Hello All, this is my first post, so a little about myself.

I am 52, female and seem to be a bit inclined towards auto immune diseases. I was diagnosed with ulcerative colitis in 2001 and had a total colectomy and ileo anal pouch formation in 2004. I am currently under investigation/ steroid treatment for Polymyalgia Rheumatica.

My diet is and has always been very good, I am a great lover of home cooking and loads of veg, with mainly poultry as my protein source. I have, however, become overweight since my colectomy. This was started by 4 years of very high doses of prednisolone and then in fairness probably by the perimenopause, but in truth I really do not think my diet and lifestyle are reflected by my bmi! I have had my thyroid hormones investigated and they are normal.

I wondered whether my biome could have been affected by my illness and need re-balancing and have taken lots of advice from this website. This has included starting on a prebiotic with 50 billion cfu daily. Unfortunately, this has not been well received by my pouch and has caused a very mild pouchitis, which stops when I stop taking the prebiotics. Has anyone had a similar experience or have any advice to offer? Should I start on a lower CFU? I do know that VSL#3 is prescribed for pouchitis, which has even more CFUs, but less species of bacteria than the prebiotic I am using. Maybe I should just persevere?

I would be really grateful for some advice!

Welcome.

The starting point is your detailed food and symptom diary with serving sizes (p.187 + p.266-267). Use this to assess the *balance and variety* of your diet and lifestyle, comparing to official recommendations and those of Clever Guts.

For prebiotics and essential minerals ensure you are eating a wide variety of seeds/ nuts/ beans/ lentils/ wholegrains/ cocoa as well as a rainbow of vegetables. For complete protein and essential fats ensure you are eating a wide variety of oily fish/ other seafood/ organic eggs/ traditional cheeses/ seeds again. Limit white poultry such as chicken breast which is shockingly low in micronutrients (see Self Nutrition Data website).

Make changes to your diet and supplement regime slowly one at a time, with the agreement of your family doctor, specialist, dietician or pharmacist (p.187-188).

HTH!

Thank you Firefox! I just realised I’d said prebiotics in my post rather than probiotics..

I do eat loads of nuts and seeds although legume wise I mainly go down the chickpea route.

I will look at the references in your post. I think for me maybe the probiotic has been a bit too much too soon!

Many nuts and some seeds are rich in omega-6 fatty acids, which are potentially inflammatory. So, if possible, slowly work towards a balance and variety of mineral and fibre rich foods (beans/ lentils/ wholegrains/ cocoa).

Omega-6s need to be counterbalanced with sufficient anti inflammatory omega-3 fatty acids, especially the usable long chain format (oily fish/ eggs from seed fed hens). Oily fish and organic, free range eggs are our only dietary sources of vitamin D, which is key in normal immune function.

Chronic inflammation has been implicated in numerous health conditions, including autoimmune diseases. So a nutrient dense, anti inflammatory wholefood diet should work synergistically with your medical treatment. But again do consult a healthcare professional about any changes.

HTH!

Hi Pen
I agree with everything Firefox has written. In addition there is only one (to be best of my knowledge) pro-biotic licensed for pouchitis- namely #VSL3. Its not cheap to purchase but is IS GP -prescribable for this specific indication (but its very much at the discretion of your GP. I’ve reviewed the evidence for #VSL3 in pouchitis and if it were me, I’d give it a go. In your circumstances I’d definitely consider a full microbiome analysis and I’d also follow Prof Ailsa Hart on social media.

Brilliant, thank you again Firefox and apologies for the late reply! I now own a lovely kefir culture, which seems to be agreeing with me very well!

Thanks Graham, I’ll have a look at the Prof. I’m very grateful that you have taken the time to look at my post, apologies for the late reply!