in Crohn's seems to be patchy through out the infected region. (I'm not asking you directly, just saying there are other variables to consider)


----------



## nitty

Speaking as a lay person, and not very scientifically knowledgable, please can you explain how, if CD is caused by a weakened immune system, how is it that drugs which suppress the immune system then improve my symptoms?

Please note: I am not asking this to doubt your information, it's just that I don't really understand how it works.


----------



## Beach

Just to throw some contrarian information out there - at least on the dentist part - and it was something I even mentioned in an earlier post about the connection to dental health, bacteria and other health conditions - i don't believe that it has been proven that bacteria, acid and sugars cause dental decay.  it is a theory, but from at least what I read in the book Cure Tooth Decay by Ramiel Nagel it has not been proven.  Additionally, bacteria will perish in a 20% or greater sugar solution.  If dentistry is correct about bacteria, then a high sugar diet should eliminate tooth decay.  

Tooth decay has been created in studies with a diet low in vitamin C.  And overall, it seems that the theories about diet, lack of nutrition, and hormones produced in the body play a central role in causing dental issues and is more likely than bacteria.


----------



## Ihurt

Steroids are like a bandaid. They do NOT really cure anything. They help with inflammation more so, but not actually the disease itself which is why when you stop the steroids, the pain and inflammation come right back. Think about it, they put people on steroids for a lot of different health issues. Just back in august I had a nasty sinus thing going on and I was put on the steorids for a week. Yeah, it helped me some with taking down the inflammation but as soon as I stopped them, my issues did come back. 

As far this whole discussion goes on what causes crohns, well that is the million dollar question. We can go round and round trying to figure it out, but in the end, it is way to complex! Each individual is different and there may  be MANY cuases out there. Do I think it is autoimmune?? NO, I dont. Autoimmune is just a word they like to throw around when they have NO clue what is wrong with you. After battling chronic illness for the last 9 years I can say with complete certainty that doctors do NOT have much knowledge when it comes to these chronic diseases. 

Example: You take one person with crohns and they get drastically better while taking antibiotics. Well in that case, maybe a bacteria is the cause. Yet you can have another person with crohns who takes antibiotics and gets NO relief. Maybe that persons crohn's is caused by something else. Also I am betting there are other diseases out there that mimic crohn's disease, but is something different all together. Unfortunately, doctors just do not know the amswers to this. Neither do the researchers. 


Sure, Barry Marshall did come to find that "most" stomach ulcers were due to the H-pylori bacteria. That was a great find indeed. In fact I can bet almost anything that ALL chronic diseases are caused by an infection of some sort. Bacterial, viral, parasitic, I mean the list can go on and on. Also the way a persons body reacts is also an important factor. This is where immune system comes into play. Some people with crohn's manage the disease ok for the most part and likley because they have a strong immune system that keeps things at bay. Then you have ones that are doing very bad, well for those it is due to a weak immune system. That makes more sense than saying these diseases are autoimmune and due to an overactive immune system. 

I had a friend who had lupus years ago. She suffered greatly with it. Well one day she caught a cold and within a month she died from it. It messed her lungs up very bad. The doctors of course were quick to tell her husband that it was because her body was attacking itself. No, I am sorry, but I tend to think more on the side of that her immune system was just so weak that the cold set into a motion a nasty infection that she could not fight. I often wonder if giving steroids to people in the presence of these infectious type diseases makes them worse since steroids are known to lower your immune system. I mean I think maybe people get this false feeling of wellness while on steroids because yes, steroids do take inflamation down, but they are not really doing anything for the disease itself. 

Anyhow, bottom line is this, yeah, it would be great if someone could come up with a reason for crohn's and many other chronic diseases out there, but it is just so complex. I mean each person is different in their makeup, no person is the same. This is why not one treatment will work for every person. It also has a lot to do with our DNA. Why do you think when people were dying like flies back when the black plague was around, yet there were people who were not affected by it at all. Immune system does play a big role in this, but when I say immune system, I do not mean like autoimmune. That is a bullshit word that some doctor came up with. I mean more like some people having a weaker immune deficiency than others do.









nitty said:


> Speaking as a lay person, and not very scientifically knowledgable, please can you explain how, if CD is caused by a weakened immune system, how is it that drugs which suppress the immune system then improve my symptoms?
> 
> Please note: I am not asking this to doubt your information, it's just that I don't really understand how it works.


----------



## Clash

Ihurt said:


> Steroids are like a bandaid. They do NOT really cure anything. They help with inflammation more so, but not actually the disease itself which is why when you stop the steroids, the pain and inflammation come right back. Think about it, they put people on steroids for a lot of different health issues. Just back in august I had a nasty sinus thing going on and I was put on the steorids for a week. Yeah, it helped me some with taking down the inflammation but as soon as I stopped them, my issues did come back.


Nitty, was probably referring to the immunosuppressants like Imuran/6MP/Methotrexate which are the maintenance meds often used to keep CD under control once tapered off the steroids.


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## nitty

Yes, Clash, that _is_ what I was trying to find out.  How does azathioprine help by suppressing the immune system if the theory is that the immune system is already weak (as opposed to the theory of an over-reactive immune system)?


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## Sarah50

I don't have the knowledge or understanding about Crohn's, the medications, diets, etc. like many of you do.  I'm newly diagnosed Nov 2012. 

Dave, what I don't understand about your hypothesis - in terms that I understand, is once I was put on medication (Asacol) and a "low residue diet" which is a lot of carbs (and for some reason, I am eating more sugar than I ever have - candy, daily) you would think my Crohn's would flare up, right?  (All of my symptoms disappeared about 6 weeks after being on the medication and diet.)  

Because you stated, from what you researched, 

"There is significant evidence that carbs are somehow linked to Crohn's. The most recent study showed that reducing carbs improved Crohn's, and this is supported by other studies."  And:

"Sugars and starches are linked to Crohn’s."

"Sugar/starch reduction can improve Crohn’s"

Why did I go into remission when I went on a low res (high carb) diet, plus eating sugar (candy and cookies or ice cream) almost every day??  I know the Asacol is reducing inflammation, so maybe that's why I'm not having problems???  BUT... when I eat food that is not on the diet, like fruit (with skin) in yogurt or salads, my symptoms come back???  

Maybe I don't understand enough and my example does not apply to your hypothesis, but if it does, do you have any feeling about it?  Or maybe I'm jumping the gun here.

Again, I really appreciate your time and effort into figuring out what causes Crohn's.  It's great info and certainly up for discussion.  I hope that everyone here can state their opinions without getting personal / put downs - so not necessary.  ALL opinions should be allowed here as long as everyone doesn't attack anyone for their opinions.


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## David

Debate is great.  I ask that it be done in a friendly manner, however.  Dave has spent a lot of work sharing his theory and while we may agree or disagree, what he does deserve is to feel welcome and respected and of course vice versa.

Stick to the facts.

Thank you!


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## flowergirl

While it's a good theory for some, I don't think you can make a blanket statement that all crohns people have weak immune systems from sugar acid. Both my dad and I have crohns, and we are (other than crohns) the healthiest people I know. Never get sick and have never had dental problems. Even on remicade I get sick less than my husband and son. And my body actually has horrible reactions to antibiotics. That's what started the crohns for me.


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## rollinstone

nitty said:


> Yes, Clash, that _is_ what I was trying to find out.  How does azathioprine help by suppressing the immune system if the theory is that the immune system is already weak (as opposed to the theory of an over-reactive immune system)?


From my understanding is that it suppresses the inflammatory response of the immune system. It doesn't make Crohn's an autoimmune disorder, although I can see why it allows doctors and people to define Crohn's as that. I personally think Crohn's is an umbrella name for a bunch of diff problems in the gut, definitely multiple causes.


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## Spooky1

Interesting stuff here!  I have major dental issues and have had since crohns started.  Just out of interest does too much lactic acid cause extreme muscle fatigue?  not sure on this, but perhaps someone can answer for me.

thanks


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## PollyH

nitty said:


> Speaking as a lay person, and not very scientifically knowledgable, please can you explain how, if CD is caused by a weakened immune system, how is it that drugs which suppress the immune system then improve my symptoms?


There are different parts of the immune system. It is like one part is yelling fire, fire, help, help, and the other part isn't strong enough to put out the fire. So, the first part just keeps yelling louder and louder and causing more inflammation. Your doctor then gives you something to control the inflammation. Your doctor often doesn't have a drug to give you that will put out the fire on a permanent basis. However, you can change your body chemistry such that it is able to put out most fires.

When there is yeast overgrowth, the humoral arm of the immune system tends to be over-active and the cellular arm of the immune system tends to be too weak to remove the yeast. When the humoral arm of the immune system is overactive, you often end up with allergies and inflammation. When the cellular immune system is underactive, the body has a hard time getting rid of yeast and certain other infections.

To get rid of yeast, you want to improve the strength of the cellular immune system. One way to do this is to bring up the energy of the cells. Anything you can do to improve the energy producing capacity of your cells should help. This means making sure the cells have vitamins, minerals, and amino acids in the correct balance; making sure the cells have fuel and enough thyroid to produce energy; and making sure there aren't too many heavy metals and toxins in the body that may throw a monkey wrench into the energy making machinery. 

Unfortunately, yeast and bacteria create toxins that interfere with your vitamins, minerals, amino acids, and fuel. They are smart. They don't want your cellular immune system to be too strong. Yeast go about this in some very devious ways. For one thing, they create Prostaglandin PGE2, which increases inflammation and increases the body's production of estrogen. Estrogen lowers thyroid and cellular immunity. Estrogen encourages the growth of yeast. Yeast even create estradiol, a strong estrogen.

Yeast also interfere with your body's absorption of coenzyme Q10. They take the coenzyme Q10 in your food, and turn it into a different form --- one that they can use, but not you. Coenzyme Q10 / ubiquinol is one of the things you need for cellular energy. 

Yeast also create acetaldehyde. The acetaldehyde really does a number on your body. Have you ever felt like you couldn't think easily? That could be due to the yeast's acetaldehyde lowering your acetylcholine. With lowered acetylcholine, you have difficulty thinking, your vagus nerve isn't able to trigger proper digestive actions, your spleen isn't activated to produce anti-inflammatory substances, and you feel tired.

The acetaldehyde also interferes with the body's ability to turn vitamin B6 into its active form (pyridoxal-5-phosphate, or P5P). Acetaldehyde causes you to dump the amino acid taurine into your urine. The acetaldehyde interferes with your ability to create methyl-folate. You need the methyl-folate to turn your niacin into its active forms of NAD and NADH. These are needed for energy production and clear thinking. You also need the methyl-folate for clearing toxins out of your body. You need the methyl-folate to create your neurotransmitters, like serotonin and dopamine. The acetaldehyde interferes with the creation of your Tregs which are needed to help calm things down after an infection.

The acetaldehyde also lowers your cholesterol. You might say good, finally something good about the acetaldehyde that is produced by yeast. Nope. Not so fast. The cholesterol protects your body from the toxins generated in your gut. The cholesterol helps your body eliminate things like strep, staph and TB. Cholesterol is needed for your T cell formation. Cholesterol is also very important for your brain's functioning. If your total cholesterol drops below 160, you can get sick, depressed and not able to think well.  Here is a video on why you want your cholesterol levels above 160 mg/dl. http://vimeo.com/12616011  If need be, you can purchase supplements of cholesterol to help bring it up. Vitamin C, fruit and coconut oil can be helpful in bringing cholesterol levels up. (Coconut oil will lower high cholesterol, but bring up cholesterol when it is too low.)

The acetaldehyde breaks down elastin. (It activates MMP-9) The acetaldehyde attaches to / forms adducts with your neurotransmitters like serotonin, dopamine and norepinephrine, making them unavailable for your use. The acetaldehyde gets rid of your asparagine, alpha ketoglutaric acid, glutamine and glutamate. The acetladehyde alters your ratio of NAD/NADH, which are forms of niacin.

To get rid of the yeast / fungus on a permanent basis, you need to get rid of the reason it started and correct all the imbalances and nutritional deficiencies it created. 

I used to have yeast overgrowth in my intestines. Fortunately, I never got Crohn's like my cousin did. However, the yeast overgrowth has been the bane of my life. That is why I've studied it and tried so many different things to get rid of it. If it wouldn't be too forward, in another post, I will outline some ideas that may help keep fungus / yeast levels down in the body. Is that acceptable on this list? If not, I can just give you some links to look at.


----------



## PollyH

Spooky1 said:


> Just out of interest does too much lactic acid cause extreme muscle fatigue?  thanks


Yes. Lactic acid will increase muscle fatigue. The lactic acid may be coming from the gut. It can also be manufactured locally if the cells are having trouble getting enough oxygen and creating energy.

Do you have fibromyalgia? People with fibromyalgia have muscle pain, joint pain, and trouble sleeping. There are tender trigger points near areas where blood flow may be restricted. There is fibrin formation that may be interfering with circulation. According to the work of Dr. Pimentel, his fibromyalgia patients had very bad cases of Small Bowel Bacterial Overgrowth (SIBO).  The small intestine is not supposed to have a lot of bacteria in it. However, if there is an overgrowth of bacteria there, the bacteria get to your food before you do. They turn your carbohydrates into D-lactic acid.

With fibromyalgia, a person is exposed to excessive serotonin in its free state. This increases fibrin formation. In general, to control the way serotonin is used, and to reduce fibrin formation, Raymond Peat suggests the following:  magnesium, niacinamide, taurine, glycine, saturated fats, thyroid hormone, antihistamines, antioxidants and other anti-inflammatory agents to help reduce or reverse fibrogenic processes. 

I would like to add, that you will need methyl-folate to use your niacinamide. The methyl-folate may be low due to mercury, acetaldehyde from yeast, or a genetic polymorphism of the MTHFr gene. There is a lot of information about MTHFr and the various forms of folate at mthfr.net

I'm presently a moderator at a yahoo group called SIBOnation. If you have fibromyalgia, join us and ask a few questions.


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## EthanClark

Dave-Thank you for the post and the upcoming articles. I look forward to reading them as I will always be open to new ideas until a cure is found.


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## Beach

PollyH said:


> I used to have yeast overgrowth in my intestines. Fortunately, I never got Crohn's like my cousin did. However, the yeast overgrowth has been the bane of my life. That is why I've studied it and tried so many different things to get rid of it. If it wouldn't be too forward, in another post, I will outline some ideas that may help keep fungus / yeast levels down in the body. Is that acceptable on this list? If not, I can just give you some links to look at.


Nice post, and I'd find it interesting to learn further about the nutrient robbing properties yeast can bring about, along with ways to deal with it.  Along similar lines, something I've taken an interest in of late is learning about anti-nutrients found in different foods, such as wheat, beans, nightshades, etc.


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## D Bergy

An oversimplified explanation is that a weakened immune system fights the pathogen, which causes inflammation.  In a normal, strong immune system the pathogen is eliminated and the inflammation goes away also.  The weakened immune system just keeps on fighting the pathogens, but never eliminates them.  Then you have chronic inflammation. 

You can further weaken the immune system so it will not fight the pathogen and if you get it right enough, you will quell the inflammation with it. 

Or, you can strengthen the immune system which allows for the reduction of the pathogens and a reduction of the inflammation. 

It is an oversimplification, but the principle is close enough. 

Dan


----------



## PollyH

Ihurt said:


> I  I also have a disease of the bladder called interstitial cystits in which "they" say is autoimmune. But oddly enough, I only get relief while on certain antibiotics! I have had to be on low dose antibitoics for over 4 years now as that is the ONLY thing that brings me relief.


I know someone who got rid of her interstitial cystitis by clearing up her gut. I think it is because certain bacteria create toxins that affect the tight junctions (cause leaky gut). Those toxins show up in the urine. I assume they do the same thing to the bladder. However, most people with IC say it is due to high oxylates in their urine. You can get your urine tested for oxlylates at the Great Plains Laboratory. The oxalates are created by certain bacteria and yeast. It is a fairly common problem in autism. There is a low oxalate diet that some of the kids with autism must follow. If you join one of their lists, you can find out what they do about it. For instance, right now, the best probiotic to use is VSL#3 for this condition. Later, they are hoping for a better one. 20 minutes before a meal, you take some calcium and magnesium taurate or citrate. The minerals will combine with the oxylates in your food and those created by the bacteria / yeast.

Here is a video by Dr. Kurt Woeller on the subject of oxalates and what to do about them. It is available for free for the next few days.

Chronic Pain, Fibromyalgia Autism and the Oxalate Connection (1 hr 10 
min) 
http://www.greatplainslaboratory.com/home/eng/recorded_webinars.asp 

It will be removed shortly from this webpage. When that happens, it will still be available, but you need to pay for it at www.AutismSeminarsonDemand.com


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## PollyH

Beach said:


> Nice post, and I'd find it interesting to learn further about the nutrient robbing properties yeast can bring about, along with ways to deal with it.  Along similar lines, something I've taken an interest in of late is learning about anti-nutrients found in different foods, such as wheat, beans, nightshades, etc.


This is my current understanding of things that will help eliminate yeast overgrowth. This isn’t a perfect list, especially since I’m not that familiar with Crohn’s and colitis. The list doesn’t represent medical advice. Use the list with caution and with the advice of your physician.

This list of remedies is based mainly on replacing the nutrients that yeast deplete, and removing the factors that contribute to yeast overgrowth. However, you may not tolerate everything on this list. There are genetics to consider and past toxin exposures. So, this list needs to be used with some testing and/or experimentation in mind. Slowly introduce a supplement that seems to be what you need. Then if you feel worse, stop and try something different on the list. Later, you may be able to tolerate the original supplement. Everything needs balance.    

I believe a general strategy for controlling yeast should address the following: 

1.	Remove much of the fuel for yeast growth, acetaldehyde production, and biofilm production. 
2.	Repair the nutritional damage caused by the yeast’s acetaldehyde.
3.	Soak up the acetaldehyde before it does additional damage.
4.	Remove heavy metals and toxins that encourage yeast growth.
5.	Reduce the size of yeast colonies with the use of antifungals and things to degrade their biofilms.
6.	Alter the environment in the intestines to discourage yeast colonization.  
7.	Remove viruses, bacteria and parasites that interfere with the body’s ability to attack and control the yeast.  
8.	Support thyroid, liver and kidney function to help eliminate toxins.
9.	Support the cellular immune system. 

LIMIT SUGAR AND CARBOHYDRATES

These allow the yeast to flourish and to create their acetaldehyde. Don’t eliminate sugars and carbohydrates completely though. Your body needs them. In particular, it would be very hard on the kidneys if you eliminated sugar and carbohydrates altogether. Besides, cutting out all sugar and carbohydrates would not kill the yeast. Yeast can live on fat and protein. If your upper intestine is clear, then you may be able to tolerate more sugars than someone else. Thyroid and natural progesterone will help your intestines absorb the sugars, leaving less for the bacteria and yeast.

RESTRICT INTAKE OF POLYUNSATURATED OILS

These increase yeast growth in low oxygen environments like the intestines. Polyunsaturated oils also encourage the formation of yeast biofilms. However, a small amount of fish oil and / or primrose oil may be of some help even though they are polyunsaturated. Use mainly saturated and monosaturated oils. Use mainly olive oil, coconut oil, palm oil and organic butter. (Animals store pesticides in their fat. That is why you want organic butter.) Get organic grass fed butter if possible, because the butter from grass fed animals will contain the anti-inflammatory vitamin K2.

FAT SOLUBLE VITAMINS (A, D, E AND K2)

These work best when kept in balance. These are all anti-inflammatory and they help to improve the gut flora. In particular, vitamin K2 lowers PGE2. Yeast create PGE2. You don’t want excess PGE2 because it increases the body’s production of estrogen and encourages yeast growth. (If you don’t tolerate vitamin A, you might want to change brands and/ or try some zinc first.) 

REDUCE ESTROGEN EXPOSURE

Birth control pills are notorious for causing yeast overgrowth. So, if possible, get rid of them. However, I realize that with Crohn’s sometimes the birth control pills are helpful. I don’t fully understand that.

Many women who are ill have an imbalance between estrogen and progesterone. During the last two weeks of a woman’s cycle, one will often find an excess of estrogen relative to progesterone. This encourages yeast growth. (Dr. John Lee has several books about this. There is also a good book by Raymond Peat, PhD about this.)

There was an experiment done with mice. They removed the ovaries, then they treated one group with estrogen and the other group with natural progesterone. Those treated with estrogen got yeast infections. Those treated with progesterone did not. So, to balance a woman’s hormones, you might think it safe to give some natural progesterone during the last two weeks of her cycle. However, anecdotal evidence suggests that when this is first tried, there may be an initial flare of yeast symptoms. I’m speculating that this many have to do with the progesterone pushing stored estrogen out of cells. (When progesterone goes in, estrogen comes out mainly in the sulfated form.) 

You need the sulfates for the estrogen to leave the cells and get transported to the liver for disposal. If you are low on sulfates, you might have some trouble with adding in the natural progesterone.

I believe natural progesterone can be helpful if there is an estrogen / progesterone imbalance. However, I would start with correcting a thyroid problem first, assuming it exists. Correcting the thyroid should help correct the estrogen / progesterone ratio. If the adrenals are weak, you may need to add the progesterone, since natural progesterone is very good support for the adrenals.

