GAPS Protocol-- YOU MUST READ THIS!!!

[Zizzle]

I'm writing this from my phone so I won't comment much, but I have to share this interview with Dr. Natasha Campbell McBride, a European doctor who is curing people with autism, adhd, depression, bipolar, etc, etc. Her hypothesis about altered gut flora and why it's so prevalent now is simply brilliant, and common sense at the same time. She ties the causes of autism to many other maladies, including diabetes, IBD, etc. It's basically about the results of leaky gut and gut inflammation, but it has much wider implications in children (susceptibility to vaccine damage, inability to learn at critical stages, inability to detox). Her GAPS diet protocol is fascinating to me because it seems it could have been written with the collective knowledge of this board...start with meats, animal fats, cooked veggies...avoid fiber...eliminate grains and processed sugars...use nuts and coconut oil...try to use probiotics. The probiotic discussion is especially fascinating, because it may explain why many of us don't tolerate them...Herxeimer/die off reactions? Maybe we should all be making and consuming saurkraut? Coconut oil with raw honey to balance our blood sugar?

This is so compelling to me. What do you think??

http://mercola.fileburst.com/PDF/Expert ... deGAPS.pdf.

[tex]

Sure

FWIW, I used saurkraut for a while when I was recovering. I couldn't tell that it helped, but it sure didn't seem to hurt anything, either.

Tex

[Zizzle]

Did you make your own saurkraut? I can't imagine the stuff in cans has any probiotics in it. I have a cabbage at home calling my name!!

[sarkin]

Hi, Z - nice to hear from you, hope the move is going well...

The GAPS diet is a refinement (extension?) of the SCD diet, and I think a pretty thoughtful one.

It's not hard to make sauerkraut - but if you have a lot else going on in your life, you can sometimes get a better version. We get one that comes in a pickle container, as opposed to a can or glass jar, and it's terrific. You might find it in a Polish neighborhood, or an upscale supermarket... prices vary accordingly.

I've been taking S. boulardii supplements (because I had them on hand), and they haven't hurt anything, might have helped... when they run out, I guess I'll know whether I should replace them, though it might take a couple of weeks for the lifecycle of any bad bugs that it's battling to come back around. I think that's one of the reasons why it's hard to figure out whether probiotics help, and which ones. I read (long ago, so may have got it wrong) that C. diff. spores can hang out in a dormant state for quite some time.

BTW So Delicious is bringing out a coconut version of Greek-style yogurt, sometime this fall. I can't wait - both for the usefulness as a food, and for any little probiotic help it *might* add.

---S

[Zizzle]

Hi Sara,
The move is complete, although the painfully long punch-list process seems to go on forever. I'll post some pics of the new house soon. I spent 3 days in Boston last week with the kids, tagging along for my husband's conference. Sorry I didn't announce my travels to any Bostonians! We went to a Red Sox game, the aquarium, Quincy Market, Boston Common and the Swan Boats and Frog Pond, and best of all, the children's museum. The goal was to avoid cars and do everything on foot. We even took a water taxi to the airport from our hotel. It was the only real getaway planned for this complicated summer. It was a nice escape from 100 degree weather in DC.

I'll try making my own saurkraut. I like the idea of fermenting other veggies too - celery, carrots, onions, etc. I'll also see is Whole Foods carries a good one.

[sarkin]

Z,

Boston's my home town! We actually had a similar week right here in NYC. My niece was visiting from Sweden with her beau. They did a lot of tourist adventures on their own, but we joined them for beach, Brooklyn Cyclones game, Coney Island...

I have a book called 'Preserving Food Without Freezing or Canning' - the recipes are gathered from gardeners and farmers in France who use traditional methods, so they're written more like a neighborly chat than a standardized formula. I'm brining grape leaves from my vine at the moment (not sure what I'll stuff them with, but I'm sure I'll be inspired when the time comes).

Given your interest in friendly bugs, you might find it fun even for reading about foods you don't intend to preserve yourself. My grape-leaf instructions include covering the jar with the top of an old wooden Camembert box, which is also soaked in brine. I don't have one of those, but it does make me feel pretty relaxed about 'bacteria' in my kitchen. (Now, if only I could keep the cats off the counters...)

http://www.amazon.com/Preserving-Food-w ... 1933392592

L,
S

[tex]

Zizzle,

My father's family was German, so when I was growing up, my paternal grandmother used to make great saurkraut regularly - in fairly large crocks, so that it was enough to last awhile. It was good stuff.

The stuff I used more recently was bought in a health food store:

http://www.bubbies.com/prod_sauerkraut.shtml

This is a good product, but I don't know how it rates on probiotics. Most commercial saurkraut sold these days has been pasteurized, so that it can be kept without refrigeration. The last time I bought Bubbies Saurkraut, it was refrigerated, which leads me to believe that it was not pasteurized. Whether or not they have changed this policy in the roughly 5 years since I last bought any, I have no idea.

As I recall, Matthew used to use this product, also. Maybe he knows whether or not it remains unpasteurized.

