A Functional Medicine Approach To Curing Crohn’s And Colitis with Dr. George Papanicolaou

Coming up on this episode of the Doctor's Pharmacy.

And if a person has a genetic predisposition to ulcerative colitis or Crohn's inflammatory bowel disease in general, then they're gonna be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment, it's the stress. All of those can trigger your genetic predisposition.

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Episode of the Doctor's Pharmacy.

Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman. That's Pharmacy with an F, a place for conversations that matter. And, if your digestive system has ever been a problem, especially if you've had some type of inflammatory bowel disease like Crohn's or colitis, this podcast is for you because we're going to discuss a functional medicine approach to inflammatory bowel disease with my friend, my colleague at the Ultra Wellness Center, Dr. George Papachronikolau, who has been with us for years and is just one of the brightest and most amazing docs I know. And I'm so happy to have him here to talk about this terrible problem which affects so many people, which I have suffered from and which is amazingly fixable using functional medicine. Welcome, George.

Mark, it's always a pleasure. It's always great to talk about functional medicine and how we, what we do with functional medicine at the Wellness Center to help people get better and reach their optimal health.

Wow, thanks, George. Well, listen, we're gonna get right into it. So, inflammatory bowel disease, how common is it? What is it? What symptoms do people get? And tell us about what we know about the disease in terms of a traditional approach from traditional conventional medicine. What's the approach to this? Because it just seems like a vexing problem and we just seem to have made some advances, but still it's not great.

Yeah, so it's very common. There's about 3 million people have it per year in the United States of America. That is actually up from 2 million in 2000. So there's a very steep increase over the last several decades and the projections are that's gonna increase at an even more rapid rate over the next 20 years. So ulcerative colitis, Crohn's disease, which both are the two major inflammatory bowel diseases, are frequent and common and are very, very disruptive to the people that have them. They can really just completely upend their lives. Depending on how quickly you wanna get into this, I can get right into, I'm just thinking of all my patients and their suffering. I can tell you that when it's uncontrolled, there is a lot of pain, there's a lot of diarrhea, there's an inability to eat, there's fatigue and weakness that keeps people from being able to do their jobs. Weight loss. All of those symptoms, malnutrition can be included in there. There's a lot of people that have it. It's a growing problem. When you have it, it's very disruptive. and even when you are well, you have to work hard at staying well. Yeah, it's a huge problem and it's.

Basically an autoimmune disease of the gut. What's amazing to me is in traditional gastroenterology, I've talked to gastroenterologists and they're like, oh, you know, what you eat doesn't really impact it. I'm like, wait a minute, you're putting pounds of some foreign substance in your mouth every day that's going through your gut. How could that not affect it? It's just so striking to me that there's just this complete almost ignoring of the role of nutrition and food in what's going on with gut disorders. That's just kind of a meta comment because it's such a big obvious like duh to me.

Yeah, but to make it to retort with another meta comment, I would say that in our food, yes, but in that food are toxins and in our environment are toxins. And, we have medications and we have, you know, we have endocrine disrupting hormones. all of which end up in our gut microbiome and are very disruptive. And if a person has a genetic predisposition to ulcerative colitis or Crohn's inflammatory bowel disease in general, then they're going to be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment, it's the stress. All of those can trigger your genetic predisposition. Absolutely. Because you have to ask yourself the question, why have we had such a rapid increase over the last several years?

Yeah, what's going on?

And this is your area that you are the leading edge of the medical voice in understanding agriculture and food production in our country and how It is toxic. And why it's toxic? We don't have healthy soil and that's where it begins because if we don't have healthy soil, we're not going to get the nutrients in our gut soil to grow good bacteria and have a healthy microbiome so that our intestines can stay healthy and do their job for us.

Yeah, it's such a big deal. And from a conventional perspective, the treatments are really to shut down your immune system, right?

Oh, yeah.

Prednisone, steroids, chemo drugs, TNF alpha blockers, things that increase your risk of cancer and infection. They're pretty extreme drugs and they can be very helpful and they can be life saving and they can work for people. But the question is, is there an alternative? Yeah, well, and do, you know, do we have to deal with this the same old way we've been doing with it? And then, of course, for a lot of patients who have it, sometimes they need surgery, they total colectomies for ulcerative colitis, where they remove your entire colon or resect whole sections of your bowel with Crohn's disease, which doesn't really even cure the problem. It's just a rough disease.

