December 9, 2025 • 28 mins
nflammatory Bowel Disease (IBD) can be challenging to treat; however, when effective self-care strategies are employed, there is better disease management and higher quality of life. On this show, Karolyn talks with gastrointestinal expert and educator Mark Davis, ND, about how people with IBD can better manage their condition. Dr. Davis specializes in the treatment of IBD and also teaches other healthcare professionals about the value of an integrative approach to IBD treatment and self-care.
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Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com).
Five To Thrive Live Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:41):
Hello everyone, and welcome to Five to Thrive Live. I'm
Carolyn Gazilla and I co host this show with my
good friend doctor LESE. Al Schuller. So how much do
you know about inflammatory bowel disease or IBD. The first
thing to know is that these illnesses are common, affecting
millions of people. In fact, in the United States there
(01:03):
are about seventy thousand new cases diagnosed each year. Fortunately,
I have the perfect expert to help us with this topic.
Doctor Mark Davis is a naturopathic physician who specializes in
the treatment of IBD. I've worked with doctor Davis a
lot over the years, and he is top notch. In
addition to his successful clinical practice, he teaches gastorentrology at
(01:24):
Sonora and University of Health Sciences, and he is on
the board of directors of the Gastorentrology Association of Naturopathic Physicians.
But before we start, our conversations. I'd like to thank
our sponsors. Beginning with Cetria, a patented form of glutathione
clinically proven to raise glutothione levels. Glutathione is the master
anti accident in the body's primary defense against free radicals.
(01:47):
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(02:07):
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(02:29):
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(02:53):
Doctor Davis, thank you so much for joining me.
Speaker 3 (02:56):
I am so excited to be here. Thank you for
having me.
Speaker 2 (02:59):
Yes, and I actually would like to start with the basics.
Tell us what inflammatory bowel diseases are. Give us the
medical definition.
Speaker 3 (03:09):
Okay, great. So there's two major kinds of inflammatory ball
disease or IBD, and that's alterative colitis and Crohn's disease.
About half a percent of people in the United States
have each of these, So about one percent of people
in the United States have inflammatory bowel disease. And these are
chronic autoimmune conditions that lead to inflammation in the intestines
(03:32):
and often have ulcerations, so deep inflammatory lesions in the
intestines that can lead to pain and bleeding. And there
is a genetic risk for each of these, but it's
not a simple genetic cause there's not like one gene
that causes it. There's over one hundred and fifty known
genes that can be activated in different ways to elevate risk,
(03:53):
and that genetic risk interacts with the environment to give
people symptoms or not.
Speaker 2 (03:58):
Okay, so remind us about what an autoimmune condition is.
What's the general description of an autoimmune condition.
Speaker 3 (04:06):
So, an autoimmune condition is where your immune system that's
supposed to attack pathogens and foreign invaders and things that
could threaten you, makes a bit of an error and
it ends up attacking your own tissues and so for
all sort of klitis and Chrohn's disease, it's a little
bit of a funny thing where they're kind of attacking normal,
(04:27):
healthy bacteria that can't cause us harm and they end
up harming your testines kind of as collateral damage.
Speaker 2 (04:34):
Yeah, we've done a lot of shows on autoimmune conditions.
You know, it seems like these IBD conditions can be
difficult to treat. Why do you think that is?
Speaker 3 (04:46):
Well, there are a few reasons for that. One is,
they can be pretty severe. So common things like IBS
can really mess with your quality of life, but they're
not going to end you up in the hospital. But
sort of clitus and crones disease can be really severe.
About twenty five percent of people with ulcert of clitis
end up needing an intestinal surgery at some point. At
(05:08):
about seventy five percent of people with CRONES will need
at least one intestinal surgery in their life. So anything
that is severe like that or even can be life threatening,
is hard to treat. Another thing is they're not that
responsive to conventional medicines. So I'm a nature pathic physician
and I love using all of our natural tools, but
(05:29):
I love for my patients to have the best of
all the conventional medicine tools available out there too. And
this is one of the conditions, or these are two
of a set of conditions that we do not have
the best tools to control them. Maybe fifty percent of
people on a really good day are gonna be in
(05:49):
a long term response with the best conventional medicines out there,
So that makes it difficult to treat. And I guess
if I had to pick a third thing, I would
say that they're both all sort of cleitysin chron disease
are both naturally waxing and waning, So sometimes you're worse,
sometimes you're better, and sometimes it has to do with
diet or stress or other things. And sometimes it's just
(06:11):
for reasons nobody knows, and so once people get in
a little bit of control, when things are waning and
they're feeling better, it's people stop there and say, Okay,
I'm well enough, I'm well enough now, and they don't
go deep enough to get into what's called deep histological remission.
So that's a whole spectrum of reasons that IBD can
(06:33):
be difficult to treat.
Speaker 2 (06:35):
Yes, yeah, it is, and it's can be difficult to
diagnose as well.
Speaker 3 (06:40):
Right, Yeah, people will go a year or two sometimes
with symptoms, or it can't even be longer before they
get a diagnosis, or otherwise the diagnosis happens right away.
So the only way to definitively diagnose them is through colonoscopy,
where you go in and you take a look with
(07:02):
the kaleioscope and you say, aha, this is some inflammation
that looks like alter of clitis or krones and then
you take biopsies and send them to a pathologist and
they say, yes, this is alter of clitis, or yes,
this is Crone's disease. Or sometimes there's something about ten
percent of the time called indeterminate kalitis where it kind
of has characteristics of both, and so that's when you
(07:23):
get the definitive diagnosis. And I have patients who get
symptoms and they're diagnosed correctly within a week, so it
can be quick, can be a long time.
