Inflammatory Bowel Disease

Transcript:

MELANIE: Welcome to Dishing Up Nutrition. Today's show is brought to you by Nutritional Weight and Wellness. We're a company that specializes in life-changing nutrition education and counseling. Each week, we bring you information on how to eat real foods in balance to help heal your body. Good morning. I'm Melanie Beasley, a Licensed and Registered Dietitian, and I've been in the field of nutrition and counseling people for many, many years, over 30. I'm pleased to be here today with my colleague, Leah. Good morning.

LEAH: Good morning, Mel. And good morning listeners. Good to be here again on a Saturday morning. My name is Leah Kleinschrodt and I'm a Registered and Licensed Dietitian. And Mel, I know you feel the same, but I find it so rewarding meeting with clients each week and we meet with people both in person and by video, and we do a couple phone appointments here and there. And hearing their success stories and finding those small wins with clients is, I I just love that part of this job.

And you and I, we, we see clients for a whole host of issues. I was just kind of thinking through some clients that I've, through some clients that I've seen in the last, like week or two. And we talk about high blood pressure. We talk about high cholesterol. I'd say that one comes up fairly frequently; joint pain, energy issues, sleep issues, weight loss.

MELANIE: Digestive issues.

LEAH: Digestive issues. Exactly. Thanks for setting the stage there. And weight loss of course, but skin stuff, all kinds of skin stuff comes in there too. So there's, there's such a range that we talk to our clients about. And some people come in and they're debilitated with symptoms, like they can't live the life that they want to live because of what's going on in their body. And then we have others that are very mild, have very mild symptoms, or some people bless their hearts, come in for prevention.

MELANIE: Yes. Good job people that come in for prevention.

LEAH: Yes. So our job is to take a really good thorough health history, which is why we have 90 minute 90-minuteppointments. We ask a lot of questions, try to gather as much data as you say, Mel, kind of try to get a mile high above things. And then we collaborate with our clients to come up with that individualized plan to help them reach their health goals and to kind of get to those markers that, that is important to them.

MELANIE: Yeah, help them reach their, their goals.

LEAH: Yeah.

MELANIE: And then sometimes we find some goals in there like I'm not sleeping, like, let's address that too.

LEAH: Oh, all the time.

MELANIE: It's, I love, I love my job, and they don't pay me to say that, but I love it because we have phenomenal clients and we, by the time they come in to see us, they are ready to feel better.

LEAH: Yes.

MELANIE: And what job do you get to see people feel better and get their lives back? Yeah, it's, it's great. We have great, it's an honor and a pleasure to really work with these people.

LEAH: Yep. Absolutely. And I feel, I feel the same way. We make these great connections. We get to know people, you know, again, whether it's video, in person, I mean, we get to know what their family is like, their job and, and just kind of that whole picture of their life. It's not just about what they're eating. It's, it's about that big whole picture and that whole person.

MELANIE: Yeah. We're not sitting there just wagging our finger. And saying what you should and shouldn't do.

LEAH: Mm-Hmm. Mm-Hmm. Yes. So, kind of going back to your comment about digestive issues, Mel, you know, I've had, I'm sure you've had too a couple of clients over the years whose main issue was diarrhea. And they have had diarrhea for, usually for a long time by the time they come in and see us. And I've definitely had those clients that they've been, they've had diarrhea for a long time and they've been on bathroom alert. They're on bathroom alert 24/7. And I've had some clients who have had diarrhea 15 to 20 times per day.

MELANIE: Yes.

LEAH: So when that happens, I mean, this affects every part of your life, your family life, social life. Can you get to work without needing to go to the bathroom? Exercising, traveling, it's, I mean, it's almost impossible to do anything spontaneous if your whole life is centered around whether you're going to need that emergency bathroom break or not.

MELANIE: It's, it really is a form of trauma when we've gotten to that place. And a lot of my clients, they just power through until they're like, this isn't normal, something's got to change. And it, it just, it really does, Leah, it breaks my heart because it can negatively affect really all the area of your life. And you know, so we have some solutions for our clients. We work with them and get their lives back. And my clients with severe digestive issues, they complain about feeling absolutely trapped and not living their full lives. And that's the tragedy.

