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Medical Journal: Resolution of Severe Ulcerative Colitis with the Specific Carbohydrate Diet

August 11, 2015

Report from Omaha, Nebraska...

The August volume of Case Reports in Gastroenterology includes an article on a 73-year-old female physician with ulcerative colitis who recovered on the SCD.

The case report is notable for diagnostic images taken before and after the SCD. The before photos show active inflammation while the after SCD photos show no sign of inflammation. In addition, biopsies confirmed both the UC diagnosis and subsequent remission.

[caption id="" align="alignnone" width="590.0"]image 1 Fig. 1. Terminal ileum (a, b) and cecum (c). Endoscopic photographs of the sigmoid and left side of the colon demonstrating active mucosal inflammation taken prior to institution of the SCD in December 2010, following 1 year of an acute exacerbation of UC in a 73-year-old patient. Pancolitis was noted on complete colonoscopy.[/caption] [caption id="" align="alignnone" width="589.0"]image 2 Fig. 2. Terminal ileum (a, b) and cecum (c) demonstrating normal colonic mucosa with no inflammation after 2 years of the SCD (December 2012). Complete colonoscopy confirmed resolution in all segments of the colon.[/caption]

The details are as follows:

Diagnosis of UC, Relative stability

  • 1997 - While in her early 40s, the patient experienced abdominal pain and rectal bleeding. After a colonoscopy, she was diagnosed with ulcerative colitis.
  • 1997 to mid-2009 - After 6 weeks of Asacol (mesalamine), she was relatively stable for the next 12 years.

Pain Returns, Drugs don't help, Unable to Work

  • Winter 2009 - The patient experienced intermittent burning and shooting pain in the left lower abdomen. Occasional pain also occurred in the right abdomen.
  • 2010 - The pain continued. Loose stools and rectal bleeding worsened over the next year. Her appetite decreased.
    • She consulted various gastroenterologists
    • Treatment with steroids and mesalamine failed to alleviate the symptoms.
  • December 2010 - Experiencing constant abdominal pain and unremitting bloody diarrhea, she was unable to work.
    • A colonoscopy showed mild to moderate UC with inflammation throughout the colon. Biopsies confirmed the UC diagnosis.
    • The "colonic mucosa revealed friability, multiple tiny ulcers and mucosa edema".

SCD Started, Health Improves

“a remarkable absence of any inflammation”
  • Winter 2010 (December) - The SCD was started.
    • Within 3-6 months, she went to the bathroom less often, the abdominal pain resolved, and blood no longer showed in the stools.
    • In 6 months, she returned to normal activities--including work as a physician.
    • Anemia resolved, with hemoglobin returning to a normal range.
    • All symptoms dissipated over the next 18 months.
  • December 2012 - An endoscopy showed "a remarkable absence of any inflammation". Biopsies confirmed the remission of ulcerative colitis with no inflammation present.

The authors of the report note:

We report complete healing of UC in a patient who had failed conventional therapies within a 2-year period. The use of the SCD for UC in patients who are able to make sustainable dietary changes should be considered more often.

citation: Khandalavala, B. N., & Nirmalraj, M. C. (2015). Resolution of Severe Ulcerative Colitis with the Specific Carbohydrate Diet. Case Reports in Gastroenterology, 3075, 291–295. doi:10.1159/000438745