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Ten Steps To Heal Inflammatory Bowel Disease – For Any Age

Ten Steps To Heal Inflammatory Bowel Disease – For Any Age

My husband’s family lineage has inflammatory bowel disease (IBD): Crohn’s, celiac, diverticulitis, pancreatitis. Recently a family member landed in the hospital with a severe bout. She was in for a week, clear liquids, IV fluids and antibiotics, and sent home. No one spoke to her about food, other than to go ahead and eat a lot of fiber from grains.

Within no time, she was in severe pain again, tolerating only clear liquids, and back to her GI specialist. After lots of poking and prodding, same advice: Go home, eat what you want. Fiber? Sure, that too.

Many infants, toddlers, and older children in my practice have been down this road too. Some have necrotizing enterocolitis, fundoplication, or feeding tubes inserted into their stomachs or upper small intestines. Others have newly diagnosed celiac, FPIES, or even Crohn’s at a young age. These conditions are deeply linked to what you eat and to what grows in your gut biome. But it’s common for the healing potential of food and “good gut bugs”to be overlooked by well meaning GI specialists. Research is rapidly expanding in these areas. But it’s not yet standard-of-care for people with painful IBD conditions to get much detailed guidance on foods and gut microbes. What you eat isn’t a GI doctor’s gig; some might choose to work closely with you on it, some might suggest or even prescribe a probiotic, some may refer you to a nutritionist or dietitian. But most are choosing whether or not you need surgery, steroids, or other drugs.

There is much that can be done beyond the prescriptions and surgeries. Check with your specialist on the recommendations I suggest here before using them. Your gut may be able to heal up (and you may avoid having a section of it removed) with some TLC, supportive eating, and some nourishing, soothing herbs. I’ve seen it happen many times in vulnerable children and infants I’ve worked with. You need and deserve to feel better – I know you’re a busy person!

1 – The common advice to eat high fiber grains after an IBD flare up is, well, bad. You might actually take some comfort in knowing that it is not surprising that those may worsen your tender condition. Grains are possibly the toughest stuff to feed an injured and inflamed gut. My usual approach in tender situations like this with vulnerable children and infants is the opposite: NO grains at all for a while. That would mean no bread, rice, pasta, pastries, bagels, toast and so on; no gluten free grains either, including rice, barley, spelt, millet, oats or oatmeal, cous cous, quinoa (not a grain technically but similar), corn (including corn starch, corn syrup or high fructose corn syrup, which is in many processed foods), and teff. No white bread, no bread, period. I usually advise avoiding all grains for a long time, at least three months, for scenarios like this. Your carbs in this scenario become certain cooked vegetables and some fruits. See below on how to introduce those, and which ones are okay. Meanwhile you can use broths (see number 2) and fats to hold you over.

2 – Broths are a good idea. But there’s not-so-great broth (store bought in a box, can, or a dehydrated cube, with MSG, gluten, corn starch, or wheat flour, additives, and little nutritional value) and then there is really good broth (homemade or special order homemade, full of minerals and helpful satiating fats)! If you happen to have vegetable scraps around and a chicken carcass leftover from a roast chicken, set those on the stove for a day or two, cover with water, add some vinegar (about a half teaspoon) or some white wine (1/4 cup) to pull the minerals out of the bones. Let everything cook until disintegrated and soft. Add water if needed as you go. Add herbs (fresh sprigs of sage and rosemary), throw in a whole chopped lemon, and 3-4 cloves of garlic. Strain this and enjoy as often as you like. It’s more nourishing and restorative that the stuff in the can, and is grain free (even tiny amounts of wheat starch might be irritating). Leave the fat in the broth, or skim off only some of it. You can use ham bones or any bones left over to make a broth, if it simmers long enough. If you like, you can even order this luscious, real bone and vegetable broth on line – you’ll find it is heartier and more satisfying than the store stuff.