It is rough. And, I think you and I can bring people some really good news today that using functional medicine and what we understand about the gut microbiome, what we understand about food is medicine, you can get better and stay better without having to use the kind of drugs that you just mentioned that can lead to cancers down the road. People on immunosuppressive drugs followed for 20 years, they're already at very high risk. They're already at increased risk with inflammatory bowel disease for colon cancer. Then, if you put them on an immune suppressive drug and follow them for 20 years, they have an increased rate of skin cancers by about 40%. And during that period of time, they have increased rates of infection, they have side effects to the medications, they have to come on and off them, they have to try new medications, and by and large, they're moderately effective and sometimes not effective at all for some people.

For sure. And I think that people suffer a lot from this and it can manage the disease, but it often doesn't go away or it's not curable. from a functional medicine perspective, it can be really curable. And I can tell you so many patients that I've had, I mean, I just actually how I got the job and probably how I got the job at Cleveland Clinic was because I met someone to the CEO who whose niece had severe colitis, was tried all the medications, wasn't working, was about to have her total entire colon removed at 32 years old. and I said, look, just have her come to me. No promises, but no, it's worth trying before she rips out her entire colon, which is irreversible.

Right.

And I think she was skeptical. She was from New Orleans and probably wasn't the healthiest, you know, lifestyle down there. And she agreed to do what I told her to do, but she was quite skeptical. But I changed her diet. I reset her gut microbiome.

Simple things.

Simple things. And six weeks I talked to her. She said, I'm perfect. I'm fine. I'm on no medication. And I'm like, what? Literally six weeks. And they were going to take her colon out, and she's symptom free and offer medication. And I can tell you story after story like that. Another young kid was 25 years old. Same thing about take his colon out. Just some simple dietary lifestyle changes and, and getting the gut microbiome straight and resetting the gut with the functional medicine for our 5R program was so key. So I think-- well, it's-- we had.

Talked earlier as we were preparing for this, and one of the, I think one of the first things that happened, and you can correct me if I'm wrong, but you met with Dr. Ruggerio, who's a GI doc, including a clinic, and you guys set up a collaborative, you know, to, you know, work with functional medicine and traditional and conventional forms to treat, ulcerative colitis, inflammatory bowel diseases. And that sounds like a phenomenal partnership.

Absolutely. It really is. And I think there's a real openness to understanding there's really room for this, including with everything. It's not either or. How do we create the best conditions for a patient to get to health? And I think in terms of causes, let's sort of dive into that because from a functional medicine perspective, we really look at root causes. And today I was going through my medical research that I do every day and just sort of looking at what's new and was sort of shocked to see this. Well, not really shocked actually kind of expected it, but I was shocked to see it sort of published so prominently in a medical journal. We're really, really discussing the way in which food sensitivities, I mean sorry, food additives and ultra processed food will drive changes in people's gut. So when you look at this data, it was quite interesting. They looked at mice and people and they basically show that high sugar processed food diet affects the gut in a harmful way. We also know that there's a lot of emulsifiers and additives in food like they're thickeners, even things like microbial transglutaminase, which is a gluten product that's put on purpose in food to make it stick together because gluten makes it glue, makes it stick together. And so, we have to sort of think about when we take care of these patients, what the causes are. So from your experience, George, what are the top things you think about when you're seeing a patient with inflammatory bowel disease?

