New evidence of how the SCD diet could help Crohn's disease and colitis

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Jan 29 2014 - 11:40am
The SCD diet changes microbial flora in the gut. Does the diet work?

Elaine Gottschall, MSc, in her book, “Breaking the Vicious Cycle” (The Kirkton Press; 2012), has some dietary advice for anyone suffering from Crohn's disease, ulcerative colitis, irritable bowel syndrome or celiac disease. According to Gottschall who developed the specific carbohydrate diet (SCD), it may be possible to quell inflammatory bowel disease by eating foods that change the microbial flora in the gut. Now Rush University scientists have found the SCD diet does change bacteria in the gut that theoretically could help treat Crohn's and other forms of IBD, IBS and celiac disease.

What is the SCD diet?

The diet focuses on specific foods and disallows others. The idea is to include anti-inflammatory foods into your eating pattern including fish, aged cheese and honey. Foods that are disallowed are cereals, grains, potatoes and dairy with lactose. The theory is that carbohydrates that turn to sugar promote bacterial overgrowth that can affect specific enzymes in the gut that keep harmful bacteria and yeast in check.

Fresh and frozen legumes are part of the diet as well as fresh, raw or dried fruits, poultry fish, eggs, other fresh or frozen meats, natural cheeses, yogurt and dry curd cottage cheese.

Canned vegetables and fruits (unless they are in natural juices), processed and smoke meats, chocolate, carob, all cereal grains, canned fish, potatoes, parsnips, chickpeas, bean sprouts, soybeans, mung beans, fava beans, instant tea, coffee and other foods are on the list to avoid, including seaweed, beer and instant teas and coffees.

Anything made with corn or other starches or refined sugar is taboo. Fermented foods are also encouraged.

The diet was originally developed by Sydney Valentine Haas, MD. Gottschall, whose daughter recovered from colitis by following the dietary recommendations, later wrote her book.

Gottschall explains the SCD diet is “predicated on the understanding that ulcerative colitis, Crohn’s disease, irritable bowel syndrome and gluten therapy resistant celiac [disease] are the consequence of an overgrowth and imbalance of intestinal microbial flora.”

The study

The diet was tested by the Rush University scientists to find out how the diet could influence the balance of beneficial versus harmful bacteria in the intestines that indeed has been implicated as a contributor to IBD and perhaps for the intermittent flare-ups experienced by those living with diseases of the colon.

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The researchers collected stool samples from 10 patients with Crohn’s disease and 10 patients with ulcerative colitis, some of whom were receiving immunosuppressant medications at the time testing.

Ece Mutlu, MD, associate professor of medicine, Rush University Medical Center, Chicago, and her colleagues studied 20 people who had adhered to the SCD diet and 20 who had not not.

In each group, 10 people had Crohn's disease and 10 had ulcerative colitis.

Diet improves intestinal microbial diversity, reduces symptoms of IBD

The researchers found differences in diversity of the microbial flora in the gut between the two groups by with a process known as 16S rDNA pyrosequencing. The SCD group had greater intestinal bacterial diversity compared to the control group.

Dr. Mutlu observed some patients experienced relief of Crohn's and ulcerative colitis symptoms, though the study did not include endoscopy or other testing to measure disease activity.

The findings are published online in Gastroenterology & Endoscopy News and were also presented at the American College of Gastroenterology 2013 Annual Scientific Meeting (poster 1619).

Mutlu also said “I have observed that a small number of my own IBD patients drastically improved on the SCD and achieved complete long-term mucosal healing, or were able to reduce or discontinue immunosuppressants for several years.” The CCFA warns no diet is proven to help IBD.

This is the first formal, though small study, that has measured any effect of the SCD diet. Until now there was no scientific evidence at all to test how the diet even might work to treat inflammatory bowel disease.

The researchers says the SCD diet shows promise for treating IBD. Mutlu explained: “A longitudinal study following IBD patients before the start of the diet, and during and after the SCD, would have been much harder for us to complete, but I think this should be done going forward and it could help us learn a lot more in the future.” Given that symptoms improve with the diet, at least for some people, you might speak with your doctor about the benefits of the specific carbohydrate diet if you are diagnosed with Crohn's disease, colitis or celiac disease that researchers hope to continue to study.

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