Crohn's disease and Ulcerative colitis.

  These are usually referred to as IBD.

 Bouts of diarrhoea, fever, pain in the abdomen, loss of appetite, weight loss, flatulence and malaise (bad feeling, pre-empt), abdominal tenderness can be present with Crohns. Fistulas (pouches) can occur which can house bacteria and lead to severe inflammation.

 Crohns is associated with the entire thickness of the digestive tract the entire length and is common in the Ileum (last part of the small intestine.).

 Granulated tissue (scar tissue) forms from ulcers and inflammation of tissue.

 Ulcerative colitis usually affects the colon but can migrate up. This is more common than crohns. Bloody stools, diarrhoea, cramps, haemorrhoids and abcess can be signs of colitis.

 Both conditions have similar symptoms and treatments and can be often diagnosed wrong. Many people have these and are diagnosed with IBS.

 Problems arising from these conditions can be similar to IBS, diarrhoea, constipation, pain, bloating, fatigue, and others caused from malabsorbsion of food. Because free radicals are produced through inflammation and repair and removal of waste from infections, then poor nutrition (which is already associated with the condition) means that free radicals can attack at will cause more damage and thus cancer is often the long-term result of IBD.

 What are the causes?

 Again  I will bullet point.  

·        Genetic predisposition, Caucasians and Jews (strong evidence)

 ·        Immune system abnormalities

 ·        Diet (well documented in relation to controlling the problem)

 ·        Infectious agents. (Virus, bacteria)

 ·        Antibiotic exposure (prescribed or consumed in diet destroys flora balance)

 ·        Stress. (Well documented as physiologically destructive)

  What are the dietary considerations for IBD?

 People with Crohns have been shown to have high sugar low fibre diets. (1 page 590. reference2,3,4,5,6 page 892) these studies also linked eating cornflakes habitually and associated allergy as responsible for onset of crohns. If this is true then dietary advice (nutritional therapy is effective at preventing onset. Generally information suggests onset of crohns is at age 15-35.

 Exclusion of irritants diet, allergy testing and whole food optimum diet is a good starting point. This may well bring about reduction in the condition.

 Supplementation of vitamins, minerals and enzymes and protein in the form of amino acids may help digestion. Many nutritional deficiencies are present for a range of reasons from psychological, physiological and practical reasons such as pain and discomfort with eating and elimination. Some examples are:

 ·        Minerals lost in diarrhoea

 ·        Decreased intake through nausea, vomiting, pain, anorexia.

 ·        Dieting without supplementation.

 ·        Malabsorbsion through inflammation and scarring.

 ·        Higher turnover of intestinal cells and mucosa production leads to extra nutrient needs.

 Flora has been found to be disturbed in crohns patients so the balance needs to be addressed (1 page 590. reference2,3,4,5,6 page 892).

 Because the ulceration and inflammation in the digestive tract, many nutrients may have trouble getting through. This can lead to excess sugar, protein and other irritants that may normally be taken care of by the liver such as alcohol. This can worsen IBD.

 Treatment of these deficiencies can be made sometimes with sublingual absorbsion or intravenous supplementation in some cases. Elemental diet with all the necessary nutrients, enzymes and amino acid supplementation is common.

 Through damage and repair more antioxidants are needed and through repair extra nutrients are needed.

 High fibre diets appear to be effective. They promote good bacteria, which controls the bad ones. In general it is accepted that flora imbalance is a factor in prevention and onset of crohns.

 Poor levels of Zinc, b12 and folic acid are associated with crohns and IBD.

 In summary an optimum diet is recommended in addition to the above considerations, some of which need medical intervention.

 What nutritional deficiencies are caused by IBD?

 I mentioned some above.

 ·        Inflammation and scarring cause a surface that cannot effectively transmit nutrients to the bloodstream. Many nutrients are affected.

 ·        Poor levels of Zinc, b12 and folic acid are associated with crohns and IBD.

 ·        Antibiotic use causes flora imbalance which can be devistating.

 ·        It is shown above that crohns patients statisticly have poor diet low in fibre and high in processed starch and sugar. This leads to deficiency in many nutrients found in whole food, fresh food and raw food.

 ·        Pain and discomfort and stress may cause loss of appetite.

 ·        Vitamin K, copper, B3, and E are common.

 ·        Stress is responsible for malabsorbsion and increased requirement through extra muscular activity.

 ·        Corticosteroids commonly prescribed for IBD affect protein synthesis therefore reducing repair of damaged tissue they also are associated with a very long list of nutrient deficiencies (1 page 594)

 ·        Diarrhoea causes loss of many nutrients.

 ·        Removed sections of intestine can hamper the already poor absorbsion of all nutrients.

 Some commonly prescribed drugs and their side effects.

 As mentioned already Cortico steroids commonly prescribed for IBD affect protein synthesis therefore reducing repair of damaged tissue they also are associated with a very long list of nutrient deficiencies (1 page 594).

 Prednisone is one of the most common drugs. Common side effects are acne and Indigestion. Indigestion is the last thing an IBD sufferer needs. Heartburn is a common side effect (4 page 187) (3,4 various.)

 Sulfasalazine is another one mainly only used for IBD. (3,4)

 Side effects are nausea, loss of appetite, general discomfort, stomach irritation, vomiting, joint pain, tinitis, headache, malaise, fever and bleeding.

 I wonder if the cons outweigh the pros in this case.

 Antispasmoic drugs include Disychlomine, which is given to decrease spasms in the digestive tract to ease pain. Side effects are decreased gallbladder contraction resulting in decreased fat absorbsion (4 page 174) and urinary tract. It is also used to control mucous.

 Many side effects include the usual ones, nausea, vomiting, heartburn, constipation, blurred vision, dizziness, headaches, bloating, difficult urination, impotence, sensitivity to light, paralysis, glaucoma, confusion, heart irregularities, hyperactivity, nasal congestion and about 20 others (4 page 174).

 Again I wonder if abdominal cramps and pain is better that all these terrible side effects and secondary damage.

 

 

 

 

 

 

 

 

 

 

 

I hope you found this article interesting and food for thought!

 

 

 

 

 

 

 

 

 

 

 

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