Well, the first thing I think of is disordered microbiome. I just think of, and then I think of all of the components that go into that from their diet, specifically their lack of foods that are prebiotic and probiotic. I think about the types of foods they eat, that would be disruptive to the gut microbiome, like grains that have glyphosate sprayed on them if you're not eating organically. That's where I really begin to dig down, dig deep. I look at stress. I will tell you that it's whenever one of my ulcerative colitis patients or Crohn's patients call suddenly with an exacerbation, it's come on. and they're in a panic and they want help, eight times out of 10, stress is triggering it. And the role of stress in triggering this disease and in driving it and in causing exacerbations and making it even more difficult to get under control. So I think about lifestyle. I think about stress. I think about the role of exercise because exercise does play a role in controlling inflammatory bowel disease. I mean, stress and exercise have been studies that have shown controlling stress, getting your exercise, and altering your diet, those are three things that can make a big difference. So I think about those when a person's coming to me, that lights up. What the causes are, there's obviously a genetic predisposition for people. And so we think about that. There's not a lot I can do to change the genetics at this point in medicine. I think about the, again, I go back to the immune system. We know that there's an immune triggering that goes on, and we know that the gut and the microbiome very specifically is the gateway to the immune system. That's why I think about it first, because we need a healthy gut microbiome to have a healthy gut lining or that mucosal lining, because that mucosal lining plays a very important role of providing very concise and precise communication between the gut bacteria and the immune system. Because the gut bacteria and the immune system work very closely together to make sure that we are protected from outside danger, things that aren't and when that gut microbiome, those bacteria aren't healthy, then that mucosal lining breaks down. And now toxins and bacteria and viruses, heavy metals can get back into our system and recirculate, increasing our toxic load, further damaging our immune system, further creating inflammation, to trigger or maintain that inflammatory process that we call ulcerative colitis and Crohn's disease.

Yeah, and what's great now is we're learning so much about the microbiome and so much about how to work with it and how to optimize it and how, what harms it. And, you know, and I, and I've seen all sorts of cases of, of Crohn's and colitis. And, you know, I, I, I just share another story of a guy who I saw years ago. who had severe colitis was really losing weight, struggling. I tried all the normal functional medicine stuff, reset his gut microbiome, did the 5R elimination diet, tried everything, the right supplements, and he just wasn't getting better. And so I went back to the principles, first principles that I learned from Sid Baker, which is what could be bugging this person that needs to be gotten rid of? Is there something else that I'm missing? And what am I missing? Is there something I'm missing?

Yeah.

So I went back to the drawing board as my medical detective hat on and and found out this guy had really high levels of mercury. And it wasn't until I chelate his mercury that he was able to correct his colitis and is now symptom free. I personally had a different cause. You know, I was. I was somebody who mostly had a healthy gut most of my life. And then I developed mercury poisoning, and that messed up my gut. I didn't get colitis, but I had really bad irritable bowel and bacterial overgrowth and all sorts of issues that I cured, but. Then a few years ago, about five years ago, I got a confluence of events where I ended up having to take an antibiotic for a bad tooth and a root canal, and it was clindamycin, and this antibiotic is known to cause C. difficile, which is a really common intestinal infection that causes death in about 30,000 people a year. And all of a sudden, I started getting not just diarrhea and this and that from it, I started getting really severe pain, nausea, going to the bathroom 20 times a day, bloody bowel movements. It was just, it was miserable. I literally was in bed five months running back and forth to the bathroom. And turned out I had developed colitis from the C. Difficile, and then it continued even after we cured the infection. The colitis continued. And so I had to really go back to the drawing board to think about what do I do? Because I also had mold exposures and I had all these imbalances, I had low acromania. So I learned a lot about on a personal level, which I really didn't want to learn that way, but. I learned about what the symptoms are, what it does, and how to actually start to think about fixing it differently.

Yeah.

And for me, I did a number of things. I used a cocktail of I call gut food, which is a cocktail of components that are, I think, have not really been put together too often, including prebiotics, probiotics, polyphenols and immunoglobulins and things that really help the body to reset the gut. And I also dealt with the mold that I had in my house, and I also used ozone to help boost my immune system and kill infections. And it was really amazing. Within a very short time, I was able to really recover. And I think a lot of us sort of struggle without really knowing what to do. And even sometimes when you do an elimination diet, if you have colitis, you don't necessarily always get cured because there may be something else going on. Maybe like what I had, maybe there was, you know, C diff or maybe there was mercury or maybe, you know, there was something else going on. But you can you can really help these patients so much. Cronin's is often a little more challenging, but we do a lot of different approaches. So traditional medicine, it's pretty cut and dried. What are the kinds of diagnostics you'd see us using with these patients to.

