*Meir was a newly married young man of twenty four, who had started experiencing digestive issues out of the blue six months after his wedding. While initially attributing his loose stools and constant bathroom breaks to the stress of adjusting to married life, continued interference with his quality of life landed him in a G.I. doctor’s office.

After a round of testing, including a colonoscopy, Meir was diagnosed with mild ulcerative colitis. He was put on a regimen of mesalamine, a relatively mild medication used to manage the inflammation associated with colitis. Yet Meir’s symptoms still weren’t under control three months later, which was brought him to my office seeking some more direction.

Initial intake findings:

Diet: Meir ate the Standard American Diet (SAD) high in processed foods, meats, dairy, and sugary desserts. Grab and go of pastries and junk-food in the coffee room was a consistent part of his lifestyle. His G.I. doctor had told him that diet had no relation to his condition, but Meir intuitively believed that line of thinking to be flawed. Recently due to his gastrointestinal difficulties, he had naturally decreased his food intake, with an accompanying unintentional weight loss of 20 pounds.

Lifestyle: Meir considered himself to be more of an uptight/high strung personality type. While he attributed stress to worsened flare ups in his condition, he found it difficult to improve his emotional state due to the inherent stress caused by his medical condition.

Appropriateness of nutritional Intervention: Meir was highly motivated to change his diet due to the decreased quality of life his condition caused, and his desire to prevent progression to other more intensive medication regimens. He was also a likely candidate to see success from dietary changes, as he had not yet tried any nutritional intervention, and his diet quality was poor.

Previously done lab work: fecal calprotectin and CRP, both markers of inflammation, were high. Vitamin D was low

Other significant findings:  frequent use of antibiotics due to recurrent strep throat infections in childhood and early teens

Meir was highly motivated to feel better and prevent progression of his disease and the need for stronger meds, and agreed to follow a more restricted diet initially to bring him quickly into remission. Because he was still experiencing loose stools with active bleeding, we temporarily restricted raw non-blended fruits and vegetables, along with whole nuts and seeds for the first 4-6 weeks, with the plan to resume those once active bleeding had ceased for 2-3 weeks. The challenge then became to incorporate anti-inflammatory plant based foods even within his raw food restrictions. As I often explain, it’s not just about what you take out of the diet for gut healing, its often just as much about making sure to put in healing anti-inflammatory foods to the diet, a principle often overlooked by many.

Animal fats from red meat and dark meat chicken were limited to twice weekly, with his remaining protein coming from white chicken, fish, and beans. In order to reap the benefits of anti-inflammatory foods that were difficult to incorporate, he purchased a daily turmeric carrot ginger based juice, and blended up a morning breakfast smoothie with pomegranate juice, chia seeds, kale, avocado, and organic strawberries and cherries. He also used a greens powder when able, and his wife tried to use more herbs, garlic, and turmeric in her cooking. All processed oils were completely removed from his diet, aside from avocado oil and extra virgin olive oil, and I provided him with a list of food chemicals that are known triggers for IBD to be careful to avoid. Dairy was limited to only healthier A1 protein free forms of yogurt or cheeses only, as the A1 protein present in most traditionally raised cows milk has been associated with gut inflammation and IBD. In addition, due to research possibly linking the glyphosate pesticide sprayed on corn wheat and oats in the US as associated with the rise of IBD, I encouraged organic forms of these grains whenever possible. We initiated a few basic supplements and put together a clear diet to follow for 6-12 weeks. We also added in bone broth (aka chicken soup made with bones!) as often as possible and fermented foods to heal the intestinal lining and colonize the gut with healthy bacteria.

Supplements: Curcumin, high dose probiotics, L-glutamine, Vitamin D

Typical Daily Intake:

Breakfast:

oatmeal cooked in almond milk with honey, smoothie, or oatmeal almond flour muffin with eggs

Snacks

Oatmeal-flax-PB energy balls (recipe below), Almond butter on rice cakes, A1 protein free yogurt, soft cooked compote most days for anti-inflammatory purposes

 Lunch ideas

Organic whole grain preservative free bread with nut butter or eggs, Lentil pasta with sauce and A1 protein free cheese, Leftover fish with quinoa or sweet potato, leftover bean or split pea soup with almond flour-based cracker

For the initial month until salads were added in, cooked veggies or soup leftover from dinner were encouraged with lunch for anti-inflammatory purposes.

Dinner ideas

White chicken or fish with a side dish: quinoa, potato, sweet potato, winter squash or corn
Bean chili with brown rice and stir fry vegetables
Half beef half chicken meatballs with organic whole wheat pasta or lentil based pasta
Homemade pizza made with organic whole grain flour
Lentil/pea or bean based soups encouraged, as well as a cooked veggie, progressing over to raw after 4-6 weeks

Meir’s progress was astoundingly rapid, and he was completely symptom free by the six week mark. After two months, he reintroduced raw produce and whole nuts successfully, and weaned off some of his supplements. His blood work and stool tests showed normal inflammation markers at the three month mark, and he was able to wean off of his mesalamine medication. Over the course of the next 6 months, he slowly liberalized his diet to allow for the occasional treat, keeping in mind the framework of 5% of the time, while maintaining a healthful anti- inflammatory diet 95% of the time, with no negative repercussions. At the one-year mark, he was feeling energetic and symptom free, in complete remission, and happy that his healthy eating had become an easy part of his long-term lifestyle.

Removing known dietary triggers that contribute to a leaky gut and overgrowth of harmful bacteria, and replacing with healing plant based anti-inflammatory foods that feed good gut bacteria usually has such dramatic and rapid success that I am no longer surprised to see inflammatory markers drop rapidly in colitis cases. In fact, such success cases are more the norm than not! Ulcerative Colitis and all IBD patients can mostly look forward to at-minimum some degree of significant improvement in their condition, and possibly complete remission, from an evidence based dietary approach.

*Name has been changed