Stop using the artificial progesterone shot for birth control. This shot contains a form of progesterone that is foreign to the body. It ends up reducing your indigenous levels of natural progesterone. This creates an imbalance between natural progesterone and estrogen in the body. (Natural progesterone is the kind of progesterone that the body produces. It is different than the kind of progesterone found in the birth control shot and in most pharmaceuticals.) 

Pesticides and plastics are also estrogen-like. Remove as much of them as possible from the diet. Stop using styrofoam cups for your hot drinks. They are a source of estrogen like compounds. Be careful with herbs that contain phytoestrogens. Large amounts of phytoestrogens are just as bad as estrogen.

CALCIUM-D-GLUCARATE

If you also have Small Intestine Bacterial Overgrowth (SIBO), consider using calcium-d-glucarate to counteract the bacteria’s effect on your body’s elimination system. Calcium-d-glucarate helps the body eliminate excess estrogen by blocking an enzyme that the SIBO bacteria create. Gradually work up the dose of calcium-d-glucarate to 3 pills, three times a day, with your meals. If you wish to stop the calcium-d-glucarate, do so gradually to avoid a spike in estrogen.

THYROID

This helps keep estrogen levels under control. It also improves the immune system and helps the body get rid of the yeast. It is often low when one has yeast overgrowth. (For one reason, the yeast’s production of acetaldehyde interferes with the g proteins signaling of the thyroid gland.) Read about thyroid first and then seek an alternative doctor for a trial of natural thyroid. (Broda Barnes, MD has a good introductory book called Hypothyroidism: the Unsuspected Illness.)

NIACINAMIDE

This disrupts the growth of yeast and their creation of biofilms. Byron Richards, ND, has found that 250 mg to 1000 mg is helpful for his yeast patients. The niacinamide may also help control anxiety. 

METHYL-FOLATE

The creation of methyl-folate is hampered by the yeast toxin acetaldehyde. You need methyl-folate to provide the methyl groups to process the niacinamide into its active NAD and NADH forms. Methyl-folate is also important for blood flow in the brain and peripheral circulation. Methyl-folate is the only form of folate that crosses the blood brain barrier. There it is needed to create your neurotransmitters. 

INOSITOL AND CHOLINE

These don’t directly help get rid of the yeast. Instead, they help balance the effects of niacinamide on the body. Choline may be low if the body hasn’t had enough methyl-folate for a while. The body will use your choline to provide methyl groups if it doesn’t have the methyl-folate. Inositol tends to increase movement in the intestines. Niacinamide tends to slow things down. You need a proper balance of these two vitamins for proper motor control.

PANTETHINE AND MOLYBDENUM

These help the body dispose of acetaldehyde. The pantethine also helps your body create taurine and acetylcholine. The acetylcholine is important for cognition, for stomach acid production, and for the functioning of the vagus nerve. Pantethine also helps create coenzyme A. Coenzyme A is important for energy production and for the detoxification of acetaldehyde. Byron Richards, ND, has found that pantethine is particularly helpful in eliminating yeast overgrowth. The pantethine is also helpful in increasing the growth of Bifido bacteria.  Here is an important quote from a excellent article on using pantethine and molybdenum to remove acetaldehyde. 

“Dr. Cooter and Dr. Schmtt suggest 300 micrograms of Molybdenum in three divided doses per day, and further suggests staying on it for at least 4 months" http://www.candidapage.com/aldehyde.shtml 

THEANINE

This is found in tea, but you can also get pills of it. Theanine accelerates the liver’s removal of acetaldehyde. It also protects the liver by reducing the liver’s loss of glutathione. Theanine has a calming / anti-anxiety effect for many who try this. http://www.lef.org/magazine/mag2006/jan2006_report_theanine_01.htm 

MSM SULFUR

Many people have found this helpful. This kills yeast and certain parasites. MSM will also help your body replace the sulfur that the yeast toxin acetaldehyde has removed. Start slow and gradually work up to more. Be consistent. MSM crystals are supposedly best. 

MSM should be balanced with other minerals, including zinc, copper, molybdenum, selenium and calcium. (Eg, if you take a lot of sulfur, then you may need more copper, molybdenum, selenium and calcium.) However, if you are low on sulfur, your body will substitute selenium for some of the usual purposes of sulfur. Hence low sulfur may mean you are also low on selenium.  

MSM isn’t always tolerated. Sometimes this occurs if one is mercury poisoned. If this happens, try sulfates instead. (Epsom salt baths are a source of sulfates. Before embarking on these baths, test your bathtub to make sure your tub glaze does not have lead in it.) If you don’t tolerate MSM, you might want to try some molybdenum first. It might help you tolerate the MSM.

PANCREATIC and DIGESTIVE ENZYMES

This helps to break up yeast biofilms, and it helps you to digest your food. Many people find this helpful. Be careful with the “plant enzymes” or the enzymes that are not from dried pancreas. These enzymes are made using a mold. You may be allergic. Be especially careful if you have asthma.

COPPER / ZINC RATIO

If you don’t know your zinc / copper ratio, it would probably be best to take both these minerals along with a little manganese. The usual supplementation ratio is one part copper to between seven and fourteen parts zinc. The Great Plains Laboratory has a test for the ratio of zinc to copper, and it also measures the amount of bound and unbound copper.

ZINC

Zinc is often low. One reason is that the aldehydes from yeast will release zinc from protein sites. Estrogen also wastes zinc. You need the zinc for healthy intestines, including the ability to transport the vitamin A from the liver. However, be careful with the amount of zinc you use. If your zinc goes too high, you are more likely to have trouble with yeast growth. Too much zinc can also be a problem because it may lower copper, iron, manganese and molybdenum levels too far. A convenient, albeit not perfect, way to monitor zinc is with Zinc Tally by Metagenics. To increase your zinc levels, consider using the Metagentics Zinc Drink, as this liquid form is easier for your body to absorb. 

COPPER

Copper is often high. If copper is high, then you can use vitamin C, zinc, sulfur, B6 and/or molybdenum to bring copper levels down. Cysteine will also lower copper, but it is important not to use cysteine for this purpose, at least not at first. Cysteine supplementation may make you sick if copper levels are quite high. Cysteine sometimes will increase yeast growth. Like with other minerals, balance is key. Not too much copper and not too little. You need copper for many purposes in the body. If copper is low, a good way to bring it up, in my opinion, is with copper bound to sebacate. For me personally, copper measured low, but I got worse when I took plain copper. Yet, copper sebacate made me healthier. This form is easier for your cells to use. Liver is a good source of copper and the B vitamins your body needs to use the copper.

CAREFUL WITH CYSTEINE

Cysteine attaches to acetaldehyde. It is very protective for this reason. However, some people have noticed that a supplement of cysteine increases yeast growth in them. Cysteine may not be tolerated if you are high in copper.  

VITAMIN C

Most of the time, high dose vitamin C can be helpful when you have yeast overgrowth. Vitamin C counters the oxidative stress caused by the yeast’s acetaldehyde. Vitamin C also helps lower histamine, which may be high due to the allergies associated with yeast overgrowth. 

However, caution is warranted with high dose vitamin C if you also have high oxalates along with high free copper. It may make the oxalate problem worse. A moderate amount of vitamin C would be fine in this situation though.

MAGNESIUM

This is very important for many functions in the body. It may be low because of the lack of taurine and because magnesium is poorly absorbed when the gut is inflamed. (Taurine helps you retain magnesium. Taurine is lost due to the yeast.)

LOW OXYLATE DIET  

This diet may be necessarily if your urinary oxalate level is high. Oxalates lower your biotin and interfere with your coenzyme A. Coenzyme A is already quite low due to the yeast’s acetaldehyde. (Coenzyme A is not related to vitamin A. It is a substance needed for energy production and to create acetylcholine.) If you have high oxylates, join one of the discussion lists that talk about this problem. One of the things you can do is take your magnesium and calcium in the form of citrate or taurate. Using these minerals 20 minutes before a meal will help bind / mop up oxylates.  

CHOLESTEROL

Get enough cholesterol in your diet. Cholesterol protects the body from bacterial toxins generated in the gut. It helps kill staph, strep and tuberculosis. It helps create T cells. It is needed for the formation of bile and for the creation of all your hormones. The body doesn’t function well if the cholesterol blood levels drop below 160 mg/dl. When rats are injected with the yeast toxin acetaldehyde, their cholesterol levels drop.

ELIMINATE H. PYLORI

The H. pylori keeps you from creating stomach acid. The stomach acid helps you to get rid of yeast. Unfortunately, you can’t just add in a stomach acid supplement when you have H. pylori, because that may make the infection worse. (You need to work on the H. pylori and the yeast at the same time, since H. pylori can hide within yeast.) 

Often the tests for H. pylori don't find it, even though it is present. So, doctors sometimes resort to checking for H. pylori markers. For instance, H. pylori gets rid of your manganese, lithium, copper, iron, B12, carnitine, phospholipids and arginine. If some of these are low, your doctor's suspicions might be raised. (Some of these markers might still look normal for various reasons.) There is also possible high readings of ammonia, seberic or taurine. Cadmium and bismuth readings may be high, even without chelation.

H. pylori can hide within yeast cells. So, part of your strategy for eliminating H. pylori should include reducing the yeast population. Lactoferrin is useful here because it helps break up yeast biofilms and it stops the growth of H. pylori. Adding in lactoferrin to your usual triple antibiotic treatment improves the outcome considerably. When you take lactoferrin along with the triple antibiotics, you have a 92% cure rate compared to a 71% cure rate without it.

Two antifungal drugs, Diflucan and Nizoral are also particularly useful. Diflucan and Nizoral kill many types of yeast and they also kill H. pylori. (We often think of antifungals as only killing yeast and fungus, but they also have some antibacterial properties.)

Taking some bicarbonates along with your therapy also helps with the eradication of the H. pylori. The bicarbonates disorient the H. pylori and make them more vulnerable.

Glycine is inexpensive, and might be of use here too. 

"When combined with amoxicillin, a common generic antibiotic, glycine reduced by a factor of 10 the amount of amoxicillin needed to kill the troublesome bacteria."

http://www.lifeextensionvitamins.com/glpoforinand.html 

There is a whole host of things you can use to get rid of H. pylori without resorting to prescription antibiotics. In this long video, Dr. Amy Yasko explains the nature of H. pylori infection and how to get rid of it. 

http://www.dramyyasko.com/resources/webisodes/h-pylori-another-piece-to-the-puzzle/

Her protocol for getting rid of H. pylori can become quite involved. However, from the lecture, I gather that the basic components are the following:

1. Baking soda or Bicarbonates with each meal.

2. Peptimycin (contains mastic gum from the pistachio tree) 

3. HELX RNA from www.holisticheal.com/microbial-helx.html 

4. Air Power (Guafenesin, an over-the-counter cough medication)

5. Range of specific enzymes

6. Range of very specific normal flora probiotics

If you want to know more about this, it is probably best to join the discussion group for Dr. Amy Yasko’s protocols. I get the impression that there can be a lot more to this. 

GENETICALLY MODIFIED FOOD 

Avoid food that has been genetically modified. Doctors and scientists have found that these foods increase gut inflammation and are more likely to cause allergies. The Roundup pesticide, which is used on most of these GMO foods, is also particularly hard on the gut.  Doctors who tell their patients to remove these GMO foods are getting faster improvements in their patients with gut problems. Later, the patients are able to reintroduce these foods in their natural non-GMO form without relapsing.

Currently, in the United States, food that has been genetically modified is not labeled as such. However, there is a way to avoid using it. Almost all the corn and soy grown in the USA is genetically modified. So, don’t eat corn or soy unless it is labeled organic. (Organic products are not genetically modified.) Sugar beets, crook neck squash, zucchini, and papaya might also be genetically modified unless they are labeled organic. Canola and cotton seed oils are often from genetically modified plants. Don’t eat them.

Here is a link to a video talking about how the Roundup pesticide and genetically modified foods can cause SIBO. Roundup and GM food can cause an increase in allergies, leaky gut, Clostridia and E. coli overgrowth, and gluten intolerance. Also Roundup and GM foods can cause a decrease in pancreatic enzymes, a decrease in the ability to detoxify, and a decrease in fat soluble vitamins. (Roundup interferes with CCK, which then causes less bile release or gallbladder stasis. Without the release of bile, the liver can’t get rid of toxins and the intestines can absorb fat soluble vitamins.) 

The Roundup pesticide kills off bacteria in the gut, but leaves Clostridia and E. coli alone. Thus, when you are exposed to this pesticide, Clostridia and E. coli will have less competition; and you are more likely to end up with an overgrowth of Clostridia or E. coli bacteria. This could make you quite ill. They have already seen an increased problem with Clostridia overgrowth in animals fed Roundup ready plants. I wonder if that is why our hospitals are dealing with an increased problem with Clostridia. 

http://vimeo.com/51259453

STOMACH ACID 

This will help eliminate yeast. However, don’t supplement with this if you have H. pylori. 

BENFOTIAMINE

This is a form of vitamin B1. It will help repair the nervous system. It is also anti-inflammatory, and it helps eliminate heavy metals. The yeast’s acetaldehyde has depleted vitamin B1. (Mercury will deplete this vitamin as well.) If you are low on vitamin B1, you may want to start replacing it slowly to allow the body a chance to get used to having it again.

TAURINE

This has been depleted by yeast. Start slow if you try this. It will release some toxins from storage. It has many benefits, including reducing allergic reactions and migraines. However, if you have H. pylori, taurine might be high. If you have certain genetics, taurine might be high. If you don’t tolerate taurine, start with some molybdenum to help your body convert possibly high taurine into sulfates.

UBIQUINOL OR COENZYME Q10

The absorption of this has been lowered by the presence of yeast. It will help you bring your cellular energy levels back up. Cellular energy is important for your cell mediated immune system. That is the arm of the immune system that fights yeast. I believe ubiquinol is usually a better supplement than coenzyme Q10.

ALPHA KETOGLUTARATE AND MALATE

These may be low. They are needed to bring your cellular energy back up. The alpha ketoglutarate doesn’t keep well, so don’t purchase more than you need for immediate use.

GELATIN

This will help repair the gut lining. However, not everyone can tolerate it.

COENZYME B6 (PYRIDOXAL-5-PHOSPHATE

This is low because of the yeast. It is important for many functions in the body, including energy production. It is delicate, so take it at a separate time from your other supplements.

ANTI-VIRALS

Some viruses alter your prostaglandin profile in such a way that encourages yeast growth. Therefore an anti-viral program may help you eliminate the yeast.

SELENIUM

Selenium will be low if you have mercury or certain viruses. The form of selenium called selenocysteine may be particularly low because the yeast toxin acetaldehyde lowers P5P. P5P is required for the enzymes that convert selenium into selenocysteine. Bringing your selenium levels back up will help your body convert thyroid into its active form. Selenium will also help eliminate certain viruses.

ELIMINATE HEAVY METALS

Mercury is notorious for causing yeast overgrowth. It interferes with the enzyme that removes the yeast’s acetaldehyde. Clean the mercury and other heavy metals out of the body. 

SUPPORT LIVER AND KIDNEYS

These organs help you eliminate toxins from your body. Toxins interfere with your ability to eliminate yeast. Saunas, homeopathics and mild exercise are some of the ways to eliminate the toxins.

BREAK UP YEAST BIOFILMS

These are shelters for infections / pathogens. More than one infection can coexist in a biofilm. Think of a biofilm as sticky substances secreted by the pathogens in which they hide. This is a shelter that your body can't easily attack. The shelter uses minerals for its structural stability and sticky stuff to hold it together. Sort of like building a house out of bricks and mortar. When the biofilm is broken up, sometimes there is a significant release of heavy metals that had been trapped in the biofilm. Sometimes that will trigger growth of yeast or other pathogens. Sometimes the person will experience a reaction to the pathogens that can now be recognized by the immune system. When using a biofilm removal protocol, one must be prepared for new symptoms and new pathogens that need to be treated.

If antibiotics and antifungals, and chelation doesn’t seem to be doing their job, then you need to go to the next step --- that is the removal of biofilms. This will make the antifungals, anti-virals, and antibiotics work better. Since biofilms can be harboring toxic metals, when you break these biofilms up, sometimes there will be a dramatic release of toxic metals that weren’t reached with simple chelation approaches.

There are several different biofilm removal protocols. They consist of enzymes and things to pull out minerals from the biofilms (EDTA or lactoferrin), followed by things to kill the organisms hiding in the biofilms, followed by things to absorb the toxins, metals and debri released. (A separation of anywhere from 20 minutes to two hours is used between each supplement.) However, before going on this full biofilm removal protocol, you need to test each product to see if it is tolerated. The first one to check is your tolerance to the absorptive materials. That way, if you have a bad reaction to one of the other products, you will have something safe to help stop the reaction.  

Here is a very good presentation on biofilms by Anju Usman, MD. www.scribd.com/doc/18583142/Gut-Rec...-Treating-Chronic-Gastrointestinal-Infections

Dr. Anju Usman suggests:

Products works best on an empty stomach

Start one supplement at a time, go slow

Do not give Enzymes on an empty stomach to patients with severe GI issues

Do not give lactoferrin to patients with dairy allergy

Avoid giving Iron, Calcium or Magnesium at same time

Here is a biofilm removal protocol that is loosely based on Dr. Kurt Woeller’s approach: 

1. Take enzyme products like nattokinase, lubrokinase, Interfase, Biofilm Defense, bromelain and/or chitosan. Sometimes add in lactoferrin and / or Na-EDTA (not Ca-EDTA).  

2. Thirty minutes later, take your anti-microbials. (Rotate the non-prescriptive anti-microbials every 5 days.)

3. One or two hours later, take absorptive products to mop up the toxins released.  (At first, I’d suggest that you start with less time in-between, for a more gentle protocol.)  Absorptive material may include charcoal, Pectasol (modified citrus pectin),Brown Algae, Destroxin zeolite, TruFiber (New Beginnings product), and / or apple pectin.

The amount of these products to take will depend on the individual.  Always start with a little and work up to more.  You don’t want to make yourself sick.  Here is a post by someone who tried too much at first. However, with time, she was able to tolerate a full dose of the products.   www.cpnhelp.org/interphaseplus_and_biofil 

Here is another biofilm removal protocol that mentions the use of homeopathics. This one is by Dr. Ettinger. 

www.advancedhealing.com/blog/2009/09/25/dr-ettingers-biofilm-protocol-for-lyme-and-gut-pathogens 

The interfase product is a mixture of enzymes. The biofilm Reduction Activity of InterFase ® has been documented invitro for these organisms:

Escherichia coli 

Staphylococcus aureus MRSA

Helicobacter pylori 

Streptococcus pneumoniae

Klebsiella pneumoniae 

Streptococcus pyogenes

Pseudomonas aeruginosa 

Candida paratropicalis

Staphylococcus aureus

FATS AND BIOFILM

Polyunsaturated fats provide the raw material for biofilm formation. Here is an excerpt from one of Byron Richard’s articles. In this article Byron is refuting someone’s assertion that stearic acid ( a saturated fatty acid) will increase biofilm formation. Saturated fats do not contribute to the biofilm.

http://www.wellnessresources.com/he...nesium_stearate/?source=Email&camp=news040909

“Biofilms are germ gangs.  They assemble based on a quorum-sensing signal, like a bell tolling in the field telling farmers to come to town and pick up weapons and go to war.  Biofilms in your digestive tract, such as Candida albicans biofilms or other bacterial biofilms are extremely problematic to human health.

These biofilm gangs need a fuel source to keep reproducing and growing. That fuel source is never a saturated fat because there is no point of biochemistry interaction in a saturated fat.

For example, a Candida albicans biofilm fuels its reproduction based on your intake of highly polyunsaturated fatty acids. This means that if you eat a bag of potato chips, corn chips, or French fries and you have a Candida biofilm, you just poured gas on the fire. Candida inserts oxygen molecules into the unsaturated bonds of the fatty acids (the more unsaturated bonds the better from Candida’s point of view) forming a highly toxic inflammatory signal called an oxylipin. Oxylipins are reproductive growth factors for the biofilm. It is technically impossible to insert an oxygen molecule into a saturated fat, which is why it is not possible for stearic acid to promote biofilm growth.”

PROBIOTICS

Use probiotics after you have eliminated protozoa. Some protozoa feed on probiotics. Add in some colostrum at the same time. 

ANTI-FUNGALS

Use anti-fungal herbs and prescriptions. If you first get a test to see which yeast is present, you can do a better job of choosing an effective anti-fungal. Often the lab will tell you which anti-fungal is most effective against your type of yeast. If you don’t have lab results, try one anti-fungal, and if it doesn’t help, try another.

CURCUMIN

This may be particularly helpful in that it is anti-inflammatory, kills yeast, and eliminates certain parasites. However, curcumin might reduce iron levels. You need enough iron, but not too much. If you are low on iron, lactoferrin is a good way to bring up iron levels without letting bacteria and pathogens get to the iron first. The lactoferrin also helps get rid of biofilms. 

BERBERINE

This is anti-fungal and it lowers blood sugar. If one is diabetic, this antifungal is a decent consideration. Be careful though. It may lower blood sugar too much.

IODINE

This has antifungal properties. However, it is very important to use the correct amount. Not too much and not too little. Also a steady small dose is easier on the body than occasional large doses. Unfortunately, the yeast toxin acetaldehyde reacts with iodine making the iodine unavailable for the enzymes in the body. The most accurate measurement of iodine is via urine.

