Epithelial Surfaces

Epithelium cells

Simple “Columnar” Epithelium

What up Colitis Folks!

The time has come, we need to get down to some basics with our Immune System.

Epithelial Surfaces

What a strange looking/sounding set of words.  Almost sounds like a part of an insect’s antennae right?  Truth is, we all have these things, and a crapload of them.  Even if you don’t have colitis, you don’t have to feel left out because you for sure have some epithelial surfaces too.

Watch the video.  You very well may learn something.  But in all honesty, I thought it was time to try and do a bit of strumming on the old (kinda getting dusty) guitar and break down some big points regarding this part of the immune system which is always working and in action.

Check this out:

Many immunologists consider these epithelial surfaces to be our biggest 24/7 fighter against infection and keeping us alive and well for that matter.  Just imagine if you ripped off all your skin and just sat around waiting to see how things went…Not a very promising situation right?

A Part in Active Colitis Symptoms?

Let’s carry things one step further.  Do me a favor, a simple one you’ve done many times before.  Ask yourself the real simple question:

“Where do colitis symptoms start?”

OK, if you have or know someone with UC, maybe you’ve done this thousands of times before. Maybe it leads into a mad cycle of theories, internet research and everything else in between.  That’s cool.  Don’t trip out.  That’s normal, and hell the FRICK YA, WE ALL DO IT, especially right after getting diagnosed with UC.

I for sure struggled with this question, and also with developing an answer that made even a tiny bit of sense.  When I asked my gastroenterologist doctors, “Hey Doc…where do colitis symptoms start”, the answers didn’t really help me out either.

Depending on which of the numerous GI’s I spoke to, it was often along the lines of, “We” (meaning the scientific and medical community) don’t know where or how it starts, and because it is an “autoimmune disease”, it doesn’t know how to turn itself off.  Then there was also the talk about genes and “pre-dispositions” to UC and other GI related disease.  But the simple fact remained, where in the body do colitis symptoms actually start?…I struggled for months on learning an answer that made any sense TO ME.

So, let’s go back to the good old epithelial surfaces which line the insides of our colon.

If what I’m singing about in the song, (based on what I’m reading about in the Immunology journals and textbooks is true), the epithelial surface(s) is/are one of the prime places where immune responses actually start.  When pathogenic organisms (AKA- bacteria) make their way into our good old colons…the epithelia start going to work.  Mucins, mucus, and a wide range of other parts of our super complex immune system crank up the engine and try their hardest to help us out.

Pathogenic Organisms – aka Bacteria

One thing I hope we all can learn from the science that exists: NOT ALL BACTERIA ARE BAD.  It’s that simple.  And, our bodies and immune systems know this as well.

Unfortunately, too much bad bacteria can lead to a full on inflammatory response.  (The epithelial surfaces work wonders, but they are still human and have their limits.  Just imagine you(epithelia) trying to put out a forest fire(bacteria), but at the same time the fire is growing twice as fast and gasoline is raining on the fire at the same time…tuffie battle to win right)

When the bad guy bacteria start colonizing the colon(overgrowing), ulcerative colitis can most certainly become the diagnosis.  After four years of treating my disease, that’s pretty much how I feel.  And, with the understanding of how the immune response works(which I’ll be posting on in the future), and in specific the inflammatory response, ulcerative colitis starts to make sense.

And then There Were Drugs

Some of you who know me well might be surprised to see me saying this, but some of the medications that are offered to UC patients actually make a ton of sense.  I think this about the immune suppresant Remicade.  This drug is/was a super blockbuster when it came out.  And many years later, it still is helping a crap ton of colitis patients worldwide.

Why did/do so many people love it?  It’s simple: Remicade found a way to shut down a big component of one specific part of our immune system’s response.  The inflammatory response associated with TNF-Α (Tumer Nucrosis Factor Alpha) to be exact.  Unfortunately it does not always work for everyone, and sometimes it stops being effective(as it was win my case after a few infusions 4  years ago, but that is also true for so many medications).