LEAH: Yep. Absolutely. So maybe there's some listeners out there this morning, or if you're listening to this later on a podcast, maybe you can relate to this, you know, that idea or that reality that your gut controls your day instead of you controlling your day.

MELANIE: Yeah.

LEAH: And other people, it's the opposite end of the spectrum. There's a whole host of digestive issues. So maybe you have chronic constipation, or maybe you have such severe heartburn that you are taking two or three different medications or, or using all sorts of measures to get that under control. Or maybe you have blood in your stool, which kind of segues into…

MELANIE: Very alarming.

LEAH: Yeah, very alarming. Which is kind of one of our big topics today.

What is inflammatory bowel disease?

MELANIE: Yes. Well, 75% of office visits to primary care doctors are due to digestive concerns right now. And our topic today is addressing inflammatory bowel disease. Leah, and I may refer to it as IBD, so have you heard of the condition Crohn's or also; easy for me to say; ulcerative colitis? Which is also commonly called just colitis, probably because the ulcerative is difficult to pronounce. Crohn's and colitis fall under the category of inflammatory bowel disease or IBD.

LEAH: Yep.

MELANIE: And it's on the rise.

LEAH: Absolutely. And let's clarify something right away too, that the topic today is IBD and those, specifically, those two diagnoses of Crohn's and colitis. A lot of times that gets a little confused or mix-matched with IBS.

MELANIE: Yes, it does.

LEAH: Yeah. Because it sounds, I mean, it sounds very similar and IBS is more common than these IBD types of diseases. So again, it, there's a lot of overlap and similarities between the two, but there are definitely some important differences. And it's, you know, and especially if you, especially if you are the one who's more struggling with that more severe side of things with IBD and gut issues.

MELANIE: And with IBD, our topic today, symptoms are more severe and more extreme.

LEAH: Yes.

MELANIE: People with Crohn's or colitis typically have severe abdominal cramping and nausea and that urgent watery bloody diarrhea. Some also experience unhealthy weight loss because they aren't able to absorb and maintain enough nutrients with all of these loose stools. Really, the transit time is so fast, the body just can't absorb. So you can imagine how hard it would be to live a normal and productive life. Picture always having to be near a bathroom. You are on alert no matter where you go. Even a 20 minute trip to the convenience store can be stressful for these people because they're wondering where is, where are they going to go for an emergency, an emergency situation where they have to find a toilet.

LEAH: Yep. And I don't remember if I saw a commercial about this or, or I've just talked to enough clients now who kind of have been in this situation. Like you have your go-to places and you have the bathrooms mapped out. And you, you kind of, again, like you kind of know where you can go. And so then if you ever get out of that comfort zone or get out of that safety zone again, it can be a very hit or miss or it can be a, a stressful situation. Absolutely.

MELANIE: And really our clients that have this condition, they, they live in anxiety all the time.

LEAH: Mm-hmm.

MELANIE: Because you don't want to be socially embarrassed.

LEAH: Absolutely. Yep. So a lot of times with Crohn's or colitis, doctors do prescribe pretty intense medications. And that makes sense because these are very intense diseases.

MELANIE: Yeah.

LEAH: IBD is an autoimmune disease. So again, Crohn's, colitis, these have autoimmune origins to them, and, and technically there's not a cure. But as a licensed dietitian, I've definitely worked with clients who have been able to get their symptoms into remission much more manageable by following a very specific food plan. And usually that food plan centers around finding out what are the big triggers, what are the things that create inflammation in their gut specifically. We've got big buckets that that kind of falls into. This typically are like the processed foods. We'll talk some more about you know, gluten, dairy, some of the other common trigger foods.

MELANIE: Get into the specifics.

LEAH: Yeah. We'll get into the specifics a little bit later on in our show here. And really kind of eliminating those and then adding in those nourishing foods that are great for lowering inflammation and helping the gut.

