The Goldberg Clinic


Paul A. Goldberg, MPH, DC, DACBN
Clinical Nutritionist, Clinical Epidemiologist, Diplomate of The American Clinical Board of Nutrition, Certified Natural Hygiene Practitioner

"Causes Identified... Causes Addressed... Health Restored"

Get Well From


Patient Information
Before After
Diagnosed With
Rheumatoid Disease & Ulcerative Colitis

Physicians told Dr. Goldberg as a young man that he would be permanently crippled by severe rheumatoid disease, accompanied by advanced ulcerative colitis, environmental allergies, chronic fatigue and psoriasis (see picture on left). Through the study and disciplined application of nutritional biochemistry, clinical epidemiology and natural hygiene, he recovered his health (current picture on right).
Since that time, for over thirty years, Dr. Goldberg has successfully helped chronically ill patients from across the U.S. recover from a wide variety of difficult, chronic, conditions by carefully seeking out and addressing the individual causes of ill health.
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About Dr. Goldberg


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Inflammatory Bowel Disease

(Ulcerative Colitis - Crohn's Disease)


WHAT IS INFLAMMATORY BOWEL DISEASE?

Inflammatory Bowel Disease, (IBD), is a general term referring to inflammatory diseases of the intestines of (medically) unknown etiology (cause). It includes the major syndromes of Crohn's Disease and Ulcerative Colitis.

Few appreciate the extraordinary suffering people endure from chronic inflammation of the intestines/colon. Children and adults alike suffer from these syndromes, which often result in a lifetime of poor health, pain, life altering hardships and hopelessness.
Patients with IBD can have numerous signs and symptoms most frequently among them; bloody diarrhea, intestinal cramping, ulceration of the colon, anemia, fever, fistulas, etc. Both Crohn's Disease and Ulcerative Colitis start most frequently in people between the ages of 20 to 40, although no age is exempt.


THE MEDICAL SEARCH FOR CAUSES UNSUCCESSFUL

Medical investigation as to the causes of Inflammatory Bowel Disease, Crohn's Disease and Ulcerative Colitis has not proven fruitful. The major areas that have been investigated include genetic, infectious, immunologic and psychological factors:

Genetics:
Some ethnic groups are more susceptible including Jewish people but no group is exempt.


Infection:
The chronic inflammatory nature of IBD has led to an ongoing look for specific infectious agents, yet no single infectious agent has been implicated.

Immune Mechanism:
Studies looking at associated abnormalities of cell mediated immunity all seem to revert to normal, when the disease is in a quiet state thus suggesting that they are part of a secondary phenomenon and not part of the etiological foundation of IBD.

Psychological Factors:
Psychological features of patients with IBD have been looked at extensively. Patients suffering with IBD often exhibit anger, anxiety, depression and frustration. These emotions, however, are likely to be an outcome of having the disease rather than a fundamental cause of it. Negative emotions are an understandable outcome of people who have been afflicted (often in the prime of their lives) with an ailment that causes so much pain, disability, fatigue and uncertainty. Prolonged physical discomfort often brings about a depressed and anxious mental state. Exacerbations of IBD are commonly seen in emotionally stressful times.



QUICK CURES

As with other chronic conditions, there is a ready marketplace for overnight remedies promising quick relief from Inflammatory Bowel Disease. Most of these fall in the category of so-called natural "bowel cleansing" products and a host of so-called natural food and herbal supplements.

No amounts of colonics, enemas or "colon cleansers" will prove of benefit to the IBD sufferer. Addressing "treatments" to the bowel itself rather than to the body as a whole is counterproductive. "Colon cleansers", enemas and colonics do nothing to address the cause of the IBD and irritate the delicate lining of the bowel. All disturb the bowel flora and further stress the patient.

If the first thing the doctor does with the IBD patient is suggest a host of herbal or other nutrient supplements, the patient would be well advised to seek out a different practitioner who is oriented toward looking for etiological factors. ... We do not acquire IBD due to a lack of any specific herbal or food supplement, and we are therefore not going to get well from such either.


