How is "remission" defined?

megamoxie · Post by **megamoxie** » Wed Oct 22, 2014 8:43 pm

Is "remission" defined by a certain period without symptoms/flares/setbacks/relapses, etc.? If so, how long is that period? Are there other factors involved as well? such as lab results/levels, colonoscopy with no further evidence of MC, etc.?

My short-term goal is to feel better and be able to gradually resume some of my former activities by making necessary adaptations to diet, lifestyle, expectations, etc. I have no problem avoiding food that seems to be problematic, but since I don't yet have food sensitivity results, it's currently a guessing game and trial-and-error process. I think I am doing pretty well compared to other stories that I have read on the forum, and I am very grateful for that. The longest I have gone without D so far is about two and a half weeks. I also have pain, churn, fatigue, and false alarms.

I assume that my long-term goal should be remission, but I don't really know quite what that means.

Post by **tex** » Wed Oct 22, 2014 9:42 pm

Meg wrote:Is "remission" defined by a certain period without symptoms/flares/setbacks/relapses, etc.? If so, how long is that period? Are there other factors involved as well? such as lab results/levels, colonoscopy with no further evidence of MC, etc.?

That's pretty much my interpretation of remission. For most of us it lasts until we either get tripped up by a meal/diet mishap, or a medication taken for some other purpose, of for some of us, an extremely stressful event.

How rapidly we heal depends on our age, and how meticulously we control our diet. By "heal" I mean a return of the mucosa of our intestines to normal histology, as verified by biopsy samples examined under a microscope. But note that we reach remission long before we heal — typically years sooner. Kids can heal in less than a year, but adults usually require 1–3 years, and middle-aged to older adults usually require 3—5 years or more. Some of us may never heal completely, because of exposure to trace amounts of food sensitivities, permanent damage, and possibly other unknown influences.

In general, each of us has our own personal opinion of exactly what constitutes remission for us, individually.

Tex

Hopeful · Post by **Hopeful** » Thu Oct 23, 2014 7:09 am

I think this is a great question and one that I am wondering about, too.
I am coming to accept that true healing will take a lot more time than I originally thought.
But I am struggling to understand what foods are triggering my system and what ones are "safe". For instance, I am now a month into a strict elim. diet. My trips to the bathroom are generally decreasing (2 - 3/day) but I still need to take an Immodium to get through most of the night. And I would define my poops are very loose.

So, I look at what I'm eating and at my meds/supplements and I'm not sure if I'm reacting to one of them. This is what my diet looks like:
3-4 oz. meat, 3 times a day - mostly chicken plus venison, lamb, occasional pork, beef. Will get into turkey around thanskgiving. Salmon about once/week.
3 veggies which I vary each day - about 3 cups total. Carrots, sweet potato, winter squash
Just started bananas and I eat about 2/3 cup homemade (peeled) applesauce most days.
Chicken bone broth - about 1 cup/day
About 4 times a week I eat rice, rice cake, or rice crackers (plain)
Potatoes seem to cause cramps, so avoid them.
1 cup coffee and 1-2 cups black tea/day with small amt. of honey and plain Goya coconut milk.
3 mg. Entecort, 2 plaquinal - 400mg. total, 1 celebrex - 100mg., Vit. C, D, B-12 (with B6 and folic acid), 1 quercetin, 5mg. of melatonin, 1 -2 low strength tylenol.
Lots of plain water

I am reluctant to try other foods, like corn or eggs until my D is more under control.
Any thoughts??

JFR · Post by **JFR** » Thu Oct 23, 2014 7:26 am

Hopeful,

It is possible that you are reacting to one or more of your meats. I know that I cannot eat chicken or beef. I would stick with just one or 2 meats, probably lamb and venison. I would also eliminate the chicken soup if I were eliminating chicken and make bone broth from the bones of a meat you are eating. Then there is a Celebrex, an nsaid, which alone might keep you from remission. The fewer foods you eat, the easier it is to figure things out. I know it might seem to you that your variety of foods is already very limited but the people who have had the most success here start out with an even more limited diet, often only 6 different foods. Leah is a good example of that. She now eats a much greater variety but stuck with a very limited eating plan for many months. I spent 2 weeks eating only lamb. So instead of thinking about what you might add to your diet, think about what else you can eliminate. The more complicated your diet the harder it is to figure out what is causing the problem.