MELANIE: Exactly. That's the goal today, right; is to give our listeners tools so they can find relief and also have their IBD symptoms go into remission. By changing a client's diet and adding in some key supplements, really, remission is possible, and we've seen it in clinic time and time again, and people are thrilled that their bathroom alert episodes start decreasing with some of these nutritional changes.

LEAH: Yeah. Right. Yeah, absolutely. So we'll come back and pick up that topic on the other side of our first break. You are listening to Dishing Up Nutrition and our topic today is Inflammatory Bowel Disease, or IBD. Are you wondering what does food have to do with Crohn's disease or colitis? Since there is no cure for this, these autoimmune conditions, it's important to do whatever we can to reduce inflammation and the chances of having flare-ups. So we will start to build on that topic of what foods are inflammatory and list off list off some of the common culprits on the other side of break and we'll be right.

BREAK

MELANIE: Welcome back to Dishing Up Nutrition. I'm Melanie Beasley, a Licensed and Registered Dietitian, and here I'm here with Leah Kleinschrodt, who is also a Licensed and Registered Dietitian. And our topic today is about your gut health. Many people are struggling with a condition called IBD or Inflammatory Bowel Disease. Leah and I have been, seen, we've really seen firsthand from our clinical experience that certain foods are more likely to cause those awful gut flare-ups. And that's what we want to address today.

What is the prevalence of IBD?

LEAH: Mm-Hmm. Yeah. We'll definitely break that down into more specifics as to what are we looking for? What do we need to avoid, at least initially, what are just some of those foods that create that inflammatory cascade in the gut? But before we get to some of that you know, Mel, you and I were just talking even before the show, how many people actually truly have IBD? What do those numbers look like? Because I remember when you shared that with me, I remember thinking like, I was shocked because it was just more, it was more than I thought.

MELANIE: Yes. It, I think it's silent. People aren't really talking about it. They're just suffering through. And it was higher than I thought too. When I did the research, over 3 million Americans have IBD. That number might be low because many people are just not getting diagnosed. They're suffering through, they're powering through, like I said.

LEAH: Yeah.

MELANIE: So you want to, you know, you want to assume that those numbers are higher I think.

LEAH: Yeah. I think you're probably right. And it's a lot of these can span again, a kind of a variety of symptoms or vary in intensity for sure. So you're right, someone might kind of limp along for months or even years without getting, without getting that diagnosed until, in my experience, usually there's some kind of tipping point. Like someone goes into a really extreme flare or like something happens where like, okay, now we got to really got to some deep, deeper digging.

MELANIE: Yeah. I had a younger client who actually came to me and he told me I had no idea that people didn't have 10 watery diarrhea episodes a day. I thought that was normal because he had always had that. And it wasn't until he was having spontaneous vomiting after he ate because he was so inflamed that he really sought some help.

LEAH: Okay.

MELANIE: And we got him straightened out, got his life back.

LEAH: Yeah. Oh, goodness. Yeah. So yeah, sometimes you just don't know what you don't know.

MELANIE: You think this is normal, right?

What is Crohn’s disease?

LEAH: Yeah. This is normal. Doesn't everybody do this? So, oh, goodness gracious. Yeah. So we mentioned that inflammatory bowel disease is autoimmune based. Now let's talk Crohn's for a second. So Crohn's refers to inflammation that can happen anywhere along the intestinal tract or really anywhere along the digestive tract. This part is important to know. I mean, 'cause our digestive tract goes from mouth to anus. It goes from north to south the whole way through. So Crohn's could be at any point in that, in that long tube, basically. So this inflammation usually, I mean, it includes bleeding ulcers. I mean that's, I, that's to me, shocking, or like, that's sounds very intense.

What is ulcerative colitis?

MELANIE: It's so painful. It is a very painful condition. And then also ulcerative colitis referred to as colitis for short affects just the lowest portion of the digestive tract, which is the colon, also known as the large intestine. They're the same. And people with colitis can have bloody stools, and the blood is going to be bright red. And this is because the inflammation and the ulcers are lower and closer to the anus. So the blood ends up being a brighter redder color. Again, that transit time doesn't have time to clot and darken.

