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Treatments for inflammatory bowel disease

MagazineJanuary 1998 (Vol. 8 Issue 10)Treatments for inflammatory bowel disease

A wide range of nutritional disturbances have been recognized in Crohn's and UC patients (J R Col Physicians London, 1986; 20: 45-8; Postgrad Med J, 1983; 50: 690-7)

Change your diet. A wide range of nutritional disturbances have been recognized in Crohn's and UC patients (J R Col Physicians London, 1986; 20: 45-8; Postgrad Med J, 1983; 50: 690-7).

Specifically, IBD sufferers can benefit from a diet high in fibre and low in sugar (Gastroenterol, 1987; 92: 1483; J Gastroenterol, 1981; 19: 1-12; Br Med J, 1979; 2: 764-6). Avoid polyunsaturated fatty acids, and food with the amino acids glutamine and argenine.Nutritional supplements. Fish oil capsules have been shown, in a small placebo-controlled, double-blind study, to reduce the rate of relapse in Crohn's patients. More than double the number of those taking 2.7 g omega-3 fatty acids over those taking placebo were in remission after one year of therapy (N Eng J Med, 1996; 334; 1557-60). Those with ulcerative colitis can also be helped by taking increased supplements of fish oil (J Clin Gastroenterol, 1990; 12: 157-61).

Taking extra folic acid may help (J Lab Clin Med, 1981; 97: 779-84; Scand J Gastroenterol, 1979; 14: 1019-24; Lancet, 1946; i: 849). Folic acid can be destroyed by drugs such as sulphasalazine or may be deficient due to inadequate diet or the malabsorption which accompanies IBD.

Extra vitamin E may also help relieve symptoms (Digest of Chiropract Economics, Sept-Oct 1984; Am J Clin Nutr, 1976; 29: 1333-8).

Healthy gut mucosa depends on the presence of several nutritional elements. Make sure you are getting enough of all the B vitamins, as well as C (levels of which can be reduced in those with IBD), vitamin A and D. Those with chronic gastrointestinal disorders may also be deficient in vitamin K (Am J Clin Nutr, 1985; 41: 639-43). Zinc, iron and calcium levels may also be low.

Taking probiotics. Replacing the gut's friendly bacteria can also help to boost immune system function (Townsend Letter for Doctors, Aug/Sept, 1997). Patients may experience what is known as the Herxheimer reaction a temporary allergic response resulting from the death of large amounts of pathological organisms when taking these. This, while uncomfortable, is a sign that your body is beginning to recover.

Herbs. Several herbs have been shown to help soothe gastrointestinal tract disorders. Of these, goldenseal, rich in berberine, can help to destroy bacteria in the gut (Nature, 1967; 215: 527-28; Yakugaku Zasshi, 1962; 82: 726-31; and 1961; 81: 1387). Licorice root contains several elements which can help heal ulceration (Gut, 1972; 13: 816-24; Scand J Gastroenterol, 1971; 6: 683-6; J Ther Clin Res, 1968; 1: 2-5). Papaya leaf also has an anti-ulcer action.

Rule out food sensitivities. Dairy and yeast products are the most common allergens. Enzyme potentiated desensitization where the patient is given minute doses of what he or he is allergic to in order to desensitize them has also proved to be more effective than placebo, providing better long-term prognosis for Crohn's patients (Clin Ecol, 1987; 5: 1131-4).

The elemental diet (see main story), which is free of protein, has been shown to be successful in treating Crohn's (Lancet, 1990; i: 816-19). This is true for children as well as adults (Arch Dis Child, 1987; 62: 123-7).

Lifestyle changes. Stopping smoking and coming off the contraceptive pill may also help since both aggravate the tendency of the blood vessels to block (Dig Dis Sci, 1991; 36: 1147-50).


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