Related Health Issues With IBD
Inflammatory Bowel Disease -  book by Paul Goldberg Patients with inflammatory bowel disease commonly develop other health issues due to the systemic effect bowel inflammation has on the rest of the body.

The following list includes some of the many problems associated with IBD in patients:
  • Chronic fatigue
  • Depression
  • Arthritis
  • Allergies
  • Fistulas
  • Hemorrhoids
  • Low back pain
  • Sacroilleitis
  • Psoriasis
  • Neck pain
  • Shoulder pain
  • Bursitis
  • Hip pain
  • Knee pain
  • Ankle pains
  • Uveitis
  • Iriditis
  • Heart disease
  • Ankylosing spondylitis
  • Fibromyositis
  • Generalized rheumatism

Many of these issues likely arise due to the increase in gut permeability that occurs with IBD. Tragically, many of the common prescription drugs used as anti-inflamatories actually increase gut permeability and thus worsen the patient's long-term condition. This lays the groundwork for allergic and rheumatological diseases particularly. Patients with arthritic problems are often observed to have GI (gastro intestinal) problems. The link between IBD and rheumatoid diseases is believed by many to be altered gut permeability. This must be addressed by seeking out specific causal factors in each patient and restoring good overall gastrointestinal and immune health.


Neurological Link

The relationship between the gastro-intestinal tract and the nervous system is an intimate one. The gastro-intestinal tract is highly innervated, containing as many or more neurons as the spinal cord. Every attempt should be made to improve and balance neurological function. Acupressure, specific Chiropractic Care and Trigger Point Therapy techniques may all prove helpful if given in conjunction with a comprehensive program to address individual causal factors. Each person differs, however, and proper analysis is important.
Other measures to improve the nervous system that patients may use to advantage include Meditation, Hatha Yoga, Tai Chi and Biofeedback.


FASTING

An irritated ulcerated intestine needs rest above all else.
A properly supervised fast by a qualified, experienced, natural hygiene practitioner will frequently expedite the patient's recovery and in some cases is essential. During the fast, body functions are able to normalize; toxins and allergens are speedily removed; and the tissues have the opportunity to heal. The fast allows all the body tissues to rest and regain vitality.
Following the fast, the rested body is in a much better position to appropriate foodstuffs and build healthy tissues.

For patients unwilling or unable to fast, liquid diets of different types suitable to the needs of the particular patient may, in some cases, be used to advantage, under experienced supervision.

Breaking of the fast and the resumption of eating must be done carefully. Improper breaking of the fast (or liquid diet) may prove to be detrimental to the patient. The need for experienced supervision is important.


Functional Gastrointestinal Analysis

The doctor must be familiar with how to analyze the gut from a functional standpoint, not simply repeated colonoscopies to see how badly damaged the intestines have become followed by endless toxic pharmaceutical agents that carry numerous risks.

The bowel flora must be examined, allergies excluded, emotional issues addressed if present, fatty acid imbalances uncovered, carbohydrate sensitivities explored, etc., etc. There are numerous different factors at play in each person and therefore patients must be addressed as a world unto themselves.


HYGIENIC CARE

Getting well from Inflammatory Bowel Disease requires a comprehensive approach. Some of the hygienic basics that the patient needs to keep in mind are the following:

    * Sufficient rest and sleep.
    * Chewing food very well and not overeating.
    * Ingesting food only when there is emotional calm and real hunger present
    * Avoiding exhaustion.
    * Obtaining adequate sunshine and fresh air.
    * Maintaining cordial relationships with friends and family.
    * Having work that is rewarding.
    * Avoidance of toxins such as coffee, tea, soft drinks, alcohol, junk foods, etc.


PATIENT CONSIDERATIONS

Patients must be patient.
Each patient should set their sights on good health and not simply focus on their symptoms. For most people, it took years to evolve into a poor state of health. Hard work, determination, persistence and effort are needed factors along with the right professional guidance. Those who expect to make full recoveries in just a few days or weeks will likely be disappointed.

