Digestive Rescue: Part 2 of 3
Understanding your symptoms, their main causes and how we can help reduce them is important but what will really make an impact is identifying the contributors, the triggers and the root cause of your symptoms and if possible of your inflammatory bowel disease (IBD).
The exact cause of the IBD called ulcerative colitis is unknown but emerging evidence shows that gut bacteria play a primary role in the development of the disease. Some researchers believe that imbalances in our intestinal flora (gut bacteria) may be at the root of IBD.
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Immune cells in the walls of the intestinal tract are engaged in continual “cross talk” with the trillions of bacteria that inhabit our gut. When beneficial bacteria are suppressed and harmful bacteria proliferate, the intestinal defense system may go into “overdrive,” resulting in an over exuberant immune response, triggering autoimmunity and consequent inflammation.
As discussed previously, our microbiome is just like our fingerprints, we all have different fingerprints and we all have a different microbiome. However, unlike our fingerprints, our microbiome can be influenced and changed by a wide variety of factors. These will include things such as how you were born and fed as a baby, what medications you’ve taken, the type of lifestyle you lead, the level of stress in your life and the food you eat.
Looking at the main contributors such as poor nutrition, that can imbalance gut bacteria and therefore theoretically cause IBD, is key to being able to restore the health of your gut and ultimately have a positive impact on your IBD remission as well as other areas of your health.
Ensuring that we eat the right foods in the right amounts specific to your individual needs is essential for a healthy long life. What your body requires, changes as we get older, for example, we need different nutrients in different quantities such as more vitamin D and calcium.
The role of your diet on both the development and the treatment of your IBD cannot be underestimated. Major changes in the Western Diet have accompanied rises in the incidence of IBD over the past 75 years. Changes to your diet in both the short and the long term can have an influence on microbial profiles such as our gut bacteria. Dietary changes will also affect the health of the bacteria within your gut.
The introduction of refined sugar and chemical-laden foods have probably fueled the rise of IBD. Diets that are high in highly-refined carbohydrates or sugars can cause the good and bad bacteria in the gut to become unbalanced. In fact, if you eat large quantities of these highly-processed foods there is potential to then develop leaky gut syndrome, a condition in which the tight junctions in the large intestine open up and allow bacteria and their toxins to get through. This, in turn, can elicit an auto-immune inflammatory response.
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By reducing your intake of simple sugars, such as those found in honey, desserts, cakes and concentrated fruit juices plus artificial sweeteners, you will help your beneficial gut bacteria but you may also reduce the chance of diarrhoea. Simple sugars and sweeteners are known to increase the chance or even cause diarrhoea, a well known symptom of IBD.
Ubiquitous trans-fats and refined omega-6 vegetable oils are thought to promote inflammation and greasy fried foods are also known to increase gas, bloating and diarrhoea. At the same time most of us also have inadequate intake of anti-inflammatory omega-3s which help to heal the gut.
A diet that is low in fruit and vegetables will also be low in fibre. Fibre feeds our beneficial gut bacteria and helps them to grow as well as helping the passage of our food through the intestines which is useful if you are suffering from constipation. If you have IBD and are suffering from diarrhoea then you may need to restrict foods high in fibre, such as fresh fruits and vegetables and wholegrains, as these can aggravate symptoms (especially when the intestines are inflamed). However, fibre is a very important part of our diet as it can also be a prebiotic which feeds your beneficial bacteria. Therefore you can try cooking high fibre foods before eating: rather than eliminating these necessary foods from your diet, thoroughly cook fruits and vegetables, and avoid eating them raw.
During a flare-up it is may be necessary to avoid things like oats and corn as well as legumes, vegetables and fruit with high fibre content (in particular cabbage, sprouts, citrus fruit, plums, grapes and apricots). Fruit and vegetables you are eating will need to be peeled, cleared of seeds and then cooked e.g. stewed apples are suitable and a great healer of the gut due to the pectin content.
