Flare-up or something else?

[SusanneK]

I've had such great success with changing my diet and have been in remission for 3-4 months.

But 3-4 days ago I started having D again. I haven't deviated from my diet at all and it feels different from CC. With the CC, I never had stomach pains which I do now. Also, the D is not super urgent like it was with CC and it's not really watery, just very un-solid - I don't know how else to describe it.

The only thing I noticed was that about 4-5 days ago, my plastic water bottle had a little dark spot in it, which may have been mold. Of course, I immediately threw it out. Could a tiny bit of accidental mold ingestion have caused this D to reoccur? Or should I go get checked for a bug?

[Gabes-Apg]

I wouldnt think that small intake of mold would have that large an impact

are you certain there is nothing new in your environment -
not just food ingredients, but personal care products or supplements? different brand of a product or different batch?
any change with routine? sleep quality work environment or places that you go ?
Any stress with thanksgiving or in the lead up to xmas?

[SusanneK]

Thanks, Gabes.

No, I really can't think of anything that has changed, food or otherwise.

And there really is no stress in my life at the moment. We keep the holidays super relaxed so I'm sure that's not a factor.

[tex]

Susanne,

It's possible that your immune system may have just recently discovered another one of your food sensitivities (due to the decline of your anti-gliadin antibody level). Early on, gluten sensitivity (resulting in an increasing anti-gliadin antibody level) tends to dominate our immune system. Because of that it sort of ignores a lot of other issues until the anti-gliadin antibody level declines to a lower level. Here's how I see it:

The immune system seems to have a unique characteristic that is not documented in the medical literature (to the best of my knowledge), but many members here have experienced it, and IMO it could explain why you may possibly be beginning to react to another food sensitivity. The sensitivity has probably been there for a while, but it was masked by your reaction to gluten. This is well described in the book, so in order to save time and effort, I hope you don't mind if I just quote from the book. And in case you don't have a copy of the book available, I'll include most (but not all) of that discussion from chapter 10, pages 119–122.

While our immune system is always alert to any perceived threats to our health, when confronted with multiple food sensitivities it seems to concentrate on the most significant single issue at any moment in time. That is to say, it appears to focus on the one food sensitivity that is likely to do the most damage to the digestive system and to long-term health.

That doesn’t mean that it will totally ignore secondary food sensitivities, but it suggests that the immune system will concentrate most of its attention on the one that it perceives as the most important threat at the moment, while postponing or minimizing action on the other food sensitivities. That implies that the immune system may have a pre-established hierarchy that it follows, when determining which food sensitivity should be the primary focus of its attention.

As we discovered in chapter six, based on the compiled experiences of hundreds of people who have microscopic colitis, the number one food sensitivity threat as perceived by the immune systems of those individuals is gluten. Casein, the primary protein in all dairy products, appears to rank number two in this hierarchy, while the third-ranking food sensitivity is usually soy. Whether by coincidence or design, it appears that this ranking also correlates with the relative probability of someone with microscopic colitis being sensitive to each of those respective foods. That is to say, gluten is the most common food sensitivity among people with microscopic colitis, casein is the second most likely food sensitivity, and soy is the third most likely food sensitivity.

This information can be very important to someone trying to control their symptoms by diet
Many MC patients who have decided to see if diet changes will reduce or eliminate their symptoms, will start by eliminating only gluten from their diet. In many cases, though not always, after a few weeks, more or less, they will discover that they are feeling much better and the intensity of their symptoms are definitely diminishing. Some will even reach remission. After the passage or more time, though, if gluten is the only food that is being avoided, most people in this situation will experience a relapse of symptoms, and from that point on their symptoms will progressively become worse as time goes by. This very frustrating turn of events inspires many people to make the mistaken decision that they must not be sensitive to gluten after all, since they are back in a full flare of symptoms. However, there is more to this dilemma than meets the eye.

