2013-08-20

Before we get started I just want to point out that there is no official “cure” for Inflammatory Bowel Disease (Crohn’s Disease & Ulcerative Colitis), or any other autoimmune disease for that matter, at least not in the context of science as we currently understand it.

Even when you heal, your body will always retain the ability to attack itself.

However, you can put your disease into full remission (which can last months, years, decades, etc), which in my opinion is just as good as a “cure”.

Now that I’ve cleared up any confusion regarding the title of this article, here’s my story:

MY STORY:

I was ‘diagnosed’ with Crohn’s Disease about 13 years ago…

When I was first diagnosed I presented with most of the classic symptoms: gastritis (stomach inflammation), ileitis (an inflammation of the ileum, which is the last part of the small intestine that connects to the colon), nausea, stomach cramps, fatigue, etc.

If you have no idea what Crohn’s Disease is or have never heard of it before, it basically feels like you’re having a bad case of food poisoning…

…the thing that sucks the most is that your “food poisoning” type symptoms can last for weeks, months, or even years on end.

If you’ve ever had food poisoning you can probably imagine how much this disease sucks…

Crohn’s disease classically presents itself as inflammation of the lining of your digestive tract (but can spread deep into the layers of affected bowel tissue), and can affect any part of the digestive tract from your mouth to your colon.

Typical symptoms include: bloody diarrhea, abdominal pain, stomach cramps, nausea/vomiting, fever, malnutrition, and fatigue – and these can range from mild to severe.

As the disease progresses you can end up with fistulas, strictures, abscesses, intestinal blockages, and end up having to have surgery (where they remove the diseased portions of your intestines. Some people end up having to have multiple surgeries.

Anyway, I don’t want to spend too much time discussing the miserable symptoms and complications of Crohn’s… so if you want to learn more about the disease you can read about it here.

I was a freshman at the University of Miami (a full scholarship athlete) when I first started showing warning signs & red flags (I wish I knew then what I know now)…

…and I believe my first symptoms showed up as malabsorption problems, which led to nutrition deficiencies, which led to chronic muscle cramping & fatigue in practice & in games, and ultimately led to frustration (from myself to my coaches and trainers).

I knew something wasn’t quite right…the trainers and doctors ran a ton of tests but nothing ever showed up. I’m pretty sure they all thought everything was all in my head.

I had chronic issues like severe migraines, sore throats, allergies, periodic IBS, etc off and on for a while back then, but I hit the wall around Thanksgiving break of the fall semester and got severely ill. I came down with what I thought at the time was food poisoning…and it lasted for 2-3 weeks.

After laying in my bed feeling like I was dying for several weeks my mom finally took me to see a Gastroenterologist in Maryland. He ran a ton of tests (colonoscopy, barium x-ray, upper GI series, etc) and when the results came back he told me I had Crohn’s Disease.

I had never heard of Crohn’s Disease before, but when he told me what it was I was shocked, confused, and devastated. I had nightmares about having to take medicine for the rest of my life, having to wear an ostomy bag, and having a never ending bout of “food poisoning” type symptoms.

Everything I ate made me nauseous and made my stomach cramp like it was having a seizure. I could actually see my stomach cramping up under my abdominal skin. The pain was almost unbearable. The thought of eating food now gave me panic attacks. I became too weak to walk up stairs by myself. I lost 45 pounds, and hit rock bottom.

I was too sick to practice during this time (even walking up stairs was a struggle) but my head coach at The University of Miami told me that he thought I was making all of this stuff up in my head and was using it as an excuse because I simply didn’t want to play tennis anymore – he then cut my athletic scholarship and I had to withdraw from school. I thought my athletic career was over. I sank into a deep depression and had suicidal thoughts. I was only 19 years old.

Needless to say, Crohn’s is a real pain in the ass (pun intended), and during the time I was at home trying to get better I made countless trips to the emergency room for severe nausea, cramping, and various other debilitating (and super annoying) gastrointestinal symptoms when I first got sick.



Funny thing is, I received a call from the coach at Clemson University while I was lying on a hospital bed puking and feeling like shit and he told me that “he believed in me and once I got better I would have a spot on the team if I wanted it” …I managed a weak laugh and said to myself “this dude is crazy…”

To make a long story short, I was able to heal myself after months and months of misery by using natural treatments from a Holistic MD in Washington DC. His regimen included food sensitivity testing, raw juicing, balancing gut flora, and various other natural supplement experimentation.

After an entire year of suffering and feeling ill, I was well enough to start training again. Several months later I was a scholarship athlete at Clemson University. I still had minor symptoms, but was off of all medication as the colonoscopy I had before I went back to school showed no signs of inflammation in my gut. Clinical + Endoscopic remission! Woohoo! I considered myself cured.

That was 13 years ago.

Ten weeks ago, however, the disease reared its ugly head again and hit me hard.

Stomach cramps, nausea, and severe bleeding in my gastrointestinal tract.

At first I thought it was just a bad hemorrhoid or something (yes you actually HOPE for hemorrhoids over IBD), but after several weeks of suffering and over-the-counter hemorrhoid treatments not doing a damn thing I finally gave in and saw a doctor. Sure enough, the lower sig test confirmed my colon was inflamed. Hey, I had a 13 year run…that’s pretty damn good if you ask me!

Of course I was a little stunned when I heard the doctor say “your colon is inflamed”…because I thought all of this stomach stuff was behind me.

I’m young, I eat healthy, I exercise regularly…what was I missing…?

But then I started thinking…

Something must have triggered this disease to come back…

…and after thinking everything over for a few days and doing some research I made a list of several factors that I believe caused me to relapse.

