Today’s question came to me from Francis and it’s one that I have a particular passion around. As I talk about in the preface and intro of my book “The Paleo Dieter’s Missing Link,” I struggled for a number of years with Ulcerative Colitis and eventually recovered and regained my health. The video above details some of the things I learned during my struggle with the illness.
Here’s Francis’ email:
Hi Adam,
Got your book, and have been reading through it (and Robb Wolf’s book)
with great interest.
My son (now 12), has had colitis for 3-4 years. It had been under
control until a few months ago, and a recent colonoscopy showed the
first 15 cm of his rectum/sigmoid are completely compromised, and
nothing but bleeding lesions. Needless to say we’re panicked as
parents, as the GI doc’s next step is steroids.
We don’t want to go that route – and are moving him to paleo like diet
(I’m convinced all the wheat/grains he eats has got to have an effect
on him).
My question(s) to you:
– I want to go paleo with him, but he’s in a huge growth spurt; should
I go strict at first, and then loosen the reigns after we get his
current crisis under control? I will cut out wheat / grains, but what
about brown rice?
– I have been reading a ton about kefir, and would like to make daily
shakes for him with organic goats milk kefir / fruit smoothies, do you
think it’s OK to have this dairy in his diet and see where it goes?
– In general, any comments or thoughts you have in going from a
“normal” western diet to a paleo diet for disease mgmt (especially
with kids) is appreciated.
– I don’t see how we can be successful if we have to cut out
simultaneously all grains, eggs, nightshades, and dairy. I think I can
come up with an eating plan if I could include limited dairy (kefir),
and eggs, otherwise, it becomes meat and veggies exclusively.
Thanks for your book and your blog – it’s inspiring and brings hope to
us.
Francis
ttys
Adam
IMPORTANT! Adam Farrah is not a doctor or medical professional. This information is based on my own opinion and is not meant to be medical advice or to treat, diagnose, cure or prescribe in any way.
Thanks for the great video! Just shared with someone I know that was just diagnosed with UC at the age of 29. I hope he gets it.
Glad you found it! Let me know if it helps!
Adam
Hey Adam, I stumbled across your site after being diagnosed with UC a week ago. The last time I had blood in my stool was about a month ago and it was a minor amount. The doctor told me I have a mild condition, and has gotten me a Rx of Lialda. I am very apprehensive of starting such an intense drug and even more afraid of the side effects. I notice that when I don’t drink, stay away from greasy foods, stay gluten free, my symptoms are almost gone. I am 27, 180, 5’10. I workout regularly. I am going to try out paleo for the next month before starting the medication.
Just wanted to thank you for the reaffirmation that lifestyle changes, meditation, diet can actually help this condition. (I have a stressful job as a computer programmer). Also, doctor’s have always shot down anything about diet when I’ve raised the question.
Hey Josh,
Yeah, diet and lifestyle (including controlling and limiting stress) are going to work better than medication and have only positive “side effects.”
Good luck with Paleo and keep in touch. Check out Paleo Magazine (http://paleomagonline.com) and also International Paleo Movement Group on Facebook for inspiration and support.
Adam
3 Months Gluten Free and 2 weeks Paleo and I have not had any flare ups in more than a month.
One question I do have it about protein powders. I work out 4x’s a week. Is there any protein powder you recommend? I currently have Muscle Milk (which I know isn’t the best quality). Should I not use this? If not, what should I use?
Hey Josh,
You have to be really careful with any dairy-based protein powders. Personally, I don’t do well with them. When I was still healing, a whey-based powder could bring on a flare-up. Even now, whey protein makes me gassy and tends not to digest well.
I’ve had good luck with a rice protein powder (of all things) made by Sun Warrior. It’s their raw brown rice protein powder (Not the blend they also sell). It seems to digest a lot better than dairy-based proteins for me. Obviously, your results might be different.
If you really, truly do OK with dairy, you might try cow or goat yogurt. Get grass-fed if you can or even make your own. You could even do a post workout shake like I have in the past of grass-fed yogurt, raw eggs and some fruit. Something like that is about 1000 times better than a protein powder in a can.
Adam
Hi Adam,
Do you recommend any supplements to cure UC?
I have ulcerative proctitis since March. My only symptom is bloody stool, but because of my NSAID’s the amount of blood is very low or even nothing. But I realize that these medications only suppress the symptoms and once I stop taking them the blood will come back. Unless paleo will help me that is.