I’m sure it was rocket science to actually develop Remicade, but the logic is not.  Maybe the drug company thought something like this:

  1. Epithelia are not getting the job done
  2. Pathogens are breaking through and activating the immune system
  3. It appears to be an inflammatory response that happens next
  4. Let’s develop a drug that breaks the immune system’s communication
  5. And let’s cut off TNF-A receptors since they lead to much of the inflammatory response
  6. And…let’s call this medication Remicade since Infliximab sounds WAY too crazy
  7. (And of course, let’s charge a CRAPLOAD, maybe $10 thousand or so per infusion)

You may not agree with this thinking, that is 100% your decision.  But the idea is simple, stopping the immune system’s communication can stop the immune response.

I Still Feel It’s a Bacteria Problem

I’m positive that the majority of the gastroenterologists, even the ones listed on the gastroenterologists page here from the site would much rather think that bacteria are not the cause of UC.  Some might continue to believe that UC is caused by an unknown source, or triggered by an unknown trigger.  It will probably always be debatable.  And again, that’s just fine.

At the end of the day, it is up to you.  Each person living or dealing with UC can decide what they believe, why and how this whole UC stuff is happening.  And heck, you don’t even have to decide now.  It’s taken me several years to form a clear idea that allows me to rest at night.

Functional relevance of intestinal epithelial cells in inflammatory bowel disease.  (A study you may enjoy from pubmed)

As for good bad bacteria/bad bacteria and using diet to control UC,  you don’t have to believe in that either.  But if you are like me and go along with this thinking, this posting should make a ton of sense to you, and things should really start to click.

So once and for all, congrats to our Epithelial Surfaces-they have a tuff job that never stops.

Below is a video/song that evolved in a campground a few days ago outside of the small, but pretty darn cool town of Woodstock, NY at a nearly vacant campground.  Thankfully it was nearly empty, not sure what others would think about this one…


Adam Scheuer Feeling Crappy to Feeling Happy

Adam Scheuer – colitis patient

Take care, if you have any questions or comments, please write them below.

Adam Scheuer
[button color=”green” size=”medium” link=”https://www.ihaveuc.com/feeling-crappy-to-feeling-happy/”]Order My eBooks[/button]


19 thoughts on “Epithelial Surfaces”

  1. I think from research DNA plays it part in the range of epithelial that line our immune system. Possibly IBD prone people have a set batch of them not fully capable of managing attack

    Absorptive cells – main job is absorption of elements and electrolytes
    Enteroendocrine – secretion of gut hormone
    Goblet cells – secretion of mucin
    Paneth Cell – secretion of anti-microbial peptide

    Mucus produced by goblet cells are rich and consistent source of nutrient for saccharolytic bacteria members of microbiota and create a micro habitat where microbiota can embed themselves in close proximity to one another to express their nutrient sharing (syntrophic) relationship. SCFA modulate expression of MUC2 gene: Propionate directly increase MUC2 expression.

    If you imagine this harmony is broken and over powered by unbenificial bacteria than the MUC2 gene is going AWOL as it continuely is secreting secreting secreting – this in inflammation, this is UC?

    I can go into t junction break down, invasion and destruction of gap junction… But I think the points above echos Adams theory; bacteria could well be the route to UC, and possibly the solution

  2. Love this Adam…

    You are so right…it seems that almost everyone believes the cause of UC may be a different one…and that’s okay…cos maybe it’s true. We don’t know for sure if bacteria caused it in every single one of us (altho I too think it could be the root).

    You are a great man Adam. A tireless advocate for all of us UCers. Don’t ever stop. You just might figure this whole thing out yet! We appreciate it so much.

    Btw…your last colonoscopy that you so unselfishly shared with us…your doc prescribed some asacol…did you end up taking it at all? Are you still?

    Cheers…and thanks as always :)

    1. Thank so much Bev,

      No plan on stopping, and whether or not we all can figure UC out, well, time will tell. But for sure we can all learn alot about it and come up with ideas that make sense to us. That always feels good right! AND, I’m pretty sure that there are a bunch of UC’ers who feel they have figured UC out. (especially the ones who have had surgery). So that’s pretty cool. In the end, whether I’m right or wrong is not really the goal with this post, I just hope people who are struggling with UC and hoping to find some answers can someday feel better about their decisions and understanding of UC and why and how it appears, comes and goes, gets better or worse etc…

      As for my colonoscopy back in September 2012, and I’m pretty sure you’re talking about this post/video: https://ihaveuc.com/colonoscopy-results-video-how-is-the-colon-really-doing/

      …Yes, my GI doctor did want me to start taking some maintenance medications, and although he handed me loads of samples (like enough to fill a whole trash bag) of one of the 5-ASA types, I think it was Pentasa, in the end, I decided not to go forward with any maintenance drugs. It was a personal decision, and I hope not an ego-related decision, but I think it was a good one.

