Newly DX - much needed advice

Discussions on the details of treatment programs using either diet, medications, or a combination of the two, can take place here.

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Deb
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Post by Deb »

I was missing a crunchy, low carb "something" too. I'm not sure if you can tolerate them but I recently started making very simple flax crackers. I use equal amounts of roasted golden flax seed and water and let it sit for about an hour. It gets a bit gelatinous.
I then spread it on parchment and put another piece of parchment on top and roll or push it thin. I sprinkle it with salt and pepper and sometimes, rosemary, depending on how I want to use it. Bake at 300 for about 45 minutes and if they're not really crispy I turn off the oven and leave them in there until it cools. They're a bit fragile and not terrific by themselves but they're good with my almond butter on top and the cheese I'm still able to enjoy. I don't know if I'm getting any nutritional value from the flax as many of the seeds seem to "pass on through" but I'm okay with that.
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Sharaine
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Post by Sharaine »

Hi Barb,

I was diagnosed with MC on June 13th. As soon as I got the information, I went GF/DF. It's made a huge difference. I'm amazed at how much less bloated and tired I am. I do understand the adjustment, but very much believe that it is worth it to make the sacrifices.

As Sara mentioned, she's hooked on Lay's potato chips. Now when I buy a bag (I hadn't bought potato chips in years), I think of her. They are good and salty and crunchy. I also like tortilla chips. I have to be careful to get regular, not flavored, though because almost all of the flavorings (lime, onion, etc) are made with milk and I can't tolerate it.

Also, if you are a beer drinker, I hate to break it to you, but you will need to give it up. All beers are made with gluten except one that is GF. I've never tried the GF; just not interested in taking that risk.

Please know you have come to the right place. We :welcome: you!

Sharaine
Barb1
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Post by Barb1 »

What do you do if your only symptom is D, I have a hard time finding a trigger food (except fresh fruit). Nothing I eat makes me sick, I just have D everyday, so I don't know what is triggering it. I started Pepto Bismul, one dose with breakfast, but if it stops D how do I know what foods are a problem, so I probably shouldn't do it.

I am thinking of taking the Asacol, I came across a study that said it was fairly sucessfull.

The flax seed cracker sounds good.

I don't think this has sunk in yet, I have been swamped at work, so no time to think.

Thanks for your support, I know I'll have more questions.

Barb
DX with MS, Hashimothyroiditis, Hypothyroid, Raynauds, Lymphocytic Colitis
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tex
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Post by tex »

Only "D" is classic microscopic colitis. All the other symptoms are satellite issues, usually due to the leaky gut syndrome, or something of that sort. Food sensitivities almost always occur according to a certain hierarchy. The most likely issues are gluten, casein, and soy, in that order. So if you want to see what is causing your D, cut gluten out of your diet. If that doesn't show any benefits after a few weeks, cut out casein, (in addition to the gluten), if that doesn't resolve the D, cut out soy, (in addition to the gluten and casein), etc.

If you don't want to control your D by diet, give the Asacol a try. It will either make your D worse, (within a week or so), or it will help, (after a few weeks). Remember, though, that if you don't change your diet, you will probably have to take a med forever, in order to control your symptoms. Usually, though, after you reach remission, you can taper the dose down to a maintenance dose, which is significantly less than the therapeutic dose.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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sarkin
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Post by sarkin »

Barb, I was an "only D" sufferer from MC when first Dx in 1997 - and you really want to keep it there, take it from me! My MC seemingly 'went away' and when it came back, it was much, much worse.

This time, I had luck with Pepto, at 8/day for a few days, then reduced the dose down. It worked for me because I also took Tex's advice - but I dropped gluten/dairy/soy all at once. Not everyone can tolerate the Pepto - but keep it in mind as a potential aid in your toolkit.