Tex

[TooManyHats]

Dang, this wouldn't help me at all. No vinegar for me.

The first time I heard the term leaky gut was while doing research on autism. I only wish I had my son, who has autism's gut. He can eat anything without any bathroom problems at all. His autism seems to be genetic, but while pregnant with him I suffered repeated sinus infections. It's now one of the scenarios that's widely accepted as to a possible cause of autism. Genetics + insult to the pregnancy via infection at a critical stage of pregnancy.

But like cancer, autism has many causes. Leaky gut, the inability to eliminate heavy metals, genetics, etc. The diet definitely helps a sector of those with autism. And to think I thought it was such a huge undertaking way back when.

[Deb]

I'm enjoying this information and put Sara's book on my Amazon wish list. I had just recently decided to try and make some kimchi and sauerkraut for the first time. I remember my dad making big crocks of sauerkraut and my uncle was married to a Filipino woman who stirred up batches of kimchi regularly. They teased her about eating the rotted food! :)

[gowest]

I've read and tried the GAPS diet, and the logic makes the most sense to me of anything else. I'm doing kind of a SCD/GAPS/Paleo combo right now.

The thing about GAPS is that it places a lot of emphasis on healthy fats, which I love, but my insides do not. I seem to have trouble digesting them, probably beacuse, as Tex mentioned in a recent post about gallbladders and bile salt diarrhea, the inflammation from the MC prevents the bile from being reabsorbed before it reaches the colon.

In that post, Tex, you said the Qestran-type medications would probably help the D symptom of MC, but not cure the underlying cause: the inflammation. I don't have insurance and can't afford Entocort, so I was just reducing my symptoms with one Imodium per day. I wanted to see if I could get by without it, and haven't had the Imodium for a week now -- but my BMs have gone from 1-2 per day, rated 5-6 on the Bristol stool scale, to now 4 or so per day of water D. :o( I need to do something to heal the inflammation. I only eat meats and cooked, pureed veggies (squash, zucchini, carrots). No eggs, dairy, nuts, fruit. Not sure what else I can do, except maybe reduce the fat. Also, the chicken soup of the Intro Diet always seems to turn my stools to water.

I wandered off topic there, but I do think GAPS makes sense. As far as fat malabsorption issues go, Dr. NCM (the GAPS Dr.) recommends the Dr. Hulda Clark Liver Cleanse Protocol on the FAQ on her website (see number 1 under "Gallstones" on this page: http://gaps.me/preview/?page_id=32):

Fat in stools means that not enough bile is being released from the gallbladder to emulsify fats. The most common reason in GAPS patients is gallstones. A gallstone is a clump of infection or a fragment of a worm, coated by bile: this is a defence reaction the liver has, when pathogens get into the bile ducts. Bile stones form all of our lives, and in the initial stages they are small and soft and pass easily through the bile ducts into the duodenum every time we eat fats. Once in the duodenum, the stones go all away to the bowel and get eliminated in stool. If the person has been eating processed carbohydrates and low fat foods for a while, then the liver does not get enough stimulation to empty the bile into the duodenum, so the bile stones stay in the bile ducts too long and become calcified. As the stones accumulate calcium salts on their surface, they get larger and their surface becomes hard and rough, so they cannot be easily passed through the bile ducts (they get stuck). When enough bile ducts are obstructed by stones, the bile flow gets impaired; hence the person cannot digest fats very well. GAPS diet is rich in fats, which stimulate bile production and excretion into the duodenum at every meal. It may take time for your liver to get into full gear, but it will do so. When juicing is introduced, the active substances in juices dissolve calcium salts in the stones and make them softer, so they can be eliminated from the bile ducts with the next fatty meal. It takes time, but in the majority of patients this situation gets resolved naturally, without any special measures (particularly in children). In some severe adult cases following Dr Hulda Clark’s Liver Cleanse Protocol may help to eliminated gallstones.

I haven't tried the liver cleanse yet -- I'm curious to know if anyone else has.

I also wonder if a few days of fasting would reduce inflammation in the colon.

Ashley

[tex]

Hi Ashley,

It's good to see a post from you again, but I wish that you were informing us that you have been in remission since the last time you visited, without the need for meds. I don't understand why the diet you described, (meats and cooked, pureed veggies), wouldn't get the job done - unless maybe you're getting too much fiber, or you happen to be sensitive to one of the veggies or one of the meats. Hopefully, you're peeling the veggies, first, because most of the fiber is in the peel.

Concerning bile - most of the theories attempting to explain the malabsorption of fat, are based on excessive amounts of bile, (thus causing D), and a few, (such as the one you quoted), are based on insufficient bile, (which can also cause D, because of all the unabsorbed fats in the fecal stream). All of these theories tend to ignore the fact that bile is not the only digestive element required in the chyme to allow the absorption of fats to proceed.