My patients who have had the most success understand these things. They accept that, along with their genetic predisposition, they have evolved into poor health and that they must work hard and make changes to evolve into good health. They understand the need for patience although many are surprised at how rapidly they begin to improve once the factors behind their illness are addressed. They also understand that, once they are well, if they return to old poor habits, that their problems will return.

A good doctor analyzes each patient as an individual, his or her biochemistry and habits, makes recommendations and guides the patient along the way. It is often not an easy task for either the doctor or patient, but when done properly can allow the patient a return to good health to obtain a new lease on life something which drugs and surgeries that remove vital organs cannot.
I have watched patients who were unwilling to make the needed changes evolve further into poor health. I have also had the pleasure of seeing many patients make the needed efforts and evolve into vibrant health.

The following studies will illustrate successful cases where patients made the needed efforts and were successful in overcoming Ulcerative Colitis or Crohns Disease


REGAINING GOOD HEALTH IS POSSIBLE!

Inflammatory Bowel Disease whether termed ulcerative colitis or Crohn's, need not lead to hopelessness and a life of misery.
Most patients with proper effort, under hygienic care, can improve greatly and often recover entirely.
Endless steroids destroy health leading to diabetes, osteoporosis, adrenal exhaustion, premature aging and many other problems. The newer "biological drugs" such as Remicaide while sometimes temporarily relieving symptoms, frequently fail after a time and the patient has a full resumption of their symptoms and often they are left much worse than before and then are led to resort to intestinal surgery and removal. Others on Remicaide or other immunosuppressive drugs develop cancer, tuberculosis or other serious infectious issues. These tragic outcomes can usually be avoided if proper analysis and the right steps are taken in time. The following case studies from The Goldberg Clinic help to illustrate some of the concepts addressed in the article.



Case Studies


CASE STUDY 1: CROHN'S DISEASE

Patient Presentation:
A 45-year-old male entered our office with a 15-year history of Crohn's disease. During this time, he had undergone four intestinal reactions, each time having a portion of his inflamed small intestine removed. Between operations, he was kept on a variety of immunosuppressive drugs. Since nothing had been done to address causes, it was only a matter of time before another segment of intestine was removed. At the time the patient came to see me, his gastroenterologist had told him that while his intestines were badly inflamed once again, nothing more could be done surgically, since there was not enough small intestine left to be able to remove any more of it.

THE CRITICAL ROLE OF THE GASTRO-INTESTINAL TRACT IN SYSTEMIC ILLNESS by Paul Goldberg The patient was badly debilitated, underweight, weak, depressed and pale. He had severe diarrhea on an ongoing basis.
His diet was poor and his medical physician had told him that his food intake had nothing to do with his disease so he could eat whatever he cared to. The patient tried to exercise, but found his efforts futile due to his profound weakness.

Analysis:
The patient's diet was heavy in coffee and refined carbohydrates. His plasma amino acid levels were extremely low although his diet was rich in protein-containing foods. There was evidence of bacterial overgrowth in the bowel, likely due to the massive doses of antibiotics and steroids he had been on. The patient was anemic. He was unhappy in his occupation as a salesman.

Care Plan:
The patient was initially taken off all refined carbohydrates, coffee and other unhealthy substances. He was put on a light diet of easily digested natural foodstuffs with attention given to eating habits as well as types of foods eaten.

After two weeks, the patient was placed on a fast that lasted nine days. The patient was concerned about losing more weight but understood that his weight loss had occurred due to his inability to digest and assimilate food properly and that the fast could help in that regard. He completed the fast feeling "clear-headed and refreshed" although the first two days were uncomfortable as is sometimes the case. The fast was broken and the patient found his cravings for coffee and junk foods had disappeared. Further steps were taken to restore improved GI function. While he lost 8 pounds during the fast, this was quickly recovered, and within a month the patient had not only recovered al the weight lost during the fast, but gained an additional 7 pounds for which he was very pleased.

