How Sauerkraut and Kefir Helped Bring My Ulcerative Colitis Into Remission

The GI Effects Panel gave me my first clue.

In late 2014, I received the results of a stool test I’d taken the previous November. Called the GI Effects Panel, this test looks for parasites in your gut, measures your inflammatory markers, and reveals insights about your gut bacteria. I was looking for clues about my newly diagnosed ulcerative colitis and how to get it into remission.

As expected, the test showed I had high inflammation—my fecal calprotectin, a measure of inflammation in the intestines, was 466 when the normal range is around 0 to 50. I had no detectable parasites, which was a relief, though also a small disappointment. Part of me had hoped some parasite would be found. I wanted to learn that my colitis had been misdiagnosed!

But the most interesting thing about the results was what they said about my gut bacteria. A graphic showed that, compared to most people’s guts, my own gut had abysmal bacterial diversity.

We’re supposed to have a thriving microbiome in and on our bodies. Trillions of bacteria are supposed to live on all our surfaces—on our skin, in our mouths, and, especially, in our guts. There are supposed to be hundreds of species. They help digest our food, train our immune systems, and just generally keep us healthy.

But according to this stool test, my gut had very few bacterial species, and very low numbers of the species I did have.

The GI Effects Panel is inconclusive. It’s not embraced by the scientific community, though it is respected among alternative practitioners. But its results made sense to me.

In various places, I had read about the importance of gut bacteria in healing ulcerative colitis. UC sufferers tend to have lower gut bacterial diversity than most people, and I’d read that probiotic foods, which contain live bacterial cultures, are often one of the keys to rebalancing health.

When I saw the test result, I was already taking a probiotic just in case it might help. I hadn’t noticed any specific effects since I’d started taking it, though, and I knew little about probiotics, so I wasn’t sure if I was taking the right one.

But the GI Effects test result fueled my desire to do more. I decided to up my intake of fermented foods.

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I started to experiment with sauerkraut.

Both the Specific Carbohydrate Diet, which had helped me a little, and the macrobiotic diet, which I was currently on, encouraged fermented foods. They differed, though, on which ones they recommended: the SCD emphasized homemade yogurt, while in macrobiotics, miso soup was essential. This was confusing—there were probably different bacteria in these different foods.

It was hard to know which bacteria I personally needed. But I figured that, if my bacterial diversity was low in general, it shouldn’t hurt to add various kinds of fermented foods as long as they weren’t harmful.

The SCD’s probiotic yogurt contains the milk protein casein as well as possibly a little lactose. I decided to keep avoiding it for now, in case I had intolerances to those. Instead, I opted to try sauerkraut. It’s usually just fermented cabbage and salt; I couldn’t think of anything inflammatory there.

I disliked sauerkraut, unfortunately. I don’t like pickly tastes; I had always given my husband Ron my pickles at restaurants. But now I began eating a large forkful of sauerkraut just before lunch and dinner, wrinkling my nose and forcing it down like cough syrup (which, actually, I did like!). Then I could move on to my meal of rice, tofu or lentils, and kale, which was all I ate these days.

Since I liked my meal and didn’t like sauerkraut, I kept the two separate so as not to “ruin” my meal.

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The results were inconclusive…at first.

Within a few days, the strangest thing began to happen. I began to crave sauerkraut, even though I still didn’t like it. It felt as though my gut was sending a signal to my conscious brain. Hey, I like this! it was saying. Give me more!

I couldn’t tell if I was imagining things. It was the only explanation I could come up with for craving a food I didn’t like.

Soon after beginning to eat the sauerkraut, my post-Thanksgiving flare began subsiding. Unfortunately, though, I’d been unscientific with my remedies. At the same time as starting sauerkraut, I’d also started two new meds, Apriso and Proctofoam, and had reverted back to my “safety meal” of brown rice, kale, red lentils, and tofu.

I’d been desperate to get better. And I had improved…but now I didn’t know which of these changes was restoring my health. It might have been all of them combined.

What became clear over time was that the sauerkraut was, at least, important. Whenever I ran out or forgot to eat it, my stools softened within a day or two. I suspected it was providing some of the bacteria my body no longer harbored on its own.

Many probiotic bacteria, whether taken through pills or through food, do not actually recolonize the gut. They just help out while they’re there, then get expelled with the waste. Sauerkraut felt like my body’s version of a diabetic’s insulin—I needed new infusions daily. Soon, I was sticking to it religiously.

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Another flare, another round of meds.

As spring of 2015 continued, I settled into a new, tenuous equilibrium with my illness. Aside from my monotonous diet, which was a thrice-daily reminder of colitis, I sometimes encountered a trace of blood on the toilet paper or had loose stools or pains in my gut. Those moments were always sobering. But overall, I felt better than in a long time, which I enjoyed.

I began to expand my diet, unwilling to continue isolating myself with my safety meal. I tried adding meat and a little gluten and dairy. In late April, I weighed myself and discovered I had hit one hundred and seventeen pounds, up from one-twelve or so. A victory! One-seventeen was what I had weighed most of my adult life. My expanded diet must be working in that respect.

