Anti-Inflammatory Diet: Best Initial Treatment for Gastrointestinal Symptoms before full work up for Inflammatory Bowel Disease

Anti-Inflammatory Diet: Best Initial Treatment for Gastrointestinal Symptoms before full work up for Inflammatory Bowel Disease



1.Two patients asked the following questions recently. 
I have mood swings, abnormal foul smelling gas and unusual bowel movements (usually solid, but now foul smelling and sheet like). What’s wrong with me?


2. Why do I wake up still feeling tired and have morning sickness but not pregnant.




Answers: 
1. What is your diet like? Do you have frequent bouts of constipations or diarrhea? Consult with us to help you get better. Begin with an anti-inflammatory diet: see cremersmd@blogspot.com; avoid all gluten, eat plenty of veggies, fish oils/omega 3 initially; if no improvement, you’ll need assessment for Inflammatory Bowel Disease. 


2. Morning sickness when you are not pregnant most likely is due to your diet. Do you have diarrhea or constipation bouts? If yes, could be Inflammatory bowel disease. Eat low inflammatory diet.





Here is my full recommendation.


Dr. Cremers’ Anti-Inflammatory Diet or Low Inflammatory Diet


More and more, many MDs are noticing the importance of eating foods which not only do NOT increase inflammatory factors in the body, but also eating foods that decrease inflammation in the body. As an eye MD, this is especially important in patients that have dry eyes, diabetes, or any autoimmune disease, such as Lupus, Rheumatoid Arthritis, Sjögren’s Syndrome, to name a few. 

If you have any unusual stomach or GI (gastrointestinal) symptoms, first try this Anti-Inflammatory Diet. Keep a good diet diary and see what is making your symptoms better or worse. Some patients will do a full elimination diet with starting with just water (flavored with stevia or Styr should be ok), and bone broth or chicken soup withouth the noodles. Some will add in almond milk (if no known history of allergy to almonds) and gluten free bread. Each person’s GI system is different so a diet diary will help you see if you are having sensitivities to dairy, gluten.

If your symptoms do not improve, start a Chron’s Diesease Diet (below)& make your appointment to see a GI specialist to be sure you do not have Inflammatory Bowel Disease, such as Chron’s Disease or Ulcerative Colitis. You may have to follow a Crohn’s Diet or Inflammatory Bowel Disease Diet (below) to get relief or even start prescriptions medicines. Some patients will need bowel surgery to get relief.



The Short-Cut Notes To “The Best Low Inflammatory Diet is to Eat the Following:

0. I do not recommend eating any form of gluten even if it is high in protein if you have GI symptoms or low energy. Even if you are not gluten allergic and have never had issues with gluten, I and many MDs are seeing patient who with aging (or maybe a change in how wheat is processed?) are becoming sensitive to gluten. These sensitivities can reveal itself in symptoms, such as, headaches, belly aches, morning sickness symptoms even if you are not pregnant, diarrhea, loose stools, smelly stools, constipation, muscle aches, joint aches, rashes, swelling in different parts of the body.

1. Plenty of green leafy vegetables: ideally fresh and not cooked. If cooked, hide them in fresh organic tomato sauce or Bone broth.
2. Organic, wild salmon as often as feasible or possible.
3. Drink plenty of water at least 64 ounces per day: avoid artificial sugars other than Stevia
4. Eat other vegetables that have a deep color like tomatoes (for the lycopene which has been proven to decrease colon & prostate cancer), broccoli, green beans, radishes, squash.
5. Increase Omega 3 intake as natural as possible to 2000-4000mg if your MD says it is ok. Salmon, wild fish, Chia seeds and Walnuts have a good deal of Omega 3.
https://drcremers.com/2015/06/omega-3-best-foods-to-naturally-get.html?q=omega+3 
6. Eat Bone Broth ideally with organic bones.
https://drcremers.com/2015/11/dr-cremers-favorite-recipes-bone-broth.html?q=bone+broth 
7. Olive Oil and Coconut Oil: are good oils to eat.
8. Nuts and Seeds: if your MD says its ok and do not have a history of diverticulitis. 
9. Seaweed: my favorite is Costco Kirkland seaweed. Still waiting to do research to be sure excess seaweed does not increase risk of radiation given most seaweed comes from Korea area.
11. Meats: still very controversial: lean organic meats– are better to eat for patients with diabetes than carbohydrates, but meats in general do increase inflammation. 


Causes of Chronic Inflammation:

A number of lifestyle factors can cause chronic inflammation. These include:

  • Stress: finding ways to get rid of stress are key. I just went on a silent retreat myself, which was really amazing in helping get rid of stress. I’m convinced that a yearly silent retreat (no talking, no internet, no phone, no texting, etc for 4 full days) is an excellent idea in helping bring the stress level down to zero.
  • Lack of sleep: 8 hours is the best. Avoiding caffeine helps or only taking caffeine in the am if possible. I try to tell my patients who note insomnia that holding a Rosary in your hands in bed and praying the prayers will help. There have been studies noting a decreased blood pressure and heart rate on those who repeat prayers over and over again.
  • Smoking: just quit! It has been shown to do so much damage to those around you and your descendants (in terms of their increased risk of cancer). Smoking is guaranteed to increase inflammatory factors in most. A dear friend told me yesterday that he has no desire to quit: despite his dad dying from emphysema and spending his last few months of his life connected to oxygen and his mom having a stroke after years of smoking. I did not expect him to say he would quit as smoking is universally addictive. If you have no desire to quit, despite being told you should quit by an MD, then there is an addiction involved. The chemicals in smoking can alter the physiology of your body and mind to the point that it becomes very difficult to truly want to stop and thus permanently stop. Humility is key here. Help from your doctor, friends, and/or family will help kick the habit for good.
  • Lack of exercise: hard to get in sometimes. But is very helpful even if it means taking the stairs (even just one flight) every day instead of the elevator all the way. Park further away. More your feet, legs around at the desk. 
  • Diet: see below. This is key.
  • Pollution: often overlooked, but important.