Jean

Hopeful · Post by **Hopeful** » Thu Oct 23, 2014 9:33 am

Jean, I appreciate your feedback and would like to hear from some other people as well.
I see widely varying advise about elimination diets on this site. What is a sensible level of elimination for a person who still needs to function in the world? I do understand about the celebrex being an NSAID and it was prescribed as the least offensive of these. Pain is a big problem for me, especially in cold weather. I have already halved the dosage and I'm trying to go off it completely...

Post by **tex** » Thu Oct 23, 2014 11:42 am

Hopeful,

Variety in diet is grossly over-promoted in the developed countries of the world, because it's "in vogue" (and it has been in vogue for at least a century or more), and because there's a lot of money to be made by doing so. If you don't believe that it's possible to thrive (notice that I didn't say "survive", I said "thrive") on a very limited diet, please read the article at the following link. This research project was done during the 1930s, under the supervision of physicians who were prominent in their profession at the time, and it is legitimate and well-documented. Of course the medical profession quickly swept it under the rug, and still chooses to ignore it, because they were obviously embarrassed to be proven so wrong.

Meat is the only food that contains all the essential amino acids necessary for good health (that's why Homo sapiens evolved on a diet of mostly meat), and meat that contains an adequate of fat is a compete (and very healthy) diet.

Eskimos Prove An All Meat Diet Provides Excellent Health

Tex

JFR · Post by **JFR** » Thu Oct 23, 2014 12:03 pm

Hopeful,

I changed my diet so I could function in the world. I live alone and if things need to get done I am the only one to do them. Two and a half years ago when I found this forum I could barely leave my bathroom and found myself changing my bed sheets in the middle of the night. I literally could not function outside in the world. As Tex says, it is possible to live quite well on a very limited diet. Eating only fatty ground meat stopped my nearly constant WD. I certainly functioned much better on a very limited diet than I did eating more foods and living in the bathroom.

An elimination diet is designed to do 2 things. First it removes foods that you are sensitive to so that your symptoms go away. Then it allow you to figure out what foods cause symptoms by adding back one a a time and watching for reactions. It may not be the way you want to live in the short term and it is not necessarily the way you will have to live in the long term but it really does work to get things under control and figure out how to keep them under control.

Jean

Hopeful · Post by **Hopeful** » Thu Oct 23, 2014 12:39 pm

Tex, I am familiar with the "all meat" hypothesis. Weston Price did a lot of anthropological studies around the world. In the case of the Eskimos, they had the advantage of eating fish, marine mammals, and arctic animals that live on those creatures. So the copious fat they consumed was rich in vitamins such as D,E and A from the sea plankton in the food chain. Other indigenous people around the world have, rightly, treasured fat in their diets. I once shared a meal with 2 older women - one from Vietnam and one from the Caribbean. They both spoke so glowingly of pig fat!

The study that you cite is from the 30's when more of the meat that was eaten was grass-fed - still grazing on pasture. Sheep and goats, in particular, thrive on this diet as do cows left to their own devises. Nowadays, we fatten them up with corn, soybeans, and other stuff that is not what they were genetically intended to eat. Grazing translates into a different fat profile than does the modern diet and that fat profile is ideal for humans, as well. The trick for human meat eaters is to focus on buying meats that are raised, as much as possible, on pasture or at least close to their genetic diet (like poultry). This is certainly not easy to procure or cheap! In my case, I have raised my own pigs, ducks and chickens until my health made that challenging.

I do not claim to be the agriculture expert that you are, but I have studied food and food sources for decades. So-o-o-, my dilemma with finding the right elimination diet is that the meats that I can procure are probably not adequate when eaten by themselves. That's why I have added some limited veggies.

Once again, I would be interested in hearing what others on the forum have to say on this.

Gabes-Apg · Post by **Gabes-Apg** » Thu Oct 23, 2014 1:21 pm

The elimination diet has limited scope to work whilst ever there are other major triggers whether those triggers be food/ingredient, medication, stress, environmental (toxins or histamines)

as you may have read here, histamine issues can be a big issue for many here, and is quite often the blockage to achieving remission.
until all major triggers are eliminated or minimised, healing is stalled. You are 'getting by' with symptoms minimised, but inflammation is still occurring and healing is inhibited.

the other interesting part about triggers in MC world, we cant always identify the 'sometimes triggers' until the major triggers are gone. maybe something you are having daily, is an ingredient that you can only have every second day. All of this is tiring, frustrating, as we give 100% to be well!
I think your ability to get the most from the elimination diet is limited while you are taking the celebrex.

