Weaning Off Entocort

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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Gloria
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Post by Gloria »

Yes, I was. :duh: I recently cut down from 3 servings per day to 2 servings. I've been a big milk drinker/yogurt consumer all my life and have been very reluctant to even reduce my intake. I've convinced myself that I can make do with 2 servings. Hemp milk won't cost as much with 2 servings per day, plus it's more nutritious. I have to travel to the nearest Whole Foods store to get it, unlike the rice milk which is everywhere.

Norman visited again today. So far, just once. It's starting to look like the rice milk has been the problem all along. I must be extremely sensitive to gluten because rice milk has a such a miniscule amount.

If this keeps up, I'll be able to try reducing the Entocort again. I'll be sure to post my progress.
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tex
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Post by tex »

If I remember correctly, Rice Dream, for example, lists their gluten limit at 0.02% or less, (which is the Codex Alimentarius limit for a gluten free label, (but is about ten times too high, IMO). I used to drink Rice Dream, but I had a reaction every once in a while, and I finally decided it was because I was ingesting enough gluten from the Rice Dream every day, that all it took was a tiny amount from any other item in my diet, and Bingo - my luck would run out.

That's one of the reasons why listing everything that you are eating every day can lead to a solution, if you're already doing everything you can think of, and still can't achieve remission. Several of us here would surely have spotted the rice milk and pointed out the risk, since we've discussed it several times in the past. If you did mention it, then I apologize, because I completely overlooked it.

I order my hemp milk on line, so that I don't have to run all over the country trying to find it. In fact, I just ordered a case, (of 12), a couple of weeks ago, because they were having a sale on it. I think the sale expires the day after tomorrow, on March 1. I get it here:

http://www.worldpantry.com/cgi-bin/ncom ... v-20080212

The case I received was dated as "Best Before 29 November, 2008, so it's dated plenty far out.

It sounds as though you may be back on track again, which is certainly good to see.

Thanks for the update.

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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Post by Pat »

Gloria,
I haven't tried them yet but Polly has some recipes to make your own rice or almond milk in the recipe section:

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=3325

Pat
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Post by Pat »

Gloria,

If you think "certain raw fruits" are giving you problems this article may be helpful in choosing fruits or other foods for that matter:

http://www.healthsystem.virginia.edu/in ... e-diet.pdf

Pat

P.S. Cooking does reduce the fructose. You have to figure out what works for you. Everyone can be slightly different.
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Post by mle_ii »

Also, there are some rice milks that do not contain gluten. I get one here in the Seattle area, but I think it might be a local brand.
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Post by Gloria »

I tried making my own rice milk several months ago, but my blender top blew off and I had rice all over my kitchen. Then my blender died. LOL I haven't tried to make it since then, but maybe I will this weekend. I can mix it with the Hemp milk. I knew that the rice milk had some gluten in it, but thought I could tolerate the small amount, especially while on the Entocort.

Today Norman appeared, but didn't stay the whole time. I have to admit that I eat ghee pretty regularly. I've always loved butter on bread and vegetables. I used to use the spray butter, but I can't now because of the diary and/or soy. I didn't put ghee on my vegetables tonight. We'll see what happens tomorrow. My stomach has been gurgling all night, so I don't have my hopes up.

I've also been eating rice bread with yeast in it about 2-3 times a week. I think Tex mentioned that most yeast intolerances only matter if you have a yeast infection, so I've figured it's safe to eat the yeast bread.

I'm still trying to figure out if raw fruits affect me. I have kept a daily journal of what I've eaten for months, but I haven't seen any real pattern.
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tex
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Post by tex »

Gloria,

I, and a couple of others here, tried ghee several years ago, and had problems it. I don't see how in the world anyone can claim that it is dairy free. The basic problem is that a dairy product, (butter), is it's only ingredient, and it's "clarified" by boiling, and then straining out the solids with something like cheesecloth. There's no sophisticated separation process involved. If it's only ingredient is dairy, no matter what you do to it, what else could the finished product be, but dairy?

I kept a food and reaction diary too, for several years. I found that many of my reactions took a day or so to develop, which made matching up the cause, pretty tricky, at times. Most people react pretty quickly, though, apparently.

