Entocort and Elimination Diet

[Debsmith]

Hi everyone! I've benefitted from much of the knowledge and experience shared here over the past several years and have started trying to determine what sensitivities I may have, despite the recommendations of my GI.

I was diagnosed with LC in Aug 12 after about 3 of 4 months of constant D. Immediately after diagnosis, I was in remission for about 11 mos. Long story short, I'm on 9mg of Entocort for 1 mo, then I was told to switch to 6mg for a mo, then to 3mg for a mo. After the first 3 or 4 days on Entocort, I felt much better. Bathroom trips reduced from 15-ish per day to 2-3.

During the same week that I started Entocort, I saw a nutritionist who recommended an elimination diet (GF, CF, SF), as well as following the FODMAPS diet. She suggested that I should start testing foods after about 1 month.

Here are my questions:

Since the Entocort is helping my gut to heal, doesn't it make sense to just continue eating GF CF SF until I've successfully weaned off the med?

Also, if Entocort calms my gut and helps to soothe any response to irritants, I wonder if testing potential irritants while on it is logical. Would I see a response at all or less of one?

Finally, I haven't seen much mention here of FODMAPS. I know that it's typically recommended for those with IBS, but I'm not sure it's what I should be doing. Thoughts?

Thanks in advance for any advice!
Deb

[tex]

Hi Deb,

Welcome to our internet family.

Since the Entocort is helping my gut to heal, doesn't it make sense to just continue eating GF CF SF until I've successfully weaned off the med?

Definitely, because most patients relapse when the Entocort treatment is discontinued (regardless of what your GI doc may have told you about his success rate). If you can make it past about the 8-week mark after discontinuing the Entocort, then you may be healed enough to begin testing foods without risking a total relapse.

In addition, if you happen to have additional food sensitivities beyond gluten, dairy, and soy, then their effects will begin to show up as your Entocort dosage is reduced, and that's a good time to fine-tune your diet some more, if necessary.

Also, if Entocort calms my gut and helps to soothe any response to irritants, I wonder if testing potential irritants while on it is logical. Would I see a response at all or less of one?

You seem to know much more about treating this disease than both your doctor and your nutritionist. Good for you. You are correct, Entocort can completely mask all food sensitivities for a few of us, and it can mask some food sensitivities for many/most of us, but while you are on a full dose of Entocort is definitely not a time to be testing foods by reintroducing them into your diet to see if you may react to them. That should be done much later. For some of us, Entocort is only effective if we carefully avoid at least all of our major food sensitivities (gluten, dairy, and soy, in most cases).

Finally, I haven't seen much mention here of FODMAPS. I know that it's typically recommended for those with IBS, but I'm not sure it's what I should be doing. Thoughts?

We discuss FODMAPs from time to time. In general, it's much safer to at least minimize them, and some of us have to more carefully avoid them. Since FODMAPs are indigestible, they tend to ferment in the colon, producing gas, bloating, cramps and D (in many cases). Small amounts may not be a problem (IOW, for most of us, it's a dosage issue), but large amounts can definitely cause problems for many/most of us.

You seem to be off to a good start. Again, welcome aboard, and please feel free to ask anything.

Tex

[Debsmith]

Thanks so much for your response, Tex. I appreciate the confirmation of what I thought I understood about Entocort and diet. As frustrating as it is to have to wait to test foods, I'll keep doing what I'm doing. I feel fortunate that I'm feeling well!

Thanks again for all of the information and support you provide!

Deb