All the doctors I talked to told me that diet/gluten/dairy/etc has nothing to do with my condition because they only affect the small intestine. They say nobody knows what is causing this disease. But many people are claiming online that they got better because of paleo diet. I want to believe.
I have also done a food intolerance test, I’m currently waiting for its result. I’m very curious about it.
I will follow a strict diet, maybe chicken+steamed carrots only. I wonder if you can recommend any supplements like probiotics, herbals, vitamins and minerals?
Thanks a lot,
Ádám
Hey Adam,
Yeah, the doctors will never acknowledge that diet has anything to do with UC. It’s always the same old story with them. Diet and lifestyle are HUGE factors in the illness and you can heal from it with enough time and effort and changes in your life.
There really aren’t a lot of supplements I recommend. Most of it will be diet and lifestyle. Some fish oil is a good idea for inflammation and Vitamin D is a good idea too. I use both. Probiotics are good IF your gut is healed enough to tolerate them. I’d go with a strict Paleo diet and lots of rest and as low stress as you can get for a few months before adding in a probiotic.
Good luck and keep in touch.
Adam
Adam, I have had UC for about four years and was looking for treatment other than prescription drugs. I have taken prednisone, colazol and remicade with very little success. I am currently taking Humira on a weekly basis. I have not reached “remission” with any of the drugs. I came across Robb Wolf’s book on paleo and the SCD book by Jordan Reasoner and Steven Wright. I have been contemplating on which one to start with and I believe I want to start with the paleo one. I watched your video and you said to find a meat and a vegetable to start out with. How long before you started adding other foods into your lifestyle? How long before you started adding in exercise into your lifestyle? Thanks!
Benjie,
I actually was never on any of those drugs. They came a bit later than when I was diagnosed. All I ever did was prednisone and the sulfa drugs like Asacol or sulfasalazine. I’m really thankful that I never got into those newer drugs as I’ve talked to people who have had some pretty negative side effects.
In my book, The Paleo Dieter’s Missing Link, I specifically talk about the Specific Carbohydrate Diet (SCD) and how it relates to Paleo. Here’s a quote out of my book regarding SCD:
“Specific Carbohydrate Diet
The Specific Carbohydrate Diet (SCD) was created by Dr. Sidney Hass and popularized by Elaine Gottschall in the book Breaking the Vicious Cycle. The SCD is promoted primarily for the treatment of inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. At one time early in my healing journey I was given a copy of the book by my aunt who had heard of it from a family friend who’s son was also battling ulcerative colitis.
The main premise of the diet is to avoid specific foods that contain specific types of carbohydrates that feed unhealthy gut bacteria. With this goal in mind, the book goes into very detailed and sometimes complicated and seemingly arcane recommendations of foods to eat or avoid. The overall result of the SCD recommendations is the avoidance of most complex carbohydrates, lactose, grains, refined sugar and starches.
SCD is, essentially, a complex route to the same end that a Paleo approach achieves with elegance and economy of effort. SCD is focused on healing the gut and starving harmful bacteria—as is Paleo to an extent—but the approach is unwieldy. One element in Breaking the Vicious Cycle is a discussion of the difficulty of finding processed lunch meat that didn’t have certain gut-irritating sugars in it. The diet is essentially a “label-reading” diet that doesn’t focus enough on food quality, in my opinion. I’ve worked with several people with ulcerative colitis who tried the SCD but found it too complex, labor intensive and hard to stick to.
In the end, simply following a Paleo approach achieves the goal of SCD without the label reading or complexity. SCD has worked for many people, from what I’ve heard, but a Paleo approach will eliminate virtually all of the foods SCD considers problematic along with things like packaged and processed foods and conventionally raised meats. And, it does it more easily and elegantly.
Paleo is an elegant, all-inclusive solution that can be applied without a lot of rules and complexity. If we didn’t have it for most of our evolution, don’t eat it. Paleo achieves with simplicity the goals of many specialized diets that focus in on a single issue or sub-set of problems. This is a recurring theme in the diet, health and medical fields— complexity, details, loads of science and biochemistry—and missing the forest for the trees. Many diets are focused attempts to achieve highly specific reactions from the body that would naturally happen with a Paleo approach, stress reduction and functional movement. They’re fun if you enjoy delving into science, but usually not 100-percent practical or executable in the real world.
If you’ve come to Paleo to heal gut inflammation, leaky gut or an inflammatory bowel disease, I highly recommend Digestive Health with REAL Food: A Practical Guide to an Anti-Inflammatory, Nutrient-Dense Diet for IBS & Other Digestive Issues by my nutritionist friend Aglaée Jacob. Aglaée’s book is the most complete and comprehensive book I’ve seen on the topic of digestive health from a Paleo perspective.”
