Hello Kiddo, I am new to this forum. I am sorry you have Microscopic colitis. I think we are similar in our recent learning and discovering, as I have not had this disease very long. I did not know there was a journal page. I am glad you posted on the main message board or I would not have seen it. I have a GI nutritionist. I am gluten free and partly lactose free, low FODMAP and Low Residue diet. Also newly cheese free. (I live in Wisconsin, U.S. a cheese state so giving up cheese is hard.)
I am just two weeks into 9mg of Budesonide. I have been very careful about my diet. I like Schar's Ciabatta rolls but not much of their other products. I like to bake so have found recipes for things I can eat. I don't have any bakery here that has anything gluten free. I would worry if they did about cross-contamination.
I wanted to comment on blood sugar. I have found that it is important for me to have a snack with some protein twice a day. It really makes a difference. My nutritionist said my hair and nails reveal that I need more protein.
I eat coconut yogurt too, and here I can get a variety. I am able to tolerate ground almonds, and ground flax seed which has given me more options. But I relied on my nutritionist to evaluate my food diary.
From this forum I am learning I need to have a lot more responsibility for my own diet and quit relying on others~except for this forum community. Maybe we could follow our journeys together since we are at about the same place. Except that I have found the Budesinode to be constipating. I dread getting diarrhea again when I am through with my course.
I hope you have some improvement. I will look out for more from you on your journey. Good luck!
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If you are constipated on budesonide you need to step down to a lower dose.
Most forum MCers do not get D when they finish their course of budesonide (Entocort or Uceris) as long as they are
GF and DF, eat simply and unprocessed and implement a long taper at the end of their budesonide course and take a antihistamine several days before their last budesonide and for about a week following their last budesonide.
Four MCers were on budesonide about the same time as me. We all went GF and DF and were successfully able to
get off of budesonide.
I was on budesonide for 4.5 months in 1010 and have been off it since then (8 years).
The general public--those that have not found our forum and those that are not GF and DF and do not do the long
budesonide taper have the high incidence of relapse.
That said, we have a tiny percent of our forum who have a tough time getting off of budesonide.
Most folks leave our forum because they are doing good.
Most forum MCers do not get D when they finish their course of budesonide (Entocort or Uceris) as long as they are
GF and DF, eat simply and unprocessed and implement a long taper at the end of their budesonide course and take a antihistamine several days before their last budesonide and for about a week following their last budesonide.
Four MCers were on budesonide about the same time as me. We all went GF and DF and were successfully able to
get off of budesonide.
I was on budesonide for 4.5 months in 1010 and have been off it since then (8 years).
The general public--those that have not found our forum and those that are not GF and DF and do not do the long
budesonide taper have the high incidence of relapse.
That said, we have a tiny percent of our forum who have a tough time getting off of budesonide.
Most folks leave our forum because they are doing good.
Getting off of budesonide (Entocort or Uceris) is definitely an achievable goal for folks that want to get off of it particularly for folks that are GF and DF. We've probably had 1000's of folks successfully get off of budesonide.
Folks that are on the low end of their taper and ready to get off should repost for tips.
Folks that are on the low end of their taper and ready to get off should repost for tips.
-
MamaBeabs
Budesonide and Constipation
Hey brandy, It sounds strange to step down a dose of budesonide when I am just halfway through it. Is it that constipation is really bad for inflammation and healing? That was my first thought when you suggested this. How do I convince a doctor? Does the medication still work? How long would I take it then? Thanks.
-
MamaBeabs
Antihistimine allergy
Hey brandy, this is the first I have heard about using an antihistamine. Unfortunately I am allergic to all antihistamines. I'm also allergic to most antibiotics and have a long list of medicinal allergies or reaction to medication. This journey began with alternating constipation/diarrhea. Many things like Imodium or Cholestyramine constipate me badly. I can't do pepto bismal so the budesinode needs to work for me!
I am so encourage that you shared most people get better better, are doing good and are not on the forum. I did notice that only a few longtime MC people are around to give tips, share support, and answer questions. Thank you.