In my opinion, this is simply a real-life demonstration of a quirk of the immune system that causes it to focus its attention on only the single threat that it considers to be the most serious of all those with which it is confronted at any given time. When gluten is withdrawn from the diet, antibody production does not cease immediately. In fact, the immune system will continue to produce antibodies for a very long period of time, at a slowly decaying rate, as it continues to remain at a high alert level, remaining vigilant just in case gluten should reappear in the diet.

Anti-gliadin antibodies have a relatively long half-life (120 days), so it typically takes them months to decay, and to be eliminated from the system. Eventually, a point will be reached where the anti-gliadin antibody level has decayed to below the threshold where a reaction is triggered, and after that point is reached, the clinical symptoms will begin to fade away and remission may occur. At some point, the immune system will cease to focus its attention entirely on anti-gliadin antibodies and it will begin to be responsive to other threats.

The immune system will then turn its attention to the next available food in the hierarchy of food sensitivities with which it is faced, and that will typically be casein, assuming that casein remains in the diet and the individual is actually sensitive to casein. The immune system will begin to aggressively produce anti-casein antibodies, and at some point, the casein antibody level will exceed the minimum threshold level required to trigger a reaction. At that point, the inflammation process will flare out of control again, due to a reaction against casein.

If casein is withdrawn from the diet, then the level of anti-casein antibodies will begin to decline much faster than the rate at which anti-gliadin antibodies decay, and at some point, the immune system will turn its attention to the next item in the hierarchy of potential threats. Experience shows that this cycle will be repeated until no more food sensitivities are present in the diet. Of course, if the person going through this procedure were to eliminate all of his or her food sensitivities at the start of the process, all of the secondary and subsequent reactions could be avoided.

This concept of an immune system hierarchy is strictly a theory and I am not aware of any scientific proof of the concept. However, as evidence that the logic is sound, note that a precedent exists to demonstrate that this concept does indeed have merit. Extensive research has demonstrated that treatment of inflammatory bowel disease and other autoimmune issues by helminth therapy is extremely effective at bringing remission of symptoms.1 In essence, the presence of parasitic worms in the intestines causes the immune system to focus on them, and as a result, the inflammatory reaction causing an IBD or some other autoimmune issue will virtually always disappear, bringing remission of clinical symptoms to the patient. If the helminths are not replaced as they reach the end of their life cycle, the previous symptoms will return as the helminth population in the intestines dwindles. Clearly, helminths are either at or near the top of the hierarchy.

In other words, the immune system perceives the parasites as a more serious threat than whatever is causing the IBD or any other autoimmune reaction. As a result, it withdraws its attention from the perpetuation of the autoimmune disease in order to focus its resources on the helminths. By the same token, the immune system seems to assign a hierarchical rating to various food sensitivities and it tends to address them one at a time, beginning with the one that it perceives as the greatest threat. If that issue is resolved, then it proceeds to the next one in the hierarchy.

IOW, your immune system may have discovered that you are also sensitive to soy, or eggs, or something else. In most cases, reactions to additional foods begin in about 4–6 weeks, and you are past that time frame. So this may not apply to you. But the fact that all of us have different response times to treatments suggests that you might just be having a slower response than most people here. Avoiding soy and/or eggs for a few days should provide some clues as to whether they are a problem for you or not. Obviously, if you are already avoiding soy and eggs, then they are not the likely problem.

I hope that some of this is helpful.

Tex

[SusanneK]

Thank you, Tex. I do have a copy of your book and have read it. I guess I thought I was "different" in that I was convinced it was the aspartame that made me sick.

I guess by now, my best option would be to get lab tested.

[Gabes-Apg]

suzanne
i agree with Tex - if none of the suggestions in my post apply then something in your eating plan is now a 'medium level' trigger (where as 3 months ago it seemed safe)

this is the sucky part of life with MC...

[tex]

Or maybe you caught some kind of intestinal virus, but if so, it should be ending soon.

Tex

[SusanneK]

Who would have thought that a person could wish for an intestinal virus? But I am!!