      I’m currently feeling the best I’ve felt since my diagnosis nearly 5 years ago, medication free, no supplements either for that matter, and pretty darn content with carrying out some cool stuff. What’s really pretty sweet too is that over the past two months, I’ve slacked off bigtime from the SCD diet, and begun eating starches again. Something that only more time and trial will let me know how everything reacts, but two months into this divergence from no starch (potato and corn/tortilla chips which I’m still addicted to) and things are looking up. I think I can actually take credit for plugging up a toilet in a campground back in up-state New York actually…but i’m sure you weren’t wondering about that.

      I still communicate with my doc, and I know he’s cool with the decision making and all(he’s not one of those high ego types which is what I was looking for). More than anyone else, my wife’s happy & I’m happy. That’s what it’s all about.

      Thanks again Bev, you are a full on UC Rock Star, and I wish you nothing but the best with continuing to manage and live with your UC.


      ***(for anyone who is wondering why I’m eating things like potato and corn tortillas and wondering if I lost my mind…you need to realize that I’ve got about 4 years with treating my UC with diet under my belt, and I’ve paid the price before with jumping off the strict no alcohol rule I use, and no bread rule, no starch rule etc… which is a big part of the thinking behind the SCD diet. So NOT IN ANY WAY, I reapeat, NOT IN ANY WAY would I be eating these sorts of things if my poop was anything less than great, and the same goes if i noticed any visible signs of symptoms such as even minute amounts of blood on the toilet paper.) AND, if I do notice any of those signs in the future, I’ll plan on doing what’s worked so well in the past – a hard core re-boot of going back to basics until the flare symptoms resolve and get better. much like I did in this video where it is all well-documented: https://ihaveuc.com/the-colitis-flare-beat-down-party-getting-out-of-my-flare/

        1. What up MassyB,

          You know what, super funny you asked. For about three days now I’ve stopped the starches, mainly because I’m out pretty remote without any easy access to things other than veggies and meats. (I’m living on a volunteer organic farm for the next few weeks testing some things out…)

          BUt, yesterday after work, wife and I decided to drive into the town (1 hr) to grocery store. I shit you not, I had a bag of tortilla chips like the ones I’ve been eating for weeks now in the cart, and then had a super huge mental debate as to if I should stop this and pull them out before paying or keep them….

          Short story shorter, I took them out when my wife came around the corner and decided to put kaboosh to starches once again..

          I dropped big old fat log in the toilet bowl yesterday, and since I share 1 toilet with 4 others now, I’m hoping to keep it that way and seeems the organic foods ALL day long is so far so good…

          way too much info, but it’s 5:56am and I’m getting ready to start morning chores in 4 mins which is pulling about 400 eggs and moving cattle and feeding pigs. gotta goesie,

          (kinda miss tortilla chops last night:)


          1. Adam,

            How interesting about the farm. Please tell more, vey interested in hearing more about it and your longer term plans with travel. What is your destination if you have one?

            The reason why I asked about starches is because your story resembles mine quite closely. I am currently hospiatilzed for severe cae of UC, second time around. I read your ebook last week and you could replace your name with mine and the story goes about the same, with the exception that you have more success with SCD than I did. I was off all medication for over two years with a stint or two with Prednisone when I flared up. I followed SCD strictly but I am sure some thing slipped in here and there but only a few times. This Spring I was doing very well on SCD, still some nightsweatsbhere and there but one solid log each morning. I had a four day bout of diarhea which prompted me to try rice and potatoes. I felt awesome, the runs stopped pooped once a day, nice logs, no foul gas, belly felt at ease. Even before I tried starches again

          2. Story continued…

            Even before I tried starches my system was not 100% there because my doc did stool tests for inflammatory markers (calprotectin, I believe) and even though I had solid logs the levels were very high, so inflammation was there.