Although I’ll probably never be able to officially pinpoint the exact cause, my instincts & initial research told me it was most likely a combination of:

1. NSAID use. I was taking Naproxen (Aleve) as needed to ease the pain of my chronic allergy migraines I get this time of year – as well as treat some of my old joint inflammation issues from years of wear and tear from sports. I’m not that old but I have osteoarthritis in my knees and tendonitis in my wrist, elbow, and shoulder from playing tennis for 20 years.
2. Consumption of inflammatory foods (processed whey protein, grains, foods I am allergic to/have intolerances to, etc).
3. Lack of sleep coinciding with an increase in stress & cortisol.
4. Unknown environmental factors.
5. Leaky Gut Syndrome.

As I stated earlier, I eat a VERY healthy diet for the most part. In fact, 95% of the foods I eat are fresh, pure, organic, grass fed, free range, etc. So naturally I found it to be quite odd that a disease involving the gastrointestinal system would strike me of all people…especially since I pretty much had it under control for over a decade.

That got me to thinking…and when I start thinking and trying to find ‘correlations’ between events…the crazy Economics/Stats dude in me comes out in full force…

Perhaps it’s food related? Perhaps it isn’t food related?

Perhaps some health foods I eat aren’t as healthy as I thought? Was it a supplement I was taking? Was it the LA smog?

Do I need to buy a water filter? Perhaps my shower is poisoning me? 

Perhaps a consistent ingestion of the same “healthy” foods over a period of time caused an inflammatory response?

Perhaps it’s a combination of many factors that all come together to create a perfect storm?

Do I have an overgrowth of bad gut bacteria? Perhaps I was mis-diagnosed?

Maybe it’s another disease process manifesting itself as gut inflammation?

Did my great great great great great great whoever relative have this disease?

Is it the Ozone Layer? El Niño?? Maybe it was Aliens?

What is the friggin deal??

And so I began my research.

After spending what seemed like 100 hours online reading research paper after research paper I finally stumbled onto several papers and theories that made perfect sense to me.

The more I read the deeper and deeper I got into Biochemical and Molecular Nutrition - and I happened to stumble onto some really interesting papers that discussed the roles of Zonulin, Gliadin, Lectins and their relation to Leaky Gut Syndrome, Inflammatory, Processes, Autoimmune Diseases, and Cancer.

Note: If you currently have Crohn’s Disease, Ulcerative Colitis, or any other inflammatory process/chronic disease and your doctor tells you that food has nothing to do with it please don’t believe him/her – if you do your research you’ll find just the opposite is true…and what I’m about to show you below may blow your mind and give you a ton of hope – especially if you’re experiencing flare after flare and your medicine/diet/etc isn’t working for you.

Disclaimer: I’m not a Doctor, Biochemist, Molecular Biologist, Molecular Nutritionist, Scientific Research Phd, or anything like that, and I’m definitely not an authority when it comes to the science presented in this post. Hell, I barely passed Biology 103 at Clemson. So please read everything in this post carefully and then do your own research and try to form your own opinion. All I did here was analyze the research and tests…then made qualitative assessments and formed positive correlations where they made logical sense. Keep in mind that most of what you’re about to read here today is purely theoretical, so be sure to tread carefully when trying new supplements or diets as many of these regiments may be contraindicated depending what medicines you’re currently taking or how sick you are. Always consult with your doctor before trying anything new or experimental. You may agree or disagree with what you’re about to read – but either way I’d love to hear your opinion in the comments section.

With that being said, here is my theory based on what I’ve read lately:

I believe most (if not all) cases of IBD (Crohn’s Disease, Ulcerative Colitis) as well as various other inflammatory conditions and chronic disease processes may be attributed to a very prevalent, confusing, widely debated condition called LEAKY GUT SYNDROME.

Now, I know this condition has been widely debated, and not every Doctor out there considers it to be a precursor to (or be a direct cause of) disease, but many Doctors are now becoming more aware of the condition and are researching and discussing new ways to treat it.

If you’re never heard of Leaky Gut Syndrome before, here’s how it was explained to me:

LEAKY GUT SYNDROME

The term Leaky Gut is just another way of describing intestinal or bowel hyperpermeability – it’s basically just a fancy medical way of saying the intestinal lining has become more porous – a condition where a bunch of developing holes (that may gradually become larger in size) start to form and the intestinal filtering process is no longer functioning efficiently.

Leaky Gut is thought to be caused by food sensitivities, cytotoxic drugs, NSAIDS, chronic inflammation, antibiotics, excessive alcohol consumption, compromised immunity, and/or radiation.

Here’s how it works:

The intestinal lining works on the front lines for our immune system – I like to think of the lining as a goal line defense. Its goal is to prevent the bad guys from scoring a touchdown or at least hold em’ to a field goal (i.e. keep the bad guys out of your bloodstream).

The outer layers of this sophisticated defense system (Intestinal Epithelial Cells) are connected by Tight Junctions (TJs), and these structures represent the major barrier within the pathway between the epithelial cells that line the digestive track. At the tips of these cells are the microvilli, which absorb properly digested nutrients and transport them through the epithelial cell and into the bloodstream.

When digestion is functioning normally (i.e. all molecules are screened properly and only pass into the blood stream through the mucosa cells) the Tight Junctions typically stay closed, but when TJs are disrupted, they become permeable or “open” and allow un-screened molecules (i.e. bacteria, toxins, pathogens, yeast, incompletely digested proteins and fats, as well as unabsorbed waste) to flow directly into the bloodstream. Hence the term “Leaky Gut”.

