Crohn’s Disease (CD) and Ulcerative Colitis (UC) are life-long debilitating inflammatory bowel diseases (IBD) that we don’t have a cure for yet, despite effective conventional and natural treatment options.

Many IBD sufferers will tell you that they suffer from an invisible illness. One which many people don’t understand or see the physical, mental and emotional tolls that someone with Crohn’s and Colitis goes through on a daily basis.

If you suffer from IBD, you’ve probably heard it all, from:

“Oh you’ve lost weight…I wish I had your problem”

To things like:

“I think you’d feel better if you just did some yoga or ate a keto diet”

Right.

Everyone seems to have an opinion on how you should take care of yourself, don’t they?! From the newest trendy diet you should follow to that awesome probiotic supplement you should take, there’s no shortage of misinformed suggestions out there.

This can be flat-out dangerous advice, leaving only YOU to the bear the consequences!

It doesn’t have to be this way…

Wouldn’t it be nice to sift through all the confusion surrounding nutritional supplements, herbs and other natural treatments out there?? Or better yet, have someone qualified do it for you?

What about having peace of mind knowing that any natural treatments are not interacting with your medications, are safe and effective, and are being monitored closely by a professional?

Today’s article highlights how Naturopathic Doctors can play a vital role on your healthcare team through various stages of disease. Young or old, medicated or un-medicated, we’ll explore how natural treatments can work synergistically with your conventional treatments. We’ll shed light on how taking a whole-person approach can not only improve bowel symptoms and reduce inflammation, but can improve quality of life by improving skin, joint and mood issues that often accompany Crohn’s and colitis.

NOTE: The following information is not intended to replace medical advice or medical treatment of your disease. Please consult your doctor.

Crohn’s & Colitis – Natural Disease Course & Treatment

Crohn’s Disease can affect virtually any part of the digestive tract from “gum to bum” and results in inflammation that affects the superficial to the deeper layers of the bowel. On the other hand, Ulcerative Colitis only affects the large bowel and results in continuous inflammation of the most superficial layer of the colon. From bowel obstructions to abscess formation and bowel cancer, they each have their own fair share of scary complications. However, most IBD sufferers will tell you that it’s the daily fatigue, the painful cramps, diarrhea, nausea, joint pain, and depression that really keep them up at night.

Thankfully we have conventional treatments that can really change the course of these diseases.

Biologic drugs have revolutionized the treatment of IBD and are essential in managing moderate to severe Crohn’s and Colitis. These drugs block the production of a particular cytokine or inflammatory messenger known as tumor necrosis factor alpha (TNF-a). This messenger has been shown to drive the inflammatory process in both CD and UC and as such, these drugs result in much better rates of remission and bowel healing.

Maybe you’re reading this thinking

“Yes, these drugs have really been life-changing!”

But maybe you’re not one of the lucky ones

Instead, you’ve been put on steroids, immunosuppressives and several biologics with escalating doses only to achieve brief glimpses of remission. Shortly after this, you relapse or get totally derailed by the intolerable side effects.Thus, the search for the next treatment begins and the cycle starts over again.

Biologics carry with them a high risk of failure. Patients can build tolerance to these drugs, rendering them essentially useless. But on the other hand, they have impressive rates of remission and when patients discontinue them about half will relapse within two years. Yikes!

You see the problem here? We need these drugs because when they work, they work really well. However, we also need natural treatments that are safe and effective and ideally, work alongside medications to enhance their healing effects in Crohn’s and colitis.

Which brings us to our topic today:

Can Crohn’s & Colitis Be Treated Naturally?

Totally. But (usually) not by itself.

As a naturopath focused on treating digestive disease, I see a ton of value in evidence-based and personalized natural treatments alongside medications for stabilizing disease, preventing future relapses and optimizing the health of those with Crohn’s and colitis.

Having a smart integrative plan can make all the difference for you!

Here are five ways a naturopath can help you better manage your disease:

1. Help you achieve healthy weight & ensure adequate nutrition

One of the most important outcomes in treatment success, especially after a bowel resection or surgery is preventing malnutrition and weight loss. Post-surgical nausea can be a real issue as well.

Getting back to your normal weight should be a priority.

An Elemental Diet is one tool we use to give the bowels rest while ensuring we meet all nutritional needs. An elemental diet consists generally of liquid meals that have the most basic components of diet broken down into their smallest sizes and thus don’t require breakdown by the digestive tract. Elemental diets have been shown to be effective in inducing remission in paediatric Crohn’s disease.

Semi-elemental diets in which 50% of nutritional needs are met by the liquid formula can be extremely valuable as well. If longer periods are required or if patients are tolerating only a select number of foods, then a semi-elemental diet may be a suitable option.

NOTE: These diets should never be initiated without professional supervision from either a dietician or a naturopathic doctor.