Speaker 2 (07:31):
Got it, Okay, So what are some of the primary
symptoms of IBD and how do those symptom symptoms impact
quality of life for the person who has the condition.
Speaker 3 (07:42):
Yeah, great question. So I would say diarrhea is the
most common symptom. Frequent loose stool, often urgent, sometimes so
urgent that there can be fecal incontinence, often so much
inflammation that along with excreting stool, you're excreting mucus or blood,
sometimes so much blood that my patients have needed blood transfusions.
(08:06):
And pain, so abdominal pain is another big one. Diarrhea
is more predominant with all sort of clitis, and severe
abdominal pain is more predominant with chrones. But it can
be either way, and I've had patients with constipation or
with no pain, so a wide spectrum of pictures. And
then there are times, especially with Crones disease, where the
(08:26):
inflammation can be so severe that the intestines narrow that's
called a stricture, and that can cause blockages, and that's
when you need an emergency surgery, or when we develop
abscesses or what are called fistulae, when there's an inflammatory
tunnel from the intestines out to like another organ, like
(08:46):
the bladder, and then you yet bladder infections. I should
also mention there are what are called extra intestinal manifestations.
So sometimes the inflammation in the gut can cause inflammation
in the joints, have joint pain, or in the eyes,
so people can have what's called uv itis or iritis
that can cause vision damage, or the liver or the
(09:08):
kidney or the lungs or other places. So big spectrum,
and I would say the inability to get out of
the house is the most frustrating way that that impacts
my patient's lives. When you're having ten or twenty urgent
bowel movements a day, it's hard to feel comfortable leaving
(09:30):
the house and going to special events, you're going on
vacations unless you know right where the bathroom is.
Speaker 2 (09:34):
So yeah, yeah, I mean that when you're talking about
quality of life, and when you're talking about that those
types of symptoms and manifestations of this illness. I can
see where this would be very troublesome. So let's dig
into your self care strategies. Why is self care so important?
And where do you like to begin with your patients?
Speaker 3 (09:56):
Okay, so with my patients, we always start by giving
the big picture, where I say there are five steps
of care, and step number one is always making sure
that you are safe out patient. And this isn't just
for me and my clinic. I recommend IBD patients think
about these steps anytime they're getting care from their gastrentrologists,
their primary care doctor, they're acupuncturists, at their nature pathic position, anybody.
(10:19):
So step number one is are they safe out patient?
And sometimes people come to my office and they have
a visit and I have to say, I'm really not
the best fit for you. You belong in a hospital right now.
I'll work with you when you get out of the hospital.
So that's step one, ensuring safety. Step two is ensuring
clinical remission, and that means no symptoms or barely any symptoms.
(10:42):
And unfortunately, that's where a lot of people stop. And
that's one of the reasons it's so difficult to treat
is gas Trentrologists and conventional doctors and nature pathic doctors
sometimes say, oh my goodness, I'm so happy you have
no symptoms. We're stopping there. I consider that to be
step two. Step three is called zero logical remission, and
croology means blood tests, so for us, that means all
(11:04):
of your blood tests and stool tests show that you're
not having excessive inflammation anymore. Step four is histological emission.
Histology means tissues and that means colonosk to be and
biopsies show all the tissues are totally not inflamed anymore.
And then step five is maintenance, which means getting regular
blood and stool tests to make sure there's no inflammation
(11:27):
starting a little bit again. So that's where I always
started saying, whoever you're working with, make sure you're working
at the right level of care and aiming for the
deepest levels of remission. And then my big next step
is to get through the patient and their values and
their health aesthetic and what their life is like. Because
(11:48):
there are so many tools, really, dozens and dozens of
helpful tools for people at IBD, and some people say,
if I can just change my diet and get into remission,
that would be the best thing in the world. Tell
me what to do and I will change my diet
to exactly as you say, and they love that. Other
(12:09):
people say, the last thing I want to do is
change my diet. Can we do anything else? So you
really have to know the patient's values and preferences in
their life and what they want are Do they want
to avoid drugs at all costs? Do they want to
use the newest experimental drugs at the first time they're available.
Are what's their budget? Like are they willing to accept
(12:31):
somewhere risky drugs or herbs or therapies for a chance
of higher benefit. So there's so many things to do
to get to know the patient, and that's where I
like to start out with them.
Speaker 2 (12:41):
So from a naturopathic perspective, do you look are your
main tools diet, lifestyle and maybe dietary supplements. What are
your main tools that you kind of go to for
a lot of your patients?
Speaker 3 (12:57):
Exactly what you said is hugely import diet, lifestyle and
dietary supplements. I can talk about some specific ones if
you're interested, but also throw out there herbs. Herbs are
a kind of supplement, but sometimes we're using them as
teas or as tinctures, and they can be hugely important tools.
(13:17):
I also work a lot with this very unusual therapy
called fecal microbiotic transplantation otherwise known as FMT or fecal
transplant that can be hugely important for some people with IBD.
And I work with another one called helminthic therapy, which
is basically a special and usual type of probiotic and
(13:39):
then sometimes as nature pathic positions, we're prescribing certain drugs
off label. One of my favorites is one called low
dose now trexone that is used for people with a
lot of inflammatory conditions and not used by conventional gastroentrologists,
but really helps some of my IBD patients.
Speaker 2 (13:57):
All Right, so let's take me through. And I love
the fact that you have this expertise at FMT and
diet or supplements and herbs and everything else. But take
me through from a dietary standpoint. I'm particularly curious if
FODMAP or some of these diets, do you recommend them
(14:21):
or do you just go with more of a whole
foods Mediterranean style diet. Talk a little bit about diet first.