I am so encourage that you shared most people get better better, are doing good and are not on the forum. I did notice that only a few longtime MC people are around to give tips, share support, and answer questions. Thank you.
Is it that constipation is really bad for inflammation and healing?
No, just painful. Also, it is the diet that does the healing. Being on budesonide helps with the symptoms
while you are figuring out the diet.I can't talk to the science of this but being on a steroid (budesonide) actually slows the healing. Tex has talked about this in the past if you want to look for the threads but I don't know the science behind it.
How do I convince a doctor?
Why do you need to? They typical dose recommendation in the US is 30 days-9 mg, 30 days 6 mg,
and 30 days 3 mg then off. Their are several problems with this. Many folks are constipated
after just several days on 9 mg. What then? Also the forum has found folks are more successful
with a 4-5-or 6 month stint on budesonide rather than the 90 day recommendation.
Does the medication still work? How long would I take it then? Thanks.
Yes. Length of time depends on your personal situation and how well you are doing. It depends on stress
in your life. It depends on your age. etc. There are a lot of variables on how long to stay on.
I was trying to stay on for 5 months per the forum but I had a lot of side effects so I got off at
4.5 months. The last month I was on one pill every 3rd day and then I stopped.
No, just painful. Also, it is the diet that does the healing. Being on budesonide helps with the symptoms
while you are figuring out the diet.I can't talk to the science of this but being on a steroid (budesonide) actually slows the healing. Tex has talked about this in the past if you want to look for the threads but I don't know the science behind it.
How do I convince a doctor?
Why do you need to? They typical dose recommendation in the US is 30 days-9 mg, 30 days 6 mg,
and 30 days 3 mg then off. Their are several problems with this. Many folks are constipated
after just several days on 9 mg. What then? Also the forum has found folks are more successful
with a 4-5-or 6 month stint on budesonide rather than the 90 day recommendation.
Does the medication still work? How long would I take it then? Thanks.
Yes. Length of time depends on your personal situation and how well you are doing. It depends on stress
in your life. It depends on your age. etc. There are a lot of variables on how long to stay on.
I was trying to stay on for 5 months per the forum but I had a lot of side effects so I got off at
4.5 months. The last month I was on one pill every 3rd day and then I stopped.
https://perskyfarms.com/phpBB2/viewtopic.php?t=22995
The foundation article in the above link is worth reading for extensive discussion on budesonide.
The foundation article in the above link is worth reading for extensive discussion on budesonide.
MamaBeabs,
This is just to support Brandy's recommendations: In general, budesonide is constipating. If one has diarrhea, budesonide is good. if one does not have diarrhea, it's not so good, and constipation is a sign that you are taking more budesonide than you need. The protocol for establishing the labeled dosage for budesonide was decided in a lab at AstraZeneca almost two decades ago. It's a one-size-fits-all treatment (which makes the FDA very happy). But out in the real world, we're all different — and we have a disease for which budesonide is not even labeled to treat. So how can you assume that the labeled treatment is right for you.
As Brandy points out, we all have different circumstances, and therefore different needs. Using the first signs of constipation as a marker indicating that it's time to step down the dosage is not a medically-proven fact. But it's been shown to work well by many budesonide users here. As the medical professionals would put it, "There's good epidemiological evidence that using constipation as an indicator that it's time to step down the dosage works". So if you don't know how to treat MC (like most gastroenterologists), follow the label. If you know what you're doing, customize the treatment to fit your needs. At least that's how I see it.
Concerning healing: Yes, there is published medical research documenting that corticosteroids slow down healing. Corticosteroids are prescribed to suppress clinical symptoms — not to improve or speed up healing. The reason why corticosteroids retard healing is because they non-selectively attempt to suppress all inflammation, Inflammation is the first critical stage in healing. When that's disrupted, the healing process is disrupted.
