Why Bad Bacteria Kills the Good Bacteria in IBD Patients' Guts

Photo from http://www.ucdmc.ucdavis.edu

Earlier this month, the UC Davis published research in an article linked here.  The bottomline is that nitrates in the gut allow bad bacteria to kill off the good bacteria in the gut, which causes inflammation (causing a vicious cycle we're all familiar with).

Here are some key bits and bites:

• "IBD begins when “good” bacteria are mistakenly killed by the immune system, while harmful bacteria multiply — resulting in inflammation and damage to the intestines"

• "The researchers found that potentially harmful bacteria in the intestine called Enterobacteriaceae use nitrate — a byproduct formed during the intestinal inflammation in IBD — to grow and thrive. Enterobacteriaceae strains include certain E. coli bacteria, which can worsen the intestinal damage of IBD. Eventually, the intestines of those with IBD become overrun by harmful bacteria, and the numbers of normal good bacteria in the gut decrease."

While this doesn't have immediate results for us (I guess we could avoid food with nitrates, but I doubt many of us indulge in those anyway), this does seem like promising progress for treatment.  And perhaps it's another argument for frequent use of probiotics.

"Ancient Chompers Were Healthier Than Ours"

I found this article on NPR interesting in its own right, but it's also interesting as it may connect to IBD.

• "Researchers found that as prehistoric humans transitioned from hunting and gathering to farming, certain types of disease-causing bacteria that were particularly efficient at using carbohydrates started to win out over other types of "friendly" bacteria in human mouths."

I can only think a similar process happened in our guts.  As we consume more sugar and processed carbs, the "friendly" bacteria in the gut is overrun by the new, disease-causing bacteria.

The article goes on to discuss the resulting oral problems:

• "...that's a problem, because the dominance of harmful bacteria means that our mouths are basically in a constant state of disease. [One researcher commented:] 'You're walking around with a permanent immune response, which is not a good thing.  It causes problems all over the place'. "

Sounds a lot like IBD to me.

The author of this article hints that this supports the Paleo Diet, and likewise, the way I see it, this also supports the use of the Specific Carbohydrate Diet to treat IBD.

A Prednisone Rant

 I would like to toss these out the window. 

But, realistically,  I'll probably need to take them again soon.

Over the course of the last four months, I've been tapering down oral prednisone.  I started at 40mg (on the IV at the hospital), and then transitioned to 40mg orally.  Over the course of many weeks, I tapered by 5mg (sometimes stalling to get blood under control).

I was on 5mg every other day for two weeks, and now I'm off completely.  (However, I still take Cortifoam and Hydrocortisone enemas, so prednisone is technically still getting in there.)  And I'm still on 80mg (two pens) of Humira every week.

Things aren't perfect.  I still see some blood and mucus daily.  But I'm hoping the enemas keep things under control (or maybe even alleviate the symptoms I'm seeing).

In the past year, I've been on high doses of prednisone for 8 out of the 12 months.  And it's taken its toll.  Here is my rant:

What I love about prednisone:

1. It lets me keep my colon inside my body.

What I hate about prednisone:

1. Fatface.  Sometimes it gets more dramatic than others, but I always get a voluptuous double chin and some truly lovely jowls.  Sexy.
2. Hairiness.  Holy fuzzy fatface!  And then when I taper (ie. right now), the hair on my head falls out in disturbingly chunky hand fulls.  You should see my shower walls, sinks, laundry lint filter, vacuum...
3. Insanity/complete lack of patience.  Looking back now, I regret the rage that almost everyone in my life (and some random strangers) were subjected to.  At the time, I was sure that they were the ones who were crazy.  Oops.
4. Insomnia. Who needs sleep when you can lie in bed thinking about all the things to be anxious about?
5. Total exhaustion when tapering.  Not sure how much of this is pregnancy related, but whooooooa...I'm tired. Maybe it's just that I'm not fueled by all that rage and anxiety anymore?

I'm sure I'll be back on oral prednisone sometime soon, but I'm crossing my fingers to get through delivery without a relapse. (Yes, I can hear the universe laughing.)

Baby Blanket Knitting Project

This isn't mine (it's from www.thecakeplate.blogspot.com).  

But let's hope mine eventually resembles this.

In case any of you are knitting for baby...

As our baby is arriving in, at most, 9.5 weeks, I decided to commit to a knitting project.

I like this cable blanket pattern: I have a penchant for cables and it's easy to memorize.  In other words, it's easy to knit while watching crappy tv.  This is a common theme, but due to my laziness, I used yarn that I already had at home (Blue Sky worsted weight organic cotton) and opted for larger needles (size 11).  This is giving my blanket a much looser gauge, but since he's basically a summer baby, this is okay with me.  Though, if I were to choose for aesthetic reasons, I'd probably opt to follow the pattern more closely.  I also don't love using cotton yarn for cables, but hopefully it comes out alright.