LEAH: Right. Yep. Whereas kind of on the other side of that spectrum, with Crohn's disease, if there is bloody stools because they're, you know, the ulcers are higher up in the digestive tract, like there might be from the stomach or in the small intestine or something like that, the blood in the stool is usually really dark or almost a black kind of color, because the blood is oxidized when there, it takes longer to get through that digestive tract. It's older blood in that sense. It takes longer to be excreted from the body. The, that blood oxidizes through that transit time, and then the color ends up being a lot darker. So we've got the bright red with the ulcerative colitis and Crohn's. If, if indeed those ulcers are higher up in the digestive tract, that that color could be a darker, either a darker red or even black.

MELANIE: Or even black. Yep. Yeah. When if you have black stools, you need to get treated.

LEAH: Yeah.

Dietary recommendations for IBD

MELANIE: Right? Because that's an indication of internal bleeding. And we want to keep our message and suggestions today as simple as possible. To reduce or eliminate IBD symptoms and flares, we have four main dietary recommendations, and I'm just going to click through them here. Cutting out gluten, all gluten: don't play; dairy, factory fats and added sugars. So really it's what we're teaching the majority of the time anyway. But if you’ve followed us for a while on Dishing Up Nutrition, this is not a surprise for you.

And giving up some of your old favorite foods may sound very daunting at first, but what's the cost/benefit here? Are you willing to replace some of your old favorites with new real foods if it means fewer trips to the bathroom each day and some ease and some healing where you're not in pain?

LEAH: Mm-Hmm. And I think you said this earlier, Mel, usually by the time people come to see us for this type of thing, they're ready.

MELANIE: They are ready.

LEAH: They're ready to make some of those trade-offs. They're willing to kind of take, do what it takes, especially initially to just get on top of it and to heal and to feel better, get their lives back.

MELANIE: Yeah, I agree.

LEAH: Yeah. And one of our, one of our colleagues, she had a, actually a great story of a friend of hers who was diagnosed with ulcerative colitis. This woman, she was in her forties, had unbearable stomach pain, and was in the bathroom dozens of times a day. She had to take off time from work because she couldn't function and ended up having to spend a couple of days in the hospital. They did a lot of testing. And usually with the testing with this, you're looking at a colonoscopy and endoscopy. So you're kind of, there's things going in on both ends. And there's other imaging that goes into this as well. But she was finally diagnosed with ulcerative colitis. And so when this woman had this diagnosis, again, some of our clients feel the same way. It's like, you kind of get thrown in the deep end. You have this diagnosis now, so you have an answer. You have kind of an indication of what's going on, but then what?

MELANIE: Right.

LEAH: What's, what are those next steps? How do I, how do I take some of that control back and actually be able to harness the healing power within myself? So she reached out to our colleague and just for some of that intestinal health advice, and the advice worked really, really well. She immediately started taking some good quality probiotics. I think it was Bifido Balance, some L-glutamine to help heal that lining of the intestinal tract, and doing some omega threes, great anti-inflammatory component there. And then she also looked at the food component. She went kind of gung-ho and did no gluten, no dairy, and she really analyzed all those processed foods, the sugars, and kind of found out where, where some of those things were sneaking in as well. So it was kind of this whole picture of she changed the foods that she was eating, and also had some really good key supplements and saw some really great strides in her health.

MELANIE: It's fantastic. And really for anyone, your overall health is going to improve, but it may sound very strict, but after all, she was in the hospital in a, in a lot of pain. So she probably thought, what have I got to lose at this point?

LEAH: Mm-Hmm.

MELANIE: And when someone is in such critical condition, they have to be that strict and careful. You cannot have a nibble here and a bit there.

LEAH: Yep.

MELANIE: You know, it's really important. We'll be going to break now.

