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Crohn's disease and inflammatory bowel disease

What is Crohn's disease?

Named after Dr. Burrill Bernard Crohn, the physician who first described the condition in 1932, Crohn's disease is an inflammatory bowel disorder - a broad title used to describe any condition which involves the intestines becoming swollen, inflamed and ulcerated. Ulcerative colitis is another example of an Inflammatory Bowel Disease (IBD).

Crohn's, in particular, is an unpleasant and painful condition, which results in inflammation of all the layers of the lining of the bowel. It causes ulcerations (breaks in the lining) of the small and large intestines (most commonly the ileum), but any area of the gastrointestinal tract can be affected, from the mouth to the anus.

It most commonly presents during adolescence and early adulthood, but it has also been known to start in childhood and later in life. Men and women seem to be equally affected, but parents, siblings and children of people with Crohn's disease are 3 - 20 times more likely to develop the disease.

Approximately 150,000 people suffer from either Crohn's or colitis in the UK. There are more than 5,000 new cases diagnosed each year and research has shown that the number of people with Crohn's is rising.

While there has been a significant amount of research into the condition, its precise causes remain unknown - although many have been postulated, including viruses, bacteria, the immune system, genetics, diet and lifestyle. For example, it is estimated that smokers are 3 times more likely to develop Crohn's disease than non-smokers.

Common signs of Crohn's disease

Self-diagnosis can be detrimental to health and so it is always best to seek the advice of a qualified health practitioner if you are concerned, or suspect that you have Crohn's disease. However, below we discuss some of the more common signs and symptoms of the condition.

Abdominal pain and diarrhoea are experienced by almost all sufferers. Having said that, of course not everyone who experiences these symptoms will necessarily have Crohn's - they are associated with many other conditions of varying seriousness and severity, which is why it is important to seek a professional diagnosis.

The reason for the abdominal pain and (sometimes bloody) diarrhoea in the case of confirmed Crohn's is that the swelling and inflammation associated with the disease extends deep into the lining of the bowel and can cause the intestines to empty frequently. Other common symptoms include vomiting, fatigue and weight loss.

Although less common, Crohn's disease has also been known to cause complications outside of the gastrointestinal tract, such as skin irritation, arthritis and inflammation of the eye.

Once a person has the disease, it tends to fluctuate between periods of inactivity (remission) and activity (relapse). Treatment revolves primarily around attempting to manage symptoms, with the aim of promoting longer periods of remission and preventing flare-ups.

Crohn's disease and diet

While there is no known cure, Crohn's disease tends to respond very well to positive dietary adjustments and tailored nutritional programmes (including supplementation). This, along with the fact that it is more prevalent in the Western world, would seem to indicate a strong dietary link.

It is also important to note that most people with Crohn's disease are allergic or intolerant to certain foods, most commonly gluten (the protein found in wheat, rye, oats and barley) and dairy. So avoiding such allergens, as well as intestinal irritants like extracted bran, can be particularly helpful.

Sufferers also tend to have higher levels of homocysteine - a naturally-occurring amino acid, which is found in the blood and is linked to a range of diseases. If levels are too high, it can have an adverse effect on a critical biological process called methylation.

The brain and body use this process to keep the body's biochemistry in balance. Where this delicate balance is disrupted, the net result can be deterioration of health, including the development, or aggravation, of Inflammatory Bowel Diseases such as Crohn's and ulcerative colitis, as well as other conditions such as arterial damage, anaemia, coeliac disease, diabetes, arthritis, depression and more.

As such, an alkalising diet packed with natural whole foods (such as fruit, vegetables and green leafy plants) are generally considered to be beneficial for Crohn's sufferers. Some of the most important nutrients to look out for and proactively include in the diet where high homocysteine levels are suspected are: folate, vitamins B2, B6 and B12, zinc and Trimethylglycine (TMG or betaine).

At the same time, it is a good idea to avoid foods, beverages or daily activities which could be contributing to acidity in the body (and therefore higher homocysteine levels). For instance, saturated fat, refined carbohydrates, alcohol, sugar, caffeine, dairy, red meat, processed foods and other acid-forming foods. In terms of lifestyle factors, exercise regularly if your health allows, stop smoking, avoid toxins wherever possible and try to minimise your stress.

And don't forget to spare a thought for the amount of beneficial bacteria inside your vulnerable and inflamed gut - the levels of these 'good guys' (essential for digestion and immunity) are likely to be very low. It is possible to support a healthy balance of friendly and harmful gut flora by increasing your intake of probiotic foods (such as sauerkraut, tempeh, miso and tofu) or taking a high-strength, multi-strain probiotic supplement.

Other nutrients which may help to calm inflammation and soothe the gut lining include Omega 3 fats, curcumin and the amino acid glutamine.

It is well worth working with a nutritional therapist, digestive health expert or other qualified health practitioner to help devise your ideal diet and supplement programme.

Posted February 20, 2015