You know that urgency you feel when you’ve really got to run to the bathroom? Some folks live with that on an ongoing basis, with days, months, years and, yes, even a lifetime of stomach pain, diarrhea and other pleasantries that can ruin your day like nothing else.
Crohn’s disease is a common form of inflammatory bowel disease (IBD) characterized by inflammation, in which the immune system attacks the GI tract. There is no cure and though symptoms may dissipate on temporary basis, they’re never really too far away.
Like other forms of IBD, Crohn’s disease can have a debilitating effect on quality of life, with work days missed, cancelled social plans and a daily regimen planned according to the nearest toilet. Crohn’s is an aggressive disease that, in rare instances, may require surgery.
Fortunately, those cases are rare. And Crohn’s, though formidable and with life-changing consequences, is a manageable condition that you can navigate with diet choice, an open communication with your doctor and an understanding of what triggers your symptoms.
Crohn’s disease has been defined both as an “autoimmune disease” and a state of “immune deficiency”. In any event, it’s a life-long condition of inflammation that can affect any area of the gastrointestinal system, from the mouth to anus, though the ileolic, ileal and colic regions are the areas most often affected, in that order respectively.
Symptoms of Crohn’s disease include:
abdominal pain (especially on the lower right side)
stunted growth (in children)
Less common symptoms include open sores, bowel blockages, tears and openings between organs. People with Crohn’s may also have cosmetic symptoms, like blotchy skin and dull hair because the condition impairs the body’s ability to process nutrients from diet – a catch-22 that we’ll explore later in this article.
Estimates put between 400,000 and 600,000 North Americans with the disease. And while there’s still much we don’t know about Crohn’s – and what causes it – we know that it’s often genetic. People of East European (Ashkenazi) Jewish descent may be at higher risk. You’re at higher risk if a sibling has the condition. The disease is most often diagnosed between age 20 and 30.
Smoking is another risk factor for Crohn’s disease and can make existing symptoms worse.
There’s no known drug at present that can cure Crohn’s, though new developments show potential. Just last week, researchers announced that a drug previously used to treat psoriasis may be an effective treatment for patients with Crohn’s in whom other Crohn’s medications, including TNF-blockers, have no effect.
That’s further down the road, however, and pending further studies. And for people with Crohn’s who’d wisely prefer to manage their symptoms naturally, and skip the potential side effects linked to Crohn’s medication, there are ways to do that, starting with what goes on your plate.
Having Crohn’s presents an interesting dilemma; your body requires nutrients from the foods you consume, yet some of the healthiest foods, including whole grains, raw fruits and vegetables, make the condition worse and can trigger symptoms that were temporarily dormant.
Foods that can aggravate Crohn’s disease include:
butter (and mayonnaise and margarine)
soda and carbonated drinks
coffee and tea
High-residue foods, meaning those that make stool bulkier, can also aggravate symptoms. Foods to avoid in this scenario include corn hulls, nuts, seeds, raw fruits and vegetables.
Bear in mind that Crohn’s is, like irritable bowel syndrome and related bowel diseases, a highly individual condition, with trigger foods that can affect one patient yet leave another unscathed. Keeping a journal of trigger foods, and the symptoms and severity, can help.
As well, Crohn’s patients may find a different cooking style or method of preparation can make trigger foods less of a problem. Steaming or boiling vegetables, for example, or choosing ground sirloin over steak, may help as well. Visit this site for more information.
People with Crohn’s disease should keep an open communication with their physician. It’s time to speak with your doctor if you feel faint or have a weak pulse, have a fever or shaking chills, you’re vomiting repeatedly or if you experience any of the Crohn’s symptoms reviewed in this article on an ongoing basis.
Your doctor will review your symptoms with you and do a physical exam. You may have lab work done that can include:
Barium X-Rays – Of your small intestine and colon.
A Colonoscopy or Sigmoidoscopy – Done with a thin microscopic camera to examine the colon.
A Biopsy – An examination of your tissue to test for Crohn’s or other diseases, including cancer.
Stool Analysis – A closer look at your stool for signs of blood and infection – both warnings of Crohn’s.
Crohn’s disease ain’t pretty.