Figure out what's going on with them? Well, traditionally, you're, you know, first you're gonna get their studies. I always like to go back to the basics. You know, we've got to remember that we're doctors are cognitive beings. We are medical detectives. We like to think. So I think you need to, make sure that you're listening to the patient's story, hearing all of the symptoms, doing a really good examination, and making sure you do that part. Because that's where you find those predispositions, you find those triggers, and you find those mediators that are so important. Because that begins to, those are the categories you think in to solve the mystery. Okay. So, once we've, you know, I've done that piece and I have a really good idea of what their predispositions are. I have a really good idea of what the potential triggers are, because those triggers can give me an idea of how I'm going to help them get better and control it down the road. And some of the mediators and perpetuators, you know, that could be, you know, stress or that could be their diet. Once I have those pieces, then I say, okay, you know what? I'm pretty sure you have ulcerative colitis. You know, how do we know for sure? we can check inflammatory markers like something called Calprotectin, which will be very elevated in people with inflammatory bowel disease. And then we can also visualize, and it's the gold standard, is to visualize with the colonoscopy, the intestines. And you can, you'll probably do both an upper and lower, and you'll see that with Crohn's disease, it can involve the entire intestinal tract, whereas with colitis, it typically just involves the very end or the distal part of the large intestine, the rectosigmoid and the first third of the colon or the last third of the colon. And that will be, that will visualize it through colonoscopy. So those are, that's the conventional way. And then, once they land in my lap after being frustrated by just not getting better or finding that their diets are really restrictive and they're constantly having symptoms and they're not finding any answers in the places they're looking in the conventional medical world, then I immediately go into action and I'll look at the complete diagnostic stool analysis where we will get a full complete picture of your digestive processes. Are you making enough gastric acid, pancreatic acids? Do you have markers of inflammation? Is your detox system in your gut working correctly? Is your immune system responding, over responding, under responding? And it will also tell us very specifically the diversity and abundance of of your gut microbiome. And so it's one of the, it is the first test that I'll get, but I'll also look for other things. And we should have mentioned this earlier, but I'll look for SIBO, which is small intestinal bacterial overgrowth. I will look for food sensitivities, particularly to gluten. I'll look for leaky gut. And I'll also look for those cross-reactive foods, foods that act like leaky gut. that can create inflammation if you're sensitive to gluten and then be a trigger for your ulcerative colitis. Those are some of the tests. I'll do an ion profile or a micronutrient. It's a functional evaluation of all the most important biologic processes that your body does. It allows us to determine which systems are or aren't working and if they're not, what nutrients are you missing? Do you have, particularly when it comes to the mitochondria, do you have compounds or toxins that might be impairing those functions like with you, you had mercury elevations that probably were impairing your mitochondria, probably impairing your immune system. And on top of the other conditions you had may have tipped you over and made you more susceptible to the adverse outcome with a antibiotic. So, we're looking at all those things and those are the tests that I look at. And, I may do some, well, yeah, I usually will stop there in my first tier. And, I usually get most of all the information I need with those tests.

Yeah, it's true. I mean, I do look at food sensitivities, look at the gut, look at heavy metals, and, and, and those can often be so helpful in figuring out what's really going on with people. And then you end up being able to sort of customize their treatment based on what you find. And, you know, there are some dietary approaches, but, you know, when you get to, you don't deal with the root causes and figure out what you're doing initially, it's a problem. That's really what we do at the Ultra Wellness Center. We map out what's going on with people at a much deeper level. I mean, look at things that most traditional physicians just don't look at, like who's measuring acromance levels? Well, we do because what this particular bacteria does. We want to know what your nutritional status is. We want to know whether gluten's an issue. We want to know what's going on with your gut. Is it leaky? I mean, we do all these things. And then we implement a plan. So, what are the kinds of things we find that work the best and talk about from a dietary approach and then sort of drill down into the other aspects of our treatment for colitis and Crohn's disease.

Right.

