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Against the Grain
New ideas and controversies in inflammatory bowel disease (Crohn's disease and ulcerative colitis)
Category: Medicine
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by Samir Kakodkar
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January 26, 2020 04:31 PM PST

Dr. Mitsuro Chiba is an MD, PhD is a gastroenterologist and researcher at Akita City Hospital, Kawamoto, Akita City, Japan.
He believes that inflammatory bowel disease is a lifestyle disease mediated mainly by a westernized diet, and has had many subsequent publications detailing his use of a plant based, semi-vegetarian diet.
He began to provide a plant-based diet for patients with inflammatory bowel disease at Nakadori General Hospital (Akita City, Japan) in 2003, and then continued to provide the diet at Akita City Hospital since 2013. We had a very detailed discussion regarding his well cited paper "Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet" published in 2010 which demonstrated the efficacy of using a plant based diet in combination with infliximab for induction of remission then maintenance with a plant based diet alone.
Though Dr. Chiba’s English is excellent, special thank you to Dr. Chiba’s daughter Kaeko who helped with translation at certain points of the interview.
This podcast should not be interpreted as medical advice as a plant based diet is not FDA approved for the treatment of inflammatory bowel disease.

Dr. Chiba's study:

Lester Breslow's 1980 publication regarding healthy habits:

January 18, 2020 05:07 PM PST

This is my much anticipated interview with Judy Herod who has been on the Specific Carbohydrate Diet (which we will often abbreviate as SCD) for over 50 years for ulcerative colitis with rapid clinical response and sustained drug-free remission. Her mother is the late Elaine Gottschall, biochemist and author of Breaking the Vicious Cycle: Intestinal Health Through Diet which is the book that describes the SCD protocol in detail and started the food/ibd movement several decades ago. Judy has likely been using dietary therapy for her ulcerative colitis longer than anyone else in the world. There are many parents who have young children on the SCD. I thought it would be valuable to hear from someone who has been on this protocol for so long to perhaps get a sense of what life can be like using SCD as a treatment strategy long term. As a disclaimer, this podcast should not be interpreted as medical advice as the SCD is not as of yet an FDA approved treatment for Crohn’s or ulcerative colitis.

SCD Website: http://www.breakingtheviciouscycle.info/

October 05, 2019 03:47 PM PDT

Barbara Olendzki RD, MPH, LDN is Associate Professor of Medicine and the Nutrition Program Director of the Center for Applied Nutrition at the University of Massachusetts. She is passionate about research and clinical care of patients with inflammatory bowel disease (IBD), cardiac concerns, cancer, diabetes, obesity, and other inflammatory diseases. She has 20 years of experience in the nutrition field. She created the IBD-anti inflammatory diet (IBD-AID) which is based on the Specific Carbohydrate Diet but with an emphasis on pre and probiotics, healthy fats and textures of foods. It also includes certain carbohydrates like oatmeal and other foods that are otherwise forbidden on the SCD.
She published a case series in 2014 of 11 patients with IBD who went on her dietary protcol. Most of these patients had failed one or more medications, or medications had no effect or there was a loss of response. After using the IBD-AID, all patients were able to de-escalate medical therapy to some degree and all had symptoms reduced. Since that publication, she has updated the protocol and kindly shared her insights regarding implementing the IBD-AID clinically. As a disclaimer, this is not an endorsement or recommendation of this diet for the treatment of IBD as the IBD-AID has not been FDA approved for this purpose.
Barbara's website can be found here: https://www.umassmed.edu/nutrition/

August 30, 2019 12:38 PM PDT

Two guests for you today! The first is Andrew Kornfeld (andrew@ibd.coach | https://www.facebook.com/andrew.kornfeld.18) who holds degrees in neuroscience and psychology from UCSC and has won awards for his work in science education. He has Crohn’s disease and has been able to achieve clinical drug free remission through a protocol he developed after doing his own extensive research with a lot of trial and error. Andrew is the founder of IBD Coach (http://www.ibd.coach) which offers consulting & educational services for IBD patients to develop their own personalized treatment protocol in coordination with their health and medical team.
My other guest is Lucy Mailing who has a PhD in Nutritional Sciences from the University of Illinois where her research focused on understanding how diet and exercise affect the composition and function of the gut microbiome in states of health and disease. She was recently named an Emerging Leader in Nutritional Sciences by the American Society for Nutrition and has authored several peer-reviewed journal articles related to the gut microbiome and health. Lucy is also a staff research associate for Kresser Institute and writes about evidence-based gut and skin health on her blog at NGmedicine.com. Lucy plans to continue her training and complete her MD at the University of Illinois in 2024.

We had a wide ranging discussion about several topics in IBD including the strengths and limitations of conventional medicines, potential to reform IBD care, health insurance, supplements, dietary therapy, mitochondrial function, candida, Genova testing amongst many other topics. As a disclaimer, I am not endorsing or recommending any of the supplements or protocols discussed in this podcast as they have not been FDA approved to treat Crohn’s or colitis. This is an open discussion and should not be interpreted as medical advice.

August 03, 2019 09:39 PM PDT

Dr. Michael Briggs is a physicist who had ulcerative colitis which he claims to have "functionally cured" using a system he developed called The Briggs Protocol. He read every article on IBD he could get his hands on and wrote a document called "Understanding the Pathogenesis of Inflammatory Bowel Diseases, and moving towards a 'Functional Cure'" which has been circulating on internet forums. You will learn about his approach to inducing remission, healing the epithelial barrier to stop bacterial translocation and then maintaining the barrier to prevent relapse. We discussed things like bupropion, limitations of the SCD/paleo diet, resistant starch and fiber, butyrate, hydrogen sulfide, fecal transplant, supplements, lectins, wim hof and this is only a fraction of the topics covered. As a disclaimer, I am not endorsing or recommending this protocol for treatment for IBD as it has not been studied in the form of clinical trials and is not FDA approved.

