Coconut Oil Enemas Saves Woman From Surgery

A new case study* out of Germany was just published in the October 2018 American Journal of Gastroenterology.

A 32-year old woman was experiencing fistulizing Crohn’s Disease complicated with diversion colitis.  Diversion colitis is inflammation of the large intestine brought on after surgical treatment (Usually an ileostomy or colostomy).

In early 2016 her perianal fistula, after not responding to pharmaceutical drugs, was treated with a diverting sigmoidostomy which is when surgery creates an artificial anus in the sigmoid colon.  After the surgery, she initially responded well to ENTYVIO®(vedolizumab), although the symptoms from the fistula did not go away. Just a few months later in late 2016, symptoms increased. This included looser stools, increasingly worse abdominal pain(most patients refer to this as stomach pain), and increased mucus and blood.

“Joel Sprechman wasn’t around when I was diagnosed. If he was, with The Crohn’s and Colitis Summit, I am sure I would have avoided surgery.” – Summit Member

 

She switched to STELARA® (ustekinumab), which did not work for her, and also added topical hydrocortisone.  As this too failed, she tried REMICADE® (infliximab) and the chemotherapy drug Purinethol®(6-MP).  Unfortunately, the disease continued to worsen.  Because of the persisting fistula, a reversal of the sigmoidostomy was not an option. She also failed 5-ASA(Mesalamine usually sold as Asacol® HD, Pentasa®, Lialda™, Apriso®, or Delzicol™and glucocorticoids (Usually prednisone or prednisolone).  Her doctor’s next wanted to try short-chain fatty acid(SCFA) enemas as they have been shown to successfully treat colitis.[1][2] However, they were unable to find a compounding pharmacy offering this therapy.

Since she had failed at least five pharmaceutical options and experienced increasing symptoms of post-surgery, her doctors recommend a proctectomy. This would remove all or part of her rectum. She refused this option. I can understand this challenging decision, while some live (mostly) symptom-free post-surgery lives, many continue to experience shitty symptoms. Perhaps she was aware of the following statistics. Up to 75% of those with Crohn’s and up to 45% of those with Ulcerative Colitis will have surgery. Also, post-surgery recurrence rates are up to 60% with Crohn’s Disease and 50% with Ulcerative Colitis, and the fertility rates of women post-surgery are one-third of normal. These numbers are from a 2014 publication. [3]

The diagnosed rates of Inflammatory Bowel Disease have likely significantly increased since 2014. [4]

As she decided to refuse another surgery, she asked her doctors for an alternative option. 100ml of prewarmed Coconut Oil was recommended as a suspension enema. Coconut oil contains fatty acids with relatively short chain length to SCFA’s.[5]

coconut oil enema

Just one week into this alternative treatment, abdominal pain and mucus in her stools decreased. After another six weeks, blood and mucus completely stopped! After 8 weeks of daily enemas, a sigmoidoscopy showed a clear improvement of inflammation(Both endoscopic and histologic).  After 12 weeks of treatment, all pain was gone, and she was able to return to work and resume physical activities up to four times a week!

Coconut Oil Enemas Saves Woman From Surgery #crohnsdisease #crohns #IBD #colitis Click To Tweet

She has continued daily enemas for 6 months with additional symptom reduction, without any adverse effects.

Endoscopic and histopathological findings of diversion colitis. Representative endoscopic images of the rectum prior (left) and after two (middle) and five (right) months of local coconut oil therapy. Before therapy, spontaneous bleeding, erosions, and fibrin indicated moderate mucosal inflammation. Follow-up endoscopies under treatment with coconut oil demonstrated only low-grade inflammation indicated by reduced vasculature and diffuse erythema.

The authors of the study do not believe the type of Coconut Oil made a difference. I recommend Dr. Bronner’s organic virgin coconut oil in a glass jar.  I’ve met David Bronner and support their commitment to socially and environmentally responsible products. Like One Great Gut, they are also a B-Corp committed to social and environmental performance, accountability, and transparency. Their products do not contain any genetically modified ingredients/organisms (GMOs), are certified as kosher food, and are also vegan and never tested on animals.

Organic is important as you don’t want unwanted pesticides in your body, especially rectally where the bioavailability is higher. When medicine is delivered rectally it bypasses much of the body’s first-pass metabolism and will reach the circulatory system in greater concentration due to the higher bioavailability of rectal delivery. Glass is important for the same reason as you don’t want unwanted plastics that mix with the coconut oil in your body. Even BPA free plastic is not clean enough, it’s still a plastic you don’t want in your body. I’ve heard doctors refer to BPA-free as BPS(BP-“Sh#t”), due to the toxicity that still remains.

To deliver the coconut oil rectally, you can use an Enema bulb or a stainless steel enema bucket kit. The stainless steel enema bucket is the cleaner solution and allows you to re-use easily for other healing medicines like Slippery Elm, Vitamin E, Aloe Vera Juice, and Probiotics. 