Tex
This is just to support Brandy's recommendations: In general, budesonide is constipating. If one has diarrhea, budesonide is good. if one does not have diarrhea, it's not so good, and constipation is a sign that you are taking more budesonide than you need. The protocol for establishing the labeled dosage for budesonide was decided in a lab at AstraZeneca almost two decades ago. It's a one-size-fits-all treatment (which makes the FDA very happy). But out in the real world, we're all different — and we have a disease for which budesonide is not even labeled to treat. So how can you assume that the labeled treatment is right for you.
As Brandy points out, we all have different circumstances, and therefore different needs. Using the first signs of constipation as a marker indicating that it's time to step down the dosage is not a medically-proven fact. But it's been shown to work well by many budesonide users here. As the medical professionals would put it, "There's good epidemiological evidence that using constipation as an indicator that it's time to step down the dosage works". So if you don't know how to treat MC (like most gastroenterologists), follow the label. If you know what you're doing, customize the treatment to fit your needs. At least that's how I see it.
Concerning healing: Yes, there is published medical research documenting that corticosteroids slow down healing. Corticosteroids are prescribed to suppress clinical symptoms — not to improve or speed up healing. The reason why corticosteroids retard healing is because they non-selectively attempt to suppress all inflammation, Inflammation is the first critical stage in healing. When that's disrupted, the healing process is disrupted.
Tex
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.
Hello everyone,
I'm still here. :) During the last weeks I did as you told me, I tried to be patient.
I monitored my food. Precisely, like Sherlock Holmes. So far I have found out that I can't eat gluten (of course you all knew that already ;) ), I can't have lactose, yeast or histamine. So far histamine poses the hardest challenge. My food, especially meat, must be fresh and can't be reheated. Precooking is not possible for me which really, really reduces my food choices for work. These days grocery shopping, cooking/baking and preping food for work is basically all I do. I live in my kitchen.
As long as I watch my diet AND take healing earth/medicinal clay after every meal I'm fine. No diarrhea, no cramps or gas or heartburn. Also my stool looks and smells normal. I also only have to go once each day (sometimes maybe even only once every other day.). Plus the eczema on my chin gets better, it's almost gone.
This is great news!
On the downside my doc checked my elastase and it's supposedly below 15! (4 years ago it was 178 and 55). I don't understand how my elastase can be this low while I have no symptomes at the same time. Does anyone have an idea how this is possible? Is an exocrine pancreas insufficiancy common in people with MC? I have to confess I'm rather worried about my Pancreas. Will it completely stop working at some point? And what then? Will this have an influence on my life expectency?
At the same time my doc suspects that maaaaybe celiac disease could be behind all this. But several antibodies are negative.
Back in 2005 they found shortened small intestine villi and lymphocytosis (30 on 100 epithelia) in my small intestine. Does anyone know if MC can spread to the small intestine or other organs?
This is my journey so far. It's not easy and very scary to me but there is progress.
I'm still here. :) During the last weeks I did as you told me, I tried to be patient.
I monitored my food. Precisely, like Sherlock Holmes. So far I have found out that I can't eat gluten (of course you all knew that already ;) ), I can't have lactose, yeast or histamine. So far histamine poses the hardest challenge. My food, especially meat, must be fresh and can't be reheated. Precooking is not possible for me which really, really reduces my food choices for work. These days grocery shopping, cooking/baking and preping food for work is basically all I do. I live in my kitchen.
As long as I watch my diet AND take healing earth/medicinal clay after every meal I'm fine. No diarrhea, no cramps or gas or heartburn. Also my stool looks and smells normal. I also only have to go once each day (sometimes maybe even only once every other day.). Plus the eczema on my chin gets better, it's almost gone.
This is great news!
On the downside my doc checked my elastase and it's supposedly below 15! (4 years ago it was 178 and 55). I don't understand how my elastase can be this low while I have no symptomes at the same time. Does anyone have an idea how this is possible? Is an exocrine pancreas insufficiancy common in people with MC? I have to confess I'm rather worried about my Pancreas. Will it completely stop working at some point? And what then? Will this have an influence on my life expectency?
At the same time my doc suspects that maaaaybe celiac disease could be behind all this. But several antibodies are negative.