LEAH: Yep. So you are listening to Dishing Up Nutrition. Melanie and I have been having a discussion on how to reduce symptoms with ulcerative colitis and Crohn's disease. So we will continue this discussion on the other side of our second break. We'll be right back.

BREAK

MELANIE: Welcome back. You're listening to Dishing Up Nutrition. I'm Melanie, and I'm here with Leah today. And having ongoing digestive issues can be so hard, but I think we all agree that chronic diarrhea is probably one of the most challenging digestive concerns. Wouldn't you agree?

LEAH: Yes. And I definitely, gosh, I'm even thinking about clients I've seen in the last couple of months. I feel like there's been a lot of diarrhea stories, there's been a lot of diarrhea going on. It's just common. It's a common thing out there. So yeah, for somebody who has these chronic loose, nonstop loose stools, it's hard to go for a walk or exercise, hard to go shopping, hard to attend social functions. Sometimes it's hard to go to work. Always needing to be close to a bathroom, just, you know, just in case. And so we were talking about one client, one client story before we went into break, but Mel, I know you had another one that you had been working with relatively recently too who had chronic diarrhea. So could you just tell us a little bit about her?

MELANIE: Yes. She's one of my great clients. I love all my clients, but I have such a heart for her. And at first, her first appointment, she said, I've been dealing with chronic diarrhea for the past year, and she really was miserable. Really diarrhea was really controlling her life. And she was having watery episodes daily. It just, she had no relief and it had been going on for several months. And after the second appointment, she came in and said her diarrhea was gone. So we did a little happy dance together.

LEAH: Yes.

MELANIE: And this woman followed every suggestion and was so compliant. I love when my clients let me be the boss of them. And she did. And she was, she was so desperate just to get her life back, Leah.

LEAH: Mm-Hmm. Yeah. Again, that's, that is a place that a, some of our clients really are in. They're just like, just tell me what to do. I will do it. I will do it a hundred percent, I'll do it 110% even. And, and really when you can commit like that, the results really can be that phenomenal. For some people it does, it takes longer to get to the bottom of their specific triggers to work on that gut healing. You mentioned that client that you worked with had had chronic diarrhea for a year. I, you and I have both had clients where it's been six years, where it's been 10 years, where there's just been a lot more damage to that intestinal tract.

So sometimes it does take a little longer to heal to really get on top of things and, and depending on where the client is at too. But that's such a fantastic success story. And for some it really can turn around that quickly with the right food modifications, healing supplements, and just kind of that go-getter commitment.

MELANIE: Yeah. And I, I do have to give a little shout out to the owner of our company, Dar Kvist, because she has mentored us beautifully in how to deal with these clients over the years. And yeah, I, I just, I really have to say I give a lot of credit to that woman for teaching us all how to work with some of these really difficult situations.

LEAH: Yeah, absolutely. And, and, and giving hope too. Like, it's very rare that we're out of ideas. It's, it's that there's, okay, maybe plan A doesn't work, we go to plan B, C, sometimes we're down to plan F, but…

MELANIE: We will all problem solve together.

LEAH: Absolutely.

MELANIE: All of us nutritionists and dietitians.

LEAH: Yes. That's what I'm really thankful for too is to just to have a great brain trust, to be able to bounce ideas off or with our colleagues brain trust.

MELANIE: Great word.

LEAH: Yes. Well, that's what I really feel about it. And so yeah. And Mel, you have a great story. And we had another client story too that we were just talking about before break. You know, again, a young woman in her forties who was diagnosed with ulcerative colitis. And she again, kind of took the bull by the horns, no gluten, no dairy, did a few key supplements, and really, again, saw a great turnaround in her health and her healing.

And we're pleased to say that even now a few years later, we heard this from our colleague, that this friend still sticks mostly to this same plan of gluten-free, dairy-free, limited grains and sugars, processed foods. She's diligent with those supplements with her probiotics and her fish oil. And, you know, sometimes, sometimes we're as careful as we can possibly be, and occasionally there might be something that still slips in or we get a little, you know, a little exposure to something. But now this particular woman, she is in a much better place, and if she does have a little something or something accidentally gets in, it doesn't create this huge inflammatory cascade in her digestive tract. She might have like a little hiccup here and there some digestive symptoms, but she's able to stay on top of that inflammation, which I mean, that's key. We want that resilience in the long term.