            Back to this Spring. I felt like a champ, gained 15 lbs and had the most energy since being diagnosed six years ago. In fact, I felt so good that I stared eating dairy again, had some wine and coffee, and tried wheat once or twice. I was over confident. But I did stop with diary, coffee and wine right when my right hip started hurting but coninued with rice and potatoes. I was still doing one solid log a day for one and a half months with slight discomfort in the hip. I had no belly pains at all. My sleep took a hit as I have a ten month old at home and I know how important it is for me to get a good night sleep with this disease. Things started going South a bit, stool got loose and saw some blood streaking. I tried FMT which I think made things a lot worse for me, but at this point I have no way of knowing all the triggers.

            So here I am at the hospital with the IV steroids and Remicade flowing through my veins hoping it takes effect. I have terrible urgency each time I go to the bathroom, nothing I experienced before. I know everyone is different and not the same things are working for everyone.

            I feel like I had to make some drastic decisions here because I have very few options. I am considering surgery if this does not work out. I seem not to be able to tolerate much in terms of food passing through me. In the past lots of veggies did the trick but things fly through now.

            I do not regret anything as I was super strict on SCd in the past and it was working only mostly well. Taking dairy out and minimizing fruit intake helped a lot but I kept falring every s ux to nine months. I am just so tired and drained and feel like I need to seriously chang things around as this flare marry go round is beating the crap out of me.

            So, this is my story. You have a wonderful thing going Adam, keep it up and even though starches might work for you be careful. I would give anthing to be back on SCD and doing one crap a day without urgency and pain.

            1. Hey Massybird,

              Thanks for all the details.

              I really hope you can start feeling well again, an SOON. I’m pretty sure you will. Although you don’t feel perfect right now, the fact that you’ve felt better before after being in a flared out situation means you know the body can recover. And no matter what anybody thinks, surgery is also an option, and I’m sure you’ve read enough on this site to know that the people who opt for that are by and large VERY happy. So for sure, you do have options, and I’m pulling for you bigtime.

              Also, I hope you’re not beating yourself up too much in trying to figure out exactly what caused your flare to begin/get worse etc…
              I for sure have spent many an hours trying to do just that with past flare ups, and its often a waste of time and more importantly energy of the mind. So with that said, there’s no reason to try and pinpoint what “may” have been the cause. It most certainly is different for every person.

              Back to starches, I full on agree with your thinking. I’ve actually learned the starches lessons before, and I think I’ve cashed my chips in early enough on this ride. But hell the heck yeah, bag after bag of tortilla chips, a few potato chips, and eventually it would for sure lead to some bread I’m guessing…well that for me has all the makings of a nasty brew called bloody flare up.

              As for travels, really not sure. We don’t have kids yet, so its all day by day. Thankfully our VW van hasn’t had any problems lately, so we’re still pretty mobile. I’ll be making some postings in the future with some cool farm pics, and crazy enough, there’s some serious gut bacteria new learning I’m getting out here from some of the organic farmers, but the details on that will have to wait for later.

              Best of luck to you in getting better, and I wish you the very best,


              —also, thanks for ordering my ebooks :) I hope you enjoyed reading, and its always crazy to me how many others write that they’ve been through the exact same crap

          3. Adam…awesome as always. I love looking at all sides of the coin!! I think all the science will come together some day, and be more than just a treatment of symptoms. It seems like some of us are more prone, higher gene count and like UC F.B. says, we may be a little miswired so to speak. And/or perhaps my theory of different UC types like diabetes may be the case. Maybe that is why meds work for some of us at least some of the time. But definitely about keeping your gut biome in balance!

            Well, thanks as always. Make sure to do tick check out here in the East.
            Oh and way to rock it out science still. You may get that Science degree yet!
            Best, Shelly. :-)

          4. Adam-

            You crack me up… Science really can be fun.

            I totally support your beliefs on bacterial imbalance. Our immune systems are incredibly intuitive- but when we are at such imbalance they are screaming out “DUDE- PLEASE help me out- I CAN no longer do this alone”. The immune imbalance ultimately creates a cascade effect is why we experience so many out of control SYSTEMIC problems/symptoms.