COCONUT OIL, PALM OIL, LAURACIDIN

These kill yeast and some viruses. Start slowly. Don’t use more than a teaspoon per day to start. If you add the warmed oil to a grated carrot salad, the roughage will help bring the oil into the latter part of the intestines.

WONDRO

This is an old remedy that removes acetaldehyde and breaks up yeast biofilms. Wondro is something that can be made at home, so long as it is done in small batches. It has many strikingly good testimonials to its credit. However, I don’t have any personal experience with this. Here is a link to an old testimonial booklet and another link to a modern ebook about why Wondro works. 

http://www.scribd.com/doc/76584628/Wondro-Historical-Testimonials-Pamphlet 

http://www.scribd.com/doc/101099776/Wondro-Inside-Out


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## Beach

PollyH - Greatly appreciated, and thanks for taking the time give your thoughts on this!  I've printed the information out.  It will give me new future ideas to experiment with.


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## Spooky1

Polly, i think congratulations might be in order!  is that the longest post on Crohns forum?  lol, it will take me a while to assimilate that, think i shall print it out and go through it slowly.  But thanks a great deal for bothering to share information with us that haven't come across such research.


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## CeeCeeGo

WOW Polly - thanks for all that!
A lot of bedtime reading this week.


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## PollyH

I'm going to give you some more late night reading material.  I hope it is helpful.

You might want to pay special attention to the methyl-folate supplement. Not only does the yeast toxin interfere with its formation, but a genetic problem with creating it seems to be prevalent in Crohn's and colitis. 

Start slow with adding in methyl-folate. If you don't feel right with it, try taking some niacinamide. You need to balance your methyl-folate with niacinamide. There is also a need to balance your methyl-folate with methyl-B12. 

"A total of 17.5% of ulcerative colitis and 16.8% of Crohn's disease patients were homozygous for the C677T variant compared with 7.3% of controls." 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1727640/

This means that both your mom and dad may have given you a genetic weakness in creating methyl-folate. In the conclusion of that abstract, the author suggested that people with Crohn's and colitis may need more folic acid and B12. However, you need to be careful with which forms of these you use. Folic acid is not the same thing as folate or methyl-folate. In fact if you inherit the same C677T weakness from both your parents, you should probably try to avoid sources of folic acid. Folic acid is the form of the vitamin they put in bread and enriched flour products. It is also the form found in most vitamin supplements. Folic acid can build up in the blood and interfere with the use of your methyl-folate. When you hear about a study saying folic acid supplementation was associated with colon cancer, that may very well be true, because it was folic acid, not folate. Excess "folic acid" is toxic and cancer causing. (This is talked about at the MTHFR.net website.)

You may need some methyl-B12 to balance your methyl-folate. Each person will be different in the proportions they need to supplement. The lack of B12 may be related to excess bacteria in the small intestine (SIBO). It is hard to say which vitamin you need the most. Here is something I wrote for a SIBO group about methyl-folate and methyl-B12.

B12 AND FOLATE BALANCE

With SIBO, folic acid /folate levels are sometimes high. We don’t know if it is caused by the bacteria creating folates or something else. One potential reason is that you need B12 to use the folates, and B12 is often low with SIBO. Another potential problem is the presence of antibodies to folate receptors. This may cause high levels of folates in the blood, but low levels in the cells.  

Methyl-folate should be kept in balance with methyl-B12. The two work together. An excess of one may suppress the other. With SIBO, usually it is the B12 that is low, and the folic acid / folate that is high. Therefore, perhaps start your experimentation with the methyl-B12 or the hydroxy-B12. (The hydroxyl-B12 converts into methyl-B12 and adenosyl-B12 in the body.) There is another reason to start with the B12. According to Wikipedia, 

 “Patients with megaloblastic anemia need to be tested for vitamin B12 deficiency before folate treatment, because if the patient has vitamin B12 deficiency, folate supplementation can remove the anemia, but can also worsen neurologic problems.” 

However, there is always the possibility that you may need more folate. Antibodies to milk casein are known to interfere with the use of folates. Acetaldehyde from yeast overgrowth will interfere with the absorption of folate and its conversion to methyl-folate. (The acetylaldehyde lowers Coenzyme A, which is needed for the enzyme that catalyzes the conversion of formyl-folate into methyl-folate.) Heavy metals, especially arsenic, will interfere with the folates. Certain drugs will interfere with the absorption or metabolism of folate. Some of these are Metformin / Glucophage, Warfarin/Coumadin, Methyltrexate, Triamterene, sulfasalazine, trimethoprim-sulfamethoxazole, anti-seizure drugs, retinoid acne pills and birth control pills Dialysis will remove folates. Alcohol consumption will lower methyl-folate.

TYPES OF FOLIC ACID / FOLATE / VITAMIN B9 

Vitamin B9 is usually referred to as folic acid, even though folic acid is just the synthetic form of this vitamin. If one were to be more exact, the term folic acid would only be used to refer to the fully oxidized synthetic compound known as pteroylmonoglutamic acid. This is the form of vitamin B9 found in most vitamin supplements and in fortified flour.  

The body will try to convert the synthetic folic acid into dihydrofolate and then into 5-formyl-tetrahydrofolate and then into 5-methyl-tetrahydrofolate. Unfortunately, up to 60 percent of the people in the USA have at least some genetic trouble converting folic acid into these various folates. This conversion process can also be thwarted by heavy metals, alcohol, solvents, chemicals, toxins, certain antibiotics or drugs, and the acetaldehyde produced by yeast. Because of these conversion problems, other forms of vitamin B9 have now become available on the market. 

If the body is having trouble converting folic acid into a more useable form, then ingesting folic acid may result in a build-up of folic acid in the blood. Some people are very sensitive to this build-up of folic acid and feel better when they avoid all food and supplements that have been fortified with the synthetic folic acid. One possible reason for their sensitivity is that a build-up of folic acid in the blood can actually interfere with methyl-folate (5-methyl-tetrahydrofolate) crossing the blood brain barrier.  Methyl-folate is the only form of vitamin B9 that crosses the blood-brain barrier. There it is needed to help create your brain’s neurotransmitters, like serotonin, dopamine and norepinephrine. When the brain doesn’t get enough methyl-folate, one may suffer from depression, migraines, foggy thinking, irritability and many other brain symptoms. 

According to Wikipedia, 

“Common symptoms of folate deficiency include diarrhea, macrocytic anemia with weakness or shortness of breath, nerve damage with weakness and limb numbness (peripheral neuropathy)[citation needed], pregnancy complications, mental confusion, forgetfulness or other cognitive declines, mental depression, sore or swollen tongue, peptic or mouth ulcers, headaches, heart palpitations, irritability, and behavioral disorders. Low levels of folate can also lead to homocysteine accumulation.[7] DNA synthesis and repair are impaired and this could lead to cancer development.” 

Dr. Ben Lynch has a surprisingly long list of things that could be caused by the lack of methyl-folate. This is his list as of December 6, 2012

Autism
Addictions: smoking, drugs, alcohol
Down's syndrome
Miscarriages
Pulmonary embolisms
Depression in Post-Menopausal Women
Schizophrenia
Fibromyalgia
Chronic Fatigue Syndrome
Chemical Sensitivity
Parkinson's
Irritable Bowel Syndrome
Pre-eclampsia
Stroke
Spina bifida
Esophageal Squamous cell carcinoma
Acute Lymphoblastic Leukemia
Vascular Dementia
Bipolar disorder
Colorectal Adenoma
Idiopathic male infertility
Blood clots
Rectal cancer
Meningioma
Glioma
Congenital Heart Defects
Infant depression via epigenetic processes caused by maternal depression
Deficits in childhood cognitive development
Gastric Cancer
Migraines with aura
Low HDL
High homocysteine
Post-menopausal breast cancer
Atherosclerosis
Oral Clefts
Type 1 Diabetes
Epilepsy
Primary Closed Angle Glaucoma
Alzheimer's
Tetralogy of Fallot
Decreased telomere length
Potential drug toxicities: methotrexate, anti-epileptics
Cervical dysplasia
Increased bone fracture risk in post-menopausal women
Multiple Sclerosis
Essential Hypertension
Differentiated Thyroid Carcinoma
Prostate Cancer
Premature Death
Placental Abruption
Myocardial Infarction (Heart Attack)
Methotrexate Toxicity
Nitrous Oxide Toxicity
Heart Murmurs
Tight Anal Sphincters
Tongue Tie
Midline Defects (many are listed above)
Behcet's Disease
Ischemic Stroke in Children
Unexplained Neurologic Disease
Asthma
Shortness of Breath
Bladder Cancer
Anecephaly

http://mthfr.net/mthfr-mutations-and-the-conditions-they-cause/2011/09/07/

One might be able to add Raynaud’s to that list, since folate is low and it is needed for circulation.
WHEN NOT TO TAKE METHYL-FOLATE
http://mthfr.net/taking-folate-and-feeling-badly-methylation-requires-balance/2011/11/15/
According to this reference, if you methionine levels are high, then you might not tolerate the methyl-folate because it could raise methionine levels even higher. If your methionine levels are high, this doctor suggests trying P5P and magnesium first to help bring methionine levels down. Then you may be able to tolerate the methyl-folate. 
Some people may have to start slowly, because the methyl-folate may open up microcirculation. When you first open up microcirculation, you may experience some inflammation or uncomfortable reactions.

WHERE TO PURCHASE METHYL-FOLATE AND FORMYL-FOLATE

Formyl-folate also goes by the names of formyltetrahydrofolate, folinic acid and leucovorin (prescription). If you are looking to purchase some formyl-folate, most vitamin supplements call it folinic acid. The other form available as a supplement is methyl-folate. It also goes by the names of 5-methyltetrahydrofolate, and 5-MTHF.  The vitamin supplements using this form call it a whole host of different names. 
Life Extension calls their methyl-folate product Optimized Folate, and Metagenics calls their product FolaPro. Solgar calls their product just Folate. Nutricology calls their product QuatreActiv Folate. Jarrow calls their product Methyl-folate. Vitacost calls their product Bioavailable Folate.  Thorne Research calls their product 5-MTHF. XYMOGEN® also calls their product 5-MTHF. These products contain anywhere from 0.4 to 1 mg per pill.  

However, there are a couple of higher dose products if you need them. The price per unit active ingredient is cheaper with these. So, if you need a higher dose, use these instead of taking a lot of the lower dose pills.   Neurobiologix sells Methyl-folate Plus and 5-MTHF. Each of these contains 5 mg per pill as well. However, there is also some folinic acid and niacinamide in the Methyl-folate Plus product. (So, it costs a bit more.) When you take into account the dose, these two Neurobiologix methyl-folate products are considerably cheaper per unit than the other products that I’ve seen on the market.

There are two prescription products that contain methyl-folate --- Deplin and Metanx.  Deplin is specifically marketed as useful for treating depression. It is a high potency product containing 7.5 or 15 mg of methyl-folate per pill.  (Rather expensive.) Another prescription that contains methyl-folate is Metanx. This prescription is used to treat diabetic neuropathy. It contains about 3 mg of methyl-folate per pill along with some other B vitamins in their active coenzyme form.  
If you find something else on the market, make sure it is the pure L form, and that it doesn’t contain the D form. Someplace on the label, the product should say L-methyltetrahydrofolate, Metafolin or Quatrefolic. 

VITAMIN B12

SIBO can interfere with the absorption of vitamin B12. (The bacteria can bind intrinsic factor that is required for absorption of B12.) B12 is needed for the health of the intestinal villi and is also required for good sleep. B12 helps the body dispose of nitric oxide, and thus helps reduce inflammation. Low B12 is associated with many autoimmune diseases like Hashimoto’s.  The common parasites called Giardia and Diphylobothrium latum interfere with the absorption of B12.

There are different forms of B12 including cyano, methyl, adenosyl, and hydroxy. The cyano form of B12, which contains cyanide, isn’t a good bet, especially if one is mercury poisoned. The hydroxyl converts into the methyl and the adenosyl forms in the body. So, if you have no trouble with this conversion, hydroxyl-B12 is great. Get your doctor to give you some shots of this. However, to make thing simple, probably, the best thing to try would be a combination of adenosyl-B12 and methyl-B12. 

For the methyl-B12, consider using a nasal spray. This is absorbed ten times better than the sublingual. (See Stan Kurtz’s website.) Currently, there seems to be only one brand of methyl-B12 liquid on the market. It is New Beginnings Methyl-Mate.  Adult dose is two sprays per day in the nostril. Sometimes improved cognitive ability is seen within as little as a minute.

There is also a more recent B12 product which is a skin cream that is absorbed very well. It is called neuro immune stabilizer cream and sold at the Neurobiologix website. There is also a liquid adenosyl-B12 available that can be used under the tongue.

Vitamin B12 and curcumin are strong scavengers of nitric oxide. Therefore they may help reduce the intestinal inflammatory response to the SIBO bacteria’s LPS (lipopolysaccaride). Niacinamide is also helpful here. It reduces the amount of nitric oxide created when the body is exposed to LPS. Together, they may be  of some use when there is danger of sepsis. With sepsis, excessive nitric oxide production expands blood vessels and creates  extremely low blood pressure and hence heart failure.

Another consideration. When rats are exposed to LPS, they are able to survive the onslaught with much less damage to their intestines and organs if they are on a diet that excludes polyunsaturated omega-3 and omega-6 oils. [1] Much fewer deaths result. This is another reason to avoid corn, soy, safflower, canola, peanut, flax and cottonseed oils. 

1.	Cook JA, Wise WC, Knapp DR, Halushka PV. “Essential fatty acid deficient rats: a new model for evaluating arachidonate metabolism in shock.” Adv Shock Res 1981;6:93-105; and  Li EJ, Cook JA, Spicer KM, Wise WC, Rokach J, Halushka PV “Resistance of essential fatty acid-deficient rats to endotoxin-induced increases in vascular permeability.” Circ Shock 1990 Jun;31(2):159-170; and  Autore G, Cicala C, Cirino G, Maiello FM, Mascolo N, Capasso F, “Essential fatty acid-deficient diet modifies PAF levels in stomach and duodenum of endotoxin-treated rats.” J Lipid Mediat Cell Signal 1994 Mar;9(2):145-5


----------



## Spooky1

Wow!!! i'm pleased my gastro bloke doesn't speak to me with all that info!!!  at leasst here i can take my time over it, lol.


----------



## PollyH

Niacin or niacinamide seems to play an important role in colitis. Deficiency of niacin can cause colitis, and conversely, colitis can cause a deficiency of niacin.

If you add on top of that an inability to use niacin, due to a lack of methyl-folate, then I think you are asking for trouble.

I've already mentioned a few other benefits of adequate niacinamide. These are the fact it is anti-inflammatory and it helps slow down yeast growth and slow the formation of the yeast biofilms.

===============================
references:

"Niacin (vitamin B3) deficiency is known to cause diarrhea and colitis. ...Niacin deficiency after bariatric surgery is supported by finding low plasma niacin levels and by resolution of the symptoms of colitis during oral niacin therapy." 

http://www.eventscribe.com/2012/acg/ajaxcalls/postersinfo.asp?title=6654

The Potential Role of Niacin in the Development of Indeterminant Colitis After Bariatric Surgery

Divyanshoo R. Kohli1, Raj Majithia1, I David Shocket1, Frederick C. Finelli1, Timothy R. Koch1
1. Washington Hospital Center, Washington, DC, United States. 
======================
Pellagra is caused by a lack of niacin.

"Pellagra also occurred in the Southeastern United States in the early 1900’s and throughout the depression, when incomes were very low and corn products again played the major dietary role.

This deficiency can also be caused by conditions or diseases that either prevent or interfere with the absorption of niacin such as chronic alcoholism, prolonged bouts of diarrhea, and gastrointestinal diseases such as ulcerative colitis. "

Read more: http://healthmad.com/conditions-and-diseases/niacin-deficiency/#ixzz2J9SGTFdG


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## Samboi

I have neutropenia - which means my immune system is almost non-existant. 
When I challenged my GI about putting me on an immune suppressing biologic drug to manage my CD - she advised (after chuckling) that the immune supressor attacks totally different cells - presumably TNF cells. 
Apparently my logic and deductive reasoning that a suppressed immune system was enough to minimize CD symptoms was extremely flawed! 

Historically - I have noticed that each time I have an extra shot of neupogen to boost my immune system, I get a slight increase in diarrhea and mild cramping. My dose has just been increased to manage severe mouth ulcers - I will be interested in seeing what impact this has on my CD symptoms.


----------



## Beach

PollyH said:


> Niacin or niacinamide seems to play an important role in colitis. Deficiency of niacin can cause colitis, and conversely, colitis can cause a deficiency of niacin.
> 
> If you add on top of that an inability to use niacin, due to a lack of methyl-folate, then I think you are asking for trouble.
> 
> I've already mentioned a few other benefits of adequate niacinamide. These are the fact it is anti-inflammatory and it helps slow down yeast growth and slow the formation of the yeast biofilms.
> 
> ===============================
> references:
> 
> "Niacin (vitamin B3) deficiency is known to cause diarrhea and colitis. ...Niacin deficiency after bariatric surgery is supported by finding low plasma niacin levels and by resolution of the symptoms of colitis during oral niacin therapy."
> 
> http://www.eventscribe.com/2012/acg/ajaxcalls/postersinfo.asp?title=6654
> 
> The Potential Role of Niacin in the Development of Indeterminant Colitis After Bariatric Surgery
> 
> Divyanshoo R. Kohli1, Raj Majithia1, I David Shocket1, Frederick C. Finelli1, Timothy R. Koch1
> 1. Washington Hospital Center, Washington, DC, United States.
> ======================
> Pellagra is caused by a lack of niacin.
> 
> "Pellagra also occurred in the Southeastern United States in the early 1900’s and throughout the depression, when incomes were very low and corn products again played the major dietary role.
> 
> This deficiency can also be caused by conditions or diseases that either prevent or interfere with the absorption of niacin such as chronic alcoholism, prolonged bouts of diarrhea, and gastrointestinal diseases such as ulcerative colitis. "
> 
> Read more: http://healthmad.com/conditions-and-diseases/niacin-deficiency/#ixzz2J9SGTFdG


Interesting about the niacin.  That is something I've been taking of late, so it isn't something I can rule out as helping.  My D has all but stopped this past week.  I'm a bit tired this morning, but of late I've been doing well to the gut and experiencing better energy.  During this improved health time I also began taking some niacin, 500mgs twice a week.  I've taken the brand Slo Niacin in the past to help with cholesterol control.  (Slo Niacin found in most drug stores is pretty much the same product as prescription niacin.) This time I had a different idea in mind.  I've noticed that niacin can sometimes give me very shinny hair and a nice attractive skin tone.  I wondered why niacin only helped sometimes with appearance - so thought possibly this could be as a way to discover food allergies.  An offending food would hurt my absorption abilities causing a poor appearance,  while the opposite happens once the offending food is out of the diet - and niacin would exaggerate this.  So far so good with the theory, might have found an "ugly" food. More work needs to be done though.  (If, and it is a big if, the food I'm thinking is a problem maker for me, it could explain why I've gotten well to the gut in the past, but never felt I could fully recover.  I apparently can eat a little of this food and not become terribly ill.)  

Wanted to mention that while niacin pills are generally safe to take, if taken wrong can cause liver issues.  Your doctor can test for this if concerned (liver testing is done once 1000mgs of more of niacin is taken per day.).  Avoid slow release niacin.  Also do not buy no flush niacin.  This is a rip off, it does not work.  Additionally niacin often causes an intense flushing for most that take it.  The best way to limit the niacin flush is to eat some nuts with the pill, plus drink lots of water.  For me, in the past before my body became used to niacin, it would cause me to turn bright red for around an hour, with a feeling of pins and needles sticking me all over.  It wasn't terribly awful to experience, but I wanted to avoid being in public when it happened.  I would joke that I looked like an Umpa lumpa with shinny hair. :redface: 

Something else also, niacin at high doses can raise blood sugar levels.  It is best to exercise after taking.  

Thought this a nice article about ways to deal with a niacin flush.  

"The dreaded niacin “flush”"

http://blog.trackyourplaque.com/2007/05/the-dreaded-niacin-flush.html


----------



## David

Polly, would you mind if I copied all your posts in this thread to their own thread?  And if you're ok with it, what would you like the new thread to be named that you feel would encompass what you're teaching?


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## PollyH

Samboi said:


> I have neutropenia - which means my immune system is almost non-existant.


I assume you have looked at wikipedia and found that a lack of folate and/or B12, or copper could be the reason for the neutrapenia. If you need the copper, my personal experience was that I felt better using copper sebacate. If you need the folate, then consider the methyl-folate because it is more likely you have a MTHFr problem common in Crohn's and colitis. Folic acid might not be good for you. People with a type of cancer called MDS find that vitamin D3 and high dose vitamin K2 can be helpful in bringing up the platelet and red blood cell counts. The type of vitamin K2 used in studies is the MK-4 form of it. The studies have been using a lot of the MK-4 form, 50 mg. You can get 15 mg pills of the MK-4 vitamin K2 from Relentless Improvement or Advanced Orthomolecular Research (AOR). Of course, the cheaper MK-7 form might work. I'm not implying that you have cancer. Don't worry. However, if it works for the people with cancer, it might work for you. Besides bringing up your vitamin D3 and K2 levels would be helpful because they are anti-inflammatory. Here is a forum where they are talking about a study involving vitamin D3 and K2 to bring up the white blood count. http://forums.marrowforums.org/showthread.php?p=25075 

(It is also important to use both vitamins, along with a little vitamin A. The fat soluble vitamins need balance. By the way, carotene isn't always a good way to bring up your vitamin A. Children and those with low thyroid are unable to use the carotene to increase vitamin A. So use the real vitamin A.)  

