Crohn's Disease
Crohn’s disease is one of two diseases classified as Inflammatory Bowel Disease (IBD). The other one is Ulcerative Colitis. Crohn’s disease is much more prevalent in United States, Great Britain and Scandinavia vs Central Europe, and is rare in Africa and Asia. The peak incidence of symptoms typically occurs during one's 20s and 30s, but may occur at any stage of life.[1]
Causes | Food Reactions, Stress, Infections |
---|---|
See Also | Digestive Conditions, Constipation, Dysbiosis, GERD, Heartburn, Inflammatory Bowel Disease, Crohn's Disease, Ulcerative Colitis, Diverticulitis |
Books | Books on Digestive and Liver Conditions |
Articles | Articles on Digestive Conditions |
Naturopathic Assessment
Article | Inflammatory Bowel Disease Part II: Crohn's Disease ñ Pathophysiology and Conventional and Alternative Treatment Options , Alt Med; 2004;Vol9(4) |
---|
Looking for the cause of Crohn's disease takes patience and exploration into many factors of one's lifestyle and into the many infectious agents that can trigger its onset. Naturopathic Doctors are known for their ability to help with the diverse symptoms and treat the root cause. A detailed intake is required to determine which factors could be implicated in an individual's case of Crohn's Disease.
Causal factors
Crohn's disease, like may conditions, most likely is the result of a combination of effects including exposure to pathogens, imbalanced bacterial flora, poor dietary choices and stress triggers which combined can result in a state of immune system dysregulation.
Lifestyle
Article | Crohn's Disease: Removing the Obstacles, NDNR [1], 2011 January |
---|
- Crohn's disease correlates with a high intake of saturated fats, refined carbohydrates and sugar.[1] Diets high in these items are usually low in raw fruits and vegetables and dietary fiber.[2].
- Nutritional imbalances or deficiencies increase a person's risk of Crohn's Disease.
- Increase ratio of omega 6 fatty acids to omega 3 fatty acids is also associated with an increased risk.
Environmental
- Infectious agents, such as microorganisms like rotavirus, Epstien-Barr virus, cytomegalovirus, and mycobacteria are correlated with Crohn's Disease.
- Other associated organisms include: Pseudomonas-like organisms, Chlamydia and Yersinia enterocolitica.[3]
External
Medical Interventions
- Prescription Medications
- Antibiotic exposure has been linked to the development of Crohn’s Disease.[5] – namely because developed countries have had steady rises in Crohn's since the 1950s when antibiotics were available in oral form and increasing prescritption numbers have paralleled increased incidence of Crohn's.
- Antibiotic resistance in organisms of the bowel flora caused by frequent and incomplete prescriptions for antibiotics is also implicated as a factor.
- Oral contraceptive use may independently increase risk of Crohn's in women.[4].
- Vaccinations
- The measles vaccine may increase a person's susceptibility to Crohn's disease later in life.[6]
Physiology
- Chronic constipation increases the risk of developing inflammatory bowel diseases such as Chrohn's.
- Bowel Flora
- Proper and adequate bowel flora is required for immune regulation. Inadequate bowel flora or increased bowel permeability is associated with increased risk of Crohn's Disease.
Genetics and Gestational Factors
- Family History
- There may be a genetic predisposition as first degree relatives are 3 in 20 or 15% more likely to develop inflammatory bowel diseases. Crohn’s Disease is associated with MHC class II alleles DR7 and DQ4 in 30% of cases in North American white males.[7]
Diagnostic Testing
The diagnosis of Crohn's disease start by taking a complete medical history with a focus on dietary patterns, digestive function and bowel function.
- Blood tests include CBC with differential, Blood Urea Nitrogen (BUN) and Creatinine
- Imaging Studies include: Terminal ileum abnormality on radiograph, colonoscopy with biopsy
Related Conditions
Ulcerative Colitis is closely related with Crohn’s disease as they are both classified as inflammatory bowel diseases (IBD).
Other conditions commonly associated with Crohn's Disease includes:
Characteristics
Dysbiosis of the intestinal microflora leading to increased inflammatory pathways in the colonic epithelial cells is thought to be an underlying cause of [IBD]. As the classification suggests, inflammation plays a role in the damage that is caused to the entire thickness of the bowel wall. Some patients with Crohn’s may suffer from lesions that are called granulomas however they may or may not be present depending on the case. It is possible for this granulomatous process to occur anywhere from the mouth to the anus but is often localized to the final portion of the small intestine the ilium.[7]
The symptoms experienced in Crohn’s are highly variable and unpredictable and can include:[8]
- Intermittent bouts of diarrhea and fevers
- Crampy pain in the lower right of the abdomen
- Loss of appetite
- gas and bloating
- fatigue
- Melenia (black stools).
- Weight loss
Naturopathic Treatment
The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Crohn's Disease is considered a chronic] and progressive disease if not treated properly.
It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.
Lifestyle
Lifestyle recommendations include:
- Smoking cessation has been reported to reduce risk of relapse by 65% which is similar to the reduction obtained with immunosuppressive therapy.[9]
Article | Diet- based management of inflammatory bowel disease: The role of food intolerance, IHP, October 2008 |
---|
- Dietary changes can significantly reduce symptoms in IBD
- Address any underlying nutrient deficiencies.