Back in 2005 they found shortened small intestine villi and lymphocytosis (30 on 100 epithelia) in my small intestine. Does anyone know if MC can spread to the small intestine or other organs?
This is my journey so far. It's not easy and very scary to me but there is progress.
Hi,
It's good to hear that you're making progress. Most (maybe all) of us have an inflamed pancreas as a side effect of MC (the disease affects the entire digestive system) when our disease is active. But most of us never check our pancreatic enzymes so we aren't even aware of the problem. The few who do sometimes (at the advice of their doctor) go through very invasive and risky testing in order to find the problem. The problem is MC (doctors just aren't aware of that), and pancreas related problems will slowly resolve and disappear as our MC is brought under control and our gut heals. Trying to rush it by trying to treat a pancreas problem will just result in a lot of wasted time and money. It will resolve on it's own, if you give it time.
No, as long as you treat MC to control the symptoms, it won't shorten your life expectancy. If you had read my book you would know that most of us have damaged villi in our small intestine because of MC. Both celiac disease and MC are symptoms of gluten sensitivity. My book contains several medical references to verify that small intestinal involvement is very common with MC. As I recall, I believe my book also discusses how common it is to have reductions in pancreatic enzymes due to MC. Doctors just don't understand MC so they get all bent out of shape when they discover all these problems in an MC patient. Stop worrying, you're just a normal MC patient. If anything is likely to shorten your life expectancy, it's worry. Worry causes unnecessary stress, and stress is a primary prerequisite for triggering an MC flare.
Tex
It's good to hear that you're making progress. Most (maybe all) of us have an inflamed pancreas as a side effect of MC (the disease affects the entire digestive system) when our disease is active. But most of us never check our pancreatic enzymes so we aren't even aware of the problem. The few who do sometimes (at the advice of their doctor) go through very invasive and risky testing in order to find the problem. The problem is MC (doctors just aren't aware of that), and pancreas related problems will slowly resolve and disappear as our MC is brought under control and our gut heals. Trying to rush it by trying to treat a pancreas problem will just result in a lot of wasted time and money. It will resolve on it's own, if you give it time.
No, as long as you treat MC to control the symptoms, it won't shorten your life expectancy. If you had read my book you would know that most of us have damaged villi in our small intestine because of MC. Both celiac disease and MC are symptoms of gluten sensitivity. My book contains several medical references to verify that small intestinal involvement is very common with MC. As I recall, I believe my book also discusses how common it is to have reductions in pancreatic enzymes due to MC. Doctors just don't understand MC so they get all bent out of shape when they discover all these problems in an MC patient. Stop worrying, you're just a normal MC patient. If anything is likely to shorten your life expectancy, it's worry. Worry causes unnecessary stress, and stress is a primary prerequisite for triggering an MC flare.
Tex
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.
Hello everyone,
I hope each of you had a wonderful Christmas with lots of healthy food.
Tex, thank you for always taking the time to reply to my posts. It means a lot to me. I have started reading your book since your last post. It's very helpful and gives me a far more complete understanding of MC than any German GI or homepage so far.
Of course I'm also very thankful for everybody else who shares his or her ideas and experiences. Since I still haven't found a GI who understands MC this forum feels like a lifesaver to me.
Speaking of Christmas and food you probably all know how hard it is to stay on your diet during these days. I was weak for a few days. I had some chocolate and some other food that's high in histamine (I was courageous and even had a gluten free beer). There was also some lactose and a tiny bit of gluten involved. Interestingly I didn't have any symptoms right away. Only after two days my stool slowly started to change and some flatulences began. Since yesterday my diarrhea is back combined with a mild burning sensation in my upper left abdomen.
I know it's not a good idea to cheat on my diet. I hope my symptoms will soon be better. The fact that my symptoms didn't start right away but only after a few days makes this healing process even more tricky. Is there an explanation why it took a while for my symptoms to reappear?
Other than that I'm doing OK. My eczema is still under control. And another thing I realised is that I haven't had any Migraine since I started my diet. Before the diet I had 4 to 6 Migraines a month. Also my monthly cycle seems to be more accurate now.