Over time, I noticed that my stools did seem to be gradually loosening again as my diet changed. My energy wasn’t waning, but my other, older colitis symptoms were returning: urgency, explosiveness, a touch of pain.

In early May, another flare-up hit, my first dramatic flare in six months. Like the one after Thanksgiving, it hit suddenly. Within a few days, I was at twelve to twenty BMs a day, with accompanying fatigue and pain.

As with the Thanksgiving flare, I didn’t know which food had triggered this one. By now I was eating a great many things. But my diet was what had changed in the last few months, and it seemed that once again, my body was confirming that diet had a profound impact on my colitis.

I contacted Dr. L for some more Proctofoam, my go-to flare-up drug. Proctofoam always helped.

But in terms of diet, I was determined to try something different from before. Never again did I want to be shackled to my isolating three-meal-a-day “safety meal” of brown rice, kale, red lentils, and tofu.

So this time, I gritted my teeth and didn’t change my diet. It wasn’t like I was eating junk food, for heaven’s sake—I still had the most conservative diet of anyone I knew! If Proctofoam couldn’t get my symptoms under control, I was now willing to talk to Dr. L about medicinal options. Even stronger, riskier meds if necessary.

Within a week of starting Proctofoam, I was down to “only” three to five BMs a day. My energy had returned, and I didn’t think I was losing weight. I felt immensely relieved. Although I was still not completely healthy, I was so far riding out this flare through meds alone. Maybe that was good enough.

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I still had “Reduced Normal Flora.”

Just as my flare was getting under control, I received the results of my latest stool test. This one had been ordered by Dr. L.

I had submitted the stool sample before my flare. The test showed that my stool had “reduced normal flora”—again, low levels of beneficial gut bacteria, even before my flare.

This confirmed the results from the GI Effects Panel of the previous year. And unlike that panel, this one was a conventional test, respected by doctors and covered by insurance.

Again the result propelled me to think about fermented foods. I was still eating miso soup with breakfast and sauerkraut with lunch and dinner, but now I decided to expand to other such foods as well.

I chose kefir to try next. Pronounced “KEE-fur,” this drink is made from fermented cow’s milk. It has very little lactose and a plethora of good, healthy bacteria that I thought might help my gut. Now that I’d expanded my diet, I was more willing to risk consuming a little lactose and casein than I’d been months earlier.

Like the aptly-named sauerkraut, kefir is sour—it tasted like drinking plain yogurt. And yet, like the sauerkraut, I could almost immediately feel it soothing my gut. As the cool liquid traveled down my throat and into my stomach, I felt like it was coating my digestive system, like the pink cartoon liquid in the Pepto Bismol commercials of my childhood. Something in my gut relaxed when I drank it.

Three days after drinking it for the first time, I had a normal bowel movement.

Not just a solid BM. A normal BM. It looked exactly like the ones from life before my colitis. The only time this had happened, since my symptoms had first begun nineteen months earlier, had been for one or two days when prednisone had briefly worked.

It might not be the kefir, I cautioned myself. After the roller coaster of the last couple years, I knew not to get my hopes up. Various factors were in flux. I was tapering off Proctofoam, but I was still on a low dose of it. And I ate enough variety that I couldn’t know for sure which ingredients were tied to which symptoms.

Perhaps my improvement was just a coincidence. Besides, kefir was a dairy product. It seemed doubtful that this potentially inflammatory drink could produce such dramatic results.

But I kept drinking kefir, and soon the same thing happened again. And then again.

Within a few weeks of starting the drink, all of my BMs were normal for several days in a row.

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The liberation of remission

I was in remission.

I was in REMISSION.

I. WAS. IN. REMISSION.

I was off the Proctofoam by now. Apriso, my mild med since December, was my only drug. My diet had remained more or less the same for a month or two. The only significant recent change was the kefir. I was convinced it was kefir that had made the difference.

Happiness and relief swept over me, like sunrise after a long, dark night. Like liberation after imprisonment. I felt, for the first time, that I had cracked the code. Deciphered my disease.

Colitis was a twofold disease, I now knew. The problem was both autoimmunity and gut microbial imbalance. I couldn’t know which had come first, whether my immune system was attacking my colon because of an out-of-whack microbiome or whether my microbiome was haywire because of my disease. But whatever the case, healing required a twofold approach.

I needed to minimize inflammation, which I was doing through Apriso, staying active, and avoiding irritants like sugar and caffeine.

And I needed to rebalance my gut microbiome, which was perpetually out of balance.

Rebalancing it required finding and ingesting the bacteria that were missing. And in my specific gut, sauerkraut and kefir seemed to contain whatever bacteria I needed.

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Developing new tastes

I still had much to learn about my disease, and probiotic foods alone would not heal it. I would also talk to others who had varying results with sauerkraut and kefir. A close relative with UC discovered that sauerkraut worsened her own symptoms. My suspicion is that that means her microbiome was different from mine—it needed different added bacteria in order to reach the right balance.

But in my case, sauerkraut and kefir were among the best treatments for my imbalanced gut. I was so grateful to discover them, and I would continue eating them daily for years to come.

I came to love the taste of them both!