- Identify and remove any food allergies or food intolerances.
- Reduce inflammatory foods by eliminating meat and dairy and products high in saturated fats
- Increase the consumption of omega 3 fatty acids such as those found in cold water fish; salmon, mackerel, herring and halibut[1]. A supplement version of omega 3 in the form of Fish oil containing 3g of EPA is a good addition to a diet rich in omega 3s.[10].
- Increase dietary fiber, brassica vegetables, onions, garlic.
- Elimination or Oligoantigenic diet involves removing the most common allergens such as dairy, wheat, gluten, eggs and corn. This can greatly reduce symptoms.[10]
- Avoid carageenan, an additive commonly used in milk products and ice cream and many other products as a thickening/stabilizing agent [1].
- Learn to become an avid label reader!
- Ensure you drink adequate water.
- Regular exercise is beneficial in the treatment of Crohn's Disease.
- Adequate sleep is required to ensure optimal digestive function.
Naturopathic Therapies
Naturopathic Therapies for Crohn's disease include:
- Vitamins such as Vitamin B1 or Thiamine, Vitamin B12, folate, retinol (Vitamin A), Vitamin C, Vitamin D, Vitamin K
- Minerals such as calcium, iron, magnesium, potassium, zinc, copper
- Other supplements such as Glutamine, Quercetin, Omega-3 Fatty Acids, probiotics.
- Herbs such as Boswellia (Boswellia serrata), Licorice (Glycyrrhiza glabra), Marshmallow (Althea officinalis), Slippery Elm (Ulmus rubra), Goldenseal (Hydrastis canadensis), Wild Geranium (Geranium maculatum), Comfrey (Symphytum officinale), Wild Yam (Dioscorea villosa), [Myrica cerifera|Bayberry (Myrica cerifera)]], Peppermint Oil (Mentha piperita)
- Homeopathics can be helpful in the treatment of both acute and chronic Crohn's disease.
- For acute Crohn's disease consider Aconite, Veratrum album, Aloe.
- For chronic Crohn's disease consider Nux vomica, Sulphur, Lycopodium.
- Traditional Chinese Medicine & Acupuncture. TCM differentials to consider include: liver invading spleen, qi deficiency and food stagnation, spleen qi deficiency, damp heat, damp cold, spleen and kidney yang deficiency, qi and food stagnation.[12].
- Acupuncture is beneficial at supporting the flow of energy through the gastrointestinal tract.[12]
Article | Intravenous therapy for inflammatory bowel disease, IHP, October 2008 |
---|
References
Reviewed by Iva Lloyd, BScH, RPE, ND [2]
- ↑ 1.0 1.1 1.2 1.3 Murray Michael, Pizzorno Joseph (1998) Encyclopedia of Natural Medicine, Three Rivers Press, New York.
- ↑ Pizzorno Joseph, Murray Michael (2006) Textbook of Natural Medicine e-dition: Text with continually updated online reference, 2-volume set, Churchill Livingstone.
- ↑ Tozer PJ, Whelan K, Phillips RK, Hart AL (2009 Oct) Etiology of perianal Crohn's disease: role of genetic, microbiological, and immunological factors Inflamm Bowel Dis; Vol15(10):1591-8 PMID: 19637358.
- ↑ 4.0 4.1 Ashley Mary (May 1997) Smoking and diseases of the gastrointestinal system: An epidemiological review with special reference to sex differences. Can J Gastroenterol;11(4):345-352.
- ↑ Shaw SY, Blanchard JF, Bernstein CN (2011 Dec) Association between the use of antibiotics and new diagnoses of Crohn's disease and ulcerative colitis Am J Gastroenterol; Vol106(12):2133-42 Epub 2011 Sep 13 PMID: 21912437.
- ↑ Bone Kerry An Innovative Approach to Herbal Therapy for Autoimmune Diseases
- ↑ 7.0 7.1 Kumar Vinay, Abbas Abul, Fausto Nelson, Mitchell Richard, editors. (2007) Robbins Basic Pathology 8th Edition. Saunders Elselvier, Philidelphia
- ↑ Dains JE, Baumann LC, Sceibel P (2007) Advanced Health Assessment and Clinical Diagnosis in Primary Care 3rd ed Mosby.
- ↑ Johnson GJ, Cosnes J, Mansfield JC (2005 Apr) Review article: smoking cessation as primary therapy to modify the course of Crohn's disease Aliment Pharmacol Ther; Vol21(8):921-31 PMID: 15813828.
- ↑ 10.0 10.1 10.2 Prousky Johathan, Hoffer Abram. (2008) Principles and Practices of Naturopathic Clinical Nutrition. CCNM Press
- ↑ El-Hashemy Shehab, Skowron Jared, Sorenson Linda (2011) Textbook of Naturopathic Family Medicine & Integrative Primary Care: Standards & Guidelines CCNM Press.
- ↑ 12.0 12.1 Kuoch David. (2011) Acupuncture Desk Reference. 2nd ed. Acumedwest Inc.