            I also chose to skip the drugs (except for a stint with prednisone). And for me as well, I have had great success with a strict diet, a few key supplements and extra special care of my whole being (sleep, relaxation, lots of love etc.,). And I think once my intestinal cells fully heal I’ll be able to give up the supplements (and use that $$$ for a vacation!!!).

            We ALL need to follow the research, put in the time and energy & with grace and patience… accept a lot of trial and error. Trust our intuition and be cheerleaders for our immune systems!
            Remind ourselves that the imbalance was most likely years in the making and it is going to take TIME to restore the balance. It was three years for me but the prize of remission and health ARE well worth it.

            Adam, enjoy those corn chips and potatoes… you have earned them. Hah!

            Best wishes to all for hope, health and contentment!

            1. Allison,

              Can you give more information on the diet you follow? Also, in terms of stress management, which I think is huge, can you give me some pointers on how you go about doing that? I feel like I have this constant nagging/fear in my gut because of this disease and I would like to find some peace with it. Currently, I’m a pretty bad flare and I’m on Prednisone again, way too many times by now. I am sweating profusely as I am sitting at work and typing this. Waiting for this to slow down so I can get back to normal operation.

              Thanks for your time.

              1. Hey Massybird-

                As far as diet, I am gluten, alcohol, milk, refined sugar, coffee- free. Cutting out coffee was sooo hard but really well worth it for me. I think all of us are unique and some of these things may not bother you but it can’t hurt, right? With that said- I eat tons of vegetables, most fruit (I react to blueberries, strawberries, watermelon & red grapes???)a raw salad every day, good quality meat poultry and fish, SCD yogurt which I make at home, chocolate (in VERY small doses) and green tea with honey. I don’t tolerate beans very well- but that may just be me… I eat grains and sweet potatoes but very small quantities. There are so many great recipe blogs for UC… check them out and start experimenting!
                Just got over a bad flare and a few months of prednisone so I sympathize with you- but it worked!
                January 1st I woke up and decided not to think of myself as “sick” anymore and to live every day like I was healthy. I don’t say the “sick” word and it shifted something internally for me. I do yoga and meditate in the morning and evening (10 – 15 mins). I take baths and give myself nice massages and I ask everyone around me to take care of me, too! I truly respect my body now.
                Before UC, I was a Type A who never slowed down and could not even think about relaxing (I thought it was just an excuse to be LAZY). So I thank UC for giving me the last 3 years to figure it out! HAh now I love to relax!
                Don’t let FEAR rule you… because you still have to live and can have an awesome life despite having UC. Change your perception of things and you truly can change your whole world!!!
                So- POSITIVE MENTAL ATTITUDE and laughter and funny youtube clips and Will Ferrell movies!
                I wish you the best on your journey to health and peace!!

                1. Allison,

                  Thank you for such a quick reply and for great information in your post. Like you, I am a type A personality and always have this nagging feeling like I need to be productive and do not let myself kick back very often. You know very well what I am talking about, the broken record that keeps replaying the same thought over and over again.

                  Congratulations on finding your peace and I could not agree more that acceptance, love of oneself and others is critical in recovering. The last couple of years I enjoyed solid BMs most of the time and without any medication but during times of stress and foolishly trying a few glasses of wine, I’d fall into the trap of UC’s grip. It takes a lot not to be tempted into things that could harm you when you feel on top of the world as if the disease was gone. But it is not worth sacrificing all the hard work for a few ‘cheap thrills’.

                  I am going through one of the toughest flares right now but I hope that it will subside fairly quickly. Last flare I was on Prednisone for only 3 weeks and was able to recover very quickly but only after I allowed myself to think that I was getting better – which is very hard to do when you’re hurting.

                  I understand that diet is individual but some things are obviously very similar. Like you, I really do well when I eat lots of veggies but I cannot eat too much fruit as I feel that gets me into trouble – gas, join point and then flare if I do not lay off. I essentially follow the SCD but without the yogurt, I have never done well with it.

                  With that understanding, what helped you a lot when you were going through your flare? Did you follow the basic SCD start diet? I find that some fiber is actually very good for me. It is like a floss for your intestines. Even if it can be painful to pass sometimes, I feel much better after I push everything out. If you have any tips, I would appreciate them and I do understand that what worked for you might not work for me.

                  Thank you and keep up the great work with relaxation!

