REVERSING CROHN’S AND ULCERATIVE COLITIS NATURALLY
A recent issue of the American Journal of Gastroenterology (May 1998;93:697-701) reports that people living with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, are more likely to use complementary medical therapies if they have had the disease for over 10 years or if they had been repeatedly hospitalized. The major reasons cited for this were the adverse side effects (diabetes, osteoporosis, cataracts and depression amongst many others) associated with and the lack of effectiveness of mainstream medical treatments.
Since IBD can cause life impairing symptoms and even death, it is treated aggressively with powerful drugs by gastroenterologists (gut specialists). The major interventions in use today against IBD are corticosteroids like Prednisone, antibiotics like Flagyl, aminosalicylates like Sulfasalazine, Asacol and Pentasa, immunosuppressive drugs Imuran and Cyclosporin and/or surgery to remove the diseased bowel. Unfortunately, the ultimate fate of some victims of ulcerative colitis is a total colectomy which is supposedly curative but leaves the patient with an ileostomy (an artificial abdominal opening with a disposable bag for stool collection). Special diets, nutritional supplements and herbs are rarely, if ever, prescribed for those who suffer from these gut disorders despite numerous reports of clinical successes using less toxic natural approaches.
A variety of factors have been implicated in the causation of IBD including heredity but it is generally believed to be an autoimmune disorder, one in which the person's immune system makes antibodies against his or her own gastrointestinal tract cells. Recent epidemiological studies indicate that users of the birth control pill as well as other oral female hormones may be at twice the risk of developing Crohn' s disease or ulcerative colitis.
Both diseases involve bowel inflammation as well as inflammation of tissues outside the gut. There are differences between the two types of IBD but there is also some degree of overlap with respect to signs and symptoms.2
Crohn’s disease (a.k.a. granulomatous ileitis or ileocolitis) is primarily a disease of white adults between the ages of twenty and forty although it can occur in both children and the elderly. Its main signs and symptoms include an abdominal pain or mass, diarrhea, fever, weight loss, rectal bleeding, anal fissures, abscesses and arthritis. In a minority of cases there may be inflammation of the liver, kidney and skin. The disease process involves the small bowel only in 30% of patients, the colon only in 15% and both the small bowel and colon in 55%. The diagnosis is usually made by x-rays or a biopsy.
Symptoms may include:
an increased urgency to defecate: up to 10-20 times/day bloody, watery, pus and mucous bowel movements normal or dry stools ( constipation) if the disease is limited to the rectosigmoidal area fever, general malaise, anorexia, weight loss, dehydration, joint pain, skin changes, liver disease and eye problems
Ulcerative colitis is a chronic inflammatory disease that deteriorates the lining of the large bowel. It shows up primarily in the twenty to forty age group and effects predominantly females. Most often, the inflammation begins at the rectum and extends up through the colon. The inflammation can progress until ulcerations and abscesses develop. In some patients, the disease can be mild and localized or excruciatingly painful with perforations of the colon. In others, arthritis and uveitis can develop as extracolonic manifestations. There is usually diarrhea with blood and mucus in the stool. Sudden attacks followed by periods of remission are typical.
Ulcerative colitis tends to recur in families and there is a high incidence of eczema, hay fever, arthritis and ankylosing spondylitis coexisting with the bowel disorder. There is a school of thought which believes that inflammatory bowel disease, especially ulcerative colitis is the result of an allergy or hypersensitivity reaction to certain foods by the colon. Some practitioners have observed an association between Crohn's disease and dental amalgam mercury sensitivity while others like Dr. Andrew Wakefield have recently associated Crohn’s with the MMR (measles, mumps, rubella) vaccine.
Salicylate (e.g. aspirin) sensitivity can be shown in a some patients with ulcerative colitis. Some researchers have shown the existence of circulating antibodies against cow’s milk and other foods, especially wheat and other grains. The commonest offending foods triggering ulcerative colitis are milk, wheat and yeast containing foods. IBD has been reported to be directly connected to a high junk food intake consisting of foods high in sugar, white flour products, corn, processed foods, fried foods, high fat snacks, pop, etc.
Common to both Crohn’s and ulcerative colitis is the fact that the antifungal medications like colchicine, nystatin and ketoconazole have been documented to reverse the inflammatory process in some cases. This and the many positive reports of disease reversal through the use of natural antifungal therapies support the theory that both Crohn’s disease and ulcerative colitis have a strong connection to chronic fungal infection.
Another theory is based on studies showing that IBD is a form of exaggerated allergic response to the presence of intestinal bugs that healthier individuals who are genetically less susceptible tolerate without difficulty. Allergy desensitization techniques, nutritional programs designed to repair a “leaky gut”, the use of natural antibiotics, digestive enzymes, antifungals and immune system modulators may all play a role in reversing IBD naturally.
