Crohn's disease and ulcerative colitis
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Introduction
When I am asked how Crohn's Disease and Ulcerative Colitis can be managed with natural remedies then the answer is never short. These are complicated health problems with no easy answer, so it's a long web page. There are a good number of things you can do in a natural way that can make your life a lot easier. Obviously the objectives remain identical to 'standard' medicine namely 1) terminating an acute attack: inducing and maintaining remission 2) management of chronic symptoms. I am going to take you point by point through the mechanisms how Inflammatory Bowel Disease is thought to come about and give you useful do's and useful don't's along the way. If you have Irritable Bowel Syndrome then please visit IBS.html |
Infectious agents
Although no causative bacteria has been cultured (i.e. Ulcerative Colitis and Crohn's Disease are non-infectious), there often is an opportunistic overgrowth of undesirable bowel flora, resulting in a prevalence of bacterial strains that do not promote health. This can only happen when the host condition <Actinic:Variable Name = 'you'/> is such, that it is vulnerable to this and then the opportunistic overgrowth results in additional problems and symptoms. It is a common finding also in people who do not have IBD or IBS and a reliable diagnosis is achieved only by laboratory testing. Note that such overgrowth is reactive and focussing on re-establishing the gut bacteria balance is just one part of the job. Trying to achieve a more optimal bowel flora can be done in several ways. It is best achieved by 'killing' and 'restocking' at the same time. Killing undesirable strains is something that must be done with extreme caution because in IBD the mucosal wall is already irritated (IBS can behave similarly). Therefore measures like Grapeseed or Olive Leaf Extract, buffered Caprylic Acid, Castor Oil or Tea Tree Oil (everybody should be extremely careful ingesting the latter!) are not tolerated. A much better way of gently killing undesirable bacterial strains is by starving them i.e. stopping to feed them. You use the tried & tested medieval way of laying siege to a walled city (see diet below). Whilst waiting for the white flag to come up, you take Aloeride® which is a new product that steadily improves stool microbiology without upsetting the intestinal wall at all. It achieves this on the one hand via anti-microbial action and on the other hand via creating a better grow environment for the good bacteria. Next you restock the gut with good bacterial strains. You should know that some probiotics manufacturers quote the viable cultures before processing but not how many are still viable afterwards. At the Integrated Medicine Practice we use special probiotics as one aspect for Ulcerative Colitis, Crohn's Disease and IBS preferably in addition to the Specific Carbohydrate diet or at least a Low Glycaemic index diet. Those people who are not 100% lactose intolerant - and most of us aren't - can use organic live cultures containing yoghurt such as Yeo Valley. Obviously you do not eat yoghurt with flavourings and/or added fruit sugars. You do however keep away from other dairy products i.e. cow's milk and cheese made from it. Goats milk & goats cheese may be tolerated but this varies from individual to individual. Eggs neither come out of a cow nor out of a goat - the most useful part of the egg is the white i.e. that part on which the growing chick would have fed itself - so eggs are usually well tolerated, they're not dairy although curiously many lay people list them as such. |
Genetic markers
About 15 to 20% of people with Inflammatory Bowel Disease have immediate family members with IBD but no genetic marker has been identified. IBD occurs more frequently in western societies with a higher incidence among Jews of Eastern European descent, often within the same families, males and females are equally affected often before age 40. In western Canada the incidence is 150 in 100,000 which is three times the global average. In respect of IBD occuring in the same families the following CAM article is of interest: Nutrition Impact On Gene Expression Shocks Researchers refers to this Suke University paper: Waterland RA, Kirtle RL. Transposable Elements: Targets for Early Nutritional Effects on Epigenic Gene Regulation. Mol.Cell.Biol. 2003;23(15):5293-5300 (August 1). The Suke University research indicated that it is not just a matter of the double helix of DNA but its expression. This means that your nutrient base influences what aspects of your DNA actually affect cell replication. So the adage "it is not what you've got but what you do with it" seems true here also, the fact that you have a whole orchestra doesn't therefore means that all the instruments (genomes) play at the same time. With Ulcerative Colitis and Crohn's Disease causing poor nutrient uptake, you can see where a self perpetuating cycle may come from despite a genetic marker staying elusive. From an intervention point of view you can 1) ensure maximum possible nutrient intake and 2) maximise the uptake thereof. An irritated gut wall does not uptake nutrients well, so we are back at taking Aloeride® twice daily to placate the wall so uptake can become better. More about diet and nutrient supplementation later. |