Also: when you are having relentless D in your life, it seems as though everything causes it - fruits, veg, air, water, coffee, sleeping, waking - once your system is sufficiently inflamed, it doesn't take much to push you into a full-on upset. Once you calm the gut down (with drugs, or chicken soup, or prayer - or all of the above - but definitely with some dietary tweaking), some foods that seem to be impossible may return. Almost all of have trouble with fiber, and a significant amount of added oils, when we are reacting. But many of us find we can add some of those back, once we're on solid ground. Start with peeled/well-cooked/simple, till you're past this rough patch.

So - for now, try Tex's hierarchy of "avoid" foods (or do the Sara protocol, and go hard core - cut 'em all out at once). And beyond that, don't try to figure out your triggers. Just do whatever you have to to stay hydrated and turn the D off. You may get the worst of your troubles out of your way with gluten/dairy/soy - and then you can see whether you need to worry about the other foods (either common irritants or unique personal intolerances).

I started out with homemade chicken broth, and gradually added potatoes and carrots etc. to that mix; was lucky that bananas seemed to work... somehow, the slower you go, adding foods, the faster you seem to get there.

I know you just said you're swamped at work. Maybe you can take a deep breath on the weekend, and set up a few days of limited/simple food. Ask someone for help with shop/prep, if you need to. Eventually, you'll have a set of "go-to" foods, in your pantry, your freezer and - yes - in your purse, if need be!

Good luck, and keep us posted,

Sara
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Post by Barb1 »

Tex,
I have gone GF, as far as dairy it's almost none. I did pick up my prescription asacol, I want to take just 1 tablet 3 times a day rather than 2 three times a day. I haven't asked the dr., because he probably won't agree. Because my case is so called mild, I don't see why I couldn't, after all it was meant for ulcerative colitis which is a lot worse. Am I wrong in my thinking? Or do you think the inflammation is purely due to gluten/dairy?

I do want to control D with diet, not to fond of big pharma.

I have an appointment on the 6th with an other dr. to see what all I am allergic to, hopefully it will give me some answers too.

Thanks,
Barb
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tex
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Post by tex »

Barb,

I understand what you're saying, but the problem with taking a reduced dose of mesalamine, (or any med, for that matter), is that it may not be enough to provide therapeutic benefits. It is true that some patients can get by with a half dose, but that's not because they have a "mild" case, it's simply because they are more responsive to that particular medication. Maybe a little explanation is in order:

Many doctors misinterpret a relatively low lymphocyte count, (IOW, only slightly elevated from normal levels), as a "mild" case of MC. Or, they may misinterpret only slightly thickened collagen bands in the lamina propria as a "mild" case of CC. They are simply jumping to a mistaken conclusion, because they don't understand the markers of the disease. There are about a dozen different kinds of MC, and most GI docs are only vaguely familiar with the two most common forms, CC and LC. You might have a case of paucicellular LC, for example. That would simply mean that your biopsy slides would not show nearly as many lymphocytes, under the microscope, as would be the case with conventional LC. I does not mean that you have a "mild" case. Some people with the fewest markers of the disease on their biopsy slides, have the most severe symptoms.

Now if he is basing his opinion that you may have a mild case, on the fact that you seem to have minimal symptoms, then he may well be correct, but that's just a guess - there's no way to tell, for sure. The point is, there is no correlation between the lab markers of MC, and the severity of the clinical symptoms.

Even so, a half dose of Asacol may not help, or, most likely, it will simply take much longer to provide any noticeable improvement. Since it typically takes Asacol at least 2 to 4 weeks, to bring improvement in symptoms for many patients, half a dose might extend that time to 1 to 3 months, or longer, or it might never help. :shrug: It's difficult to say, because we all respond differently to meds.

It is true, though, that a reduced dose would also probably reduce the adverse effects, if you happen to be sensitive to it, (allergic), or it might take longer to notice that you are having an adverse reaction to it.

Good for you, for choosing the diet as your primary treatment program. The purpose of taking a med while using the diet is to speed up remission of symptoms, because it takes the diet a while to work, for most people. IOW, a med can help to relieve the symptoms while the diet heals the gut. If you don't see any improvements in a couple of weeks, though, and you aren't having any adverse side effects from the Asacol, you might need to consider trying a higher dose. You'll probably be able to tell more about how you feel about it, after you try it for a week or so. There's certainly a chance that the dose you mentioned might work just fine for you. You'll know after you try it.