Intravenous infusion therapy (IVIT) is another natural treatment that can help restore much needed vitamins, minerals, micronutrients and amino acids to your body.  When digestive absorption is compromised, especially in Crohn’s and colitis, IVIT can make a big difference in your energy levels and overall health. You can  learn more about infusion therapy here.

2. Personalize your diet

“Diet doesn’t matter”

Ever heard this before?

Understanding what foods help YOU and what foods trigger you is a big piece of the puzzle. Don’t let anyone tell you different! Learning to adjust your diet through a flare is important and goes beyond switching to the Wonderbread and Corn Flakes diet…

So what does work?

One of the best strategies of identifying possible triggers is by the use of an elimination diets in which commonly irritating foods are removed from the diet and carefully re-introduced one at a time.

Alternatively, one of the functional testing strategies I use for Crohn’s & colitis patients is IgG Food Sensitivity Testing.

There are now a few well-designed studies in IBD. To summarize, here’s what researchers have found regarding the benefits of following an elimination diet based on food IgG testing in IBD:

• Reduced disease scores (Mayo score), improvement in quality of life – Ulcerative Colitis
• Improved nutritional status (increased body mass index and albumin) – Ulcerative Colitis
• Decrease in disease score (Harvey Bradshaw Index; Crohn’s Disease Activity Index) – Crohn’s Disease
• Improvement in quality of life –  Crohn’s Disease

Food IgG testing is controversial and does have some limitations especially when used in IBD patients. For example, certain immunosuppressive and biologics can decrease IgG food antibody production. Therefore, if you are taking immunosuppressives this may skew testing. Also, some believe that food IgG responses simply represent a normal tolerance of the immune system to a particular food. However, research has never supported this idea. In fact, the same researchers from the studies above correlated higher IgG antibodies with higher disease activity. Clearly we need to do a lot more research on food IgG testing, but the research we have so far is encouraging, at least in the treatment of Crohn’s and colitis.

3. Educator & Advocate

You probably know more about your disease and poop than you’d care to admit, and maybe even more than some of the people who treat you. And kudos to you, for being an advocate for your health and asking the tough questions.

Unfortunately, this will often only get you so far.

A naturopath can help you sift through the enormous amount of false information out there to develop an evidence-based treatment plan that works for you, not against you. We’ll provide education on aspects of your disease that GP’s and specialists may not have time to cover.

And maybe you don’t have all the answers –  no one does!

We’ll help you answer those tough questions and if we don’t know we’ll find out for you!

But please: ask away! We have time. Time to discuss your concerns, to ask your questions and to go over your options. We won’t brush off your ideas or your symptoms. Because we get to spend a lot more time with patients we can hear you out, the good and the bad. We understand your medications, your disease and what keeps you up at night. We’re your personal advocates!

4. Reduce inflammation/disease activity

The following are some of the effective evidenced-based natural treatments Naturopaths may use in the treatment of your Crohn’s or colitis:

Vitamin D

It’s become increasingly clear that vitamin D supplementation goes way beyond maintaining proper bone health and preventing osteoporosis.

In the gut, vitamin D:

• Diversifies the microbiota –  those with Crohn’s and colitis have less diversity in their microbiota
• Improves the intestinal barrier –  Crohn’s & colitis patients have defective intestinal barriers
• Increases antimicrobial peptides –  these help microbes from overgrowing or infecting the gut

Vitamin D is also absorbed in the last part of your small intestine, also known as your ileum. This also happens to be the most commonly inflamed site in Crohn’s disease. Therefore, it’s not surprising that vitamin D levels in those with Crohn’s are significantly lower than healthy controls.

So what happens when deficient Crohn’s patients supplement vitamin D to optimal levels?

There’s a whopping 44% decrease in hospitalizations, a reduced risk of relapse and a significant decrease in inflammatory markers like fecal calprotectin. Finally, and most importantly, Crohn’s patients experience significant improvements in their quality of life!

Probiotics – Colitis

Probiotics are a controversial topic as a natural treatment for Crohn’s & colitis. Can they help in both conditions? Which strains work? “Can I take them in a flare or only when I’m in remission?”

To answer these questions here’s what we know regarding probiotics and outcomes in IBD:

• Improved remission rates in active UC when used without medication (Only one specific probiotic cocktail has shown this benefit)
• Can improve remission rates when combined with medication better than medications alone (same probiotic)
• Maintain remission in UC with longer disease free periods (same probiotic)
• Treats and prevents pouchitis in UC patients (same probiotic)
• Probiotics have not consistently shown benefit in Crohn’s Disease (therefore discouraged)

*Don’t miss my article: Probiotics: not all equal for a detailed discussion on all things probiotics

Curcumin (Curcuma longa) – Crohn’s & Colitis

One of the most well-studied natural treatments, this herbal extract from the popular turmeric spice can decrease disease activity in both Crohn’s and colitis. Although curcumin is generally poorly absorbed, this actually works in favour of those with IBD as it stays mostly within the confines of the digestive tract, right where we need it!

