Sunday, February 28, 2016

Another Night Of Crohn's Cramping...Sleep To The Rescue

On Saturday morning I woke up around 9 A.M. (this was after I went to bed around 4 A.M.). Usually on weekends I go to bed later but typically I fall asleep around 1 A.M. or so. On Friday I wasn't in any pain just watching Netflix and YouTube online. Anyways, since I only got 4 hours of sleep my stomach was cramping a little bit. However, the pain got worse as the day wore on. Last night (Saturday night) I was really cramping and tried to take a hot bath which helped a little bit. My strategy then was to use some ice on my stomach and that seemed to numb the pain a little bit which felt nice. I was able to sleep pretty well last night and fell asleep around 11 P.M. since I was so tired and woke up around 8:30 A.M. this morning. This helped compensate for some of the sleep but I still feel a little tired. I really do think sleep is an important factor in not only maintaining a healthy lifestyle and aiding memory but it seems to really help cramping for Crohn's. 

I see my GI this week for a regular checkup (and also to get my Humira renewed). I will ask him the question about the SCD diet I wrote about in my last post (I will show him the picture too). Overall though I still feel pretty though, although in the back of my mind I wonder if and when I will have my next flare (I use to think about this more, however I stopped thinking about it as much because always worrying about it will prevent me from living the best life possible. 

Saturday, February 20, 2016

Specific Carbohydrate Diet (SCD) Does It Help Crohn's or Ulcerative Colitis?

(The image above shows the before an after photos from a colonoscopy of a patient who used the specific carbohydrate diet)

So for years I have heard about the specific carbohydrate diet (SCD). Initially I was skeptical about it given there wasn't lots of evidence looking at how much it actually impacted people with Crohn's or ulcerative colitis. The specific carbohydrate diet is a very strict diet that is based on the theory that carbohydrates, dairy, and sugar products cause inflammation when trying to be digested. Also it should be noticed the SCD has no dairy or grains so your body somehow has to make up the nutrients for this absence. A book was written about the topic called Breaking the Vicious Cycle by Elaine Gottschall who had a daughter who had ulcerative colitis. After about 10 days her daughter started to show improvements. Within 2 years after starting the diet she was symptom free.

The issue I have had with SCD is that there wasn't really any data outside of patient stories claiming that it worked to support whether or not it worked. What I wanted to see was a before and after of colonoscopy images taken before and after the diet to measure the difference. For years I had been trying to find this from people who claimed they were "cured" (in remission a while).

I came across a case study that was written in the Case Reports of Gastroenterology of a 73 year old woman physician who had ulcerative colitis since 1997. After usual therapies failed she started the SCD diet and within 3-6 months saw improved. Within a year no pain or diarrhea occurred. For her diet she excluded wheat, soy, barley, corn, and limited rice. Her main meals consisted of fish, lean meat, fruit, and non-starchy vegetables. After 2 years of being on the diet a colonoscopy was performed and there was no evidence of inflammation.

Another study from October 2014 in the Journal of Pediatric Gastroenterology and Nutrition showed clinical and mucosal improvement not only after 3 months (75% of patients were in clinical remission after 3 months) but even a year (85% of the patients who remained on the diet were still in remission) after they started the SCD diet. What is interesting is that 10 child patients started the study and only 1 dropped out since they were not able to comply.

A study of 50 patients in the summer of 2015 from Rush University that was done on patients who were in remission showed that 52% of Crohn's patients were able to stop medicatons. What I found interesting is 66% of patients said it took on average about almost months before there symptoms were resolved.

This fairly recent study from November 2015 with again pediatric patients with inflammatory bowel disease showed improvement for both Crohn's and ulcerative colitis. Of course as with all studies the common disclaimer of saying that more studies have to be conducted to assess the safety and efficacy is needed.