Yes, it's true that bile emulsifies fats to initiate the process, but the emulsified fat cannot be absorbed unless pancreatic lipase, (secreted by the pancreas), is also available, because pancreatic lipase is the primary enzyme that hydrolyzes, (breaks down), dietary fat molecules, converting triglycerides into monoglycerides and free fatty acids, so they are in an absorbable form. If the pancreas isn't functioning properly, then the fats will remain in the form of peptides, similar to gluten peptides, and they will not be in a suitable form to be absorbed. And if they should be absorbed, they would probably cause the same type of systemic problems that gluten peptides cause, whenever a leaky gut condition allows them to be absorbed, (because they cannot be utilized as fuel by any of the cells in the body, in peptide form).

Bile salts coat the fat droplets in the chyme, and break them into smaller droplets, (in a nutshell, that's really all that the emulsification process involves, in this instance), thereby increasing the overall surface area of the fat, which allows the pancreatic lipase better access, so that it can break down the fat more effectively, into free fatty acids and monoglycerides.

Of course, it's not quite this simple. Even though the pancreatic lipase is released into the duodenum in it's final, (ready to use), form, it can only work efficiently if colipase is present. Colipase is also secreted by the pancreas, but it's secreted in an inactive form, (procolipase), which requires activation by trypsin, before it can be used. Bile salts tend to inhibit the hydrolysis of long-chain triglycerides, and the colipase, (after activation), overcomes the capacity of bile salts to inhibit the reaction, so that the lipase can proceed with the breakdown process.

So, in consideration of the above facts, I seriously doubt that bile salts are ultimately responsible for most of the digestive irregularities attributed to them. I suggest that pancreatic enzymes play a much larger role, and are more likely to be ultimately responsible for fat malabsorption problems.

Normally, about 90% of excreted bile acids are reabsorbed from the intestinal system and recycled back to the liver and the gallbladder. The reabsorption takes place in the terminal ileum. I have a hunch that the reason why the bile fatty acids are not properly recycled when they get to the terminal ileum, (as they should be, if the digestive process were proceeding normally), is because they are still coating the fat colloids when they reach the ileum, and so they are in a state where they cannot be absorbed. IOW, if the pancreatic lipase does not hydrolyze the fats, then the bile salts cannot be reabsorbed. Since they cannot be absorbed and recycled, they pass on through, causing D. That doesn't mean that bile is the problem, though - the failure of the pancreatic enzymes to hydrolyze the fats, is almost surely the cause of the problem.

Also, consider this: If most of the bile is lost, rather than recycled, then the demand for bile is roughly 10 times the normal amount. In the long run, losing all that recycled bile is bound to place abnormal demands on the liver and gallbladder, just to keep up with the body's needs. This may be why so many of us with MC have gallbladder problems.

Of course, this is just my interpretation of what I think is happening, so I could be all wet.

Tex

[sarkin]

Ashley,

My comments are at a much more trivial level - but have you tried using a different meat other than chicken? (Turkey would be the closest thing, but other meats would work, and might give you some of that benefit without the watery D.) Stools turning to water sounds to me like a specific food reaction (at least, that would be the case for me).

I'm with Tex - with a diet as thoughtful as yours, I would expect the inflammation to be dust in your rearview mirror. Hope that happens, soon.

Tex,

I have seen Lipase products (Enzymedica makes one) - that probably wouldn't really solve the problem you describe, because of the complex interplay with other enzymes like colipase - right? What you have said makes a lot of sense to me - the inability to reabsorb bile acids would surely stress liver/gallbladder, and might give confusing cholesterol readings - which, since MDs these days are obsessed with those numbers, could easily lead to a prescription that further throws things out of whack.

I didn't know about the Bristol stool scale. (I've had diarrhea conversations with a few doctors over the years, and they never asked any questions along those lines, either.)

All my best,
Sara

[tex]

(I've had diarrhea conversations with a few doctors over the years, and they never asked any questions along those lines, either.)

No surprise there - no one knows poop like a potty person.

I once had the bright idea to try an expensive enzyme supplement. As I recall, I was already in remission, and seemingly doing just fine, but for some reason or other, I thought that a good enzyme supplement might help to expedite the healing process, doncha know.

I took the first tablet just before breakfast, (luckily, I only took one). In about an hour and a half, I was feeling nauseated. Roughly an hour later, I was vomiting up some vile, green-looking stuff, that burned like fire, on the way up. By mid afternoon, I had nothing left in my stomach, but that didn't stop the vomiting, (or rather the dry heaves). Mercifully, trying to do the impossible task of ejecting my stomach, finally ended, during the evening hours, and all I was left with, was a burning pain in my abdomen, which kept me from sleeping, and lasted for 3 or 4 days, before it finally faded away.

Needless to say, that was my last experiment with an enzyme supplement.

Love,
Tex

[sarkin]

WOW, that sounds awful!

Years ago I tried some enzymes based on the recommendation of a friend's brother (he's a pretty smart and knowledgeable guy). They were just fine, though I don't know if they helped me or not. I liked them, but I probably was taking an array of supplements at the time, so who knows which if any were really making my life better. All that was before MC...

YIKES!

[Deb]

Years ago, when I first started with acid reflux issues, I used enzymes and they were quite effective....later, not so much.