New Perspectives on Nutrition

for Crohn’s and Ulcerative Colitis Patients

Frank W. Jackson, M.D.GastroenterologistCamp Hill, PA

Plan

Plain Talk on Diet Gut Bacteria Probiotics Prebiotics Hydrogen Sulfide Gas and Ulcerative

Colitis Food Emulsifiers and Crohn’s

References Jackson GI Medical: www.jacksongi.com

Ulcerative Colitis Diet Crohn’s Disease Diet Crohn’s Patients: Plug Your Leaky Gut!

Crohn’s and Colitis Foundation of America ccfa.org

Search: Diet and Nutrition Mayo Clinic

mayo.org Search: Ulcerative Colitis, Lifestyle and Home Remedies Search: Crohn’s Disease, Lifestyle and Home Remedies

Plain Dietary Talk for Crohn’s and Colitis

Protein – weight Dairy Products Complex Carbs &

Adequate Fats Vitamins

Multi-vitamin B12 & Crohn’s Vitamin D

Minerals Calcium Iron Selenium

Fish, Fish Oil & Flax Seed

Herbs

Lactose Intolerance 12-16 Oz. Skim Milk in

AM If no…

Cramping Diarrhea Excess Flatus…

In 4-5 hours, then You don’t have Lactose

Intolerance (If symptoms do occur,

see your physician)

Minerals Calcium

Dairy Products

Iron Consider Supplement

Selenium Brazil Nuts

1-2/Day

Herbs An herb is any plant which is dried & ground up! 100’s of different chemicals/molecules in every plant

Broccoli Apples Ginko Echinacea St. John’s Wort Spinach

BUT: Use only recognized food herbs. Avoid other herbs.

Gut Bacteria Microbiota

Mostly colon bacteria Over 1,000 species Trillions and trillions!

What we know now The colon is a health

organ when the good bacteria grow and proliferate

Take care of it! Don’t abuse it!

Prebiotics

Soluble Plant Fibers NOT digested by human gut Fermented by gut bacteria Positive health benefits demonstrated

PrebioticsRemarkable Benefits When Colon Bacteria are Fed Well Calcium Bone Density Immunity Good Bacteria Regularity

Allergies/Asthma Triglycerides Cancer Factors Appetite/Weight Bad Bacteria Flatus Smell

Oligofructose-Inulin Rich Foods*:Prebiotics

Chicory Root (65% prebiotics by weight)

Jerusalem Artichoke (32%) Dandelion Greens (24%) Garlic (18%) Leek (12%) Onion (9%) Asparagus (5%) Wheat (5%) Banana (1%) Thousands more <1%

The King of Prebiotic Foods: Chicory Root is 65% Prebiotic Fiber by Weight!

*The Journal of Nutrition, 2007

Prebiotin

Oligofructose-Enriched Inulin Combines prebiotics

with both shorter and longer molecular chains to nourish entire colon

Probiotics - Bacteria

Probiotics - Bacteria Healthy: more hype and

hope than fact. UC: VSL#3 – maybe Crohn’s: Unknown Bottom Line for UC and

CD patients Regular/natural yogurt

probably okay Bacteria “Enhanced”

Yogurts, like Activia, and all other probiotics – avoid

Talk to your physician.

The Colon

Right (ascending) Colon

Left (descending) Colon

Transverse Colon

Ulcerative Colitis 1. Outside Surface

2. Inside Lining Cells

3. Mucus Layer (Biofilm)

4. Bacteria

5. Hydrogen Sulfide Gas

Ulcerative Colitis results in inflammation ofInterior lining cells.

H2S

H2S

Hydrogen Sulfide (H2S)

Made by Colon BacteriaLow Concentration = Smelly FlatusMedium Concentration = Irritate Eyes &

AirwaysHigh Concentration = as deadly as Cyanide

A nasty gas!

Hydrogen Sulfide (H2S)

Noxious Flatus Odor Made in the Left

(descending) colon Why? H2S bacteria do not grow

in acid environment Left colon is neutral –

neither acidic nor alkaline

.org

Prebiotics Prebiotic Foods and Oligofructose-Inulin

Formula (Prebiotin) Feeds good bacteria which in turn make short-chain

fatty acids (SCFA) - Energy Pods

Energy Pods (SCFAs) Nourish the colon cell wall itself Create energy Protect mucous layer Acidify the Colon

Prebiotic Energy Pods (SCFA)

Does Acidifying the Colon Help U.C.? Prebiotics decrease production of H2S How do we know?

Flatus stops smelling

.org

Crohn’s DiseaseOutside Surface

Cell LiningMucus Layer

Bacteria

Healthy Crohn’sIn Crohn’s, the

bacteria penetrate the mucus layer and invade the

inside lining cells.

Bacterial invasion of mucus layer and cell lining in Crohn’s

Healthy Crohn’s

Prebiotics Prebiotic Foods and Oligofructose-Inulin

Formula (Prebiotin) Feed good bacteria which in turn make short-chain

fatty acids (SCFA) - Energy Pods

Energy Pods (SCFAs) Nourish the colon cell wall itself Create energy Acidify the Colon Protect mucus layer

Prebiotic Energy Pods (SCFA)

EmulsifiersFood Additive: What are they?

Why are Emulsifiers Used? Prolong shelf life Blends and homogenizes water, oil & any liquid Binder Increases Taste Mouthfeel Substitute for Fat and Gluten Allow labeling of foods as fat free, low calorie, etc.

FDA classes them as GRAS (Generally Recognized As Safe) Therefore, manufacturers often do not have to declare on

ingredients label

Emulsifiers Who are They? Cellulose (derived from wood chips)

Methyl Cellulose (Citrucel) Carboxy Methyl Cellulose (most used) Hydroxy Propyl Methyl Cellulose

Gum (gum trees & plants – natural, organic) Guar Gum Xantham Gum Gum Arabic Taro Gum

Emulsifiers are everywhere

Emulsifiers at work…

Oil + Water Oil + Water + Cellulose Emulsifier (Carboxy Methyl Cellulose)

Oil + Water + Xantham Gum

WOW!

WOW!

Food Emulsifiers

A profound experiment on an unsuspecting public

Probably safe for the otherwise healthy For the Crohn’s Patient:

They may damage the mucus layer (biofilm)They may allow invasion of bacteria!

Recommendation for UC and CD Patients Good Dietary Health Eat prebiotic rich foods Consider a prebiotic supplement such as

Prebiotin (www.prebiotin.com) Restrict emulsifiers as much as possible.