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.
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, 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. 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 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 Disease, 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 woman post surgery is one-third of normal. These numbers are from a 2014 publication. 
The diagnosed rates of Inflammatory Bowel Disease have likely significantly increased since 2014. 
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.
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 enema’s a sigmoidoscopy showed 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 enema’s for 6 months with additional symptom reduction, without any adverse effects.
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 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 which guarantees cleanliness, purity, and quality. Their products are also vegan and are 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 bodies 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.
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 manged 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 test 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:
I hope this has been helpful for your IBD, IBS or general gut health journey!
Full study found here (subscription needed).
Have you tried a Coconut Oil enema? We’d love to hear from you. Your response can help other’s heal. Please comment below, add your story to our research center, or leave us a comment on our Facebook page.
References 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.
 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
 CCFA 2014 Fact Book
 CDC Morbidity and Mortality Weekly Report (MMWR) – Prevalence of Inflammatory Bowel Disease Among Adults Aged ≥18 Years — United States, 2015 – Published October 2016
 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.
Note: Originally published in October 2018, this article has been revised and updated for accuracy and thoroughness.