So, the, you know, neck and neck, it's diet and gut microbiome. It's really neck and neck. I will say with the gut microbiome, it's very intriguing because there's more and more research being done into the differences between a healthy gut microbiome and the gut microbiome of a person that has inflammatory bowel disease. There are significant differences. In a person that has inflammatory bowel disease, one of the key bacteria, as you mentioned earlier, is Akkermansia. Akkermansia plays a role in keeping the mucosa, the gut lining, the goblet cells really healthy. It breaks down the mucin, and then when it breaks that down, it turns it into short-chain fatty acids. And we know that short-chain fatty acids are the, you know, that's the honey. of the colonocyte. It just loves its short chain fatty acids and that keeps it really healthy. People who have inflammatory bowel disease tend to have really low levels of Akkermansia. It's not uncommon for me to find that they're not even detected when I do the complete diagnostic stool analysis on patients. Replacing Akkermansia has been shown to have an important role in helping the gut mucosa heal. There is a study that I had come across in preparing for this. It was in the European Journal of Inflammation 2020. And basically in this study, they took bifidobacterium. Another strain of bacteria that is found to be really low in patients with inflammatory bowel disease. And they took a specific strain of Bifidobacterium lactis, and they combined it with xylose glucan, which is a non-digestible fiber source. So it had a prebiotic probiotic together in a patient with ulcerative colitis. and they followed all of the patients in the study and control groups, and they found that there was at six weeks, the study group had significantly more healing and resolution of their symptom, more healing of the gut mucosa and healing and resolution of their symptoms. And this is just they had no other therapy. this is just a prebiotic and a probiotic that they use. Using probiotics to control and to resolve an exacerbation can be really critical. I think we're learning more and more about how they work. There are other probiotics or other bacterial species that are missing or in low concentration in patients with inflammatory bowel disease including lactobacillus GG, saccharomyces boulardii, and when you replace these you find huge benefits. So I use probiotics pretty quickly in a patient. I also will use, there's a probiotic called VSL number three. A lot of people know about that because it's frequently used and it's really powerful. It has all the screens of lacto, bacillus and bifidobacterium that are low and are also very helpful in healing that gut lining and gut mucosa. And just by using that, I've been able to help people start to feel better and see their symptoms resolve. So as you can tell, the gut microbiome using probiotics are really a big part of how I'll treat my patients. But that has to be balanced about what they can tolerate and where they are in their disease because the diet then becomes really important. Sometimes I can't give probiotics right away. Sometimes, I've got to get this person eating. I've got to get them feeling better.

Before.

They can actually tolerate the addition of the probiotics.

Absolutely. What I would say, George, is also the diet's such a key thing for most people. And, it's not only eating an anti-inflammatory diet, it's not only getting rid of the food additives, the emulsifiers, and the things like the carrageenan and other things that can cause damage to the gut lining, but it's also thinking about how do we reduce all the potential inflammatory factors in the diet and all the potential food allergens. And, there's been some interesting research done on what we call an autoimmune paleo diet that's been shown to be effective for Crohn's and colitis in, in trials. And I think it's really been overlooked for the most part. But can you talk about what is an autoimmune paleo diet and how does it work for Crohn's and colitis?

Yeah. So, you know, as I said earlier, the microbiome is the Gateway to the immune system, and we know that there is a strong immune component to inflammatory bowel disease. The autoimmune paleo diet. I want to put my glasses on so I can see you better. So the autoimmune paleo diet basically is going to eliminate foods from your diet that can trigger your immune system to have that autoimmune response and to create that inflammatory response. It's going to allow the gut lining to heal. And, so, there are foods that are.

Fought to really- what do they take out? What is an autoimmune paleo diet? What do they take out?

They're going to take out grains, legumes, nuts, seeds, nightshades, eggs and dairy. All of these have inflammatory components to them. And, so, then, you know, yeah, so that's the main things.

So, like grains and beans and nuts and seeds and eggs are supposed to be healthy.

Right?

They are. How does that— They have inflammatory components to them. Once your system begins to break down, then those foods can tend to have, trigger the immune system to have an increased autoimmune response. Because what happens with some of those foods is that you develop the mucosa breaks down so it can't do its job. Number one, it can't break foods down. so you're not gonna get your nutrients that you need. Number two, that mucosa now, this very finely designed gate system is broken. And these foods, when they're not broken down into the smallest peptides possible.

They.

Don'T have to be, because the gates are broken. So now you have these larger peptide forms. And these particular foods, they're proteins. are inflammatory to the immune system when they're larger and the immune system can't recognize them. So the immune system begins to create the autoimmune response and the inflammatory response. So that's why these particular foods are taken out. And it includes alcohol, coffee, it includes processed oils, corn oil, canola, cotton seed. You want to not have those oils in your diet as well.

Absolutely. And so you're getting rid of all that stuff. And what are the kind of results you're seeing with those patients?

