Crohn's Disease

Crohn's disease is characterized by a chronic and long lasting ulceration of the digestive tract. The ulceration extends through all layers of the intestinal wall & can affect any part of the digestive tract from mouth to anus.

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What is Crohns Disease?

Crohn's disease is characterized by a chronic and long lasting ulceration of a section of the digestive tract. The ulceration extends through all layers of the intestinal wall and involves the entire digestive system, from the mouth to the anus, as well as the adjacent lymph nodes. The inflamed parts heal, leaving scar tissue that narrows the passageway. This disorder is not contagious.

Its cause is still uncertain, although it is known that a history of food allergies increase the risk of developing it; conversely, eliminating allergenic foods often relieves the symptoms. Studies also suggest that free radical damage may be involved and that a lack of vitamins C, E and other antioxidant enzyme systems may play a role.

What are the symptoms of Crohns Disease?

Symptoms of Crohn's disease include:

Chronic diarrhoea
Pain in the upper and lower abdomen
Fever
Headaches
Malabsorption and consequent malnutrition
Steatorrhea - bulky stools that float
Loss of energy, appetite and weight
Chronic bleeding may cause iron-deficiency anaemia and further deficiencies of folate and vitamin B12
Secondary lactase (milk sugar) deficiency may develop if not already present
If the ulcerated intestinal wall leaks, peritonitis can result
Mouth and anal sores may be present when the disease is active

Crohn's may stimulate specific gut infections necessitating the use of antibiotics.Antibiotics cause a further unfriendly environment in the already irritated bowel. Hence, further gut infections may precipitate or exacerbate the condition.

Sometimes Crohn's is diagnosed as appendicitis because the pain it causes is centred in the same location. In addition to the ulceration and inflammation, people with Crohn's disease may develop strictures that partially obstruct the bowel. They also may develop fistulas, abnormal passages that lead from one loop of intestine to another, or even to other organs.

Who gets Crohns?

The onset of Crohn's disease typically occurs between the ages of fourteen and thirty, although more and more cases are being reported in children. Attacks may occur every few months to every few years. In rare cases, it appears once or twice and does not return.

If the disease continues for many years, bowel function gradually deteriorates. Left untreated, it can become extremely serious, even life threatening and it may increase the risk of cancer by as much as twenty times.

Crohn's disease is similar to ulcerative colitis in many respects. Both involve loss of appetite, abdominal pain, general malaise, weight loss, diarrhoea and rectal bleeding. The primary difference between the two conditions is the degree of involvement of the wall of the intestinal tract.

Ulcerative colitis is limited to the mucosa and submucosa - the first two layers of the lining of the bowel adjacent to the lumen (the central passageway). Crohn's disease involves not only these layers, but also the next two layers - the muscular layer and the connective tissue layer below it.

Factors that can contribute to the onset of Crohns Disease and Colitis

High stress or poor stress tolerance
Anxiety
Fatigue
Hostile feelings
Depression
Sleep disturbances
The degree of a persons emotional stress will often indicate the severity of their bowel disorder
A diet high in refined sugars
Allergies - food or chemical sensitivity
Often there is an underlying yeast allergy, such as Candida
Genetic predisposition
Intestinal infections, such as parasites
Nutrient deficiencies
Chlamydia
Frequent dieting
Antibiotic use - the widespread use of antibiotics results in many intestinal upsets and liver malfunction due to the loss of the intestinal flora
Other factors such as laxative abuse, antibiotic overuse, metabolic disorders, adrenal insufficiency, diabetes and hyperthyroidism

Dietary factors affecting Crohns

Yeast found in bread and other related foods including alcohol has been found to irritate the bowels of IBD sufferers.

A high fat, sugar and a low fibre diet has a strongly disruptive effect on gut flora.

Wheat and dairy have been found to be the most common offenders.

Dietary fibres generally have positive effects on bowel symptoms. However studies have shown that wheat bran can be a major problem. In one study it was found that 55% of patients were actually made worse by wheat bran, with only 10% finding it to be helpful. In contrast, patients report better results with fibre products that are not normally in the diet. An example is psyllium, which has been found to be a good addition in the diet for reducing constipation and decreasing diarrhoea.

