Posted 7/16/2015 7:12 AM (GMT -7)
I've done research on multiple facets of Crohn's disease and the more I look at different approaches and therapies, IF looks like it's all inclusive and touches on so many of them, I think it's a really promising way to maintain health of the gut.
Intermittent fasting is generally taking in 0 calories for a certain portion of the day, usually with a 5-8 hour feeding window. Some go beyond a 24 hour rotation but chance of health complications due to things like electrolyte imbalance increase over time, I'm not going to suggest anyone do that without a doctor's supervision, while a standard 8 / 16 split is safe and by my experience effective.
Lets just get the obvious out of the way, bowel rest of course, but that's, in my opinion, not even the most important factor.
In the gut of every crohn's patient is likely an overgrowth of harmful, invasive bacteria, and too few of the healthy bacteria we need to properly produce SCFAs and digest food to keep our colon healthy.
It's theorized that many of these invasive bacteria are allowed to thrive in our gut by over-feeding and bad diet. Over feeding leads a series of events like oxidative stress which can negatively impact our oxygen-phobic natural gut bacteria like the bacteroidetes and clostridia strains that are so important to us.
In a fasted state, we promote the starvation of harmful upper GI bacteria that aren't naturally found in high concentrations in a healthy gut, it seems likely that they've been provided the means by which to survive by a combination of factors including diet and inflammation and improper function of the gut via Crohn's. This is a cyclical process, they thrive in the environment caused by inflammation, causing more inflammation and allowing them to thrive better.
We know however that after a fast or a dose of antibiotics, many of the other gut bacteria aren't able ot survive, but certain Bacteroidetes strains feed on the mucins of the gut, producing SCFAs as a biproduct and stimulating healing of the colon.
There's a risk of loss of other good bacteria strains like clostridia and bifido, I wish there was testing to determine to what extent, and if the food taken in the 8 hour feeding window is enough to maintain them.
It's important to realize that our gut bacteria are extremely co-dependent though and that bacteroidetes may be able to feed the others.
Hand in hand with bacterial load is evidence of insufficient protease deactivation in Crohn's disease. Bacteroidetes is implicated as one of the primary bacterias in deactivation of protease enzymes in the large bowel. Protease is the enzyme produced by the pancreas responsible for breakdown and digestion of proteins. Normally it would be deactivated in the large bowel by the native gut bacteria, but studies suggest Crohn's patients insufficient bacteria load may fall short of this capacity.
By reducing the frequency and amount of protein we consume we gain a better chance of recovering from the harmful effects of protease on our gut, as well as giving the bacteria responsible for shutting the protease off a chance to repopulate.
Some of you may have heard of Dr Stein's amino acid therapy for neurological symtpoms being used to treat Crohn's and Colitis, some members of this bored have undergone his therapy with mixed success rates.
During a fasted state your gut up-regulates seratonin production, but your body also floods with catecholamines stimulating you with a level of alertness and focus naturally wired to increase our chances of finding food.
The interesting thing is that Dr Stein's therapy basically applies the same concept - an increased dosing of catecholamine producing L-tyrosine, seratonin producing 5-htp, plus dietary cofactors in high doses.
While in a fasted state the body releases the stress hormone cortisol which is our natural anti-inflammatory & immune suppressing hormone.
While in a fasted state the body up regulates apoptosis, or cell death, including those of the macrophages in the gut. It's believed that pathogens associated with Crohn's like AIEC and MAP reside in macrophages due to an inability for Crohn's patients to properly regulate cell death. Vitamin D combined with fasting and possible aloe vera juice can up regulate this cell turnover rate to help evacuate these pathogens from the body.
My personal experience
I experimented with IF for 2 weeks. During this time I experienced mixed feelings but a general improvement in feelings of well being. My bowel habits normalized, pain, discomfort and diarrhea were greatly reduced, and mental state was greatly improved.
The most noticeable side effect was low energy levels and occasionally feeling cold (probably for the same reason). Arguably both were the result of failing to consume sufficient calories during the 8 hour feeding window, which is what lead me to discontinue the therapy in pursuit of alternatives.
Also at the time I wasn't consuming sufficient prebiotic foods to keep up my health gut flora during the fasted state.
I plan to revisit IF soon with some of my knew dietary protocols in place.