MELANIE: Right. Do they ever return to what they were eating before? No.

LEAH: Right.

MELANIE: But certainly it's not as devastating if something slips in.

LEAH: Absolutely.

MELANIE: And that's, that's kind of the goal.

LEAH: Yeah.

MELANIE: So this may be something you're hearing from for the first time. So we want to back up and give more details about foods that have gluten and dairy, what we're talking about.

What is gluten and where do you find it?

LEAH: Yep. So let's, I mean, let's start with gluten. I'd say again, if you're a long time listener, this is, this is review, but for some people you might be hearing this for the first time. So gluten is a protein that is found in certain grains. The big one is wheat, right? So you think about everything, anything that is made with wheat, flour, you know, those kinds of things. Gluten is that protein that acts like the glue that binds those things together. So we’ve got to think about breads, pasta, muffins, bagels, pancakes, crackers, pastries, desserts, tons of other processed foods that are usually boxed, canned, frozen. They come in, you know, come in a package.

MELANIE: Yeah. It's really, actually, it's pretty easy because wheat is one of the top eight allergens. So if you roll the label over and you read in the ingredients, it says wheat is gluten, you know, that's, that's a good tell.

LEAH: Absolutely.

MELANIE: So there's research showing that people with IBD share similar genetics to those with celiac disease. And we mentioned briefly that Crohn's and colitis are both autoimmune diseases. This means a person's body is attacking its own cells, and in the case of digestive conditions, the cells that line the intestinal tract are being attacked. And that is what leads to intestinal inflammation and bleeding ulcers up and down that tract. However, I've seen many, if not most of my clients who have intestinal inflammation and chronic diarrhea that do not have celiac disease. They've been tested negative, but they still benefit greatly from removing these items we're talking about.

LEAH: Mm-Hm. Same. Yeah. I've, I've had a number of clients come in who have done some of that testing. They're, they're convinced, you know, they must have celiac disease or something like that, and they, and they don't, but that doesn't mean that these foods aren't creating inflammation for them still.

MELANIE: Exactly.

Genetics do not determine the future of our health

LEAH: Yeah. So if you haven't heard much about Crohn's or colitis before, are you wondering how, how does somebody get this diagnosis? Why do some people, maybe they have a little gas and bloating and then others really swing to the other end of the spectrum and have full-blown colitis, severe bloody diarrhea all day long? So research has found that people carry specific genes for Crohn's and colitis. But the most, I, here's the most important part: our genetics do not determine the future of our health.

MELANIE: Right. Yeah. That's important. Leah, say that again.

LEAH: Yep. Our genes do not determine the future of our health.

MELANIE: Yeah. And this is not, it's not doomsday for you just because you're someone in your family has it as well.

LEAH: Mm-Hmm. Yep.

MELANIE: So let's chat about this for a minute. What about the people listening who have close relatives that have a diagnosis of Crohn's disease? Does that mean that they're going to get Crohn's disease based on the information you just gave us?

LEAH: Yeah. Yeah. I think we just kind of alluded to that. It's not, it's not that simple, which is that's good news. Yes, it's more likely with someone who has a family history of Crohn's and colitis, that they are predisposed, there's the word I'm looking for, that they may end up with more digestive issues, but there's this whole field out there. And I remember learning about this for the first time in my graduate program. It's this field called epigenetics, which just means that there are things that turn our genes on and off. So like, there's little tags or there's like, there's little switches. There has to be a switch that gets flipped.

MELANIE: Yeah.

LEAH: And that's the part that is really super interesting. We have kind of like this blueprint with our genes, but what actually gets turned on and turned off is what this epigenetics field is all about. So lots of people carry certain genes that are not turned on at all, and they, they end up not act actually affecting their health.