Good luck with your treatment.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Gloria
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Post by Gloria »

FWIW, I agree completely with Tex. I'd probably categorize my MC as a "mild" case, not because of the number of lymphocytes, but because of the symptoms I've had. I only go to the bathroom during a flare between 3-9 times a day, averaging 3-4 times. I don't have stomach cramps or any real pain associated with it. I've never thrown up, either.

Yet, my MC has been one of the most difficult cases to resolve. I always think that I only need to take a reduced amount of Entocort to get me out of a flare, but I'm always wrong. I have to take the full dosage and taper it once my symptoms get under control.

I would recommend that you take the prescribed dosage so that you can reduce the inflammation ASAP. You can always reduce the dosage if your symptoms improve quickly.

It's always best to view the meds as a partner in determining which foods are problematic, not as a solution to your MC. Once your symptoms get under control, you can reduce the meds just enough so that you react to some foods. This is where the med is a partner, allowing insight into your intolerances, but keeping the major symptoms at bay.

Good luck with your progress.

Gloria
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Barb1
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Post by Barb1 »

Thanks Gloria and Tex,

Your are helping me along, I appreciate it immensely! I am just having a hard time knowing what to eat and getting the right nutrition. Is Ensure ok or something like it?

When eating GF how careful do you have to be, example if you are fixing gravy and use bouillon and your not sure if it has gluten in it (it doesn't say GF on the jar). Lets say something might have a small amount of gluten in it, is that ok.? I know Celiacs can't even have a miniscule amount, does that go for MC too?

Thank you,
Barb
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sarkin
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Post by sarkin »

Barb,

Most of us are highly sensitive to even tiny amounts... or unwilling to take the chance. I had a label misreading mishap a few weeks ago - I had a tiny amount of something that had a tiny amount of gluten in it, and it made me plenty sick. As you already have other autoimmune conditions, I would treat gluten like kryptonite, and avoid it at all costs even in minuscule quantities.

I would avoid products like Ensure, which has a lot of suspect ingredients (dairy, corn, carrageenan... who knows which of those may cause you to react?). Once you are more healed, you will absorb nutrients better from food, and in time you'll find safe vitamin supplements, etc.

You will become quite an expert at label reading, and finding substitute strategies for kitchen and pantry. Some of us use a lot of GF products, but I'm one of the ones avoiding most of those.

I hope this helps and isn't too alarming :grin: And I wish you speedy healing,

Sara
Barb1
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Post by Barb1 »

Thanks Sara, I appreciate your advice.

Barb
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tex
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Post by tex »

Barb,

I completely agree with Sara. I used products such as Ensure, Boost, etc., early on, because they are advertised as good nutritional supplements. The problem is that they have an ingredient list as long as your arm, and they contain a lot of dairy and soy ingredients. It eventually dawned on me that they were causing problems for me, so I had to avoid them.

Most of us tend to be about as sensitive as celiacs, except that we usually have more food-sensitivities that we have to avoid. Bouillon usually contains gluten.

To give you an idea of how little contamination it can take to make us sick, if someone in the kitchen dips a cup of wheat flour out of the bag, (or worse yet, pours it out), just the dust in the air, settling onto our food, can cause many of us to react. And, of course, if someone touches a slice of bread, or cake, or some other pastry that contains gluten; or touches a counter top, or spoon, or pan, or some other utensil that contains, (or did contain), flour dust or other gluten residue, and then touches our food - many of us will almost surely be "glutened". Some of us aren't quite that sensitive, of course, but it usually takes less than most of us realize.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Barb1
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Post by Barb1 »

I have some questions,

How do I know what is making the D better, being GF or Asacol, if it is the Asacol, then how do I know for sure what foods might cause problems if the Asacol is working? Quit the Asacol, I don't want a false sense of security, I don't want to take this for too long.