On the yeast, it sounds as though I may have not clearly expressed what I was trying to say, and/or you may have misunderstood what I meant. While it may be possible that a yeast intolerance is only of concern in the event of a yeast infection, the point that I thought I was trying to make, (if I recall correctly), when I made that statement, was that a yeast intolerance can only be detected, (by testing for antibodies), if there is a yeast infection present. IOW, if no yeast overgrowth is present, the antibody test will show negative results. That's not the same as saying that someone cannot be yeast intolerant unless they have a yeast infection. I apologize for misleading you, if I just confused the issue. Do you see what I'm trying to say? Just because a yeast infection is not present, is no proof that an individual is not yeast intolerant, it's merely evidence that a yeast intolerance test would be vulnerable to false negative results, due to the limitations of the test.

The gurgling noise is definitely not a good sign, as you mentioned, but maybe it will be a false alarm, this time.

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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Post by Gloria »

I just ate dinner and I'm getting some gurgling again. And I just had explosive D, which is unusual for me. I haven't changed anything in my diet other than to replace the rice milk with the Hemp milk. I didn't eat any ghee yesterday or today, nor have I eaten any rice/yeast bread since Wednesday. I think I may be intolerant to the Hemp milk. I don't know what other conclusion to draw.

I don't think I understand what you're saying about the yeast antibodies. Are you saying that I must have had a yeast infection if I tested positive for yeast antibodies? And anyone who doesn't test positive may or may not be intolerant? In other words, the only time someone will test positive is when they have a yeast infection? So I had a yeast infection when I sent the sample in? As far as I know, I haven't had a yeast infection in 18 years. I'm still confused.

Also, I know that that it doesn't matter how much above the limit your antibodies are, as long as your numbers are above the limit, you're intolerant, period. But I'm wondering - do the numbers reveal the severity of the intolerance? Most of my numbers were higher than I've seen on anyone else's test results. Does that mean I'm more sensitive? Since yeast was my lowest number, I've always hoped it meant that I wasn't as sensitive to it as the other foods.

I'm posting my numbers again:

Fecal Antigliadin IgA 116 (Normal Range <10 Units)

Fecal Antitissue Transglutaminase IgA 64 Units (Normal Range <10 Units)

Fecal anti-casein (cow’s milk) IgA antibody 130 Units (Normal Range <10 Units)

Fecal anti-ovalbumin (chicken egg) IgA antibody 22 Units (Normal Range <10 Units)

Fecal Anti-Saccharomyces cerevisiae (dietary yeast) IgA 18 Units (Normal Range <10 Units)

Fecal Anti-Soy IgA 118 Units (Normal Range <10 Units)
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Post by tex »

Hi Gloria,

I agree - it sure sounds as though you may well be intolerant of the hemp nut itself. The label says: Dairy-Free, Soy-Free, Cholesterol-Free, Gluten-Free, etc., but what bothers me is that we have no way of knowing what "convention" they are adhering to, as far as their standards are concerned. If they are using the Codex Alimentarious limits, then they are, (IMO), far too liberal for many of us, and especially for you. I'll be glad when this country finally adopts some standard, whatever it is. At least that way we'll all be on the same page, in interpreting labels.

I think I would definitely try cutting it out for a couple of days, and see what happens.

Yes, if I understand the test methods for yeast intolerance correctly, what you stated is correct. Basically, that you had to have at least some degree of a yeast overgrowth, in order to receive a positive test result for yeast intolerance. I'm not sure if that meets the definition of a yeast infection, or not. What I'm referring to is an overgrowth of the GI tract, (or at least part of it), with candida albicans. Looking back, I can recall a number of times, when I was reacting regularly, when I would look in the mirror and see a white coating on my tongue. I'm pretty sure that had to be evidence of a yeast overgrowth. "Thrush" is common for people with compromised immune systems, and for people taking antibiotics and steroid meds.

Despite what Dr. Fine says about those numbers, I am fairly certain that what you suggest about them is mostly correct. I think that what he is trying to point out is that it doesn't matter what the numbers are - if you're intolerant, you're intolerant, and a little bit of poison is just as bad as a lot of it.

In my business, (corn processing), I've done a lot of testing for mycotoxins, (primarily aflatoxin), using immunoassay tests similar to the tests used to determine food intolerences. There are various ways to go about it, but even if you use a simple pass/fail ELISA type test kit, designed to trigger a color change upon reaching a preselected threshold, a skilled operator can get a pretty good idea of the relative numbers involved, simply based on visual comparison of the intensity of the color change, compared with a calibration test with a known sample, for that particular batch of test kits. And, of course, with a more sophisticated setup, (which I'm pretty sure they would use), precision chromatography would yield actual numbers that definitely have a direct relationship to the amount of reactant present.