As this process continues over time, the intestinal lining can become so damaged that it will become less and less able to protect the internal environment and filter critical nutrients… so EVEN MORE bacteria, toxins, pathogens, yeast, incompletely digested proteins and fats, as well as unabsorbed waste can leak out of the intestines and flow directly into the bloodstream.

In most cases, the liver will start working overtime to try to filter our all of the junk that’s escaping through your intestinal lining. However, as your gut becomes more and more damaged/porous over time, it may be hard for the liver to keep up with the increased and constant flow of bacteria, toxins, pathogens, yeast, incompletely digested proteins and fats, and waste flowing directly into your bloodstream.

As more and more of these foreign invaders break through your weakened gut barrier and pass through the weakened and overworked liver filters they will begin to settle and absorb into various tissue(s) throughout your body.

The situation is now critical and the body begins to manufacture T cells and antibodies directed against self-antigens in its own cells and tissues – triggering an autoimmune reaction that causes the attacked tissues to inflame.

Once your body begins to produce antibodies specifically designed to fight these foreign “invaders” (i.e. the foods you eat, toxins, etc) – your immune system can develop reactions to many of them (these reactions can manifest as symptoms such as bloating, cramps, gas, diarrhea, as well as joint pain, skin rashes, headaches, etc).

As a result of this immune activation, the gut gradually becomes more damaged and inflamed over time. Healthy cells and tissues are destroyed and the enterocytes experience more intestinal cell damage. The microvilli that line the intestines and absorb nutrients become unable to efficiently do their job, which leaves the person’s body unable to perform important functions. Basic tasks like fighting microbes (tiny organisms such as bacteria, parasites, and fungi) are performed with less efficiency.

As the immune system continues to fight back against the ever increasing and constant flow of garbage that is streaming into your bloodstream it will eventually become overworked and your defenses will weaken.



When this vicious cycle continue for weeks/months/years your body may ultimately end up fighting itself, thus leading to a variety of “food sensitivities” and chronic “autoimmune diseases” such as Crohn’s Disease, Ulcerative Colitis, multiple sclerosis, type 1 diabetes, Lupus, rheumatoid arthritis, Chronic Fatigue Syndrome, fibromyalgia, vasculitis, urticaria (hives), alopecia areata, polymyalgia rheumatica, Raynaud’s syndrome, vitiligo, thyroiditis, and Sjogren’s syndrome(1).

Now, I’ve heard of Leaky Gut Syndrome before, and the entire process explained above made a ton of sense to me – but I wasn’t exactly sure exactly what TRIGGEDED all of this stuff to happen. Everyone’s disease is so different, so I figured there must be a few hidden variables at play.

THE MISSING LINKS

As I dug deeper into the whole Leaky Gut thing I stumbled onto a few interesting research papers that hypothesized several factors that could possibly be triggers to opening the “doorways” to Leaky Gut. A few variables that really grabbed my attention were Zonulin, Gliadin, and Lectin.

Zonulin is a protein that modulates the permeability of tight junctions between cells of the wall of the digestive tract. It has been implicated in the pathogenesis of coeliac disease, diabetes mellitus type 1, and is currently being studied as a target for vaccine adjuvants. (ALBA Therapeutics is developing a zonulin receptor antagonist, AT-1001, that is currently in phase 2 clinical trials)

Gliadin (glycoprotein present in wheat) activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules. It’s a class of proteins present in wheat and several other cereals within the grass genus triticum. Gliadins and glutenins are the two main components of the gluten fraction of the wheat seed. Gliadin is the soluble aspect of it while glutenin is insoluble. There are three main types of gliadin (α, ϒ, and ω), to which the body is intolerant in coeliac (or celiac) disease.

Lectin is a protein in seeds and other parts of certain plants that binds with glycoproteins and glycolipids on the surface of animal cells, causing agglutination. Some lectins agglutinate erythrocytes in specific blood groups, and others stimulate the production of T lymphocytes. They are ‘sticky molecules’ and their stickiness also allows them to bind to the lining of the small intestine and cause problems.

Some of the most interesting research I found came from world-renowned pediatric gastroenterologist Alessio Fasano M.D., the founder and director of the University of Maryland Center for Celiac Research.

Dr Fasano proposes that autoimmune/inflammatory/etc disorders can occur when Zonulin pathways are altered (i.e. Leaky Gut Syndrome)…and that these diseases can all be reversed by reestablishing the zonulin-dependent intestinal barrier function.

Here’s the Abstract from Dr. Fasano’s paper:

The primary functions of the gastrointestinal tract have traditionally been perceived to be limited to the digestion and absorption of nutrients and to electrolytes and water homeostasis. A more attentive analysis of the anatomic and functional arrangement of the gastrointestinal tract, however, suggests that another extremely important function of this organ is its ability to regulate the trafficking of macromolecules between the environment and the host through a barrier mechanism. Together with the gut-associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier, with its intercellular tight junctions, controls the equilibrium between tolerance and immunity to non-self antigens. Zonulin is the only physiological modulator of intercellular tight junctions described so far that is involved in trafficking of macromolecules and, therefore, in tolerance/immune response balance. When the finely tuned zonulin pathway is deregulated in genetically susceptible individuals, both intestinal and extraintestinal autoimmune, inflammatory, and neoplastic disorders can occur. This new paradigm subverts traditional theories underlying the development of these diseases and suggests that these processes can be arrested if the interplay between genes and environmental triggers is prevented by reestablishing the zonulin-dependent intestinal barrier function. This review is timely given the increased interest in the role of a “leaky gut” in the pathogenesis of several pathological conditions targeting both the intestine and extraintestinal organs.