Immunological mechanisms
Meaning impaired cellular immune mechanisms, a lower capacity of body cells to fight back. Quoting Professor J.O. Hunter of Addenbrooks Hospital and Cranfield University: "it is likely that immunological changes are produced after the disease started, rather than causing it". So a faltering immune capacity is not so much the chicken as it is the egg. Autoimmune antibody mediated reactions are discussed below. Are there natural things you can do to improve your immune capacity? Aplenty and this starts with you getting/keeping fit by brisk walking for (much) longer than 20 minutes no less than 3x each week. We use Mycoferon®, a remedy including maitake and shitake mushrooms that are well known to be immune modulatory but also use Aloeride® because of its unique preservation of very long chain polysaccharides (especially aloerides) that are researched potent immune modulators. |
Allergic reaction to cows' milk
This always plays a role in mucous formation. Pointers towards this can be always having an uncomfortable tummy immediately after ingestion, having a bit of a snotty nose first thing in the morning, nasal airway obstruction [yes think snoaring], recurring sinusitis and of course mucous in stools. The simplest way to find out if you react adversely to cow's milk products is by stopping consuming them for 2 months and change to sensible alternatives like goats milk/cheese/yoghurt, Rice Dream® or such like. If symptoms improve then you have identified one helper. Lactose intolerance is very common and can be caused by having too little of the enzyme lactase - so you can convert some lactose but have not enough lactase to convert all ingested lactose - and this leads to fermentation of any lactose that is not converted in the gut to the body-useful glucose. The best known end product of all fermentation is alcohol which is a known trigger for Crohn's Disease and Ulcerative Colitis, gas formation is equally well known - to you but unfortunately also to all around you. Most mammals produce about 12 - 40 grams of alcohol per day without even drinking alcohol, so lowering the source of your own internal alcohol production is a wise move. In case you wonder about creating an osteopenia or osteoporosis risk by eliminating dairy products, Calcium is in everything and anything that has any structure to it. You will find it in all leafy vegetables as well as in the herbal food supplement Aloeride® - which next to calcium has lots of very useful Magnesium in it too. So do not worry about you developing osteopenia/osteoporosis when you give up dairy, if it helps to reduce your IBD symptoms you will increase general nutrient uptake and one of them will be Calcium. And for good measure you ought to know that Calcium does not lock into the bone matrix if there is not enough Magnesium, Manganese, vitamin D, Boron and a good pH balance - the four main blood buffers adhere to the isohydric principle which means that they all run at the same time so the phosphate buffer gets phosphor from bones Ca3(PO4)2 as well as from dietary sources. Finally there are hormones like the parathyroid hormone that regulate Calcium metabolism. For Calcium to become an issue, there are many things more important than you consuming cow's milk and related products to help you manage your IBD. A trial for 2 months is not going to do you any harm whatsoever and just might pinpoint a common trigger for IBD and IBS. |
Hypersensitivity reaction
This is true when a cell reacts abnormally to a stimulus. This sentence tells you that it takes two to tango (trigger substance & host reaction) and as such, we can alter the stimuli we present to the intestine. At the Integrated Medicine Practice we use IgG food sensitivity testing (ELISA Enzyme-Linked Immunosorbent Assay) to rule out foods that may evoke irritation and an immune response. Diet modification works well in Crohn's Disease but not so well in Ulcerative Colitis. Because these tests are quite expensive, it would be wise to start with keeping a food diary to see if & how food types affect your IBD or IBS. If you think any food/drink type influences it then you can consider elimination for 1 - 2 weeks and provoke the issue by eating or drinking a gluttonish abundancy of this food/drink type and see if this aggravates your symptoms (if quick allergic IgE reactions are so much as suspected you do NOT try this). If reintroduction does trigger symptoms then eliminate this food/drink permanently from your diet. This is a laborious method but at least there is no cost involved. Sensible for anybody's body is food rotation: the foodstuffs you ingest on day1 you do not ingest again until day3 or day4. This advice is given in mildly positive ELISA tests anyway so you might as well experiment with this. Other than elbow grease & bemoaning a different routine it doesn't cost you a penny. In this section there are also two no-brainers because both affect the lining of the digestive tract, the first is smoking - smoke mixes with saliva and this you swallow into your digestive tract - and the other one is alcohol. When you have IBD, smoking and drinking are the equivalent of shooting yourself in the foot. Alcohol slows gastric emptying, interferes with the