Hidradenitis Suppurativa

AKA Mr. BETA NEGATIVE 1000 AURA OHIO

Some evolving evidence-based guidelines to support HS management

Dietary

1. Alikhan A, et al. (2012). "Hidradenitis suppurativa: A comprehensive review." Journal of the American Academy of Dermatology. This review discusses various factors impacting HS, including lifestyle and dietary influences.

2. Zouboulis CC, et al. (2015). "Hidradenitis suppurativa." The Lancet. This article addresses the multifactorial aspects of HS, encouraging lifestyle adjustments and dietary considerations as part of management strategies.

3. Lemaire M, et al. (2020). "Dietary factors and hidradenitis suppurativa." Dermatologic Clinics. This article specifically explores the correlation between diet and HS, highlighting foods that may exacerbate or alleviate symptoms.

4. Reddy V, et al. (2019). "The Impact of Psychosocial Factors in Hidradenitis Suppurativa." American Journal of Clinical Dermatology. While it focuses on psychosocial aspects, it acknowledges the role of lifestyle, including diet, in the management of HS.

5. Karp CL, et al. (2013). "Hidradenitis Suppurativa: Management and Treatment." The American Journal of Medicine. This source offers insights into holistic management approaches for HS, including potential dietary adjustments.

6. Zouboulis CC, et al. (2020). "Contemporary management of hidradenitis suppurativa." American Journal of Clinical Dermatology. This article reviews current management strategies, including dietary influences on HS.

7. Ghosh A, et al. (2019). "The Role of Diet in the Management of Hidradenitis Suppurativa." BMC Dermatology. This publication reviews the impact of different dietary components on HS severity and discusses potential dietary adjustments as part of management.

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So if humans can’t digest dietary fiber, why do we need it? It’s for 2 big reasons: poop and bacteria.

1. Poop: Fiber helps you have regular, unstrained bowel movements. Constipation and low-fiber diets are common causes of hemorrhoids, and over 50% of adults over the age of 50 in the US have had hemorrhoids. Not fun. Here’s more on the condition by Mayo Clinic. There’s evidence that both insoluble and non-fermentable soluble fiber (“gelling”) help with this.

2. Bacteria: I’m sure you’ve heard of our friendly colony of gut bacteria, sometimes referred to as our “gut microbiome” or “gut microbiota”. We have more bacteria in our bodies than human cells, so they’re a pretty important ally to keep. I mentioned that human cells can’t break down dietary fiber, well it turns out these gut bacteria LOVE eating fiber. In sum, we feed them fiber, and they give us gifts in return in the form of lowering the risk of colon cancer, lowering bad cholesterol levels, reducing the risk of type 2 diabetes, and keeping a healthy weight.

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How does dietary fiber work?

1. Poop: Since fiber isn’t digested, it stays within the GI tract from the moment we eat until it exits, adding bulk to our stool. More bulk and weight of stool increase the natural muscular movement of our GI (gastrointestinal, aka “gut”) tract, literally keeping things moving and preventing constipation. It helps keep our poop in the ideal range of being not too dry and not too wet. On the other side of the spectrum, fiber will absorb extra water in your stool to help with diarrhea. The bristol stool chart is a 1-7 scale that you can use to compare if you’re in the ideal 3-4 range. Here’s a quick link to the chart. The sweet spot is between “corn on the cob” to “sausage”!

2. Bacteria: Our gut microbiota breaks down fiber into shorter molecules that interact with the human cells in our gut lining, which trigger hormones that signal to our brain and the rest of the body that we’re full. You might have heard them as “satiety” hormones. This is one of the ways high-fiber foods make you feel fuller! There’s also evidence to support that fiber will slow down the absorption of nutrients throughout the entire GI tract, helping further regulate satiety, blood sugar, and insulin levels.

   One of these short molecules, in particular, called butyrate, is highlighted to act on many different parts of our body. Notably, butyrate interacts with our fat cells (called adipocytes) in the body to reduce fat accumulation, lower insulin levels, and increase fat breakdown. This effect is compounded by the happy gut bacteria also releasing chemicals that aid in the increase in fat breakdown.

   In colon cells, butyrate promotes the self-destruction of pre-cancerous cells, reduces inflammatory chemical markers, and provides energy for the cells. In the liver, it reduces inflammation and fat accumulation, both protective measures for a healthy liver. Butyrate even interacts with skeletal muscle cells to increase lean body mass and decrease fat accumulation.

   Here’s what Mayo Clinic has to say about dietary fiber.

Great job for making it all the way here! I know it’s a lot of information, so feel free to come back to this page again and again until you’re ready to take your first step. I started calling my journey “chasing fiber”, it’s a whole lifestyle! If you know me, I’m a quality-over-quantity type of person, and this applies to my health. I want to eat and drink the things I want with minimal time in the hospital as I get older, and I think meeting fiber goals is a huge step in the right direction. Let me know if you have suggested edits, comments, or questions!

edited Dec 23, 2022