Conditions

Crohn's Disease

Crohn's disease is a chronic disorder characterized by severe inflammation leading to ulceration of the interior of the intestines. It most often affects the lowest portion of the small intestine, but it can occur in other parts of the digestive tract, from the mouth to the anus. Unlike ulcerative colitis, which affects the top two layers of tissue lining the intestines, the ulceration in Crohn's disease involves all four layers of the intestinal wall. When affected areas heal, scar tissue often narrows the passageway. In some cases, the bowel becomes partially or completely obstructed. When an area closes, one or more fistulas (abnormal passageways) may develop that join one part of the intestine to another, or even to another organ.

Signs and Symptoms:

• Cramps
• Abdominal and stomach pain
• Nausea
• Diarrhea
• Weakness
• Rectal bleeding
• Lack of energy
• Overall feeling of tiredness
• Iron deficiency anemia
• Fever
• Chills
• Loss of appetite
• Weight loss
• Steatorrhea (pale, bulky stools that float)

Diagnosis:

A physical examination and complete review of your medical history is the first place your doctor is likely to start in the diagnostic process. The next step in diagnosing Crohn's disease is taking an x-ray of the digestive tract, usually aided by a barium enema and barium "milkshake." The x-ray is used to track the movement of the barium through the gastrointestinal tract, allowing the doctor to determine what parts of the tract are affected. An endoscopic examination may also be necessary.

Treatment Options:

Since there is no cure for Crohn's disease, the goals of treatment are to control inflammation, relieve symptoms, and correct nutritional deficiencies ­ all of which can help place (and keep) Crohn's disease in remission.

Traditional Treatments:

• Diarrhea may be treated with medications like loperamide (found in Imodium AD and other over-the-counter products) or diphenoxylate and atropine (Lomotil), a prescription medication. Both of these work by slowing peristalsis, the rhythmic movement of the intestines that moves food and wastes along. In some cases, an agent such as cholestyramine (LoCholest, Questran), that binds with bile salts so that they are excreted, may be effective.
• For cramping, an anticholinergic drug may be prescribed. These drugs work by interfering with the transmission of nerve impulses that cause muscle spasms in the gastrointestinal tract.
• To attempt to control the inflammation of Crohn's disease, a doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID).
• The drug most often used is sulfasalazine (Azulfidine) although other medications are available. Severe side effects are possible ­ consult your doctor before taking any NSAID. If such a drug is used, its use should be tapered off as quickly as possible to avoid adverse effects on the adrenal glands and immune system.
• Serious disease may be treated with mercaptopurine (Purinethol). This drug depresses the body's immune response, but it takes three to six months before any benefits may be noticeable.
• Many victims of Crohn's disease end up needing surgery to remove badly affected portions of the intestine. If large portions of the intestine are removed, problems with nutrient absorption may result, necessitating a special low-fat diet and supplementation with medium-chain triglycerides to help maintain a healthy weight.
• If the disease results in severe malnutrition, intravenous feeding may be necessary.

Complementary and Alternative Therapies:

Although the cause of Crohn's disease is not known, nutritional support and herbal therapies can be very effective at minimizing the possibility of malnutrition due to the inability to absorb nutrients. These therapies also possibly speed the healing of effected tissues. Specifically, nutrition and herbs can enhance the integrity of the intestinal mucosa by possibly restoring the mucosal barrier and reducing intestinal permeability. Homeopathy may be helpful in acute cases. Mind-body therapies, such as meditation, yoga, and tai chi may help reduce stress and make living with Crohn's disease a little easier.

Jordan Rubin, founder of Garden of Life, was diagnosed with a fatal case of Crohn's disease. When doctors failed to find a cure, Jordan created one himself. Garden of Life carries a wide variety of nutritional products focused on intestional health that brought Jordan's health back.

Nutritional Supplementation:

• The drugs commonly prescribed for Crohn's disease interfere with normal metabolism and increase the likelihood of multiple nutritional deficiencies. People with Crohn's disease are often lacking in calcium, magnesium, potassium, vitamin B6 (pyridoxine), folic acid, vitamins C, and D, and zinc. Take a good multivitamin and mineral formula that supplies at least the minimum daily requirements of these important nutrients.
• Antioxidant nutrients scavenge free radicals and have been shown to lower the risk of developing Crohn's disease. Take a good antioxidant formula that supplies 5,000 IU of vitamin A, 25,000 IU of beta-carotene, 250 mg of vitamin C, 1,500 mg of bioflavonoids, 400 IU of vitamin E, 200 micrograms of selenium, 500 to 1,000 mg of N-acetylcysteine (NAC), and 100 of lipoic acid daily.
  Warning: If you are pregnant, or intend to get pregnant, or if you have liver disease, consult your doctor before taking supplemental vitamin A. If you are taking a blood thinner, consult your doctor before taking vitamin E.
• Bromelain helps reduce inflammation and aids in the digestion of protein. Take 500 mg three times daily.
• Duodenal glandulars aid in healing gastrointestinal ulcers.
• Fish oil may help people stay symptom-free. Take 1,000 mg three times daily. After two weeks, increase the dosage to 2,000 mg three times daily and continue for six weeks. Choose an enteric-coated supplement that supplies approximately 800 mg of the omega-3 fatty acids per 2,000 mg.
• Ask your doctor about liver extract injections to help aid digestion.
• The amino acid glutamine helps to soothe an inflamed gastrointestinal tract. Take 3,000 mg of L-glutamine three times daily for two weeks, then decrease to 3,000 mg twice daily for two weeks. Then take 3,000 mg daily for two months.
• Take a probiotic supplement containing acidophilus, bifidobacteria, or colostrum. The friendly bacteria are necessary for a healthy intestinal tract. Studies show probiotics can help the body overcome Crohn's disease. Follow label directions.
• Pine-bark (pycnogenol) and grape-seed extracts are excellent natural anti-inflammatory agents. Take 25 to 50 mg of either twice a day.

