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Please help! Need help with SCD -- still seeing blood/mucus in stool after 3 months of the diet

I have UC and am on Humira.

I've been on STRICT SCD for 3 months. My diet has been pared down to:

- scd chicken soup
- sautéed kale
- shiitake mushrooms
- scd 24 hour yogurt from local, pastured cow's milk
- freshly ground organic peanut butter with nothing added
- cinnamon
- organic apples
- squash

This is literally all I eat, and yet I still see blood in my stool. This is my only symptom of Colitis. I'm on Humira.

Do you think I should stick with SCD for another 3 months? Should I eliminate the peanut butter? Try a new diet? Please help.

I can't go to the gastro for a while because I have crappy insurance right now.
 

my little penguin

Moderator
Staff member
How long have you been on humira ?
What is your shot frequency?
My child (who is an adult now ) was on humira for five years but each year or so had to switch from every 14 days to every 10 days then every 7 days . The final year he was on it he was taking it every 5 days plus methotrexate.
My point is in some folks it stops working.

there is the crohns exclusive diet which has worked for some .
There is also exclusive enteral nutrition (formula only ) no solid foods.
Both have scientific peer reviews .
Een is tough to do and not sure if it helps a lot with UC my kiddo has crohns .
 

kiny

Well-known member
There is ample evidence dietary interventions are helpful in ileal crohn's disease.

But there's no evidence that diets or EN are helpful in UC. Nor is there evidence for crohn's colitis.

It would be very surprising and difficult to explain if dietary interventions would be helpful for UC. Nutritional transport happens in the small intestine, not the colon which just absorbs water.
 
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Anecdotically I heard of many people for whom SCD was helpful for UC. There is a group on facebook “breaking the vicious cycle” that you should check out. In fact SCD was developed by Elaine for her daighter who had UC. I think it wouldnt be hard to explain why it works for some ppl - if we believe its somehow related to bacteria in the bowel, some diets could enable absolutely minimising certain types of leftover food reaching the large bowel - in this case, di and polysaccharides. Although why for example fiber is OK on SCD is beyond me. I think things like this are worth a try.

But the question you should ask yourself OP is if you are feeling better since following such a strict diet. Did inflammation markers improve? You should find a way to see a doctor and get a blood test for Humira and potentially that will lead to dose change. Also UC has quite a few decent options when it comes to supplements - some studies have found even certain probiotics like VSL3 to be helpful. Did you take mesalamine before?
 

kiny

Well-known member
Although why for example fiber is OK on SCD is beyond me.
Fermentable fiber shouldn't be allowed on SCD, but not all fiber is fermentable. Cellulose has no no nutritional value, neither for us nor for bacteria, yet it still serves a function to bulk stool.

But Fermentable fiber is a carbohydrate and energy source for microbial populations in both the small and large intestine so it stands to reason it should be avoided when following SCD.

Elaine's argument is that fermentation of undigested carbohydrates provides energy for excessive microbial growth. She also argues that overgrowth of colonic microbial species will take up residence in the small intestine causing mucosal damage. This is a decent theory since we have lately seen SIBO being effectively treated with EN. As her theory goes, avoiding carbohydrate malabsorption will decrease bacterial load and lead to remission. So yes, that should include the avoidance of fermentable fiber.

There is a direct genetic link between Crohn's and pathogens, an innate immunodeficiency due to NOD2 and ATG16L anomalies, involved in detection and elimination of pathogens through xenophagy and lysosome fusion. Not just that, neutrophil recruitment seems delayed in crohn's disease.

These anomalies are completely absent in UC, people with UC simply do not have these anomalies. Antibiotics are unhelpful in UC, but often lead to short-term remission in Crohn's disease.

Even though the colon is home to most bacteria, the link between pathogens and UC is very weak. In crohn's disease however, there is a direct genetic link and ample data that show inflammation in crohn's disease requires cross border interaction with pathogens, and can not exist in sterile environments.
 
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A little update here: I stopped eating peanuts the same day that I posted this, out of sheer desperation. It's been 4 days without peanuts. Instead of peanut butter with apples, I eat unsweetened dried coconut with blueberries as my treat. I've noticed that I'm seeing much less blood in my stools (and this morning I had NO BLOOD AT ALL which hasn't happened since I started SCD). I'm not sure if this is psychosomatic or a fluke, but I'm going to keep abstaining from peanuts for the next month to see if it has any effect on the bleeding. I'm feeling really hopeful already, actually!

I do have faith that SCD can be helpful for UC, because Elaine's daughter had UC. I'll be back here if I see anything significant. But so far, replacing peanut butter with coconut has had dramatically reduced my bloatedness, so maybe there is something to the claim that peanuts can sabotage the SCD diet.
 

kiny

Well-known member
Good to hear. I don't live in the US, but I have to say it is depressing to read that some people have to wait for insurance to get medical assistance. Hopefully you get the help you need soon enough.
 
A little update here: I stopped eating peanuts the same day that I posted this, out of sheer desperation. It's been 4 days without peanuts. Instead of peanut butter with apples, I eat unsweetened dried coconut with blueberries as my treat. I've noticed that I'm seeing much less blood in my stools (and this morning I had NO BLOOD AT ALL which hasn't happened since I started SCD). I'm not sure if this is psychosomatic or a fluke, but I'm going to keep abstaining from peanuts for the next month to see if it has any effect on the bleeding. I'm feeling really hopeful already, actually!

I do have faith that SCD can be helpful for UC, because Elaine's daughter had UC. I'll be back here if I see anything significant. But so far, replacing peanut butter with coconut has had dramatically reduced my bloatedness, so maybe there is something to the claim that peanuts can sabotage the SCD diet.
How interesting! I feel horrible from any form of coconuts but smooth 100% peanut butter has grown to be the main source of energy for me, I eat it with everything and have actually entered symptomatic remission since I consume it. I have Ileal Crohn's though, and loosely follow SCD. Glad to hear this change has helped you. Keep on experimenting back and forth ideally with a food and symptom journal and potentially monitoring the inflammation levels. Good luck!
 
How interesting! I feel horrible from any form of coconuts but smooth 100% peanut butter has grown to be the main source of energy for me, I eat it with everything and have actually entered symptomatic remission since I consume it. I have Ileal Crohn's though, and loosely follow SCD. Glad to hear this change has helped you. Keep on experimenting back and forth ideally with a food and symptom journal and potentially monitoring the inflammation levels. Good luck!
My mom is Southern Indian from a coastal region, so I'm pretty sure I'm genetically adapted to eating coconut LOL. It's definitely problematic for most people, but me and coconut get along well! I adore peanut butter but at this point I am so tired of bleeding. Desperation has made me willing to experiment!
 
Just an update here. The culprit seemed to be peanut butter. When I eliminated peanut butter, the bleeding reduced dramatically. I had a few months off SCD, but am now back on it without any peanuts, and I make the 24hr yogurt from goat milk. I'm doing quite well!! I see a small amount of blood occasionally, but not every single BM.
 
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