heal inflammatory bowe

Starting a vegetable broth – scraps are perfect too

3 – If you’re on a clear diet (clear fluids only), some foods may still be okay for you and I have seen this work in my practice too. Certain vegetables and fruits cooked soft that are easier to digest (because they have simpler, smaller, less fibrous carbohydrate in them) are where I would start. You can find a list of those that fit this criteria here: http://www.breakingtheviciouscycle.info/legal/listing/ Any food that is “legal” on this list worth a try. Clear foods that may be more harm, and do you no good: Store bought juices with corn syrup or sugar added, broths processed with additives as mentioned above, clear jello, or any processed, artificially colored and flavored “food”. Some veggies that you might not enjoy so much right now are the brassicas: Broccoli, cauliflower, Brussel sprouts; cabbages; or most any raw vegetable. Even well cooked, these may not feel good just yet. If you crave greens, enjoy them well cooked and not raw for now, if at all, until your IBD flare settles down.

4 – Meats, poultry, fish: These are very possibly okay even for a tender gut. Watch how you respond. They are very nourishing, so include whatever feels okay. Start with white soft cooked fish like tilapia or cod, without any bread coating; you can brush with coconut oil, ghee or olive oil or butter, garlic, lemon, and as much salt as you are currently allowed to use. For some, salt does not impact blood pressure, so use your usual amount – and use good culinary salt (sea salt or Himalayan salt, not plain old Morton’s type sodium chloride). The better salt has more minerals in it, which your gut needs to heal up. Next you might advance to some really good, organic, slow cooked, tender roast of beef, done in perhaps a crock pot or slow cooker so the juices stay in and keep it moist. Cook it to the point of just falling apart, soft enough for a fork to cut through. Roast chicken may also be okay, with skin. We often make a crock pot recipe that is easy (we skip the aluminum foil in the recipe, and add a whole lemon or two, some onions, and extra garlic chunks). Again the meat should be very tender and falling off the bone, juicy and moist. Roast pork, same thing, if it can be cooked long enough to be falling-apart tender. Avoid barbecue sauces until you feel better (usually they have gluten, grains, or other harder to digest additives). Avoid bread coatings, or gravies made with thickeners like corn starch, any flours (even gluten free), or arrowroot.

5 – Even if you are already using a probiotic, a prescription probiotic called VSL-3 is often beneficial and preferable for these situations. See if your specialist would agree. Don’t bother with the store bought stuff. Not worth it, may contain irritating additives, and the potency is so low as to be of no value in circumstances like progressed IBD. You might alternatively benefit from VSL-3 capsules, which are available without prescription. The prescribed version is a sachet of powder that mixes with soft food or liquid. It has a very high potency of 900 billion CFUs per dose of mixed strain beneficial microbes. The capsules are the same formulation except lower potency (180 billion CFU each), and without the maltodextrin. Caveat: If you have a condition called small intestine bacterial overgrowth (SIBO), probiotics may cause more pain and diarrhea. Check with your specialist about ruling out SIBO before using a high potency probiotic like VSL3. SIBO may need treatment first, before probiotics will be helpful. In my office, Dr. Jill Carnahan and I use a urine microbial organic acid test as well as stool tests to assess this.

6 – Use daily gut soothers: Peppermint tea, chamomile tea, or a blend of those. Other herbal helpers include slippery elm, ginger (fresh root), licorice (added benefit for some of lowering blood pressure), and you can use tinctures or teas. Skip capsules at first if you can, to give your gut one less thing to do (digest the capsule before getting to what’s inside). Glycerite tinctures are especially gentle and absorbable, versus alcohol blends. Meanwhile, another really good soother and healer for the gut is pure aloe juice. This is available at most better supermarkets or health food stores. Buy pure organic aloe juice – not the topical preparation, but the juice for oral consumption. Use 1-2 Tablespoons daily in water. Also eases any constipation if you have it. Avoiding all caffeine sources may help.

heal inflammatory bowe

Yummy green smoothie

7 – Juices can help too – but not the store bought corn syrup stuff. We’re talking fresh juices you make at home.  To make nourishing, easy to digest, healing juices, you need a powerful juicer machine that strains things (not a macerator juicer, but one with a strainer). Try what feels good, and your intuition may surprise you with its own skill! Some of my favorites are here. A good combination for a sore gut:

–       1-2 Delicious apples

–       1 inch peeled fresh raw ginger

–       5 stalks celery

–       some sprigs of fresh mint or basil leaves

Your juicer should strain this while it juices. When you feel a little better, you can add ½ a small whole lemon to this blend. This is soothing for liver, kidney, and digestion. As for heartier greens like kale or chard, initially, searing those and eating them cooked, especially with healthy oils like coconut or sesame, will feel more soothing at first. Straining and drinking them raw can work better later on.

heal inflammatory bowe

Juicing underway with a centrifugal strainer type of juicer by Breville.