MELANIE: Yeah. It's, it's really curious, you know, it's a really curious thing that happens in a family zone where somebody has it, somebody else has it, and then you'll have that one person no problem.

LEAH: Yep.

MELANIE: And then it, it, it's a very it's an interesting field.

LEAH: Yeah. And it's something, I mean, we just don't understand all of it. There's a lot that researchers and doctors and all these smart people really, they, we know a lot about it, and yet there's still so much that we don’t.

MELANIE: Yeah. And what do we do with that information?

LEAH: Right.

MELANIE: So some things I've heard from clients are that certain triggers cause the underlying Crohn's or colitis genes to be turned on. And this is usually what kicks in the start of symptoms like diarrhea or bloody stool, constipation or nausea, you know, all the symptoms, the pain. But the bottom line is we want to get them relief.

LEAH: Yeah.

MELANIE: That's our job.

Triggers that might turn on IBD genes

LEAH: Absolutely. Well, and let's backtrack for a second. You said, I mean, there are some triggers that we have suspicions on or that we look into. What are some of those triggers that might turn on…?

MELANIE: Tremendous stress.

LEAH: Mm, definitely.

MELANIE: Tremendous stress, stressful event or trauma, is a, is a huge trigger.

LEAH: Yep. Another, another one that I'll look at, what I really try to do some deep diving in with clients too, is like, were you sick around that time? Did you get a virus?

MELANIE: Yes.

LEAH: Did you get a bacteria? Like, was something going on at that time?

MELANIE: Food poisoning.

LEAH: Food poisoning. Yeah, exactly. I ask about food poisoning. Did you travel? I do ask about the stress piece. So again, like what, what was going on around that time where your symptoms really started to kick in?

MELANIE: And is the stress ongoing?

LEAH: Yes.

MELANIE: Because that, that's something that we need to work and address as well.

LEAH: Mm-Hmm.

MELANIE: So a lot of the information is interesting, not necessarily curative.

LEAH: Yeah.

MELANIE: So it, it could be a variety of things. So it could even be shingles, which could be coming from physical and emotional stress as well that triggers it.

LEAH: Yep.

MELANIE: So something like strep or staph infection. There's a variety of triggers.

LEAH: Yep. Absolutely. And some lifestyle habits as well can also cause symptoms to start. So smoking, drinking alcohol, even a, a few rounds of antibiotics.

MELANIE: Oh yeah, good.

LEAH: That I've heard, and again, like that's another question I've learned to start asking people, 'cause I'll hear from clients, you know, I had to go on because antibiotics for a sinus infection or, or X, Y, Z fill in the blank there. And after my colitis had been in under control for months, all of a sudden it flared again, couldn't leave the house for days because I was in pain and now I'm still in that inflammatory spiral.

MELANIE: Yeah. I had a client and her, we had her straightened out. She was doing great. And then her mother began to pass and fail. And there was some sibling issues. She went, she ate on point, but she went right back to watery diarrhea. So we actually worked on her stress in managing stress and it straightened her out.

LEAH: Absolutely. That's a great, great anecdote. So we do have to take our final break. You are listening to Dishing Up Nutrition. I'm Leah Kleinschrodt and with Melanie Beasley here in studio. Today we will be talking a little bit more about foods with sugar or things that can turn into a lot of sugar that can also contribute to these Crohn's or colitis flare-ups. And you may be someone out there who says, okay, yeah, maybe I know sugar is bad, but it has such a hold on me. How do I get out of that cycle? How do I break that hold? And so if that's you, you're not alone. And at Nutritional Weight and Wellness, we've got you covered with our upcoming 28 Day Breaking Up with Sugar Challenge. I'm really excited to put this out into the world.

MELANIE: It is so fun.

LEAH: Yes. And Melanie will tell you a little bit more about it after our break.

