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What do you suggest?

I'm new to this forum and the word "Crohns" is also new to me. I did my capsule endoscopy as my calprotection result was 472. The test detected scattered inflammation in mid to distal ileum. Some ulcerations are deep. My symptoms are soft stools,lack of energy, weight loss and insomnia. Doctor told me that I can try various medications(Entyvio). I consulted a naturopath and he doesn't think I have crohns as I don't have blood in stools and I don't have any pain. He thinks I need to get rid of bacteria/yeast "Candida spp" and "Streptococcus spp." based on stools test. Please let me know if you have any suggestions for me. OR what would you do if you are in my place!!!
 
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Welcome to the forum. Kittz128 is right about blood in stools being a marker for crohn's. It's not always the case. Some people have practically no symptoms but still have crohn's. You can always get a second opinion from another GI specialist. I am all for naturopaths but you have solid proof through diagnostic testing that there are ulcerations going on. What did the Naturopath suggest for treatment?
 
A capsule endoscopy is not a proper way to diagnose someone. Diagnosis should include histology. A colonoscopy with biopsies is needed to rule out other diseases like intestinal TB and foodborne infections.
 
There is some research out there connecting yeast with Crohn's, though the relationship isn't exactly clear yet (or at least I've only see correlations, not exact causation up to this point). There's a lot to read on the subject:


Here is a series of videos discussing some of the research:


If you have a naturopath, I assume you're looking to avoid medication. I personally chose to go the dietary route to try avoiding meds. Yeast was one of the first things I cut out. I was already following a vegan diet, so I didn't have dairy or meat in my diet, but a lot of people with Crohn's seem to react poorly to dairy as well.

Although my condition did improve after cutting out certain foods, I only progressed so far and I had to take on a much more restricted diet in order to heal. I posted my regimen and rationale on the following thread, as well as my blood tests (before and after) showing my general inflammation markers have dissipated.


I have not done a calprotectin test to see if there is still anything I should be concerned about, and will see what my GI has to say about that. However, I do not currently have any of the Crohn's symptoms I previously struggled with (fistula issues, diarrhea, lots of mucus, occasional blood, frequency/urgency, random fever, etc.) and feel fine overall. I'm just starting to slowly reintroduce other foods.

Having gone the natural route and seen some success, I feel confident that dietary changes can make a big impact on this. However, there is little research out there, conflicting information, and you're your own guinea pig.
 
Location
San Diego
A capsule endoscopy is not a proper way to diagnose someone. Diagnosis should include histology. A colonoscopy with biopsies is needed to rule out other diseases like intestinal TB and foodborne infections.
Histology specimens cannot be collected from the small intestine for anything farther upstream than the last few centimeters of the ileum, because the colonoscope cannot physically reach farther up than that. So if the Crohn's lesions are confined to out-of-reach portions of the small intestine, as mine were, then there is no hope of collecting histology specimens, and thus the diagnosis must be made by other means.

My Crohn's was diagnosed by capsule camera endoscopy when the images showed aphthous lesions in the small bowel. This combined with severe anemia, and previous observations by both x-rays and MRE showing thickening (inflammation) of the intestine in the same area was enough for the GI to make the diagnosis.

I did have mild abdominal pain, but I never had blood in the stool, so that is not necessary for a diagnosis. For more than two years I tried to avoid medication, but had to give in when I came down with a serious extra-intestinal manifestation (pericarditis). I am now on Stelara and very happy with it. My Crohn's has been in remission ever since I started with the Stelara.
 
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Thanks for all the replies.

1) Thanks for letting me know that stools may not have blood.
2) Will try to get second opinion from GI.
3) yes through colonoscopy,biopsy and small capsule images, my GI doctor thinks that it is crohns. We also tested for TB.
3) The major symptoms I have is weight loss(lost 15 pounds in 2 years), insomnia and lack of energy. Hope to get young look back in my face. Someone on this website pointed out that serotonine cannot be produced properly when crohns exists. Can that explain my insomnia? Trying to connect dots...Need smart and experienced people to connect dots.
4) Naturopath suggested probiotics, candida tablets, saccharomyces boulardi, biofilm tablets. Tried for 20 days. Felt very very warm in the body while I tried.
5) "Diagnosis should include histology" = Will talk to GI doctor about food born infections. I can guess his answer.
6) My plan: Follow diet changes as suggested by people here. Take colonoscopy again after few months. if its improved, will continue and if not medicines :-(

Appreciate your willingness to help.
 
