31: How to Prevent and Fix Recurring C.Diff Infections

C.Diff (clostridioides difficile) is almost unavoidable with IBD. I'm going to show you why you keep getting these infections and what you can do about it.

TOPICS DISCUSSED:

• Need to know facts about C.Diff
• Why you keep getting it
• Why your doctors treatments may be making you worse
• How to build defences against C.Diff
• Antibiotic alternatives
• How to prevent C.Diff infections down the road

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Transcript

Josh Dech:

Crohn's and colitis are synonymous with C. diff infections. And you get an infection, so your doctor gives you antibiotics, which messes up your gut, and you get another infection, and you're in this cycle. And so today, I’m going to show you how to get off this roller coaster of C. diff infections.

You're going to learn, first of all, why you keep getting them over and over again. You're going to learn why your doctor’s treatment might be actually keeping you stuck in the cycle. And of course, what you can do to keep C. diff infections at bay and even heal from them faster.

Contrary to what your doctor has told you, Crohn’s and colitis are reversible. Now, I've helped hundreds of people reverse their bowel disease, and I’m here to help you do it too. Because inflammation always has a root cause. We just have to find it.

This is the Reversing Crohn’s and Colitis Naturally Podcast. Now, I do these live trainings in my Facebook group every single week and put the audios here for you to listen to. If you want to watch the video versions of these episodes, just click the link in the show notes to get access to our Facebook group and YouTube channel. And for weekly updates, information, tips, and tricks, you can sign up for our email list by clicking the link in the show notes below.

Now, if you don’t know me, my name is Josh Dech. I'm an ex-paramedic, IBD specialist, medical lecturer, and physicians’ consultant, as well as the scientific strategist and education director for the Root Cause for Crohn’s & Colitis organization. I really gotta trim those down.

But anyways, today we are talking about fixing the cycle of C. diff infections that you keep finding yourself in. C. diff is short for Clostridioides difficile. This is the extended version of C. diff. It’s a really nasty infection and it's extraordinarily contagious. As in, in the hospital, you can get it if you don't flush with the toilet seat down, and your partner touches something in the bathroom—they can get it.

It’s a very gnarly, highly infectious bacteria which causes a lot of problems. Very, very contagious. If you do have an infection, you’ll know. The signs and symptoms look like things such as loose bowels—really, like foul-smelling loose bowels or diarrhea. They can be often yellow in color as well. Comes with a lot of pain, fever, nausea, sometimes you get the chills and sweats, dehydration, blood or mucus—there's a lot of symptoms it can come up with. And it can even trigger you right overboard into a full-blown flare, which obviously you want to avoid.

In the worst case that you can end up with a C. diff infection is what's called toxic megacolon, where your entire colon is just so infected and overgrown with microbes, it's an emergency, and they want to remove it. You can get septic, where you have toxins leaking into the rest of your body, which can effectively kill you.

And so C. diff is nothing to mess around with. Now, I want you to be aware of your risk factors as well. Repeat antibiotic use leads to more C. diff overgrowth. That’s one of the biggest problems that we see with those who are going through Crohn’s and colitis who have these infections. It’s repeat antibiotic use that ends up leading to these repeat infections.

Another major risk factor is long-term use of PPIs—that’s your proton pump inhibitors—or H2 blockers. These are going to be like your antacids. Prescription-grade antacids are a huge risk factor for developing a C. diff infection. Not only because of how it doesn't kill off some of these spores, but it creates this whole cascade of dysbiosis inside of your gut. And we need bacteria to control each other, which we’re going to get into in a sec.

Another issue we see is what's called generalized dysbiosis, where your gut microbes don’t have good balance, and a lot of the bad or opportunistic guys overgrow because a lot of the good guys aren’t there to really police them. So that's a big one as well.

And of course, if you have a history or previous history of recurring C. diff infections, this is a nasty risk factor as well, and you're prone to be getting more.

So we talked about a couple of things creating dysbiosis—antibiotics, which create dysbiosis. We keep using this word. It means imbalance of gut bacteria.

So again, your gut—think of it as this really nice tidy healthy ecosystem where everything is just so. You have all these levels of good guys and bad guys all here just doing their job. They come and go. They pump up a little bit. They come down a little bit. But in general, they’re here in balance. You have your good guys and you’ve got—well, we’ll call them your bad guys. They’re not bad. They’re supposed to be there.

