I Be a fooDie recently had the unique opportunity to communicate with fellow Crohnie, Damion Moyer. While Damion has been struggling with symptoms of Crohn’s Disease throughout his life, he was officially diagnosed with the disease this past summer. In an effort to maintain his health, Damion has committed himself to following the SCD Diet (Specific Carbohydrate Diet). Below, you can learn about the diet and about Damion’s journey with SCD.
If you are interested in following Damion visit “My Cranky Gut” at http://mycrankygut.wordpress.com/.
When reading this blogpost, please remember that diets work differently for everyone. I Be a fooDie encourages individuals to experiment with foods and diets on an individual basis to discover personal trigger and comfort foods. The information that we present is for education purposes only. Happy reading!
Q: How and when were you diagnosed with Crohn’s Disease?
A: That’s kind of a funny story, actually. In June of this year (the 17th, to be precise), I started feeling sick… feverish and weak, with an ache in my lower right abdomen. The next day, the ache turned into a pain, and on the morning of the 19th, it was excruciating enough that I was convinced I had appendicitis. I checked in to the local ER where they poked and prodded me until they were convinced I was a hypochondriac. After a CT scan, they confirmed it… “Congratulations!”, the ER doc said, “You’ve just won yourself a few days in the hospital!”. Preparations were made and within a few hours, I was being prepped for a laparoscopic appendectomy. Once I was coherent enough to talk afterwards, the surgeon had some interesting news for me. Rather than a simple laparoscopic removal, he’d had to cut me wide open because what he found was a ‘softball-sized’ mass of inflamed gut, and he’d had to perform a hemicolectomy, with iliectomy. He never could find my appendix… it had been completely absorbed by the inflamed tissue! All told, he had removed my entire ascending colon and the last 6” or so of my small intestine. It took a couple of days for the pathology lab to finish their work. They determined it was Crohn’s.
Q: How have your symptoms affected your daily life?
A: Now that I’m aware of my condition, it’s easy for me to look back all the way to childhood and see that I’d been experiencing symptoms for nearly my entire life. As a kid, I would spend many hours in the bathroom, in tears as it felt like my guts were leaking out my bottom. I complained to my parents about it, but we never got much traction with my pediatrician, so it pretty much just went untreated. I came to believe that this was just how guts worked, and that my experience was normal. Over time, I learned to avoid certain foods, which helped, but never entirely took care of it. Interestingly, the older I got, the less severe my symptoms became. By the time I was old enough to advocate for my own health care, I just figured that I had a cranky gut. It was sometimes uncomfortable, but it never felt unmanageable. It wasn’t until my crisis flare this year that I remembered just how miserable I had been as a child.
Q: At first, how did you manage your symptoms?
A: Grin and bear it. It wasn’t until my crisis this year that I came to think of my gut issues as a ‘thing’. Up until then, I just avoided stuff that I thought might make my tummy upset.
Q: How did you found out about the SCD diet?
A: My wife, Diana, works in a clinic specializing in natural medicine. She came home one day excited about a new doc that had started there. Dr. Siebecker specializes in treating and managing SIBO (Small Intestine Bacterial Overflow). After talking with her, Diana thought that the symptoms of SIBO sounded an awful lot like what I was dealing with and inquired as to treatments for it. There are 3: Specialized antibiotics, 2-3 weeks on an elemental diet, or long-term adoption of the Specific Carbohydrate Diet. Eventually, I scheduled an appointment with Dr. Siebecker to investigate whether or not I actually had SIBO. Ironically, I’m staunchly convinced that it was the lactulose breath test used to diagnose SIBO that put my Crohn’s into overdrive and me into the hospital.
Q: What in particular attracted you to the SCD diet?
A: There were a couple of reasons that I felt like SCD was a good option for me. For one thing, although I had to cut out many of my favorite foods (bread and rice, in particular), there was the ‘consolation prize’ of being able to continue eating many other foods that I really like (meat of any kind, fish, etc). Also, the sheer volume of anecdotal evidence out there that shows that SCD really is an effective tool for many people, allowing them to achieve and maintain remission of their IBD.
Q: Had you tried different diets before?
