MICROSCOPIC COLITIS SUPPORT

I’ve been diagnosed 1 week, taking Mesalanine and have started the Recovery Diet. I’m also taking Magnesium and D3, per your recommendation. I am 70 yo and grateful to have had 70 years of disease free life. If I continue the Mesalanine indefinitely, do I need to restrict my diet? Thank you Tex, Gabe’s, et al.

Hi,

Welcome to the group. Without the diet changes, a few people are able to mostly control their microscopic colitis symptoms by taking mesalamine (or some other medication) indefinitely, to suppress the inflammation. Eventually, most anti-inflammatory medications slowly begin to lose their effectiveness. The diet changes never lose their effectiveness, but sometimes we have to modify or fine tune our diets in order for them to continue to work properly.

We're all sensitive to even small traces of gluten, so we have to avoid gluten for the rest of our lives. About two thirds of us are sensitive to casein, so we have to continue to avoid all dairy products. About two thirds of us are also sensitive to soy, so we have to avoid it for life, including most legumes. Over half of us are sensitive to chicken eggs, so we have to continue to avoid them, in the future. But most of the other diet restrictions, such as no raw vegetables (salads), no spicy seasoning, minimal amounts of citric acid, fiber, sugar, etc., can usually be abandoned after we reach full remission. And after wer'e in remission, no anti-inflammatory medications, such as mesalamine, are needed, at least for almost all of us.

Again, welcome aboard, and please feel free to ask anything.

Tex

Thank you, Tex. I think I understand you to say that medication is an adjunct treatment for MC.

If you go to most gastroenterologists for advice, medications are their primary treatment. But 85% of patients relapse when their most popular treatment for MC (budesonide) is ended, for example.

Medical treatments for microscopic colitis typically focus on the use of anti-inflammatory medications, and either minimize, or totally avoid treatments that properly incorporate dietary changes. Medications are only temporary treatments. They only address the symptoms, not the cause of MC. To stop the inflammation from recurring with each meal, we have to avoid every food or medication antigen that causes our immune system to produce antibodies.

Some physicians are beginning to learn this, but many of them are still way behind on the learning curve and they incorrectly insist that diet has nothing to do with the disease. In fact it has everything to do with not only microscopic colitis, but all inflammatory bowel diseases. Claiming that food has nothing to do with digestive diseases is a lot like claiming that breathing polluted air has nothing to do with respiratory diseases like asthma, COPD, and lung cancer.

We've always recommended a low fiber diet, at least when trying to recover from microscopic colitis, to achieve remission. The medical community has continued to recommend fiber, although it's clearly contraindicated for treating an IBD. Within the last month, medical researchers have finally published some research data which proves that fiber increases the inflammation level, and therefore the severity of the disease, for most people who have an IBD. So probably, in about 10 to 20 years, most gastroenterologists will begin to recognize that fiber should not be recommended when treating inflammatory bowel diseases.

Tex

Thank you, Tex. Your last paragraph stunned me. 10-20 years for GI docs to “get the memo”, so to speak.

The medical profession in general, and medical specialists, in particular, seem to be agonizingly slow to change, whenever new research is published proving that what they have been recommending for decades is totally incorrect. Most likely, they don't like to admit that some of the recommendations are/were based on guesswork, and they guessed wrong. Looking at some of the research that's been published in the last 10 or 20 years, much of their dietary advice has amounted to little more than poor guesses (such as eating eggs, or animal fat is unhealthy, and causes high cholesterol, etc.). Gastroenterologists are certified as "experts", and everybody knows that experts can't be wrong.

Tex