Right now I feel stuck with my diet though. I have indentified a few foods I can eat without trouble. I bake my own bread, I created a nice apple pie recipe and I came up with two very easy versions of lunch (either turkey breast or salmon). If I strictly stick to my diet I'm fine. So now I'm kind of scared and maybe kind of lazy to widen my culinary horizon. Do you have any advice what would be smat foods to try next?
Also I have realized that gluten is a major trigger for me. At the beginning I was frustrated by the prospect of having to live gluten free. Now I start to see that being gluten free is an important act of self care, I stopped seeing it as a challenge. (Besides watching my histamine intake is far more challenging to me.)
A thing I'm still not very good at is to stop worrying. This is maybe bc I haven't found a trustworthy GI yet. Also I think it's bc I sometimes watch what people around me (can) eat and I feel like I must be very sick bc my diet only allows me a handful of food. And how am I supposed get all the necessary vitamins and minerals from such a small variety of food?
Then there is my last Elastase result (which was supposedly below 15) that keeps on wandering through my thoughts. How can it be this low yet I haven't seen any major weight loss or bad diarrhea since I started my diet?
Since it's already late over here I wish you all a good day and night. And, as we say in German: Rutscht gut rein ins neue Jahr 2019!
I hope each of you had a wonderful Christmas with lots of healthy food.
Tex, thank you for always taking the time to reply to my posts. It means a lot to me. I have started reading your book since your last post. It's very helpful and gives me a far more complete understanding of MC than any German GI or homepage so far.
Of course I'm also very thankful for everybody else who shares his or her ideas and experiences. Since I still haven't found a GI who understands MC this forum feels like a lifesaver to me.
Speaking of Christmas and food you probably all know how hard it is to stay on your diet during these days. I was weak for a few days. I had some chocolate and some other food that's high in histamine (I was courageous and even had a gluten free beer). There was also some lactose and a tiny bit of gluten involved. Interestingly I didn't have any symptoms right away. Only after two days my stool slowly started to change and some flatulences began. Since yesterday my diarrhea is back combined with a mild burning sensation in my upper left abdomen.
I know it's not a good idea to cheat on my diet. I hope my symptoms will soon be better. The fact that my symptoms didn't start right away but only after a few days makes this healing process even more tricky. Is there an explanation why it took a while for my symptoms to reappear?
Other than that I'm doing OK. My eczema is still under control. And another thing I realised is that I haven't had any Migraine since I started my diet. Before the diet I had 4 to 6 Migraines a month. Also my monthly cycle seems to be more accurate now.
Right now I feel stuck with my diet though. I have indentified a few foods I can eat without trouble. I bake my own bread, I created a nice apple pie recipe and I came up with two very easy versions of lunch (either turkey breast or salmon). If I strictly stick to my diet I'm fine. So now I'm kind of scared and maybe kind of lazy to widen my culinary horizon. Do you have any advice what would be smat foods to try next?
Also I have realized that gluten is a major trigger for me. At the beginning I was frustrated by the prospect of having to live gluten free. Now I start to see that being gluten free is an important act of self care, I stopped seeing it as a challenge. (Besides watching my histamine intake is far more challenging to me.)
A thing I'm still not very good at is to stop worrying. This is maybe bc I haven't found a trustworthy GI yet. Also I think it's bc I sometimes watch what people around me (can) eat and I feel like I must be very sick bc my diet only allows me a handful of food. And how am I supposed get all the necessary vitamins and minerals from such a small variety of food?
Then there is my last Elastase result (which was supposedly below 15) that keeps on wandering through my thoughts. How can it be this low yet I haven't seen any major weight loss or bad diarrhea since I started my diet?
Since it's already late over here I wish you all a good day and night. And, as we say in German: Rutscht gut rein ins neue Jahr 2019!
Hi Kiddo,
Kiddo said
If I'm not doing well (stressed) and I am exposed to higher dose of problem foods my reaction is more immediate....