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What does your normal diet look like? I personally question how much taking "tablets" of things will help heal Crohn ulcers. I mean, most probably won't hurt, but if some thing(s) in your diet has led you down this road, this sounds like an attempt at a "quick fix". Without making necessary alterations to the diet, I doubt anything would fundamentally change in the long run (even if they did help, once you went off of them I presume whatever is inflaming you would start back up again). The best thing would be to remove whatever food(s) are causing the inflammation, as well as heal the ulcers, which can be tough when you have a fecal stream constantly running up against the wounded areas. This is one of the great challenges of this condition -- healing a wounded area where there's a lot of action occurring.

My method to help heal was to give the gut rest with intermittent fasting and to make my meals as easy to digest as possible -- avoiding all hard foods, hard to digest foods, and predigest (blend) all my meals, eating smoothies or soups that were free of inflammatory agents (and included as many anti-inflammatory ingredients as possible).

Possible common aggravating agents include oils, dairy, gluten, yeast, and anything processed or with artificial ingredients. You might start cutting back and/or eliminating some of these to see if it helps.

A couple of good digestive teas to drink several times per day are slippery elm and marshmallow root (drink with some unpasteurized, raw honey).

Good luck and keep us posted on how it all goes.
 
1) Intermittent fasting: I like your reasoning. I also want to do this but I guess I need to stop worrying about further weight loss.
2) eliminate oils: Even virgin coconut oil?
3) Blend foods: Wont I get hungry soon as it will be digested fast?

Is this plan OK? I want to try the foods that most of the people accepted.

Breakfast: Whey protein/Peanut butter, Banana, Blue berries etc. shake.
Lunch: Rice/Quinoa, Lentils, Veggies
Snack: Walnuts/Peanuts or banana
Dinner: Rice/Quinoa, Vegetables, Lentils
 
I haven't seen research that suggests blending will make you hungrier faster. In fact, there is research out there suggesting it could make one feel fuller longer:


Some people tolerate certain oils better than others with Crohn's. I think Coconut Oil is one of those that people do seem to tolerate better than other vegetable oils.

My personal take on oils is that these are concentrated fats that would be very hard to consume in large quantities within nature. For example, crunching some quick numbers, you'd have to eat around roughly 15-16 pounds of olives to take in the total amount of oil in one cup of olive oil. Well, taking in 15 pounds of olives in a week, or even a month, would be quite a tall task. I question whether our guts have evolved to be taking in large, concentrated forms of oil like this. Even though olive oil has been around since 800 BC or so, people were not able to come close to producing it to the capacity we have access to today (plus, 1500 years isn't a lot of time in terms of evolution). I used to eat oils regularly and wonder if this isn't one of the possible reasons my gut deteriorated. Hard to avoid them entirely, but I will use them sparingly and in small quantities moving forward.

As far as the intermittent fasting, I try to eat all three meals within an eight hour period (so that my gut is resting the remaining 16 hours). I don't think this necessarily means you have to lose weight if you're getting all your calories in. But not all calories are the same, either. If you're eating 2000 calories of bananas, there's so little fat that you will surely lose weight. If it's 2000 of avocado's, you are probably taking in far too much fat. I did lose a good amount of weight, but I hardly took in any fat at first and stuck mostly to the softest, easiest to digest foods I could (banana centered smoothies and sweet potato soup). I eventually had to work avocado's in, which finally helped me stabilize.

Note: I do my teas with honey throughout the day and am not worried about keeping it within the 8 hour window.

That looks like a great starting plan, though I'd probably skip the whey and put in avocado or something with some fat/protein that isn't processed. I'd try that diet out for a few weeks and see how it goes for you. I did something very similar to this at the beginning of the year - basically centered my meal plan around rice/quinoa/veggie meals. My symptoms did improve, but they only progressed so far, which is when I decided to take more extreme measures. I wasn't doing the intermittent fasting back then, though, so that might have helped me out. My initial suspicion was that perhaps the nuts, veggies, and grains were just too hard and were scratching my wounds.

Masticate your harder foods as much as possible to help with digestion.

Keep in mind, most of this is all theoretical. There's no research out there on much of this stuff, but hopefully the logic makes sense.
 
Oh, also... some great anti-inflammatory spices with research behind them include turmeric, cloves, and ginger. I include them in some form everyday (ground cloves taste better paired with cinnamon in the smoothies, imo).

I also put Amla powder in my smoothies, but blueberries have the same benefits. Whatever you add around the bananas, I would avoid acidic fruits in the smoothies. My staple add-in fruit are dates - they add a lot of sweetness with their natural sugar and are calorie dense.
 
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