If you are deficient in vitamin D, a doctor may give you a high dose vitamin D2. However, the natural vitamin D3 works better. The only place I know to get the high dose vitamin D3, is from International Anti-aging Systems. A typical protocol is to give you 50,000 IU three times a week for a month. Then they retest in 3 months. (That is how often insurance will pay for testing.) However, you can order vitamin D testing yourself. Then you can find out more quickly if the therapy is working. The vitamin D council has referrals on where to get the testing. Here is a very entertaining video by Dr. Stasha Gominak's, a sleep doctor, on the amount of vitamin D that you need. (Not too much and not too little.) She talks about getting her patient’s vitamin D 25(OH) levels into a narrow range of between 60 and 80 mg/mL. 

http://www.youtube.com/watch?v=h7cbBB1c0IM

http://www.youtube.com/watch?v=1APENOUWxBQ&feature=related

http://www.youtube.com/watch?v=_JUq4fphjC0&feature=related

http://www.youtube.com/watch?v=qeb3PtkCd_c&feature=related

http://www.youtube.com/watch?v=YOUybbVOoRU&feature=related

Wikipedia also mentioned arsenic poisoning from ground water as a possible reason for the neutropenia. (The people in Southern California are at risk for this in the USA.) The arsenic interferes with your folates.

There are other sources of arsenic. In the USA, they legally feed chickens arsenic. This is allowed because arsenic can kill parasites. However, the arsenic also makes the chickens grow faster, and hence the farmers make more money. Fortunately, one of the major feed producers has recently stopped putting arsenic in their chicken feed. They stopped when it was shown that the arsenic was present in the livers of chickens. (It was easier to test for it in the liver. We don't know if it accumulates in the meat. However, the meat does become more pink.) I'd read that Tyson doesn't feed their chickens arsenic, because Russia refuses to by the meat. You might call and find out if they still have that policy. Of course, your other option is organic chickens.

Another source of arsenic is rice if it is grown in soil high in arsenic. Rice preferentially takes up arsenic from the soil. Unfortunately, they used a lot of arsenic pesticides on some of the cotton fields in the Southern US states. So, rice grown there may be high in arsenic. You can do a search for the arsenic content of rice and where it was grown. 

You can get rid of the arsenic with the typical chelation protocols.

The mouth sores may be related to the viruses typically associated with Crohn's and colitis. These viruses are particularly hard on your selenium stores. Also, selenium and sometimes lysine will help get rid of them.


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## PollyH

David said:


> Polly, would you mind if I copied all your posts in this thread to their own thread?  And if you're ok with it, what would you like the new thread to be named that you feel would encompass what you're teaching?


We are getting off topic, aren't we.  How about naming the new thread The Fungus-Yeast Connection.


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## shamrock15

Some really good info here - big thanks to Dave and Polly. I am at a bit of a loss on how to take carbs out of my diet though. I know I need to limit at least the simple sugars due to effects that I have noticed. I don't absorb much fat due to previous surgeries, so I could potentially end up with a real shortage of raw calories otherwise. Even the shift from enriched white bread to store baked has lead to a loss of weight for me. Need to get calories from somewhere!


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## David

PollyH said:


> We are getting off topic, aren't we.  How about naming the new thread The Fungus-Yeast Connection.


Thank you.  I have copied your posts here.

Folks, if you want to discuss what Polly is saying, please take it to this new thread.  Let's allow the thread as it is to discuss Dave's work.

Thank you.


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## Hope345

Keep the articles, information and debate coming.  It is good to question everything.

One more addition, why does my nephew, 10 years older than my daughter have the exact same Crohns symptoms?  just something to add into the pot.

It would seem genetics are involved along with the infections...

the cause will tie it all in together.


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## tots

In was a very healthy kid- the ONLY health issue I had was diagnosed Crohns. My favorite foods- were fruits, veggies, and salads.

Once I got sick enough I couldn't eat any of that.

If carbs are the problem why the h$&& does salad cause severe pain and diarrhea?

I just don't follow yoit logic. I have not heard of people ending up in the hospital
 over carbs.



lauren


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## Laura44

Thanks for the article!


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## Spooky1

Can;t take B3 at all.  i end up phoning nhs direct.  the flush is full body and very very red, itchy and cold baths for five hours,  any suggestions.  i have crohns


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## Beach

Thought this a nice article on how to get rid of the niacin flush.  It helped me greatly in the past as I can flush badly also.  

"The dreaded niacin “flush”"

http://blog.trackyourplaque.com/2007/05/the-dreaded-niacin-flush.html

snippet from Dr. Davis's article:



> As most anybody who takes niacin knows, it can cause a hot flushed feeling over the chest and face that is generally harmless, though quite annoying.
> 
> Many doctors are frightened by this response and will warn patients off from niacin. Some people who take niacin are so annoyed that they find it intolerable.
> 
> However, a very simple maneuver can relieve the hot flush in over 90% of instances: Drink water. Let me explain.
> 
> I usually instruct patients to take niacin at dinnertime. That way, food slows absorption modestly. I also ask them to drink water with dinner. If the flush occurs after dinner (usually 30-60 minutes later), then drinking two 8-12 oz glasses of water immediately breaks the flush within 3 minutes in the great majority of people. It’s quite dramatic.
> 
> Doing this around dinner (lunch works just as well) allows sufficient time to clear the excess water from your body before bedtime and spare you the aggravation of disrupted sleep to urinate. Drinking plenty of water works most of the time. Only an occasional person will need to take a 325 mg uncoated aspirin to more fully break the flush. I generally suggest that patients keep the uncoated aspirin in reserve if the water doesn’t provide relief within a few minutes.
> 
> Thankfully, the intensity of the niacin flush lessens, often disappears, with chronic use....


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## Grant

Wow. This is totally the opposite to what I thought like Nitty. Tks D Bergy for posting a simple explanation. 
Rgds
Grant


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## Spooky1

I don't quite get the anaphalactic shock but i flush for at least four hours and from head to toe.  nhs direct said i'm probably allergic to it.  good website though, very interesting and i might give it a go with the quercetin.  many thanks though.


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## sugacookie

Hi Dave, thank you for taking your time to write your post.

I have been told by many people if you cut sugar and dairy from your diet and you can see a great improvement to crohns.

I have recently had a sub-total colectomy and formation of ileostomy, so theirfore have a stoma bag for life. I am theirfore very confused about what to eat and what diet to follow. The stoma nurse said to me only drink fruit squash not plaine water as you will get dehydrayted but that just sounds wrong.

Can you recomend anything or do you know anywhere I can get some info?

Thank you x


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## Beach

Spooky1 said:


> I don't quite get the anaphalactic shock but i flush for at least four hours and from head to toe.  nhs direct said i'm probably allergic to it.  good website though, very interesting and i might give it a go with the quercetin.  many thanks though.


I was reminded yesterday why I stopped taking niacin regularly.  I used to take 1000mgs of niacin a day to help control cholesterol levels.  It did a decent job of raising HDL levels and lowering LDL a bit, along with changing the particle size.  What I didn't enjoy though was how niacin made me feel lethargic.  Over the weekend, I decided to take 500mgs of niacin Saturday and 500mgs Sunday.  Yesterday evening I was feeling it, having lower energy than I thought i should.  I'm going back to my taking niacin once or twice a week routine.


----------



## PollyH

Spooky1 said:


> I don't quite get the anaphalactic shock but i flush for at least four hours and from head to toe.  nhs direct said i'm probably allergic to it.  good website though, very interesting and i might give it a go with the quercetin.  many thanks though.


Niacin gives a flush, but niacinamide does not. Must you use the niacin? I think for most purposes, niacinamide would be just fine. With Crohn’s and colitis, the niacinamide would fulfill the primary needs of lowering inflammation and helping to remove the acetaldehyde, yeast and yeast biofilms. Why make the body go through the extra step of converting niacin into niacinamide? The niacinamide should also be a little easier on the liver.

In the case of Crohn’s and colitis, I think sometimes niacin could be the wrong thing to use. Some people use niacin to lower cholesterol, especially the “bad” LDL cholesterol. (Niacinamide doesn’t lower cholesterol but niacin does.) Yet, is that what you want? Lower cholesterol? You need to be careful here. It is the LDL cholesterol that protects the body from the toxins generated in the gut. LDL cholesterol should not be allowed to drop too low. Also, if your total cholesterol drops below 160 mg/dl, then there are general health problems that ensue. You are more susceptible to staph, strep and tuberculosis infections. You are more likely to suffer from depression or poor brain function. So, before using niacin, you need to look at your LDL cholesterol and your total cholesterol levels. If those are super high, then perhaps you want to use niacin. If not, then maybe you are better off using the niacinamide.

According to the following references, cholesterol is low during active or acute Crohn’s. Cholesterol levels may be low due to a decreased dietary intake and/or decreased synthesis. Either way, low cholesterol is associated with a poorer outcome in many critical diseases.

Cholesterol metabolism in active Crohn's disease.
http://www.ncbi.nlm.nih.gov/pubmed/19562284

[Changes in lipid metabolism in patients in the active phase of Crohn's disease]. http://www.ncbi.nlm.nih.gov/pubmed/18072426

LIPID METABOLISM IN ACTIVE CROHN’S DISEASE: PRE-RESULTS
http://mefanet.upol.cz/BP/2006/2/363.pdf

We detected lower serum levels of total cholesterol (P < 0.001), LDL- and HDL-cholesterol (P < 0.05) in the patients with active Crohn's disease than in the control group.

The serum total cholesterol, LDL and HDL cholesterol, and triglyceride concentrations were lower in patients with acute Crohn's disease than in the control group. … Alteration in lipid metabolism has been described in patients after trauma, surgery, burn injury or in sepsis and low level of cholesterol in critically ill patients is associated with poor prognosis1–3.


----------



## PollyH

sugacookie said:


> The stoma nurse said to me only drink fruit squash not plaine water as you will get dehydrayted x


Sugar and salt help you absorb your water. You don't have to add in a lot of sugar to get the benefits. For instance, Gatorade isn't that sweet, and yet it is specifically used for hydration.  However, be careful with which flavor of Gatorade that you use. Some of the Gatorade products contain bromated vegetable oil. There is enough bromine in those drinks to cause illness in people who use a lot of it. (The bromated vegetable oil is used to make the lemony flavor more uniform.)


----------



## Beach

Sure, I can give the no flush niacin a try to see if it helps further with the gut, and effects energy levels.  Thanks for the article links.  I'm no longer much of a believer in cholesterol being majorly involved with heart disease, and that played a part in my stoping the niacin too.  I'm now under the impression that it is best to have a CT heart scan to see if plaque is present, and if so find out why from the many risk factors that make heart disease plaque possible.


----------



## PollyH

Beach said:


> Sure, I can give the no flush niacin a try to see if it helps further with the gut, and effects energy levels.


No flush niacin is also called inositol hexaniacinate. That isn't the same thing as niacinamide. It is really confusing because niacinamide doesn't cause flushing and inositol hexaniacinate doesn't cause flushing, but only one of them got the name of "no-flush" niacin. 

I believe the niacinamide would be a much better choice for someone with IBD. The inositol hexaniacinate has the draw back of reducing cholesterol. Plus I bet it would also increase insulin resistance. (Niacin reduces cholesterol by formation of a chemical that also causes the insulin resistance.)


----------



## Redtail

First post. I'll probably come across as a bit crass, but really I am not. 

My mind is always open to new ideas and theories. The fact is, poor oral hygeine and oral disease has been linked to a whole lot more than just Crohn's, the mouth being the direct opening to a tunnel that leads right to the core of the organs.
To see a study linking Crohn's to this, really is just the latest in many diseases that have already been linked. All sorts of GI disorders along with heart disease, liver diseases, cancer, etc. . Now, they are going to have to sort out the information they have. In the coming years, some will probably be found to be coincidental, some likely will not.
Swallowing high amounts of harmful bacteria in to your GI system likely can have all kinds of nasty effects on the body. It's not just from tooth and gum decay, but rotting food in the form of plaque can produce these populations of germs that one would rather not have inside their own mouths.

Brush, floss, waterpik. Religeously. Even if you have a mouthful of cavities right now, doing so can quickly clean up and keep the levels of these microorganisms where they belong. Your cavities will remain a problem, but at least your mouth will be clean.


----------



## jac521

I personally just don't get the no sugar, no carbs theory.  About all I can eat is simple sugars, and simple carbs.  Complex carbs and fruits and vegetables I cannot tolerate.  I used to be able to eat a Caesar salad, but I can't even eat that now.  I don't think that there is a "one size fits all" diet or treatment for anyone.  Just my two cents.


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## tots

I am not following the sugar to carbs to oral hygiene. 

With the amount of low income families and lack of dental care, Crohns would be much more common.

Not to mention as jac521 said for a lot of us that's most of what dosent make us sick.


Lauren


----------



## PollyH

jac521 said:


> I personally just don't get the no sugar, no carbs theory.  About all I can eat is simple sugars, and simple carbs.  Complex carbs and fruits and vegetables I cannot tolerate.  I used to be able to eat a Caesar salad, but I can't even eat that now.  I don't think that there is a "one size fits all" diet or treatment for anyone.  Just my two cents.


The theory of the SCD diet is that your body needs to get the sugars and carbohydrates before the bacteria and yeast get them. If you can eat simple sugars, that is wonderful. It means your problem is further down in the intestines. Keep on eating a little of these with each meal. They are good for you! Just avoid the polyunsaturated oils that cause yeast to overgrow.


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## Pentasa

Too much scientific jargon. Nature is simple. Eat the foods you were meant to eat, exercise and be healthy.


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## PollyH

PollyH said:


> The theory of the SCD diet is that your body needs to get the sugars and carbohydrates before the bacteria and yeast get them. If you can eat simple sugars, that is wonderful. It means your problem is further down in the intestines. Keep on eating a little of these with each meal. They are good for you! Just avoid the polyunsaturated oils that cause yeast to overgrow.


The best way to get sugars is from fruit. You get vitamins a minerals that way. However, you may have to peel the fruit at first. Also, the SCD diet suggests that you start by cooking your fruit. It makes it easier to digest that way.


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## PollyH

Pentasa said:


> Too much scientific jargon. Nature is simple. Eat the foods you were meant to eat, exercise and be healthy.


That is perfect advice if you have a healthy body and want to keep it that way. However, once things are broken, you need to be more careful with your diet and supplements. The only advice that the gastroenterologist gave me was to watch which foods made my condition better or worse. That was good advice. I ended up re-inventing the classic anti-candida diet. (I didn't have Crohn's or colitis. The only thing the doctor found was yeast in the lab tests, but but told me that yeast doesn't mean anything, because everyone has that.)


----------



## tots

Pentasa

I wish it were as simple as a healthy diet and exercise.

For me fresh fruits and vegetables make me very sick. It is 
Really that simple.

Lauren


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## jac521

Tots said:

For me fresh fruits and vegetables make me very sick. It is 
Really that simple.


Ditto tots - fruits and vegetables make me very sick also. Along with the so called "healthy" whole wheat bread stuff.  I can only eat the "bad for you" white bread stuff!

Jac521


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## David

PollyH said:


> The theory of the SCD diet is that your body needs to get the sugars and carbohydrates before the bacteria and yeast get them. If you can eat simple sugars, that is wonderful. It means your problem is further down in the intestines. Keep on eating a little of these with each meal. They are good for you! Just avoid the polyunsaturated oils that cause yeast to overgrow.


My theory on the SCD is it forces you to eat healthier, your magnesium intake increases, 1,25(OH)2D (calcitriol) (magnesium is a cofactor of vitamin D) production increases, and the body starts fighting off those bacteria and yeast as the immune system begins to function again.

I don't think anything starves.  I think our immune system kicks their little asses.


----------



## PollyH

David said:


> I don't think anything starves.  I think our immune system kicks their little asses.


I agree that you can't get rid of the bacteria and yeast by starving them. However, if you slow either their growth or the production of their toxins, then you are better off.


----------



## LondonSnow

My mum _did _always say that having six spoons of sugar in my tea everyday was probably a bad idea.


----------



## tots

Jac 521

After 22(?)yrs my mom still says if you ate this or that you would feel better.


Right...  I gave up on that topic along time ago.


Lauren


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## jac521

tots-

People think I don't want to eat fruits, vegetables, or high fiber food and that is not true.  They make me sick and it seems lately there is less and less I can eat without becoming sick.

jac521


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## Hope345

My daughter  has always had a sweet tooth, and even with good teeth brushing, had several cavities as a young child.  I was told that some people develop more bacteria in their mouth than others.  My older daughter did not have one cavity for 15 years.(She does not have Crohns)

So the question is:  Could that have been one early symptom, (increased bacteria in mouth) of Crohns?     

The integumentary System is responsible for the saliva in the mouth. Saliva in your mouth contains an enzyme called lysozyme which kills bacteria.  It is also responsible for inflammation.  There certainly could be a connection.


----------



## David

I'd wager that it wasn't so much bacteria that was the problem but mineral and maybe vitamin deficiencies that led to degradation of her teeth.

The thing is, there is always a ton of bacteria in our mouth.  In fact, most of us often even have some strep bacteria present.  But there is a BALANCE so none grow out of control and create disease.  I'm always very weary of products that kill bacteria and advertise that as some benefit as that negatively affects the balance.  

It's not the bacteria that's the problem.  It's the health of the immune system.  If our immune system is working as it should, then it keeps things in balance.

My wife works in a hospital.  As such, we are both no doubt MRSA carriers.  So why don't we get MRSA infections when others do?  Why don't we constantly get the flu and colds even when nurses, doctors, and techs around her are getting them and taking them home to their family?  Because we take the necessary steps to ensure our immune systems are healthy.

For us, those steps are an extremely healthy organic diet focusing on high quantities of vitamins, minerals, essential and beneficial nutrients, plenty of vitamin D via the sun, some supplementation, exercise, stress reduction, proper hydration, and not using any anti-bacterial anything.


----------



## Hope345

David, 

What you are saying is probably part of the problem.  Although, both daughters grew up in the same household eating almost the exact foods.

I just think more of the research centers should look at this as a possibility.  If it is genetic, which I believe it is, something is flawed in the IBD patients body.  It could be the endocrine system and start here.   Crohns starts in the mouth and can go through the entire digestive tract.  So why the mouth?      

What if the endocrine system causes the lack of enzyme which fights the bacteria,  which in turn  affects the immune system to fail, mainly in the digestive tract?

The enzymes Amylase and lysozyme are produced in saliva.  I just read this below:

  Serum and urine lysozyme levels may be elevated in acute myelomonocytic leukemia (FAB-M4), chronic myelomonocytic leukemia (CMML), and chronic myelocytic leukemia (CML). Increased serum lysozyme activity is present in tuberculosis, sarcoidosis, megaloblastic anemias, acute bacterial infections, *ulcerative colitis, *regional enteritis, and *Crohn disease.* Elevated levels of urine and serum lysozyme occur during severe renal insufficiency, renal transplant rejection, urinary tract infections, pyelonephritis, glomerulonephritis, and nephrosis.


----------



## jac521

Sorry - I messed up.
jac521


----------



## PollyH

PollyH said:


> Sugar and salt help you absorb your water. You don't have to add in a lot of sugar to get the benefits. For instance, Gatorade isn't that sweet, and yet it is specifically used for hydration.  However, be careful with which flavor of Gatorade that you use. Some of the Gatorade products contain bromated vegetable oil. There is enough bromine in those drinks to cause illness in people who use a lot of it. (The bromated vegetable oil is used to make the lemony flavor more uniform.)


I heard on the news last night that Gatorade removed the bromated vegetable oil from its drinks. However, it may still be present in other drinks. You will have to read labels.


----------



## Spooky1

our equivalent, lucozade, has sunset yellow in and comes with a health warning of hyperactivity on the label.  i would drink it otherwise, but i'm like a child having eaten all the wrong things at a birthday party.


----------



## aloe

Thanks for all this info. The theory that it's inflammatory and not auto-immune makes sense to me. I wonder about the acid causing burns though because I have stricturing in a small section of my ileum. The section was removed, and now 20 years later it started to stricture again in the same area. If it was an acid burn, why would it only be happening in that one section, and why would it grow back?

In another thread I mentioned some info about chewing more, and in that blog post (on the Megan's Mind blog) she explains that unchewed food causes your stomach to produce more acids to try and break down the food. She believes that acid production which is unnecessary if you chew enough might be causing Crohn's. I have been accused of eating fast and not chewing enough, so that seemed like a possibility for me.

If the theory about carbs and sugars is true, why do only certain people get Crohn's? I've always had a pretty normal/healthy diet, and barely any cavities. I am on the low-residue diet now too, but if I chew enough, fresh vegetables don't cause me problems, so I'm having trouble convincing myself that I should stay low-residue. My doctor insists it will help me avoid surgery, so I'm sticking with it. I do crave sugar like crazy, and I don't notice problems when I eat a small amount of sweets.

