For most of us, keeping an eye on our diets means trying our best not to gorge on all the leftover Halloween candy in one night or limiting the number of Big Macs we eat each month. But for people with Irritable Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis, and gluten therapy-resistant Celiac disease, controlling diets can become a lot more complicated.
The Stowaways in Our Body
To answer this question, we need to look toward the little organisms that call our gut their home. Our digestive system houses a microbiome that contains a rich ecosystem of bacteria. Don’t worry, most of the bacteria in our gut are harmless and help us digest food. These bacteria happily coexist in balance with one another… until trouble comes along.
Problems, like the conditions above, arise when the microbiome gets out of balance due to an overgrowth of specific species in the intestinal flora. This can happen when certain foods we eat don’t get properly digested. Patients can counter this overgrowth by adjusting what they eat. Restoring balance to the microbiome can have a major effect in improving quality of life and relieving symptoms.
The Specific Carbohydrate Diet
While there are many different diets you can try to coax your microbiome back under control, the ones that succeed vary depending on the person. It may be necessary to try many different diets before finding one that works.
One of the diets you can try is the Specific Carbohydrate Diet (SCD). It involves eliminating from your diet all carbohydrates except monosaccharides, seeing if that makes any difference in your symptoms, then adding non-monosaccharide-containing foods back one at a time and tracking how these challenge foods affect your symptoms, health and well-being.
While this diet is a bit less researched and harder to follow than the low-FODMAP diet, we will see that it is still a worthy alternative with a long history of improving the health of patients.
How It Works
How does the diet help patients? First, there are two kinds of carbohydrates:
- Simple carbohydrates (monosaccharides), single sugar molecules
- Complex carbohydrates, which are made up of two or more sugar molecules linked together (disaccharides, oligosaccharides and polysaccharides)
Once complex carbs are in our gut, things can get complicated because they are harder to digest than monosaccharides and remain in our gut longer than optimal (poorly or unabsorbed). These undigested carbs then feed bacteria that can digest them, which leads to microbiome imbalance and symptoms such as diarrhea, cramps and gas.
“Sustained clinical remission was seen in 6 of the 7 patients who remained on the diet to 52 weeks, with none of the patients requiring medication change or dosage adjustment.”
This is where the diet comes in: Limiting complex carbohydrates may stop this malabsorption, bacterial overgrowth and downstream byproducts that lead to inflammation of the intestine wall and other more serious symptoms, such as leaky gut and immunological stress.
SCD cuts out and restricts very common foods:
- refined sugar
- all grains
- many starchy vegetables
- most dairy (home-made yogurt, being predigested by its own bacteria, is an exception)
- canned and processed meat
Allowed foods include vegetables (not canned), fruits and juices, nuts, oils and natural cheeses and meats.
Even for the expert dieter, SCD can be a challenge, but it is worthy of your efforts. Multiple studies present it as a potential noninvasive way to help patients with gastrointestinal conditions get back on their feet. One study looking at SCD in pediatric patients with Crohn’s disease reported sustained clinical remission and mucosal healing, while another showed SCD to have a positive effect on both symptoms and inflammatory markers.
Because of the limited nature of SCD, one thing to note is its effect on total energy intake which can result in suboptimal weight gain and growth in children. However, with close monitoring of the child’s growth it would not pose as much of an issue for a conscientious adult.
“I have had flare-ups, once or twice a year, but although the same symptoms recur, they’re less frequent, less extreme and less debilitating.”
Don’t Let the Decrease in Energy Intake Deter You from Trying
SCD can and has made a difference. One woman living with ulcerative colitis was managing her symptoms through medication, even though they carried the risk of eventually becoming ineffective and leading to colon removal surgery. If not for developing a stubborn cough, that did not go away despite medication, she would never have tried SCD. Immediately, her cough disappeared within days, while her symptoms were less frequent, extreme, and debilitating. After a few months, she completely ended her reliance on medication.
In another case, a high school football player suffering from inflammatory bowel disease also attempted to manage his symptoms with a myriad of medications, but suffered from a gamut of side effects. By switching to SCD, he was able to limit the symptoms and pain associated with his disease without having to deal with the negatives of medication.
Getting Started
The best way to start would be to read Breaking the Vicious Cycle: Intestinal Health Through Diet, the go-to book about the diet written by Elaine Gottschall, the biochemist who popularized the diet. It is particularly useful for the SCD beginner with its introductory recipes.
For more recipes, check out these two popular SCD cookbooks.
Don’t forget to keep a food diary!
With the huge list of things you can and cannot eat, maintaining a journal is vital to tracking your journey. As you eliminate foods, your food diary will be essential to seeing the effect of specific foods has on your symptoms. It will help you correlate which foods caused which symptoms so the next time you feel a bit off, you’ll know why.
If you have from Irritable Bowel Syndrome (IBS), Crohn’s Disease, Ulcerative Colitis, or gluten therapy resistant Celiac disease, the Specific Carbohydrate Diet can be a life changer. The power to optimize your health is always in your hands.