WD next morning.
Kiddo said
eating plan (hyperlink middle of top page). Or try some new overcooked veggies and some new proteins.
Processed foods will be the riskiest by far. Try beets, rutabagas, turnips etc and in the protein category bacon, wild boar,
rabbit, deer, goose etc. bananas and avacados etc. Again....safest thing is to stick with what you know for awhile.
Kiddo said
For 100's and 1000's of years mankind has been living and thriving on very narrow diets and eating "seasonally."
In the US it has only been since the late 1970's onward that we have the plentitude of food options that we have now.
In the US in the 60's we ate strawberries in May, blueberries in July etc. Now we have fruits and veggies flown in
from South America and Australia, South Africa and Europe and we have a plentitude of products year round (albeit not local.)
Irish people living in Ireland prior to the potato famine ate potatoes almost exclusively. The Irish people had large families
eating for the most part large quantities of potatoes.
My ancestors migrated from the UK to Philadelphia in the 1680's. I suspect while living in the UK(Nottingham) they ate a lot of
porridge, bread, butter and root vegetables and maybe an egg here or there. Life, while hard, would have exposed my
ancestors to more protein in the New World than they would have had access to in the UK at the time....oysters, turtles, wild game etc were easily available in the Atlantic coast settlements in the 1680s.
The plethora of cheap foods that first world societies have available today is really a very modern thing. Again, prior to the 1970's folks ate seasonally and for thousands of years got by with narrow diets due to famine, wars, growing seasons etc.
I'm not sure what Elastase is so I can't comment on that.
Overall it sounds like you are doing pretty good!
Kiddo said
I find that: If I'm doing fairly well and I have low exposure to problem foods that my reaction can be delayed and more minor.Is there an explanation why it took a while for my symptoms to reappear?
If I'm not doing well (stressed) and I am exposed to higher dose of problem foods my reaction is more immediate....
WD next morning.
Kiddo said
If you are doing fairly well why rush things. If you feel like you want to try some new things check out Gabes suggestedIf I strictly stick to my diet I'm fine. So now I'm kind of scared and maybe kind of lazy to widen my culinary horizon. Do you have any advice what would be smat foods to try next?
eating plan (hyperlink middle of top page). Or try some new overcooked veggies and some new proteins.
Processed foods will be the riskiest by far. Try beets, rutabagas, turnips etc and in the protein category bacon, wild boar,
rabbit, deer, goose etc. bananas and avacados etc. Again....safest thing is to stick with what you know for awhile.
Kiddo said
You are definitely absorbing vitamins and minerals if you are not in a WD flare. WD flare=low to no absorption of nutrition.Also I think it's bc I sometimes watch what people around me (can) eat and I feel like I must be very sick bc my diet only allows me a handful of food. And how am I supposed get all the necessary vitamins and minerals from such a small variety of food?
For 100's and 1000's of years mankind has been living and thriving on very narrow diets and eating "seasonally."
In the US it has only been since the late 1970's onward that we have the plentitude of food options that we have now.
In the US in the 60's we ate strawberries in May, blueberries in July etc. Now we have fruits and veggies flown in
from South America and Australia, South Africa and Europe and we have a plentitude of products year round (albeit not local.)
Irish people living in Ireland prior to the potato famine ate potatoes almost exclusively. The Irish people had large families
eating for the most part large quantities of potatoes.
My ancestors migrated from the UK to Philadelphia in the 1680's. I suspect while living in the UK(Nottingham) they ate a lot of
porridge, bread, butter and root vegetables and maybe an egg here or there. Life, while hard, would have exposed my
ancestors to more protein in the New World than they would have had access to in the UK at the time....oysters, turtles, wild game etc were easily available in the Atlantic coast settlements in the 1680s.
The plethora of cheap foods that first world societies have available today is really a very modern thing. Again, prior to the 1970's folks ate seasonally and for thousands of years got by with narrow diets due to famine, wars, growing seasons etc.
I'm not sure what Elastase is so I can't comment on that.
Overall it sounds like you are doing pretty good!