I tried the SCD diet and after 3 days of intense diarrhea, had to go back to my normal diet. Plain chicken, small amounts of rice, and steamed vegetables mainly are my staple, and if I stick with that mostly, I don't get diarrhea often. Since I'm dealing with a fistula, it seems a high priority to avoid diarrhea which I believe causes fistulas and makes them worse.


----------



## PollyH

Spooky1 said:


> our equivalent, lucozade, has sunset yellow in and comes with a health warning of hyperactivity on the label.  i would drink it otherwise, but i'm like a child having eaten all the wrong things at a birthday party.


Yes, all the artificial colors can aggravate hyperactivity. Some people find relief from the hyperactivity by following the Feingold diet.  It lowers the amount of phenols and salicylates in the diet. (Things like artificial colorings are removed from the diet.)  The need for this diet may have to do with a weak PST enzyme in the liver. Food colorings (they contain phenolics) and salicylates inhibit this enzyme. 

Sulfates and thyroid can help support the PST enzyme. Active B6, P5P, is necessary for the activity of this enzyme, but too much P5P (pyridoxal-5-phosphate) will inhibit this enzyme. Of course mercury messes up this enzyme. Glycine and an alkaline urine pH will help the body remove salicylates through the urine. 

If you take the Feingold diet to the extreme, you get Sarah's diet. With Sarah's diet, you avoid even all the natural colors found in food. Note that some people have trouble with certain colors but not others. It is more likely that green will be tolerated among those with autism.


----------



## SugarberryGA

I have three questions:

Is Dave a physician or a scientist?

Like Sarah50, why do I feel better when I eat refined carbs and sugars, but feel worse when I eat things that are supposed to be good for me?  When I was the sickest years ago, the only thing that wouldn't come out the other end and actually made me feel better, were vanilla milkshakes from McDonald's.  Go figure.

If Crohn's disease is not an autoimmune disorder, then why does Remicade work so well?


----------



## Dave Watson

A1. Amateur scientist, with various post-grad qualifications. 

A2. Opinions are interesting, but when trying to solve complex problems - like Crohn's - it's better to work with established data. For example, there are over 12 studies that confirm carb links to Crohn's, multiple studies and several decades of anecdotal evidence support that carb restriction can help CD.

A3. Suggesting that CD is an autoimmune disease because Remicade may help does not make sense. There is NO evidence that CD is an autoimmune disease. Read this paper about the mis-labelling of CD as an autoimmune disease: http://211.144.68.84:9998/91keshi/Public/File/36/376-9736/pdf/1-s2.0-S0140673610602826-main.pdf

Also, what if certain bacteria invaded the immune cells of CD sufferers and these immune cells "spewed out" TNF, and Remicade simply caused the infected immune cells to die and thus improved the disease and perhaps induced remission, does that mean CD is an autoimmune disease?




SugarberryGA said:


> I have three questions:
> 
> Is Dave a physician or a scientist?
> 
> Like Sarah50, why do I feel better when I eat refined carbs and sugars, but feel worse when I eat things that are supposed to be good for me?  When I was the sickest years ago, the only thing that wouldn't come out the other end and actually made me feel better, were vanilla milkshakes from McDonald's.  Go figure.
> 
> If Crohn's disease is not an autoimmune disorder, then why does Remicade work so well?


----------



## Hope345

Dave,

Keep studying, posting and engaging in our forum.  Maybe you will be the one to cure Crohns.    I am still stuck thinking it starts with the enzymes in the mouth, maybe the lack there of to digest the sugars and foods we eat.  

Cant wait until your next post.

do you think that Amylase or the other enzymes could play a role in Crohns?


----------



## SugarberryGA

Dave, I do appreciate the research you've done and the time it has taken you to compile everything.  I'm open to new ways of looking at Crohn's; however, my gastroenterologist is one of the most well-respected in the country and he's convinced the CD is an autoimmune disease.  Honestly, I do hope you're on to something and that a cure can be found.  What do you know about the genetic link?  Just curious.  Thanks.


----------



## Dave Watson

SugarberryGA, I understand your respect for your GI, but ask him for proof that CD is an autoimmune disease; there is none, in fact, the only available evidence suggests the exact opposite! 

As for the genetic element of CD, multiple studies have confirmed Crohn's sufferers have a WEAK immune response, see below.

In Crohn’s disease, a constitutionally weak immune response predisposes to accumulation of intestinal contents that breach the mucosal barrier of the bowel wall.
    Source: http://www.thelancet.com/journals/la...265-2/abstract

    The cause of Crohn’s disease (CD) remains poorly understood. Counterintuitively, these patients possess an impaired acute inflammatory response, which could result in delayed clearance of bacteria penetrating the lining.
    Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737162/

    recent molecular biological and clinical investigations indicate that CD is actually a primary immunodeficiency. 9
    Source: http://www.ncbi.nlm.nih.gov/pubmed/20594132​
Now, if CD is not an autoimmune disease and there no sign of an aggressive immune response in the guts of Crohn's sufferers, what the hell is causing the the inflammation and ulcers?

Great post here by David: http://www.crohnsforum.com/showthread.php?p=589382 about SSI.

Now read this study about granulocyte-macrophage colony-stimulating factor for CD: http://www.ncbi.nlm.nih.gov/pubmed/12433518 

There's a connection! It's proven bacteria are penetrating the gut lining in Crohn's. Normally, immune cells protect the gut lining but excess TNF can affect there normal behaviour (is that why TNF blockers work?). What if SSI and GMCSF are simply recruiting immune cells to the inflamed tissues where they remove bacteria from the gut lining contributing to the inflammation as well as dead cells?

In Dr Olendzki's study with a low-carb diet, all CD sufferers improved and virtually all were off TNF blockers. 

What could link SSI, GMCSF, TNF blockers and Dr Olendzki's study? Bacteria?

Consider what Dr Olendzki stated: "These carbohydrates are thought to provide a substrate for pro-inflammatory bacteria. "

If we want to get to the bottom of Crohn's, let's find out what certain bacteria are doing with sugars/starches that could cause inflammation and ulcers?









SugarberryGA said:


> Dave, I do appreciate the research you've done and the time it has taken you to compile everything.  I'm open to new ways of looking at Crohn's; however, my gastroenterologist is one of the most well-respected in the country and he's convinced the CD is an autoimmune disease.  Honestly, I do hope you're on to something and that a cure can be found.  What do you know about the genetic link?  Just curious.  Thanks.


----------



## SugarberryGA

Why do my symptoms improve when eating a low residue diet, but return when I eat foods that are "healthful?"  Oh well, I'm not sure any of us will ever know what causes CD.  I do know people who have gone into full-blown remission for the first time in their lives after starting Remicade infusions, so I can't help but think it works.  Thanks again for everything.  You've given me a lot to think about.


----------



## Dave Watson

Here's the story of woman who used tree bark to "cure" her Crohn's: http://www.dailymail.co.uk/health/a...s-disease-says-grandmother.html#axzz2K8VNQ181

What could certain tree bark and Remicade have in common?

(If you dig deep enough, you'll find the connection.)


----------



## Dave Watson

This study shows that cannabis can potentially improve Crohn's: http://www.ncbi.nlm.nih.gov/pubmed/21910367

Video of Shona who used hemp oil to induce remission where drugs failed:

http://www.youtube.com/watch?v=x_otUB7pVMA

What's the connection: hemp oil, tree bark, low carb diet, SSI, TNF blockers, etc?


----------



## SugarberryGA

Oh my.  Well, I'm certainly not going to eat tree bark nor use an illegal substance to treat my CD.  I'll just stick with the Pentasa and Entocort.  Thanks though for sharing the links..


----------



## David

SugarberryGA said:


> Oh my.  Well, I'm certainly not going to eat tree bark nor use an illegal substance to treat my CD.  I'll just stick with the Pentasa and Entocort.  Thanks though for sharing the links..


You may want to ask your GI what he thinks about this Cochrane review that suggests that mesalamine (the active ingredient in Pentasa) is no better than placebo.

Conversely, there are a variety of studies showcasing the efficacy of medical marijuana and the science behind medical marijuana is pretty darn good.


----------



## burton1064

Dave, where can I find the next article in this series?  ~Scott


----------



## JennyT

This is an interesting hypothesis and I have no problems with it - in fact I may have something that will help. Try something so simple its ridiculous ......  1 teaspoon of pure baking soda disolved in a glass of water and drink it every day. (Salty!) It turns all that acid to alkaline. Google/youtube it - there is very interesting scientific info out there. I personally can vouch for unexpected and unprecedented results in a heart attack survivor who had an extremely poor quality of life and much pain - all turned around 180degrees now. Just a thought, so simple it cant hurt!


----------



## PollyH

JennyT said:


> 1 teaspoon of pure baking soda dissolved in a glass of water and drink it every day. (Salty!)


Baking soda is sodium bicarbonate. There are also other bicarbonates that you might want to employ with it, depending on your needs, to obtain something more balanced. There is a product called Tri-salts from Ecological Formulas which contains calcium carbonate, magnesium carbonate and potassium bicarbonate. (Notice there is no sodium in that particular product.) There is also a tri-salt product from Biotech that contains calcium carbonate, sodium bicarbonate and potassium bicarbonate. Then there is Alka-Seltzer Gold that contains anhydrous citric acid, potassium bicarbonate and sodium bicarbonate. (There are other Alka-Selzer products that contain aspirin or aspartame. So be careful to get the Gold form.)  

Unless your kidneys have trouble removing salt, salt in the diet is very good for you. Without enough salt, changes occur in the body that are bad for the heart -- even for your immediate life function if you have weak adrenals. (My Aunt in-law died from a lack of salt.)


----------



## JennyT

Thanks Polly, that is really interesting. The research I did for my friend didn't mention other bicarbonate alternatives so I never considered them. It was originally looking for help for a cancer patient that led me there - it is purported to be very effective so thats worth researching if you are curious about cancer cures - but another friend just stated taking it because it touched on other benefits and honestly - both myself and his Dr are blown away by the results. (The Doc said "I didnt prescribe that!!  LOL  Like he would prescribe a common leavening agent dirt cheap at the supermarket)


----------



## PollyH

Not enough salt is very stressful for the body. For instance, without enough salt, you have trouble retaining your magnesium. 

Carbonates are very good for you. Carbon dioxide actually helps your red blood cells release oxygen to the cells. That is why the slow breathing techniques are so helpful. With slow breathing, your body isn't getting rid of carbon dioxide quite so quickly. When your cells are healthy, they are producing more carbon dioxide. Thyroid helps your cells produce more carbon dioxide. That is one reason it can be so helpful. Cancer cells produce lactic acid, which interferes with the carbon dioxide.


----------



## PollyH

Benefits of Salt

The following few paragraphs on salt are an excerpt from a little booklet I wrote about fibromyalgia. However, the principles apply to almost any disease. 

A reasonable amount of salt in the diet may be helpful in the treatment of fibromyalgia. I’ve chosen a few bits of information from one of Raymond Peat’s newsletters on the benefits of salt and have shown here how it relates to fibromyalgia. [111]

1.	Energy. Salt helps remove excess calcium from cells. This improves the cells’ ability to produce energy. Salt also helps produce ATP, the energy molecule.

2.	Osteoporosis. Salt is a good buffering agent. This spares calcium. Without salt, more calcium may be taken from bones to buffer the acids in the blood.

3.	Sleep. Sleep is often a problem in fibromyalgia. Salt taken at bedtime can reduce adrenaline levels and thus help a person get to sleep.

4.	Magnesium. Magnesium is often deficient in fibromyalgia. Adequate sodium prevents urinary magnesium loss.

5.	Hypothyroidism. Many fibromyalgia patients are hypothyroid. Hypothyroidism makes it difficult to retain salt.

6.	Serotonin Release. When sodium is restricted, there is a sharp increase in serotonin secretion.

Many people avoid table salt in their diet because they think it will lower their blood pressure. This is a questionable practice. A recent study showed that changing from a high salt diet to a low salt diet lowers the average systolic pressure by 6.7mm. [111] That is a rather extreme change in dietary salt for so little improvement. Another study showed that salt restriction lowered mean arterial pressure only in untreated hypothyroid patients, not in hyperthyroid or control patients. [112] In other words, if a person finds that salt restriction lowers their blood pressure, then perhaps the real problem is that they are hypothyroid.  

Restricting salt is not going to prevent heart disease. Michael H. Alderman of the Albert Einstein College of Medicine in New York points out that previous studies show that salt restriction can trigger changes in insulin, nerve activity, and other factors that may lead to the vascular damage that underlies heart attacks. [111] However, if you already have a heart condition, and are restricting your salt intake, please be careful. When a person first starts increasing salt intake, it increases water retention and this make things harder on the heart. Time is needed for the body to adjust to any change in salt intake. Also, if one has poor kidney function, any increase in salt must be done carefully. If you have insulin resistance, your body may have been able to compensate by producing more insulin. High insulin levels increase salt retention. [113] 

111.	Peat, Raymond, PhD, “Recharging the System” Ray Peat’s Newsletter, 1998 and Peat R, “Tryptophan, serotonin, and aging” Ray Peat’s Newsletter, 2002

112.	J. Raloff, “Salt trial provokes DASH of skepticism,” Science News, volume 157, May 27, 2000

113.	Marcisz, C. Am J Hypertens 2001;14:995-1002 as referenced in this article http://diabetes.medscape.com/44892.rhtml?srcmp=endo-110901


----------



## Sarah50

David said:


> You may want to ask your GI what he thinks about this Cochrane review that suggests that mesalamine (the active ingredient in Pentasa) is no better than placebo.
> 
> Conversely, there are a variety of studies showcasing the efficacy of medical marijuana and the science behind medical marijuana is pretty darn good.


Interesting about "mesalamine" .... but the fact remains that ALL of my Crohn's symptoms - very bad stomach aches daily, vomiting, night sweats (nightly), loss of appetite, extreme weight loss, fatigue, achy joints, etc .... ALL disappeared after being on Asacol (mesalamine) AND a low residue diet (full of carbs and junk food - well, that's on my part... LOL) ......... after about  6 weeks... now going on 4 months of remission.  

"Splain that one, Lucy!    I don't get it either (especially the 'junk food')!!!

Edited to add that before Crohn's symptoms... I ate very healthy (for the most part) - high fiber bread and cereal, tons of raw veggies/salads, mostly chicken and turkey protein - and low carbs! :eek2:


----------



## David

Hi Sarah,

I see that you have a stricture.  I assume you have disease in your small intestine?


----------



## David

Polly, I wasn't aware of sodium helping retain magnesium.  That doesn't actually make sense to me actually considering salt is used to remove magnesium from water (hard water treatment systems).  But I'm definitely open to it!  Do you by chance have a source that showcases that?

Thank you


----------



## Sarah50

David said:


> Hi Sarah,
> 
> I see that you have a stricture.  I assume you have disease in your small intestine?


Hi David,

Yes, I have crohn's disease in my small intestine - doctor said it was at the terminal ileum and a moderate long stricture in small intestine.


----------



## David

Hi Sarah,

The problem is, Asacol is coated with an acrylic based resin that is designed to BEGIN dissolving at pH 7 or higher.  For most people that means in the terminal ileum though intestinal pH varies from person to person.  What that means is that it is very likely waving to your stricture as it passes by in tact and is delivering medication to your colon like it was designed to.  And even if it is getting some medication to your inflammation, mesalamine is topical in nature whereas Crohn's disease is transmural (affects every layer of the intestine).  So the top layer of your intestine may be doing a little better but serious damage is being done deeper down.

Now, maybe Asacol is perfect for you.  Everyone is different.  But I'm extremely concerned that we're going to see you back here in one month or one year with complications from what was actually active inflammation (despite reduced symptoms) causing additional damage to your bowel.  

Hopefully I'm wrong though.


----------



## Sarah50

David said:


> Hi Sarah,
> 
> The problem is, Asacol is coated with an acrylic based resin that is designed to BEGIN dissolving at pH 7 or higher.  For most people that means in the terminal ileum though intestinal pH varies from person to person.  What that means is that it is very likely waving to your stricture as it passes by in tact and is delivering medication to your colon like it was designed to.  And even if it is getting some medication to your inflammation, mesalamine is topical in nature whereas Crohn's disease is transmural (affects every layer of the intestine).  So the top layer of your intestine may be doing a little better but serious damage is being done deeper down.
> 
> Now, maybe Asacol is perfect for you.  Everyone is different.  But I'm extremely concerned that we're going to see you back here in one month or one year with complications from what was actually active inflammation (despite reduced symptoms) causing additional damage to your bowel.
> 
> Hopefully I'm wrong though.



David, when I googled Asacol and Crohn's, this is what I found:

TARGETED RELEASE
One benefit of Asacol is that this formulation of mesalamine is designed to be released specifically in the ileum, the part of the small intestine most commonly affected in Crohn's disease, the Johns Hopkins University Department of Gastroenterology and Hepatology reports. Because Asacol and other mesalamine-containing drugs act at the specific location where they are released, it is crucial that the drugs are released in the correct part of the digestive tract.

Anti-Inflammatory Effect
The primary beneficial effect of Asacol is to reduce inflammation of the digestive tract, explains the Johns Hopkins University Department of Gastroenterology and Hepatology. Asacol also reduces the production of free radicals, highly reactive chemicals that can damage tissue in the digestive tract. Overactive cells of the immune response are also reduced by Asacol, including lymphocytes, plasma cells and monocytes. For patients whose Crohn's disease is primarily affecting the ileum region of the small intestine, Asacol is effective in reducing symptoms and inducing remission, reports an article published in the August 2003 issue of American Family Physician.


Read more: http://www.livestrong.com/article/22...#ixzz2MUzEMs2t

But please tell me, what medication is suppose to work with the crohn's that I have in the area that I have???   I know you have seen and heard a lot, having this forum, so please tell me what you know.  

Thanks, I appreciate it!


----------



## David

Never use Livestrong as a source.  

From the Asacol prescribing information: 


> Each Asacol ® delayed-release tablet for oral administration contains 400 mg of mesalamine, an anti-inflammatory drug. The Asacol delayed-release tablets are coated with acrylic based resin, Eudragit S (methacrylic acid copolymer B, NF), which dissolves at pH 7 or greater, releasing mesalamine in the terminal ileum and beyond for topical anti-inflammatory action in the colon.


As for your other question, I'll elaborate in the morning.  I'm off to bed.

*hugs*


----------



## PollyH

David said:


> Polly, I wasn't aware of sodium helping retain magnesium.  That doesn't actually make sense to me actually considering salt is used to remove magnesium from water (hard water treatment systems).  But I'm definitely open to it!  Do you by chance have a source that showcases that?
> 
> Thank you


Here is an article about a lack of sodium in cattle. When the cattle are grazing on high nitrogen food, and if they are low in sodium, then they become deficient in magnesium and calcium, even though there is adequate magnesium and calcium in the food. From this, it looks like you need the sodium for the retention of both magnesium and calcium.

http://www.hinsleyracingstable.com/articles/Grass_Tetany_Syndrone.pdf


----------



## JennyT

That is really interesting Polly - my question is based on the fact that cow gut and human gut works really differently and we have hugely different diets. (Altho Ive heard some peeps eat grass LOL) Can cattle health findings relate to human health? Id be keen to see results in human studies as I find the subject quite interesting.  Jen


----------



## David

As Jenny states, due to the enormous difference in the digestive system of humans and ungulates, I don't feel we can reliably conclude the same holds true for humans based upon that paper.  I'm certainly open to the idea, but that doesn't sell me on it


----------



## David

Sarah50 said:


> But please tell me, what medication is suppose to work with the crohn's that I have in the area that I have???   I know you have seen and heard a lot, having this forum, so please tell me what you know.


I'm sorry I didn't get to this last night but I was exhausted and needed to get to bed.

If you wanted to stick with just mesalamine (the idea of that makes me cringe) then Pentasa would be a MUCH better formulation than Asacol.  Now, I'm all for people with Crohn's disease taking a formulation of mesalamine IN CONJUNCTION with other treatments.  But when I read that's all they're on, it concerns me a great deal.  If you switched to Pentasa and that's it, I'd be worried, especially since you have stricturing disease.  Conventional medications that are commonly used that have much better data supporting their efficacy in Crohn's disease than just mesalamine:

- Azathioprine
- 6-MP
- Remicade
- Humira
- Cimzia

Non conventional that I'm excited about via small studies and anecdotes on the forum:

- Low Dose Naltrexone

All heavy hitters, I realize.  But Crohn's needs to be hit hard, especially since your disease is already stricturing.  Heck, I'm a fan of throwing the kitchen sink.  In my opinion, you want to hit it from every angle.  For example:

- Western Medicine - Something more than just Asacol.
- Dietary changes - Improve your n3-n6 fatty acid ratio, Enteral/elemental nutrition, [wiki]paleo diet[/wiki], or [wiki]specific carbohydrate diet[/wiki].  Juicing is also growing on me a lot and we now have a juicing subforum located here.
- Hydration - Dehydration and loss of electrolytes is common.  Proper hydration and adding electrolytes back in can help you a lot.
- Alternative treatments - I'm a big fan of Low Dose Naltrexone.  Two studies in adults and one in children have had great results (see the stuck thread when following that link) and there are very few side effects.  It's also not very expensive.  Medical marijuana has been shown to help a lot as well if that's something you're comfortable with and is legally available in your area.
- Stress reduction.  Do whatever it takes to reduce your stress levels.  In addition, a weekly or even monthly massage if funds are tight is great.  Studies have actually shown that massage can reduce inflammation.  Give yourself self-massages as often as possible in between the professional ones.
- Exercise if you're able - a gentle yoga is a good one 
- Vitamins and minerals - find out which you're deficient in and properly supplement.  People with Crohn's disease are commonly deficient in vitamin B12, vitamin D, and magnesium as well as a host of others.  But those three first ones should definitely be checked.  Do not blindly supplement vitamin D and B12, treat these as medications and get your levels tested first.  Although the blood test for magnesium is pretty useless and I strongly suggest you eat foods high in magnesium or discuss supplementation of it with your doctor.
- Supplements - there are a variety that help improve overall health.  Check our our diet/fitness/supplements forum for ideas.  I'm personally a big fan of tumeric (curcumin) and strongly suggest utilizing it if your doctor is ok with it.
- Alternative medicine - This could be stuff like acupuncture, including a naturopath in your treatment team, etc.