Lab Testing

I recommend checking your Inflammatory markers throughout the year at regular intervals so you can track your progress. What gets measured gets managed. What gets managed can improve.

Inflammatory markers to track include Calprotectin, a stool test that measures inflammation in the gastrointestinal (GI) tract, C-Reactive Protein which is a blood test marker to test inflammation in the body, and Sed rate, also known as erythrocyte sedimentation rate ( ESR) which is also a blood test used to test inflammation in the body and help monitor the status of inflammation, progression or decline.

Your doctor can order these tests for you or you can order directly from the One Great Gut account at Ultra Lab Tests. This is the first company that not just lets patients order their own labs (and receive the results), but also allows you to submit your receipts to your insurance for billing! Please be sure to check with your insurance, as each company has different rules.

Here are the direct links to the tests at Ultra Lab Tests for your convenience:

Sed Rate by Modified Westergren (ESR)
Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.

Calprotectin, Stool 
Calprotectin, Stool – Canada
Indicator of inflammation specifically in the GI tract. Clinical Significance Used to diagnose inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, or to differentiate IBD from irritable bowel syndrome (IBS).

C-Reactive Protein Cardiac (hs-CRP)
Also useful in predicting risk for cardiovascular disease

Lactoferrin, Quantitative, Stool
This is an Enzyme-Linked Immunosorbent Assay (ELISA) for measuring concentrations of fecal lactoferrin, a marker for leukocytes. An elevated level is an indicator of intestinal inflammation. The test can be used as an in vitro diagnostic aid to distinguish patients with active inflammatory bowel disease (IBD) from those with noninflammatory irritable bowel syndrome (IBS).

Lactoferrin, Qualitative, Stool
The Lactoferrin IBD-CHEK® is a qualitative (QL) Enzyme Linked Immunosorbent Assay (ELISA) for measuring concentrations of fecal lactoferrin, a marker for leukocytes. A positive level is an indicator of intestinal inflammation. The test can be used as an in vitro diagnostic aid to distinguish patients with active inflammatory bowel disease (IBD) from those with non-inflammatory irritable bowel syndrome (IBS).

Fecal Globin by Immunochemistry (InSure®)
The fecal occult blood test is an immunochromatographic fecal occult blood test that qualitatively detects human hemoglobin from blood in fecal samples. This is a useful screening aid for detecting primarily lower gastrointestinal (G.I.) disorders that may be related to iron deficiency anemia, diverticulitis, ulcerative colitis, polyps, adenomas, colorectal cancers or other G.I. lesions that can bleed. It is recommended for use by health professionals as part of routine physical examinations and in screening for colorectal cancer or other sources of lower G.I. bleeding.

Fecal Globin by Immunochemistry (InSure®), Medicare Screen
The fecal occult blood test is an immunochromatographic fecal occult blood test that qualitatively detects human hemoglobin from blood in fecal samples. This is a useful screening aid for detecting primarily lower gastrointestinal (G.I.) disorders that may be related to iron deficiency anemia, diverticulitis, ulcerative colitis, polyps, adenomas, colorectal cancers or other G.I. lesions that can bleed. It is recommended for use by health professionals as part of routine physical examinations and in screening for colorectal cancer or other sources of lower G.I. bleeding.

Another good company to use is True Health Labs who offer more specialized testing. TrueHealthLabs, founded in 2009, was created by a Doctor to make lab testing directly available to those who are uninsured, underinsured, whose doctor refuses to order tests and those who simply want to make their own healthcare choices. Your results will be sent to you via encrypted email. Turnaround times are usually 3-4 business days, however, more complex tests can take 14+ business days.  TrueHealthLabs  saves you 20-80% off lab tests by negotiating directly with CLIA certified labs. With a very high trust rating from thousands of users I am a fan.

They conveniently accept HSA +FSA Accounts, too! 

Some of these tests are more expensive than your usual test, and that is because they give specific insight into certain lab markers that other labs are not able to see. For example, the last time I tested my

pro-inflammatory IL2-TH1 with lab corp they were only able to tell me that I was under 31.2. Not exactly helpful!! CytoDx, seen below, will show you IL2-TH1 with greater granularity, and since we would like it to be below 12, this further shows that the <31 from the other lab is not very useful information.

Antibodies to Saccharomyces cerevisiae
These are found in approximately 75% of patients with Crohn’s disease, 15% of patients with ulcerative colitis, and 5% of the healthy population. High antibody titers increase the likelihood of disease, especially Crohn’s disease, and are associated with more aggressive disease. As the inflammation in Crohn’s disease is focused at the gut mucosa, most patients have IgA antibodies to S cerevisiae and half of these also have IgG antibodies. A minority of patients have only IgG antibodies to S cerevisiae.