WHAT YOU CAN DO FOR YOURSELF
Conventional medical treatments for Crohn’s disease and ulcerative colitis often ignore the value of diet despite a large amount of published medical literature that emphasizes its importance. Your garden variety gut specialist will neither prescribe a diet nor advise IBD sufferers to avoid therapeutic diets. In the minds of most conventional doctors, the word “diet” is equated to weight loss, which, in IBD cases, can worsen the general state of health. The well documented book by Elaine Gottschall: Breaking The Vicious Cycle. Intestinal Health Through Diet. (Kirkton, Ont.:The Kirkton Press, 1994) outlines how the Specific Carbohydrate Diet can reverse Crohn’s and ulcerative colitis. It is the first and most important book to read for anyone suffering from IBD. If used as directed and if total caloric intake is not restricted, then weight loss is not an issue, a fact which can soothe the anxieties of mainstream medical professionals.
Many victims of inflammatory bowel disease can control their symptoms simply by eliminating lactose (milk sugar), starches, grains, yeast and refined carbohydrates from the diet. Gottschall’s book contains menus, recipes and other self-help information. Some need only follow these diets for six months while others must follow them for years before being able to eat the disallowed foods without symptoms.
If you suffer from IBD, do not go off your prescribed medications when you start the Specific Carbohydrate Diet. As the gut symptoms improve, discuss tapering the drugs with your doctor while following the diet strictly. Eventually, the inflammatory process resolves enough to reverse the bowel lesions.
WHEN TO CONSULT NATURAL HEALTH CARE PRACTITIONERS
More difficult cases that do not respond within a few months to Gottschall’s Specific Carbohydrate Diet require help from a natural health care practitioner (naturopath or holistic medical doctor) for diagnosis and treatment of hidden food allergies, candida (yeast) infections, bacterial flora imbalances and parasite infestations. This usually involves the use of lab tests such as comprehensive digestive and stool analysis, comprehensive parasitology tests, livecell microscopy, food allergy testing and other blood, urine and hair mineral analysis tests. Diet therapy and nutritional and/or herbal supplements can then be more accurately prescribed.
Severe nutritional imbalances and deficiencies can make it difficult for even the best of diets to reverse IBD. These are frequently seen in sufferers of Crohn’s because of malabsorption but are quite common in ulcerative colitis cases as well. Zinc, B complex vitamins, especially vitamin B12 and folic acid, vitamin A and vitamin D are probably the commonest nutrients requiring supplementation. The following supplements have been reported to help most cases of IBD. Dosages depend on individual needs and tolerances as determined by trial therapies as well as objective biochemical tests.
Vitamin A 50,000-75,000 I.U. daily Zinc picolinate 30 mg daily Magnesium 100 - 400 mg daily (may aggravate some cases of diarrhea) Folic acid 20-30 mg daily Omega-3 fatty acids (fish oils) 6-9 g daily Vitamin E 800 I.U. daily Vitamin B12 IM 1000 mcg. once or twice weekly Vitamin C 1 g daily (may aggravate some cases of diarrhea) Lactobacillus acidophilus, bifido bacteria or sacchromyces boulardii - 1 tsp. (3 capsules) daily Quercetin 500-1000 mg 15 minutes before meals Bovine colostrum - 2000 mg twice daily
Herbs which could benefit inflammatory bowel disease include chamomile, ginger, comfrey, licorice root and a combination of slippery elm, Turkish rhubarb, burdock and sheep sorrel. This same combination of herbs can be used in the complementary treatment of many gastrointestinal problems including hemorrhoids, constipation, ulcers, diverticulitis, obesity, adult onset diabetes and hypoglycemia. Side effects are negligible.
Aloe vera juice is soothing for practically all gastrointestinal inflammations but may aggravate diarrhea in some cases of IBD. Garlic and probiotics like lactobacillus acidophilus (dairy and grain-free) may be helpful in normalizing the population of gut bacteria. Natural antimicrobials like grapefruit seed extract, goldenseal, gentian, wild mountain oregano oil, bovine colostrum and others are also effective at normalizing the gut ecology. Quercetin and other bioflavonoids found in garlic and onions minimize food reactions in IBD because they stabilize the mast cell membranes preventing histamine release when taken 15 - 30 minutes before meals. None of these natural treatments interfere with conventional medical treatments. In fact, it’s quite possible that they will help make medical therapy work better. For best results, work with your doctors to integrate diet, food supplements with prescription medications.
Supplements Dr. Rona has recommended to his patients
Boyko, E.J. et al., Increased Risk of Inflammatory Bowel Disease Associated with Oral Contraceptive Use. American Journal of Epidemiology, 140:268-278, 1994. Gottschall, Elaine. Breaking The Vicious Cycle. Intestinal Health Through Diet. Kirkton, Ont.:The Kirkton Press, 1994.
Martin, Jeanne Marie and Rona, Zoltan P. The Complete Candida Yeast Guidebook. Rocklin, California:Prima Books, 1996. Rona, Zoltan P. and Martin, Jeanne Marie. Return to the Joy of Health, Vancouver: Alive Books, 1995.