What is Crohn's Disease - An integrated treatment approach

In the next two blogs we will be discussing inflammatory bowel disease (IBD). IBD is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss Crohn’s disease, and you can find out more about ulcerative colitis in next week’s blog.

What is Crohn’s disease?

Crohn’s disease is a chronic (on going) condition characterised by inflammation of all the layers of the bowel wall.  While the most common parts of the digestive tract that are affected are the large intestine (colon) and the last section of small intestine (ileum), Crohn’s disease may affect any part of the digestive tract, from the mouth to the anus.  

Causes of Crohn’s disease

Like many of the conditions we see at The Health Lodge, the cause of Crohn’s disease remains unknown. Crohn’s disease is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an immune deficiency state, where the immune system is unable to control bacterial growth in the bowel, leading to chronic infection and inflammation.

While the cause of Crohn’s disease remains a contentious issue, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of Crohn’s disease in susceptible individuals. 

Symptoms of Crohn’s disease

The main symptoms of Crohn’s disease are abdominal cramps and pain; frequent, watery diarrhoea; and weight loss. Other symptoms include fatigue, fever, and loss of appetite. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, jaundice (yellowing of skin), and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms). 

Crohn’s disease treatment

Crohn’s disease can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of Crohn’s disease is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques.
  • Acupuncture: In a study of 51 patients with Crohn’s disease, acupuncture was found to improve disease activity markers, and to improve general wellbeing.

Naturopathic approach to management of Crohn’s disease

This section will discuss some of the naturopathic considerations in managing Crohn’s disease. We advise you to consult your health carer provider before considering commencing any of these therapies.

 

Diet

There is no single diet for Crohn’s disease. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with Crohn’s disease include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Low fat diet – Many people with Crohn’s disease experience diarrhoea that contains undigested fats. These people may benefit from a low fat diet; however care should be taken to prevent weight loss and nutrient deficiencies.
  • Identifying and avoiding problem foods- Certain foods may increase cramping, bloating, and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Eating small frequent meals- Small meals are easier to digest and so you may feel better eating five or six small meals per day.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with Crohn’s disease are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

A word on smoking: If you have Crohn’s disease, smoking can lead to a worsening of your condition. Smoking increases your likelihood of having flare-ups, needing medication and requiring repeat surgeries. Quitting smoking can improve the health of your digestive tract, as well as your general wellbeing.

Correcting nutritional deficiencies

People suffering from Crohn’s disease are at risk of a number of nutrient deficiencies. If the last part of the small intestine is inflamed, you will have difficulties absorbing B12 from your diet and B12 injections may be needed. If the entire small intestine is inflamed there will be difficulties absorbing all nutrients. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them. 

Identifying food allergies

While there is much contention as whether food allergies play a role in Crohn’s disease, some researchers suggest that food allergies may trigger Crohn’s disease and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Crohn’s disease. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.