Zonulin is what opens up the tiny spaces between the cells of the intestinal lining in order for nutrients and various other molecules to get in and out of the intestine, but in a Leaky Gut scenario the spaces between the cells open too wide which allows larger protein molecules to escape into the bloodstream. As discussed earlier, this process can trigger an immunologic reaction.

The worst part is that once the body mounts a defense against any particular protein that escapes, it becomes trained to react to those proteins every time they appear which can lead to a chronic inflammatory process.

Based on Dr. Fasano’s research there are two key triggers to open the zonulin pathways: (1) gut bacteria in the small intestine and (2) gluten. He suggests that gliadin causes zonulin levels to increase in people who have Celiac Disease as well as in people who do not have Celiac Disease. As Zonulin levels rise, the seal between the intestinal cells gets weaker and weaker, thus opening up larger spaces (pathways) between cells that allow numerous unwanted particles to pass through(2).

In conclusion, Dr. Fasano states:

The classical paradigm of inflammatory pathogenesis involving specific genetic makeup and exposure to environmental triggers has been challenged recently by the addition of a third element, the loss of intestinal barrier function. Genetic predisposition, miscommunication between innate and adaptive immunity, exposure to environmental triggers, and loss of intestinal barrier function secondary to the activation of the zonulin pathway by food-derived environmental triggers or changes in gut microbiota all seem to be key ingredients involved in the pathogenesis of inflammation, autoimmunity, and cancer. This new theory implies that once the pathological process is activated, it is not auto-perpetuating. Rather, it can be modulated or even reversed by preventing the continuous interplay between genes and the environment. Since zonulin-dependent TJ dysfunction allows such interactions, new therapeutic strategies aimed at reestablishing the intestinal barrier function by downregulating the zonulin pathway offer innovative and not-yet-explored approaches for the management of these debilitating chronic diseases.

In another research study, Dr. Fasano suggests that gluten/grains may contribute to the development of all autoimmune diseases due to Zonulin being activated by Gliadin – so this type of disease process may stretch far beyond just Celiac Disease. It may extend to IBD and various other inflammatory processes as well. Check out his piece in Scientific American or read the abstract below:

Abstract

OBJECTIVE:
Little is known about the interaction of gliadin with intestinal epithelial cells and the mechanism(s) through which gliadin crosses the intestinal epithelial barrier. We investigated whether gliadin has any immediate effect on zonulin release and signaling.

MATERIAL AND METHODS:
Both ex vivo human small intestines and intestinal cell monolayers were exposed to gliadin, and zonulin release and changes in paracellular permeability were monitored in the presence and absence of zonulin antagonism. Zonulin binding, cytoskeletal rearrangement, and zonula occludens-1 (ZO-1) redistribution were evaluated by immunofluorescence microscopy. Tight junction occludin and ZO-1 gene expression was evaluated by real-time polymerase chain reaction (PCR).

RESULTS:
When exposed to gliadin, zonulin receptor-positive IEC6 and Caco2 cells released zonulin in the cell medium with subsequent zonulin binding to the cell surface, rearrangement of the cell cytoskeleton, loss of occludin-ZO1 protein-protein interaction, and increased monolayer permeability. Pretreatment with the zonulin antagonist FZI/0 blocked these changes without affecting zonulin release. When exposed to luminal gliadin, intestinal biopsies from celiac patients in remission expressed a sustained luminal zonulin release and increase in intestinal permeability that was blocked by FZI/0 pretreatment. Conversely, biopsies from non-celiac patients demonstrated a limited, transient zonulin release which was paralleled by an increase in intestinal permeability that never reached the level of permeability seen in celiac disease (CD) tissues. Chronic gliadin exposure caused down-regulation of both ZO-1 and occludin gene expression.

CONCLUSIONS:
Based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.

According to Dr. Fassano, gluten attaches to the transport molecule, which causes an enormous release of Zonulin. This Zonulin surge can dissolve the Tight Junctions between the intestinal epithelial cells (enterocytes) and leave the door wide open for systemic inflammation and autoimmunity to happen. This process does not appear to be isolated to just Celiac Disease, everyone is at risk(3).

After reading through these papers I was convinced Dr Fassano was onto something big here with his Zonulin pathway theories, but I still wasn’t exactly sure what my “food derived triggers” were…

SNEAKY INFLAMMATORY TRIGGER FOODS

After a few more days of research, however, I came across some highly controversial proteins called Lectins.

Lectins are essentially carb binding proteins that are commonly found in all plants and animal products to varying degrees, but they have exceptionally high levels in grains of all types (especially wheat), dairy, seeds, nuts, legumes (especially soy), and nightshade plants (potatoes, tomatoes, eggplant, tamarios, tomatillos, pepinos, pimentos, paprika, cayenne, and peppers of all kinds except black pepper).

They are estimated to be present in roughly 30-40% of the American diet and they are not degraded by proteolytic enzymes or stomach acid, which makes them literally impossible to digest – digestive enzymes only do about half the job (lectins totally suck if you have IBD).

One of the more interesting things I discovered about lectins during my research was that they can be a precursor to Leaky Gut Syndrome as they can help “open the door” from the small intestine so they (along with other particles and toxins) can leak into the bloodstream.

Here’s how the whole Lectin scenario typically goes down: 

After ingestion, most dietary lectins bind to the absorptive microvilli of the small intestine. From there they may gain access into the blood and lymph system through a process called endocytosis which carries the intact lectin across the microvilli membranes as a vesicle(4). Then, the lectins may enter the liver, pancreas and systemic circulation.