Speaker 3 (14:29):
Well, there are there have been a lot of different
diets studied for IBD, and actually Mediterranean diet and FODMAP
low FODMAP diet both have been studied to show some
benefit for people with IBD, which is great. Actually, there
are so many diets that can be helpful, and you
never know which one will help the individual in front
of you. That I tell people, I give them a
(14:51):
list and basic descriptions of a bunch of different potentially
therapeutic diets, and I say, look, these are very different,
and some are going to fit with your lifenle better
and some aren't. My two favorite diets actually for people
with IBD are complete opposites of each other. The first
one is called specific carbohydrate diet, and that is a
diet that has no grains initially no beans, and never
(15:15):
has soy, and it includes lots of meat and fish,
and the only dairy it allows is special twenty four
hour fermented yogurt. Another of my favorite diets is called
the semi vegetarian diet, and that is a diet where
you have rice at every meal. The specific carbohydrate diet
(15:36):
allows rice never, you have miso soup every day, which
is a diet invented by a Japanese gastroent trologist. So
that's why it's such a specific diet that has miso
in it. But that's soy which is never allowed on
a specific carbohydrate diet. And you only have meat about
once a month and fish about once a week, and
you have lots and lots of vegetables, including fermented vegetables.
(15:58):
So these diets are very different. And I tell people,
if you're the type of person who can leave grains
behind and you just want to eat meat all the time,
let's start you on this specific carbohydrate diet because it'll
be a good fit for your life, and will see
how it affects your biomarkers CRP, fecal colprotect and other
biomarkers that measure inflammation levels. If you're the type of
(16:19):
person who would rather avoid me and you would like
to have a vegetarian lifestyle, let's start you on a
diet like that that's a good fit for your life
and see how you do on it and tweak it
from there. So highly individualized, highly individualized. There is no
single food that is quote unquote safe for every person
(16:40):
with IBD, and there's no single food that is dangerous
or increase his risk of inflammation for every single person
with IBD. You know, I can think of a patient
of mine with very severely actible sort of colitis who
had some dietary triggers, and he said the worst of
them are lettuce and garlic. I have any lettuce or
(17:00):
garlic in my diet, I am sure to see blood
in the toilet next morning, Whereas many of my patients
can tolerate those foods just fine. Some people do very
well on a high meat diet. I've had other people
that cannot tolerate any meat or they will they will
have recto bleeding. So hugely individualized.
Speaker 2 (17:17):
Yeah, and Scott, I mean that has to add to
the challenge of the treatment protocol that you're creating, because
every patient seems to be presenting differently.
Speaker 3 (17:28):
Yes, that is true. There are some ways we can
help dial in what the best diet is if somebody
just doesn't want to pick a blueprint. One is blood
testing for food sensitivities IgG IgE food sensitivities or especially
I like one called IgG four food sensitivities that's been
tested in people with IBD. So doing that kind of
(17:50):
testing can give you a bit more of a roadmap
of what things to avoid or what things might be safe.
And then there's the difficult but rewarding elimination challenge diet
where we take it down to just two or three
or four basic foods and see if that really enhances remission.
And then we add foods in a new food every
(18:12):
twenty four to forty eight hours to see if you
react to them negatively. So it's a long, laborious process,
but it can be really rewarding for some people.
Speaker 2 (18:21):
Okay, so let's switch to lifestyle. You know, when I
think about lifestyle and I think about conditions such as
this autoimmune inflammatory, I think about stress and I think
about sleep, do those two bubble to the top of
your list as well?
Speaker 3 (18:38):
Yes? Absolutely so. Higher stress definitely can influence flares and
make them more likely to happen. And lack of sleep
is the same. And when you look at surveys, sleep
can be a challenge and being over stressed can be
a challenge as well for people at IBD. So that's
pretty individualized two. In terms of what the best tool
(18:59):
is for a given person to reduce stress levels and
get good sleep in we use a ton of different tools.
I love some nutraceuticals and botanicals and certain rituals around
sleep can be helpful. And for stress, I'm a big
fan of yoga. Inflammatory ball disease often can decrease bone
(19:22):
density as well, and so there's a great book called
Yoga for Osteoporosis that I recommend a lot that can
also help with stress management. And then there are other
things like air pollution. Air particulate matter is linked to
frequency of IBD flares, so sometimes where you live or
what sort of air purifier you have can help. Microplastics
(19:46):
are a risk factor, so cleaning up diet and making
sure you're eating more whole in organic food. So a
lot of different potential aspects of lifestyle to address.
Speaker 2 (19:58):
Yeah, what about exercise you mentioned you Is there any
limitations that one may have when it comes to exercise
in general, or is exercise just you know, almost always recommended.
Speaker 3 (20:11):
So during a moderate to severely active flair, we don't
encourage exercise because it's just such a toll on the
body to be having a lot of inflammation in the
gut and bowl frequency and losing blood for most people
that we don't encourage a lot of vigorous exercise during
(20:33):
that time, we tend to recur recommend more rest and
recuperation type attitude. But for people who are only mildly
or sometimes mildly can moderately active, or who are in remission,
exercise does tend to decrease risk of flares a little bit.
And the truth is, even though IBD makes you suffer,
(20:55):
the vast majority of people in twenty twenty five do
not die of IDA. They're dying of other things. And
because they tend to have more inflammation they do have,
people's IBD do have somewhat increased risks of cardiovascular disease
and other things. So I'm really encouraging exercise for a
long healthy life for people for other reasons not directly
(21:19):
related to their IBED diagnosis.
Speaker 2 (21:21):
Yeah, that makes a lot of sense, because there is
comorbidity with these conditions that you have to manage as well,
in addition to symptom management, in addition to this particular condition.
