Much of the course content notes if high inflammatory markers for IBD, then refer out, but there’s not a large mention of how to support someone with active IBD. Nineteen-year-old male with very high IBD markers astronomically high, actually white blood cell count high, high sIgA, low lymphs. Family physician and I have hooked arms to help him. So far we have him on one pharm, which is LDN. Began this week at two milligrams working his way up to four. Beyond that he’s on a lot of anti-inflammatory nutraceuticals and botanicals, namely curcumin, resveratrol, boswellia, butyrate, aromatic plants. Improving steadily but with inflammatory markers like his, I’m curious if he needs more conventional intervention. Also his C. diff clarification is pending.

Chris Kresser:  Yeah, so it depends on the patient. In some cases we’ve been able to reset really severe IBD by GAPS intro, LDN, anti-inflammatories like you’ve prescribed, a lot of rest and stress management, which is almost always a big issue in IBD cases, and then probiotics; sometimes VSL#3, sometimes Mutaflor can be helpful, and then some of the soil-based organisms we’ve discussed. All that stuff together, butyrate enemas rather than oral butyrate can be helpful. We’ve had patients who’ve gone from 15 bloody bowel movements a day to two to three and then basically gone into remission. And in other cases, patients have needed to take some prednisone or 5-ASA drug in order to kind of put the brakes on the inflammation and even make it possible for them to do this other stuff. So there’s not really a one single recommendation that I can make because it does vary from patient to patient. But it’s almost always worth trying what you’re trying first. And especially like as you just followed up, if he’s at three to four bowel movements and no blood, I would at least try what you’re doing and give it a chance. Unless there’s some impending, facing surgery or there’s some urgency involved.