Bring your doctor in on the conversation for all of this.  Get their input and let them help supervise your disease state.  Some doctors might need a little push on some of this stuff, but we can provide studies that showcase the efficacy of all the above.  I hope this helps a little.  I know it's frustrating to be told that the medication that seems to be working for you probably isn't the best choice and I'm sorry for that


----------



## Sarah50

David said:


> I'm sorry I didn't get to this last night but I was exhausted and needed to get to bed.
> 
> If you wanted to stick with just mesalamine (the idea of that makes me cringe) then Pentasa would be a MUCH better formulation than Asacol.  Now, I'm all for people with Crohn's disease taking a formulation of mesalamine IN CONJUNCTION with other treatments.  But when I read that's all they're on, it concerns me a great deal.  If you switched to Pentasa and that's it, I'd be worried, especially since you have stricturing disease.  Conventional medications that are commonly used that have much better data supporting their efficacy in Crohn's disease than just mesalamine:
> 
> - Azathioprine
> - 6-MP
> - Remicade
> - Humira
> - Cimzia


David, I really appreciate the time you took to answer my question!!!  Thank you!  The problem for me is I have HMO insurance.  Switching meds *might* be a problem with my doctor.  For example, when I saw him for my follow-up appointment, and all of my symptoms were gone after being on Asacol and a low res diet, I asked him how do we know I'm in remission and the inflammation is gone.  He said, you have no symptoms.  I asked if I could get a blood test to confirm the inflammation it gone.  He said, no not without any clinical symptoms.  I thought... oh, I have to be sick to get the damn blood test!!  He's a bit arrogant too so I don't know how to approach him about changing the meds but I possibly could change gastro doctors.  

I'll research those drugs but I will say I was told I have 'mild crohn's' ... don't know if that's true but I'm very leary of those heavy hitting drugs that could have drastic side effects... unless I really need it.  But I'll look at the others you listed because I hear what you're saying - the Asacol dissolves at the terminal ileum so then how is the inflammation/stricture getting treatment?  I don't know where the stricturing is exactly.

I love all of the other alternative therapies and will look into those as well.  Thanks again, I really appreciate your info and knowledge.


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## crohnicaly stinky

anecdotal but none the less.  Prior to my diagnosis I would get flare up every spring and fall when the pollen seasons were in full swing.  The one year I didn't was the year I went on the glycemic load diet,  strictly for losing weight.  I basically cut carbs to a bare minimum.  No rice, no chips, no potatoes, no refined sugars.  I would have them in small portions with other food, i.e. you could have a bite sized chocolate at the end of a meal, according to the diet, since the contents of yoru stomach slowed the sugar absorption and so you didn't spike your blood sugar.

Well it was fabulous for weight loss and not only that, it was the only year I didn't have a flare up.


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## JennyT

Hi David - OH MY GOSH YOU MENTIONED PALEO DIET. With no help I found a diet by myself just using trial and error and a friend I was talking to said "Thats a Paleo Diet" and I looked it up and pretty much I was eating (when I could then) exactly that. Trouble is, and it has been soooo frustrating, no-one in my household agrees with me that this is either healthy or safe with Crohns and I have been called all kinds of stupid and when I flare "Its that food you are eating'  <sob>  SO is it true - other Crohnies find Paleo relieves the pain and allows you to eat a wider variety without doubling over?  Jen


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## David

Jenny, click here to meet your new friends.


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## PollyH

I did some searching, and I couldn’t find any human studies showing that low sodium might induce low magnesium or low calcium. However, you might want to look at the problem this way. The predominant cations in the body are the positively charged electrolytes of sodium, potassium, calcium, and magnesium. (These also happen to be the same minerals people say will help alkalinize the saliva and urine.)   If one of these minerals is deficient, the body may be able to use one of the others instead. That could cause a deficiency of the other mineral. That is essentially what the article on cattle and tetany is saying. If the body doesn’t have enough sodium to deal with the protein / nitrates, then it will substitute magnesium and calcium and cause a deficiency of those minerals. Those cations will be excreted with the nitrate anions. (Anions are negatively charged. Cations are positively charged.) 

 If they are right, then it seems reasonable that the general principle would apply to all animals, not just cattle. A high protein diet with not enough salt would deplete calcium and magnesium. (I found an article that said dogs on a high protein diet required more salt. However, the article didn’t mention calcium and magnesium.)  I think the following paragraph from the cattle article is the best summary of their hypothesis. 

“Since cations utilized to eliminate the excessive nitrate from the body have different solubilities and affinities for nitrate, the body will utilize the cations, if available in adequate concentrations, that have the highest affinity for nitrate. Magnesium, calcium and then sodium are the most soluble and potassium the least soluble [13], and likely the affinity of each cation for nitrate is similar to their solubility with nitrate. It is hypothesized that if there is a deficiency of sodium, and most forages and rations are deficient in sodium and excessive in potassium, and when there is a spike in nitrate, or excessive nitrate in the body, anionic nitrate is eliminated from the body as an ionic complex associated with magnesium and calcium. If nitrate is excessive, a hypomagnesia and/or hypocalcaemia may develop as the body is eliminating magnesium and calcium with the excessive anionic nitrate. However, if there is adequate sodium in the diet and organs and tissues, the excessive anionic nitrate is removed by the gut, kidneys, and mammary glands in lactating animals, as a ionic complex associated with sodium; and magnesium and calcium are maintained at physiologic levels and hypomagnesia and/or hypocalcaemia will not occur. For this reason adequate levels of sodium in the body and ration will lessen or prevent the drastic effects of nitrate toxicity. Also, it explains why adequate sodium in the diet will aid in the prevention of grass tetany, which is associated with high potassium and low magnesium levels. It also explains why the grass tetany syndrome cannot be readily induced experimentally unless cattle are exposed to high nitrogen or nitrate forages, and likely low sodium diets.”


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## Sarah50

David said:


> I'm sorry I didn't get to this last night but I was exhausted and needed to get to bed.
> 
> If you wanted to stick with just mesalamine (the idea of that makes me cringe) then Pentasa would be a MUCH better formulation than Asacol.  Now, I'm all for people with Crohn's disease taking a formulation of mesalamine IN CONJUNCTION with other treatments.  But when I read that's all they're on, it concerns me a great deal.  If you switched to Pentasa and that's it, I'd be worried, especially since you have stricturing disease.  Conventional medications that are commonly used that have much better data supporting their efficacy in Crohn's disease than just mesalamine:
> 
> - Azathioprine
> - 6-MP
> - Remicade
> - Humira
> - Cimzia


David, I'm going to get a blood test at the end of this month from my regular doctor who said she'll also have my vitamin levels checked along with Iron since I was low in that.  

Since my gastro doctor wouldn't check to see if the inflammation was gone - my regular doctor will check it.  I have a couple of questions for you, David.  

1.  Are there any specific blood tests I should ask to have done for inflammation, to see if it's gone?

2.  If the inflammation is gone - white blood cells and whatever is checked... is "normal" .... then would you still be telling me to change medication?  

I guess what bugs me about what you said is the fact that ALL of my horrible Crohn's symptoms are gone after being on Asacol and a low res diet ... going on 3 months.  I found a study from John Hopkins that says Asacol does stop inflammation cells.  

I guess my question is, do people with Crohn's have all of their symptoms go away but their not really in remission?  I know your concern is that the stricturing is not being treated but if I was still having problems with it, wouldn't I still be having abdominal pain and vomiting and night sweats, all which would indicate problems with stricturing/inflammation???  I just don't understand this point or how you know you're in remission when all of your symptoms are gone.  :ybatty:

Thanks for any info ... I'm still learning about this disease.


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## Sarah50

David, this is what I found on WebMD about Crohn's, the goal of treatment and medications prescribed.

How is Crohn's disease treated?

There is no cure for Crohn's disease. The goals for treatment are:

to reduce inflammation
to relieve symptoms of pain, diarrhea, and bleeding
to eliminate nutritional deficiencies
Treatment might involve drugs, nutritional supplements, surgery, or a combination of these therapies. Treatment choices depend upon where the disease is located and how severe it is. They also depend on the complications associated with the disease and the way the person has responded in the past to treatment when symptoms reoccurred.

What kinds of drugs are used to treat Crohn's disease?

There are several types of drugs used to treat Crohn's disease. The first step usually involves reducing inflammation. Many people are first treated with sulfasalazine (Azulfidine). This drug is the most common of those that contain mesalamine. Mesalamine is also known as 5-aminosalicylic acid, or 5-ASA

If a person does not respond to sulfasalazine, the doctor may prescribe other types of drugs that contain 5-ASA. These other products include:

olsalazine (Dipentum)
balsalazide (Colazide, Colazal)
mesalamine *(Asacol*, Lialda, Pentasa, and others)

Crohn's disease may also be treated with drugs that stop the immune system from causing inflammation. Immunomodulators change the way the immune system behaves. Immunosuppressants decrease the activity of the immune system. Immunostimulators increase the activity. Immunosuppressants prescribed for Crohn's disease include:

azathioprine (Imuran, Azasan)
6-mercaptopurine (6MP, Purinethol)
tacrolimus (Prograf)
Methotrexate (MTX, Rheumatrex, Mexate)
Side effects of immunosuppressants may include:

diarrhea
higher susceptibility to infection
nausea
vomiting

A biologic drug, infliximab (Remicade), is often prescribed *when a person with Crohn's disease does not respond to the standard treatments of mesalamine-containing drugs*, corticosteroids, and immunosuppressants.


So.... I don't know what to think based on what you believe about Asacol and what I find on various crohn's websites.  I'm confused why you think it doesn't work when all of my symptoms are gone???   It seems, according to WebMD, that the goal has been met and as long as my blood test shows inflammation gone in my body... why would you assume it's not working?  

Again, thanks for any info you're aware of, preferably with links since we all need to see the research that you've seen to understand the science behind what you're saying.  I'm sure I'm not the only person that's been prescribed Asacol for Crohn's disease (in the termial ileum).  Thanks!  


Edited to add, I remember my gastro doctor talking about one of these -  sulfasalazine (Azulfidine)  - asked if I was allergic to sulfa? and said that this medication often causes side effects in patients so I guess that as well as where my crohn's is, decided to prescribe Asacol, which has no side effects for me.


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## David

Please take a few minutes to read our wiki entry on remission.  It may help you understand where I'm coming from a little.  

Blood tests can be a signpost but are not an absolute indicator of inflammation.  They are much more useful if you've been getting them regularly to determine trend.  CRP, ESR, CBC can all help give us an idea of what's going on.  They may be normal (biochemical remission) and yet you may not be in the remission you should be in.

Could you post the study you found from John Hopkins?

I suspect a lot of your symptoms are gone because of the low residue diet.

But hey, maybe Asacol is your miracle drug for some reason and your disease is responding incredibly well to it.  I'm simply going by the numbers from studies and papers I read and innumerable stories I have read here where being just on mesalamine ended poorly.  I pray that I'm not coming across as a jerk with all of this.  I sincerely want you to have the best treatment and outcome as possible, thus my responses.

While WebMD is a step up from Livestrong, they still suck and the information they provide on Crohn's disease is terrible and misleads a lot of people.  I could tear that article to shreds but for the sake of brevity, I'll just do the first line.

"To reduce inflammation"

No.  The goal is to completely eliminate inflammation and promote full mucosal healing so the patient is in deep, stable remission. 

Nothing less is acceptable.  You may feel better in the short term with reduced inflammation, but Crohn's disease is a lifelong disease at present and even low levels of chronic inflammation will likely catch up with you sooner or later which is unacceptable.


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## Sarah50

David said:


> Please take a few minutes to read our wiki entry on remission.  It may help you understand where I'm coming from a little.
> 
> Blood tests can be a signpost but are not an absolute indicator of inflammation.  They are much more useful if you've been getting them regularly to determine trend.  CRP, ESR, CBC can all help give us an idea of what's going on.  They may be normal (biochemical remission) and yet you may not be in the remission you should be in.
> 
> Could you post the study you found from John Hopkins?
> 
> I suspect a lot of your symptoms are gone because of the low residue diet.
> 
> But hey, maybe Asacol is your miracle drug for some reason and your disease is responding incredibly well to it.  I'm simply going by the numbers from studies and papers I read and innumerable stories I have read here where being just on mesalamine ended poorly.  I pray that I'm not coming across as a jerk with all of this.  I sincerely want you to have the best treatment and outcome as possible, thus my responses.
> 
> While WebMD is a step up from Livestrong, they still suck and the information they provide on Crohn's disease is terrible and misleads a lot of people.  I could tear that article to shreds but for the sake of brevity, I'll just do the first line.
> 
> "To reduce inflammation"
> 
> No.  The goal is to completely eliminate inflammation and promote full mucosal healing so the patient is in deep, stable remission.
> 
> Nothing less is acceptable.  You may feel better in the short term with reduced inflammation, but Crohn's disease is a lifelong disease at present and even low levels of chronic inflammation will likely catch up with you sooner or later which is unacceptable.



First I want to say that in no way do you sound like you're coming across as a jerk!!!  I have seen enough of your posts to know your genuine concern and wanting to help.  So I don't take it in any 'bad' way whatsoever!!!  I truly appreciate the knowledge you've gleaned over this disease and sharing it with us.  I'm the type that likes to get to the facts and appreciates studies/links too, to back up what you state.  I am obviously new to Crohn's so I'm at the stage of weeding through fact vs fiction... and my posting links I find about Asacol doesn't mean I think it's the be all to end all.... but what else do I have to go on?  And the fact that I *seem* to be in remission, or at least all of my horrible Crohn's symptoms are gone.

So here's what I found about Asacol and crohn's - from my notes from my gastro doctor, I have crohns "ileitis" and said my crohns was "mild".  I found  the following describing where Ileitis is located: Patients with ileitis, Crohn's disease at the bottom three fifths of the small intestine" - this is where the article below states that Asacol works specifically in this area.  Maybe this is where my stricture is located... I'm not sure but it's definitely in the small intestines area.


The article below is from the American Academy of Family Physicians - 2003 ... I'd rather find something more recent about crohn's and Asacol but haven't come across anything yet.... what I want to know is if YOU know it doesn't work ... why don't gastro doctors not know, I'm obviously not the only person prescribed this.  ??????????????


"Mild to Moderate Disease
Mild to moderate Crohn's disease can be treated with a salicylate preparation, and in patients who are unresponsive, an antibiotic may help.  Response to therapy should be evaluated after several weeks; patients who do not respond should be treated for moderate to severe disease or with alternative therapy.

The salicylates include mesalamine (Rowasa) and sulfasalazine (Azulfidine). In its various preparations, mesalamine can be released in the stomach, duodenum, ileum, and colon (Pentasa), or *primarily in the terminal ileum and colon (Asacol).*7 *Both mesalamine preparations are generally more effective than placebo in improving disease symptoms and inducing remission in patients with active Crohn's disease; however, greater benefit is seen in patients with ileitis versus colitis or ileocolitis.*8 The dosage of oral mesalamine is 3.2 to 4 g per day.

http://www.aafp.org/afp/2003/0815/p707.html



If you don't mind David, do you have any article links that state your claim about Asacol?  It's not that I don't trust what you've read... I would like to read it for myself.  I'm sure others here that are on Asacol would like that too.  How else can I go to my doctor and say I want to try something else besides Asacol with nothing to back it up?  

Again, thank you... I appreciate your taking the time with my questions about Asacol, remission, etc.


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## Sarah50

David said:


> Please take a few minutes to read our wiki entry on remission.  It may help you understand where I'm coming from a little.
> 
> Blood tests can be a signpost but are not an absolute indicator of inflammation.  They are much more useful if you've been getting them regularly to determine trend.  CRP, ESR, CBC can all help give us an idea of what's going on.  They may be normal (biochemical remission) and yet you may not be in the remission you should be in.
> 
> 
> "To reduce inflammation"
> 
> No.  The goal is to completely eliminate inflammation and promote full mucosal healing so the patient is in deep, stable remission.
> 
> Nothing less is acceptable.  You may feel better in the short term with reduced inflammation, but Crohn's disease is a lifelong disease at present and even low levels of chronic inflammation will likely catch up with you sooner or later which is unacceptable.



I just found other notes from my doctor's office after my GI barium x-ray:

*"Moderately long segment of abnormal narrowing and mucosal irregularity of the terminal ileum is consistent with manifestations of Crohn's disease."*

Then from an "IBD Differential Panel"  that stated the results were "consistent with Crohn's disease" - both tests were from last November when he diagnosed me with Crohn's:

Saccharomyces Cerevisiae AB (ASCA) (IGG)  *109.0 U  (Flagged High) *
Reference range:  <= 20  Negative
                         20.1 - 29.9 Equivocal
* >= 30  Positive * 

Saccharomyces Cerevisiae AB  (ASCA)  (IGA)   *62.4 U  (Flagged High)*
Reference range:  <=20.0 Negative
                            20.1 - 24.9  Equivocal
* >=25.0  Positive*


So is the above blood test the same as any of those that you posted??  
"CRP, ESR, CBC" ??  Do I just ask my regular doctor for those specifically?  

Again, THANK YOU for your help, David!!


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## Sarah50

Ok, David, since you asked, I found the John Hopkins info:

"Anti-Inflammatory Drugs 
Mild to moderate Crohn’s disease has a good response to 5-aminosalicylate-containing agents. 5-aminosalicylic acid (5-ASA) derivatives (mesalamine, mesalazine and sulfasalazine) provide anti-inflammatory actions for connective tissue. Aminosalicylates can be targeted to sites along the gastrointestinal tract. *Asacol, coated with a pH-sensitive acrylic polymer, releases 5-ASA in the distal ileum and colon at pH of 7.0.* Sulfasalazine acts as the transport mechanism to carry the 5-ASA component to the colon tract. Pentasa is comprised of coated granules that release 5-ASA in the upper gastrointestinal tract, as well as the ileum and colon.

*Aminosalicylates have multiple anti-inflammatory effects that are primarily topical (mucosal), not systemic. They also inhibit oxygen radical production and are scavengers of free radicals. Sulfasalazine and 5-ASA preparations inhibit the function of lymphocytes, monocytes, and plasma cell production of immunoglobulins* (Figure 19)."
*

"Continuous-release mesalamine (5-ASA products) has been shown to induce clinical improvement or remission. These drugs have also been evaluated for use in maintenance therapy with inconsistent results.* Benefit has been demonstrated, however, with 3 g doses in reducing endoscopicendoscopic and clinical evidence of disease process in postoperative recurrence studies.."

http://www.hopkins-gi.org/GDL_Disea...sease_ID=291F2209-F8A9-4011-8094-11EC9BF3100E


Regarding the Ileum, here's what I found out:  

*The ileum is the final section of the small intestine.  In humans, the ileum is about 2–4 m long, and the pH is usually between 7 and 8 (neutral or slightly alkaline). * 

So this would seem to support the use of Asacol.  


It does state "evaluated for use in maintenance therapy with inconsistent results" so that backs up what you've read.  There is no way I want to go on the heavy duty drugs - nor is it warranted, from what I've read so far, with mild crohn's.  I'm just not sure of what to say to my doctor without proof one way or the other.  I'll need to get at least some of these tests you've recommended to see if I have any inflammation going on or not.


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## Sarah50

David, I went to the "American Gastroenteroloy Association" website, put "Crohn's disease and Asacol" into the search and found this abstract that stated:


"Oral 5-aminosalicylic acid (Asacol) in the maintenance treatment of Crohn's disease. The Italian IBD Study Group"

"It is concluded that oral 5-ASA coated with Eudragit S (Rohn Pharma GmbH, Wieterstadt, Germany), 2.4 g daily, is safe and seems superior to placebo in preventing or delaying clinical relapse in Crohn's disease, especially in milder cases and in ileal disease. (Gastroenterology 1992 Aug;103(2):363-8)"  I

http://www.gastrojournal.org/articl...efissn=0016-5085&refuid=S0016-5085(02)70129-7

I would still like to see something more recent or something that says it doesn't work.  ?????????


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## David

Hi Sarah,

You've thrown a lot my way, kudos!  I have to catch up on some other conversations but will reply when I get a chance.  I just wanted you to know I'm not ignoring you and I really respect how much you're delving into all of this.  All this knowledge and research is sure to result in you being able to better advocate for yourself which will no doubt result in a higher standard of care.  Good for you!


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## David

Hi Sarah,

I've been super strapped for time lately, I'm sorry about that.  I didn't want you to think I've been ignoring you though so let me toss a little your way.

