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Against the Grain
New ideas and controversies in inflammatory bowel disease (Crohn's disease and ulcerative colitis)
Category: Science & Medicine
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by Samir Kakodkar
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December 17, 2018 08:21 AM PST

Fecal microbiota transplantation, otherwise known as FMT, is putting the stool from one person into the GI tract of another. This is an accepted treatment for recurrent clostridium dificil colitis which is a type of bacterial infection. Because we know that people with Crohn’s and colitis have a less biodiverse microbiome, some have hypothesized that a fecal transplant could theoretically be helpful for inflammatory bowel disease.

I interviewed Saffron Cassaday who is a documentary filmmaker based in Toronto and Los Angeles. Her films have been broadcast in over 40 countries including on PBS, Netflix, Hulu and CBC in North America.
Her current film, “Designer Shit”, is about Fecal Microbiota Transplant (FMT) for IBD. Saffron, who has suffered from ulcerative colitis for nearly a decade, sets off on a journey to determine if this form of treatment could potentially cure her of her disease. Through interviews with some of the top researchers in the field, Saffron is enlightened on the power “poo” has to affect our health, happiness and possibly even our physical appearance.
The film is set to be released in Spring of 2019.

As a disclaimer this is not an endorsement of FMT for treatment of inflammatory bowel disease. This is not FDA approved for this condition and at this point is still being actively researched.

Information on Designer Shit:
https://designershitdocumentary.com/

December 01, 2018 02:56 PM PST

I spoke with Raman Prasad who has been following the Specific Carbohydrate Diet for 20 years with sustained drug free remission of his colitis. He had a severe case of inflammatory bowel disease with possible primary sclerosing cholangitis and was facing surgery before discovering the SCD. He has published his experience in the book Colitis and Me: A Story of Recovery which I found personally inspiring and I highly recommend. He has also published two SCD cook books - Recipes for the Specific Carbohydrate Diet and Adventures in the Family Kitchen: Original Recipes Based on the Specific Carbohydrate Diet. He has been an advocate and spokesperson for the diet for almost two decades, and has worked alongside Elaine Gottschall in her efforts to promote the SCD to a wider audience.

November 11, 2018 08:47 AM PST

Today I had the pleasure of interviewing Joshua Bradley who overcame a severe case of fistulizing Crohn’s disease using a combination of conventional methods, ketogenic diet, endurance exercise and supplements which were guided by a biohacking -- that is he used objective data from testing to help determine what was working for him. I found our discussion regarding how foods affected his microbiome analysis to be particularly interesting. As a disclaimer, this is not an endorsement or recommendation of any of the methods discussed in this podcast and this is not medical advice. The particular tests mentioned in this interview are not FDA approved and are lacking in evidence to support clinical validity - that is the ability to measure or detect a clinical condition or predict a health outcome.

November 11, 2018 08:23 AM PST

Today I spoke with Stephanie Colo Manning who is chef and owner of Colo Kitchen which offers consulting and cooking lessons for people who want to transition to a nutrient dense, whole foods diet. She also had colitis and is someone who had a relatively rapid response to the Specific Carbohydrate Diet (SCD) and was able to maintain her remission without the use of medications with confirmed healing by colonoscopy. We also have a very detailed discussion about implementing the SCD which I imagine would be very helpful to both those who are thinking about starting it and also to those who are SCD veterans.
As a disclaimer, it is advisable that you discussion any dietary therapies with your physicians first. I have done many of the research studies regarding SCD for IBD and so far the evidence is still considered weak (in the form of case reports/case series); however, randomized controlled trials are being conducted now at other centers so I am hopeful in the future we will have stronger evidence to determine more details regarding the efficacy of the diet.