Note: Experts argue that about 5 percent of ingested lectins enter the body systemically, where, depending on the lectin and depending on the person’s unique glycoconjugates, lectin binding occurs on other tissues such as nervous and connective tissue and the bladder, which are very sensitive to the agglutinating effects of lectins.

Some of the lectins consumed in everyday foods can act as chemical messengers that can in fact bind to the sugars of cells in the gut and the blood cells, initiating an inflammatory response which can lead to intestinal damage, compromised intestinal villi, altered gut flora, malabsorption, impaired cellular repair potential, cellular death, and disease.

When Lectins escape the gut in a “Leaky Gut” scenario they are then free to travel throughout the body and bind to any tissue they come across. Autoimmune mayhem ensues as the body reacts by attacking these particles and the healthy tissue they have attached to. As discussed earlier this could be a precursor to chronic disease.

Note: The intestinal lining of people with Crohn’s disease and IBS (irritable bowel syndrome) appear to be more sensitive to the effects of food lectins because the lining is constantly being replaced by new tissue that is made up of immature cells that are more glycosylated and thus more susceptible to lectin attachment. It becomes a vicious cycle.

Researchers are still trying to identify specific lectins and how they may be associated with certain diseases (studies have shown that lectins are linked to many autoimmune disorders like Crohn’s Disease, Ulcerative Colitis, Arthritis, etc) but more research is needed to confirm any specific connections. Based on what I’ve read so far, the correlation between intestinal lining damage, gut permeability, and powerful autoimmune reactions appears to be quite strong.

For example, in wheat, gliadin, a component of gluten and an iso-lectin of wheat germ agglutinin (WGA), is capable of activating NF kappa beta proteins which, when up-regulated, are involved in almost every acute and chronic inflammatory disorder including neurodegenerative disease, inflammatory bowel disease, infectious and autoimmune diseases(5).

There is also an abundance of literature from the most prestigious journals suggesting that Lectins like WGA can initiate allergic reactions in the gut causing the release of IL-4, IL-13, and histamine from human basophils producing noticeable allergic symptoms(6-7). WGA has also shown to interfere with protein digestion and increase gut permeability(8-9).

Other examples of lectins that have influences on bodily tissues are peanut lectin, kidney bean and soybean lectins. On the flip side, the lectins in broad beans, jackfruit, and culinary mushrooms have been shown to slow the progression of colon cancer(10-11).

Lucretius said, “One man’s food is another man’s poison” and lectins are a prime example of this. Our individual genetic inheritances determine how and to what degree lectins can affect any of us. Just about all of us have antibodies to some dietary lectins in our bloodstream and many experts agree that most food allergies are nothing more than immune system reactions to lectins(12).

Now, it’s almost impossible to avoid eating lectins because they are in just about every plant and animal to varying degrees (even if you try to avoid them you’ll still end up eating small amounts given their omnipresence in nature). However, lectins are definitely more concentrated in some sources than others.

Foods with high lectin activity: All grains (wheat is the worst offender), dairy, nuts, legumes (soy is the worst offender), and nightshade plants (potatoes, tomatoes, eggplant, tamarios, tomatillos, pepinos, pimentos, paprika, cayenne, and peppers of all kinds except black pepper).

THE EVIDENCE IS STRONG

Given the overwhelming amount of scientific evidence out there that suggests Leaky Gut Syndrome may be a direct trigger of a variety of autoimmune diseases I decided that the concept was worth exploring and placed most of my focus onto healing my “Leaky Gut”.

Of course I don’t have any solid scientific evidence just yet that zonulin, lectins, escaping toxins, NSAID use, etc contributed to me having a ‘Leaky Gut’ and triggered my relapse (I plan on taking a Gut Permeability Test soon to confirm), but these are the areas that stood out the most to me and are also areas that I have the ability to control.

I can’t control any immunological, genetic, or environmental factors, but I can control what I put into my body. I can definitely stop eating foods that activate Zonulin signaling and/or foods that could possibly contribute to a Leaky Gut situation.

I know it’s easy to look at this and say “dude, it was the foods you were eating that caused the problem” but I completely disagree. To a certain extent it may be somewhat true, but I don’t think that IBD is directly caused by an unhealthy diet, or any diet for that matter. A terrible diet may be a contributing factor which can increase your risk of developing IBD, but the research shows that diet isn’t really a direct cause.

Now I know certain ‘health peeps’ may also look at this situation and say “it’s the animal protein that did it” or “these types of diseases never happen to vegans/vegetarians” etc etc… while these naïve assumptions may make practical sense on some levels, science proves them to be completely off base and flat out dangerous.

I know quite a few vegans and vegetarians who have been diagnosed with Inflammatory Bowel Disease while never touching animal protein pre-diagnosis. On the flip side, I know the same amount of people who have reversed their disease by going vegan/vegetarian post-diagnosis. There doesn’t appear to be a correlation either way.

This disease can hit you regardless of your gender, race, age, or diet plan – it doesn’t discriminate. Plus, research has shown vegan/vegetarian diets, while healthy in many respects, can trend toward the consumption of more Lectins & Inflammatory Proteins (i.e. soy, grains, nightshade plants) thus leading to an increased disease risk.

This evidence leads me to believe most diseases aren’t caused directly by the foods we eat per-se, but more so caused by a leaky gut allowing food molecules into the bloodstream. Sure, they can be some exceptions (severe allergies, Celiac, etc), but for the most part I truly believe most of this stuff is caused by a Leaky Gut issue.

