Inflammatory Bowel Disease (Part 1): Crohn’s Disease

July 22, 2010

Inflammatory bowel disease is usually first diagnosed at a young age, although it may by symptomless for years prior to diagnoses. Unfortunately, inflammatory bowel disease is one of those conditions that can be difficult to diagnose, requiring extensive testing and samples for confirmation and to rule out other diseases with similar symptoms or diseases that can cause IBD.

There may be a genetic component to inflammatory bowel disease, so if a close relative has had it you may be at risk. Other factors as to who gets IBD include race (whites and Ashkenazic Jews), environmental factors (living in a big city), diet, and medications you may be taking (such as Accutane/Isotretinoin). Sometimes inflammatory bowel disease is triggered by a weakened immune system, or an immune system that isn’t functioning properly (usually due to a genetic trigger), in which case IBD can actually be an auto-immune disease. Smoking increases the likelihood of developing Crohn’s Disease.

Inflammation is a natural process of the body that removes dead and damaged cells. If our diets aren’t balanced (we’re eating too much Omega-6, which triggers inflammation, and not enough Omega-3, which competes with Omega-6 and stops oxidative damage by acting as an anti-oxidant), or if our immune system overreacts to a pathogen (a bacteria, virus, fungus, or other foreign element) inflammation can occur. Symptoms of inflammation include redness, swelling, and pain (redness and swelling being the main signs for inflammation of the intestines).

Crohn’s Disease can be patchy and spread out, usually affecting the last part of the small intestine and parts of the large intestine. Crohn’s Disease causes inflammation of most or the entire bowel wall.

Crohns Disease Symptoms:

  • Abdominal Pain/Cramping (Pain can be caused by ulcers affecting nerves, or from muscle contractions)
  • Diarrhea
    • Dehydration
  • Ulcers can appear anywhere in the gastrointestinal tract (mouth to anus and perineum).
  • Ulcers can penetrate the bowel wall becoming fistulas, causing contents to leak into a different part of the GI tract, a different organ, or the skin.
  • Mucus or blood in the stool. Deep red colors indicate blood originating from the intestines, while brighter, redder blood is usually from hemorrhoids/tears in the anal skin.
    • Anemia
  • Constipation (due to swelling or scar tissue), or the feeling of constipation when your bowels are actually empty (but you still feel the need to have a movement).
    • If severe, this can also cause nausea and vomiting.
  • Lack of an appetite (as a result of the severity of other symptoms, or as it’s own symptom).
  • Inflammation in other parts of your body such as your skin, liver and joints (which may cause arthritis)

Risks of Inflammatory Bowel Disease:

  • Malnutrition
  • Stunted growth/development in children
  • Weight loss
  • Bone Loss (a risk if you have the disease for many years)
  • Infection (watch for a lasting fever)
  • Kidney Stones & Gall Stones
  • There is an increased risk of colon cancer for Crohn’s Disease

If your doctor suspects you have IBD, there are a number of tests that might be performed (a colonoscopy, biopsy, MRI…) in order to confirm symptoms, rule out other diseases with similar symptoms, and to rule out diseases that may cause Crohns Disease symptoms. Medical treatment for inflammatory bowel disease can include anti-inflammatory drugs, immunosuppressives (which may increase the risk of cancer as well as other diseases), and antibiotics. In severe cases, surgery may be recommended, but with Crohn’s Disease inflammation is likely to recur. See a gastroenterologist if you have severe symptoms, difficulty managing your symptoms, or are considering your treatment options.

In the meantime, a number of things may help reduce or manage symptoms.

  • Fight inflammation.
    • Antioxidants like Omega-3, found in nuts like walnuts, fish oil, as well as other anti-oxidants like those found in berries (all available in supplement form) may help reduce inflammation as well as the risk for cancer.
    • Avoid Omega-6 (try and get a 1-1 ratio with Omega-3) which is found in meat and meat products (so don’t just think meat and dairy, but baked goods that contain butter, lard, etc. However, if you are having trouble digesting, substituting with heavily processed and synthesized foods may not be ideal–try vegan recipes instead).
    • Try a low-fat diet that’s full of anti-oxidant rich foods like fruits, vegetables, etc.
  • Ease Digestion and improve nutrient absorption
    • Try and find out what foods work for you, and avoid those that increase your inflammation, irritate ulcers or worsen other symptoms.
    • Graze throughout the day rather than having large meals.
    • Supplement to fill nutritional gaps, especially if there are a lot of foods that are now restricted from your diet. Some suggestions:
      • A good multivitamin
      • A calcium-magnesium supplement to help avoid bone loss
      • Digestive enzymes to help your body break down what you eat into absorbable pieces
      • Probiotics, which are the “good” bacteria naturally found in our digestive tract that sometimes need replenishing from sources like yogurt or a supplement. However, if your IBD has a genetic cause tied to an overreaction of your immune system, introduce probiotics to your GI tract slowly to see how your body reacts.
  • Avoid stress, which can trigger bile production that can worsen ulcers. In general, stress is not good for your immune system.

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