I have lived on my 'staples' for almost 5 years. Only in the past 5 months with inflammation balanced, cell health improved, toxins eliminated that I have been able to introduce new ingredients.
My eating plan is lamb, chicken, salmon, pork, veal, eggs, (bone broth made from lamb/chicken) sweet pot, carrot, parsnip, cauliflower, potato, rice, small amounts of corn, black coffee, coconut water,

after a couple of years, sometimes foods included GF flours, small peeled apple, avocado,

hope this helps

Post by **tex** » Thu Oct 23, 2014 3:00 pm

Hopeful,

Feedlot beef proteins contains the same protein amino acid chains that they always have. Any given beef protein today is composed of exactly the same molecular composition that it always displayed. That hasn't changed (and it can't change without drastic changes in the DNA). Only the distribution patterns of, and the chemistry of much of the fat has changed. For the purposes we're discussing here, the fat isn't necessarily relevant to the amino acid needs of the body. The fat is there to prevent rabbit starvation.

Have you actually considered the science behind the grassfed vs. feedlot issue? On the surface, science appears to support your position, and that's about as far as most people go when they are making a comparison, because comparisons of this type always begin by listing the virtues of grass-fed beef (after all, this is the agenda that prompted the research in the first place). But it's an incomplete comparison because as noted in the last paragraph of the following quote from the article at the link below, all one has to do is to eat the higher-fat portions of grain-fed beef to achieve the same effect. IOW, it could be concluded that eating lean beef defeats the purpose of eating beef, if one is attempting to utilize beef as a "complete food". But you will never see that stated as a conclusion in studies of this type, because today research is almost always done to support an agenda.

Conclusion

Research spanning three decades supports the argument that grass-fed beef (on a g/g fat basis), has a more desirable SFA lipid profile (more C18:0 cholesterol neutral SFA and less C14:0 & C16:0 cholesterol elevating SFAs) as compared to grain-fed beef. Grass-finished beef is also higher in total CLA (C18:2) isomers, TVA (C18:1 t11) and n-3 FAs on a g/g fat basis. This results in a better n-6:n-3 ratio that is preferred by the nutritional community. Grass-fed beef is also higher in precursors for Vitamin A and E and cancer fighting antioxidants such as GT and SOD activity as compared to grain-fed contemporaries.

Grass-fed beef tends to be lower in overall fat content, an important consideration for those consumers interested in decreasing overall fat consumption. Because of these differences in FA content, grass-fed beef also possesses a distinct grass flavor and unique cooking qualities that should be considered when making the transition from grain-fed beef. To maximize the favorable lipid profile and to guarantee the elevated antioxidant content, animals should be finished on 100% grass or pasture-based diets.

Grain-fed beef consumers may achieve similar intakes of both n-3 and CLA through consumption of higher fat portions with higher overall palatability scores. A number of clinical studies have shown that today's lean beef, regardless of feeding strategy, can be used interchangeably with fish or skinless chicken to reduce serum cholesterol levels in hypercholesterolemic patients.

The red emphasis is mine, of course.

A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef

I'm not arguing that grain-fed beef is better than grass-fed beef (nor am I arguing that grass-fed beef is inherently better than grain-fed beef). That's mostly irrelevant to my original point. In defense of my original point, I never said that anyone had to eat grain-fed beef — I simply referred to meat with an adequate amount of fat to prevent rabbit starvation. It could be 'possum meat, as long as it contains an adequate amount of fat.

That research from the 1930s is still just as valid today as it was back then. Certainly anyone who does not trust grain-fed beef will be much happier eating grass-fed beef. We are fortunate to have such choices available. Besides domestic grass-fed beef, there is a heck of a lot of imported beef from Argentina and Australia that is grass-fed.

Tex

megamoxie · Post by **megamoxie** » Thu Oct 23, 2014 7:22 pm

Once again, I find myself deeply grateful that my troubles are not as bad as those that others describe here... but I certainly wouldn't call having D "only" 4-5 times per month these days either normal or remission. But it is better than it was three months ago, when it was a daily event, multiple times a day (and sometimes at night).