June 20, 2019 12:33 PM PDT

Dr. Jack Kruse is a practicing neurosurgeon and also a "theoretical quantum biologist." He specifically has an interest in our light environment, circadian rhythm and mitochondria in relation to health and disease.
In my opinion, these are topics that require more attention and research in the context of Crohn’s disease and ulcerative colitis.
This is one of the most high level podcasts I have ever recorded as Dr. Kruse’s knowledge base regarding these topics is unparalleled.
You will hear things in this interview that will make you rethink some of your assumptions about what you think you know about how the human body works. We overall need to do this more often for there to be progress in the treatment of IBD.
Resist the temptation to immediately believe or disbelieve anything that we discussed but actually go into the literature. See for yourself if Dr. Kruse is right. I did this myself on some of these topics..
As a disclaimer, nothing in this podcast should be interpreted as medical advice from my perspective. None of these interventions have been investigated in the context of clinical trials to determine if they affect actual clinical outcomes in IBD. Also increasing sun exposure with IBD, especially while on certain immunosuppressive medications and biologics, comes with the controversial but theoretical risk of skin cancer.

Dr. Kruse's website: https://jackkruse.com

Some referenced mentioned in podcast:

Sun exposure associated with decreased mortality

Red light therapy as a drug equivalent

Cell phone radiation and cancer (NTP study)

EMF as Risk for Disease

June 02, 2019 08:01 AM PDT

Although my training is in evidence based medicine (or what other alternative fields refer to as “allopathic medicine”), I am fascinated by other disciplines that operate on a completely different understanding of the human body and disease. There is much mystery surrounding Ayurveda in the US, which is the most ancient form of medicine developed in India and still practiced today. There is an inherent paradox here - how can an ancient Indian system of medicine be used to treat Crohn’s and colitis which are diseases that have only been well described relatively recently? Today I spoke with Vikram Chauhan who is an Ayurvedic doctor who practices in India and also the founder of Planet Ayurveda (planetayurveda.com). He has a particular interest in treating inflammatory bowel disease and claims to have an 80-90% “cure” rate. I obviously was skeptical so we had a detailed conversation about his protocol and experience. I did challenge some of his assertions but overall this was a respectful exchange of ideas. We specifically discuss the cause of inflammatory bowel disease according to Ayurveda and the herbs, diet and lifestyle modifications he recommends to treat it.
As a disclaimer, this is not an endorsement or recommendation of Ayurveda for IBD at this time since there is insufficient evidence published to show efficacy and it is not FDA approved. You must discuss any treatments you decide to use with your doctors.

April 27, 2019 03:01 PM PDT

Jini Patel Thompson is an internationally recognized expert on “natural healing” for digestive diseases. She says she has healed herself from widespread Crohn's Disease and has remained in drug and surgery-free remission for over 20 years. Jini has appeared on numerous TV and radio shows throughout the U.S. Her books on natural healing for digestive diseases have sold worldwide in over 80 countries.
We had an epic almost 2 hour long conversation about her methods to treat Crohn’s and colitis. We talked about the limitations of conventional medicine, her treatment protocols, mycobacterium avium paratuberculosis, the dogma of diets, tricks to make exclusive enteral nutrition more palatable, electromagnetic radiation/5G amongst other topics that most conventional doctors would think of as “out there” but I’m not afraid to delve into. As a caveat, I want to make it clear that this is an open discussion, and I do not endorse my guest's methods of treating IBD. This is not an endorsement or recommendation of any of the so called natural methods discussed on this podcast as they have not been FDA approved as treatments for Crohn’s or colitis. You should discuss any complementary/alternative treatment with your treating physicians.
Her website can be found here: http://www.ListenToYourGut.com

February 25, 2019 07:59 PM PST

If you have Crohn’s or colitis, I bet you have encountered someone either in person or on the internet who claims to be able to control his or her disease with the use of cannabis. Or maybe you are using medical marijuana already. This may seem appealing as an alternative to medications that can have a frightening side effect profile. The regulatory climate in the US makes marijuana difficult to study so we don’t have good, high quality information about it regarding its effect on IBD. The Crohn’s and Colitis Foundation commissioned a white paper on the topic.
Dr. Arun Swaminath is the first author on this publication.
He is the director of the Inflammatory Bowel Disease Program at Lenox Hill Hospital in New York also associate professor at Hofstra/Northwell.
His twitter page is located here: https://twitter.com/Swaminath_IBD
I hope we address any and all questions you may have about cannabis and IBD, both from the patient and clinician's perspective.
As a disclaimer, this podcast is not medical advice and I am not endorsing the use of cannabis for IBD as it has not been FDA approved for this purpose.

February 17, 2019 10:32 AM PST

After 10 years of researching the Specific Carbohydrate Diet (SCD) and implementing it along with other dietary therapies clinically, I wanted to share some of the insights I've gained along the way. I present the major findings of my research studies including brand new, exciting results from the SCD microbiome analysis. I also discuss my approach to co-managing diet along with medical therapy for Crohn's and colitis. For too long there have been two warring factions: 1) those that only believe in diet with a conspiratorial distrust of the pharmaceutical industry and 2) those that believe diet has nothing to do with IBD and think diet only influences symptoms. I believe there is value to using both diet and medication depending on a patient's unique circumstances. My wish is to finally bridge this gap with the goal of attaining optimal quality of life for my patients. I call this approach The Middle Path, a reference to the Buddhist teaching for attaining liberation.

My most recent review article on diet and IBD can be found at this link:

My case series on diet and IBD can be found here:

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