IBD (including ulcerative colitis, which increases the risk of colorectal cancer dramatically) is also increasing in developed/westernized countries.[1]
It's unclear how much of this is is due to changes in diet, hygiene hypothesis, or environmental pollutants/endocrine disruptors.
My family has personally experienced this and it is terrifying to learn how little information and how few resources there are for young children with IBD.
Right out of the gate you hit the issue that there simply aren't many "very early onset IBD" (impacting children under 6 years old) specialists because historically there were so few cases. We've seen well regarded IBD specialists who reflexively try to order tests and procedures that their own hospital will then refuse to even perform because they can't be done safely on young children. The IBD specialists are in general simply unfamiliar with young children because of the historical rarity.
From the VEO IBD specialists we have worked with they all report that the numbers are exploding and no one has any real idea why.
On top of that most of the more modern and effective treatments for IBD and Crohns aren't approved for young children at all and even top tier insurance will fight tooth and nail against covering them because their use in children can be considered off-label.
Chloramine (chlorine and ammonia) in the water we drink has been linked to IBD, IBS and Crohn’s. Most large cities switched to this now in the US (San Francisco switched in 2004). It is also difficult to filter out of water. We shower in it too, vaporized into our lungs with hot water.
Why does San Francisco put anything in the water? It has some of the best tap water in the country. Hetch hetchy water exceeds all federal and state criteria for tap or bottled water. Raw.
I don't get why people think that water is somehow safe because it comes from some magical place.
Water still needs to be transported 167 miles from HH, during which it can pick up plenty of things, like lead, chromium 6, bacteria and all sorts of other fun stuff. Never mind it has likely sat in a local reservoir for some period of time and who knows what the condition of those things are.
Before it was chlorine and then apparently that wasn't enough, so they switched to chloramine. Then, they do shit like this, with some weird spin on it:
I had several fish tanks (one ~400 gallons) that I was caring for during that switch over. I tried to do filtration and additives and the fish were never the same, they all died. It just seems intuitive that adding something to water that kills fish almost instantly, couldn't be great for humans either.
Needless to say, I only drink RO water, put a filter on my whole house and in my shower. That probably isn't enough, but at least it is better than nothing.
"
Even when disinfection occurs during water treatment processes, bacterial regrowth may occur in the long journey through water distribution systems.
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Bacterial regrowth in water distribution systems can occur because of the accidental entry of microorganisms at cross connections and broken pipes and the recovery of microorganism populations affected by disinfectants in water treatment plants.
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Since this article was written, there have been fires almost every year. The water also moves from HH to other reservoirs along the way. Let's also not forget that the dirty air from SF, blows east.
I also wasn't talking about rainwater, I was talking about reverse osmosis.
I'm 99% certain it's a new lack of fiber as the American diet becomes more attuned to meat and starch.
I would bet MONEY that if you looked at IBD rates among people who tend to frequent taco bell (lots of beans == lots of fiber) and people who tend to frequent, say, McD's, you'd see a lower rate among TB-goers. Doesn't seem like a hard experiment to set up.
Fiber supplementation can worsen symptoms of IBS as it draws water into the colon. "Just eat more fibre" is a knee jerk response of people unfamiliar with the science. These conditions are corelated to inflamation and often it's FODMAPs which are a major contributor.
This is just wrong. First of all, IBS != IBD. Second of all, IBD doctors will flat out recommend high fiber Mediterranean style diets for anybody who is not in an active flair.
Low FODMAP is also recommended for IBD and is quite reputable although not a silver bullet. I agree with the above poster that Fiber if anything is an old hat approach which can make things worse as easily as they make things better. Low fiber diets are used ALL THE TIME in the treatment of ibs/Ibd, as are high fiber diets.
I am rather convinced quite a few peopl have IBS/IBD in significant part due to their high fiber diet which tend to be high in FODMAPs if not meticulously designed and inflame the intestines with solid residue. People blindly recommending fiber as a panacea, and I’m not saying it doesn’t have a place in the treatment of IBS/IBD, but just blindly throwing fiber at the problem as if it’s always going to help us legitimately going to land people in hospital.
A big advantage to the low FODMAP diet and why it’s taken off is that it can treat constipation and diarrhea without having to adopt a high fibre diet.
I have no idea, but is it possible that the lack of fiber can cause an illness, and that adding fiber at that point can make symptoms of that illness worse, once it's taken hold?
Yes, you can get inflamed from constipation and bacteria screwing with you and such, and then insoluable fiber and other material that doesn’t digest can cause more irritation, but I’d argue the biggest problem with fiber might not be fiber itself but the foods that have fiber in them because they all tend to have FODMAPs which are also implicated in ibs/ibd.
Fiber I believe it’s generally recommended you take as much as you can if you aren’t having issues.
Dennis Burkitt documented this in 1973[0][1]. Unfortunately "Don't Forget Fibre in your Diet" (1979) and "F-Plan Diet" (1983) have faded into history a bit.
The Mayo Clinic [0] says the recommended daily intake for adults is 38g for men or 25g for women. A little less if you're over 50.
The USDA [1] makes their calculations from a proportion of 14g fiber for each 1000kcal consumed - if you're an adult male with a healthy diet you're likely consuming around 2000-2500kcal, which puts your fiber needs at 28-35g per day.
You probably need more of it, but I'm not a doctor and even less *your* doctor, so please don't just take my word for it. :)
It's unclear how much of this is is due to changes in diet, hygiene hypothesis, or environmental pollutants/endocrine disruptors.
I wish we understood this better.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020403/