When I had my tests done at Enterolab, I had already been GF for over three years, so I didn't bother with the regular gluten detection tests. I got the gene test, soy, eggs, and yeast, and the fecal fat test, (thinking that the fecal fat score would show whether I still had a hint of any residual small intestinal damage). My antibody tests were negative to everything, and my fecal fat score was 294. Note that 294 is below the listed threshold of 300, and yet, he unequivocally stated, "Analysis of this stool sample indicates you have dietary gluten sensitivity".

He couldn't have reached that conclusion unless the numbers actually have a quantitative meaning. IOW, he recognized that if I still had that much residual SI damage, three years after adopting the diet, I had to have had a much higher level of damage, before adopting the diet. If the numbers didn't actually have a quantitative value, then he couldn't have legitimately made that statement.

IMO, your test result numbers are all very high.

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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Post by Gloria »

I haven't posted here for quite a while because I had decided that I wouldn't try to wean off Entocort again until Norman was visiting nearly every day. Since I've increasingly restricted my diet and have stopped taking chances eating out, Norman has become more regular. I felt pretty confident in reducing my dosage to 3 mg. every other day while staying on 6 mg. the alternate days.

Unfortunately, after only 8 days of the alternating regimen, I had explosive D two times , D the third time. I was about to give up and go back on the 6 mg every day, but this next morning, Norman visited me again. He had decided to take a one day vacation, but he's back!

I think that yesterday must have been a reaction to a specific food I ate. If the Entocort reduction was causing the D, I think I would have seen a gradual decline instead of Norman one day, explosive D the next and back to Norman again. I am lucky that Norman is so forgiving.

I did eat some crescent cookies w/ground walnuts. I stopped eating them last week because I thought they may have been a problem. My food diary shows that almost every day after eating them, Norman didn't visit. I made them with Mother's Margarine, the only margarine I've found without soy. It's only available during Passover and I bought several tubs. It could be the walnuts are a problem. I can't seem to handle much roughage at all. I had to stop eating rice cakes. Salads are off my list, too.

I'm going to take 3 mg of Entocort again today and see what happens.

Gloria
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Post by tex »

Thanks for the update, and good luck with the continuing "experiment".

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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Post by Gloria »

Another update:
I'm back on the 6 mg/day Entocort regimen. I only reduced it to 3 mg. for 4 out of 8 days, but began having problems. I'm still not quite back to where I was before I began reducing it.

I think I need to wait until Norman is visiting me every day for a month before I try again.

Gloria
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Post by tex »

I agree - it takes time to heal.

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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I Think I've Figured It Out!

Post by Gloria »

I've got great news to share! I think I've figured out my last (hopefully) intolerance!:banana:GREEN BEANS! Who'd have thought?
Since I stopped eating them 11 days ago, Norman has visited me every single day. The improvement was immediate. That's pretty miraculous, especially considering I've been visiting my daughter in Utah this past week and ate out 4 times. I even had some chocolate fudge one day, :oops: - but Norman still visited the next day.

I gave up all other legumes a few months ago, including hummus, peanuts, and certain GF flour mixes. But I never gave green beans a thought because others never mentioned them as a problem. I ate them about 3-4 times a week. I became suspicious after noticing that sweet potatoes didn't bother me one day, but the next day they did. I looked at my food diary and saw that I also ate green beans the second time. Then I remembered having a problem every day after eating vegetable beef soup (with green beans) several times one week. At the time, I blamed it on using a new broth. As I looked over my food diary, I could see the pattern after each time I ate green beans. What will I do with the four rows of green beans planted in my garden...? :???:

I'm hoping this will be an inspiration to others who are still struggling to achieve remission. There is hope!! You can find the answer! I've been keeping a food diary for 1 1/2 years, even before I found this board. I always felt that MC is related to food we eat. I have been on Entocort for almost 1 year. I've gotten pretty discouraged and felt like I would never find the solution. I'm resuming this thread because I will probably begin weaning off Entocort in another couple of weeks, hopefully with success this time. :grin:

Gloria
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Post by tex »

WOW! Good Work! Here's your gold star: :star: I have to say that I'm kind of surprised too, because I'm not aware of anyone else who has a problem with green beans.

Still, I remember that you're a member of the Double DQ-1 club, so I guess I really shouldn't be surprised, after all. That's good detective work, though, to track down such a rare food intolerance. A food diary is probably the ultimate "weapon", when it comes to tracking down obscure intolerances of that sort.

We're mighty proud of you. It just goes to show, perseverance does pay off. Please keep us posted on how weaning off the Entocort goes, (for real, this time).

The magic number is 8. If you can remain in remission for at least 8 weeks past the last day that you take any Entocort, you probably have it made.

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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