BREAK

MELANIE: Welcome back to Dishing Up Nutrition. September 25th is the start of our upcoming 28 Day Breaking Up with Sugar Challenge. We've done shorter versions of this Sugar Challenge in the past, and people had a lot of success and fun when the challenge was a week long. So imagine how much progress you could make in four weeks. You'll get so much support and education, four weekly topics, 13 recorded video lessons, a challenge tracker, and a weekly guide, a private online community moderated by nutrition experts and weekly live question and answers with our fabulous dietitian, Teresa. She really makes it fun. And to find out more information and sign up, go to our website, weightandwellness.com and you'll see a link to click on.

LEAH: Yes.

MELANIE: It's a great one.

LEAH: Yes. It's been a long time coming. We've been hearing little bits about it and it's fun. It's so fun to have it out in the wild and ready for people to register and kind of get started with that. Like you said, we've done kind of little snippets in, in the past, and so to have this be something really structured and really and having it a little more longer term, I, I can't wait to hear the results some people are getting.

MELANIE: Yeah. I know Teresa's been working really hard to make it a great program.

LEAH: It’s taken a whole team of people, Teresa and yeah, a whole team has really worked hard to bring this together.

MELANIE: Yeah.

Replenish good bacteria in the intestinal tract

LEAH: So, yes. So before break we were just chatting about actually some triggers that can bring on ulcerative colitis, Crohn's, or really that inflammatory cascade in the digestive tract. And, and one of them where we left off was antibiotics. If you go on a round of antibiotics, and sometimes we need them, we need those antibiotics to clear things up when things that get out of control. But if you go on a round or maybe a couple of rounds, that could be something that it kills off both the good and the bad bacteria and just can create that inflammatory cascade in the digestive tract.

So it might cause if your gut has been well for a long time, it can cause that flare up in symptoms again. So again, sometimes we have no choice but to go on antibiotics, but then what I would think about with a client is like, okay, we got to replenish that good bacteria.

MELANIE: Yes.

LEAH: Hopefully we can do some of that while you're on the antibiotic. And if not, then we do it immediately afterwards. We get some of that good bacteria back into the system. Bifidobacteria is kind of one of the big ones I think about, but there's others out there.

MELANIE: Right. And you, you have to have some caution. You don't just run out and start a probiotic with the big guns, 50 billion or something like that because you don't want to, you know, blow up like a balloon. And I call it blowing your guts up because it can make you really uncomfortable.

LEAH: Yeah.

Remove gluten for colitis and Crohn’s

MELANIE: So it's good to do that with a professional nutritionist or dietitian. So let's circle back talking about removing gluten from the diet to help put colitis and Crohn's symptoms into remission. The, you know, the reason we brought that up is because gluten is also one of those triggers, one of those triggers that can turn on the dormant genes someone might have.

Maybe they had the genetics for IBD but weren't having any symptoms and those gluten containing grains can flip the switch and the intestinal cells start attacking each other. And this creates all that inflammation and problems in the gut. I have to say also, Leah, that it's not the gluten of our childhood. You know I'm older than you, but you know, so a hundred years ago when I was born, we could eat all of the bread and the pancakes and so forth, and not have the distress that I'm seeing in clients today. Because it has been genetically modified. It’s been bred to be something different than it was, you know, a hundred years ago. So our bodies don't even kind of recognize it as food a lot of times and creates that inflammation.

LEAH: Yeah. Yeah. That's a great call 'cause someone might say, well, I've been eating gluten for 20 years, 40 years. Like I've always had bread. Why is it a problem now? And again, like it, there could be a lot of reasons behind that, but that shift, like you said, yeah. Like that could be one of them.

Dairy can be inflammatory for IBD

And so we think about gluten, we also think about dairy for a lot of clients, especially when they're really struggling with the gut issues. When we think about dairy, dairy can be a double whammy because we're talking about the proteins that are in dairy, and specifically casein. That's one of the, the milk proteins that's hard to digest and can create inflammation. We also think about lactose. That's the one most people think about with dairy is that if that's the milk sugar, that if you can't break that down really well, usually people feel gassy, bloated, diarrhea, abdominal cramping, things like that.