Breaking the Vicious Cycle: Intestinal Health Through Diet

The mother of a child diagnosed with “incurable” ulcerative colitis, Elaine Gottschall, offers us an easy-to-read book on reversing colitis, Crohn’s disease, celiac that has not responded to a gluten free diet, diverticulitis and other diet-related digestive ailments. Based on the earlier work of Sidney V. and Merrill P. Haas, the book describes the so called “specific carbohydrate diet”.

Diarrhea, gas, loss of weight, excess mucus, cramping, blood loss, and constipation may be indications that one’s body is not tolerating one’s diet. And central to all these complaints is the likely possibility that the microbial balance in the gut is off and that improperly digested carbohydrates -– sugars and starches -– remain in the intestinal tract and contribute to an overgrowth of problematical yeasts and bacteria. When these organisms take hold for whatever reason, a cycle of events ensues:

* Injury to small intestine surface
* Impaired digestion of disaccharides (sugars and starches) 
* Malabsorption of disaccharides
* Bacterial overgrowth
* Increase in bacterial by-products and mucus production.

The specific carbohydrate diet breaks the cycle by depriving the microbial world in the intestine of the food that it needs to overpopulate the gut.

Disease process in the gut relates to putrefaction (bacterial activity on protein) and fermentation (microbial activity on carbohydrates). Antibiotics can be counter productive as they can lead to a proliferation of precisely the kinds of fungal organisms that don’t belong in the gut. Unabsorbed carbohydrates account for most of the gas that gets produced in the intestine.

There is growing concern that many children are affected neurologically by the microbial activity in their guts. In this case, toxic products from the intestines alter brain activity as the brain is “downstream” from the gut. Again, the SC diet is believed to work by nourishing the person but withholding the food preferred by the unwanted intestinal microbes.

The Diet

On this diet, what you don’t eat is “almost more important” than what you do eat. “Fanatical adherence” in the first stages is necessary. The introductory version of this diet requires the cooking of most fruits and vegetables, at least until no diarrhea remains. This is not at all a low glycemic diet. In fact, bananas are recommended to be eaten only when fully ripe and speckled as this assures that the starches have converted into mono sugars.

* Eliminates legumes (temporarily), all grains and potatoes including corn and corn products.

* Eliminates disaccharides: lactose, sucrose, maltose and isomaltose. This means temporarily eliminating most dairy products, many drugs and mineral supplements. Sucrose is table sugar. It is found in many prepared products. Maltose and Isomaltose are found in corn syrup, malted milk and candy and starches.

* Allowable fiber comes from fruits, vegetables, and nuts. Other forms of fiber, i.e. from grains and bran, are not permitted.

* Allows monosaccharides – single sugars: glucose, fructose and galactose found in honey, fruits and some vegetables. Galactose is found in lactose-hydrolyzed milk and in yoghurt (not all of them).

* All forms of sugar and brown sugar are out.

* All cereal grains in all forms are out.

* No artificial sweeteners are permitted except saccharine.

* Honey is the sweetener of choice

* Only homemade yoghurt prepared precisely by her directions is permitted. It is important to make sure there is virtually no lactose (a disaccharide) remaining.

* No potatoes or yam.

* Fats are well tolerated, including all animal fats.

* All fresh meats, fish, fowl, eggs and canned fish are allowed.

* No processed, canned or smoked meats.

* Fresh and frozen vegetables are allowed.

* No canned or jarred vegetables.

* Fresh, raw, or cooked fruits are allowed.

* Fruits in their own juices are allowed but otherwise no processed fruit.

* Very limited dried fruit with no sulfites.

* Nuts are allowed as long as there is nothing extra on them, no salted mixes. So, almonds, pecans, Brazil nuts, hazelnuts, walnuts, unroasted cashews, and boiled chestnuts.

* Peanuts - only peanut butter is allowed.

* Freshly squeezed fruit and vegetables juices are allowed.

* Permissible beverages include mint tea, very weak coffee.

* Butter is OK; margarine is not.

* Legumes are tricky. See the book for soaking instructions.

* There are permitted dairy products, see book for details.

Half of this book is recipes, most are fairly easy to follow. There’s a dynamite bread substitute made out of almond flour and some good cookie recipes, assuming you can tolerate some honey.

Gottschall recommends trying the SCD for one month and evaluating. There should be changes for the better in that time. If not, then the SC diet is probably not going to help.

She estimates that people with celiac disease, spastic colon or diverticulitis will require about a year to heal while those with Crohns disease or ulcerative colitis will require at least two years.

In recent years, the SC diet has come to be favored by many parents of autistic children, many of whom are plagued by chronic constipation, diarrhea, and abdominal pain. Many also seem to be addicted to carbohydrates. When their digestive tracts are deprived of fermentable carbohydrates, their neurological symptoms are reduced. She notes that improvements in brain symptoms are even seen before the gut is entirely healed. Various theories on why changing the diet improves the brain examine inflammatory reactions that are like allergies or food sensitivities, the fact that certain undigested proteins have an opiate effect because they can occupy the same receptor sites in the brain as morphine, and of course a gut full of pathogenic organisms can give off toxins that are damaging for brain cells.

Gottschall warns that the initial detoxing may be so rapid that symptoms will flare up, requiring support for the parents who are trying to implement the dietary changes.

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