So that makes a lot of sense. So let's go
back to dietary supplements you mentioned low dose meltrek zone
and take me through your probiotic philosophy when it comes
(21:45):
to IBD.
Speaker 3 (21:47):
Okay, awesome question, because we group all sort of kalaitis
and Crohn's disease into this category called IBD, and they're
very very similar in some ways, but they're also very
different in some ways. One interesting way is their response to tobacco.
Tobacco flares people with Crohn's disease, but quitting smoking tends
(22:09):
to flare people with alter of colitis. So when I
have smokers, I say, we want to get you out
of smoking tobacco, but not until you're out of a flare,
because it's going to make things worse. So that's the
way in which they're opposite. And another way is probiotics.
So probiotics are usually very beneficial for people with ulster
of kolitis in a dose dependent manner where I will
(22:32):
dose hundreds of billions to low trillions per day, very
high dose. Lack of Bacillus in bifodobacteria probiotics, and the
literature supports that I've seen it in my patients, and
it's clear in randomized controlled trials and meta analyzes regular
lack of Bacillus biffidobacteria probatics help. I have had occasional
(22:55):
patients with crones who say probiotics help and leave it
every individual is different. However, the literature shows that probiotics
versus placebo are not different for people with chrones, and
there was one trial actually where the people in the
probiotics group did significantly worse than the placibo group. So
(23:18):
in terms of our most common probatic Lactobacillus and Bithotobacteria probatics,
I generally do not recommend them for people with crones,
and I recommend them strongly for people with full sort
of klitis. There's a lot of other great probatics out
there that I like to use.
Speaker 2 (23:32):
One is E.
Speaker 3 (23:34):
Coli nissil, otherwise known as mutafloor. That is a great one.
There's an originally Japanese one now is available in some
products in the United States called Claustridium butyricum produces butyic acid,
which is anti inflammatory. That's a great one. So there's
a bunch of different probatics, but the most common ones
(23:56):
I dose high in ulcer of colitis and generally avoiding chrones.
Speaker 2 (24:01):
You know, that's fascinating to me, doctor Davis, because here
we have two conditions in the same category basically, and
there you have to treat them so differently and I
feel like that's why you need an expert. You need
a specialist in this area because it is so highly individualized.
Speaker 3 (24:19):
Yeah, yeah, agreed. And you know, I see a lot
of my non specialized colleagues in naturopathic medicine providing an
awful lot of benefit for people with IBD two. So
it's I think you can see any nature pathic doctor
who's close to you, even if they're not specialized. But
often those colleagues will refer their trickier cases to me,
and I'm always delighted to see them.
Speaker 2 (24:41):
Yeah. And are there any other dietary supplements that you
want to mention just briefly before we wrap up.
Speaker 3 (24:48):
Oh? Wow, so many, So I'll try to be concise.
I mean I test my patients a lot for vitamin
D and zinc and selenium. Those are three super important
ones to know what their levels are and give it
to them if they're low. Oh, if they're on pregnison,
which they often are, I always give them a supplement
called dhea to compliment that and reduce side effects. Oh,
(25:10):
there's for people with crones especially. Let me throw out
one of my favorites is called n acetyl glucosamine can
stop or slow down or in some cases even reverse
the stricturing process that narrowing of the intestines due to
inflammatory scar tissue being laid down. So I love that one.
Oh and for my ulcert of clitiest patients who are
(25:31):
severely active, there is an herb that is amazingly effective
and does have a small amount of risks, so I
like it to be managed by an expert called ching
Dai or indigo naturalis. So those are some of my
top top supplements, but there are many.
Speaker 2 (25:46):
Yeah, that's great. It sounds like you do have a
lot of tools in your toolbox when it comes to
treating this very, very complex of illness. So where can
listeners find out more about you? Do you have a
website that you'd like to share?
Speaker 3 (25:59):
Yes, myself and two colleagues treat almost exclusively inflammatory ball disease.
We're at Foundational Medicine. Our website is foundational dash medicine
dot com and we're licensed in Arizona, California, Colorado, Washington, DC, Massachusetts, Maryland, Oregon,
and Vermont between the three of us, and we see
(26:20):
people with IBD from all over.
Speaker 2 (26:21):
And you do telehealth through Foundational Medicine correct exactly yep.
Speaker 3 (26:25):
So we're licensed in all those states. People in Maryland
can come see us in person if needed, but mostly
it's telehealth and we do have a course there. It's
a twelve hour course cost the same amount as one
initial visit with us, and it's twelve hours of the
material that we've spent decades telling people about and the
most important things that we want people to know about
diets and drugs and labs and imaging and herbs and
(26:49):
lifestyle and everything like that.
Speaker 2 (26:51):
And it's Foundational dash Medicine dot com exactly. Yeah. I
highly recommend listeners. If you or someone that you love
is strugging with IBD, go to Foundational dash Medicine dot com. Uh.
This is an amazing work that doctor Davis and his
colleagues have devoted their professional careers to. So definitely Foundational
(27:13):
Medicine dot Com. Doctor Davis, thank you so much for
joining me today. This was This was great.
Speaker 3 (27:20):
Yeah, so great to be here and great to talk
to you as always. Well.
Speaker 2 (27:23):
Great. So that wraps up this episode of five to
Thrive Live once again. I'd like to thank our sponsors Prothrivers, Wellness, Sleep, Cetria, Glutathione,
the superior glutathione to sport, liver and immune health, Cognizance
citacoline to enhance memory, focus and attention, and doctor oher
is Award winning shelf stable probiotic. Thanks for listening and
(27:46):
remember you can find past shows at ithriveplan dot com
or wherever you listen to your favorite podcast, that's I
Thriveplan dot com. May you experience joy, laughter and love.
