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Inflammatory Bowel (IBD)

Inflammatory Bowel Diseases: A Natural Approach ©

By Dr. Rahim B. Habib ND, Naturopathic Doctor

 

Most people wake up each morning and go to the washroom without much thought about it.  However, when you start getting severe pain in your stomach, and looser and looser stool, especially when there is blood in the toilet bowl, waking up and going to the washroom can be an intensely stressful experience.  People who have inflammatory bowel disease (IBD), including Crohn’s Disease and Ulcerative Colitis, often go through this experience on a daily basis.  In this article I’ll talk about the importance of the gastrointestinal tract, and refer to the common symptoms of IBD, and speak to the effectiveness of integrating a naturopathic assessment and treatment to re-establish the intestinal functions.

 

The Importance of the Intestines

The beginning of your gastrointestinal tract runs from your mouth, and ends at your anus.  What happens between the two ends can affect how well your food is digested, and how much of the nutrients in your food are absorbed.  It is also fascinating to know that most of the immune cells in your body are in, or around your intestines – this means that the intestinal lining is a very, very important boundary, or ‘inner-skin’, separating the outside world from your inner body tissues/cells.The gastrointestinal tract also represents the first barrier against ingested chemicals, food contaminants, and natural toxins; so we also depend on the intestines to eliminate these toxins through our bowel movements.  In addition, what many do not realize is that there are trillions of microorganisms that live in your intestines (10X more microbial organisms than the total amount of cells that make up our body!).  These intestinal organisms, primarily bacteria, are friendly and normal, and actually communicate with our internal immune system to encourage a healthy immune relationship.  So, not only do our intestines have to figure out what to absorb from our food, but it also has the job of keeping the microorganisms that live there in a happy balance. 

 

What Happens to the Intestines in people with IBD?

When the intestinal lining is irritated or damaged, inflammation begins.  It’s like having a small fire along your intestinal tract and it’s painful.  Of course, your body’s immune system will respond and try to put this fire out, but in the cases of people at risk for IBDs, their immune system is not balanced, or may overreact, due to imbalanced nutrition, toxicity, stress, in relation to genetic susceptibility.  If the inflammation is in the small intestine, as it is in most cases of Crohn’s disease, then the absorption of nutrients will be particularly compromised, and will decrease your energy, stamina, and eventually reduce other nutritionally important areas, such as maintaining bone density.  In ulcerative colitis, the large intestine is involved.  In many cases of IBD, the intestinal lining becomes ‘leaky’ and lets larger particles into the body’s tissue environment, which can trigger the immune system to react negatively.  Sometimes, this immune activation can affect other areas of the body at the same time (during relapses) such as the eyes, joints, skin, and liver or gallbladder.

 

IBD Increasing in Young Canadians

A disturbing development is the increasing incidence of IBDs in Canadian children under 10 years of age.  Recent research links the influence of the pregnant and lactating mother’s nutrition, in the likelihood of her child developing an IBD.  In particular, the mineral selenium, and the vitamin folic acid are currently implicated in this association.  A study released in 2017 shows the rate among Canadian children under 5 years of age has been rising at the rate of 7% each year.   

Naturopathic Assessment

Typically, when someone starts showing the symptoms of inflammatory bowel disease, it is very shocking and prompts either a visit to the family doctor, or even the hospital.  Usually preliminary tests are conducted, including stool analysis, intestinal imaging, biopsy, and blood tests.  Likely, anti-inflammatory medications are prescribed including steroids, to reduce the inflammation, and the symptoms.  Unfortunately, IBDs tend to come and go, or relapse.

 

From a naturopathic medical perspective, there are some additional screening tests that are helpful at individualizing the treatment plan for the patient.  Comprehensive stool analysis can reveal if there are specific pathogenic microorganisms that are out of balance (bacteria, yeast, parasites, protozoa), or if there are sufficient amounts of the good bacteria.  This test can also indicate the digestive strength of the pancreas and stomach as well as determining various markers of inflammation (eg: calprotectin, lysozyme and lactoferrin).  Other tests can reveal just how leaky the intestinal lining is.  Food allergy and intolerance tests or elimination-reintroduction diets can be useful to find out what aggravates their condition; the most common problem foods are cereals, milk, eggs, vegetables and citrus fruits.  Testing for nutritional sufficiency is also useful, including homocysteine, vitamin B12, vitamin B6, folic acid, vitamin D and others.