Well, with an AIP diet, we see very, you know, we see very good results. You know, we, because a lot of folks, when they've come to us, they've never been told that you can eat a certain way to improve your symptoms. So when we take these foods away, for six to eight to 12 weeks, it gives the intestine and the immune system opportunity to rest. And now you can get healing of the gut because you are still eating very nutritious foods that are healing to the gut. We're able to, once the symptoms begin to be vanquished, they're able to tolerate more foods. We can get more fiber in, we can get more probiotics in, and then the healing process really begins. And, you know, by 12 weeks, we're seeing, you know, people with, you know, all symptoms are gone and they feel great. And that's just the AIP with, with probiotics.

That's incredible. I mean, really, when you think about the fact that this is such a debilitating disease that It's such a difficult challenge for patients that the drugs are so potentially toxic and harmful that.

You.

Know, so many millions of people suffer from this. And that what you're saying, George, is that in functional medicine, we have a map to figure out why. We have a approach to improve the microbiome, to treat them with an anti-inflammatory diet, and to reset the gut microbiome through a whole host of interventions that we call the 5R Program in Functional Medicine. We've talked about that on the podcast before. And, we also tend to look for other things that people don't look for like heavy metals or infections or other issues. And, it's amazing what you'll find and what you see and it's so gratifying. I mean, I've all the conditions. I love it when I get a patient with Crohn's or colitis because it's such a slam dunk. And, for me, I had one of those cases that just was not getting better. and so I always get the cases, the worst of whatever it is, and then I have to figure it out. And I figured it out. And I think, you know, there's other treatments that can be helpful. And I used ozone, I used exosomes, these are a lot of different things, but it's quite amazing when you see the potential for this.

Yeah. And I want people to know that, you know, it's. There are. Look, you're really sick, you're not feeling well, and you're having bloody mucusy stools. and you're having them 11 times a day and you're having pain and you can't eat, you're desperate. Then you're going to be told, well, guess what? We're going to put you—we're going to eliminate all the foods that you like. Well, you know what? Sometimes, unfortunately, you can't even start an AIP diet. Because people, when they come, can be so debilitated that they can't tolerate foods. To really give their gut a rest, I'll use something called an Elemental Diet. An Elemental Diet is basically a medical food that has all the nutrients that you need but doesn't require your body, your broken mucosa, to break down the proteins and the complex carbohydrates. We're able to use the Elemental Diet to really rest and really get all the symptoms calmed down, then move on to AIP, then add in our probiotics. Then we have other things that we can do for long-term maintenance of a healthy state. And that is some things that can boost the immune system, modulate the immune system. I commonly will use things like low dose naltrexone, which modulates the autoimmune response. And I'll use CBD with THC blends that again can have a modulatory effect on the immune system, decrease inflammation in the gut, increase appetite. And so there are a lot of things that we can do. in functional medicine, just as you've just pointed out. And those are some of them in a little bit more detail. And I agree with you. I'm, you know, that's what we do. There's not a patient that comes to me that even if they're coming for one thing, that we don't end up talking about their gut. It seems like gut issues are epidemic.

Huge, huge. It's huge.

And also Crohn's disease and Crohn's disease, I think, are at the apex of the severity of what can happen when you have a poor diet, you have a disordered microbiome, and now you have an immune barrier that's broken, and now your immune system's under siege and it can't respond appropriately.

Yeah, well, I'm telling you, George, this is one of the areas in functional medicine that I've found over the last 30 years has been such a gratifying area because people really suffer. The traditional approaches are kind of limited and the potential to heal the gut through restoring the microbiome, changing diet and some simple measures is just huge. It's huge. And so, I'm excited about having this podcast with you because I think when we see these interventions in functional medicine working out the way they do, it's just such a life affirming thing for me as a physician to know that I'm helping someone. And, I've been there. Like, I've had all this. I had 20 bloody painful bowel movements a day. I was nauseous and in pain for five months. I was just, it was in bed. Like, all I could do is go bed, bath, bed, bath. It was like it was terrible. And, and now I think, you know, we have such a clear roadmap to how to fix this. And, there's some other weird things that people are doing, like using worm therapy and other things. I'm not, I'm not, I don't use that that often, but it can be helpful. So, there's a lot of tricks in the functional medicine toolkit. and George, you've been really great helping us understand inflammatory bowel disease. This has been another episode of the House Call with Dr. George's Pharmacy with Dr. George Papamichael. If you love this podcast, please share with your friends and family on social media. Please leave a comment. How have you dealt with your inflammatory bowel disease? Have you gotten better using a different approach?

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Hey everybody, it's Dr. Hyman.

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