It's time to thrive everyone. Have a great night.
Speaker 3 (28:27):
Sh
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:41):
Hello everyone, and welcome to Five to Thrive Live. I'm
Carolyn Gazilla and I co host this show with my
good friend doctor LESE. Al Schuller. So how much do
you know about inflammatory bowel disease or IBD. The first
thing to know is that these illnesses are common, affecting
millions of people. In fact, in the United States there
(01:03):
are about seventy thousand new cases diagnosed each year. Fortunately,
I have the perfect expert to help us with this topic.
Doctor Mark Davis is a naturopathic physician who specializes in
the treatment of IBD. I've worked with doctor Davis a
lot over the years, and he is top notch. In
addition to his successful clinical practice, he teaches gastorentrology at
(01:24):
Sonora and University of Health Sciences, and he is on
the board of directors of the Gastorentrology Association of Naturopathic Physicians.
But before we start, our conversations. I'd like to thank
our sponsors. Beginning with Cetria, a patented form of glutathione
clinically proven to raise glutothione levels. Glutathione is the master
anti accident in the body's primary defense against free radicals.
(01:47):
It also helps support respiratory health. For more information, visit
Cetria Glutathion dot com. Also cognizance citicoline, which is nature's
way of keeping the brain's energy producing centers firing on
all cylinders. If you're looking for a way to enhance
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(02:53):
Doctor Davis, thank you so much for joining me.
Speaker 3 (02:56):
I am so excited to be here. Thank you for
having me.
Speaker 2 (02:59):
Yes, and I actually would like to start with the basics.
Tell us what inflammatory bowel diseases are. Give us the
medical definition.
Speaker 3 (03:09):
Okay, great. So there's two major kinds of inflammatory ball
disease or IBD, and that's alterative colitis and Crohn's disease.
About half a percent of people in the United States
have each of these, So about one percent of people
in the United States have inflammatory bowel disease. And these are
chronic autoimmune conditions that lead to inflammation in the intestines
(03:32):
and often have ulcerations, so deep inflammatory lesions in the
intestines that can lead to pain and bleeding. And there
is a genetic risk for each of these, but it's
not a simple genetic cause there's not like one gene
that causes it. There's over one hundred and fifty known
genes that can be activated in different ways to elevate risk,
(03:53):
and that genetic risk interacts with the environment to give
people symptoms or not.
Speaker 2 (03:58):
Okay, so remind us about what an autoimmune condition is.
What's the general description of an autoimmune condition.
Speaker 3 (04:06):
So, an autoimmune condition is where your immune system that's
supposed to attack pathogens and foreign invaders and things that
could threaten you, makes a bit of an error and
it ends up attacking your own tissues and so for
all sort of klitis and Chrohn's disease, it's a little
bit of a funny thing where they're kind of attacking normal,
(04:27):
healthy bacteria that can't cause us harm and they end
up harming your testines kind of as collateral damage.
Speaker 2 (04:34):
Yeah, we've done a lot of shows on autoimmune conditions.
You know, it seems like these IBD conditions can be
difficult to treat. Why do you think that is?
Speaker 3 (04:46):
Well, there are a few reasons for that. One is,
they can be pretty severe. So common things like IBS
can really mess with your quality of life, but they're
not going to end you up in the hospital. But
sort of clitus and crones disease can be really severe.
About twenty five percent of people with ulcert of clitis
end up needing an intestinal surgery at some point. At
(05:08):
about seventy five percent of people with CRONES will need
at least one intestinal surgery in their life. So anything
that is severe like that or even can be life threatening,
is hard to treat. Another thing is they're not that
responsive to conventional medicines. So I'm a nature pathic physician
and I love using all of our natural tools, but
(05:29):
I love for my patients to have the best of
all the conventional medicine tools available out there too. And
this is one of the conditions, or these are two
of a set of conditions that we do not have
the best tools to control them. Maybe fifty percent of
people on a really good day are gonna be in
(05:49):
a long term response with the best conventional medicines out there,
So that makes it difficult to treat. And I guess
if I had to pick a third thing, I would
say that they're both all sort of cleitysin chron disease
are both naturally waxing and waning, So sometimes you're worse,
sometimes you're better, and sometimes it has to do with
diet or stress or other things. And sometimes it's just
(06:11):
for reasons nobody knows, and so once people get in
a little bit of control, when things are waning and
they're feeling better, it's people stop there and say, Okay,
I'm well enough, I'm well enough now, and they don't
go deep enough to get into what's called deep histological remission.
So that's a whole spectrum of reasons that IBD can
(06:33):
be difficult to treat.
Speaker 2 (06:35):
Yes, yeah, it is, and it's can be difficult to
diagnose as well.
Speaker 3 (06:40):
Right, Yeah, people will go a year or two sometimes
with symptoms, or it can't even be longer before they
get a diagnosis, or otherwise the diagnosis happens right away.
So the only way to definitively diagnose them is through colonoscopy,
where you go in and you take a look with
(07:02):
the kaleioscope and you say, aha, this is some inflammation
that looks like alter of clitis or krones and then
you take biopsies and send them to a pathologist and
they say, yes, this is alter of clitis, or yes,
this is Crone's disease. Or sometimes there's something about ten
percent of the time called indeterminate kalitis where it kind
of has characteristics of both, and so that's when you
(07:23):
get the definitive diagnosis. And I have patients who get
symptoms and they're diagnosed correctly within a week, so it
can be quick, can be a long time.
Speaker 2 (07:31):
Got it, Okay, So what are some of the primary
symptoms of IBD and how do those symptom symptoms impact
quality of life for the person who has the condition.