Recent studies has isolated the following foods as being especially allergic to the intestines:

Dairy products
Wheat
Sugar
Fermented foods and drinks and
Yeast products
Cruciferous vegetables like cabbage and cauliflower can be a problem
Corn
Tomatoes
Citrus fruits
Eggs

A diet high in sugar, increases the bacterial fermentation in the colon. Studies have shown that symptoms of an irritable bowel where higher in people with a diet high in refined carbohydrates.

Fat is the major dietary stimulant of the gastro colonic response and patients, especially those with diarrhoea, react to a fatty meal by having an increase in symptoms. Fatty red meats, sugar substitutes, processed foods, caffeine, tea, chocolate, cola and all foods known to be irritants should ideally be avoided.

Some fruits that contain fructose can annoy the lining of the bowel and should therefore be eaten with other foods or after a meal. These include peaches, pears, plums, prunes and apple juice.

A trial of an elimination diet with 428 patients resulted in improved symptoms in 60% of patients. The data suggested that simply eliminating common foods from the diet for 2 weeks is likely to result in symptom relief for perhaps as many as 2/3 of patients.

Dietary suggestions during an attack

During an attack, eat mashed or pureed foods and vegetables, soup, vegetarian style diet with plenty of vegetables.

Avoid spicy foods, fried and greasy foods, pepper, tobacco, caffeine, alcohol, dairy products, margarine, all carbonated beverages, chocolate, animal products and meat.

White fish is fine.

Steam, boil or bake your foods.

Limit your intake of grains, seeds or nuts, except for well cooked brown rice, but particularly wheat.

Mucous forming foods such as dairy products, wheat and processed foods should be avoided.

Eat a little often, but avoid big meals.

Drink plenty of liquids, such as water, herb teas and juices.

Exposure to food allergens stimulates the release of inflammatory cells in the intestines. People with inflammation in the bowel have enhanced immune responses against food allergens, but also against other antigens in the gut, particularly bacterial toxins.

You can dampen the inflammatory cascade by using the spices ginger and turmeric. You can also purchase these in supplement form.

An elimination diet, removing allergic foods shows a marked improvement in a high percentage of IBS sufferers. This is especially so in patients with diarrhoea, rather than constipation.

Nutritional treatment

One of the most amazing products the clinic has used is colostrum, a unique substance that has healing abilities within the colon.

Acidophilus, or similar products contain a mixture of probiotic flora and insoluble fibre to help promote bowel stability and endotoxin clearance. We consider both these products are essential in the treatment of all bowel disorders, including Crohns disease.

Essential fatty acids - linseeds, ground almonds, evening primrose oil and fish oil, such as salmon. Fish is a good choice for its fatty acid composition and high protein content. In fact a high protein diet is ideal.

A digestive enzyme complex containing pancreatin and the enzyme bromelain is considered essential. Enzymes may be taken at meal times as well as in between meals. Digestive enzymes taken between meals help break up clots.

The inclusion of mucopolysaccharides in the diet is highly beneficial. These are amino sugars found in all body tissues and fluids, cell walls and connective tissue and are used for strengthening the elasticity and tissue of mucous membranes. You can find these in aloe vera juice, oatmeal, raw oysters, shell fish, slippery elm and wheatgerm.

Deficiencies of Vitamin B5 (pantothenic acid)cause abdominal distress, vomiting and cramps.

A mineral combination will be necessary, especially as malabsorption is common.

Use the herbs Echinacea, Garlic, Goldenseal Root, Pau d'Arco, Rose Hips and Yerba Mate for Crohns.

Alfalfa supplies needed vitamin K and chlorophyll for healing.

Also beneficial are products that contain glutamine, aloe vera, garlic, licorice and zinc. Glutamine is used by the intestinal mucosa and lymphocytes as fuel, while supporting bowel growth and gut immunity.

Garlic combats free radicals that are involved in Crohns and aids healing. It also offers anti-fungal properties.

Oral zinc has achieved results in Crohns patients with associated low zinc levels, as zinc is critical for healing and growth.

All these products and more are available at Ideal Health.

Please remember that in all cases of bowel disturbances, get a correct diagnosis from your health care professional before self-prescribing.