Instead of blaming every disease on diet (especially autoimmune disease) I think a more accurate description or scenario of the disease process would be:

1. You may be genetically predisposed to certain diseases; 2. You eat food(s); 3. You are exposed to a variety of environmental toxins; 4. Over time the gut breaks down after repeated exposure to certain foods and/or environmental toxins in genetically predisposed people; 5. A leaky gut situation occurs and toxins spew out into the bloodstream; 6. Those toxins attach to various tissues throughout the body; 7. The body begins to manufacture T cells and antibodies directed against self-antigens in its own healthy cells and tissues; 8. An autoimmune reaction is triggered that causes the attacked tissues to inflame; 9. A chronic disease state or inflammatory process occurs; 10. Patient takes medicine & may temporarily get better 11. Patient stays healthy for a certain duration and then relapses, perhaps all correlating to disease progression, toxin/sensitivities exposure levels, genetics, and a variety of other lesser factors.

I could be dead wrong here, but this is just my opinion based on what I’ve been reading lately. When you think about it though, this very cycle may be the reason the SCD Diet has worked so well for many patients with Crohn’s & Colitis.

Anyway, based on my research and learnings about Leaky Gut, elevated Zonulin levels, Lectins, and various other protein molecules, I decided the best course of action to get out of my latest flare was to: (1) address my leaky gut issue via diet; and (2) heal my inflammation via medicine.

I did not consider these two factors to be mutually exclusive – and I thought that by addressing the Leaky Gut issue directly, the inflammation would slowly go away on its own either by taking my medicine, by a direct result of my dietary restrictions and nutritional supplementation, or a combo of both.

So I decided to make the following changes in a personal experiment I hoped would (1) help me get better; and (2) prevent me from getting sick in the future (or at least prolong remission as long as possible).

THE PLAN

Here’s what I did to heal my damaged/inflammed gut:

DIET/NUTRITION

I completely avoided:

1. All grains (Oatmeal, Brown Rice, Wheat (as well as sprouted wheat like Ezekiel Bread and cross gluten reactive foods) due to the gluten and various other zonulin pathway triggering proteins.

2. Nightshades (potatoes, tomatoes, eggplants, sweet and hot peppers, cayenne, red pepper, tomatillos, goji berries etc. and spices derived from peppers, including chili powder, curry, red pepper, paprika, etc). Nightshades contain two primary toxins: Saponins and Lectins, both of which can increase gut permeability and act as an adjuvant, thus exaggerating immune responses.

3. All derivative products from nightshade food sources (i.e. nightshade derived oils).

4. All GMO food (lectins are often merged into modified varieties of GMO foods in order to enhance their natural pest and fungal resistance).

5. Dairy (bye bye whey protein).

6. All processed foods (for obvious reasons).

7. Nutritive sweeteners – (i.e. fructose, dextrose, lactose, maltose, corn syrup, concentrated fruit juice, sorbitol, mannitol, xylitol, maltitol and erythritol) Note: I had a limited daily fructose allowance from fruits.

8. Non-nutritive sweeteners – (i.e. saccharin, aspartame, acesulfame-K, sucralose and stevia) Note: I had a limited daily stevia allowance but rarely used it.

9. NSAIDS (Naproxen, Ibuprofen, Asprin, etc). NSAIDS block Prostaglandins, which have a protective effect on the mucosal lining of the gut. NSAIDS may also may trigger the recurrence of IBD in patients who are in remission causing bleeding and inflammation. Studies have shown rapid development of colitis in NSAID-treated IL-10-deficient mice.

10. Emulsifiers, thickeners, food colors/additives, or anything that said “natural flavors” (these ingredients are in a ton of “health foods” including protein powders).

11. Alcohol (yes even wine).

12. Nuts & Seeds (including coffee, cocoa, and seed-based spices). I did eat small amounts of almond butter when I was absolutely starving.

My goal for this “diet” was to remove all potential gut irritants and immune system stimulators, but I also wanted to address any underlying nutritional deficiencies. There is a ton of evidence out there which suggests that vitamin/mineral deficiencies are one of the strongest factors that can increase your risk of autoimmune disease, especially deficiencies in: Vitamins (A,B,C,D,E,K); and Minerals (Zinc, Magnesium, Selenium, Iodine, Iron, Copper, etc.).

After eliminating all potential trigger foods, I put a ton of focus on eating more of the following:

1. Quality meat (Wild/grass fed/cage free/pasture raised bison, salmon, white fish, etc).

2. Veggies (green, red, purple, yellow, white, and orange), while upping my intake of cruciferous vegetables.

3. Fruits (mostly organic and tried to keep fructose intake lower than 25g per day).

4. Healthy fats (coconut oil, avocado, fatty fish, healthy animal fat, etc) while restricting nuts and other types of oils.

Note: I plan to increase my intake of fresh fruit/veggie raw juices and start eating probiotic foods like kimchi, kombucha, healthy yogurt, etc in the next few weeks.

If you currently have digestive issues you may want to read these 10 simple digestion tips that have helped me tremendously.

SUPPLEMENTS

Here are the supplements I am currently taking:

1. Digestive Enzymes (Digest Gold 3 per day taken with larger meals).

2. Probiotic (RenewLife Ultimate Flora 100 Billion taken before bed).

3. Astaxanthin (Nutrex Hawaii 12mg once a day). Studies have shown that dietary astaxanthin inhibits colitis and colitis-associated colon carcinogenesis in mice via modulation of the inflammatory cytokines.

4. L-Glutamine (RenewLife Intestinew 1 serving twice a day). Glutamine helps restore gut barrier function and supports the healthy function of the intestinal lining. Studies have shown that L-glutamine enemas attenuate mucosal injury in experimental colitis.

5. Evening Primrose Oil (3 per day, 1500mg). A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis shows evening primrose oil may be of some benefit in IBD.