8 – You can temporarily use a supplement for ready-to-absorb protein, in case eating protein from whole food is painful. This is important because you need protein to build healthy gut tissue. If eating meats, poultry, eggs, or fish just does not work, I lean on specialized supplemental formulas in my practice. There are some available by prescription and some that are over the counter. These can help keep you replenished and give your gut something to rebuild with. I generally don’t reach for protein supplements based on dairy, soy, or rice, since so many of my patients have trouble tolerating them. Hemp protein may also be harder to use at first in a tender gut. When all else fails, I work with prescription essential amino acid mixtures from SHS North America. Some do well with whey protein that is from organic, grass fed cows and not denatured; I will order a specific brand that meets those criteria in some cases. Lastly, a supplement called Galactommune often helps my patients recover gut function more quickly, as it helps build immune boosting globulins in the gut. This can be ordered directly from its manufacturer with code 825.

9 – Fats and oils: These are healthful and important for you while you eat a limited diet. They keep hunger at bay, transport and absorb certain nutrients and vitamins into tissues and cells, and cut inflammation (when you eat the good fats). Eat what feels comfortable, from least processed sources if possible. That means butter, ghee, coconut oil (for cooking), eggs (if you find them comfortable), olive oil, bacon (if easy on you), meats, and fish. Fats to avoid are margarines, fake fats, canola oil, corn oil, soy bean oil, processed cheeses, dairy desserts with lots of corn syrup, highly processed puddings or calorie boost drinks, or anything GMO. Go organic if possible, since fats and oils are where many toxins situate in plants and animal foods. Nuts and seeds or their butters, a good source of minerals, proteins, and fats, may not be tolerable yet. Long short: Fake fat and low fat is not going to help your body. For a gentle soother, try cooking a soft scrambled egg in a tablespoon of coconut oil. Mix the egg and oil briskly with a whisk for about a minute. Coconut oil is easier to break down than most other fats and can work to calm an irritated gut wall.

10 – If you use a reflux medication on a regular basis, ask your specialist how to stop. Reflux medicine, when used too much, weakens digestion and makes it harder for beneficial gut bacteria to grow. Beneficial bacteria support your gut wall in avoiding autoimmune storms and infections. Meanwhile reflux medicine makes it easier for damaging, detrimental gut bacteria to grow. Minerals, including calcium, zinc, and iron, are harder to absorb in this context. Some studies have shown that long term use of reflux meds in elderly people means more broken bones. I have a number of young patients with delayed bone age and stunting who were given reflux medications from birth. These are over prescribed. If you use one daily and stopping is painful, there is a simple strategy to wean off slowly: Begin using raw apple cider vinegar (such as Bragg’s brand) daily in a glass of water. Use about a half teaspoon. You can do this at each meal, or only when you feel reflux or heartburn. This will gently promote normal digestion. A more aggressive strategy is to use betaine hydrochloride capsules, and swallow 1 to 3 of these with meals. As many as 6 or 7 capsules of betaine hydrochloride are safe to use at a time, but no more. You will know your limit if using these triggers a burning sensation at top of stomach. Find your comfortable dose. It may be just one capsule, it may be four; use only what you need. Note any changes (good or bad) in demeanor, behavior, anxiety, or affect too: Gut ecology has been linked to shifts in what we categorize as psychiatric disorders.

Have a conversation with your specialist and see what s/he says. Remember: Their tools are antibiotics, antiviral medications, steroids to stop inflammation, reflux medications, and surgery. All these have a place, but none of them are food. Food is what your body needs to rebuild, even as you use the specialist’s tools. If all the juicing and cooking is overwhelming while you are managing your symptoms, consider a home health aid or someone who might come in your home for two hours a day to help out. A week or two of help can pay itself back in quickening your return to health, if you are debilitated by symptoms or just had surgery. Meanwhile there are many, many supplements that are often used to help a gut heal too. But, food is still the baseline, and it’s what your body will work with to rebuild, recover, and heal.