Anyhow, the pattern is very well written, and I highly recommend it for anyone looking for a very simple yet satisfying project.

UPDATE: I ripped out that stretchy, cotton yarn and bought a merino from Malabrigo (606 Frost Gray). What's the point of dedicating hours to a project that's going to turn out sub-par? Also using size 9 needles now. Much happier so far.

A Sweet Pastry: Hamantaschen

Hamantashen! With pregnancy on the mind, I can't help but think these could also be viewed as Uterus Cookies (sorry, sorry...gross, I know...)

This week is the Jewish festival of Purim.  There's a whole story behind this holiday, but basically it means children in costumes, rowdy adults, and delicious stuffed pastries called Hamantaschen.

I was hesitant to even try an SCD recipe for Hamantaschen because I grew up with my mom's insanely addictive creamcheese-based version.  But, alas, almond meal pastries are better than no pastries.

And, what a relief, these are actually very good.  Even if you're not Jewish, you'll appreciate this yummy cookie-like pastry.

This is also a good basis for any pastry recipe.  I'm super uptight about eating only well-done eggs and meat while pregnant, but I was so tempted by the amazing smell of this raw dough, I almost tasted it.  That doesn't happen often with SCD recipes.

Here's the original recipe.  I followed it fairly closely (just added cinnamon--which was actually pretty important to the final flavor. I also disregarded the egg wash instruction).

Ingredients:

• 2 1/2 cups of almond flour
• 1/2 teaspoon of salt
• 8 tablespoons of unsalted butter, cold and cut into pieces
• 1 egg
• 1 tablespoon of vanilla
• 2 tablespoons of honey
• about 1 cup of fruit preserves or other filling of your choice (I like Fiordifrutta because they don't add sugar.  It's surprisingly hard to find preserves without sugar added!  But there is pectin, which is illegal on SCD.  You could use fruit or berries if you're being strict.)
• 1/8 teaspoon of almond extract 
• cinnamon to taste (for sprinkling)

Directions:

1. Pulse all the ingredients in a food processor, until most of the butter is dispersed in well. Aim for all butter bits to be pea-sized or smaller.
2. Place the dough into a big piece of plastic wrap and roll it into a log. Freeze for about 15 minutes.
3. Preheat your oven to 350 degrees F. Take the dough out and slice a circle off the end of the dough roll.
4. Place the circle on parchment paper on top of a cookie sheet. Place about a teaspoon or so of filling in the middle and then fold the dough around the filling into a triangle. Repeat for each pastry.
5. Make sure to pinch each corner so that the pastries don’t open up when baking. This step is really important.
6. Optionally, you can wash the pastry edges with egg wash. I don't love egg wash on almond meal because I think it turns a little gummy, but it's your choice.  It will be prettier.
7. Sprinkle all pastries with cinnamon, for appearance and taste.
8. Bake the pastries for about 15 minutes, or until they start to brown around the edges.
9.  Cool well before removing from baking sheet.

Check Your Fridge: Spinach Recall

Hello, fellow immuno-suppressed folks.  Look out for E.coli contamination with this spinach recall from Taylor Farms.

According to the Huffington Post article:

• The spinach that is being recalled is being sold in 5-oz and 16-oz trays under the following names: Central Market Organics, Full Circle Organics, Marketside Organics, Simple Truth Organics and Taylor Farms Organic. All the recalled spinach has a "best by" date of February 24, 2013.

If you have that spinach in your refrigerator, toss it.

Everything Crackers

 These crackers are delicious enough to eat alone, 

but they're also great vehicles for all sorts of dips.

I miss everything bagels.  Is there anything as satisfying as that salty, oniony mix?  With a small tweak to this cracker recipe, we can (sort of) replicate that taste.  Plus this is a good cracker recipe to accompany dips and soups.  (I'm making Amy's Split Pea soup tonight and wanted some crackers to go with it.)

Also, I doubled the recipe.  Why not have some extra crackers around the house?  Here's the original (undoubled) version:

Ingredients:

• 2 cups of blanched ground almond flour
• 1/2 teaspoon of sea salt
• 1 large egg
• 1 egg white in a bowl with a brush
• 1 tablespoon of olive oil
• 1 tablespoon of poppy seeds
• 1 tablespoon of sesame seeds
• 1 tablespoon minced, dried onion
• coarse salt to sprinkle on top of the crackers

Directions:

1. Preheat oven to 350.
2. Combine the flour and salt in a bowl and mix.
3. Add the egg, minced onion, and oil, and mix.
4. Shape the mixture into two balls of dough.
5. Place each dough ball on a non-stick baking mat (I used silpats), then place a piece
   of parchment paper (or other non-stick mat) over the ball and roll the
   dough into a thin layer.
6. Brush the top of the cracker sheets with egg white, and then sprinkle
   the seeds and coarse salt evenly over each sheet.
7. Score the crackers with a pizza cutter.
8. Bake for about 15 minutes, or until they start to lightly brown.
9. Cool for about 15 minutes and break apart into crackers. 
10. Store in a sealed container. (I actually might leave my tupperware unsealed to avoid the gumminess that seems to overwhelm everything almond flour-based.  But I'm planning on eating these pretty quickly.)