Q: Can you provide a brief overview of the SCD diet?
A: The core tenet of SCD is based on the premise that IBD (and Celiac) are correlated with gut flora dysbiosis, or an imbalance in the intestinal bacteria. The thought is that the immune system detects this imbalance as an infection and attempts to fight it. In so doing, it coats the intestine with mucous. This causes the gut to be unable to process certain types of carbohydrates, and since these carbs are going unprocessed, they are available as food for the unbalanced bacterial colonies, which makes the imbalance greater, which makes the immune system more active, which makes the gut less able to process foods, which feeds the bugs…. you get the idea. So the idea behind SCD is to starve out the unbalanced colonies in order to restore balance, thereby allowing the immune system to stop inflaming the gut.
I mentioned earlier that the gut becomes unable to process certain types of carbohydrates. So the main idea behind SCD is to stop eating carbohydrates that the injured gut can’t process. What does this mean in the kitchen? The only permissible carbohydrates are honey and the sugars (fructose) that occur naturally in fruit. Starches are forbidden, as are anything with sucrose. Processed fructose is also forbidden. Fruit carbs are allowed only because, in addition to the sugars they contain, fruits also have the necessary enzymes to process those sugars. All grains of any kind are disallowed…. no rice, no wheat, no barley, no quinoa, etc. Also, since dairy products contain lactose, another forbidden sugar, the only permissible dairy products are ones that have been cultured long enough to ensure that the lactose has all been removed.
That’s a pretty high-level summary, and I probably left some crucial stuff out. The official source for information on the diet is the book, Breaking The Vicious Cycle, by Elaine Gotschall. I’d highly encourage anyone struggling with IBD, celiac, SIBO, or pretty much any autoimmune issue to at least read the book. If what you read makes sense to you, give it a try… you have nothing to lose, after all!
Q: How soon after you started the SCD diet did you feel better?
A: It’s important to bear in mind that at the time I started the diet, I had just had all my inflammation surgically removed, so I was technically in remission already. My experience was that I felt pretty good the day before I started it, but spent the first week on SCD feeling like hell. This is normal and to be expected. There’s a lot of die-off occurring in the gut and it’s bound to make one feel a bit off. After the first week though, I started feeling a lot better, and I now that I’ve been following it for about 6 months, I feel awesome! Better than I ever did before!!
Q: Do you feel the SCD diet has contributed to your improved management of Crohn’s Disease?
A: I do. I can’t prove that it’s had an effect one way or the other, but I feel healthy, my moods are more stable, and I’m dealing with stress a lot better (and we all know how important stress management is!). I attribute this all in large part to SCD.
Q: Do you recommend the SCD diet for everyone, or to any specific sub-population?
A: My feeling is that anyone dealing with autoimmune issues ought to at least give a chance. Follow the diet for a year. If it doesn’t work for you (and there are people who say it doesn’t), what have you lost? But if it DOES work for you??
Q: What is a typical SCD-diet day like?
A: Once you get past the shock of what you CAN’T have, it’s amazing the kind of delicious foods you can make out of the things you can!
For breakfast, I’ll typically have either a bowl of granola (roasted nuts and dried fruits) with yogurt (SCD yogurt is key! Lots of good bacteria!), a fruit smoothie, or maybe some scrambled eggs.
Lunch is usually a portion of something we made over the weekend along with a piece of fruit, some sliced cheese, maybe an apple with some peanut butter.
Dinner is where I get the most variety. Last night I had a big plate of roasted spaghetti squash with butter, garlic and Parmesan. The night before that it was baked tilapia fillet with lemon juice, olive oil and thyme, served with steamed green beans.
Q: Do you find it difficult to adhere to the SCD diet?
A: Some days are harder than others. It seems to me that difficulties with SCD-conformance fall into two categories: Convenience, and Habit.
Convenience is a real problem with SCD. If you’re used to eating food that is convenient, you’re going to have serious difficulty. Pretty much all convenience food has some problems with it. It’s made using flour or corn, it’s highly processed so you can’t really know what’s in it, and it’s often got ‘modified food starch’. The only food you can really trust is food you’ve made yourself from simple ingredients, and if you’re going out to eat, you have to ask a LOT of questions! Do they make their own salad dressing? Does it have any corn syrup, sugar or food starch in it? Do you marinate your steaks? If so, what’s in the marinade? You get the picture. I find that the more expensive a restaurant is, the more willing and able they are to answer my questions, but even then, you’re taking your chances.
