Saturday, September 3, 2011

No Colitis

Hard to believe that it’s been over a year since I updated this blog, and two years since I started it. Where does the time go?

I’ll probably bump in here once a year or so with updates, just to make sure this information is current and honest. If at year three I have a massive flare up and die from meat clogging my intestines, it’d be a good idea to note that rather than let people believe this all worked out.

Of course, I have yet to have meat clog my intestines, and the title of this post is the summary from my latest colonoscopy: no colitis activity. Yay! Two years “cured”. My pipes looked good enough for the gastro to move me off of the once a year colonoscopy schedule – I go back in two years, August 2013. Awesome. This’ll be the first year I go without a colonoscopy since 2002.

What’s perhaps more interesting than the result is my behavior in the past year. I did not continue to eat only meat. Meat continues to form the basis of my diet; most meals are mostly meat. But I have added back in a pretty broad variety of other things. For the first few months post meat, I added back in some vegetables and drank a TON of Lactaid milk to gain weight. After a few months of that, I was up to nearly 200lbs from a starting weight of 160lbs. So that worked.

There were no apparent Crohn’s consequences from the milk or the vegetables. I did get more gassy and bloated at times, but no flare up of symptoms or pain. I did discover that brussel sprouts are not really human food as much as they are gut-bacteria food, and that if I wanted to avoid generating sulphurous methane at a rate which would astonish a cow, I should avoid them. So brussel sprouts = bad, at least for me.

That brings me up to December 2010. At that point I was getting tired of milk, and had started to break out in acne on my upper back. That seemed like a clear indication that milk, even if it wasn’t going to trigger Crohn’s, was probably not helping overall. I also hurt my back and had to take a break from weights for a while, so there was no point in chugging that much milk.

So I decided to give the starch hypothesis a direct test. I started eating potatoes.

I did experience some discomfort at first, but no real Crohn’s symptoms. It seems that my digestive system had to reset a bit to handle a pile of starch. Again, I would have more gas (as in gas at all; the meat only diet left me without any) with the potatoes, but no Crohn’s flare. I’m still eating potatoes now, eight months later, with no obvious consequences and no Crohn’s activity in my latest biopsies.

Hypothesis falsified?

Was Wulfgang Lutz right? Just eat 72g of carbs of whatever source and you’ll be fine?

I don’t know. One could argue that the year of zero starch allowed my intestines to heal sufficiently to the point where the bacterial mimetic necessary to generate the autoimmune response are no longer crossing the gut barrier, and so the starch hypothesis stands. Or maybe I didn’t need to eat only meat for a year – maybe just dropping the total starch load to some lower level would be sufficient, ala Lutz. Or maybe the starch hypothesis is total crap and I just happened to have a flare up and remission which coincided bizarrely well with a radical shift in diet.

The one thing I have not tested myself with is gluten. Maybe all of the above is a red herring, and removing gluten and various grain proteins from my diet caused the gut healing necessary to shut down the Crohn’s reaction. I was tested for celiac and came up negative back when I was first diagnosed, but frank celiac and gluten sensitive are different levels of response. When it comes to generating totally unscientific explanations for the results of my N=1 experiment, I’m coming to think that it might just come down to avoiding bread.

I did have a few moments of insane cramping and diarrhea over the past year. In each case, I could not ascertain a direct cause. It seemed to happen at random, but usually coincided roughly with some deviant behavior. I really can’t say if this is just me finding patterns in chaos, but when I eat a lot of nuts (pistachios are apparently equivalent to crack cocaine for me), I usually end up in trouble. Unfortunately, I was also eating some fruit at the same time I was gorging on pistachio, so maybe it was fructans in the fruit. I have yet to do any real exclusionary experimentation to isolate which food(s) were sending my guts down the toilet, mostly because “success” involves my guts trying to jump out of my body and down the toilet.

So, there you have it. I’m still “cured” despite adding in a number of foods which a year ago I would have predicted would cause a relapse. Who knows what I’ll be saying in a year or two. I’ll make one golden prediction: I’ll be less certain about the truth of the matter than I was when I started.

In the meantime, though: no colitis!