It’s really important to mention that when you combine curcumin with a particular biologic, it reduces the likelihood of loss of response to that drug. This means that curcumin makes the drug work better and for longer periods of time –  that’s a huge win!

Wormwood (Artemisia absinthium) –  Crohn’s

Wormwood is a a powerful herbal remedy with significant anti-TNF effects, therefore it would seem a suitable herb in IBD. In fact, three clinical trials have looked at the benefits of wormwood. Spoiler alert: all three have been positive in the treatment of Crohn’s disease resulting in significant reductions in disease activity.

5. Treat you as a person, not as a disease

Yes, your bowels are (or were) inflamed. And yes, we can help you with that (if needed)!

But we can also help you with the laundry list of other health concerns that often accompany your disease.

“Well I’m on medication, and my disease is under control why would I get any additional benefit from seeing a naturopath?”

Well, as you probably know, the symptoms of Crohn’s & colitis don’t stop in the gut. At one point you’ve probably experienced extra-intestinal manifestations (EIMs) or symptoms associated with UC or Crohn’s that occur outside the digestive tract.

Even if you’re in remission, they may still rear their ugly heads! And just because you’re in “remission” doesn’t mean you’re not still experiencing digestive symptoms like nausea, gas, diarrhea and pain!

Which is to say that your bowel disease, isn’t just a chronic bowel disease but a system-wide inflammatory disease. This can lead to many symptoms, including the following:

• Mood issues like depression & anxiety
• Nutrient deficiencies & malnutrition (iron, vitamin D, zinc, folate, magnesium, & protein deficiencies)
• Joint & back pain
• Skin issues like blistering sores, mouth ulcers and rashes
• Other autoimmune disorders (ankylosing spondylitis, Hashimoto’s, lupus)
• Kidney stones
• Eye changes (pain, redness and light sensitivity)

Final Thoughts

Taking a patient-centred approach allows me to target the underlying causes of your Crohn’s or colitis so that we can develop a comprehensive natural treatment plan that may include treatments like acupuncture, diet, mindset, probiotics and herbal medicine. Also, it’s especially important to seek a professional who understands the potential for interactions between your medications and your supplements or herbs, knows your full medical history and looks closely at the research to determine a personalized plan for you.

Lastly, while natural treatments (likely) aren’t going to cure your Crohn’s or colitis, they can certainly make life a lot more comfortable and put you back in the drivers’ seat of your health!

References:

1. Ananthakrishnan, Ashwin N., et al. “Normalization of plasma 25-hydroxy vitamin D is associated with reduced risk of surgery in Crohn’s disease.” Inflammatory bowel diseases 19.9 (2013): 1921-1927.
2. Jørgensen, Søren Peter, et al. “Clinical trial: vitamin D3 treatment in Crohn’s disease–a randomized double‐blind placebo‐controlled study.” Alimentary pharmacology & therapeutics32.3 (2010): 377-383.
3. Takagi, S., et al. “Effectiveness of an ‘half elemental diet’as maintenance therapy for Crohn’s disease: a randomized‐controlled trial.” Alimentary pharmacology & therapeutics 24.9 (2006): 1333-1340.
4. Gunasekeera, Viran, et al. “Treatment of Crohn’s disease with an IgG4-guided exclusion diet: a randomized controlled trial.” Digestive diseases and sciences 61.4 (2016): 1148-1157.
5. Jian, Liu, et al. “Food exclusion based on IgG antibodies alleviates symptoms in ulcerative colitis: A prospective study.” Inflammatory bowel diseases24.9 (2018): 1918-1925.
6. Omer, B., et al. “Steroid-sparing effect of wormwood (Artemisia absinthium) in Crohn’s disease: a double-blind placebo-controlled study.” Phytomedicine 14.2-3 (2007): 87-95.
7. Krebs, Simone, Talib N. Omer, and Bilal Omer. “Wormwood (Artemisia absinthium) suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn’s disease–a controlled clinical trial.” Phytomedicine 17.5 (2010): 305-309.
8. Schneider, Allaire, et al. “Comparison of remicade to curcumin for the treatment of Crohn’s disease: a systematic review.” Complementary therapies in medicine 33 (2017): 32-38.
9. Garg, Sushil K., et al. “Curcumin for maintenance of remission in ulcerative colitis.” Cochrane Database of Systematic Reviews 10 (2012).
10. Derwa, Y., et al. “Systematic review with meta‐analysis: the efficacy of probiotics in inflammatory bowel disease.” Alimentary pharmacology & therapeutics 46.4 (2017): 389-400.