What if your only symptom is D, do you cheat once in awhile, have D then get back to GF? What about eating out? I could suffer with D once in awhile to eat out.

What do you use for bouillon? I use Better Than bouillon, I have found in a celiac forum that said it is GF.


Thanks,
Barb
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tex
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Post by tex »

Early on, if you improve, you can probably assume that the Asacol is helping, because it takes a while for the diet to work. At least in that case you would know that the Asacol is not making your symptoms worse, so it's safe for you to take it. It usually takes at least a month or two, and in many cases much longer, for the diet to start working, because the gut has to at least partially heal. Later, when your doctor tries to wean you off the Asacol, you will know if the diet is working, because your symptoms will relapse, if the diet isn't working. if that happens, it means that you have additional food sensitivities.

If you cheat on a regular basis, your intestines will never completely heal, and your immune system will remain on high alert. The severity of your symptoms in response to "cheating", will depend on how sensitive you are.

I don't use bullion, so i can't answer your last question.

You're very welcome,
Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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sarkin
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Post by sarkin »

When I took Asacol, it didn't help all that much. It could be different for you (and it is likely that the Asacol was one of the reasons why I stumbled into remission, without really understanding anything about MC, some years ago). But I would guess that if you are experiencing significant improvement, the diet is at least partially helping, even if the Asacol is doing some of the 'heavy lifting' for you.

I don't like the word 'cheating' - it makes it sound as though gluten is some forbidden thrill, instead of a dangerous toxin - which is what it is for me. D is one thing; long-term autoimmune problems are quite another. I am sorry I didn't drop gluten years ago, when I was first sick, and it makes me sad to think that I may now have health problems I don't need to have... not all of which (at my age) are likely to leave me alone now that I have seen how gluten affects my health. (I'm now dwelling on that - but I think if you're over 30, the power to "bounce back" starts to wane.) Also... just because your only symptom is D doesn't mean something else isn't lurking. Many of us have had many other 'minor annoyances' clear up, along with the D, when we got our MC under control. To me, that means, that D is the only symptom screaming at us, and we put up with various achs and pains, or unexplained skin rashes, or itchy ears and graying hair (both mine!)... my husband finds his scalp is itchier and his dandruff worse when he eats more gluten. And he's "perfectly healthy" as far as any big issues or diagnoses.

Happily - I eat out all the time. I just go to trusted places, or if it's a new place, I am very careful. It is not risk-free, but I have been fortunate many times, and only once really was served something that didn't work for me. It is easier if the place isn't jam-packed. As it happens, my chorus rehearses on Monday evenings, and I almost always meet my husband at a local restaurant afterward. Sometimes we eat before the rehearsal - never crowded at 6pm... but mostly we get there around 9:30pm. If it's really empty, sometimes I will engage the waiter and ask about eating something other than my "usual." But when in doubt - I order what I know has worked for me. Some folks carry a 'chef card' - something the waiter can bring to the kitchen. At my first meal on vacation in Paris in June, the chef came out of the kitchen to speak with me about what to substitute for the buttery mashed potatoes. Also - I try to ask, not "what can I eat" but "I'm thinking of having one of these two dishes; is either of them impossible to make GF/DF, and if it's an accompaniment, is there a good substitution?" So, I can have roasted potatoes instead of mashed, which always have dairy; or a different salad or salad dressing... you get the idea.

I have not used bouillon for some years - but I am sure you will find one that works for you, if it is an important part of your cooking habits. Start with recommendations from the celiac forums, and then read the fine print on the label (you can usually find that info online, which is easier than juggling reading glasses in the store). If you are uncertain about any ingredients, you can post them here, and someone will help you decode the jargon...

I make a lot of chicken broth, and freeze some to use in cooking. It is not as convenient as bouillon, of course, but it might be worth a little extra planning during your recovery, or at least until you find a boullion that works for you.

Good luck and speedy healing,

Sara
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