23: Top 5 Things That Will Cause You to Flare

Once you know what's causing you to flare, you can avoid it. We're talking about the worst offenders for IBD, so you know what to avoid to stay healthy, and in remission.

TOPICS DISCUSSED:

• Root causes vs. Triggers
• The wrost offenders for IBD
• Stress and stress management
• Why fibre is good or bad
• Diet types
• NSAIDS / anti-inflammatory drugs
• Why probiotics might be bad for you

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Transcript

Josh Dech:

One of the worst things about having IBD is the risk of constantly going into a flare. You never know when it’s going to sneak up. You never know if you’re going to be at a birthday party, a special event, before an occasion, if it’s going to be in the middle of the night. They almost seem to be entirely random.

But what if there was a way you could control those flares—or at the very least avoid the most common offenders that drive your body to flare up in the first place?

Well, on this episode, I’m going to be taking you through exactly that. We're going to be covering the worst offenders for IBD—the things that are most likely to put you into a flare—and some of them you probably don’t even expect. You're not going to see it coming.

I’ll give you a hint: even probiotics—that’s one we’re going to cover here, spoiler alert—can drive you into a flare.

The question is why? And that’s what we’re going to be talking about here on this episode so you really understand this.

Now I do want to apologize if you're a regular listener. It’s been a couple of weeks since I’ve gotten a new episode out. I am working entirely solo, in addition to everything else, trying to get these out to you. So I do apologize for the delay the last couple of weeks here, but I’m working really hard to get back on top of these.

Now if you do want more access, of course, feel free to join our live groups—that’s on Facebook—where we do these every week. You can join us on YouTube or, of course, here on the podcast.

Contrary to what your doctors told you, Crohn’s and Colitis are reversible. Now I’ve helped hundreds of people reverse their bowel disease, and I’m here to help you do it too.

Because inflammation always has a root cause—we just have to find it.

This is the Reversing Crohn’s and Colitis Naturally Podcast.

Now I do these live trainings in my Facebook group every single week and put the audios here for you to listen to. If you want to watch the video versions of these episodes, just click the links in the show notes to get access to our Facebook group and YouTube channel.

And for weekly updates, information, tips, and tricks, you can sign up for our email list by clicking the link in the show notes below.

Once you know what makes your IBD worse, you can avoid those things to help keep you out of flares. It’s the most important information I could probably ever give you. It’s how to stay out of flares.

So I’m going to show you the top five most common offenders for IBD, why they cause you problems, and the last one—you’ll probably never expect.

You’re also going to learn how to avoid these common triggers. We’ll talk about alternatives, what to do when they start causing you problems, and of course, how to begin healing to make these things we’re talking about—these common triggers or flares—less of a problem for you.

Now if you don’t know me, my name is Josh Dech. I’m an IBD specialist, medical lecturer, and physician consultant for Crohn’s, Colitis, and severe IBS. My team and I have helped reverse hundreds of cases of IBD, and we can help you do it too—because I’m telling you, I promise you from the bottom of my heart, this is not an irreversible condition that you’re stuck with.

It’s just an inflammatory condition that has a root—like all other things.

And today, I’m going to show you the top five offenders that are worsening your IBD, how to avoid them, and what you can do about it.

First off, I want to separate the word trigger from root cause, and here’s why.

This is going to make the whole thing a lot more simple.

For example, the number one thing we’re talking about today—the first offender for IBD—is going to be stress.

Now I hear all the time—people say, “Well, stress is a trigger for me,” or “Stress is the cause of my IBD. Every time I’m stressed, I flare up.”

That’s not the cause. It’s a trigger.

So the root cause is the thing that created your disease—what drove your body to disease. A healthy bowel does not get stressed and then start to bleed and develop flare symptoms.

So this is the difference between stress and trigger: a trigger is something that’s going to worsen your gut health or make you more prone to having flares, whereas a root cause is what actually caused this to happen in the first place—making you susceptible to all the things we’re talking about today.

So I want to make that very clear. A trigger is not the same as a root cause.

Root causes are made worse—or the symptoms are made worse—by triggers. But again, a healthy bowel under stress, for example, isn’t going to bleed and have bowel disease symptoms.

So with that being said, I want to keep that in mind as you and I are going through this conversation together.

So the first thing I want to tell you about—number one, and I know you know this one, but I want to show you why—is stress.

Stress is the number one driver that I see of worsened IBD symptoms. Not to say again it’s causing your IBD, but it’s worsening it.

Here’s why. There’s a lot of different kinds of stressors you’ll experience in a day. There can be a lot of things. It can be physical stress. It can be emotional. It can be immunological stress—like maybe getting the flu. It can be sleeplessness. So things like hormetic stress even, where going to the gym is a good stressor for your body—but it’s still stress.

The analogy I like to use all the time is your body is like a cup of water.

All these stressors are filling that cup. When it gets to the top and overflows—it causes disease.

Well, stress fills that cup. But hormetic stressors—so things that your body will go up against that can make it stronger—like working out, getting exposed to the flu bug going around...

The stronger your body gets, the less susceptible you are to some of these problems.

If you go to the gym and you work out often, well, you’re not going to be crippled, walking around limping sore for three weeks—because you go often.

But if you’ve never gone before and you go hard at the gym, of course you’re going to be stiff and sore.

And so what happens under stress—all these different kinds—they fill your cup.

It doesn’t have to be just psychological, emotional stress. Going to the gym can be stress.

Or maybe you’re someone who is fasting—you’re trying intermittent or long-term fasting. Maybe you’re trying cold plunges because you heard they’re good for your immune system.

These are forms of stress that are filling your cup and could very well be contributing to your flares.

The ones we just happen to recognize are emotional stressors—like work stress or relationship stress—where you think, “Wow, I got into a fight last night. I’m flared up today.”

Well, of course, that’s the one you recognize.

But there’s many kinds of stressors, and your cup overflows.

So when we're talking about managing this, I want you to keep in mind—number one is reduction, obviously.

But you can’t always avoid a stressful situation.

So what can you do when you’re under stress?

Very simple things: breath work.

There are apps you can use for this—Nerva, Apollo Neuro is another good one.

There’s all kinds of apps out there you can actually use to get yourself better.

Because if we can’t reduce the stressors going on in your life, what can you do to manage or combat the damage stress is doing to you?

So avoid ice baths if you’ve got bowel disease. I will not have you ice bath by any stretch of the imagination.

I won’t have you fast either.

There’s other ways you can get food in. I know fasting can almost give you relief, because you’re not requiring exercise or requiring work—mechanical work—on your inflamed bowels.

So fasting might feel better, but there are ways to get your food in that aren’t applying these stressors to the body.

So working on that breath work, working on other stimuli—you can do all kinds of tapping and things you can work on for your body to stimulate that vagus nerve.

But we want to watch the stressors—all of them. Physical, emotional, immune stressors.

Getting yourself in the sun, gentle exercise, not going too hard—it’s very important.

The next one I want to tell you about is roughage.

Now again, you probably know this one. But I want to go into this one with you and explain why.

Roughage is one of these things—it’s not… not everyone’s going to have it.

You and your best friend might both have IBD, for example.

One of you will have more of a problem from fiber, from dried meats or thick, like, hard meats like beef versus fish, for example. But not everybody.

And this is where we have the really important distinction.

I want to say roughage—so in general, when you’ve got IBD, the first thing I want you to do: cook your foods, skin your vegetables, get soft foods.

Think—you would think about feeding a toddler.

Your gut is inflamed.

Think of it this way: if I sprain my ankle and I gotta walk up a flight of stairs—it’s going to hurt, but I can get through it.

But the second that I put on a backpack with weights—100 pounds—and I try to walk on that sprained ankle—now it’s worse, and it hurts that much more.

The same thing’s happening when you eat roughage.

When you're eating things that are requiring work out of inflamed tissue, the less workload, the easier it is.

The less weight I put in my backpack walking upstairs, the easier my journey is going to be.

The more I put in it, the worse it’s going to be. The more pain I’ll be in.

And when you’re eating food, you want to think about things that require very little breakdown.

So things that are blended, things that are mashed, things that are cooked, things that are soft.

Skin your vegetables—that type of stuff.

But the management—we always have to get back to the root, right?

You’re inflamed for a reason.

I can’t emphasize that enough.

But these are just simple managements that you can do.

The next one I want to put in here—this one might throw some controversy. And I want to hear your thoughts on this one, because it’s not about what I know is good—it’s what you also have been told that we want to compare with here.

So diet.

Oftentimes doctors, dietitians—they’re going to tell you: go with the white diet.

White bread, white pasta, white carbs, white sugars, etc.

Because the truth is, it’s less mechanical work.

We’re not requiring a lot of load out of your gut, because it’s stuff that basically breaks down in the mouth.

But we have to watch for other things.

One: those are not very nutrient-dense foods.

Your body needs these nutrients to help you heal and help you get better.

The next one though is a lot of additives that are pro-inflammatory.

Sugar—huge inflammatory process.

It feeds nasty microbes, can increase permeability in the gut.

As well as dairy and gluten, primarily. These are the first three things.

Including alcohol—so four—I have people cut out: sugar, dairy, gluten, alcohol immediately.

Whether or not you believe or know they’re causing you a problem, they’re causing a problem somewhere.

And given how easily avoided these are, it’s always best to just take them out of your diet.
So these things will feed nasty microbes.

We also have to look at the additives.

We have different chemical additives, preservatives, pesticides.

Glyphosate—one of the biggest offenders.

We have to watch these in your food.

They give rise to bad microbes which produce bad byproducts, which stress your immune system, which inflames you and causes more problems.

They create permeability—so they actually will take your gut and they’ll poke little holes in your gut lining, which allows toxins to go from your gut out, and then toxins from outside to get into your gut as well.

And this is a big problem.

Now your immune system doesn’t know which way to go.

We got nasty byproducts getting into your blood, which means your immune system overreacts.

It’s a big deal.

So all this extra permeability is a problem. It stresses your immune system, makes you sick, you get inflammation in other areas in your body.

The next is it decreases—your sugar, dairy, gluten, these chemicals—they actually decrease that protective mucus layer.

It’s like wearing a sock in a shoe and going for a walk.

Imagine you take your sock off—of course, you’re going to get a blister.

Because you’ve worn down the gut lining or this protective layer inside.

And so things are actually connecting to tissues more directly, and now you’re having a problem.

You’re having more inflammation on top of inflammation.

Your sugar, alcohol, dairy, gluten, other additives, chemicals—they also stress your immune system.

So it’s impairing immune function.

Your immune system—think of it like it only has so many soldiers to work with.

And then what do you do? Well, you send soldiers off to battle in one area, you send them off to the next and the next and the next.

Well, suddenly your army’s spread too thin.

It can’t really do its job.

Think of your immune system similarly.

When it spreads so thin, it’s overactive, overreacting, it’s overworked—and now you’re having problems.

And we’re stressing our immune system.

Keeping in mind—70% or so of your immune cells are made and matured and grown inside your gut.

Well, guess what—if they’re marked all over the place and your gut’s not even healthy, you’re not producing good soldiers either.

So your immune system becomes more stressed, it overreacts, it can contribute to more inflammation and imbalance.

These other things—especially like sugar—will also alter the pH of your gut.

Inside your intestines here, it’s this very fine ecosystem.

You’ve got trillions of microbes who are living in harmony, doing their jobs.

However, they like to live—picture—I’m from Canada, it’s here, it gets colder than the surface of the Moon here.

But imagine I go to Ecuador, where suddenly it feels like the surface of the Sun.

And so what happens? I go from surface of the Moon to surface of the Sun.

My body can’t handle that. I’m not equipped for that.

What happens—your gut likes to live in a certain ecosystem, a certain type of climate.

What happens when you change the pH?

Typically, you’re bringing it down, making it more acidic.

It’s going to give rise to a lot of these nasty microbes, which then overgrow, start to cause problems, because they produce bad byproducts—which make you inflamed.

We have to watch that.

So the first we’ve talked about—these are the obvious ones: stress, roughage, and other parts of your diet.

So sugar, gluten, dairy, additives, alcohol.

The next two—you may not have heard of. I hope this next one you have, I really have.

And the last one is going to surprise you.

You might actually get mad at me for it.

And I hope you do, because I’d love to talk about this a bit more.

Now if at any point you have questions, drop them below. I want to make sure you have a chance to ask those questions.

So the next one I’m going to tell you about here is NSAIDs.

This stands for Non-Steroidal Anti-Inflammatory Drugs.

Think Naproxen, Ibuprofen—like your Advil, those types of things.

Here’s the thing—this is one of the top things you should be told from your GIs and your gut health team at the hospital, but oftentimes they neglect this, or miss this, or forget it—and that’s a huge problem.

In fact, if you’re familiar with one of the functional medicine OGs, Dr. Andrew Weil—he actually gave himself bloody bowels from taking too much NSAIDs.

Ibuprofen.

A lot of aches and pains going on in the body—instead of addressing the roots, this is what got him into functional medicine.

He was a traditional physician. He was severely overweight, he was sick, aches and pains, taking the drugs like recommended—caused bloody bowels and gave himself colitis.

Because of the over-NSAID use.

This damages that gut lining—we just talked about this.

Imagine your gut has a layer or a lining in it—it’s like a sock in a pair of shoes.

If you go for a walk in your shoes without socks, that rubs and rubs and rubs, it gets red, your foot will blister and it will bleed.

But if you put a sock in there—you’re protected.

The same thing happens in your gut.

This mucus layer protects them—but these NSAIDs actually damage that lining.

It increases permeability—again, like we just talked about.

It actually—NSAIDs like Ibuprofen—you take them for aches and pains—it helps, it’s anti-inflammatory in the body.

In the gut? It is pro-inflammatory inside your digestive system.

So you’re already inflamed, then you’re taking NSAIDs like Ibuprofen or something else, and you’re making your inflammation worse.

You’re pouring gas on the fire and wondering why it’s burning down.

So you have to watch for these.

Another thing it does is—it can of course increase bleeding, but it also disrupts that microbiome.

We talk about this very delicate ecosystem living inside your gut—well guess what?

You get an increase of the bad guys and a decrease of the good guys when you’re taking things like Ibuprofen into your body.

And of course, you’re going to be inflamed, and it contributes to these problems.

We really have to watch for these.

Josh Dech:
The last one—this one is going to surprise you:

Probiotics.

Probiotics can be a huge, huge problem in IBD.

And I’ll tell you why.

I hear all the time, “Well, I gotta take your probiotics, make sure you’re taking your probiotics, they’re good for your gut.”

But here’s what we need to know: Probiotics are not always good.

Probiotics are living organisms.

If you haven’t heard my analogy, I’ll give this one to you fresh.

I talk about probiotics, prebiotics, and postbiotics like having fish in a fishbowl.

If I’ve got a fish inside my bowl—that’s the living organism—that is my probiotic.

Now, that fish has to eat, right? I gotta put fish food into the bowl.

That is my prebiotic—that’s what the fish eats.

Then naturally, the fish, being alive, it eats—and what does it do? Just like you—it poops.

Now that is called the postbiotic.

So:

• Prebiotics are the fish food,
• Probiotics are the fish,
• Postbiotics are the fish poop.

Inside of your gut, the microbes are the probiotics—the things we consume.

And what happens? The prebiotics—they eat.
Postbiotics—they poop.

When you take a bunch of probiotics, what do they do?
You're putting a whole lot of fish inside their fish tank.

And we don’t know:

• Do they belong there?
• How many species are there?
• Are we altering the ecosystem?

What’s happening when you’re adding a bunch of living things into a delicate ecosystem?

Even helpful things—it may not be helpful for you.

I’ve had clients who’ve come in, who’ve actually taken probiotics and bled profusely—like cups a day.

Like, to the hospital, emergencies, needing transfusions, because it caused so much bleeding.

We also have to consider what happens in the ecosystem.

The big fish eat the little fish.

Some fish will eat each other.

Well, we have certain microbes, for example like Lactobacillus reuteri.

This is known as a bacteriocin.

So it actually will gobble up and destroy other microbes that shouldn’t be there.

Well, when they destroy them—think of it like popping a balloon full of confetti.

What happens when you pop that balloon?
 All that confetti goes everywhere.

Now your immune system has to jump all over the place like freakin’ Seabiscuit to try to clean it all up.

And so sometimes, destroying microbes is actually a bad thing.

And so I’m going to put this in line here and say—if you take things like oregano oil, and you just, “Oh, let’s just see what happens”—you might cause yourself a big issue, might really mess yourself up.

They drive immune pathways.

Your probiotics can drive immune pathways.

They can kill off certain things which lead to excess toxins in the system you may not be able to get out.

There’s a ton of problems that can be created from taking probiotics.