Alternative Therapies:

• Aloe vera is beneficial for Crohn's disease because it softens stools and has a healing effect on the digestive tract. Drink _ cup of aloe vera juice three times daily.
• There are many combination herbal products designed to offer gastrointestinal relief. (i.e. Robert's Formula by Enzymatic Therapy)
• Cat's claw has known anti-inflammatory effects, as well as antifungal, antiviral, and antibacterial properties. Take 500 mg of standardized extract three times a day.
  Warning: Do not use cat's claw if you are pregnant or nursing, or if you are an organ transplant recipient. Consult your physician before taking cat's claw if you are taking a blood thinner.
• Licorice may help fight the ulcerative effects of Crohn's disease. The effective dosage was 750 mg taken three times daily. Select deglycyrrhizinated (DGL) chewable tablets.
  Warning: Licorice should not be taken daily for more than five days as it can elevate blood pressure. Do not take licorice if you have high blood pressure.
• Reishi mushroom is an excellent natural anti-inflammatory that is useful for a variety of autoimmune disorders. Take 500 mg three times daily.
• Flavonoids can help reduce inflammation and minimize reactions to food sensitivities. Take 500mg of Quercetin before meals.
• Marshmallow tea (1 qt. daily) is soothing. Make a cold-water extraction by soaking 1 heaping tablespoon of root in 1 quart of cold water overnight. Drink throughout the day.
• Other herbs that are good for this disorder include: burdock root, echinacea, fenugreek, goldenseal, pau d'arco, enteric-coated peppermint, red clover, rose hips, silymarin (milk thistle), slippery elm, and yerba mate. Warning: Do not take goldenseal on a daily basis for more than one week at a time. Do not use goldenseal during pregnancy. Consult your physician before taking goldenseal if you have a history of cardiovascular disease, diabetes, or glaucoma.
• When dealing with Crohn's disease, it is best to consult a homeopathic practitioner for a constitutional remedy.
• The following acupressure points may be beneficial in Crohn's disease: Large Intestine 4, Liver 3, Pericardium 6, and Stomach 36.

General Recommendations:

• Eat a diet consisting mainly of non-acidic fresh raw or cooked vegetables such as broccoli, Brussels sprouts, cabbage, carrots, celery, garlic, kale, spinach, and turnips. Steam, broil, boil, or bake your food.
• Drink plenty of liquids. (Fresh cabbage juice is very beneficial)
• During an acute attack, eat organic baby foods, steamed vegetables, and well-cooked brown rice, millet, and oatmeal.
• Try eliminating all dairy foods (including cheese), fish, hard sausage, pickled cabbage, and yeast products from your diet, and see if symptoms improve. These foods are high in histamine. Milk and other dairy products also contain carrageenan. Carrageenan, which is widely used in the food industry, has been shown to induce ulcerative colitis in laboratory animals.
• Avoid (where possible) alcohol, caffeine, carbonated beverages, chocolate, corn, nuts, popcorn, eggs, foods with artificial additives or preservatives, fried and greasy foods, margarine, meat, dairy products such as milk and cheese, pepper, spicy foods, tobacco, white flour, and all animal products, with the exception of white fish from clear waters. These foods are irritating to the digestive tract.
• Mucus-forming foods such as processed refined foods and dairy products should also be avoided. Limit your intake of barley, rye, and wheat.
• Diets high in refined carbohydrates have been associated with Crohn's disease. These foods must be eliminated from the diet.
• Check stools daily for bleeding.
• As much as possible, avoid stress.
• Make sure the bowels move daily, but do not use harsh laxatives. Gentle enemas made by adding a dropperful of alcohol-free herbal extract and 1 teaspoon of nondairy acidophilus powder to 2 quarts of lukewarm water are good.
• Do not use rectal suppositories that contain hydrogenated chemically prepared fats.
• Use a heating pad to reduce abdominal pain.
• If you suffer from diarrhea, make certain to take supplements supplying both the major minerals and trace minerals.
• Fatigue is often caused by chronic sodium-potassium imbalance. You may find that supplementing your diet with potassium lifts your mood as well as your energy level.

Warnings:

• Do not take goldenseal on a daily basis for more than one week at a time.
• Do not use goldenseal during pregnancy.
• Consult your physician before taking goldenseal if you have a history of cardiovascular disease, diabetes, or glaucoma.
• Licorice should not be taken daily for more than five days as it can elevate blood pressure.
• Do not take licorice if you have high blood pressure.
• Do not use cat's claw if you are pregnant or nursing, or if you are an organ transplant recipient.
• Consult your physician before taking cat's claw if you are taking a blood thinner.