Speaker 3 (07:42):
Yeah, great question. So I would say diarrhea is the
most common symptom. Frequent loose stool, often urgent, sometimes so
urgent that there can be fecal incontinence, often so much
inflammation that along with excreting stool, you're excreting mucus or blood,
sometimes so much blood that my patients have needed blood transfusions.
(08:06):
And pain, so abdominal pain is another big one. Diarrhea
is more predominant with all sort of clitis, and severe
abdominal pain is more predominant with chrones. But it can
be either way, and I've had patients with constipation or
with no pain, so a wide spectrum of pictures. And
then there are times, especially with Crones disease, where the
(08:26):
inflammation can be so severe that the intestines narrow that's
called a stricture, and that can cause blockages, and that's
when you need an emergency surgery, or when we develop
abscesses or what are called fistulae, when there's an inflammatory
tunnel from the intestines out to like another organ, like
(08:46):
the bladder, and then you yet bladder infections. I should
also mention there are what are called extra intestinal manifestations.
So sometimes the inflammation in the gut can cause inflammation
in the joints, have joint pain, or in the eyes,
so people can have what's called uv itis or iritis
that can cause vision damage, or the liver or the
(09:08):
kidney or the lungs or other places. So big spectrum,
and I would say the inability to get out of
the house is the most frustrating way that that impacts
my patient's lives. When you're having ten or twenty urgent
bowel movements a day, it's hard to feel comfortable leaving
(09:30):
the house and going to special events, you're going on
vacations unless you know right where the bathroom is.
Speaker 2 (09:34):
So yeah, yeah, I mean that when you're talking about
quality of life, and when you're talking about that those
types of symptoms and manifestations of this illness. I can
see where this would be very troublesome. So let's dig
into your self care strategies. Why is self care so important?
And where do you like to begin with your patients?
Speaker 3 (09:56):
Okay, so with my patients, we always start by giving
the big picture, where I say there are five steps
of care, and step number one is always making sure
that you are safe out patient. And this isn't just
for me and my clinic. I recommend IBD patients think
about these steps anytime they're getting care from their gastrentrologists,
their primary care doctor, they're acupuncturists, at their nature pathic position, anybody.
(10:19):
So step number one is are they safe out patient?
And sometimes people come to my office and they have
a visit and I have to say, I'm really not
the best fit for you. You belong in a hospital right now.
I'll work with you when you get out of the hospital.
So that's step one, ensuring safety. Step two is ensuring
clinical remission, and that means no symptoms or barely any symptoms.
(10:42):
And unfortunately, that's where a lot of people stop. And
that's one of the reasons it's so difficult to treat
is gas Trentrologists and conventional doctors and nature pathic doctors
sometimes say, oh my goodness, I'm so happy you have
no symptoms. We're stopping there. I consider that to be
step two. Step three is called zero logical remission, and
croology means blood tests, so for us, that means all
(11:04):
of your blood tests and stool tests show that you're
not having excessive inflammation anymore. Step four is histological emission.
Histology means tissues and that means colonosk to be and
biopsies show all the tissues are totally not inflamed anymore.
And then step five is maintenance, which means getting regular
blood and stool tests to make sure there's no inflammation
(11:27):
starting a little bit again. So that's where I always
started saying, whoever you're working with, make sure you're working
at the right level of care and aiming for the
deepest levels of remission. And then my big next step
is to get through the patient and their values and
their health aesthetic and what their life is like. Because
(11:48):
there are so many tools, really, dozens and dozens of
helpful tools for people at IBD, and some people say,
if I can just change my diet and get into remission,
that would be the best thing in the world. Tell
me what to do and I will change my diet
to exactly as you say, and they love that. Other
(12:09):
people say, the last thing I want to do is
change my diet. Can we do anything else? So you
really have to know the patient's values and preferences in
their life and what they want are Do they want
to avoid drugs at all costs? Do they want to
use the newest experimental drugs at the first time they're available.
Are what's their budget? Like are they willing to accept
(12:31):
somewhere risky drugs or herbs or therapies for a chance
of higher benefit. So there's so many things to do
to get to know the patient, and that's where I
like to start out with them.
Speaker 2 (12:41):
So from a naturopathic perspective, do you look are your
main tools diet, lifestyle and maybe dietary supplements. What are
your main tools that you kind of go to for
a lot of your patients?
Speaker 3 (12:57):
Exactly what you said is hugely import diet, lifestyle and
dietary supplements. I can talk about some specific ones if
you're interested, but also throw out there herbs. Herbs are
a kind of supplement, but sometimes we're using them as
teas or as tinctures, and they can be hugely important tools.
(13:17):
I also work a lot with this very unusual therapy
called fecal microbiotic transplantation otherwise known as FMT or fecal
transplant that can be hugely important for some people with IBD.
And I work with another one called helminthic therapy, which
is basically a special and usual type of probiotic and
(13:39):
then sometimes as nature pathic positions, we're prescribing certain drugs
off label. One of my favorites is one called low
dose now trexone that is used for people with a
lot of inflammatory conditions and not used by conventional gastroentrologists,
but really helps some of my IBD patients.
Speaker 2 (13:57):
All Right, so let's take me through. And I love
the fact that you have this expertise at FMT and
diet or supplements and herbs and everything else. But take
me through from a dietary standpoint. I'm particularly curious if
FODMAP or some of these diets, do you recommend them
(14:21):
or do you just go with more of a whole
foods Mediterranean style diet. Talk a little bit about diet first.
