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Curing from the cupboard

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Desperate times call for desperate measures – a thought generally attributed to the Greek physician Hippocrates, the father of medicine, after writing in his Aphorisms, “For extreme diseases, extreme methods of cure… are most suitable.”

This has been the catchphrase of medicine ever since. If a patient has some sort of serious condition, so the thinking goes, it can only be cured by a heroic measure: chopping it, burning it, freezing it or poisoning it with a potent drug.

Inflammatory bowel diseases (IBD) like Crohn’s fall into that category of ‘extreme diseases.’ To date, the modern treatment has zeroed in on the most extreme methods of treatment, whether steroids or powerful immune system-suppressing drugs like azathioprine, infliximab and methotrexate, all of which can have a number of life-threatening effects, from lowered resistance to infection and osteoporosis to liver and lung disease and lymphoma.

This might be worth it, if doctors had a clue that IBD required it, which would entail understanding what on earth IBD actually was. It also would be worth it if these extreme measures actually worked.

But no less distinguished an institution as the Mayo Clinic falls back on the same old story: faulty genes: “The exact cause of Crohn’s disease remains unknown… A number of factors, such as heredity and a malfunctioning immune system, likely play a role in its development.”

The Mayo also dismisses any notion that diet could be behind an inflamed gut: “Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don’t cause Crohn’s disease.”

Tell that to Dane Johnson, featured in our cover story this month (page 28). Johnson, a successful American male model, was so sick with uncontrollable bloody bowel movements that he had to quit his work. Drugs weren’t helping, so eventually he had to take matters into his own hands.

Johnson found the bulk of his treatment in the kitchen cupboard. A change of diet – adding some things, eliminating others – essentially did the trick. No towering pile of supplements, no drugs, no radical anything.

Six dietary measures probably accounted for the vast majority of his positive outcome, and a few other lifestyle changes – minimizing stress, getting enough rest and staying positive – put the icing on the cake.

Increasingly, pioneering researchers are discovering what the Mayo Clinic is still blind to: the answer to most gut problems – even the most extreme ones – is in the diet. In fact, new research from Case Western Reserve University in Ohio shows that gut problems like Crohn’s disease can even be reversed simply by eating more ‘good’ fats, such as from coconut oil and cocoa butter.

In the Case Western study, mice with a condition that mimics Crohn’s that were given these good fats in their diet had some 30 percent fewer types of gut bacteria in the portion of the intestine commonly inflamed in Crohn’s disease, compared to mice fed a normal diet. Even when the animals were given low concentrations of the coconut oil or cocoa butter, they had less severe intestinal inflammation and fewer of the distressing symptoms of Crohn’s, such as swelling, cramping and diarrhea.

Although this preliminary study was carried out on animals, and of course may not apply to humans, it does offer a possible link between the types of fats we eat and the state of our microbiome.

“The finding is remarkable because it means that a Crohn’s patient could have a beneficial effect on their gut bacteria and inflammation only by switching the type of fat in their diet,” said lead researcher Alexander Rodriguez-Palacios.

The study is among the first both to identify specific changes in gut bacteria that are linked with Crohn’s disease and to show that high-fat diets can bring about those changes and thus combat inflammation.

Rodriguez-Palacios and his team are now studying which components of the ‘good’ and ‘bad’ fats change which types of gut microbes and make the animals healthier.

Because the fats lower inflammation, they could have the same beneficial effects on other inflammatory bowel disorders too.

The Case Western team are hopeful that they’ll be able to produce dietary advice to help IBD patients without the side-effects of drugs. Perhaps they should have a word with Dane Johnson. And while they’re at it, they might remind the Mayo Clinic of another one of Hippocrates’ famous aphorisms: ‘Let food be thy medicine.’

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