6. Alfalfa (3 servings per day taken with large meals, 3,645mg).

7. Lily of The Desert Aloe Vera Juice (Taken as needed).

8. Slippery Elm Bark Powder (You can find the good stuff at Vitacoast.com, Mountain Rose, or Pacific Botanicals).

9. Boswellia (300mg 65% Boswellic Acids 3 times a day). Studies have shown Boswellia serrata gum resin to be effective in patients with ulcerative colitis.

10. Kyolic Garlic Extract (Two servings per day). Herbs with natural antimicrobial effects like garlic, grapefruit seed extract, golden seal, artemisia, sanguinaria, and gentian have been shown to be helpful in Crohn’s Disease and Ulcerative Colitis.

11. Vitamin D (from the sun). Vitamin D deficiency is common among patients with active IBD (particularly those requiring corticosteroids) and studies on experimental mouse models have suggested a role of vitamin D in immune system regulation and IBD disease severity.  Vitamin D deficiency in mice has been shown to impair colonic antibacterial activity and predisposes to colitis. The vitamin D receptor has an important role in maintaining the integrity of the intestinal mucosal barrier.

12. Technology (iPhone app) I use an app called D-Minder to help optimize my vitamin D levels naturally.

Note: I may start using Deglycyrrhizinated Licorice (DGL) in the next few weeks because it helps repair the gut and has been shown to support a normal mucous lining in the digestive system.

Leaky Gut Test: If you suspect your issues may be due to Leaky Gut you may want to look into getting an Intestinal Permeability Assessment, which is a noninvasive assessment of small intestinal absorption and barrier function in the bowel. This test analyzes urine for the clearance of two non-metabolized sugars, mannitol and lactulose, identifying intestinal permeability (“leaky gut”) and malabsorption.

Rx Strength Probiotics: If you have advanced IBD you may want to ask your doctor about prescription strength VSL3, aka the probiotic medical food for the dietary management of patients with Ulcerative Colitis, IBS, or an Ileal Pouch.

Pro Tip: everyone’s disease process is different and IBD doesn’t affect everyone the same way, nor will everyone respond to the same supplements, medicines, or have the same foods trigger symptoms. These supplements may or may not work for you so be sure to do your own research to come up with a plan designed to work for you.

Expert Advice: Sarah Ballantyne, Ph.D. has some very helpful information on how to fix autoimmunity issues over on her website.

RESULTS/CURRENT STATUS

So far the results from my “experiment” have been even better than I anticipated. After 10 weeks of pain & suffering my flare is pretty much under control. I was sick for about 7 weeks but within 3-4 days of eliminating grains (brown rice, oatmeal, pastas, etc), as well as various other potential triggers (nightshade veggies, etc) from my diet the bleeding stopped and I started feeling a lot better.

It has been almost two weeks now and I haven’t had a single “allergy migraine” (I used to get one or two per week this time of year). Of course this could be statistically insignificant, but it is definitely worth noting.

I was taking my medicine (which I’m sure helped a great deal) as well as gut friendly supplements during this time – but after 6 weeks of flaring, my symptoms pretty much cleared up during my ‘Grains Armageddon’ week allowing me to function as a normal person again. I know that my medicine definitely helped a TON in my recovery process, but I strongly suspect that the diet modifications and supplementation worked synergistically to accelerate the healing process.

I may re-introduce brown rice (as well as a few other suspected trigger foods) into my diet within the next few weeks and see what happens – I’ll update the results section of this post if anything significant happens.

TRAINING/EXERCISE

I strongly recommend against any strenuous exercise when you’re sick (some studies have shown it to cause Leaky Gut even in healthy people). While I was flaring I trained at a moderate intensity 2-3 times per week for 45-60 minutes. Also, if I felt super sick I didn’t force myself to go to the gym and cause more damage, I rested, which is probably what my body needed anyway.

A pic from my workout a few days ago – still feeling a little sick, but getting back into the swing of things. 

 

MENTAL & EMOTIONAL FACTORS

I think two huge factors in allowing your body to regain optimal health and heal itself are: (1) controlling stress and; (2) getting enough sleep. Try to get at least 8-10 hours of sleep per night, and practice deep breathing and relaxation techniques like meditation and yoga regularly to de-stress and clear your mind of all negative energy. Also, try to laugh every day.

I believe the mind-body connection is more powerful than many people give it credit for. You may fix your “Leaky Gut” or your respective disease, but if your mind isn’t healthy you’ll continue to experience symptoms. I know this from experience.

So try to sort out all of the issues and stressors in your life (relationships, family, work, etc) and try to calm your mind. The goal is to get yourself into a calm, relaxed, happy place emotionally where you’ll experience less stress and anxiety.

Your emotional well-being is SUPER important and I know it can be a difficult ongoing process to re-claim your “mental health” but trust me all of the hard work will be worth it – your stomach and loved ones will thank you! I also highly recommend reading self-help books or talking to a professional if you struggle with the mental aspect of wellness.

Pro Tip: Don’t be afraid to talk to a friend, relative, or healthcare professional about your mental health. I know it can be a difficult thing to discuss and that there is a certain stigma surrounding “mental health”… but you’ll be thankful you did in the long run. I saw a psychiatrist when I first got sick 13 years ago and it was one of the best decisions I’ve ever made.

Here are some great places to get advice and find emotional support for IBD:

1. Crohn’s Disease Forum – Support group and forum for Crohn’s Disease, Ulcerative Colitis, and other IBD.

2. I Have UC – International Community of People Sharing Stories about Ulcerative Colitis

FINAL THOUGHTS

Like many of you, I have been constantly asking myself the classic question, “why me?”