TH1 TH2 Cytokine Test – Basic
For those with a confirmed autoimmune condition, the Th1 Th2 test is possibly the most important test. The test points out imbalances in the immune system by looking at cytokines, proteins that the immune system relies on to communicate. Bad communication results in complications for those with autoimmune conditions. The information this test provides helps your doctor develop a strong and effective treatment plan for you, especially when seeking alternative medicine support.
The immune system works like a seesaw. On one side you have Th1 cytokines that initiate the first line of defense. On the other side, you have Th2 cytokines that help produce antibodies to protect you from future invasions. However, when one side goes up, the other side goes down. This can contribute to a weak immune system and potentially promote autoimmune issues. Running this test will help to understand where the imbalance is. Because certain botanicals used in natural medicine can boost Th1 cytokines and Th2 cytokines, this test can help you and your doctor develop an effective plan to help balance a weak immune system and turn the volume down on autoimmune attacks.

TH1 TH2 TH17 Cytokine Test – Advanced aka CytoDX
This test is more detailed than the above with readings including

  • Inflammatory Cytokines- Th1
    • INF Gamma: Th1
    • IL-1 beta: Th1
    • IL-2: Th1
    • IL-6: Th1 and Th2
    • IL-7: Weak Th1
    • IL-8: Weak Th1
    • IL-12 p70: Th1
    • IL-17A: Th17
    • IL-18: Weak Th1
    • TNF alpha- Th1
  • Anti-Inflammatory Cytokines- Th2
    • IL-4: Th2
    • IL-5: Th2
    • IL-10: T-regulatory cells
    • IL-13: Th2
    • IL-15: Weak Th2

TH17 Test
New studies show that an increase in a particular type of white blood cell, called Th17 cells, can trigger and determine the severity of autoimmune conditions. Monitoring Th17 levels can help you and your doctor better treat the condition.

Basic CD4 CD8 Ratio Test
The CD4 CD8 ratio profile helps assess the immune system in detail. This test is crucial for patients who are suspected of having a compromised immune system as seen in autoimmune conditions and HIV.

I recommend to run the Th1 Th2 test along with this CD4/CD8 ratio test if you have any concerns with an autoimmune condition like Crohn’s or Colitis.

I hope this has been helpful for your journey towards a Great Gut!

Have you tried a Coconut Oil enema? We’d love to hear from you. Your response can help others heal.  Please comment below, add your story to our research center, or leave us a comment on our Facebook page.

References

[1] Harig JM, Soergel KH, Komorowski RA, et al. Treatment of diversion colitis with shortchain-fatty acid irrigation. N Engl J Med. 1989;320:23–28.
[2] Vernia P, Cittadini M, Caprilli R, et al. Topical treatment of refractory distal ulcerative colitis with 5-ASA and sodium butyrate. Dig Dis Sci. 1995;40:305–7
[3] CCFA 2014 Fact Book
[4] CDC Morbidity and Mortality Weekly Report (MMWR) – Prevalence of Inflammatory Bowel Disease Among Adults Aged ≥18 Years — United States, 2015 –  Published October 2016
[5] Orsavova J, Misurcova L, Vavra Ambrozova J, et al. Fatty acids composition of vegetable oils and its contribution to dietary energy intake and dependence of cardiovascular mortality on dietary intake of fatty acids. Int J Mol Sci. 2015;16:12871–90.
Case Study: The American Journal of Gastroenterology: Successful Long-term Treatment of Diversion Colitis with Topical Coconut Oil Application Dec 2018 : Zundler S, Dietz L, Matzel KE, Geppert CI, Becker E, Rath T, Neurath MF, Atreya R

Note: Originally published in October 2018, this article has been revised and updated for accuracy and thoroughness.

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Categories: Abdominal Pain, CalProctetin, Case Study, Colonoscopy, Colostomy, Crohn's Disease, Diversion colitis, Enemas, Fistula, Hematochezia(Blood in Stool), Ileostomy, Inflammation, Pharmaceuticals, Supplements, Surgery, and Ulcerative Colitis.
  • EF says:

    I have had some relief from UC symptoms using vitamin E enemas, which was the subject of this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760182/. Joel — do you know exactly what type of coconut oil was used in the referenced study?

  • Joel Sprechman says:

    They didn’t mention. I sent them an email. Will update the blog post if I hear back.

  • EF says:

    Thanks Joel. Wondering if it was organic? Raw? Fractionated? I’m amazed the study authors don’t mention the type.

  • Joel Sprechman says:

    Coconut oil (bio quality) of a German drug store chain. I don’t know what that means either, however they do not think the type made a difference.

  • Lance says:

    Great article! Do you know how much they used per treatment? Wondering if it would work to add coconut oil to coffee enema’s? If that would be as effective?