The listserve members were curious about the success rate with SCD and other treatments at Dr. Purdue's clinic. Here is the original message, and Dr. Purdue's response.

The Questions

1. How many patiends of IBS or IBD did You treat with SCD?What percentage showed definitive improvment?
2. In case the improvment (remission)has appeared did it last or was it only temporary state of health?
3. Do You approuve patients on SCD to take prescription medicine like antibiotics etc?
4. Did You have many (number if posible) cases where SDC DID NOT help?
5. Do You think even people who DONT CHEAT on SCD may fail and their health cannot be improved in spite of SCD? (regarding myself I have been pronounced colitis sufferer had been ion very bad state (nauseated,constipated,depressed and very slim..)

Kind Regards,
Patrick Zdenko -- In 4 weeks my health dramatically improved and after 6 months of SCD I have NO SYMPTOMS,TAKE NO MEDICINES and have a 100% normal life)

The Answers

Subject: Re: Zdenko's letter
Date: Tue, 16 May 2000 05:56:26 EDT
From: PPurdue10@aol.com
To: scd-list@longisland.com

My responses:

1. I first heard an interview with Elaine Gottschall about 2 1/2, or so, years ago on a professional audio magazine called "Functional Medicine Update." I began using the SCD at that point, and to date have treated several hundred people with IBS/IBD, and related disorders, with this diet. Since I'm "in the trenches" everyday, treating patients, and not doing a study, I don't keep statistics on percentages. However, I know that the vast majority of patients who stick with the diet, have shown improvement. Sometimes the diet alone does the job. More often than not, I have to help it along with additional modalities. But as far as diet is concerned, this is the most effective approach I have tried.
   
   
2. Most of my improvements tend to last. With many of these patients, the diet is a lifetime commitment. Some patients reach a point of balance in gut bacteria, and, with caution applied to dietary choices, can "cheat" a couple or three times per month. A rare few seem to be able to eat anything once they've become symptom-free (although I don't advocate this since more factors than starchy carbs can throw off the bacteria in the gut -- such as stress factors).
   
   
3. My scope of practice does not include the use of prescriptive substances. If a patient is on a prescription drug (such as Prilosec), I tell them that it is my experience that they will not need the drug after following my protocols and the SCD, and that they should consult with the prescribing physician about getting off the drug. Some physicians cooperate, some don't. Most patients take themselves off the drug. Regarding antibiotics, the whole idea behind the SCD is to reduce overpopulation of the fermenting group of bacteria (as many of you know, there are over 450 species of bacteria living in the gut, with the fermenting bacteria being one class within this complex milieu). Gut flora live in a delicate balance, and antibiotics throw this off. It is self defeating to take antibiotics to treat an inflammatory bowel disease while trying to rebalance gut flora. In my medicine, the control of bowel inflammation and pathogenic bacteria overgrowth can be controlled with the complex Traditional Chinese Medicine (TCM) medicinal formulas I use, along with various Western-style nutrients and homeopathic medicines I also use. I treat infections all the time, quite successfully, without the patient having to use an antibiotic, and without throwing off the delicate balance of gut flora. Using this method saves the antibiotics for truly serious infections where my medicine would be less effective or not strong enough.
   
   
4. Again, I don't keep numbers. I certainly do have failures. Nothing is 100%. However, most of my failures are with patients who don't want to follow the diet or, for whatever reasons, follow my protocols. As the author Carolyn Myss points out in her book "Why People Don't Heal And How They Can," some people have hidden reasons (which they may not be aware of) why they can't allow themselves to get better, but that is outside this discussion. There are a couple of cases which come to mind where the patient did everything correctly, and didn't get better. These cases are always a source of frustration for any practitioner. I'm always trying to find out why some cases don't respond.
   
   
5. I think I covered this in "4." To embellish this subject a bit, there are, again, many reasons for gut bacteria to go haywire. You may or may not be aware, for instance, that there is as much neurotransmitter activity occuring in the GI tract as in the brain. We literally think and feel with our gut as well as our brain. So stress and emotional strife can wreck the GI tract. Over 50% of the body's total mass of lymph tissue is clustered around the GI tract. This means that over 50% of one's immune system is dependant upon gut activity. So other challenges to one's immune system will upset gut bacteria. All the blood that drains the GI tract passes through the liver first before going to the rest of the body. Thousands of complex chemical reactions occur in the liver to detoxify whatever is in the blood that may not be of benefit to the organism. We are all different from one another, and some of us don't detoxify various substances at the same rate. Alcohol, for instance, is detoxified by the enzyme dehydrogenase. This is the same enzyme that detoxifies many environmental contaminants (such as formaldehyde that is present in the smell of new fabrics and carpeting). So those folks who get tipsy quickly with only a glass of wine and suffer ill effects the next day are often environmentally sensitive. This can have a profound influence on the gut, throwing off all those bacteria we try so hard to control with the SCD. So these are a few factors that can contribute to a gut problem that may have to be addressed in addition to the diet. Ignoring or missing any related problem will slow or inhibit recovery. Additionally, there is no one who knows it all. Our knowledge is always evolving. I, like all of you, are constantly searching for the answers to cases that befuddle me.

I hope I've answered your questions. Please let me know if you have any others.

Sincerely, Patrick Purdue, D.O.M. (Doctor of Oriental Medicine, Florida)