I Like My Colon Just Fine Where It Is, Thanks: A Tale of Fibre and Starch

I was started on medication the very same day I was diagnosed with ulcerative colitis.

PENTASA

Hard to swallow

Mesalazine comes in different forms, but the one I was prescribed was made for a giant; quite possibly it is the largest tablet ever made. I took four a day. They made no difference.

Then two rounds of prednisolone made no difference either. I explained in my previous post, how antibiotics triggered my ulcerative colitis and how stopping them helped me get better. But before that I had to sort out my diet and was referred to a dietician for help.

I was a 6 or 7 on the Bristol Stool Guide (named after the city where I was born) and I had lost 45lb, leaving my excellent gastroenterologist so concerned about the rapid and continuing weight loss, that she booked me in for a full body CT scan in case I also had a cancer tumour somewhere too. If that was normal then I was going to move onto the harder drugs – Azathioprine (Imuran) and Infliximab. If they failed then I might have needed surgery to remove my colon. It was fibre and starch that helped me avoid these eventualities.

“Stay away from fibre,” the dietician said.

“Oh, Really?”

“Yes.”

“Why?” I asked.

“It creates a lot of gas which patients find painful and increases bowel movements, and we’re trying to reduce your bowel movements. A lot of people find the specific carbohydrate diet (SCD) beneficial.”

I wasn’t convinced. I don’t doubt that some people with UC find the SCD helpful – I agree with some of it – but my gut had been giving me it’s own opinion, and I had begun excluding a whole load of stuff based on what it said. A pattern was emerging and the pattern was that gluten, maize, egg, most dairy, tea, coffee, and additives were bad; and that fibre, starch and meat were good. My gut spoke to me in a voice like Audrey out of Little Shop of Horrors –  it screamed, “Feed me Clark. Feed me. Must be starch. Must be fibre. MORE! MORE!”

I think dieticians sometimes assume fibre is the baddie because in healthy people it makes up the majority of waste that comes out the other end. But when you have UC everything comes out the other end – fast. This isn’t fibre’s fault though. There is no time for your body to absorb what it can and leave only the fibre behind. The problem is not the fibre. The problem is an immune reaction, and certain foods seem to precipitate this reaction.

Breakfast is oat porridge, made with oat milk which is really just ground oats and water. Every. Single. Monotonous. Day.

Sweet Potato

Here are some sweet potatoes my wife dug up today

I get more variety in my lunch and dinner though, which consist of vegetables, fruit, rice and meat. I get through so many potatoes that I started growing them myself. And I take potato starch as a supplement too. And this is where I struggle with the SCD, because potatoes, and their starch is strictly illegal. It’s also interesting that some versions of the SCD allow soaked legumes, which contain starch, but these are another thing that my gut says no to.

When I finally figured out the last few things to cut out so that my gut didn’t complain any more (soya lecithin was last), my colon finally got a break and started to heal up. I eat stuff that would be considered illegal under SCD and I eat it because my gut says it’s okay. It’s probably no coincidence that many of these things are food to the friendly bacteria in my colon. I am now more concerned about feeding my little bacterial buddies than I am about feeding myself. Maybe if my gut heals up and my gut bacteria recover, I’ll be able to reintroduce what I’ve had to cut out, but I still think that’s way over the horizon for me. Till then I’ll stick to the fibre and complex carbs.

What does your gut tell you?

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2 thoughts on “I Like My Colon Just Fine Where It Is, Thanks: A Tale of Fibre and Starch

  1. I am so happy to come across your blog. I am in the middle of Ulcerative colitis flare, avoiding oral prednisone. This time stress triggered my flare, and I wanted to find out how my gut flora changed as a response to stress. I didn’t look into sequencing gut flora when I was in remission so its difficult to find out now, but as I go into remission, hopefully, I will sequence again and see how it changes.

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    • And I am happy you found it too; I know first-hand how bad ulcerative colitis is, so I hope you manage to get over your flare quickly. Sorry for what you are going through right now. Do keep in touch and let me know how you get on. I think those flare/remission comparisons could be really interesting.

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