I counseled the patient on the need to adjust better to his occupation or find a new one. The patient took the advice seriously and located another sales position, which proved to be much less stressful and more satisfying.

Outcome:
Six years later the patient remains well. He takes excellent care of himself and has followed recommendations almost to the teller. Due to having had so much of his intestines previously removed, he still has some diarrhea, but reports it is mild in comparison to what it had previously been. He is careful not to return to former habits and to lead a healthy lifestyle.


CASE STUDY 2: CHILD WITH SEVERE DIARRHEA AND WEIGHT LOSS

Presentation/History:
An 11-year-old male was brought to me by his mother, desperate for help and seeing me as a "last resort", having been referred by another patient.

Nine months previously, the boy had begun to experience diarrhea, along with weight loss and accompanying fatigue. His pediatrician sent him to a local hospital after a course of antibiotics failed to produce any results. A colonoscopy was performed. Due to the ongoing weight loss, the boy was transferred to a well-known Atlanta Children's Hospital, where he was given further testing and another colonoscopic examination. He stayed there for two weeks, undergoing extensive testing. The tests were unrevealing and he continued to lose weight. He was transferred to another children's hospital associated with a university. In addition to repeating the same tests, a careful search for malignancy was conducted, but was negative. An extensive psychiatric evaluation was then conducted.
After two weeks at this hospital, the patient was still continuing to have diarrhea and weight loss, leaving him with a "skin and bones" appearance. The university hospital sent him home with the following counsel to his mother:
  1. Her child was in serious condition, but there was nothing more that could be done at the hospital. Having ruled out any organic cause for the patient's problems it was assumed to be the result of a psychiatric imbalance resulting from his parents' divorce and that he needed to receive psychiatric care.
  2. The hospital's registered dietitian advised the mother to give the boy "regular feedings of ice cream and milk shakes to help maintain his weight, along with a balanced diet."
  3. The child's lack of progress and continued weight loss indicated that he might not survive -- that re-hospitalization would likely be needed within the next few weeks to put the boy on intravenous feedings.

 At this point, the child's hospital and doctor bills totaled over $155,000.


Analysis:
The patient presented in a very weak state. Both he and his mother were frightened by his condition. I ran a battery of functional tests, including food allergy testing and multiple stool parasitology samples. Test results showed the child to have the presence of a protozoa named giardia and a high sensitivity to cow's milk.
I immediately took the patient off of all the dairy products (including the milk and ice cream the registered dietitian wanted the mother to give him) and put him on a light diet of easily digested natural foods that he exhibited no allergic responses to, along with a few nutrient supplements, in light of his emaciated condition. Simultaneously, I referred him to a local medical doctor with the results of his parasitology test to receive appropriate medication to rid him of the parasite.

Outcome:
The patient rapidly improved after the allergens were removed from his diet and he was treated for giardia.
Within the next two weeks, his weight increased along with his strength. His mood elevated (as did his mother's!).
This was ten years ago. Since then, he has turned into a tall, well built young man, who played football in high school, went to College on an academic scholarship, graduated and is currently married, employed and healthy. He has had no recurrence of his illness.

Hospital workups frequently fail to identify even basic causes of disease quite commonly even with their highly sophisticated equipment and many specialists. We have frequently seen patients who have been to many medical facilities including the Mayo Clinic, Columbia, and The Cleveland
Clinic and other "prestigious institutions" where the basic causes of disease and the factors needed for the successful restoration of good health were overlooked.