 In my own treatment plan I would use it as a back up to a back up plan and just see if it had any effect. Personally I would find it very hard to give up some of the foods I really enjoy: Mexican, chocolate, etc. With that said I have made improvements to my diet from my pre-Crohn's days of adding more salads, vegetables, and some fruit to my diet. Also I would say I am more mindful of what I eat than before I had Crohn's.

My own belief is that a SCD diet can help inflammatory bowel disease. Although, there is only some evidence that it helps I am open to the idea that it could improve the lives of patients with both ulcerative colitis and Crohn's disease. Doctors are not open to this idea of course. I personally would like to see more evidence with more patients. It would be really nice to see more data and studies showing that SCD diet was helpful to add yet another treatment for inflammatory bowel disease. Maybe scientists could even develop a drug to mimic the effects of SCD diet.

Saturday, February 13, 2016

Update: Feeling Better No Flare/Took Humira

So in my previous post and I talked about my mini flare that I had in the prior week. I have been doing better ever since. I had felt some cramping and had a few loose bowel movements but it tended to get better towards the end of the week. My sleep has been pretty good. What is really strange is that this morning I went to sleep at around 4 A.M. and woke up around 9 A.M. and felt a little tired but not as much as I usually do (or the abdominal cramping I have when I typically don't get my sleep. 

It looks like my mini-flare was thankfully was short lived. I haven't woken up in the middle of the night for any bowel movements. Tonight I took my Humira shot and thankfully nothing leaked. I would estimate that pretty rarely do my shots leak. Thankfully I am feeling good and intend to keep this up! 

Monday, February 8, 2016

Mini Flare, Super Bowl, and Humira

So I have had a little cramping lately and it isn't too bad (more of just being annoying). This morning I woke up around 1:30 A.M. in some pain and had to use the bathroom for a bowel movement. I honestly don't remember much but remember going back to bed and feeling a little better. Anyways, I think the pain stems from the fact that the last time I took Humira it did leak somewhat (this is rare but can happen-more likely when I have to inject the stomach area). Usually it takes a few days for Humira to kick in. Since I didn't as much sleep as I want I am heading to bed early tonight and took a hot bath before to relax. Last night was the Super Bowl and I really enjoyed watching the game but probably had too much to eat. For dinner tonight I just some chicken noodle soup and a light chicken sandwich to ease my stomach. Generally, my mode for mini flares or flare is sleep, bath in hot water, and eat well. By eating well I mean not eating anything greasy. I like to think of the stomach/intestines as a brown paper bag and think about the food I consume. If the food I consume would leave a grease mark in the brown paper bag I probably should avoid it but if not then it is okay (note this is not scientific by any means). 

Hopefully lots of sleep and staying hydrated will help me out. At work today I was fairly tired and by 2 P.M. was ready to head home (but I stayed until 5 P.M.). Usually my mini-flares can be solved with a fair amount of sleep. I am looking forward to taking my next Humira shot and hopefully finding some relief. Although, I have some minor pain I am grateful for my general good health and well-being. 

Saturday, February 6, 2016

Foltx Helping Energy Levels for Crohn's

So I went for my physical back in November and my doctor had recommended that I take more vitamin B. He prescribed Foltx which is a combination of different things (folic acid, B6, and B12). I was somewhat curious what effect it would have on me. I noticed pretty quickly it made me more alert, more energy, and I felt less tired. I already take a high dose of Vitamin D which seems to make me feel very good the day after I take it. For a while I wondered if I could take anything to boost my energy and it seems like I have found it.

My Crohn's seems still be under control. I have had a few cramps at night the past week. I took my Humira shot last week and there was some leakage. Although, I am fairly careful leakage is rare and can happen. I tend to notice that I cramp more when I have some leakage the week after. Usually the greatest chance of leakage is when I have to take the shot near my stomach (the angles can be difficult at times). Other than this I really can't complain about how I feel. Although, I do know Humira will one day not work (but there are a number of different drugs out there that I can take). I have heard some patients who took Humira for over a decade before they lost response to it. I would be very impressed and happy if this happened but like always just take it one day at a time and am grateful for a calm GI system. :-)