1.  Are you aware that no form of mesalamine is approved for use in Crohn's disease?  It is only approved for use in Ulcerative Colitis.  Anytime mesalamine is used for Crohn's disease it is off-label.  There's a reason no form of mesalamine has made it through clinical trials for Crohn's disease.  Point two showcases why.

2.  This is a Cochrane review for mesalamine in Crohn's disease.  http://onlinelibrary.wiley.com/doi/...ionid=C7E8160A5E5989EB38CDC05D30095591.d02t01 -- What the Cochrane group does is they pull every study they can find, every paper they can find, pretty much every piece of information they can get on a treatment and disease and do all kinds of analysis on it.  The review the hell out of it.  In the case of Crohn's disease and mesalamine, they reviewed 19 studies.  19.  The took all the data from those studies and came up with the following conclusion:


> Olsalazine and low dose mesalamine (1 to 2 g/day) are not superior to placebo. High dose mesalamine (3 to 4.5 g/day) is not more effective than placebo for inducing response or remission. High dose mesalamine was inferior to budesonide for inducing remission in a single trial. In conclusion, sulfasalazine shows modest efficacy for the treatment of active Crohn's disease. However, the existing data show little benefit for 5-aminosalicylates.


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## David

By the way, in addition to those blood tests, I strongly suggest utilizing fecal calprotectin to help monitor inflammation.


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## shamrock15

My personal experiences with 5-ASA type meds in the late '80s and early 90s was really not beneficial - I think I tried three different types with no benefit. In most cases, they passed through me without acting. They were visible in my stool. I was one of the budesonide trial patients in Canada, and it did not work for me due to my skip lesions.


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## Sarah50

David said:


> Hi Sarah,
> 
> I've been super strapped for time lately, I'm sorry about that.  I didn't want you to think I've been ignoring you though so let me toss a little your way.
> 
> 1.  Are you aware that no form of mesalamine is approved for use in Crohn's disease?  It is only approved for use in Ulcerative Colitis.  Anytime mesalamine is used for Crohn's disease it is off-label.  There's a reason no form of mesalamine has made it through clinical trials for Crohn's disease.  Point two showcases why.
> 
> 2.  This is a Cochrane review for mesalamine in Crohn's disease.  http://onlinelibrary.wiley.com/doi/...ionid=C7E8160A5E5989EB38CDC05D30095591.d02t01 -- What the Cochrane group does is they pull every study they can find, every paper they can find, pretty much every piece of information they can get on a treatment and disease and do all kinds of analysis on it.  The review the hell out of it.  In the case of Crohn's disease and mesalamine, they reviewed 19 studies.  19.  The took all the data from those studies and came up with the following conclusion:


Thanks for getting back with me...  no problem when you do... I'm sure you're busy.   

The info you posted is interesting .... but...how do you explain all of my crohn's symptoms gone after taking Asacol for 6 weeks (along with a low residue diet)?  You had suggested that my low residue diet got rid of my symptoms in another post.  I find it very hard to believe that that diet alone got rid of all of those symptoms - how would it get rid of nightly night sweats which has to be indicitive of inflammation?  I can see the diet really helping the bad stomach aches as well as the nausea and vomiting.  But what about the achey joints, backache and loss of appetite all diminishing after taking Asacol for 6 weeks?  Again, I cannot believe that was all from the low residue diet.  But tell me, is that what you think?  

And why do you think, David, that doctors recommend Asacol for Crohn's disease?  I'm in LA and in an area with a good health group system.... the doctor was highly recommended - not saying that he could be better.... but I don't get a doctor recommending the wrong medication for a serious disease - how would he recommend it if Asacol was ony recommended for UC???  It doesn't make sense and particularly since I have no more symptoms for 3 months.  ???

And if Asacol works for UC and works - it obviously has the anti-inflammatory properties ... and according to the links I posted above, it works in the distal ileum, along with the colon.... and I was told my crohn's was in that area - the terminal ileum.

So I'm still confused about what you think and post about Asacol and crohn's.... again, especially since all of my symptoms are gone.  ????????? 

Thanks again....I appreciate any info!!


----------



## David

Hi Sarah,

Again, please read the wiki entry on [wiki]remission[/wiki] (click that) very carefully.  I'm not saying Asacol isn't helping.  While I think that the low residue diet is doing more than the Asacol, the Asacol may very well be helping.  It may very well have you in clinical remission (a reduction of symptoms).  However, Asacol is thought to be topical in its action.  Crohn's disease is transmural (affects every layer of the bowel) and as you have stricturing, your disease is definitely not affecting just the mucosal layer.  I do not believe you are in deep, stable remission in which case there is chronic inflammation slowly damaging your bowel.  This is why some people do well with mesalamine formulations for awhile but then come back six months, a year, or two years later with symptoms of stricturing: it helped the top layer of inflammation but there was deeper damage going on.

Inflammation doesn't typically cause night sweats.  My guess is you had some sort of infection going on.

I'd be curious what your diet was like prior to the low residue diet and what specific foods you're eating now?

Here is the Asacol prescribing information.  Nowhere is Crohn's disease mentioned because it is not approved for Crohn's disease.  Not one formulation of mesalamine has prescribing information that mentions Crohn's disease.

Why do I think that a doctor would prescribe just mesalamine for someone with stricturing Crohn's disease?  Because they don't know how to properly manage the disease.


----------



## Sarah50

Ok, I understand what you're saying - Asacol is "topical" treatment, not systemic.  It's just been hard to accept what you're saying when 1) many websites (Mayo Clinic, WebMD, etc, list Asacol for Crohn's treatment;  2) my doctor recommended it and/plus..... 3)  ALL of my symptoms disappeared after 6 weeks on Asacol.  So you can see why it's been hard for me to believe that it doesn't work.  But you're saying, since it's not working systemically, there's a good chance the crohn's symptoms will come back within 6 months to a year or so and be worse.  I already have stricturing.  

So this makes me want to make an appointment with my regular doctor and discuss referring me to another gastro doctor!!!  I will definitely do this when I see her at the end of this month for blood tests!!!  So thank you for the information!

Before crohn's symptoms came on last fall, I pretty much followed Weight Watchers which is high fiber food (cereal, bread, pasta), lots of salads and veggies, mostly chicken and turkey for protein and a LOT less carbs/sugar type food than what I eat now!!  Doesn't make sense.  I used to smoke but quit 2 1/2 years ago.


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## kiik

My personal theory about food is that processed carbs (white bread, pasta, etc.) may not hurt going through your digestive tract as they are soft and not too hard to digest. However, over time they can contribute to an imbalance of bacteria.

How you start cutting those out when healthier foods hurt too much to eat, I don't know! I try to eat fruits/veggies but they often cause me pain and I'm already skinny enough as is without cutting out more food.


----------



## crohnicaly stinky

Kiik, you can try to mix them with other food.   I used to eat a poached egg on dark rye toast.  This helped slow the absorption down so I'm not sure how that impacts the feeding of the bad bacteria.  But maybe limiting process carbs can still help.  I think from a sustainability point of view you need some amount of enjoyment or you eventually fall off any diet.  I used to treat myself with a scoop of carb smart vanilla topped with a broken up Hershey mini dark chocolate!


----------



## David

I totally understand your frustration Sarah.  Hey, maybe I'm wrong.  Let's get some insight from someone who knows more about IBD than me.

Aussie -- what's your opinion on someone with stricturing ileal Crohn's disease being only on mesalamine (Asacol specifically) and no other treatment other than a low residue diet?


----------



## Spooky1

Hi there,

diet plays a huge part in my crohns and bones issues.  I'm liquid food and bland food, that's salmon and potatoes or boiled chicken and potatoes.  But i'm certainly not as bad as I was.  I know what i'm like if I eat normally, or get glutenous stuffs, along with dairy and fructose in the diet.  omg.  diet helps tremendously.  Asacol made me sit on the floor by my loo for days, I was just so nauseous with vomiting.  What suits one crohns sufferer may not suit another.  we are very individual with our illness.


----------



## JennyT

Me too spooky, Im best on fibre free, gluten free, sugar fee, lactose free and its really worth it but some times I just think bugger it and I know Im in for a night on the loo, a burnt bum and a blimmin sore tum. Its hard getting people to beleive I shouldnt be on a "balanced diet" with peas n cabbage etc etc, I get flack from family who say Im making myself sick and why dont I just eat a sensible sandwich or loads of veg  arghhhh! I find sweet potatoes are better than potatoes but we have a drought here at the mo and they are expensive to buy. Everyone is different as you say jusy addin my story so someone else can say "Oh thats just like me" and you dont feel so alone, theres another Crohnie like you


----------



## Spooky1

I agree, food is bad for us lol.  shame, but that's the way it is.  but better have less pain, sickness and diarrhoea than stuff my gob and pay a very hefty price.


----------



## Aussie

Hi David and Sarah. If you have a long segment of ileal involvement with stricturing, then you are in a poorer prognostic group, and your Crohns needs to be treated more aggressively, I'd agree with David, and suggest you talk to your Gastro about escalating to thiopurine therapy.

As to why you felt better, mesalamines do work well for extra intestinal manifestations of IBD, particular the joint symptoms (not as we'll as sulphasalazine though). Also, there is a poorly described subtype of Crohns, a superficial Crohns, that is usually colonic, and typically quite mild that does respond to mesalamine therapy. However, once you have stricturing, then you're not in that category, even though some of the surface inflammation may have reduced causing you to feel better, remaining on only mesalamine would be a poor clinical choice in my opinion.

As to why your doctor prescribed it. It wasn't that long ago that mesalamines were first line standard of care in Crohns, and perhaps old habits die hard. Also, mesalamines are relatively risk free (interstitial nephritis is very rare with them), so the doctor worries less about causing harm, whereas the thiopurines (Imuran and 6mp) do have a host of potential side effects. Perhaps your gastro is not an IBD specialist, if they were, I'd be quite surprised if they left someone with long segment ileal inflammation with stricturing not on something stronger.

Best wishes.


----------



## Sarah50

Hi Aussie,

Thank you for the information.  I do intend to discuss this with my doctor, and yes, he is a gastroenterologist.  I hear you about the stricturing, it does make sense but I don't think it goes away - from my understanding of research (so far), you can only get the inflammation down which helps.  It's either that or surgery.  Do you know something different?  What would the medication you recommended do for stricturing that Asacol hasn't done?  

If what you say is true, and that other gastroenterologists would recommend the stronger choice, then almost ALL websites I've looked at for Crohn's are giving out the wrong information... .. because they all list mesalamines that include Asacol as the first medication recommended for mild Crohn's.  Apparently, it is still recommended ... which is disturbing if this isn't what is recommended for mild Crohn's because, obviously, I'm not the only one researching this disease.  So again, it's confusing.  

And yes, you're right, that the more 'heavy duty' medications come with some risks... and some of those, quite serious.  I guess that's why different medications are recommended and different medications work for different people.  As we know, this disease, how it affects each person, what gets one under control and does nothing for another is more of the norm than the exception.  Which makes it frustrating for patients and doctors alike.  

The good news for me is that I am and have been symptom-free for the past couple of months (since late December) with one bout of a 'flare' for a week when a situation stressed me out to the hilt.  So although I'm not on a heavy duty drug (yet?), I seem to be doing very well with Asacol and a low residue diet.  Thank God!  I have looked at some posts here and other forums where there have been many people that have had success with Asacol - remission and no side effects.  So... I will take into consideration what you and David believe, ask my doctor about it at my next appointment which isn't until July - unless, God forbid, I need to see him sooner.  In the mean time, I am seeing my regular doctor/internist at the end of the month and will ask for those tests for Crohn's / inflammation.  

Again, thank you for your opinion.  It's appreciated.


----------



## Sarah50

For an example, when I go to the CCFA (Crohn's & Colitis Foundation of America), it first lists aminosalicylates:

Medical treatment for Crohn's disease and ulcerative colitis has two main goals: achieving remission (the absence of symptoms) and, once that is accomplished, maintaining remission (prevention of flare-ups). To accomplish these goals, treatment is aimed at controlling the ongoing inflammation in the intestine—the cause of IBD symptoms.
There is no standard regimen for managing all people with IBD. The symptoms, course of disease, and prognosis vary considerably. Proper disease treatment depends upon an accurate diagnosis.

Aminosalicylates are compounds that contain 5-aminosalicylic acid (5-ASA). These drugs, which can be given either orally or rectally, interfere with the body's ability to control inflammation. *They are effective in treating mild-to-moderate episodes of ulcerative colitis and Crohn's disease, as well as preventing relapses and maintaining remission.*

Oral Medications
Sulfasalazine (Azulfidine®), the first aminosalicylate to be widely used for IBD, is effective in achieving and maintaining remission in people with mild-to-moderate disease. The active portion of the drug, 5-ASA, is bonded to sulfapyridine, a compound that delivers 5-ASA to the intestine but comes with disagreeable side effects in some patients, such as headache, nausea, and rash. However, sulfasalazine is inexpensive and effective for the many patients who can tolerate it.

Researchers have also developed newer oral drugs that deliver 5-ASA without sulfapyridine. These include:

mesalamine (*Asacol®,* Pentasa®, Apriso™, Lialda® );
olsalazine (Dipentum®); and
balsalazide.

Up to 90 percent of people who cannot tolerate sulfasalazine are able to take other 5-ASAs.


http://www.ccfa.org/resources/types-of-medications.html


I will post what it says about the next level up... this is why it's confusing and we all need to find the right solution for each of us that have this disease.


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## Clash

My son has stricturing at his ICV and due to the stricturing the GI(pediatric GI that specializes in IBD) would not even consider 5ASAs. He stated that once CD is stricturing or fistulizing one could not be classified as having mild active CD and treating with 5ASA would be similar to aspirin for a brain tumor. 

We do know adults treated with 5ASAs but none of them were dx'ed with stricturing or fistulizing C one although that progressed to stricturing CD and had to move to Remicade to get full mucosal healing.

That is just what we've encountered and most of what David has mentioned was reiterated by my son's Ped. GI but I do hope you are able to reach remission with whatever treatment you feel most comfortable with.


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## Sarah50

From the same website, CCFA:

As their name implies, immunomodulators weaken or modulate the activity of the immune system. That, in turn, decreases the inflammatory response. Immunomodulators are most often used in organ transplantation to prevent rejection of the new organ, and in autoimmune diseases such as rheumatoid arthritis. Since the late 1960s, they have also been used to treat people with IBD, which appears to be caused by an overactive immune system. 

*These drugs are appropriate for those who:

do not respond to aminosalicylates, antibiotics, or corticosteroids*
have steroid-dependent disease or frequently require steroids
have experienced side effects with corticosteroid treatment
have perineal disease that does not respond to antibiotics
have fistulas (abnormal channels between two loops of intestine, or between the intestine and another structure—such as the skin)
need to maintain remission

An immunomodulator may be combined with a corticosteroid to speed up response during active flares of disease. Lower doses of the steroid are required in this case, producing fewer side effects. Corticosteroids also may be withdrawn more rapidly when combined with immunomodulators. For that reason, immunomodulators are sometimes referred to as "steroid-sparing" drugs.

Oral Medications
The first two immunomodulators to be used widely in IBD are azathioprine (Imuran®, Azasan®) and 6-mercaptopurine (6-MP, Purinethol®), drugs that are chemically quite similar. They are used to maintain remission in Crohn's disease and ulcerative colitis. Both have a slow onset of action (three to six months for full effect). Accordingly, they are usually given along with another faster-acting drug (such as corticosteroids).


This is just from one website - this is what I find all over the internet.  Aminosalicylates that include Asacol for Crohn's, not just UC.  It's hard to believe it hasn't worked when ALL of my symptoms went away....... bad stomach aches daily (this was the worst symptom - called into work sick often or worked poorly), extreme fatigue, night sweats (almost nightly), intermittent nausea and vomiting, definitely loss of appetite and fast weight loss, achy joints/back ache).  I was really sick for several months... so when they all disappeared after 6 weeks on Asacol and a low residue diet... it's hard to believe the Asacol is not working.  BUT - I am still open to it not being the right medication for me...  of course I want to be in remission and stay in remission and hopefully avoid surgery .. for ever or for as long as possible!!!!!


----------



## Sarah50

I found the following article/clinical study that's interesting and confusing, again.  (This is a 4 page in-depth study but I only took the info from the last page as it is a lot to include - so I wanted to 'cut to the chase':  


Alimentary Pharmacology & Therapeutics
*Systematic Review: The Potential Influence of Mesalazine Formulation on Maintenance of remission in Crohn's Disease*
A. H. Steinhart, A. Forbes, E. C. Mills, B. S. Rodgers-Gray, S. P. L. Travis
Disclosures
Aliment Pharmacol Ther. 2007;25(12):1389-1399.

Discussion
*The benefit of mesalazine treatment for maintaining surgically induced CD remission is reasonably well established; however, the effect of mesalazine for maintaining medically induced remission remains controversial because results vary between studies.*[6,29,34] More compelling have been the meta-analyses[12,15] investigating mesalazine as a class for maintenance of medically induced remission, which have failed to detect any significant effect. *This systematic review is the first to examine the efficacy of different mesalazine delivery systems for the maintenance of CD remission after both surgically or medically induced remission. It shows that the formulation appears to matter.* 

Care has to be taken when outcomes depend on the results of single trials (such as maintenance with pH 7-dependent mesalazine), but the results are consistent between medically and surgically induced remission. Furthermore, the number of patients approached or exceeded 100 for each study included in this review, and outcomes were extracted from carefully conducted RCTs. *In both scenarios, pH 7-dependent mesalazine has a greater therapeutic benefit, with a lower NNT compared with pH 6-dependent and controlled-release mesalazine. In addition, the pH 7-dependent mesalazine has a statistically significant advantage over placebo, whereas neither the pH 6-dependent and controlled-release mesalazines do when each is analysed against placebo.*


The three mesalazine formulations investigated in this study (pH 6-dependent, pH 7-dependent and controlled-release) are designed to release active drug (5-ASA) at different levels along the gastrointestinal tract. It has been suggested that differences in the various mesalazine formulations, with respect to 5-ASA release, may explain observed differences in therapeutic efficacy in CD.[17] 

The Eudragit-S coating of pH 7-dependent mesalazine, however, is not broken down until the pH rises above 7 in the terminal ileum and colon.[38,40] *It is known that CD most commonly affects the terminal ileum and colon;[1] thus, pH 7-dependent mesalazine may have greater clinical benefits because of a drug release profile that fits the most common disease location. *Further, pH 7-dependent mesalazine may be particularly beneficial in the treatment of subpopulations of patients with ileocolonic or colonic disease.

_Although our systematic review does not definitively answer whether formulation matters, we propose that the selection of mesalazine formulation potentially remains a key contributory factor in the clinical outcome of patients with quiescent CD maintained on mesalazine. Our study suggests that the apparent lack of impact of mesalazine in the maintenance of CD is open to different interpretation, and challenges the outcome of the Akobeng meta-analysis.[15] Large-scale, well-designed RCTs to investigate the efficacy of these different mesalazine formulations in CD patients are needed in order to confirm the findings of this analysis._

http://www.medscape.com/viewarticle/558396_4


*Eudragit S-coated 5-ASA (Asacol) *


----------



## PVail

Real interesting topic as i have been on Asacol for inflammation in the ileum for nearly two years. It works for me as the bleeding ,mucus and most of the pain has been stept down . I have from time to time stopped taking the Asacol in the hope that this has gone away but within a few days it all returns again . There is no question that it works for certain inflamation types , what they are specifically I cant say . But as someone who lives by this drugs I have to say it works. Do i have Crohns disease I dont know but I do have Inflammation which is controlled by taking Asacol.
Very interesting topic though.


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## Sarah50

PVail, glad to hear you are doing well with Asacol for the past 2 years.  I have only been on it for almost 4 months and so far it seems to be working for me in that all of my Crohn's symptoms are gone.  

If I find out that I need the stronger medication - Immunomodulators, of course I will take them.  I want to do whatever it takes to keep this disease in remission.  

I'm hoping, naturally, that I don't have to take Immunomodulators as they can have a *serious* side effect:

*"These medicines may increase your risk of getting cancer, including lymphoma."* 

I can see why a doctor would try the milder drugs first, to see if they work!!!


----------



## Aussie

Hi Sarah, 5ASAs in Crohns is definitely a contentious topic. A lot of the data is quite heterogenous with regards to which 5ASA was used in the trials, and moreso, the location of the Crohns (upper GI, ileal, colonic). There was a recent analysis in the American Journal of Gastro. (AJG Apr 2011) which looked at this question and there was interesting letters following (AJG Oct 2011). Essentially, probably okay to try for mild Crohns given the good side effect profile, however, no significant benefit over placebo unless drilling down on particular subanalyses (I tend to think that if you have to look at particular subanalyses to see a benefit, then the likely benefit is going to be modest at best.)

At the end of the day however, it doesn't matter so much about what the trials say, it's more important looking at what the drug does to you - if you are lucky enough to be in remission with Asacol then keep going. Just be sure you're in remission though. Clinical remission is when you may have no symptoms, previously a target of treatment. However, that target has recently changed as ongoing inflammation could be asymptomatic and thus you could have ongoing bowel damage in the absence of symptoms. What you need is deep remission (clinical, biochemical and endoscopic). Unfortunately, CDAI and CRP and WCC etc are not reliable indicators of endoscopic activity of Crohns.

