The Natural Approach to Colitis and Crohn’s Disease
May 01, 2012 05:40AM
By Dr. Janice Piro, DC, DABCI and Dr. Natalie Regalado, DC
Crohn’s and Ulcerative Colitis fall under the umbrella of Inflammatory Bowel Disease (IBD) since the most predominating symptoms are those from inflammation. IBD affects close to three million Americans. If that sounds like an awfully high number, you are right, it is… especially when it is realized that these diseases can possibly be prevented, or at least greatly curtailed. Just consider the risk factors for these diseases: a diet high in processed foods, animal protein, dairy products and sugar (aka the Standard American Diet – S.A.D.), with additional risk factors for Crohn’s Disease to include smoking and heredity.
Symptoms of IBD are those that many Americans can say they have experienced at least a few times in their lives, although with IBD sufferers, the frequency and severity may be greatly increased, occurring as "flare-ups". These symptoms include abdominal pain, alternating diarrhea and constipation, gas and bloating, loss of appetite, nausea, and blood in the stool. Also, IBD symptoms are not necessarily confined to the gastrointestinal tract; often there is inflammation in the joints, skin, and/or eyes, and in children it can cause delayed growth as well.
As with all diseases, understanding the underlying causes can illuminate what a successful course of treatment might be. There are many ideas about what causes IBD, but an imbalance in the gut flora is central to every major theory. Further, autoimmunity to the normal gut flora may result, complicating the disease further.
Normal gut flora is the very specific and individual conglomerate of beneficial bacteria present in our intestines. These bacteria live symbiotically in the gut and function to create normal, healthy digestion. They also greatly support healthy immune function. When this normal flora becomes imbalanced due to the risk factors mentioned above (remember the S.A.D. diet?), pathogenic microorganisms are allowed to overgrow, crowding out the normal flora. An imbalance is created known as dysbiosis. This sets the stage for acute gastrointestinal infections to develop. (Have you ever wondered why one person eating the same dinner as another will get food poisoning while the other did not?). In Crohn’s disease, a bacterium known as Mycobacterium paratuberculosis (MAP) has been implicated as the triggering bacterium. People with Crohn’s disease are seven times more likely to have MAP present in the blood or gut compared to people who do not have Crohn’s. These bacteria are found in cow’s milk and extremely heat-resistant, unaffected by pasteurization. With Ulcerative Colitis, cytomegalovirus (CMV) and other viruses have been studied as triggers of the disease. By the way, CMV has also been implicated in Chronic Fatigue Syndrome (hmm…). Carrageenan, a compound found throughout the food industry as a stabilizing and suspending agent, particularly in dairy products, has induced Ulcerative Colitis in experimental animals. Do you think it may be wise to avoid dairy?
The autoimmune component to IBD happens when the imbalanced gut flora has caused a reprogramming of the intestinal immune response. Through a mechanism described as molecular mimicry, the immune system begins to attack the normal flora in the intestines. To explain this, all organisms have their own specific protein code. It is like the organism’s nametag for the immune system. When the immune system "sees" a nametag that essentially signifies to it that this is an "enemy", the immune system attacks it. This is normal function. However, with molecular mimicry, an over-stressed immune system only sees part of that nametag… say, the cell’s first name. It doesn’t read the last name as it is too busy handling the imbalanced flora. So, a normal cell may be named "Natalie Smith" while a pathogenic cell may be named "Natalie Jones". This stressed immune system starts attacking all "Natalies", Smith and Jones, good and bad. Whoops! The immune system is now attacking the normal, beneficial gut flora located on the intestinal lining. Big problem! Here we now have the mechanism of the colitis’ and Crohn’s inflammation and ulcers in the intestinal wall.
Unfortunately, conventional medical treatment usually consists of only controlling symptoms and neglects to address these underlying causes. Additionally, long-term use of anti-inflammatory drugs, usually corticosteroids, is wrought with side effects, including bone loss, muscle deterioration, weight gain, skin problems, and neurological side effects. Antibiotics, as often prescribed, will indiscriminately kill off the beneficial bacteria, which will perpetuate and continue to worsen the IBD. Further, nutritional advice is usually limited to recommending that the patient simply eat whatever can be tolerated.
But now, with this deeper, more functionally focused understanding of IBD, it can be seen that rather than simply controlling the inflammation with pharmaceuticals, although these can be helpful during flare-ups, it is essential to regain the balance in the normal gut flora while killing off the pathogenic bacteria. Fortunately, there are excellent medicinal herbs that can be prescribed by licensed, natural medicine-minded physicians to target pathogenic bacteria while leaving the good stuff alone. Functional testing can be helpful to give the doctor insight into what pathogens are present and the degree to which dysfunction is present in the digestive system, aiding in the correct prescription of natural medicines.
Supporting the growth of the beneficial bacteria with high quality probiotics is essential. Diet alterations such as eliminating dairy and wheat (a significant gut irritant even to healthy intestines) will greatly curtail flare-ups. Eliminating foods that contain sulfur (such as garlic, onions, and grains) may be necessary since it is possible to have an increased amount of pathogenic bacteria that metabolize sulfur. This can lead to a very unsociable habit… have you ever been lucky enough to experience someone else’s intense, foul, "egg-smelling" gas? Well, now you know you can blame this on those sulfur-loving bacteria! Supplementing with Vitamin D3 helps to decrease inflammation, heal the intestinal lining, and improve overall health. Digestive enzymes, as well as both soluble and gentle insoluble fiber, can be of great benefit in normalizing digestion and elimination. Vitamins such as folic acid and B12, B complex, C and the mineral zinc can all help with healing the intestinal lining. Modulating immune function, which loosely means to help the immune system differentiate between good and bad bacteria, with physician-prescribed Echinacea, as well as other herbal medicines, is an important treatment adjunct that is often misunderstood.
Natural, nutritional treatment for IBD and many other intestinal disorders may not only decrease symptoms, but also address the underlying causes of these illnesses and give patients the best chance of stabilization and recovery. In the authors’ opinions, it is essential care.
The Piro Clinic of Natural Medicine is located at 971-B Virginia Ave., Palm Harbor, 727-789-4020, PiroClinic.com. See ad page 27.