Gut-Skin Connection
You’ve probably heard a lot lately about the link between digestive health and emotional health. It’s a hot topic on social media, and if you just google “gut-brain axis,” there’s no shortage of scientific documentation explaining the enteric nervous system of the gut and how it communicates directly with the brain, impacting mood and mental health.
What’s not so well-known or widely talked about, though, is the gut-skin connection. When gut health is off kilter, the skin will often show it. If the skin condition is severe and visible to the outside world (facial acne, psoriasis on the arms and legs), it can really take a toll on emotional health as well.
In today’s post we’re going to touch on the gut-skin connection a bit, and then round it out with a GIThrive case study on a fellow we’ll call Alfred.
A Bit of Background
First, when we talk about inflammatory bowel disease (IBD), we’re referring to digestive diseases that flare up when the GI tract is inflamed. The two most common IBDs are Crohn’s disease and ulcerative colitis. Horrible pain, deterioration of the intestines, bleeding, malnutrition, and debilitating digestive symptoms are part of life for people with Crohn’s and colitis. (While there’s no official cure for Crohn’s or colitis, with treatment, long-term remission from symptoms is possible, but that’s a whole other blog post.)
Skin Disorders and IBD
With IBD, it’s not all digestive symptoms. Skin disorders like eczema and psoriasis often go hand in hand with digestive disorders. One study showed patients with IBD were four times more likely to have psoriasis than those without IBD. Another study estimates up to 40% of people with Crohn’s also deal with some kind of related but non-digestive symptoms. Of these non-digestive symptoms, skin disorders are the most common.
Treatment Overlap
Here’s something perhaps even more interesting. There’s strong evidence that the same culprits responsible for inflammation of the GI tract in IBD are also be responsible for skin disorders. In fact, the super expensive biologic drugs Remicade and Stelara—if you watch TV, you’ve undoubtedly seen the ads—are now approved by the FDA to treat both Crohn’s disease (an IBD) and plaque psoriasis (a skin condition). Hmmm….
See where we’re going with this?
If the same medications can treat both IBD and psoriasis, what impacts can other therapies have on both the gut and the skin? At Vivante Health, we don’t shun the use of medications. In fact, we have a whole Smarter Meds program that helps people optimize their drugs to get most bang for their buck. BUT, we also know that meds aren’t always the answer. Sometimes, the same or better results can be achieved through other, less expensive methods.
Let’s take a look at Alfred, age 35…
BACKGROUND
Medical Summary
• Diagnosed with ulcerative colitis 6 years ago
• Taking double dose of Remicade for 4 years, every 6 weeks
• Chronic symptoms: pain, bloating, uncontrollable and unpredictable diarrhea, severe psoriasis
Social / Emotional Concerns
• Living in constant state of anxiety and fear
• Confused about diet, food triggers, and what to safely eat
• Stressed and confused about treatment options
• Fear of going to work or social functions due to disease
• Self-conscious about skin appearance
GITHRIVE INTERVENTION
Psychosocial Support
• We listened to understand his journey, needs, and stressors
• Boosted his confidence and eased his anxiety by assigning him an expert Care Team for on-demand support
• Improved his communication, coping, and self-management skills with relevant lifestyle courses
Science-based Therapeutic Nutrition
• Tested microbiome to determine which gut microbes were lacking and which ones needed to be reduced
• Matched Alfred to the low-FODMAP therapeutic nutrition plan, based on his microbiome results
• Monitored gas production to further pinpoint Alfred’s trigger foods
“Med-ucation” and Clinical Support
• Used a Smarter Meds approach to arm Alfred with unbiased truth about his treatment options
• Monitored and tracked his daily symptoms and gas production with the GIMate breath device
• Worked with Alfred and his doctor to de-escalate his condition severity and step down Remicade dosage
Life-changing Results
After 6 weeks following the low-FODMAP diet, Alfred’s psoriasis began to clear. His hydrogen gas production (indicative of bacterial imbalance in the GI tract) decreased substantially, back to normal levels.
IMPROVED OUTCOMES OVER TIME
• Completely clear skin
• Went from “High Risk” to “In Remission”
• 90% reduction in GI symptoms
• Psoriasis cleared → Increased confidence, reduced stress
• Decreased days absent from work: from 28 days to only 8
• Significant savings: $57,945 saved from optimization of medication (dropped from $73,211 Rx drug cost to $15,266)
• 75% reduction in Remicade dosage: from double dose every 6 weeks to one dose every 12 weeks
CONCLUSION: More than just diet
While it’s tempting to give all the credit for Alfred’s success to the low-FODMAP therapeutic nutrition plan, the truth is diet alone was not the answer. After all, plenty of free resources on the low-FODMAP diet can be found online, readily accessible to anyone.
Through GIThrive, Alfred’s success was optimized because he had immediate access—in one place—to everything he needed to manage his condition. The psychosocial support; the one-on-one, on-demand help from knowledgeable experts; the empathetic Care Team; the microbiome analysis, gas monitoring and personalized food plan; the empowerment through relevant education; the unbiased medication facts; the willingness of Alfred’s Care Team to support his decisions and work with his doctors to step down medication dosage—these were the difference makers.
Hippocrates said it over 2000 years ago: “All disease begins in the gut.” Nutrition has always been the answer; the GIThrive program from Vivante Health makes it doable.
About Vivante Health
Vivante Health is an innovative digital healthcare company reinventing the way chronic conditions are managed, gut first. Vivante’s virtual GI care delivers the right care at the right time by pairing data-driven technology with a coordinated team of experienced physicians, registered dietitians and health coaches. For more information, visit the company website or email [email protected].
Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/
https://pubmed.ncbi.nlm.nih.gov/28617755
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804366/