 

Naturopathic Treatment

After going through the pain and dramatic symptoms of inflammatory bowel disease, it is inevitable that there needs to be some significant lifestyle changes made in these patients.  We know that when the body is under stress, the intestinal lining gets ‘leaky,’ so learning effective stress reduction techniques and calm breathing exercises are very helpful in patients with IBD.  Inevitably, the diet also needs to be modified, since some food components can irritate the intestine or immune system.  Particular supplements have proven beneficial such as omega-3 fats (eg: flax, chia, or fish oil), since they help to reduce inflammation of the intestinal lining, and also have been shown to reduce the dose of anti-inflammatory medication and frequency of relapses.  Many herbs can be useful in soothing the inflamed intestinal lining, these include turmeric, aloe, chamomile, licorice, calendula, marshmallow, flaxseed, and many others.

 

Since there is lowered intestinal nutrient absorption, intravenous nutrients can be very helpful at the beginning of treatment to boost energy and the body’s ability to recover.  Supplementation of iron, zinc, vitamin C, vitamin B12, vitamin K, vitamin D, vitamin A, calcium, folic acid and others can be helpful.  Another important supplement to consider are probiotics, or healthy bacteria which helps prevent relapses, by balancing the disturbed intestinal microbial environment.  Butyrate enemas can also be very helpful at calming inflammation and feeding colon cells.  Ensuring sufficient amounts of vitamin D and folic acid is also important to decrease the risk of developing colon cancer.

 

Conclusion

In my experience, there is a lot of hope for improvement in patients facing inflammatory bowel disease from an integrative naturopathic perspective.  Considering it is affecting younger and younger children, it is important to address the underlying causes to even prevent its development in the first place.

 

Symptoms of Inflammatory Bowel Diseases

fullness feeling in your abdomen

sporadic, then constant severe abdominal pains and cramping

diarrhea

weight loss and low appetite

anemia

fever

blood mixed in your stool (more common in ulcerative colitis)

 

Risk Factors to Developing IBD:

Crohn’s Disease                                              Ulcerative Colitis

-Westernized diet, high animal protein          -Western diet, high animal

-vitamin D deficiency                                      -vitamin D deficiency

-poor gestational or infant nutrition               -poor nutrition

- Jewish descent                                             - Jewish descent

-NSAIDs and Accutane medication use          -NSAIDs and Accutane

-family history of crohn’s disease                  -family history of UC

-long term (>6 months) debilitating illness   

-4 or more antibiotics in 1 yr in adolescence

-urban, industrialized environment

-cigarette smoking

 

References

Benchimol EI, Guttmann A, et al. Gut. 2009 Nov;58(11):1490-7. Epub 2009 Aug 2. Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data.

 

Jantchou P, Morois S, et al. American Journal of Gastroenterology. 2010 May 11. [Epub ahead of print]. Animal Protein Intake and Risk of Inflammatory Bowel Disease: The E3N Prospective Study.

 

Han DY, Fraser AG, Dryland P, Ferguson LR. Mutation Research. 2009 Sep 12. [Epub ahead of print]. Environmental factors in the development of chronic inflammation: A case-control study on risk factors for Crohn’s disease within New Zealand.

 

Larauche M, Kiank C, Tache Y. Journal of Physiology and Pharmacology. 2009 Dec;60 Suppl 7:33-46. Corticotropin releasing factor signaling in colon and ileum: regulation by stress and pathophysiological implications.

 

Maunder RG, Levenstein S. Current Molecular Medicine. 2008 Jun;8(4):247-52. The role of stress in the development and clinical course of inflammatory bowel disease: epidemiological evidence.

 

Hanai H, Sugimoto K. Current Pharmaceutical Design. 2009;15(18):2087-94.  Curcumin has bright prospects for the treatment of inflammatory bowel disease.

 

Erzin Y, Uzun H, et al. Journal of Clinical Gastroenterology. 2008 May-Jun;42(5):481-6. Hyperhomocysteinemia in inflammatory bowel disease patients without past intestinal resections: correlations with cobalamin, pyridoxine, folate concentrations, acute phase reactants, disease activity, and prior thromboembolic complications.

 

Calder PC. Molecular Nutrition and Food Research. 2008 Aug;52(8):885-97. Polyunsaturated fatty acids, inflammatory processes and inflammatory bowel diseases.

 

Rajendran N, Kumar D. World Journal of Gastroenterology. 2010 Mar 28;16(12):1442-8. Role of diet in the management of inflammatory bowel disease.

 

Cantorna MT. The Procedings of the Nutritional Society. 2010 Jun 2:1-4. [Epub ahead of print] Mechanisms underlying the effect of vitamin D on the immune system.

 

Barnett M, Bermingham E, et al. Mutation Research. 2010 Feb 25. [Epub ahead of print]  Investigating micronutrients and epigenetic mechanisms in relation to inflammatory bowel disease.

Benchimol E, Bernstein C, et al. Am J Gastroenterol 2017 April 18 [Epub ahead of print].

Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases