Inflammatory bowel disease (IBD) like Chron’s and Ulcerative Colitis affect nearly 1.6 million people in the US.  Chron’s can affect the entire gut while Ulcerative Colitis has an affinity for the large intestine.  Both cause significant inflammation and can also create issues in the eye, skin as well as joints.  Symptoms often include abdominal pain, diarrhea, bloating, unexplained weight loss, anemia as well as pain in other areas like the joints.  Symptoms can vary from mild to severe but can have serious complications due to the degree of inflammation especially during a flare.  Standard of care is decreasing the inflammation before serious side effects occur.  Treatment options include medications like sulfasalazine, steroids, biologics as well as immunomodulators like methotrexate if severe.  Sometimes parts of the intestine have to be removed in extreme cases.  Even with these medications persistent inflammation and disease progression may occur.

When I work with someone who has IBD, I always start with their diet and remove any offending foods that may also be triggers.  Then attention is turned to the gut microbiome and testing and treatment are administered to optimize this.  Supplements or more natural anti-inflammatories are added to aide in decreasing the inflammation as needed.  Even with all of these approaches some people will still need medications but often they don’t need as much or are under much better control while on them than prior to all the changes.  Recently, I have been reading about one possible culprit that we need to consider especially in resistant cases.  Cue Anti-saccharomyces cerevisiae antibodies.  If you or if you know someone who has serious gut issues then READ ON to learn about this test that a regular lab can check and what it means for treatment and prognosis of Chron’s and some cases of Ulcerative Colitis….

Saccharomyces Cerevisiae is a species of yeast that has been a key ingredient in winemaking, brewing and baking.  It was originally isolated from the skin of grapes and is used wide-spread in probiotics. While this is often considered a good bacteria in the gut occasionally this strain can cause infections in humans.  Europe requires verification if there is a strain that is used in food preparation it must be demonstrated to not be resistant to anti-fungal medications for this reason.

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This seemingly overall harmless yeast is starting to become a suspect especially in people with Chron’s.  Studies are showing people who have Chron’s often have these antibodies (60-70%) compared to those with Ulcerative Colitis (10-15%).  In addition, a study in children revealed when using biologic drugs this antibody might be a prognostic indicator of response to treatment with biologic medications.

While this is good for diagnosis and maybe prognosis one of the key areas that we are missing is that if there are antibodies to this yeast then the person with the antibodies may be having significant reactions to anything that has yeast components.  This goes beyond a food allergy or a food sensitivity.  This is an immune response to potentially a food component.  Basically, anything with yeast in it may be a trigger!  This includes alcohol, vinegar and gluten free options that have yeast.

If you have IBD, then get tested for these anti-saccharomyces cerevisiae antibodies.  If you have them then eliminate all products that contain yeast and see if you improve.  If you can’t get tested or even if these are negative, it is worth a trial of elimination to see if this helps your symptoms.  Any time you do a food elimination it needs to be at least 3 weeks and ideally 6 weeks or longer.   I would also avoid all probiotics that have saccharomyces.  Something else to consider, when someone has yeast antibodies due to candida I often find they improve when treated with anti-fungal medications and supplements.  I wonder if anti-fungals would be beneficial in select cases of Chron’s and ulcerative colitis?  Hmmm…?

To your health,

Laura Miles