These are actually better than many of the store bought gluten-free options (and we can't eat those on SCD anyway).  

"Just Try Them!" Carrot Pancakes

This photo is from www.glutenfreehappytummy.blogspot.com because hers were much nicer looking than mine.  I didn't drizzle pureed strawberries; I nuked frozen berry medley and slopped them onto the pancakes. Still tasty.

This morning I asked my husband if he wanted pancakes, and he was initially intrigued.  But then he walked over, took a look at the batter, and said, "UGH! No!"

So they look really...healthy.  But start cooking them, and you'll see they're more like donuts.  My guy still won't try them, but if you give them a chance, I think they'll impress you.

Here's the original recipe which I didn't change much, but I did double it. Hey, I'm hungry.

Ingredients:

• 2/3 cup almond flour
• 6 carrots, grated (I bought pre-grated carrots, used 5oz.  Definitely worth the short cut!)
• 1/4 tsp salt
• 2 tsp cinnamon
• 1/8 tsp (more of a sprinkle) cloves
• Pinch of nutmeg
• 1/2 tsp baking soda
• 1 tsp pure vanilla extract
• 1 tsp honey
• 4 egg whites 
• Frozen berries of your choice

Directions:

1. If you're not as lazy as me, and you didn't buy pre-grated carrots, grate your carrots. Place them in a clean kitchen towel and wring out the excess liquid. 
2. In a medium-sized bowl (I used a standing mixer), whip your egg whites until they form nice peaks. 
3. In a separate bowl, combine your grated carrots, almond flour, spices, and baking soda. 
4. Fold your dry ingredients into the egg whites.
5. Add vanilla and honey.
6. On medium high, melt butter on a frying pan or griddle, spoon pancakes onto cooking surface. Cook for 2-3 minutes a side, until golden brown.  Watch out--they burn quickly!
7. Microwave your berries for about a minute and thirty seconds, til their warm.
8. Pour berries (I include some juice too) over pancakes.

Sugarless Fudge

 For the record, this recipe isn't SCD legal (we can't technically have cocoa).  But the third trimester is "first trimester"-ing my taste buds. 

Suddenly all I want are carbs and sugar again, and it's doing a number on my will power.

I've been trying to limit my sugar intake, but I have been cheating here and there (especially when my husband and I go out to dinner...the dessert menu is my Achilles' heel).  As a result, I am beginning to flare again, seeing blood daily.  (This should give you an indication of how crazy these sugar cravings are.  Even with the fear of a flare, I'm still cheating; I cannot control myself!)

So I tried out this less evil recipe today, and it's pretty good.

As I often say with recipes like this, if you don't expect real fudge, it's great.  Definitely not real fudge though.

Ingredients:

• 1/2 c. coconut oil (melted)
• 1/2 c. cocoa powder 
• 1/2 c. almond butter
• 1/4 c. honey
• 1/2 teaspoon vanilla extract (alcohol free)

 Directions:

1. Mix all ingredients together in a blender/Cuisinart
2. Spoon mixture into muffin tins with silicone muffin liners, filling each about 1/3 of the way.
3. Refrigerate for 30 minutes or freeze for 10 minutes.
4. Store in the fridge.

Ready-to-Eat SCD Lunches

Here are some of my go-to (almost) ready to eat SCD lunches.

• Avocado, filled with low mercury tuna (when not pregnant), or organic canned chicken breast (for these past 7 months), topped with ground pepper.

• Applegate Farms Organic Beef Hot Dogs.  I use mustard and dill pickle relish as condiments. Sadly, no bun.

• Paleo Bread (coconut) sandwiches.  I recommend toasting the bread to mitigate the gumminess.  I usually make either...
• Toasted, with peanut butter and bananas or thinly sliced apples OR 
• Toasted, with one fried egg and a slice of cheddar cheese (toast the bread with the cheese on it before sliding the egg on).

There you go.  My super quick, "I don't have time for homemade sh**!" lunches.

Store Bought SCD Snacks

Following Specific Carbohydrate Diet makes me yearn for the days when I could just microwave a ready-made meal.  We have to make absolutely everything from scratch.