But here’s what happens. Like any ecosystem, just like an economy or a city—if you lose your police and law enforcement, people who keep things in checks and order, and you get all these drug dealers running around dealing crack to children in kindergarten classes, well then, of course, it's going to be bad stuff. And so when you have a bunch of bad guys who don’t have anything to police them and keep them in check, they become really bad.

But here’s the thing—C. diff, or clostridia, is not inherently bad by any means. It’s the dysbiosis that allows them to overgrow where they become bad.

And so your big factors for dysbiosis, of course—antibiotic use, early onset, early childhood (which you can’t really fix, but maybe for you and your children)—would be things like bottle-feeding instead of breastfeeding. There are medical necessities sometimes where you can’t, but if you have the opportunity to, the outcome for both you and your baby are extraordinarily better. So it’s important to do that as well.

Medications can mess up your gut, like we talked about. Alcohol use, poor diet, sugar, high stress—all these things sort of rearrange your gut bacteria and make you extremely prone to developing these infections. So you want to watch for that.

So here’s what we need to know—long and short—when it comes down to creating dysbiosis, which is a prime environment for C. diff infections to thrive, there’s a couple things that happens.

Number one—now that you have a diagnosis of Crohn’s or colitis, or you're waiting to maybe get one—you have active inflammation inside of your gut. Not only do other factors like diet and lifestyle lead to this dysbiosis or imbalance of gut bacteria, but inflammation. You wouldn't want to live in a house that’s on fire—neither would your microbes. And so inflammation also contributes to this dysbiosis. So we have to watch for that.

Well, dysbiosis leads to overgrowth of opportunistic “bad guys” in this case. And then you go to your doctor, and what do they do? Well, they give you some antibiotics to control the overgrowth because that’s a problem. What do antibiotics do? They further contribute to the dysbiosis, which leads to C. diff infections.

What happens if you get a C. diff infection? Well, guess what? Your doctor goes, “Well, it's a major infection. It's really dangerous. So what are we going to do?” Antibiotics. Which does what? Causes more C. diff.

And now you’re stuck. Antibiotic–C. diff–antibiotic–C. diff—and around and around the cycle goes.

So the question is—how do we stop this cycle from continually cycling?

So a few things you want to understand about C. diff.

Number one—C. diff, again, it’s not bad. In fact, clostridia is an extremely beneficial microbe. Hope I spell this right. So C. diff is Clostridioides difficile—that’s what it stands for.

Now clostridia, there’s about 200 different species of clostridia that live inside of your body. They do all kinds of amazing things. They’re not bad. When they’re overgrown, they’re bad.

Clostridia is extremely beneficial. In fact, clostridia helps regulate your immune responses, immune system inflammatory responses. They produce something called short-chain fatty acids, which are actually the primary fuel source for the cells inside your colon. It helps with your gut barrier, gut barrier integrity and gut function. It helps reduce inflammation. There’s all kinds of benefits. They signal to immune cells.

Short-chain fatty acids are absolutely essential for life and for health, and they come from clostridia. They’re a major producer. So again, they’re not bad. Clostridia protects against pathogens, believe it or not. They actually have antimicrobial peptides they can produce, which compete against C. diff overgrowth, salmonella, and others. It’s all about balance—having the good guys to control some of the bad guys.

Clostridia even helps with your metabolism. They help metabolize carbohydrates, help balance out your blood sugar. Again, they reduce inflammation. There’s so many good things.

Imbalance is the problem—not clostridia. So we have to deal with the imbalance if we want to deal with the infections, because they’re connected.

Having IBD, you’re going to have had at some point a nasty bit of antibiotic use. It’s almost inevitable. When you’re dealing with IBD, your doctor might just have thrown them at you. In fact, I've known dozens, if not hundreds of people I’ve spoken to over the years who had some kind of gut issue, who were given antibiotics just to see what happens, just in case, who developed a C. diff infection, who ended up with Crohn's or colitis because of that.

And so it’s a really nasty cycle.

So let’s talk about antibiotics for a minute. They are major, major risk factors. Again, they push down a lot of your good bacteria, but they also run the risk of creating something called AAD.

