Crohn’s Disease 

 Introduction  

Also known as regional enteritis or ileitis. Crohn’s is an idiopathic inflammatory bowel disease (IBD) most often affecting the small intestine and colon and characterized by sharply segmental transmural fibrosis and strictures (skip lesions), non-caseating granulomas, and fissures which lead to fistulae formation. Genetics, bacterial infections, immune system disturbances, and dietary factors are some suggested etiological factors. Food sensitivities are strongly implicated 

What should I know about Crohn’s Disease? 

Crohn’s disease is serious chronic illness that inflicts severe damage to the intestinal tract, causing diarrhea and abdominal pain. Though it can strike anywhere along the GI tract from the mouth to the anus, Crohn’s disease usually affects the endmost portion of the small intestine, called the “ileum.” 

Crohn’s disease is an inflammatory condition; the delicate mucous membrane (villi)  lining the intestinal wall becomes inflamed and ulcerated in spots called “skip lesions.” The intestinal lining looks somewhat like an old cobblestone street, with lesions spaced between  normal tissue. The inflammation can penetrate the bowel wall, leading to the development of abscesses and deep cracks. Even worse, these cracks may lengthen, forming complete openings from the inside of the intestine to the outside called “fistulas.” The intestinal wall eventually becomes hardened and inflexible. In later stages of the disease, the intestine may become obstructed. 

Crohn’s disease is one of two inflammatory bowel conditions that affect the intestinal lining. The other is ulcerative colitis. The exact cause of these conditions is not known for certain. Both illnesses are thought to have a genetic component. Other contributing factors have been implicated, including food allergies, stress, poor nutrition,and infection. It is also believed that an “autoimmune response,” where the immune system attacks the body’s own tissue as though it were a  foreign invader, may play a role in Crohn’s disease. Although Crohn’s disease is sometimes mistaken for ulcerative colitis, it has several unique features. Crohn’s disease most commonly affects the small or large intestine, while ulcerative colitis shows up in the lower intestine and the rectum. Ulcerative colitis is more common than Crohn’s disease, but the incidence of Crohn’s appears to be on the rise. Although these conditions hit the gastrointestinal tract hardest, they can lead to many other conditions affecting different parts of the body. 

Food allergies and Crohn’s disease appear to be closely related. Inflammation and irritation of the intestinal wall cells can eventually increase sensitivity to many foods. When the cells are damaged, they leave gaps between them through which large proteins can penetrate, a phenomenon known as “leaky gut”. These molecules, identified as antigens by the immune system, stimulate an inflammatory reaction in the gut lining. Many people afflicted with the disease have identified and eliminated foods that aggravate symptoms. Such foods include chocolate, dairy products, yeast, cereal grains, fats, and artificial sweeteners. In one multicenter trial, subjects with Crohn’s disease who followed a diet that excluded the foods they were allergic to remained symptom-free almost twice as long as those receiving standard therapy with corticosteroid drugs treatments.

Conventional Treatment Options 

Conventional treatment for Crohn’s disease targets three major goals. First, proper nutrition is of paramount importance. The inflamed and thickened intestinal lining cannot absorb nutrients properly, so extra care must be taken to keep the body’s nutrient levels up. Next, the inflammation must be reduced. Third, therapy aims at controlling the autoimmune response mentioned earlier, to keep the body from attacking itself. The following list of medications may be prescribed for inflammatory bowel disease. 

• Antidiarrhea treatment consists of loperamide, which slows down peristalsis, the wave-like contraction and relaxation of the intestinal tract that propels digested material along. (Loperamide should not be used by anyone with a liver disorder). Cholestyramine removes bile acids from the intestine and is sometimes effective in controlling diarrhea.
•  Anticholinergic drugs, such as atropine sulfate, are used to decrease GI tract activity and cramping. Side effects include mydriasis (dilated pupils), blurred vision, tachycardia (rapid heartbeat), urinary retention, and dry mouth. Tremors, irritability, hallucinations, nerve blockage in muscles, and difficult breathing are among the possible toxic side-effects. Dicyclomine hydrochloride also controls hyperactivity of the GI tract, without the side effects of anticholinergic drugs. 
• Anti-inflammatory treatment consists of steroidal and nonsteroidal drugs. Sulfasalazine and mesalamine are NSAIDs of the sulfonamide group. Side effects include gastric irritation, headache, dizziness, nausea, fatigue, and loss of appetite. Oligospermia and infertility in men has been associated with sulfasalazine but has not been reported with mesalamine.
• Steroidal medications may be taken during acute attacks to control inflammation and suppress the autoimmune response. Prednisone, a synthetic glucocorticoid, is often prescribed. Rapid withdrawal can affect the body in the same way as low function of the adrenal glands, and long-term use can lead to muscle wasting and osteoporosis. 
• Mercaptopurine is a powerful drug used to suppress the immune system in severe cases of Crohn’s. (This drug is also used to treat leukemia). Its ability to inhibit immune function makes it useful in the treatment of severe Crohn’s disease. Because of its immune-suppressing activity, people taking the drug have decreased resistance to infection. Mercaptopurine can be highly toxic, leading to bone marrow suppression and anemia. Taking mercaptopurine with the drug allopurinol, which decreases uric acid formation, significantly increases its potential toxicity.

 Natural Treatment

There are a great many vitamins, minerals, herbal supplements and other natural remedies that have been shown to effectively treat this condition safely and effectively. Which therapies are chosen will be based on the root cause and not just the symptom. Your practitioner will carefully evaluate your situation and put together an effective protocol with natural remedies rather than dangerous medications that merely treat the symptom.

Diet & Lifestyle 

• Generally, a high protein, vitamin, and calorie diet is recommended. 
• Long chain fatty acids found in saturated fats are minimized, as they can aggravate diarrhea and promote inflammatory pathways in the intestine. However, short chain fatty acids, found in omega-3 essential fatty acids have been reported to reverse the inflammatory response. Supplementation with fish oil high in omega-3 fatty acids is recommended. 
• While low-fiber, low-residue diets are traditionally recommended, there is evidence that diets high in refined carbohydrates increase the incidence and severity of acute episodes. Therapeutic regimens that include increased fiber and decreased refined carbohydrates have demonstrated a positive influence on the disease. In one study, 16 of 20 subjects on a sugar-free, fiber-rich diet remained in remission for an average of nineteen months after discontinuing drug therapy. It is interesting to note that diets high in sugar and consumption of fast food are positively correlated with an increased risk of Crohn’s disease, while diets high in fiber are associated with a reduced risk. 
• Reduce saturated fat: Saturated fat and cholesterol have also been identified as dietary risk factors. 
• Avoid thickening agents such as carrageenan used in dairy and other foods such as ice cream, cottage cheese, milk, chocolate.  Studies have shown that carrageenan causes ulceration and lesional damage to the gastrointestinal lining and should be avoided in all conditions of inflammatory bowel disease origin such as Crohn’s and colitis.  

Over­all, it’s more impor­tant to focus on the root cause and what are the under­ly­ing mech­a­nisms that are caus­ing sickness and lack of vitality rather than just treat­ing it symp­to­mati­cally.  Each per­son is encour­aged to seek out a qual­i­fied nutri­tion­ist or other qualified healthcare practitioner in order to assess exactly which nutri­ents, herbs, home­o­pathics and nat­ural reme­dies; in which com­bi­na­tion; in what pro­por­tion are right for the par­tic­u­lar individual and are intended at treat­ing the root cause rather than just a symptom.