Check out my book and Aglaée’s and drop me an email if you need anything or want to talk about one on one help.
As far as adding in foods, you can add in Paleo foods pretty quickly. If you’re eating chicken and carrots as your main foods, you can try beef and carrots within a week or two and see how you do. I definitely WOULD NOT add in non-Paleo foods for a year or more – if ever. I think the biggest mistake people make – and one I made a lot early on – is adding in things like raw dairy, yogurt, sprouted grains, brown rice, etc. too early and having a flare up. Then the doctors will say: “See, that Paleo diet didn’t help, diet has nothing to do with it.” If you’re really sick with colitis or Crohn’s you literally need months or YEARS on a very strict Paleo diet with possibly some good dairy after a LONG stretch of good health on the basic “meat, vegetables and fruit” approach. Adding non-Paleo foods too fast or cheating with junk food is probably the number one way to trigger a flare up and end up in trouble.
As far as exercise, that’s pretty individual I think, but movement – of appropriate intensity – can’t be bad for you. Even when I was very sick I still walked, did karate and lifted minimal weights. I even lifted weights when I was really anemic and didn’t know it. Not smart, but I was OK. Start slow and consider yoga. Yoga is the single best practice I’ve started for my health. Try Sara Ivanhoe’s “Yoga on the Edge” DVD. I do the afternoon or evening practice on the disc daily. The morning one is more intense. Don’t start off with that one.
Good luck,
Adam
Thanks Adam!
Hi would be great if you can share some paleo vegan recipes or suggest some web sites.thanks
Ananya,
Paleo and vegan don’t really go together very well. Certainly, for colitis, vegan is NOT a good idea and won’t provide the fats and proteins needed to heal. You can find “vegan Paleo” stuff online, but I don’t recommend it.
Adam
Your advice in the above videos seems wise and logical. I have severe ulcerative colitis and, although I’ve had times of “remission”, I haven’t regained a level of prolonged comfort. I’ve tried many things, dietary changes, exercise, acupuncture, supplements. I’m completely lost about diet, my confusion only increased after meeting multiple times with a naturopath. I’ve run the gamut of drugs and am now on Imuran (since September), which has gotten the 24 inches of diseased colon to appear normal. The problem is, now I have 5 inches of proctitis and my doctor is considering Remicade infusions as an option, which terrifies me. Do you recommend any supplements while dieting/ healing the gut on chicken and carrots?
Hey Lea,
Sorry to hear about the diagnosis. I’ve been there and I completely understand. It’s not easy and the confusion you can get into trying to get healthy again is pretty massive.
The very simple and brief answer is to eat 100% strict Paleo. You’ll also want to google “autoimmune paleo” because there are a few exclusions like nuts and eggs that make sense for people with UC and other autoimmune problems. So, yeah, Paleo with absolutely NO CHEATING is the way to go. And organic, pasture-raised meats and organic veggies besides. Local if you can.
From there, rest, reduce stress, start a yoga and meditation practice, etc. Exercising too intensely can be a problem also. So make sure your frequency and intensity is right. I do yoga and meditation every night, but other forms of training you have to be careful with. And my yoga is “restorative” vs. “power yoga,” etc.
With that handled, a fish oil or cod liver oil supplement might be a good idea, maybe Vitamin D3 too and a probiotic once you really heal. The supplements can become an endless learning thing – which is OK – but without a solid Paleo diet foundation they’re pretty useless. Most Naturopaths focus WAY too much on supplements – which they always seem to sell, coincidentally – and don’t focus enough on diet or focus on diet but aren’t Paleo.
I’m thankful when I was sick back in 2004 there were none of the drugs they have now. All I ever got was prednisone and Asacol. The prednisone worked great in short cycles and I never took the Asacol long because it made me sick. I’d find a Paleo GI doctor – there are a few now – who can help you get your diet right and deal with the medication properly. I’ll help refer you if you want.
My friend Lindsey Twyman has a good story about healing UC on Paleo: http://scdlifestyle.com/2013/11/remmission-ulcerative-colitis-paleo-diet/
Also, my friend Aglaee Jacobs book “Digestive Health with REAL Food” is great as well as Sarah Ballantyne’s “The Paleo Approach.” I’d recommend you read them both.
