'The Specific Carbohydrate Diet' - A Cure for IBD?

For thousands of people all around the world, inflammatory bowel diseases cause fatigue, pain and a lifelong struggle to manage crippling symptoms with hospital stays when flare-ups occur. While the future can look painfully bleak when the disease is first diagnosed, famous icons such as Sir Steve Redgrave, John F. Kennedy and Anastasia are all examples that an extremely successful and normal life can be achieved.

Possible Causes:
            Specialists in Colitis still do not know the exact cause of the disease, however there are 3 favourable factors: Gentic; Environmental and Autoimmune Disease. Genetically, the most convincing theory is that there are HLA's (Human Leukocyte Antigens), a large gene family found in chromosome 6 which is key to the function of the immune system, that may not be functioning properly. Environmental factors include diet and, surprisingly, breastfeeding. Diet is the key topic of this blog that i will come back to shortly. Breastfeeding is a peculiar one, there has been conflicting reports to show that breastfeeding may cause the development of IBD, and some studies have been carried out, but solid evidence is yet to be found. Finally, some sources refer to Colitis as an autoimmune disease, which is when the immune system malfunctions and attacks parts of its own body, in this case being the bowel, often for unknown reasons.
              These are all theory's that scientists have come up with, and some are much more feasible then others, however there is one possible cause that is regularly overlooked by many; diet. Everyone knows that the gut plays a vital role in digestion and absorbtion, so surely diet is an obvious factor to consider? Sadly not as many sufferers of IBD take no notice of there food intake, eating foods high in saturated fats, complex carbohydrates and refined sugars, all of which do much more damage then they realise. Even IBD specialists are very sceptical that diet makes much of a difference, often only recommending that patients are not to eat curry's, take-away's and excessive sugary foods which may aggravate the condition further. Strong medications such as Azathioprine and Prednisolone are prescribed eagerly, and while they work for many patients, the sufferers that they don't work for are usually left with limited options, and they all know one option is surgery. A persistent thought, and very daunting to address head on.
       
How Things Go Wrong:
         To fully understand how the diet works, you must first understand how the gut is harmed by the diease process: The gut of a normal person has over 400 bacterial species, some which are harmless, some which are not, these species are constantly competing for sparse food which causes them to be in constant equilibrium. Cleverly, in the large intestine, each species inhibits an over-abundance of the others which prevents one particular microbe from overwhelming the body. However, when the balance in the gut is disturbed, an overgrowth of bacteria can occur, and as a result, damage the small intestine. This overgrowth can be triggered by many things: overuse of antacids, weakened immune system (by poor diet, malnutrition or genetics) or a change in microbial environment through long term antibiotic use. 

The Link to Diet:
          However, diet may be much more significant than many think in calming, and in many cases, curing the inflamed bowel. 'Breaking The Vicious Cycle' is a book by Elaine Gottschall which focuses on dramatically altering the diet of a Colitis sufferer to improve intestinal health. The diet completely eliminates all complex carbohydrates, commonly found in bread, rice, oats, potatoes, starch and hundreds of other everyday foods and flavourings. It also prohibits the use of lactose and refined sugars.
         Quite simply, when foods such as carbohydrates are not digested, they remain in our gut and become a breeding ground for microbes, unfortunately microbes digest these carbohydrates through fermentation. The waste products of fermentation includes methane, carbon dioxide, lactic acid, acetic acid and other toxins - all of which damage the gut wall. There is evidence to show that this increased acidity mutates harmless bacteria into much more dangerous ones, and interestingly, the lactic acid produced has had proven links to abnormal brain function and behaviour often related to IBD. This overgrowth of bacteria further mutates bacteria and creates more and more gas and acid which in turn damage the gut wall even more, this damage causes protective mucus to form, which further damages the lining and causes it to become ulcerated - This is the vicious cycle. This whole process also destroys microvilli, the absorptive cells which means we take less nutrients into the body and as more carbohydrates are left in the gut, they cause water and nutrients to be pulled from the body into the colon, resulting in chronic diarrhoea. Absorption is further affected as diarrhoea increases the rate with which food travels through the gut, leaving insufficient time for nutrients to be absorbed from the food.


How the SCD Works:
           This is how the diet helps: The Specific Carbohydrate Diet bases itself around eating the foods that contain simple carbohydrates, ones that we can fully digest and leave virtually none behind in the gut, thus causing a decrease in the harmful bi-products of fermentation as microbes food supply of carbohydrates decreases. As the presence of these harmful acids and gases decrease, the gut wall stops the need to be protected, so mucus production stop, and carbohydrate digestion is improved. As the individual becomes more nourished and gains more energy from their food, they are in a better state to fight off bacteria. A key part of the diet which the book insists on is eating home made yoghurt. Commercial yoghurt is banned as it has not properly fermented and the complex sugar molecules are still present which are strictly avoided in the diet, however home made yoghurt can be made as long as it is left to ferment for at least 24 hours. In this time all of the complex sugar molecules (disaccharides) are converted into simpler ones (saccharides) which the gut can digest. This yoghurt is very important as it naturally contains healthy bacteria to help maintain an even balance in the intestines. Through this diet, harmful microbes creating harmful bi-products are slowly eliminated, causing the natural flora in the gut to return to equilibrium and with the addition of friendly bacteria from the yoghurt, a much calmer and healthier environment is created. Diarrhoea begins to stop as less water is drawn from the body to flush out the mucus produced when inflammation is high, gas is reduced as the microbes, producing gas as a bi-product of fermentation, decrease and finally, blood is eliminated ulceration on the gut lining is repaired.


Drugs are very often a miracle cure, completely restoring a Colitis sufferer back to full health. However for those who drugs have not worked for, specialists are keen to suggest the option of surgery, while completely disregarding another diet such as SCD. Thousands of sufferers have been cured by sticking to the diet, proof that it really does work for many, the science behind the diet makes perfect sense, and while it doesn't work for everyone, the information and support on the internet for IBD sufferers is fantastic. So please, if you suffer, or know of anyone who suffers from Ulcerative Colitis, Crohn's, or any other IBD, recommend them to read 'Breaking The Vicious Cycle by Elaine Gottschall'. Even if from this post, one sufferer of IBD becomes aware of the positive effects of this diet, i would consider it a huge achievement.

I myself can report first-hand that, after a 3 year struggle with Colitis, this book has changed my life for the better, and i pray that it may just change yours too.