What I would suggest is consider a faecal calprotectin (+/- colonoscopy), if the calprotectin is normal, then continue as is, however, if that is significantly elevated, then there is ongoing subclinical inflammation that can, over time, further damage your bowel, and you should consider an escalation of therapy.

Best wishes.


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## Sarah50

Aussie,

Is the faecal calprotectin test something I can ask for with my internist?  Is it a fecal test or a blood test or ???  Excuse my ignorance... but I want to know what I'm asking for.  LOL  Thanks!!

Edited to add:

I believe that it's a fecal test from what I could find by googling it.  I will ask my doctor to do this test.  Thanks again.


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## David

It is indeed a fecal test and your internist should be able to order it.


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## Clash

Sara50, the fecal calprotectin test has been a great test for my son since his blood work isn't a good barometer for his inflammation levels, hope it all goes well.

David or Aussie, I have a question regarding deep remission. My son's GI explained deep remission in much the same way as Aussie(clinical, endoscopic etc.) full mucosal healing. If you have reached remission by all these standards then could missing a couple of doses of your meds result in automatic symptoms? I am just trying to wrap my brain around, I guess, the idea of full mucosal healing and at that point how tenuous this level of remission is.


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## mreyn

I went from page one to page six.. I guess I'll have to read all the ones in between. I'm just trying to find what to give my son to help him heal so that he can get off of remicade. If there's any possible way to point me to something that says do this and take this.. etc.. that's what I need.  ~Overwhelmed


----------



## Hope345

mreyn.

It *is *overwhelming.  I am having that same feeling.
One thing my husband reminded me was to just try to keep her comfortable, that may be the best we can do right now.    

WE have doubled the Remicade, but still having a flare.  Hopefully the next treatment will show some improvements.

I am sorry that there is no right answer. 
thinking of you and your son.


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## Aussie

Sarah, faecal calprotectin just a simple poo test, but probably the most sensitive non-invasive test looking for active inflammation, I imagine any doctor in US could write the path form.

Clash, deep remission is usually reasonably sturdy. In a cohort of patients who achieved deep remission, the majority could come off their Infliximab (continuing immunomodulator) without flaring (Stori trial). 

When you say, could you miss a few doses, in regards to the Infliximab, I would try to avoid that because episodic therapy (have long gaps in between doses) increases your chance of developing antibodies to the Infliximab, which will likely lead to loss of response. Missing a few doses of methotrexate is probably not as serious, although best to be avoided if possible.

Best wishes.


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## Clash

Aussie, thanks for the information, and I wasn't considering him missing doses of any medication at any time just trying to grasp of deep remission. In relation to diet or meds, I have read many posts that mention if they miss a few days of their pills or alter their diet the symptoms immediately return, I was just hoping that "deep remission" was less tenuous than that since it won't be long until my son will be away at college and it will be up to him to remember to take his MTX.


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## Deba

So, If Crohn’s sufferers eat a low-carb diet will the inflammation/ulcers heal quickly?? ..
still waitn 4 ur nxt article ..  and thnx


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## Div

Did Dave Watson ever post articles 2-5?  I cannot find them, but I would really like to read them.


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## JennyT

PollyH said:


> . I ended up re-inventing the classic anti-candida diet. (I didn't have Crohn's or colitis. The only thing the doctor found was yeast in the lab tests, but but told me that yeast doesn't mean anything, because everyone has that.)


One heaped teaspoon of plain old baking soda in water a day is all you need. GOOGLE baking soda cure (especially cancer) and you will be amazed. No pharmacutical company  wants to spend the millions to prove it cos its so cheap its not marketable. I watched my 52 year old male flatmate go from high blood pressure and using his angina spray sometimes a dozen times a day and being an invalid to normal BP and NO spray EVER and being well enough to become a gym bunny just by drinking baking soda daily.

Works for some, worth a try. Google it up first, the science of it is on Youtube.


----------



## poing

Dave Watson said:


> Your comment is *complete rubbish*
> 
> *I've demonstrated a carb link to Crohn's. I've demonstrated that reducing carb comsumption improves Crohn's. That in itself suggests carbs are being used by bacteria.*


Bacteria aren't the only things that eat carbs.... yeasts and other gut parasites do too.

Just thought that was worth pointing out.


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## SugarberryGA

I was diagnosed with Crohn's nearly 30 years ago and what has helped me the most, I do believe, is not drinking alcohol of any kind, not smoking, eating about as well as my tummy will allow, and taking my medicine regularly.  Alcohol and smoking are huge no-nos with Crohn's.  Crohn's patients that I have know who drink and/or smoke, have frequent flares and wind up in the hospital.  I'm 52 and have only been hospitalized once for my Crohn's, and that was two years ago because I took Motrin for arthritis pain.  Never again will I make that same mistake!


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## pb

Crohn's disease IS an autoimmune disease, our immune system doesn't properly recognized certain bacteria as being good and therefore attacks it thinking it's attacking bad bacteria....it's a malfunctioning immune system (not over active or under active) it simply has it's lines crossed and that's what causes the polyps and inflammation.

Same with Celiacs for example, difference being is once you take the wheat and gluten out of a Celiacs system, their immune system no longer attacks the GI tract because the wheat and gluten is no longer considered an invader by the immune system.

It's the immune system in IBD that needs to be fixed in order for the intestines to be healed (or cured).


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## rollinstone

Actually more and more evidence is showing that crohns could likely be caused from a microscopic infective agent, MAP in some people and Maybe AIEC in others, the problem is the immune systems in us crohnies don't clear the microbial agents out. Look at qu biologics SSI vaccine, I strongly Support their hypothesis, and it is about 180% from the autoimmune theory which has way too many facts against it.


----------



## Ihurt

I agree that a faulty immune system does play a role in this disease and many others, but there is more to it than that. Like for instance, what you said about celiacs disease, true, you take the Gluten out of the picture, the intestines heal. BUT, I read an article years ago about why the only reason people that have this reaction to the gluten is because of the way it is processed( it is crossbred with an actual weed that is not digestible to the human gut)! I believe there is only once place that has never crossbred their wheat fields and that is in Ireland. They say a person that has celiacs can actually eat wheat over there and have no problems. Now the big question is WHY then does everyone not have issues?? I guess that is where the faulty immune system comes in. 

It is so very complex, that is for sure. It could be people get certain diseases due to a LOW immune system as well and also I think people have to already have a certain gene that allows this whole disease process to take hold. There are many factors involved I believe. 

Now Polyps could be from ones diet as well and lifestyle factors. Millions of people get colon polyps and they do not have inflammation anywhere in the intestines. 

















pb said:


> Crohn's disease IS an autoimmune disease, our immune system doesn't properly recognized certain bacteria as being good and therefore attacks it thinking it's attacking bad bacteria....it's a malfunctioning immune system (not over active or under active) it simply has it's lines crossed and that's what causes the polyps and inflammation.
> 
> Same with Celiacs for example, difference being is once you take the wheat and gluten out of a Celiacs system, their immune system no longer attacks the GI tract because the wheat and gluten is no longer considered an invader by the immune system.
> 
> It's the immune system in IBD that needs to be fixed in order for the intestines to be healed (or cured).


----------



## pb

Joshuaaa said:


> Actually more and more evidence is showing that crohns could likely be caused from a microscopic infective agent, MAP in some people and Maybe AIEC in others, the problem is the immune systems in us crohnies don't clear the microbial agents out. Look at qu biologics SSI vaccine, I strongly Support their hypothesis, and it is about 180% from the autoimmune theory which has way too many facts against it.


Except not all CD patients have MAP in them...years ago they did studies and test a large group of CDers and found not all of them had MAP.

I'm not 100% familiar with how having MAP works, if someone has it, is it in their blood?  Where in the body is it?  Does having MAP alter the immune system?


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## SugarberryGA

It's like my gastroenterologist told me once about Crohn's... if he knew how and and why people developed Crohn's disease, he'd be a wealthy man.  I've learned to simply accept the fact that I have it, that I'm going to have it the rest of my life, and have quit researching it.  The more I researched it, the more confused I got.  Now I just say the Serenity Prayer.  )


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## Amy2

What exactly is deep remission?


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## PollyH

pb said:


> I'm not 100% familiar with how having MAP works, if someone has it, is it in their blood?  Where in the body is it?  Does having MAP alter the immune system?


You can have the blood tested for the MAP DNA. However, even if a pathogen doesn't show up in the blood, it may still be present in the intestines. 

MAP and invasive E Coli can be found inside macrophages. Therefore, they are able to interfere with your immune system.


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## danieldresen

While you do provide good points in reference to Crohn's research, albeit research into Crohn's is limited, your hypothesis loses flare when you become insistent. In any clinical setting when presenting a new take (unless you have letters such as PhD, MD, etc...) you should not suggest that it is, but that it could be. An example:

"In Crohn’s, the inflammation/ulcers are CAUSED by acid-producing bacteria along the gut lining."

When presenting a scholarly argument, utilize may be caused (and use lower case). This will limit criticism by many people. I am going to school for psychology but research writing is the same across the disciplines. 

As for thoughts on prevalency, the VA has been conducting studies into Crohn's as well and there has been a surge in diagnosis between 1998 to 2008. Do you think MREs may be a source, or the environment? I have noticed that soldiers who have had a high risk of dysentery have a reduced risk of developing Crohn's Disease. Its odd to think that poor sanitation and altering the diet can reduce the risk... Check this study out and let me know your thoughts.

http://www.ncbi.nlm.nih.gov/pubmed/9732925


----------



## PollyH

danieldresen said:


> I have noticed that soldiers who have had a high risk of dysentery have a reduced risk of developing Crohn's Disease. Its odd to think that poor sanitation and altering the diet can reduce the risk... Check this study out and let me know your thoughts.
> 
> http://www.ncbi.nlm.nih.gov/pubmed/9732925


 It could be the unsanitary conditions that are helping. Here is an article about using worms to treat IBD.

http://www.altmedrev.com/publications/16/1/50.pdf

Of course, it could also be that those who survived the unsanitary conditions were less likely to get Crohn's in the first place.

As for the increased prevalence noticed between 1998 and 2008, I suspect the food or the vaccines. There has also been an upsurge in autism, which is associated with gut problems.


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## Ihurt

Actually it is not so odd at all. Think about it, when you are in an area where sanitation is poor, you are being exposed to many different types of bacterial strains that can likely help protect the gut. Also not to mention that in these areas where sanitation is poor( especially in certain countries) where exposure to antibiotics is also very low, it stands to reason why developing Crohn's would be low. 

In Africa people who have Sickle cell anemia cannot get Malaria. They are immune to it due to the Sickle Cell anemia protecting the cell somehow from allowing the malaria to get through. So I can understand the theory of people who have been exposed to Dysentery may be immune to getting Crohn's. There also have been some articles on how people who Have H-pylori have a much less risk of having Gerd issues. One thing kind of staves off the other. 












			
				
As for thoughts on prevalency said:
			
		

> http://www.ncbi.nlm.nih.gov/pubmed/9732925[/url]


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## rollinstone

pb, you are right, that is whats so confusing, some people have crohns and don't have MAP. they are starting to classify crohns into subtypes (I don't have the link on me atm but hopefully some1 will post it), its very interesting though and it makes a lot of sense why some people respond to certain meds and why others don't, it suggests that crohns is a condition with various causes, each cause showing certain sub-type features when looked at extremely closely... ah I hope someone can post more on it. its very interesting though.


----------



## hans

Dave,

I've read your inputs regarding crohn's and also read the rest of the posts in the page. I think that there are more than one Valuable Key within your theory and article that can lead to the discovery of a solution to crohn's and many other illnesses.

I was diagnosed with crohn's last year .. 
Few days ago, I had a feeling that my symptoms has much to do with smoking (Acid) and eating sugar (Acid residue). I've been a (sugar addict) almost all my life. Instead of eating normal food, i used to have loads of food and drinks full of sugar. I even ate raw white sugar alone with a spoon several times after waking up in the middle of the night craving for sugar. 

I've also noticed that the symptoms are reduced when i don't eat bread or rice (High Carb).

My point is that my notes come from a personal experience, i'm not a doctor, but i believe that crohn's has much to do with sugar and yes acids - no matter what that means (we don't have to be doctors to feel that something is burning our guts..). Thanks Dave.


----------



## hans

Hi everyone. 

I was diagnosed with Crohn's last year. I've been a (sugar addict) almost all my life. I used to eat loads of Cakes, Chocolate and drinks containing sugar. I used to wake up in the middle of the night craving for sugar and ate white sugar with a spoon!

During my illness I've noticed the pain and the flares are reduced immediately when eating (1) food containing refined sugar, and (2) High-Carb food such as rice and bread, and (3) Milk and Diary. But! after few days the flares becomes worst and persistent.

In the times that I didn't eat (1) Milk and Diary, (2) Bread and (3) Food containing refined sugar, I suffer for few days from sever pain attacks, but after few days the pain and symptoms almost disappear.

I'm not a doctor, and I'm not sure whether this works for someone else - this is only my personal experience.

What brought me to this page, is that few days ago I've (felt) that my problem is mainly related to relying on eating too much food containing sugar for most of my life.. that's why I types in Google: Sugar Intolerance and Crohn's!


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## Spooky1

Hans, I also confess that for many years, but not recently, I have been a spoonful of sugar person.  I also felt I needed a lot of sweets.  I read once, about 25 years ago, that Kabi pharmaceuticals produced a booklet on Crohns, and in it they said that research shows that Crohns sufferers all head towards the high sugar foods.  But I also wonder whether this is a result of feeling nausic, fatigued and just giving the body what it needs, sugar for energy.  I think we are much better off on a carb free diet, but i'm on liquid feeds, and can't get a balanced diet with all nutrients without it.

Must say, you did bring back memories of eating sugar.


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## Axelfl3333

My feeling on crohns is mostly caused,created over the years by the over processed food that is more and more the norm in westernised nations a prime example of that is peanut allergy which is almost unknown in the far,middle east nations and exacerbated by over prescription of needless and useless drugs that have helped to create super bacteria.


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## PollyH

Axelfl3333 said:


> My feeling on crohns is mostly caused,created over the years by the over processed food that is more and more the norm in westernised nations a prime example of that is peanut allergy which is almost unknown in the far,middle east nations and exacerbated by over prescription of needless and useless drugs that have helped to create super bacteria.


Peanut oil is a hidden ingredient in many vaccines. Some feel that repeatedly injecting this oil into the bloodstream could be the reason for the increase in peanut allergies.

http://www.thedoctorwithin.com/allergies/vaccines-and-the-peanut-allergy-epidemic/


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## mjr

Hi Dave,
Wow Thanks for the research with and keeping open mind when doing your research. 

Could you send me a link to your next thread you have or will be writing.  I would love to read your information you post.  Your suggestions may help me.

allergies (food & enviro since birth requiring medical treatment at a week old)
asthma - began age 3 and tonsils removed at that time too
Crohn's - Not diagnosed till age 45.  Had severe abdominal pain that calmed after a couple of days, but still could not eat and bowels still hadn't moved.  At that time, I had constipation.  Ten years before that I had severe diarrhea with nausea and vomiting.  Nothing the dr.'s gave me seemed to work.  I went to my allergist and my Ige levels were extremely high, my weight was barely 100 lbs.  He did food allergy testing on me and most foods came back positive, all meats except chicken, coffee, chocolate, tea, etc.  A lot of very commonly consumed foods.  He gave me script for Sodium Cromoglycate capsules.  I was to take the 20 min before meals.  This helped enough to keep me working for about 6 years.  Then one dr appointment (pap test), my dr found a lump in my lower right pelvic area and squeezed it.  He asked if it hurt, I said no, but I was starting to feel much more sick.  Before I got to my vehicle, I was vomiting uncontrollably.  This seemed to trigger the constipation.  Also, I never had another menstrual cycle after this.  At age 44 I was in full menopause (no menstrual cycle after this and before it was still normal and was very predictable when it would start each month).  I was also very sick like this when I was pregnant for my second child.  I took lots of medicine to try to keep the symptoms down enough so I could work.  I worked for another 20 months, till I could no longer work.  The pain, migraines, vomiting, 24 hr sweating (would come and go every day, and every night I wake up several times totally soaked, then would need another blanket to try to go back to sleep.  I found that the 100% polyester blankets and housecoats that are fluffy would help some to keep me feeling dry enough to sleep a bit) became intolerable for me to continue working.  About 2 weeks after I stopped working, after Thanksgiving dinner.  I had the 3 days of severe pain and no bowel movement and of course no eating.  The severe cramping subsided but my bowels did not move.  So after a total of 6 days, I went to the ER for help.  I ended up have bowel resection and strictures expanded.  The surgeon had no idea how my bowels got so damaged.  Kept asking about other surgeries, but at that time, all I had had was tonsils removed, Fallopian tube removal for requested sterilization, and appendix removed 3 years earlier.  His report about my surgery stated he thought I had some kind of adhesion disease, but he did not see any cause for all the scar tissue, distended bowel, and multiple strictures.  The section of bowel that was removed was sent to the lab and from the lab tests, I was diagnosed with inflammation consistent with Crohn's disease.  They tried me on all Crohn's medication, including remicade (cause of severe sinus infection) and none helped to relieve my symptoms.  Now I've been told I have IBS, which to me means I do not know.  The GI Dr. diagnosed me as Crohn's in remission based on blood tests showing normal CRP levels.  But my symptoms had not improved.  Then Dr. says he doesn't think I ever had Crohn's and only explanation is IBS and I would need to find out what the food triggers are and avoid those foods.  To date, I still have not found even one food that agrees with me.  Anything I eat, even soft foods would cause a lot of pain.  My understanding of Crohn's is that it is always visible during surgery/colonoscopy.
The only time in those years my symptoms improved was when I was on antibiotics, which I may get once every couple of years.  At the time of my surgery, I hadn't had any antibiotics for almost 5 years.
I am still praying for anything that will ease the symptoms I have to live with everyday.  There is another thing about Crohn's that doesn't fit, I do not get flares, my symptoms are chronic daily if I do anything more than drinking water.

I thought sharing my story, you or someone else may be able to advise on some things I could try to do to relieve some of the symptoms.  I have tried a lot of things, some of them crazy desperate.

Thank God for people sharing :ghug: on the site.  I am sure many have been helped with the information here.

Happy 2015, I hope.
Maggie :mademyday:


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## leezapeza

Omg I thought my mum was bs ing me when she said that sugar can cause inflammation but after reading this I'm more than willing to cut my sugar out and see if it helps


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## worriedboy

mjr, it sounds strange whatbyour dr says... If they diagnosed Crohns in lab, it's most probable that it is what you have. CRP is really not enough to monitor your condition. You might want to push for some scopes if you hadn't had any lately.

Besides, if antibiotics helps you, maybe it's worth that you take a look at RHB104 trial, it's on phase III in the US and some other countries.

Feel well.


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## Spooky1

If perhaps it's IBS then maybe try the 50 billion probiotics available.  I sincerely don't have anything else to suggest.  However, strictures are part and parcel of Crohns.  I can't believe your doctors leave you in limbo like this.  Not sure anyone with IBS has strictures, but I do stand to be corrected.

Good luck.


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## PollyH

Strictures can cause IBS.  MJR, I suggest that you do some reading about SIBO (Small Intestinal Bacterial Overgrowth). The stictures interfere with the removal of bacteria from the small intestine. The small intestine isn't supposed to have a lot of bacteria. When this happens, you get IBS.  

The overgrowth of bacteria will produce hydrogen which can be measured in the breath. The test to determine this problem is called a hydrogen-lactulose breath test. You can get this test on-line without a doctor's prescription, if you want. If you or your doctor orders such a test, make sure they also check for methane in the breath. Methanogens in the gut will turn some of the hydrogen into methane. The methane will cause constipation. 

To get rid of this problem, you can use certain antibiotics or certain "herbal antibiotics."  You can learn more about this from Dr. Siebecker's website, or from some of the publications of Dr. Pimentel. Also, there are discussion groups on the internet, like yahoo's SIBOnation.


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## Spooky1

Thanks for the SIBOnation link, Polly.


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## frank246

Dave,

Looking forward to your follow-up. 

BTW, I don't think most of the apparently negative, or "hostile," comments here are in fact that. I think it's just that the comments might not have been worded as carefully as they might have been in the responders' anxiousness to post their reactions. And, as we all know, that's a hazard of online communications since voice inflections, as well as facial expressions, are absent.


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## Nym

Catalyst - 'Gut Reaction' Part 1 (2014) 

Published on 14 Aug 2014

Reported by Dr Graham Phillips
Produced by Dr Graham Phillips & Geraldine McKenna
Edited by Vaughan Smith

https://www.youtube.com/watch?v=w94D45txSxo


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## crohnschef

Dave Watson said:


> That's coming in a later article Dan where I explain how AIEC and MAP are *indirectly* responsible for the inflammation and ulcers.
> 
> Recent research has found 92% of CD sufferers infected with MAP, and up to 36% of sufferers infected with AIEC. If this research is fairly representative, it's quite possible all Crohn's sufferers are infected with either MAP, AIEC or both.


 Well...
i was diagnosdd with moderate to-severe crohn's disease in may of 09', after over ten long years of bleedin and all the other symptoms.
 I have never ever had a cavity in my life.  But i def.have crohns. So much bleeding. I have chronic dry mouth which can cause teeth and mouth issues.  Its because of my meds.  This potentialooly could be the reason for it


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