CASE STUDY 3: ULCERATIVE COLITIS WITH RHEUMATOID ARTHRITIS

Presentation/History:
A 57-year-old female with multiple complaints of eczema, arthritis pain, back ache, severe ulcerative colitis, headaches and fatigue entered the office in a depressed state, having been referred to me by her Doctor of Chiropractic.
The problems had begun 18 years earlier with bowel discomforts, and she had been originally diagnosed with "irritable bowel syndrome."
Since then, she had seen numerous doctors for her multiple conditions including dermatologists for eczema, Doctors of Chiropractic for back discomforts, Rheumatologists for arthritic pains and Gastroenterologists for ulcerative colitis. She had consulted with medical dietitians as well.

Rheumatism & Arthritis book She was receiving a variety of steroids by the rheumatologist, the dermatologist and the gastroenterologist. The patient had received
Chiropractic Care, which she found helpful, but the low back pain persisted. The patient complained of chronic fatigue, ongoing bloody diarrhea, stiffness, pain and depression. She described her condition as "desperate".

Analysis:
The patient was tested a number of functional issues including mineral imbalances, intestinal dysbiosis, fatty acid balance, cortisol production and food allergies. Food sensitivity testing was positive. Foods the patient was allergic to e.g. eggs, wheat products and dairy, were the same ones recommended to her by her gastroenterologist and medical dietitian to "soothe the colon."
There was a complete absence of normal bacterial flora in the intestine, along with the presence of yeast in excessive amounts.

Program of Care:
The patient was put on a hypoallergenic liquid diet for a period of 10 days, followed by a diet of cooked vegetable foods and moderate amounts of proteins, excluding all allergens. The patient was instructed on hygienic measures to take (e.g. additional rest and sleep, fresh air, emotional poise, etc.). The fatty acid imbalances, flora imbalances and abnormal cortisol levels were addressed. The patient began to reduce the amounts of corticosteroid compounds prescribed for the colitis and arthritis. Appropriate steps were taken to restore the normal GI flora.

Outcome:
During the first two weeks, the patient went through a stormy period of discomfort. By the eighth day, the bowels began to quiet. Joint pain subsided by the sixth week, accompanied by an increase in the energy level. In three months, the patient reported her stools were partially formed without blood, and that her joint pains had reduced by 80 percent.
In her fourth month of care, she went off her plan and ate a variety of foods she had been warned to avoid. Within 10 days, she was again passing bloody stools and experiencing severe joint and muscle pain. We gave her a program for resting the gastrointestinal tract and urged her to follow the entire health program carefully. She was soon feeling well again and reported she had "learned her lesson".

Follow-up:
The patient has continued well for seven years without joint pain or colitis and only occasional mild looseness of stool. Her headaches and skin problems gradually dissipated and she no longer takes any steroidal medications.

Discussion:
It is common to see patients with medical diagnoses of Crohn's and ulcerative colitis report that they also have rheumatoid arthritis, fibromyalgia, skin problems, etc. These patients frequently have poor digestion and allergy problems.
Medical care, including corticosteroids and anti-inflammatory drugs (NSAIDS), serves to aggravate and complicate the clinical picture.
Resolution of the patient's digestive dysfunction and bowel problems frequently results in ending the bowel problems and rheumatic complaints and other health problems simultaneously.



INFLAMMATORY BOWEL DISEASE - QUESTIONS & ANSWERS

Q: I have ulcerative colitis and also have skin problems and very bad arthritis. Can these be interrelated?

  A:  Yes. The relationship between the bowel, the skin and the musculoskeletal system is a very intimate one. Gastro-intestinal dysfunction commonly is accompanied by skin and musculoskeletal problems, and likewise when the G.I. tract is returned to healthy functioning, these problems usually disappear as well.


Q: My ulcerative colitis is advanced. Are there any special steps I will have to take in order to recover?

  A:  In some cases, where tissues are damaged, it is often advisable for the patient to undergo a supervised fast as an initial step. Just as you would not expect a broken leg to heal if the person continued to walk on it and did not allow it to rest, neither is it reasonable to expect a bloody, ulcerated colon or small intestine to heal while the person continues to send undigested food and feces continually over it not allowing the digestive tract a chance to rest.


Q: How long a fast is usually required and how does one go about it?

