the times | Tuesday October 13 2020 1GT 7
times2health
Gut feelings: bowel disease symptoms
6 In the UK about one person
in 210 has Crohn’s disease or
ulcerative colitis, the two main
forms of inflammatory bowel
disease (IBD). Lifelong diseases
of the gut with no known cure,
they are caused by a fault in the
immune system that leads to
the body attacking itself.
6 In colitis the ulcers and
inflammation are in the colon
(large intestine); in Crohn’sthey can be in any part of the
digestive system.
6 They are more serious than
irritable bowel syndrome (IBS),
which is not an inflammatory
disease, although it is possible
to suffer from IBD and IBS.
6 Treatment can include
steroids (used short-term, for
example during flare-ups),
immunosuppressants (which
dampen the immune system’sability to attack the gut) or
biologics (made from proteins
and natural substances). Up to
eight in ten people with Crohn’s
and three in ten with colitis will
also require major surgery.
6 Common symptoms can
include urgent and frequent
bloody diarrhoea, severe pain,
extreme fatigue, malnutrition
and dramatic weight loss.
Source: Crohn’s & Colitis UK156 fewer calories the day before
fasting, and 239 fewer on the day they
fasted. The men’s dieting regimen was
supposed to cut their intake by 2,
calories over each three-day period.
But they only cut it by 1,000 calories,
thanks to their eating more on food
days and generally exercising less.
“I don’t think the dieters were
consciously compensating for lost
calories,” says Dr David Clayton, one
of the authors of the study and a
senior lecturer in nutrition and
exercise physiology at Nottingham
Trent University. “Their reduced
exercise was at a very subtle level
of generally moving less, and they
didn’t report feeling hungrier on days
one and three.
“I think our findings probably go
some way to explain the findings from
Dr Weiss’s study. The lower levels of
energy expenditure may possibly also
explain losses in muscle mass.”
The solution is obvious. Exercise can
compensate for diet-induced muscle
loss. It doesn’t have to be a punishing
regimen of weights and pull-ups, says
a 2017 report in the journal Medicine
& Science in Sports & Exercise.
Researchers at Saint Louis
University, Missouri, followed more
than 50 sedentary people on
weight-reduction diets and found that
those who habitually did light daily
cardiovascular exercise saw no loss in
muscle mass. The types of exercise
included brisk walking, jogging,
cycling, gardening or walking to work.
Strength training was not included.
As Clayton says, common sense
should still prevail when fasting
intermittently. “Many see it as a
miracle diet, but it’s not. It’s simply an
alternative way to reduce calorie
intake. Practising a degree of
mindfulness over your eating, and
taking up some exercise, could
increase your regime’s effectiveness.”
GETTY IMAGESI learnt to conceal sudden agony
(yet) surgery. Still, after the third day
of intravenous prednisolone I feel like
I have been admitted to the psych
ward and no one has told me.
Fluorescent lighting, drugs coursing
through my veins that made me madly
anxious and insomniac, gave me acne
and a puffy face, exhausted with a
useless simultaneous energy.
Fellow students were weird about it.
A girl who struggled with her size got
angry with me for only being able to
stomach dry Frosties for weeks on
end: “Your body wouldn’t let you put
on weight even if you wanted it to.”
And I encountered lots of helpful
experts: “Oh I get that when I eat red
peppers”; “Oh you really should be
vegetarian”; “Honestly, maybe have
less butter”; “Have you tried yoga?”
In my third year, my doctors hit on a
winning drug combo that included the
immunosuppressant azathioprine. I
came off steroids long enough to have
a normal-sized face, but had to go on
antidepressants to help resolve what
the steroids had done to my brain
and what the UC had done to my
self-esteem. I started playing netball
again and even got a first for one of
my dissertations. Not the Wilde one.
There is no neat ending, but since
leaving Cambridge I have experienced
only occasional relapses that were
easy to hide away in the storm of
London life. Mostly these have been
mild, but at times UC has returned in
a more determined way. One low
point involved me turning up to see
my consultant dressed for work,
company BlackBerry in hand, and
being told they had no choice but to
admit me on the spot because I was
not responding to treatment. I hadn’t
even told my boss I was sick.
I’ve made some weird decisions
along the way to survive emotionally
and financially. I’ve walked away from
opportunities I just didn’t have the
strength for and I’m sure it’s affected
a few relationships, or at least my
attitude towards them.