I, too, struggle with having to function in the world. I have a fast-paced job that can be stressful at times; but it has definitely been much worse at other points, and I have always been able to cope with relatively large amounts of stress in my life. Fortunately, I have a very supportive boss and team, and I have the flexibility to work from home part of the time.

I find it interesting that there is a strong focus on eating meat. I find myself doing the worst when I have large amounts of meat other than white meat poultry (chicken, turkey) or fish. I cannot eat shellfish.

I find it really difficult that everything about this disease is so widely varied by individual...

megamoxie · Post by **megamoxie** » Thu Oct 23, 2014 7:28 pm

One more thing that I find a bot worrisome: I have read many times here that people's sensitivities change. While this is usually mentioned in a positive context -- with healing, someone is able to expand their diet without reacting badly to food they used to avoid -- does it often go the other way, too? Foods that have previously been safe become intolerable?

Gabes-Apg · Post by **Gabes-Apg** » Thu Oct 23, 2014 7:44 pm

I find it really difficult that everything about this disease is so widely varied by individual...

This is why it is hard for the medical profession to support patients with MC. There is no 'one size fits all' solution.
and why we mention so much to newbies in the discussions, what works now may not work so well in 2 years time. Learning to listen to your body, and decode the messages is a valuable skill.

Meat aka Protein is very important, as Tex mentions it has the amino acids we need, we need animal fat for balanced digestion, and good levels of protein are required for healing, cell rebuilding etc.

There are some ingredients that 4 years ago, I could have daily, that now are "sometimes" foods. (sometimes foods is no more than 3 times a week)

Being able to function, juggle work requirements, social requirements, partner/family requirements gets easier, and way less stressful.
I had a bit of a hunt and gather plan through the week/month, to ensure I always had plenty of my safe ingredients at all times (as I had to get items from different sources), do cook ups on the weekends to set up meals and snacks for the week, things like protein powders are fantastic for work, working lunches, travelling or going out for the day.
within 3 months it was all 'normal' part of life. This system has got me through the past 5 years, I have been able to travel for work, (including a 36 hr each way transit to france!) move cities/move house 3 times /move interstate,

megamoxie · Post by **megamoxie** » Thu Oct 23, 2014 8:27 pm

Gabes, you are an inspiration in many ways!

You are right, it has already gotten easier to manage with my new "normal". It wouldn't do me any good to fight what I know is best, I just have to accept it and go with the flow. It's always worth the up-front effort to make the rest of my day that much less stressful. I just find that for me personally, protein from plant sources (nuts, quinoa) does not cause the same amount of churn or pain in my gut that meats do. Meats have been a problem for me for years, long before my dx. So I observe this meat-favoring trend on the forum with a sense of wonderment... Seeking protein alternatives, it was hard for me to find a protein powder that did not contain something that I have recently (or always) reacted to, but I did manage to find one. I haven't tried it yet, though. I've taken to not trying new things until Fridays so I can have the weekend to recover if it doesn't go well. Kind bars and small packets of nuts are my life savers. I take these with me so I will have something safe to tide me over no matter where I happen to be. I also bring along water and herbal tea bags (ginger, chamomile).

You are also so right that it is imperative to learn to recognize and interpret the body's messages.

I'm not yet ready to travel, but you give me hope that it may someday be possible again.

Gabes-Apg · Post by **Gabes-Apg** » Thu Oct 23, 2014 10:00 pm

You are right, it has already gotten easier to manage with my new "normal".

you are on the right path of acceptance, this is your 'normal' and will be for life per say....

Re the meats etc, do what works for you! stick with whatever works best!
if you are having plant based protein and not having any dairy, then you may want to look at supplementing fats/oils. (quick read http://www.jctonic.com/include/healingc ... gh_fat.htm)
This may mean using things like coconut oil, or rice bran oil in cooking. supplementing with some oils such as Fish oil or Evening Primrose or Flaxseed etc

I've taken to not trying new things until Fridays

thats exactly what i used to do, Friday after work I would hunt and gather on way home so I had ingredients to do cook ups on saturday, try new things friday night.
Saturdays would be washing, chores, simmering bone broth, baking etc, all the while I was home near the Loo if i needed it!