Foods that Cause Inflammation

The issues most MDs have with the list below is that there are still no great randomized, prospective, double blind studies to “prove” they are harmful. Yet, most of my MD colleagues and all my eyeMD colleagues especially those at Harvard have starting moving to a low gluten (gluten free in many cases), very low carb, low fat diet: Mediterranean you could say without the pasta or bread or fatty meat: a lot of good fish (wild salmon, high Omega 3 fish with low arachadonic levels); majority item is green leafy veggies (kale, green lettuce (no iceburg), broccoli, brussel sprouts (a family favorite: see my posting on how we make brussel sprount chips).

1. Sugar and refined starch
Each time you eat refined carbohydrates (i.e., any type of sugar including high fructose corn syrup, sucrose, lactose, and others, as well as white foods such as white bread, etc.), it results in a rapid rise in blood sugar. This causes insulin levels to spike which trigger the cascade of immunological responses that can cause damage in your body. When blood sugar levels and/or insulin levels are high, the result is a pro-inflammatory response. This occurs every time you eat foods containing refined carbs, sugars, and starches, which can lead to chronic inflammation.

Also be aware that too much fruit (especially fruit juices) is risky as well as they contain fructose which is fruit sugar. A friend recently noted that she was diagnosed with type 2 diabetes: she could not understand as she never ate refined sugars and carbs but did eat A LOT of fruit. 

Some sites also note to avoid agave, which may be low in glucose but super high in fructose, which creates its own set of problems.

2. Vegetable oil Many vegetable oils are high in omega-6 fats, reducing your body’s critical balance of omega-3 to omega-6 fats. While omega-6 fatty acids are not bad in and of themselves, when your body gets out of balance, inflammation can result. That’s why I recommend cooking with just a tiny amount of coconut oil, which contains medium chain fatty acids. Olive oil is okay in small amounts as it is a monounsaturated oil. Avoid corn, soybean, safflower, etc. oils and products that contain them- like vegan “butter” spreads and mayonnaise.

3. Dairy products Dairy can cause inflammation in some people because your body recognizes it as a foreign invader and fights it with an inflammatory response. That’s because the human body does not process the high levels of protein (casein) or sugar (lactose) in dairy products well. If you feel tired or run down after a heavy load of cheese, dairy, consider refraining for a time to see how you feel. This could be a sign that it is causing an inflammatory reaction.

4. Red meat  Eating non-grass fed red meat produces a chemical called Neu5gc. The body produces an inflammatory immune response to it. Some people predisposed to Gout, often react poorly to red meat. Be aware that in The body produces an inflammatory immune response to it.

 5. Wheat, rye, and barley These grains all contain the common allergen, gluten. When an allergen enters the body, the result is an immediate inflammatory immune response.
6. Foods high in trans fats When you eat trans fats (hydrogenated oils found in many processed foods), they create low-density lipoproteins. LDLs feed inflammation.
7. Processed CornYou’d be shocked at just how much corn there is in processed foods. The food processing industry uses a number of corn derivatives such as high-fructose corn syrup, corn starch, corn oil because it is cheap and plentiful. In its refined form, corn spikes blood sugar, leading to an increased insulin and inflammatory response.
8. Peanuts Peanuts are one of the most common food allergens. There are naturally occurring molds found on peanuts. Even if you don’t have an anaphylactic response to peanuts, your body may recognize them as foreign invaders and create an inflammatory response.
9. Foods containing chemicals The human body has not evolved to eat artificial chemicals such as additives, preservatives, food coloring, and the many other chemicals found in processed foods. Because your body doesn’t recognize these things as foods (and with good reason – they aren’t!), it launches an immune system response.



CROHN’s Disease DIET

Many people with Crohn’s disease or Ulcerative Colitis find that one or more of the foods on the following list aggravate symptoms during disease flares. It’s possible that at least some of these listed foods will trigger your symptoms:
  • alcohol (mixed drinks, beer, wine)
  • butter, mayonnaise, margarine, oils
  • carbonated beverages
  • coffee, tea, chocolate
  • corn husks
  • dairy products (if lactose intolerant)
  • fatty foods (fried foods)
  • foods high in fiber
  • gas-producing foods (lentils, beans, legumes, cabbage, broccoli, onions)
  • nuts and seeds (peanut butter, other nut butters)
  • raw fruits
  • raw vegetables
  • red meat and pork
  • spicy foods
  • whole grains and bran
You may also need to start a Low-Residue Diet.
A Low-Residue Diet is low in foods that add residue to the stool. Many individuals with small-bowel Crohn’s disease have a narrowing or stricture of the lower small intestine (the ileum). For them, a low-fiber with low-residue diet can help lessen abdominal pain, cramping, and diarrhea. There are no prospective, randomized, controlled, double blinded studies on these diets, but this diet may also help decrease frequency of bowel movements for some people. 
Foods to avoid on a low-residue diet may include:
  • corn hulls
  • nuts
  • raw fruits
  • seeds
  • vegetables
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