That's fine for dinner, but sometimes I just want something quick and easy--and portable.  Seems like every granola bar (even gluten free) has rice, sugar, or agave syrup in them.

These are a couple options I've found that don't have verboten ingredients:

• Larabars are made of just dried fruit and nuts.  Some flavors are better than others. My faves are Peanut Butter & Jelly and Cherry Pie.  They're the most filling granola-like bar I've found.  

  

• "That's It" bars are made of just dried fruit.  They're sweeter than Larabars, and pretty good.

• I wouldn't classify this next one as a granola bar, and they're not filling at all, but they satisfy my sweet cravings because they kind of taste like fruity gummy candy.  Stretch Island Fruit Co.'s fruit strips are about 80% as delicious as fruit roll-ups.  Which is pretty decent.

Crispy Kale

Always hearing that kale is so healthful but not sure how to make it appetizing?  Cover it in salt and oil!

Ingredients:

• One bunch of kale
• Olive oil to taste (about 2 T., but it depends on how much kale you're using)
• Kosher salt to taste (Use a little less than you think you'll want--it gets overly salty pretty quickly.  I'd say use no more than 1/4 teaspoon.)

 Directions:

1. Preheat oven to 400.
2. Rip the kale off its stems into bite-sized pieces.
3. Toss kale with olive oil and salt (like you're tossing a salad).
4. Lay kale on a baking sheet.  
5. Bake for 10 minutes, until the edges are looking crispy.

I serve this as an easy side dish, like a salad. 

If you lay the kale in a single layer on the baking sheet and bake it a few minutes longer, the pieces will bake into a chip-like consistency, which is also pretty good.   

Mmmm, salt.

Coat anything with egg wash and kosher salt, and I'll eat it.

The toughest time to follow SCD?  3pm.  Craving a snack, and who wants ANOTHER piece of fruit?  Here's a snack that is almost as good as its real world counterpart: almond flour pretzels.   

The link to the original recipe is here.  I followed it pretty closely, and it turned out well.  You won't trick anyone into thinking it's a real pretzel, but it's still a good substitute.

Ingredients:

• 3 eggs, divided use
• 1-1/2 cups almond Meal Flour
• 1/2 tsp. salt
• 1 T. butter 
• 2-3 T. coconut Flour
• 1 teaspoon water
• coarse salt (I used kosher salt since that's what I had.)

Directions:

1. Beat 2 eggs, and set them aside.  
2. In a separate bowl, add the almond flour, salt and butter together and mix well.  Into this mixture, pour and mix the beaten eggs.  
3. Add in one tablespoon of coconut flour and mix in well. Allow coconut flour time to absorb before adding any more.  You are looking for a dough that can be easily kneaded, yet will not stick to your hands.  Add a second tablespoon of coconut flour (and a third if necessary), aiming for a play-doh-like texture.  
4. Let the dough rest for five minutes.  Preheat oven to 350°F.   Line a cookie sheet with parchment paper, a silpat, or liberally grease it.
5. Take a ball of dough about half the size of a golf ball, and roll the dough on a flat surface into a long skinny rod about the length of a pencil.  Keep the dough uniform in thickness.
6. Carefully lift the long skinny piece of dough to the cookie sheet.  Twist it carefully into the shape of a pretzel (or whatever shape you'd like!)
7. Place the pretzels in the oven and bake for 10 minutes.  
8. Beat the remaining egg and add 1 teaspoon water.
9. Remove the pretzels from the oven. Turn the oven up to 400°F.
10. Turn all of the pretzels over and you will see the bottom is browned.  This is the top of your pretzel. Lightly brush with the beaten egg and sprinkle with coarse salt.
11. Return to the oven for 5 minutes.

Bio-K: Conveniently Packaged Probiotics

$5 worth of health in this little bottle?  I hope so!

The Crohn's/Colitis board on Babycenter is a wonderful community and its members offer a wealth of information and support.  One of those members recently mentioned a probiotic I'd never heard of: Bio-K.

Today I'm tapering off Prednisone. (Well, 5mg every other day for two weeks, then nothing: that feels like practically being "off".)  Nervous without my drug crutch, I ran to Whole Foods this morning for a probiotic fix.   

Since this was the first day I tried it, I don't know if it works yet.  But I really hope Bio-K prevents flare symptoms, because it's got two strikes against it:

1. It's very expensive.  $30 for a 6-pack.  Yikes!
2. I don't love the taste of plain yogurt.  And it's kind of...chunky.  

 But the word on the Babycenter board is that the probiotics in Bio-K are more powerful and effective than in the SCD yogurt, so I'm giving it a shot.  (Though the yogurt has worked for me, so I may just stick with that in the long run.)

Let me know if you've had any experience with Bio-K (or if you've found a cheaper source)!