Hi Kiddo,
Brandy did a great job of answering your other questions, so I'll just comment on the elastase.
These are uncharted waters because to my knowledge no one has done any research on the specific association of MC with pancreatic inflammation (at least I've never come across any published research articles about it). But there has been some research published concerning pancreatic inflammation and IBDs in general. Here's what I wrote about it in Understanding Microscopic Colitis:
12. Koskela, R. (2011). Microscopic colitis: Clinical features and gastroduodenal and immunogenic findings. (Doctoral dissertation, University of Oulu). Retrieved from http://herkules.oulu.fi/isbn97895142941 ... 294150.pdf
13. Pitchumoni, C. S., Rubin, A., & Das, K. (2010). Pancreatitis in inflammatory bowel diseases. Journal of Clinical Gastroenterology, 44(4), 246–253. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20087199
I hope this will help you to stop worrying about it. It's concerning, I realize, but the inflammation will fade away as your gut heals. Because we know that it usually takes from 2 to 5 years for adult intestines to completely heal (age increases the healing time), it will very likely take that long for your pancreas to heal also. Note that stopping the inflammation is not the only reason why we change our diets in order to stop the symptoms and allow our digestive systems to heal. Another important reason why we have to change our diets is to reduce carbohydrate consumption because our small intestine will not produce sufficient enzymes to digest normal volumes of carbs when it's (the small intestine) inflamed. To compensate, so that we can at least digest small to medium amounts of carbs, it helps to eat smaller, more frequent meals (so that we don't run out of enzymes before a meal is completely digested). The same strategy can be used to compensate for reduced pancreatic enzymes while healing is proceeding (smaller, more frequent meals). In many cases, it appears that we will not completely recover our original ability to produce digestive enzymes, but our ability to produce enzymes will recover well enough for all practical purposes.
I hope this helps.
Tex
Brandy did a great job of answering your other questions, so I'll just comment on the elastase.
These are uncharted waters because to my knowledge no one has done any research on the specific association of MC with pancreatic inflammation (at least I've never come across any published research articles about it). But there has been some research published concerning pancreatic inflammation and IBDs in general. Here's what I wrote about it in Understanding Microscopic Colitis:
And here are those references:Though the disease is named for its classic colonic inflammation, many other organs in the digestive system also tend to become inflamed. For example, the stomach and small intestine are commonly inflamed (Koskela, 2011).12 And less frequently, the pancreas may become inflamed, either because of the disease itself, or because of some of the medications used to treat IBDs (Pitchumoni, Rubin, & Das, 2010).13
12. Koskela, R. (2011). Microscopic colitis: Clinical features and gastroduodenal and immunogenic findings. (Doctoral dissertation, University of Oulu). Retrieved from http://herkules.oulu.fi/isbn97895142941 ... 294150.pdf
13. Pitchumoni, C. S., Rubin, A., & Das, K. (2010). Pancreatitis in inflammatory bowel diseases. Journal of Clinical Gastroenterology, 44(4), 246–253. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20087199
I hope this will help you to stop worrying about it. It's concerning, I realize, but the inflammation will fade away as your gut heals. Because we know that it usually takes from 2 to 5 years for adult intestines to completely heal (age increases the healing time), it will very likely take that long for your pancreas to heal also. Note that stopping the inflammation is not the only reason why we change our diets in order to stop the symptoms and allow our digestive systems to heal. Another important reason why we have to change our diets is to reduce carbohydrate consumption because our small intestine will not produce sufficient enzymes to digest normal volumes of carbs when it's (the small intestine) inflamed. To compensate, so that we can at least digest small to medium amounts of carbs, it helps to eat smaller, more frequent meals (so that we don't run out of enzymes before a meal is completely digested). The same strategy can be used to compensate for reduced pancreatic enzymes while healing is proceeding (smaller, more frequent meals). In many cases, it appears that we will not completely recover our original ability to produce digestive enzymes, but our ability to produce enzymes will recover well enough for all practical purposes.
I hope this helps.
Tex
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.