Baby Reflux and Baby Poop: What’s Normal, What Isn’t, and What To Do

Baby Reflux and Baby Poop: What’s Normal, What Isn’t, and What To Do

Note: Questions for individualized care advice cannot be answered in this forum. For individualized help with your baby’s reflux, bowel habits, feeding or growth, make an appointment so I can give the support you and your baby deserve. You can also learn more on how to help your baby in my book Special Needs Kids Go Pharm Free. Get a copy today if you need step by step instructions that you can try at home. Lastly, if you’re new to my blog or practice, get an intro to integrative whole health for kids here – along with a freebie for joining my list! Thanks for stopping by! 

Babies, like everybody else, need to move their bowels daily. Stool that sits in the intestine and colon for too long permits toxins to flow back into circulation, can feel painful or uncomfortable, and can diminish your baby’s appetite. Stool that passes too fast will carry too much fluid out with it, and nutrients and energy won’t be adequately absorbed. More than anyone else, babies are quite sensitive to these dilemmas. Occasional changes in this pattern are of no consequence; persisting patterns are. This is common sense as much as it is sensible nutrition science!

Many things disrupt stooling for babies. Teething, stress, immunizations, antibiotics, badly tolerated foods, and infections or illnesses can all cause changes in stooling pattern, but the changes should be temporary for your baby. Even if your baby has special needs or circumstances, make restoration of comfortable digestion a priority. On balance, your baby should comfortably pass one or two formed soft stools every day (possibly more if exclusively breast-feeding), and it shouldn’t smell terrible. Breast-fed infants have softer, mushier, wetter stools that look more seedy and light brown or gold, and these babies may pass stools more often. Younger babies may also have more frequent stools. But if any of the following signs persist for more than two or three weeks with no explanation, consider it a flag for distressed digestion and absorption. Think about making a plan to correct it, so your baby can absorb all the nutrition he needs to grow and thrive:

  • More than four stools per day
  • Liquid, runny, or watery stools
  • Mucus in stools
  • Undigested food in stools
  • Stools that are explosive or overflow onto your baby’s back or neck
  • Yellow, gold, tan, pale gray, black, or green stools (dark mustard colored stools are normal for breast fed infants)
  • Blood in stools
  • No stools passed for more than three days on a regular basis
  • Hard, dry, pebble-like stool that appears painful or difficult to pass
  • Plugs of hard stool followed by explosive loose stool
  • Unusually foul-smelling stools

Probiotics are one of the corrections you may want to use to restore a healthy stool pattern. Generally, these guidelines can help. Check with your doctor. If he or she isn’t sure about how to dose and use these, you can always schedule time with me to get targeted help.crying baby

  • Place 1/8 teaspoon of bifidobacterium blend probiotic powder in your baby’s feeding once a day. If this is tolerated and no improvements ensue, increase to ¼ teaspoon.
  • Stop if you notice explosive diarrhea, hives, fever, or sudden rashes.
  • Look for Bifido strains such as B. breve, B. infantis, B. longum, and B, bifidum in the product, and a potency of at least 8 billion CFUs per dose.
  • Safe Lactobacillus strains that can be added for babies nearing their first birthday or for toddlers are L. rhamnosus, L. casei, L. paracasei, L. gasseri, L. reuteri, and L. salvarius.
  • Don’t use L. acidophilus in babies, premies, or infants with NEC. The form of lactic acid made by this species appears to be tolerated poorly in babies. In fact, one study showed that it actually increased allergy (noted as skin rashes) in babies.
  • Probiotic powder can be blended with soft food, breast milk, or formula. You can also dust some on the nipple of the bottle or the breast.
  • Infants should avoid probiotic strains and blends that are intended for adults.
  • Don’t give probiotics at the same time as an antibiotic. The antibiotic will kill the probiotic. Wait until the course of antibiotic is completed, then begin using a probiotic daily.
  • If your baby must use antibiotics for longer than two weeks or indefinitely, you can add probiotics at the opposite end of the day. For example, if an antibiotic is given in the morning, give the probiotics in the afternoon or evening.