Speaker 3 (14:29):
Well, there are there have been a lot of different
diets studied for IBD, and actually Mediterranean diet and FODMAP
low FODMAP diet both have been studied to show some
benefit for people with IBD, which is great. Actually, there
are so many diets that can be helpful, and you
never know which one will help the individual in front
of you. That I tell people, I give them a
(14:51):
list and basic descriptions of a bunch of different potentially
therapeutic diets, and I say, look, these are very different,
and some are going to fit with your lifenle better
and some aren't. My two favorite diets actually for people
with IBD are complete opposites of each other. The first
one is called specific carbohydrate diet, and that is a
diet that has no grains initially no beans, and never
(15:15):
has soy, and it includes lots of meat and fish,
and the only dairy it allows is special twenty four
hour fermented yogurt. Another of my favorite diets is called
the semi vegetarian diet, and that is a diet where
you have rice at every meal. The specific carbohydrate diet
(15:36):
allows rice never, you have miso soup every day, which
is a diet invented by a Japanese gastroent trologist. So
that's why it's such a specific diet that has miso
in it. But that's soy which is never allowed on
a specific carbohydrate diet. And you only have meat about
once a month and fish about once a week, and
you have lots and lots of vegetables, including fermented vegetables.
(15:58):
So these diets are very different. And I tell people,
if you're the type of person who can leave grains
behind and you just want to eat meat all the time,
let's start you on this specific carbohydrate diet because it'll
be a good fit for your life, and will see
how it affects your biomarkers CRP, fecal colprotect and other
biomarkers that measure inflammation levels. If you're the type of
(16:19):
person who would rather avoid me and you would like
to have a vegetarian lifestyle, let's start you on a
diet like that that's a good fit for your life
and see how you do on it and tweak it
from there. So highly individualized, highly individualized. There is no
single food that is quote unquote safe for every person
(16:40):
with IBD, and there's no single food that is dangerous
or increase his risk of inflammation for every single person
with IBD. You know, I can think of a patient
of mine with very severely actible sort of colitis who
had some dietary triggers, and he said the worst of
them are lettuce and garlic. I have any lettuce or
(17:00):
garlic in my diet, I am sure to see blood
in the toilet next morning, Whereas many of my patients
can tolerate those foods just fine. Some people do very
well on a high meat diet. I've had other people
that cannot tolerate any meat or they will they will
have recto bleeding. So hugely individualized.
Speaker 2 (17:17):
Yeah, and Scott, I mean that has to add to
the challenge of the treatment protocol that you're creating, because
every patient seems to be presenting differently.
Speaker 3 (17:28):
Yes, that is true. There are some ways we can
help dial in what the best diet is if somebody
just doesn't want to pick a blueprint. One is blood
testing for food sensitivities IgG IgE food sensitivities or especially
I like one called IgG four food sensitivities that's been
tested in people with IBD. So doing that kind of
(17:50):
testing can give you a bit more of a roadmap
of what things to avoid or what things might be safe.
And then there's the difficult but rewarding elimination challenge diet
where we take it down to just two or three
or four basic foods and see if that really enhances remission.
And then we add foods in a new food every
(18:12):
twenty four to forty eight hours to see if you
react to them negatively. So it's a long, laborious process,
but it can be really rewarding for some people.
Speaker 2 (18:21):
Okay, so let's switch to lifestyle. You know, when I
think about lifestyle and I think about conditions such as
this autoimmune inflammatory, I think about stress and I think
about sleep, do those two bubble to the top of
your list as well?
Speaker 3 (18:38):
Yes? Absolutely so. Higher stress definitely can influence flares and
make them more likely to happen. And lack of sleep
is the same. And when you look at surveys, sleep
can be a challenge and being over stressed can be
a challenge as well for people at IBD. So that's
pretty individualized two. In terms of what the best tool
(18:59):
is for a given person to reduce stress levels and
get good sleep in we use a ton of different tools.
I love some nutraceuticals and botanicals and certain rituals around
sleep can be helpful. And for stress, I'm a big
fan of yoga. Inflammatory ball disease often can decrease bone
(19:22):
density as well, and so there's a great book called
Yoga for Osteoporosis that I recommend a lot that can
also help with stress management. And then there are other
things like air pollution. Air particulate matter is linked to
frequency of IBD flares, so sometimes where you live or
what sort of air purifier you have can help. Microplastics
(19:46):
are a risk factor, so cleaning up diet and making
sure you're eating more whole in organic food. So a
lot of different potential aspects of lifestyle to address.
Speaker 2 (19:58):
Yeah, what about exercise you mentioned you Is there any
limitations that one may have when it comes to exercise
in general, or is exercise just you know, almost always recommended.
Speaker 3 (20:11):
So during a moderate to severely active flair, we don't
encourage exercise because it's just such a toll on the
body to be having a lot of inflammation in the
gut and bowl frequency and losing blood for most people
that we don't encourage a lot of vigorous exercise during
(20:33):
that time, we tend to recur recommend more rest and
recuperation type attitude. But for people who are only mildly
or sometimes mildly can moderately active, or who are in remission,
exercise does tend to decrease risk of flares a little bit.
And the truth is, even though IBD makes you suffer,
(20:55):
the vast majority of people in twenty twenty five do
not die of IDA. They're dying of other things. And
because they tend to have more inflammation they do have,
people's IBD do have somewhat increased risks of cardiovascular disease
and other things. So I'm really encouraging exercise for a
long healthy life for people for other reasons not directly
(21:19):
related to their IBED diagnosis.
Speaker 2 (21:21):
Yeah, that makes a lot of sense, because there is
comorbidity with these conditions that you have to manage as well,
in addition to symptom management, in addition to this particular condition.
So that makes a lot of sense. So let's go
back to dietary supplements you mentioned low dose meltrek zone
and take me through your probiotic philosophy when it comes
(21:45):
to IBD.