It is also important that you try to make your diet as colourful as possible. The different colours contain different micronutrients and particularly phytochemicals which benefit your gut bacteria as well as the structure of your gut.
Consuming a diet high in polyphenols has a beneficial impact on your gut bacteria. If your diet is lacking in these types of foods then the health of your gut bacteria will not be optimal. Polyphenol-rich foods are excellent to include as part of your overall gut-healing plan along with some of the other heavy-hitters like probiotics and prebiotics.
Polyphenols are naturally occurring compounds found in plants. Many of these plants make up our food supply, including fruits, vegetables, coffee, tea, and wine. Once consumed, only about 5-10% of polyphenols are directly absorbed in the small intestine, while the rest make their way to the colon to be broken down by our gut bacteria into metabolites, which then exert their important physiological effects.
Researchers are now discovering that the relationship between polyphenols and the gut microbiota is a two-way street; that is, the polyphenols positively change the composition of the gut bacteria, and the gut bacteria are responsible for metabolizing the polyphenols into their bioactive metabolites which then benefit our health.
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When considering IBD a healthy diet is more about what you keep in your diet, rather than what you cut out. Initially you may need to exclude foods to find out what triggers your symptoms. However, if you exclude foods, but find no real difference in your symptoms then you can try to reintroduce them slowly back into your diet.
To determine which foods tend to provoke symptoms and flare-ups, it can be useful to keep a food diary. This can help you to see how your diet relates to your symptoms.
Within the clinic, I can help you discover which foods particularly aggravate your symptoms and advise on those foods which will be important for you to include for your gut health. Whilst looking at your current lifestyle and your own exposure to stress, I will also work with your food diary making changes that will fit easily with your life. Over time we can try various different combinations to discover what works for you and what doesn’t.
A classic mistake people tend to make is thinking they can create their own food groups, but without properly understanding how food impacts their health and the health of their gut bacteria they end up aggravating their IBD symptoms.
When considering IBD, a healthy diet is more about what you keep in your diet, rather than what you cut out. Initially you may need to exclude foods to find out what triggers your symptoms. However if you exclude foods but find no real difference in your symptoms then we can try to reintroduce them slowly back into your diet.
By looking at what you are currently keeping in your diet and more importantly what you have left out, will help determine the right course of action.
Using a food diary, tracking symptoms, looking at lifestyle and stress levels as well as using functional stool, blood and urine tests will all help determine the best personalised plan for you. A plan that fits in with your life. By making small gut healthy changes specific to your IBD you can enjoy creating a healthier and happier gut environment.
Whilst we can never underestimate the role that diet plays on both the development and the treatment of IBD, it is important to understand the impact of other areas such as stress.
Stress is an important part of our lives, and a little stress can be beneficial; it can help us boost brain power as low levels of stress can stimulate the release of chemicals called neurotrophins, which may boost productivity and concentration. Furthermore, short term stress can help boost immunity by producing chemicals that regulate our immune system. It can also make you more resilient and motivate you to succeed.
However, if that stress becomes chronic, long term stress will have numerous negative consequences, including ones that affect the health of your gut. For example, stress can change the way your food moves in your intestines as well as the secretions it produces.
Stress is known to provoke IBD and research has also shown that chronic stress can lead to an overgrowth of harmful bacteria and reduce beneficial bacteria as well.
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The gut is especially vulnerable to the presence of stress and may lead to the development of a variety of gastrointestinal diseases such as gastroesophageal reflux disease (GERD), peptic ulcer disease, IBD, IBS, and even food allergies.
Stress can be extremely negative for our bodies. As part of your plan, addressing stress management techniques will be key. Together, along with nutritional interventions, the goal will be to heal your gut, reduce inflammation, and provide a diverse array of friendly bacteria. This can make a big difference in your gut’s susceptibility to the negative effects of stress. Taking cod liver oil and probiotics on a regular basis may make a significant difference in your overall resilience to stress.