Between 5 to 25% of people who take them can develop AAD. That stands for antibiotic-associated diarrhea. 5 to 25% of people can get this AAD. Now, you might think it’s not that big of a deal—a little bit of diarrhea. Did you know that 15% of these cases can be fatal? Death by diarrhea—not a way anybody wants to go.

Due to nutrient loss, dehydration, infection, sepsis, overgrowth, dysbiosis, whatever it may be—antibiotic-associated diarrhea can affect 5 to 25% of people who take antibiotics, and up to 15% of cases—casual up to 15% of cases—can be fatal.

This is not information your doctor gives you. They say, “Take these, give it a whirl, and let me know.”

And so now you have the antibiotics. You have the diarrhea because it created what? Dysbiosis.

Well, now that you got this case of dysbiosis, what’s happening? You now have breakthrough infections. You have overgrowth, dysbiosis—especially in the case of IBD, previous infections, etc.—once again leads to more C. diff.

And now—back in the cycle.

So what do we do about it?

Can you avoid taking antibiotics? Well, I can’t and won’t legally advise you against your doctor’s advice when they say take an antibiotic. Sometimes, you need it. But antibiotic consumption is up 40% in the last 25 years, and the vast majority of antibiotics are frivolous. We don’t actually need them. They’re just given just in case, or because you got the flu or something else.

It’s crazy. We’re destroying our microbes, extincting our gut microbiome.

So we have to understand—there are better ways. In fact, there are many over-the-counter antimicrobials that can help keep back C. diff. Now again, if you have an active C. diff infection, you are risking sepsis, toxic megacolon, and ultimately death. Get the antibiotics.

What I’m saying is—for the sniffles, you don’t need antibiotics. What I’m saying is—for a topical infection, maybe you cut yourself—oftentimes, you can use a topical antibiotic. You don’t have to go systemic through the gut to get something on your skin, for example.

So there’s a lot of other ways that we can use these antimicrobials that are plant-based and actually beneficial to your gut, that are not going to be destroying and disrupting your gut microbiome leading to these C. diff infections.

I want to answer the first questions that we actually led this conversation off with—why do you keep getting the infections?

Well, here’s the thing—you’re, again, you’re inflamed. And so that means you’re going to have dysbiosis.

Which means your doctor says, “Well, let’s give you antibiotics.”
 Antibiotics create C. diff, which again is going to create more dysbiosis, which you get more antibiotics for, and more C. diff, and on and on the cycle continues to go.

And this is why you’re constantly having these issues.

If you’re in the hospital non-stop, well, your exposure goes up again another 10 or 20%, because in-hospital is where C. diff is most commonly transmitted.

Now we also have—if we have poor microbiome recovery after antibiotic use and dysbiosis—here’s the thing: you’re inflamed. So if you actually stop it here, deal with the reason why you’re inflamed or why you’re dealing with this disease, you don’t have to get the dysbiosis.

Now, sometimes dysbiosis causes inflammation. So if you correct your gut, you stop the cycle anyway. But if you get yourself in a spot where you need to be taking antibiotics, that’s all right. You need to take intervention here before it leads to the C. diff infection.

And this is why we’re getting stuck, and what we can do about it. And what your doctor is doing, unfortunately, is they’re giving advice based on acute intervention—not thinking long scale, long term, how to actually help you heal and rebuild your gut.

It’s acute intervention, which is for long-term bad advice.

And so in order to prevent C. diff infections from coming back or even to heal from a C. diff infection quicker, there’s a lot of things that we can look at.

So I want to go back quickly for those of you who have kids, and then we’re going to talk about for those of you who are already adults.

Number one—we’re going to be talking about vaginal birth and breastfeeding. This is extremely important. In fact, statistics have now shown that children who are strictly bottle-fed versus breastfed are twice as likely to die from SIDS. You're more likely to get things like autism, schizophrenia, type 1 or type 2 diabetes, obesity, cognitive issues, ADHD, depression, anxiety—you name it—from simply getting a bottle of formula. It’s artificial rather than what nature designed.

And so proper birth, breastfeeding, is ideal from the ground up.

Next is going to be outside. Now, this might be playing with pets, playing on a farm, it might be traveling—but it’s ultimately exposure. These are the biggest seeds of foundation for building your microbiome in childhood all the way to your teen and adult years.

But I don’t think we have any babies watching right now, so let’s talk about what adults can do.

Number one thing that you can do, of course, is going to be probiotics.

