Center for Applied Nutrition Blog

Hello Barbara,

I am writing you because I could use some help and I'm not sure where to go.  My name is Jon and I had a nutritional appointment with you last year in the fall after an 11-day hospital stay for an ulcerative colitis flare.  I followed some of the advice you gave me and along with meds it worked well for a while.  However, since then I was diagnosed with Crohn’s and recently my symptoms have been severe. I have been in a constant state of flare up for about 4 months. I have tried all sorts of meds and nothing seems to be working anymore.

I am currently taking Balsalazide (daily) and Humira (weekly).  I currently have a malecot drain in my buttocks from an abscess/fissure (caused by my Crohn’s) that required 2 operations in the last 5 weeks and as such I have been out of work on disability. 

My GI doctor, previously told me that drastically changing my diet probably wouldn't work for me because of the location of illness (very near the rectum).  However, my partner and I decided to try the SCD diet as I feel I am out of options/medications at this point.  My GI doc agreed last week it couldn't hurt.  We bought a number of books and have done a lot of research on it and started Friday.  We are on the 5th and last day of the intro diet today but we both feel sick, and my Crohn’s symptoms are worse than when I started the diet.  We could REALLY use some help.  I called your office to make an appointment and I took the next available but that isn't until July 9th.  If you would be so gracious as to take the time to email or call me back with your advice I would greatly appreciate it.

Jon

Barbara's Response:

Hi Jon,

So, we decided, while experiencing a flare and having difficulty tolerating foods, bring it back to basics and be gentle on the gut.

• Pureed foods (veggies, fruits, etc) encouraged.
• Steel cut oats, once or twice daily (can be savory or sweet, with raw honey) well cooked, pureed if needed.
• Increase probiotic supplements: 4 PB-8 daily, 2 S Boulardii daily.
• Introduce yogurt and/or Kefir (a most potent probiotic drink)

Check out our website for recipes and ideas when moving forward. http://www.umassmed.edu/nutrition/ibd/sample-daily-menus-for-each-phase/

Best,
Barbara 

Jon's following email:

Hi Barbara,

So I've increased my probiotic supplements and we added the Banana Oat smoothie from your website to the diet this morning and are going to add more well-cooked puréed vegetables to the diet tonight. We are also adding yogurt ASAP but that leads me to a couple quick questions...

1. Yogurt - we have all the supplies to make homemade SCD-friendly yogurt tonight but the directions we found that are SCD specific is a 36 hour process including cooking the yogurt for 24-28 hours.  However, the instructions that came with the machine (we got the Yogourmet machine and starter kits) only take 5 hours. Do you think it's ok to follow the simpler/shorter instructions or should we follow the SCD instructions?
   
   Answer: Make the longer one, AND, go to the store and buy commercially made yogurt, GreenValley lactose free is my favorite, do NOT buy Chobani, but other FRESH brands.
   
   
2. Protein - We are currently eating ground beef and chicken mostly as a part of dinner. We usually broil them. Does cooking style matter at this point: intro phase, in a flare? Can we grill them?
   
   Answer: Right now it has to be soft, or finely ground, so yes, cooking style matters. Other good sources of soft proteins could be natural nut butters, eggs, etc.
   
   
3. Miso-Tahini sauce - I have notes from our previous appointment that this is important and could be bought online at Amazon.  I can't find it anymore.  Do you know of a place I can buy it or do I have to make it at home following the recipe you gave me?

   Answer: The Living Earth has it, or go to the South River website, and order directly from there. Trader Joe’s even has it. There are many kinds, all are good!