Speaker 3 (21:47):
Okay, awesome question, because we group all sort of kalaitis
and Crohn's disease into this category called IBD, and they're
very very similar in some ways, but they're also very
different in some ways. One interesting way is their response to tobacco.
Tobacco flares people with Crohn's disease, but quitting smoking tends
(22:09):
to flare people with alter of colitis. So when I
have smokers, I say, we want to get you out
of smoking tobacco, but not until you're out of a flare,
because it's going to make things worse. So that's the
way in which they're opposite. And another way is probiotics.
So probiotics are usually very beneficial for people with ulster
of kolitis in a dose dependent manner where I will
(22:32):
dose hundreds of billions to low trillions per day, very
high dose. Lack of Bacillus in bifodobacteria probiotics, and the
literature supports that I've seen it in my patients, and
it's clear in randomized controlled trials and meta analyzes regular
lack of Bacillus biffidobacteria probatics help. I have had occasional
(22:55):
patients with crones who say probiotics help and leave it
every individual is different. However, the literature shows that probiotics
versus placebo are not different for people with chrones, and
there was one trial actually where the people in the
probiotics group did significantly worse than the placibo group. So
(23:18):
in terms of our most common probatic Lactobacillus and Bithotobacteria probatics,
I generally do not recommend them for people with crones,
and I recommend them strongly for people with full sort
of klitis. There's a lot of other great probatics out
there that I like to use.
Speaker 2 (23:32):
One is E.
Speaker 3 (23:34):
Coli nissil, otherwise known as mutafloor. That is a great one.
There's an originally Japanese one now is available in some
products in the United States called Claustridium butyricum produces butyic acid,
which is anti inflammatory. That's a great one. So there's
a bunch of different probatics, but the most common ones
(23:56):
I dose high in ulcer of colitis and generally avoiding chrones.
Speaker 2 (24:01):
You know, that's fascinating to me, doctor Davis, because here
we have two conditions in the same category basically, and
there you have to treat them so differently and I
feel like that's why you need an expert. You need
a specialist in this area because it is so highly individualized.
Speaker 3 (24:19):
Yeah, yeah, agreed. And you know, I see a lot
of my non specialized colleagues in naturopathic medicine providing an
awful lot of benefit for people with IBD two. So
it's I think you can see any nature pathic doctor
who's close to you, even if they're not specialized. But
often those colleagues will refer their trickier cases to me,
and I'm always delighted to see them.
Speaker 2 (24:41):
Yeah. And are there any other dietary supplements that you
want to mention just briefly before we wrap up.
Speaker 3 (24:48):
Oh? Wow, so many, So I'll try to be concise.
I mean I test my patients a lot for vitamin
D and zinc and selenium. Those are three super important
ones to know what their levels are and give it
to them if they're low. Oh, if they're on pregnison,
which they often are, I always give them a supplement
called dhea to compliment that and reduce side effects. Oh,
(25:10):
there's for people with crones especially. Let me throw out
one of my favorites is called n acetyl glucosamine can
stop or slow down or in some cases even reverse
the stricturing process that narrowing of the intestines due to
inflammatory scar tissue being laid down. So I love that one.
Oh and for my ulcert of clitiest patients who are
(25:31):
severely active, there is an herb that is amazingly effective
and does have a small amount of risks, so I
like it to be managed by an expert called ching
Dai or indigo naturalis. So those are some of my
top top supplements, but there are many.
Speaker 2 (25:46):
Yeah, that's great. It sounds like you do have a
lot of tools in your toolbox when it comes to
treating this very, very complex of illness. So where can
listeners find out more about you? Do you have a
website that you'd like to share?
Speaker 3 (25:59):
Yes, myself and two colleagues treat almost exclusively inflammatory ball disease.
We're at Foundational Medicine. Our website is foundational dash medicine
dot com and we're licensed in Arizona, California, Colorado, Washington, DC, Massachusetts, Maryland, Oregon,
and Vermont between the three of us, and we see
(26:20):
people with IBD from all over.
Speaker 2 (26:21):
And you do telehealth through Foundational Medicine correct exactly yep.
Speaker 3 (26:25):
So we're licensed in all those states. People in Maryland
can come see us in person if needed, but mostly
it's telehealth and we do have a course there. It's
a twelve hour course cost the same amount as one
initial visit with us, and it's twelve hours of the
material that we've spent decades telling people about and the
most important things that we want people to know about
diets and drugs and labs and imaging and herbs and
(26:49):
lifestyle and everything like that.
Speaker 2 (26:51):
And it's Foundational dash Medicine dot com exactly. Yeah. I
highly recommend listeners. If you or someone that you love
is strugging with IBD, go to Foundational dash Medicine dot com. Uh.
This is an amazing work that doctor Davis and his
colleagues have devoted their professional careers to. So definitely Foundational
(27:13):
Medicine dot Com. Doctor Davis, thank you so much for
joining me today. This was This was great.
Speaker 3 (27:20):
Yeah, so great to be here and great to talk
to you as always. Well.
Speaker 2 (27:23):
Great. So that wraps up this episode of five to
Thrive Live once again. I'd like to thank our sponsors Prothrivers, Wellness, Sleep, Cetria, Glutathione,
the superior glutathione to sport, liver and immune health, Cognizance
citacoline to enhance memory, focus and attention, and doctor oher
is Award winning shelf stable probiotic. Thanks for listening and
(27:46):
remember you can find past shows at ithriveplan dot com
or wherever you listen to your favorite podcast, that's I
Thriveplan dot com. May you experience joy, laughter and love.
It's time to thrive everyone. Have a great night.
Speaker 3 (28:27):
Sh
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