Now, not all probiotics are great. I often promote them or say avoid them—and it’s all contextual. But if you’ve taken them and you know they’re good for you, get them in. You can even get what’s called a spore-based probiotic. Introduce them slowly, especially if you had a history of antibiotics.

Probiotics are probably a really good idea. Even in the modern world, like westernized industrialized countries, we need more of these. And so spore-based is kind of like a seed where it will actually go all the way through instead of getting beat up in your stomach acid—where a lot of probiotics go to die. What ends up happening is they get all the way through the small and into the large intestine, where they can then plant seeds and grow. And that’s what a spore-base will do.

And so getting some of these introduced—getting into nature, travel, go see people—there’s a theory called the hygiene hypothesis, which states that we’re too clean. In fact, if you look at all the chemicals and toxins we often tout about making us sick in our modern world, consider that we have—still—North America has the highest rate of Crohn’s and colitis per capita in the world, even though we’re exposed to a lot of toxins and chemicals.

There’s also the hygiene hypothesis that takes over and says, “Well, look at China and India and all these industrialized countries. They are exposed to a lot of the same chemicals and toxins that we are—but they don’t have nearly—I mean like a hundredth if not a thousandth—of the disease cases that we have per capita.”

Because we’re so overly hygienic. We’re not exposing ourselves to outdoors and elements and other microbes, and this is what’s making us sick. We don’t have enough of an ecosystem or diversity in our guts to keep us healthy and whole and defend us and keep things at bay.

And so we want to go back to rebuilding our gut—get exposure, get outside, travel around, see people, eat new foods, try new things, eat probiotics, avoid eating food that are destroying the gut microbiome, because then that’s the wrong kind of exposure. It’s important to get the right exposure.

We want to work on prevention and introduction—reduce toxins, chemicals, pesticides, glyphosate processes...

If you’re prone to infection or need antibiotics, what we can actually look to do is heavy doses of probiotics. In fact, different strains of lactobacillus and bifidobacterium—these are the most common ones you’ll see. You can get like Visbiome, 200 billion plus.

Taking these actually prevents the AAD we talked about—your antibiotic-associated diarrhea. Taking high doses of bifido and lacto actually reduces your risk by up to 54%. It reduces your risk of this antibiotic-associated diarrhea by 54%.

So simply taking some probiotics—even though some may be transient, they don’t necessarily plant like spores do—they can make a huge difference in your outcomes, in your C. diff infections. And so probiotics can combat C. diff.

If you're somebody who's prone to it—start rebuilding your gut microbiome.

Let’s find the root cause of your IBD—why you’re inflamed, what’s actually creating this disease. It’s not a genetic, autoimmune, or unknown condition—like at all.

Genetics play a very small part—only about 24 to 28% of people have any family history. Genes don’t work in a vacuum. Toxins, chemicals, exposure, etc.—even how you’re born—change the gene expression, turning up or turning down.

It can’t be autoimmune across the board. 30% of cases of Crohn’s and colitis have no antibodies. And the 50 to 70% that do—most of those are not autoantibodies. So they’re not really attacking yourself.

We’ve also seen a 3,000% increase in the last 75 years. And it’s isolated to the industrial countries—North America, USA, Canada, UK, Australia, New Zealand. This is where we see the vast majority of cases.

So something has to be causing it. The information you’ve had so far is unfortunately wrong.

And so we have to understand—there’s much more we can do to prevent these infections. Because we get the most of them here. And if you’re prone to Crohn’s, colitis, you’re prone to these infections.

We don’t want you to have to deal with that. So this is our simple solution—being able to keep them at bay and reverse them.

Probiotic products, exposure, exercise, lifestyle, hydration—get yourself a water distiller. Keep things clean. All the basics that we need to actually rebuild your gut.

Eat whole organic foods—or if you can’t afford organic everything, just get foods off the Dirty Dozen list. You can Google “Dirty Dozen.” If those are not organic, avoid them or buy them frozen organic—like strawberries and blueberries, stuff like that.

And that’s really what’s going to make the difference.

The standard American diet—ironically enough, acronym “SAD”—60 to 80% of the food we eat in North America is processed or refined in some way, shape, or form. Which actually means we are contributing on a daily basis to the destruction of our gut, which contributes to that inflammation–dysbiosis cycle we just talked about.