Habit can also be a real challenge. Over time, we’ve all developed our routines for dealing with life. Food is no exception. There are foods we eat when we’re happy, foods we eat when we’re sad, or when we’re starving. There are foods we’ve come to think of as delicious and satisfying and foods we’ve come to think of as unappealing. All of this has to get thrown out the window. It is both a challenge and an opportunity, but the only way to follow SCD is to throw out all the old rules and start over again. Pizza and a beer is something I’ve always come to associate with the accomplishment of a hard day’s work. Nope… not legal. I love a cheeseburger on a Sunday afternoon. Again, nope. It becomes incumbent upon the SCD’er to make new rules and to build new habits. Easier said than done, to be sure, but if you don’t do it, if you just continue to hold the old rules dear and then deny yourself, you’ll go crazy!!
If there is one key to successful adoption of SCD, it’s preparation. I spend a lot more time in the kitchen now because it’s imperative that I always have some prepared food in the house. Hunger is a different experience for me now, and when it hits, IT REALLY HITS! So I use the slow cooker and make huge amounts of delicious food to put in the fridge and the freezer, I preserve foods so that I don’t have to make them from scratch when I need them. And I never, NEVER leave the house for more than an hour or so without something in my bag to eat… a Lara bar, a baggie of granola, SOMETHING! If you get caught out on a long day with nothing to eat, you will be overly tempted to cheat.
Having been on this diet for a while now, I usually don’t have too much difficulty sticking to it, but every once in a while, I’ll see an ad for a crappy fast-food cheeseburger and feel pretty wistful!
Interested in trying out the SCD diet? Here is a tasty recipe from Damion:
Chicken Stew with Preserved Lemon and Olives
1 Tbl ground cumin
1 Tbl ground coriander
1 Tbl almond flour
1 tsp salt
1 tsp ground black pepper
4 lbs chicken pieces, skin removed
2 onions, diced
2 cloves garlic, minced
½ cup white wine
1 ½ cups SCD legal chicken broth
Juice and finely grated zest of 1 lemon
1 preserved lemon, diced**
¼ cup fresh Italian (flat-leafed) parsley
½ cup pitted kalamata olives, coarsely chopped
Stir together spices with almond flour, set aside.
Heat olive oil in large skillet, preferably stainless steel, over medium-high heat. Brown/sear chicken pieces, in batches, about 3 minutes per side. The skinless chicken will stick to the pan a bit, this is okay – it will develop the flavor of the dish in lieu of the fact that the chicken is not dredged in flour. Place seared chicken in crock pot and cover.
When all the chicken has been cooked, add more oil as needed and sauté the onions until the bottom of the pan is quite brown and the onions are translucent. The onions will not caramelize with the chicken bits stuck to the pan. When a rich color has developed, turn heat down to medium-low add a tad more oil and stir in garlic and spices. Keep this moving in the pan so that the spices don’t burn, and when everything is aromatic, deglaze the pan with the white wine and chicken stock. Turn heat up to high, scraping the browned bits off the bottom of the pan while mixture comes to a boil.
Once boiling, add to the crock pot. Add the lemon peel and preserved lemon pieces to the crock pot, cover and cook on low for 4-6 hours, until chicken is falling apart.
Gently lift chicken pieces out of the crock pot, placing on platter. Stir in lemon juice, parsley and olives into the sauce, then spoon over chicken to serve.
**If you can’t find preserved lemons in your area (specialty grocers with Mediterranean items will be your best bet), you can order them from Mustapha’s Moroccan, http://www.mustaphas.com or Zamouri Spices, www.zamourispices.com. Alternatively, you can make a reasonable substitute by cutting a lemon into ¼ inch slices, sprinkling both sides generously with kosher salt. Let sit for 1 hour. Rinse before using.
Recipe adapted from: The Art Of The Slow Cooker, by Andrew Schloss