Hope that helps you out and good luck. Shoot me an email if you need anything.
Adam
Hello,
I am currently feeling well and haven’t had a flare since 2015, however I know I am not 100% where I want to be. Like you I have dealt with this since early in the 2000’s and have managed to avoid the harsh drugs and surgery. I currently take Pentasa but dont think it does anything and want to get off of it. My diet now is Plant based, not vegetarian as I will eat meat when I want to, Gluten and Dairy free, think the TB12 diet (sure your familiar with that living in NE, I am in MA). I continue to think about going back to Paleo and full AIP , however anytime I start to cut out the gluten free grains, I get horrible constipation and pain in the rectum. The pain and constipation disappear once I add the gluten free grains back. I want to be completely healed so how can I go Paleo and not have that constipation happen? I have been also wondering about chi seeds, and hemp seeds to add bulk or fiber. Also what type and brand of protein powder would you recommend, I have been looking for a hemp brand but can not seem to find one that looks good and healthy.
Thank you for taking the time to put all of this wonderful information out on the web to help heal so many people.
Hey Allen, Nice to hear from you.
I’m glad you’re doing well overall and healing.
I was on Asacol many years ago. Apparently, that’s also Mesalamine, which is what Pentasa is. [LINK] I used to pass the “time release” Asacol tablets pretty much intact. They were useless.
I took sulfasalazine and prednisone many years ago in the early stages and I did well until I went off the prednisone. I don’t think sulfasalazine does much either.
My best results were with short “cycles” of prednisone. Start high and taper down over 6 weeks or so. Just like bodybuilders do with the high side-effect anabolic steroids like Dianabol (sp), ….
Prednisone for too long is just nasty and way too hard on the body. I also get massively depressed on it. I haven’t taken prednisone since 2009.
Fiber, UC, Paleo and Differing Opinions
So, there’s two differing views on fiber and UC. The generally accepted “Paleo” or ancestral approach is no fiber. At least that’s what Robb Wolf told me when he worked with me and it was a prevailing idea in other Paleo and Weston A. Price circles.
The general idea here being that the fiber is too harsh on the colon.
I also had a raw vegan coach tell me it was “like eating sawdust” and it wasn’t good for me. His solution, of course, was to eat more fruit. It was always about more fruit…
I personally THRIVE on fiber. Both natural fruit fiber like bananas and mangoes (blended into smoothies) as well as psyllium husk fiber and flax seeds.
There’s also some fiber in the hemp protein I use.
Here’s what I use for fiber daily:
Last year I put a client with IBS and chronic constipation on the psyllium and hemp. She was allergic to the flax seeds. Psyllium and hemp significantly improved her constipation with no autoimmune symptoms that we could observe.
There are a few caveats here:
The psyllium husk is a bit harsh. It’s definitely not something to use during a flare-up. It sounds like your body is pretty healed, so you should be pretty safe. Start with about 1 teaspoon of the Organic India psyllium in a fruit smoothie and increase from there. I use 1 heaping Tablespoon per day in a big smoothie.
Once you do well with the psyllium, add in the protein powder and see how you react with that.
Add the seeds in last. Either flax, chia, etc. I do flax and don’t seem to react at all. Even to 3 heaping Tablespoons daily.
Keep a close eye on the seeds. These are the most likely to start an autoimmune flare-up.
Nuts and Seeds and Paleo-AIP
Technically, Paleo-AIP would exclude both nuts and seeds. That would mean flax, chia and probably even the Nutiva hemp protein.
I do definitely react to nuts. I totally avoid them.
Flax seeds and the hemp protein I do very well on.
So there’s nuance even with the Paleo-AIP approach. At least for me. It’s a template that should guide choices like anything else.
But the ultimate authority is you and your own body and the testing you do with various foods and eating styles.
It doesn’t surprise me that you’re struggling when you remove fiber.
I don’t do well on no fiber, though for me my stools are too loose and unformed without a huge fruit and fiber smoothie every day. As my first meal of the day.
I don’t do well at all on any kind of gluten-free grains. They pretty significantly damage my gut still. Even in a smaller dose.
For UC and Crohn’s I suggest totally avoiding all gluten-free grains. I don’t think you can fully heal without removing all grains. I still don’t tolerate gluten-free oatmeal too well. I’m not sure I’ll ever be able to eat any grains again, though I suspect I’ll try every year or few, just to see. If anything, I may be able to get away with a gluten-free thing or two in five years or so. Maybe.
Good luck, man. Keep in touch.
Adam