But you can intervene. You can do something about it. You don’t have to be stuck on the cycle of infections over and over and over again.

I want to show you how you guys can get help. Because I promise—you don’t have to do this on your own.

There’s a common misunderstanding with disease—like it’s just something you’re stuck with, something that nobody can help you with, that it’s this inevitable, unfixable condition.

Well—if it’s not genetic, it’s not unknown, and it’s not autoimmune—then what is it? There has to be something to this.

So I want to make sure you have all the resources you need, and here’s how you can actually reach out to get more resources, to get help—whatever you need.

First of all, if you just have questions, I’m just going to put this up on the board here for you:
 Reach out to me — josh@gutsolution.com.
Send me an email. We’re going to have a conversation. Just see what you guys want, see what you need. Very easy to reach me.

And lastly, if you’re watching on YouTube or you’re listening on the podcast, and you think, “It finally makes sense—like I’m actually getting explanations,” and you want more—we have all the information, we have the resources.

Just check the links in the show notes for how to get help.

Now I’m going to turn over to the comment section to see if we have any questions here—I want to make sure I get through these ones…

So the question here is, “Can you have this infection without knowing, and can it mimic a flare? I don’t think I’ve ever had it.”

C. diff is pretty, um, pretty distinctive—especially when it gets to a high point. Here’s the thing about C. diff: it’s going to come with like yellowy, watery, like foul-smelling stool. Like you’ll pass gas or a bowel movement and it lingers in the air—like you’ll clear out a room. It’s quite foul.

It can have a lot of other symptoms as well. Fatty foods, high calcium-type foods might make you bleed or cause more flare-type symptoms. But it can absolutely mimic a flare.

Because what is a flare? Pain, cramping, nausea, hot flashes, sweats, changes in appetite, fatigue—like an infection. That’s really what a flare is, because an infection causes an immune response.

C. diff infections cause an immune response, so it can absolutely mimic that, and they can look very similar for sure.

Your doctor will often check—if you go into the hospital, they’ll do a stool sample for active C. diff, so you often know. But if you’re at risk for them, these tools are absolutely necessary.

Carla asks:
“Is bioengineered similar to GMO?”

So here’s the question—GMO foods. We talk about GMOs. Is bioengineered the same as GMO? Yes and no.

Technically, GMO means genetically modified, and what they’re doing is actually modifying plants to resist the poison that they spray on them to kill everything.

Think about it—if you get a spray on a plant that’s designed to burst—to put holes in the gut lining, for example, of a microbe or a bug like a grasshopper or something—you want to destroy them by eroding their insides. You spray this on the plant. When they eat it, it erodes their insides, and they die. That’s really how pesticides work.

Now GMOs—these are, again, they’re genetically modified plants. They resist the poison, so the plant doesn’t die, but the creatures that eat it do.

Well, lo and behold, we are those creatures. It’s just—we can resist them enough to have holes in our gut and create disease, without actually falling over dead. But we just die slowly and end up contributing billions of dollars to the medical–financial–industrial complex.

So is bioengineered the same? One could argue GMO is bioengineered. It sort of fits under the umbrella. A lot of those are going to be synthesized chemicals, etc., but if it’s GMO or it’s bioengineered—it’s not something I want to eat.

These are foods that, like, your great-great-grandmother would never recognize as an edible substance. I wouldn’t want to eat it either.

90% of the foods we have today didn’t exist a hundred years ago, and neither did 90% of our diseases. Just think about that one.

The next question we have here comes from Lynn:
“Is using antibiotics IV any better than taking them orally?”

Is the question—is antibiotic IV any better? No. Absolutely not, unfortunately, in the grand scheme of things.

Now here’s what we gotta know—is it better than hitting you right into your gut? If you have a gut infection like C. diff, you’re going to be taking oral antibiotics. They might give you something systemic like an IV. But think about this—

So if you have—this is my little gingerbread man—you should see a doctor look at that physique...

So here’s the thing: if you have your guts in the middle here, and you take something—this’ll be your stomach, boom, there we go—you take an oral antibiotic, it pops in, goes down the stomach, it travels through, and it starts absorbing from your intestines into your blood, into your lymphatics, and it circulates around the body. That’s how the oral is going to work. They also do a lot of destruction in the gut.