                  1. Hi again-

                    Unlike most UCer’s I tend toward constipation! I almost NEVER have diarrhea. When I am in a flare, I have AWFUL constipation and blood and pain like childbirth. SO, I was in my last flare for 6 months before I went on the prednisone… I started at 40mg and tapered down SLOWLY over 6 months. During my flare I avided all the obvious things and made sure I had lots of cooked veggies but honestly the inflammation was so bad and intense that nothing really helped.
                    I whole heartedly believe a commitment to the following supplements have helped me: Renew Life Critical Care probiotics, digestive enzymes, vitamin D, fermented l-glutamine powder, curcumin 2000mg/day. I also have had weekly acupuncture for the last 3 months and that has been incredible! I go to “community acupuncture” which may be available near you… it is more affordable than private sessions. I only pay $30 per visit. It helps balance my nervous system (which I feel is the root cause of UC) and it is immune supportive rather than OVER-stimulating.
                    Again, be patient and breathe as often as you can.
                    There is a light at the end of this darkness.

                2. All of the info makes so much sense! I hired a naturopath (graduated from the school in portland oregon) a few months ago and we are on this road to healing my epithelial cells.

                  I wrote for the first time at my stay with mayo clinic and was scheduled for my j pouch surgery only to have it cancelled by the surgeon the day before the proceedure due to his ‘sniffin crohns’ too. They tested me for everything under the sun…NO GLUTEN ALLERGY, NO SKIP PATTERNS, PATHOLOGY/RADIOLOGY/LABS ALL POINT TO UC…Was put on cimzia and sent home to follow up with ku med center in 6 months. Lots has happened in that 6 months following and I followed scd (blood and mucus improved but never stopped urgency never improved) up until the first of the year when mind, body and soul was done. Almost 2 years into a flare. I ate whatever didnt make my symptoms worse. Allison like you I struggle more with constipation. Not that stool is hard but motility stops once the poop reaches the the end of the decending colon where the worse of my disease is. Its like the poop says I’m not going down there!

                  ku med center ran all the tests again from mayo to see my ‘improvement’. A small improvement in how far the disease went up, less backache and in general felt better. I attributed my feeling better due to the imuran clearing my system. (the side effects of that is what finally got me to mayo) I shared my concern in what they saw in improvement vs the risks of cimzia and my doubt of crohns. My labs/radiology/pathology ALL POINT TO UC! yet the dr says crohns too. The doctor said he wanted me to do rowasa enema and repeat a colonoscopy in two weeks. If this didn’t work they were going to add methatrexate injections to my regiment. I scheduled the scope and on the way home my husband and I talked ( 2hour drive from ku to home) and decided to cancell the scope and no rowasa. DEF no methatraxate injections! I was also told by doc that with crohns on my diagnosis that surgeons wont touch me unless it is an emergency. frustrated again..

                  I hired a naturopath and she started talking the sense that you are talking Adam. I agreed to an Alcat food sensitiviy test, hormone panel, vit D test. Alcat is controversial in many loops but it showed for me a SENSITIVITY to: GLUTEN, CHICKEN, BEEF, TURKEY, EGGS, BANANA, ZUCCHINI,HONEY, ALMONDS just to name a few but howdy did this explain why SCD wasn’t doing the full job! I started June 1st with my list of foods in the green list (safe list). Adam- Corn chips and potatoes are on my safe list. A glimmer of light peeking through…after 60 days the ND says I can introduce beef then honey on rotation since we raise our own beef and honey. How I feel? DIFFERENT. Things are changing. Blood has virtually stopped. Mucus is dramatically reduced. urgency has not changed but the frequency has. I can almost trust myself to pass gas without ‘treats’. If I had not started with SCD and a surgeon ‘sniffin’ crohns I would not be where I am… ROLLIN WITH MY COLON KICKING UC BUTT!

                  1. Yo what up Jill,

                    It was a big thrill
                    to read what you said,
                    Even gave me a chill.
                    (OK, i be trying to rhyme on saturday!:)

                    WOW, way cool response, and I be a big fatty happy that you’re seeing some good improvement with what you’re up to for treaing your UC!!!:)

                    Way way cool Jillie! (that’s what my grandpa called my mom who’s also got your name:)

                    Take care, and keep it up,


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