Website: http://www.colokitchen.com

October 18, 2018 02:22 PM PDT

The answer is we don’t know yet but there may be a mechanism to explain how it theoretically could be anti-inflammatory and possibly helpful for autoimmune disease. Today I spoke with Dr. Paul O’Connor who recently published some very interesting work on anti-inflammatory effects of baking soda -- something that you probably have in your fridge right now. However, as a disclaimer, this is not an endorsement or recommendation to use baking soda for IBD as it has not been FDA approved and has not been studied in the form of a randomized controlled trial (which admittedly would be a lot easier to do than some of the other treatments discussed in other episode so I am optimistic that it will eventually be done).

October 18, 2018 02:02 PM PDT

Fasting is becoming more and more popular nowadays and is being promoted for everything from obesity, diabetes, cancer and now diseases of immune dysregulation. There are many forms including prolonged water fasts, fasting mimicking diets, intermittent fasting and time restricted eating. There is no strong research I know of supporting the use of fasting as a treatment modality for IBD and can in fact be dangerous in someone who is malnourished and underweight. By chance I discovered a thread on a forum where a man named Vit Smilauer from the Czech Republic claimed to have cured his Crohn’s disease by fasting for 38 days. Yes you heard that right, 38 days! I contacted him and he kindly shared his experience which is truly remarkable and a compelling story. As a disclaimer, this is not an endorsement or recommendation to try fasting for inflammatory bowel disease as I think this can be very dangerous depending on your personal circumstances and health. This also has not been rigorously tested in a clinical trial to confirm safety and efficacy so at this point this is simply an anecdotal success story. I would not recommend anyone try this but hopefully this can open the scientific community’s eyes so that the appropriate research can be done.
His protocol can be found here:
http://mech.fsv.cvut.cz/~smilauer/Crohn_Smilauer_fasting_en.pdf

August 01, 2018 07:31 PM PDT

Today we are talking about hyperbaric oxygen therapy for inflammatory bowel disease. This is a hot topic with some studies suggesting efficacy in both Crohn’s disease and ulcerative colitis. Recently there has been interest in using it for hospitalized patients with severe ulcerative colitis. We speak with Dr. Scott Sherr who is a physician with training in internal medicine and also practices health optimization medicine. He has a subspecialization in utilizing hyperbaric oxygen for various conditions and today shares his insights and experience using it off-label for inflammatory bowel disease.
As a disclaimer - this is not an endorsement of this therapy for inflammatory bowel disease since it is still being studied and efficacy has not been established. It is not FDA approved to treat IBD at this time. You must discuss all treatment decisions with your physicians.

June 10, 2018 12:10 PM PDT

Garin Aglietti is worm farmer and gut ecology expert who offers worm therapy and fecal transplants for patients with autoimmune diseases including Crohn's disease and ulcerative colitis. These treatments are not currently offered as standard of care options for the vast majority of IBD patients in the US with exception of some clinical trials. Garin shares his experience utilizing his protocols which include using fecal transplants from a rural tribe in Mexico!
Disclaimer: This is not an endorsement of worm therapy or fecal transplant for treatment of IBD. You must discuss any treatment you decide to try with your gastroenterologist.

April 29, 2018 02:12 PM PDT

We venture into the realm of complementary and alternative medicine(AKA CAM) for Crohn’s and ulcerative colitis. These include various diets, supplements, and other lifestyle interventions that are not part of the standard of care.
Today we speak to Reid Kimball who has made a documentary called Wanted: Crohn’s End which is one of the most comprehensive investigations into complementary and alternative treatments for IBD that I have seen.
His documentary can be found at http://crohnsend.com/

As a disclaimer - this is a frank conversation about what he has learned and his personal experience. This is by no means a recommendation of any of these therapies for you. Any CAM treatment you decide to try should be discussed with your treating gastroenterologist first.

March 15, 2018 06:28 PM PDT

We catch up with a patient who recently had surgery for severe ulcerative colitis. We talk about his experience and his decision regarding if he should get a J pouch. We also address prior criticisms about how we discussed the Specific Carbohydrate Diet on the prior podcast.

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