What does this have to do with reflux? Probiotics can help digestion a lot when used correctly. Digestion, when normal, permits the baby’s stomach contents to move along. When this isn’t happening, food sits for too long in the baby’s stomach. This feels like heartburn, and your baby will cry and be miserable. This can be avoided without medication in many cases. Changing formula, changing diet when breastfeeding to avoid trigger foods, or using various herbs have all proven effective, without the side effects from using reflux medicine for too long. Note: Reflux is not the same as spit up, which happens to babies who are doing just fine. Your baby does not have to lose feedings on your shoulder to be experiencing reflux! Signs can include misery, crying, hiccups, burps, arching with crying, pulling away from feedings, and weak growth pattern.

Goat milk can be used to make an infant formula that many colicky babies can tolerate nicely

Goat milk can be used to make an infant formula that many colicky babies tolerate nicely

Reflux, diarrhea, constipation, and colic are not necessarily benign for a baby. They can signal malabsorption, imbalanced bowel microflora, inflammation, infection, milk protein intolerance or allergy, or any combination of these, especially when they persist for weeks on end. These problems can worsen reflux if a baby already has it, or trigger it to begin with. Giving reflux medication can give a quick reprieve from symptoms, but using it longer than a few weeks may set a downward spiral in motion. Work on the causes of the reflux if you can, rather than medicating it away. Reflux medications alter pH of the GI tract, and make digesting and absorbing food harder. They also shift your baby’s gut micro-biome away from ideal species of bacteria that help the immune system “learn”, protect from viruses, and digest food. Instead, reflux medicines favor fungal microbes and detrimental bacteria such as klebsiella or clostridia. These microbes produce toxins of their own that further alter the gut’s pH. They can injure the gut wall, and circulate to your baby’s brain to alter behavior or even trigger seizures.

Some babies whom I’ve encountered in my practice came to me “stuck” on reflux medication, and this is a scenario to avoid. In these cases, the baby will need increasingly higher doses that become less and less effective. One child I worked with was given reflux medication daily for the first three years of his life. Though he had been off this medication for three years by the time I met him at age six, he was stunted with delayed bone age and poor bone mineralization, growth failure, developmental and learning problems, and was unable to eat enough to sustain normal growth since eating was so uncomfortable. He’d had chronic infections as an infant and toddler, needed antibiotics often, and became asthmatic as well. Another youngster who came in for nutrition care at age three was also stuck on it, had fallen into growth failure, and showed the same pattern of not being able to achieve a typical food intake to support growth and gain. Many other toddlers I have met show this pattern of growth failure owing to picky, weak appetites after using reflux medications for a long time (more than a month or two). Reflux medications are intended for short-term symptomatic treatment, not as a long-term strategy. You may have more success by trying the corrections described here first instead, so discuss them with your provider. Your baby will be healthier, and will grow and feel better , when digestion can evolve normally rather than with the digestive down-regulation from the medication strategy.

When unhappy poop patterns persist for weeks and months, nutrients and energy are not being optimally absorbed by your baby. Medicaitons for reflux or constipation may ease the symptoms, but won’t do much to improve the malabsorption. Toxins from this addled gut can be absorbed more easily too. Babies with weak growth amid these symptoms are sending a clear signal that it’s time to intervene. Don’t wait for your baby to slide into a failure to thrive (FTT) diagnosis, which means less than the 5th percentile in weight for age. Babies in growth failure need two to three times more calories per pound per day to recover a normal growth pattern, and this is even more challenging to accomplish when a baby has reflux or other GI issues. Intervene as soon as you notice a “dropping off channel”—that is, if your baby’s weight for age or length for age percentile drops more than fifteen points, it’s time to intervene.

This blog is an updated excerpt from the first chapter in my book, Special Needs Kids Go Pharm-Free. Get more strategies on kicking reflux naturally there  – including which herbs are gentle and effective, how to avoid allergy or intolerance to milk, breast milk, or other feedings and formulas, what commercial formulas to avoid and what to try, and tips on breastfeeding a colicky baby. There are many options before going to Zantac that your doctor may not know about!