Now we also have to look—there are certain strains, particularly Lactobacillus—so your L strains—they tend to be higher in histamines.

Well, a lot of what we see in bowel disease—in the hundreds of cases that we’ve helped now reverse—is histamine intolerance or dominance.

Not necessarily MCAS—we call it Mast Cell Activation Syndrome—but histamine dominance or intolerance.

So certain foods:

• Ferments,
• Probiotics,
• Maybe it’s your kimchi,
• Your kombuchas,
• It could be things from a can,
• Things that are cured, like cured meats, beef jerky, sausage—

These things might be contributing to histamine release in the body, leading to more bloat and elevated immune responses—which can contribute to your bowel disease.

So you have to watch for that.

And of course, if you have conditions like SIBO—we call that Small Intestinal Bacterial Overgrowth—

Let’s go back to your fishbowl.

Imagine now you have a fishbowl that’s only meant to hold 30 fish, but you put 300 fish in it.

You’re going to have an overgrowth issue.

The tank’s going to get nasty, microbes are going to die, it’s going to be really toxic and polluted.

Small intestinal bacterial overgrowth is when your microbes—there’s too many inside the small intestine—and they overgrow, and they cause a lot of problems.

We see this connected into things like parasites, etc.

But now, this fish tank is so full of fish that all we have is cloudy water and fish poop.

It’s not going to be a good environment.

It’s also going to be a nasty environment for your gut microbes to live.

So probiotics, depending on what you’re taking, why you’re taking them, how your body’s responding, the state of your system—probiotics might be a very bad idea.

It can make things much, much worse.

We have to use them selectively or therapeutically.

You wouldn’t just go randomly into a pharmacy and pop a bunch of prescription pills just to see what happens.

We should treat your microbiome—your probiotics—with the same type of reverence.

I don’t want you just taking a whole bunch because you think they might be helpful—because they’re probiotics.

They could actually be very harmful for you.

And if they’re causing you a lot of issues, we have to be very careful.

You may not notice they cause you issues for several days.

And this is where taking probiotics—microdosing, very low doses—is less of an issue.

The dose is definitely what contributes to the issues you may have.

But I don’t throw probiotics at my clients almost ever randomly.

If I do, it’s very controlled, and very slow scale to increase, because we need to know what’s going on—especially in the early stages.

So if you’re taking something and these probiotics are muddying your fish tank—that’s a problem.

If you contribute to the overgrowth—that’s a problem.

If you’re taking—if you have histamine issues with IBD (you probably do at some point, somewhere on the scale)—they might be causing you problems, especially your Lactobacillus strains.

So we have to be very, very careful what we’re taking, why we’re taking it, and what it’s doing inside your system.

Now these are the top five most common offenders I wanted to go through.

And the probiotics are less well understood, but super important to know, because if you’re taking them—again, you could be making yourself worse.

If you’re on the YouTube or you’re listening on the podcast, there’s links below that you can actually click to get to, to talk to me and my team.

We’ll sit down, find a time in the schedule, make sure we can get you some help.

There is help for everyone—no matter how far along you are, how new or old the diagnosis is, how many symptoms you do or do not have—there is help for you.

Because your body is going through it for a reason.

The analogy I use is this:

If you step on a nail and go to the doctor, and your doctor looks at that nail and goes, “Man, it’s really bad. But it’s kind of part of your body now. There’s nothing we can do. So here’s some numbing cream for the rest of your life. And if it gets really bad, we’ll cut off your foot.”

Well now you go to your doctor—having you been perfectly healthy—suddenly you’re not.

Now you’re inflamed and you’re sick.

And they go, “Yep, it’s just part of your DNA, there’s nothing we can do. Here’s some drugs to take for the rest of your life. It’ll help the symptoms. And if it doesn’t work, we’ll cut your bowels out.”

It’s crazy.

You know it, I know it.

You can’t go from healthy to sick and it just be this genetic random condition.

There’s a reason for it.

In fact, genes are only correlated less than 25% of the time.

There is no gene that causes bowel disease.

We’ve mapped the entire human genome—not one that guarantees you get bowel disease.

So what causes that change?

We know it just can’t be these random issues.

You only ever inflame for a reason.

And most cases with antibodies—they’re probably not even attacking you.

So who’s to say it’s autoimmune?

They’re attacking something else.

This is where we have to get into the details about it.