I’m a young person with no other health issues, in pretty good shape, been healthy for over a decade, have no other family members with the disease, etc…

I thought I was doing everything right…

…but there’s no point in worrying about situations I can’t control.

I’ve learned from experience that constantly worrying if your disease is going to get worse only leads to a never ending spiral of mental anguish and despair. Constantly worrying yourself sick, questioning why, and feeling sorry for yourself only adds to the frustrating, embarrassing, inconvenient, painful, debilitating, isolating and lonely feeling IBD already gives you. My advice is not to do it.

Some of you may agree with this (or maybe you won’t) but I believe worst part about IBD is the lack of understanding (or lack of giving a crap at all) from family and friends. They really don’t know much about or understand the disease…and by looking at me you would probably never know I was sick. Most people with IBD look completely normal on the outside…but their insides are a friggin mess.

Sure, I try to act normal, but you can only excuse yourself from meetings, dinners, family events, and lie to your girlfriend and say you “hate that sushi place” or make up some other lame excuse so you don’t have to go out so many times before people start asking, “what’s wrong with you dude…?” or talking about you like, “that guys sucks, he’s always in a bad mood, what a buzzkill…”

…and you’re not really sure whether to be honest and tell them a long boring IBD story they wouldn’t understand…or just say “I’m fine” because your symptoms are super embarrassing and you may feel gross, ashamed, and annoyed.

If you have UC or CD and ever had to sprint to the bathroom and expel all sorts of weird colored nastiness from your butt crack 15-30 times a day and felt like nobody in the world could possibly understand your pain or know what you were going through I’m sure you know exactly what I’m talking about here.

I guess what I’m trying to say is, even though we may not know each other personally I feel your pain and I know what you’ve been through. The pain, the suffering in silence, the lack of empathy from family, friends, and loved ones… the feelings of despair and isolation, etc – we all go through it to some extent.

I know there are a ton of people out there that are a lot sicker than I am, but I have experienced the pain and frustration that accompanies your body giving up on you in a super embarrassing way – it can be very depressing, debilitating, and isolating. I can totally relate to what you’re going through.

So with that being said, I just want to encourage all of readers out there who may be currently battling illness to stay positive. Especially any young teens or kids reading this that may be sick with IBD. Sure, IBD sucks and you may feel hopelessly depressed, but you can get better if you start taking your health and wellness seriously. These days you’ve got to be your own healthcare advocate – you can’t put all of the responsibility in your doctor’s hands – that’s not fair to you or to your doctor.

So go do some research, ask your doctor the tough questions, talk to your doctor and pharmacist about any supplements/drugs you may be taking, go get second opinions, talk to people who have done things to get themselves into remission and see if you can copy some of the things they did or tweak them according to your own needs. The main thing is to just keep fighting and always stay positive. Never lose hope.

I think half of the recovery battle in any disease all comes down to mindset. You have to stay positive – even when things feel hopeless.

Before I get out of here I just want to thank my friends who encouraged me to write this post – I was feeling a little apprehensive about it at first because I hate talking about my problems (in my family it’s called whining and complaining) and wasn’t sure if I’d be able to present the research in a way that the average person would understand (and in a way that an expert wouldn’t say was stupid).

I truly hope that this post will help someone else out there get better just like I did. If this post helps just ONE person I will consider it to be a massive success. That’s what life is all about – helping others succeed. We can overcome just about anything in life if we work together and help each other. I wish you the very best in health.

Please leave your questions/comments/thoughts/concerns below. Thanks for reading.

REFERENCES

1. Fasano, A. Leaky gut and autoimmune diseases. Clinical Reviews in Allergy & Immunology, Feb;42(1):71-8. doi: 10.1007/s12016-011-8291-x.
2. Fasano, A. Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer. Physiol Rev January 1, 2011 vol. 91 no. 1 151-175
3. Fasano, A. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology, 2006; 41: 408 Á/419
4. Pusztai A, Ewen SW, Grant G, Brown DS, Stewart JC, Peumans WJ, Van Damme EJ, Bardocz S. Antinutritive effects of wheat germ agglutinin and other N-acetylglucosamine-specific lectins. Br J Nutr. 1993 Jul;70(1):313-321.
5. Jones, David S., ed.. Textbook of Functional Medicine. Gig Harbor:The Institute for Functional Medicine, 2005, 303.
6. Watzl B, Neudecker C, Hansch GM, Rechkemmer G, Pool-Zobel BL. Dietary wheat germ agglutinin modulates ovalbumin-induced immune responses in Brown Norway rats. Br J Nutr. 2001 Apr;85(4):483-90.
7. Eur. J. Immunology. 1999. Mar;29(3):918-27.
8. Falth-Magnusson K., et al. Elevated levels of serum antibodies to the lectin wheat germ agglutinin in celiac children lend support to the gluten-lectin theory of celiac disease. Pediatr Allergy Immunol. May 1995; 6(2): 98-102.
9. Hollander D, Vadheim CM, Brettholz E, Pertersen GM, Delahunty T, Rotter JI. Increased intestinal permeability in patients with Crohn’s disease and their relatives. A possible etiologic factor. Ann Intern Med, December 1986; 105(6):883-85.
10. Gut 1999. May; 44(5):709-14
11. J Cell Physiol. 2001 Feb;186(2):282-287.
12. Pusztai A. Dietary lectins are metabolic signals for the gut and modulate immune and hormonal functions. Eur J Clin Nutr. 1993 Oct; 47(10):691-699 ( Pusztai A Rowett Research Institute, Bucksburn, Aberdeen, UK.)

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