   A: The length of the fast varies greatly from person to person, and the total time cannot be determined at the onset. It depends on the progress of the fast, which should he determined by a doctor who is specially trained and experienced in fasting supervision (not something taught in medical school). Ideally, the fast is undertaken in a quiet environment away from home, business and family, where the person can obtain unlimited rest, both for their digestive tract and for the body as a whole.

    This should not be attempted on one's own, but only under the careful supervision of an experienced doctor trained in the art and science of fasting. Most doctors experienced in fasting supervision are members of the International Association of Hygienic Physicians, a professional organization that credentials doctors for fasting supervision. Conducted properly under supervision, fasting is safe and effective at helping to restore good function. It is a true "physiological rest". I have supervised fasting patients for over 30 years, yet am still amazed at the healing power of the body to remedy difficult problems when we give it the opportunity and quit all of our meddling with pills, potions and treatments.


Q: What conditions would contradict a fast?

 A: Generally insulin-dependent diabetics, patients currently taking steroids, patients with cancer, those with advanced tuberculosis and pregnant women should not fast, although short fasts of a day or two may sometimes be employed.
    A problem with some patients is the fear of missing a meal or two, i.e. psychological factors. Americans are so indoctrinated with the thought that if they miss a meal or two, something terrible will happen. How often I've seen patients surprised to find that, after the first few days of fasting, while they may have some transient discomforts, they felt stronger and more clear-headed and saw their disease symptoms disappear. I have had cases where I needed to convince the patient to break their fast, because they felt so well after the first two or three days, they did not want to stop!

Q: Does the fast result in a permanent cure of the patient's IBD?

A: No. It must be followed by an individually tailored program of living for the patient to adhere to. The fast when employed is just a beginning step. Returning to old habits will eventually result in a return of disease.

Q: Must the patient make lifestyle changes in order to get well and stay well in most cases?

 A: Emphatically yes! It is time we dispensed with this irrational notion that we can take some treatment and be cured of diseases (including IBD) that evolve out of a combination of our habits and our genetics. There is no treatment or pill or potion that will alone resolve this degenerative condition. It first takes a search for the individual causes of the problem in each patient, followed by a comprehensive health program tailored for the individual, who then must follow through with patience and perseverance. This includes understanding and respecting one's own limitations and making appropriate lifestyle changes as recommended.


Q: I read a book that says that all disease is caused by parasites, including colitis. What is your opinion on that?

 A: It would be convenient if all health problems were related to one single factor. There are many "one cause-one cure" type theories most of which involved a certain degree of cultism. We are a diverse population of individuals living under diverse conditions. Health and disease have numerous causes for them, and no single factor is responsible for all cases of IBD, let alone for all health problems. Parasites, particularly protozoa, can be responsible for some cases of colitis, although in the United States it is not a primary factor in most cases. Having a good stool microbiology/parasitology conducted, however, can help eliminate the possibility of parasitical involvement. Unfortunately medical physicians sometimes overlook parasite involvement and fail to appreciate the importance of normal bowel flora in health and disease.


Q: What are the determining factors in how long it takes to recover from IBD?

 A: Each case will vary. The most important factor, as with most health problems, is the extent to which the patient is motivated to get well and make the needed efforts.
    Those unwilling to undergo proper analysis, followed by a program that will likely include dietary restrictions, disposing of bad habits, change of rest and sleep habits, a period of detoxification, steps to insure emotional poise, adequate sunlight, fresh air and activity, cultivation of a balanced state of mind, and other specific steps will fail. Simply eating a little better or giving up a few bad habits alone will rarely suffice.
    The amount and types of drugs taken, their age, their energy reserves, the extent of bad habits they have had, their ability to avoid stressful situations and obtain rest and other factors all play an important role.


Read patient letters here.

The above text was from the booklet "Inflammatory Bowel Disease" (Ulcerative Colitis - Crohn's Disease), which can be ordered from the Goldberg Clinic. More information here.




 

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