By balancing your gut bacteria this may also have positive effects on other areas within your body that have been negatively affected by stress. For example, by balancing your gut your immune system may also become stronger and improvements may be seen in skin conditions such as eczema, acne and psoriasis.
By working together we will look at your lifestyle and explore different stress management techniques that work for you. The overall objective will be to help bring everything back into balance.
Stress is an important part of your life, and a little stress can be beneficial. Long term chronic stress impacts the health of your gut negatively, causing a whole cascade of problems.
Exposure to stress may lead to the development of a variety of gastrointestinal diseases including IBD and IBS.
Part of your programme with me will be to implement simple stress management techniques that work for you. We will support the stress response system nutritionally allowing you to become more resilient and helping you arrive back in a more balanced state. Once we have reduced your levels of stress and your body is naturally balanced it becomes much easier for us to create an effective plan that works faster.
Sometimes it is difficult to see what might be stressful in your life. Your personalised nutrition plan will then also include different stress management techniques that resonate with you.
Your nutritional plan will include foods that support your stress response and help your body cope better with stressful situations. Once you can manage stress properly, this will give your body the best chance of recovering, getting back into balance and able to use the nutrients from food to heal your gut and work more efficiently.
Certain parts of your lifestyle may be causing you stress, but there are other areas that will impact greatly on your own personal health as well. This will include how active you are; staying active is good for you psychologically as well as physically. There is evidence to show that exercise builds up bone and helps to prevent osteoporosis, which can be a complication of IBD.
It’s also important to realise that even the medications you take can interfere with your gut bacteria. As an example, antibiotics are used to get rid of harmful bacteria, but they cannot distinguish between the harmful and beneficial bacteria, so unfortunately all bacteria will generally be wiped out.
Therefore, if you have been using antibiotics, it is important to ensure that at the same time you help to increase beneficial gut bacteria.
Commonly used medications can also play a role in colitis. Non-steroidal anti-inflammatory drugs (NSAIDs–like Motrin, Aleve, ibuprofen and Celebrex) may set the stage for IBD by damaging the intestinal surface, creating a leaky gut situation and potentially causing an autoimmune reaction.
Whilst medications are obviously an essential, important and lifesaving part of our lives, it is important to make sure these are only taken when absolutely necessary. When taking medications, it is important to also support your body nutritionally so you can recover from potential negative side effects. For example, you could supplement with specific probiotics to help reduce side effects.
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The level of toxins that we are exposed to will also have an impact on our general health and especially the health of our gut. Toxins can include the chemicals from the processed foods that we eat and the alcohol we consume; it will include toxins in the air we breathe such as those from cigarette smoke and it will also include the chemicals from the products that we put on our skin or hair and the medications / drugs that we take etc.
All this toxic load will overburden our gut (and our liver) and may lead to an imbalance of our gut bacteria, incomplete digestion, and damaged intestinal cells for example. These may then lead of a wide range of symptoms that can appear completely unrelated and will include skin conditions, mental health disorders and low energy.
When it comes to your lifestyle, it is important to understand how all of these things can affect you in different ways. This is why I work with my clients to identify their levels of exercise, the medication history and toxins that could be currently affecting them.
By looking at your nutrition, stress levels and overall lifestyle we can quickly understand what is contributing towards your gut symptoms. We can support these systems through food, supplementation as well as reducing toxic load where possible. This may then reduce IBD flare-ups, improve your gut health and move you closer to reaching and staying in remission.
The way you live greatly impacts your health.
Eating the right food, reducing your stress will be undermined if your lifestyle is not taken into consideration. The exercise you do, the medications you take and the toxins you are exposed to all play a significant role in the development or remission of IBD.
Nutrition, stress management and lifestyle considerations all need to be in sync in order to bring about good gut health with the ultimate goal of bringing your IBD into remission.
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Digestive Rescue: Part 3 of 3