action of gastroesophageal sphincters, stimulates gastric secretion and often injures the gastric lining, especially when combined with Aspirin. Alcohol also produces alterations in intestinal mobility and mucosal function that results in malabsorption (Seventh Special Report to Congress, Dept. of Health and Human Services, 1990]) Chronic or regular use of alcohol damages the lining of the stomach and the small intestines. It alters gastric-acid secretion, first increasing it and then decreasing it (The Mount Sinai School of Medicine Complete Book of Nutrition, Victor Herbert, MD and Genell J. Subak-Sharpe, 1995). Whilst on the topic of feeding, one way to achieve full remission of Crohn's Disease is via 2-3 weeks of qualified dietitian supervised enteral feeding after which food sensitivity tests are carried out. For most patients with IBD this is not a readily available option. |
Autoimmune antibody mediated reaction
This is suggested as a mechanism by extra intestinal manifestations and the fact that treatment with corticosteroids leads to favourable response. As soon as the intestinal wall becomes inflamed, the selective uptake of nutrients by enterocytes (these cells make up the wall) is compromised because tiny spaces appear in between these enterocytes through which macromolecules enter the system. This is called hyperpermeability syndrome or in common terms "leaky gut". When foreign molecules enter a closed system such as the body, the body responds with an immunological response i.e. it starts to kill the foreign invaders. When there is confusion about cells being 'mine' or 'thine' we speak of auto-immune disorders. Aloeride® helps here in two ways. Firstly and most importantly by sealing the leaky gut it stops those macromolucules from migrating where they should not venture, the aminoacid L-Glutamine is of further help here. Secondly the (and only those) very long polysaccharide chains in aloe vera modulate immune response BUT be careful, there is a humongous difference between the various products on the market which is why we exclusively use Aloeride® which has independent laboratory-proven the best immune modulating polysaccharide profile. |
Psychological factors
There is no actual proof that stress causes the disease but psychological factors do influence the course of the disease. At the Integrated Medicine Practice we use Neuro-Linguistic-Programming counselling and occasionally herbs or complex homeopathic remedies. Some of our patients have tried medical hypnosis with varying response. A lifestyle review should form part of an integrated approach and a change of perspective could be as 'simple' as for the Type A individual to ask oneself "does this need doing right now or can it wait just a little". The Worrying Type could change perspective by not spending so much of today "drawing the picture of what tomorrow's meeting, exam, interview or workday will be like". And definitely not drawing it as well as colouring it in :-) A Dutch saying translates as: man suffers most from the suffering he fears and that does not necessarily materialises,
thus man carries more than God gives him to carry. There may not be research proof that stress causes Inflammatory Bowel Disease and IBS, feedbackfrom patients makes it clear that psychological influence is very significant. The English term 'gut reaction' pointed at the link between thinking, feeling andthe intestines which modern science has validated as the gut-brain axis: the relationship between cerebrospinal fluid and plasma cholecystokinin, regulatory peptides common to both gut and brain etc. Gut reaction points at one way of this linking 'street' - from down to up - but if the other way around is trafficable too, then you can see that sorting out the psychological factors may have good clinical mileage in helping Crohn's Disease, Ulcerative Colitis and IBS. It may not always be an in-your-face sort of an issue and in the IgG scorers it may be a needlessly exploited issue, but it is definitely something not to be overlooked. |
Location
In Ulcerative Colitis only the large intestine (rectum = proctitis, descending colon = left sided colitis, when whole colon is affected = pancolitis) is affected with a marked tendency to symptom relapse. Because Ulcerative Colitis does not affect the small intestine, signs like abdominal mass or issues of malabsorption are absent, fistula formation and gross perianal disease do not occur, but fissuring and aphthoid ulceration do. Crohn's Disease is a chronic inflammatory disease, which can affect the whole of the alimentary tract from mouth to anus, the inflammation extends through all layers of the gut wall (transmural) and is characteristically patchy in distribution (skip lesions) with areas of normal tissue in between. To give you an idea of the 'topography', the small intestine has an absorptive surface area of roughly 250 square meters (2,355 sq.ft.) - the size of a tennis court - and the large intestine being some 1.5 metres (5 foot) long and 8 centimetres (3 inches) in diameter again has another huge surface area of 3,768 square centimeters i.e. 37.68 square meters. You can see where this leads to: the potency of the remedy versus the inflamed surface areas to sooth, when you have IBD you really must use remedies that can hit home hard. |