Now if you take an IV antibiotic—it goes in the arm, it circulates around the blood, which will of course contact the gut as well, but it’s also going to filter through the liver. Some of that, depending on you, may recirculate through a little bit.

So the question is, is it any better? I’m speculating, truthfully. And I’ll tell you why, Lynn—I haven’t actually read the studies or can’t recall studies to say are they better for your gut microbiome. If I had to throw a guess, I would say yes.

However, there are so many more alternatives, especially for like non-emergent—excuse me—there are so many better alternatives for non-emergent antibiotic use.

Some ones I really like—no affiliation—but I love the companies Biocidin and I believe they went—either they’re Biocidin Botanicals or BioNutra… Naturals. But they actually make one for the gut, and it’s a Biocidin drop, and they also make Biocidin LSF, which goes under the tongue, which is kind of like the IV version.

These are really powerful. Now, if you need these—I got a doctor I work with, he used to get this weird infection in his elbow with some kind of cyst or something—it would build up. A couple of pumps a day with this LSF, and it was gone. Never needed antibiotics, and it’s all plant-based.

So there are lots of really great options out there that are non-pharmaceutical and that may actually support your gut and the microbiome as opposed to just destroying it.

Next question from Carla:
“I 100% believe that my son’s Crohn’s started with a high dose of antibiotics while he was in the NICU, because he had C. diff when he was born 10 weeks premature. Three run-ins with C. diff and four years later, he had full-blown Crohn’s.”

No doubt about it, Carla. And that’s the thing we have to watch for. Sometimes these early-onset infections—be it cross-contamination from the hospital, be it poor development, like whatever happened—can set the stage to have more of these infections down the road.

And what we have to consider is that the Crohn’s we may now have today could be this long-term stretching immune response from something that happened way back then, that never got fully corrected. And that can create these major inflammatory reactions.

Last question we have here from Lynn:
“Is SB a good probiotic—that’s saccharomyces boulardii—when taking antibiotics?”

Absolutely. Some really common ones that we can take—again, I want to run over some of these. This is a great chance to do that.

Just your general blends of any kind of bifidobacterium or lactobacillus—these are going to help control a lot of stuff.

Some that a lot of us are really depleted on right now is also Akkermansia, which is getting more popular. And I know Pendulum makes a really good one. But they’re getting more and more common.

What she’s talking about is saccharomyces boulardii. That is actually a yeast, and that’s going to help prevent the overgrowth of certain fungi like candida. Really, really beneficial. They typically come in small doses like 5 billion, which is typically fine—that’s plenty for these guys.

So a mix of these are going to be really beneficial. If I had to pick just two, it’d be bifido and lacto. If I had to add a third, it’d probably be saccharomyces boulardii.

Again—they’re really, really beneficial. Antifungal, antibacterial, help with the benefits of balancing your immune system, inflammation—you name it. They’re remarkable.

And so probiotics—they’re everything.

Here’s what you need to know. When you are born—give or take, right—when you are born, assuming you’re born the right way, and you’re bottle-fed or you’re breastfed, etc.—you’re about 99% human cells and 1% microbes.

By the time you die, you’re about 90% microbes and only 10% human cells. They outnumber us nearly 10 to 1. There are hundreds of trillions of them inside of our body.

And your whole body has its own ecosystems—your gut, your mouth, your eyes, your scalp, your groin, your armpits. It all has its own ecosystem, and they all communicate. They’re like neighborhoods within a larger city. Everything works together for the greater good—or the greater whole—of your body.

And that’s something very important to keep in mind.

That’s all we got for you guys for today. Thank you so much for being here. We appreciate you. We’re going to see you next time.

One of my favorite things to hear as an IBD specialist is something along the lines of,
 “I learn more from you in 15 minutes than from my doctor in 15 years.”

And if this—for the first time—is really starting to click, and it’s starting to make sense, and you’re going, “Wait a minute. This might be reversible. I think there’s more that I can do.” This condition came out of nowhere. It happened to me out of the blue. I was healthy for 10, 20, 30, 40 years—and suddenly I wasn’t.

And you’re telling me there’s no cause?

If you’re understanding finally that there is a cause—that something is driving this—I want to invite you to check the link in the show notes below. Send me an email. Ask a question. See if a program is the right fit for you.

Because I promise you—this doesn’t have to be a lifelong sentence.
 You’re not doomed to this.
And IBD can be reversed.