At the moment my illness is kept at
bay by a new drug (Vedolizumab), life-
changing as far as I’m concerned, that
I get intravenously every few months
courtesy of the NHS and thanks to the
consultant who has looked after me
for 17 years. I’m symptom-free and can
eat everything either side of muffins
and black coffee. I also, eventually,
took some of the advice I received as
a student and took up yoga. It didn’t
turn out to be a cure, but it does allow
me to feel, for now at least, like my
body and I are back on the same side.I
t was freshers week and I was
sitting in the front row at an
Amnesty International meeting at
Cambridge University with a few
new friends. All I wanted to do was
nod along intelligently so that they
would still like me by the end of the
evening, but this was proving hard,
because my stomach was making
intermittent, thunderous groans. I
sucked in my stomach, shifted and
squirmed, and pretended I wasn’t
mortified, hoping everyone thought it
was my friend Jim. Eventually the
speaker broke off from her solemn
words and — in front of the whole
auditorium — told me that I really
ought to have eaten something.
The symptoms intensified. The full
gamut of gastro symptoms. Food
became the enemy — severe, stabbing
pain would follow 20 minutes after
every meal. I learnt to excuse myself
with a poker face concealing sudden
agony, the room falling away as I held
my breath and found privacy to
breathe, usually in the nearest toilet.
I went to my GP repeatedly. I sensed
these doctors felt most comfortable
dismissing young, female undergrads
as the victims of essay-induced stress
or food issues. I was put on a pointless
exclusion diet — only allowed to eat
cauliflower and rice, weight fell off me
rapidly. One male GP asked me if the
rectal bleeding I was describing was,
in fact, my period. There seemed to
be a disconnect between what I was
experiencing and how seriously it
was being taken. I seemed destined
slowly to die from drowning in mint
tea — “worth a try for IBS”.
A female doctor eventually decided
my hellish symptoms merited an
urgent endoscopy. The inflammatory
bowel disease ulcerative colitis
(UC) was diagnosed. I was put on
medication and told there was no cure.
It was a weird thing to throw into
the mix with my early undergraduate
days. I was constantly exhausted — a
bleeding, ulcerated colon will do that
— and having original thoughts about,
say, modernist poetry didn’t figure
highly on my to-do list any more.
I remember discussing my Oscar
Wilde dissertation in a one-on-one
supervision. I was trying to decide
whether to write about Wilde and the
colour yellow or something to do with
Wilde’s moral universe. My supervisor
was on the edge of his seat. So was I,
but for different reasons. I braced my
entire body to the sudden pain, trying
to utter sentences worthy of Wilde’s
memory while simultaneously holding
my breath. Maybe if I could nail my
idea this would pass. But it wouldn’t.
“I’m just... in... quite a lot of pain.. .”
When symptoms crescendoed I’d
spend hours doubled up in pain on my
bedroom floor. Or I’d stalk the halls at
night, not wanting to visit the same
toilet twice in a row so I didn’t wake
anyone up or cause too much of aEithne Staunton
fell ill during her
freshers week. It
was life-changing
literal stink. Like a skinny, bookish
ghost haunting the toilets of Girton
College. I lived on coffee and muffins
for days on end — calories and fuel to
get through the day with minimum
impact on my intestines.
At the early stages of a relapse I’d
tell myself that it was something I had
eaten — that funny burger — or the
college bar wine. Over weeks the pain
would intensify until I’d have to start
taking steroids, which would make me
feel manic and depressed. Worse, they
would make my face look fat. College
balls, parties, my graduation, all the
photos I have track my illness through
how much weight I had lost or how
my cheekbones had disappeared
beneath the steroids’ hormonal puff.
On Valentine’s Day in my second
year I welled up at a bus stop as boys
in turtleneck jumpers cycled past with
bouquets for girls whose most intimate
relationship that year was not with
their gastroenterologist, while I waited
to be scooped off to a bone density
scan at Addenbroke’s hospital. I had
appointments with dietitians, endless
ultrasounds, x-rays and endoscopies;
an appointment with a dermatologist
to discuss my hair loss. Was it the
illness, was it the drugs or was it the
anaemia? Or was it the stress caused
by the illness, drugs and anaemia? One
small victory: a couple of med students
observing my consultation weren’t able
to identify the chief causes of it, but I,
an English undergrad, could list them
all. Living the dream.
When oral steroids just wouldn’t
keep me well, I had a couple of
term-time hospital stays. I seem to
fall somewhere in the middle of how
serious UC can get. I’ve had my share
of admissions over the years, but neverThe drugs
gave me a
puffy face
and made
me madly
anxious
Eithne Staunton
TOM JACKSON
65%The percentage of lean
muscle mass lost by
some dieters who went
on an intermittent fast
for three months