Treatment of Crohn’s disease will depend on the severity of symptoms. In mild cases, a combination of a healthy and balanced diet with regular exercise can be beneficial and keep symptoms under control. When they’re absent for several months, they’re in remission, though they can flare up at any time.
Patients with mild symptoms may also find that OTC medications, and anti-diarrheals, can help as well.
When symptoms are more persistent and greater in severity, your doctor may prescribe drugs to reduce inflammation, one of the most common being sulfasalazine (Azulfidine). This is one of several drugs that contain mesalamine, or 5-aminosalicylic acid (5-ASA).
If these drugs don’t work, the doctor may also prescribe corticosteroids, an immunosuppressant or, at the highest end, a biologic drug like infliximab (Remicade) that inhibits an inflammation-causing protein called tumor-necrosis factor-alpha, or TNF-alpha. A drug designed for this purpose is called a TNF-blocker.
It’s important to note that prescription medications for Crohn’s should always be taken as directed by your doctor. You should note any side effects as well. Drugs with mesalamine, for example, may cause nausea, vomiting, head ache, heartburn and diarrhea.
You should also have realistic expectations with Crohn’s medications. TNF-blockers only work for about 60% of patients with medium to severe symptoms.
And that’s one of several factors that make a recent announcement of all the more interest.
Last week, researchers announced that a drug previously used to treat psoriasis may provide a much-needed alternative medicine for patients in whom other drugs and TNF-blockers prove ineffective.
The drug, called Stelara, reduced symptoms in patients with medium to severe Crohn’s disease, in a new study of 526 patients and published in the October 18, 2012 issue of the New England Journal of Medicine.
Like TNF-blockers, Stelara inhibits the TNF-alpha protein that promotes inflammation. With inflammation being a common factor between Crohn’s and psoriasis, this link would appear quite logical.
What makes Stelara of particular interest is that it reduced symptoms for most patients that did not respond to TNF-blockers. That’s a large demographic – remember that TNF-blockers only work for about 60% of Crohn’s patients. Even then, their effects may wear off and require a switch to another TNF-blocking medication.
Studies are ongoing, though, and it should be said that Stelara’s not without side effects. Six people developed a serious infection during the study and one even developed skin cancer. These side effects are also linked to TNF-blockers, as they both affect the immune system.
Still, it’s encouraging news. And for patients with troublesome symptoms of Crohn’s, and when other drugs haven’t worked, Stelara might be the prescription break-through that many are seeking.
Drugs aren’t everyone’s cup of tea. This being Natural Health Source, that sums up our perspective on how to live well, reduce digestion problems and, it should be said, how to manage symptoms of Crohn’s disease.
Adding to that, it’s especially important for patients with Crohn’s to pay attention to diet choice. Patients with Crohn’s may have trouble processing nutrients, but you’ve got to get them from somewhere. So where do you start?
You can start with a high-protein, high-calorie diet. In particular, the foods listed below are rich in essential nutrients and less likely to trigger flare-ups:
Almond Milk – An excellent dairy source for the lactose-intolerant, when fortified, almond milk has as much calcium as milk. Now add vitamins D and E and subtract cholesterol and saturated fat. Choose an unsweetened product.
Eggs – More Crohn’s-friendly protein here. You can boil them, scramble them, poach them or other. Choose your style, eggs are inexpensive, easy to digest and packed with nutrients.
Oatmeal – Another morning food that’s easy on your tummy, oatmeal is a rich source of soluble fiber, meaning it absorbs water for slower passage through the GI tract.
Vegetable Soup – Afraid that veggies will trigger your symptoms? The solution may be to whip’em up in a puree. Vegetables like pumpkin, carrots, squash and parsnip are ideal for this and, unlike boiling, you won’t lose nutrients when prepared in this manner.
Salmon – One of the healthiest foods on the planet, wild salmon is high in much-needed protein and absolutely bursts with omega-3 fatty acids, which may reduce inflammation. But fish in general may be helpful to patients with Crohn’s – you can also try shrimp and white fish like tilapia and flounder.
Papaya – Crohn’s doesn’t have to be a death knell for fruit lovers. Case in point, papaya, which has an enzyme called papain that helps your body digest proteins. Papaya’s also an excellent source of vitamins C and A, potassium and folate.
Poultry – Swap dark chicken and turkey for breast from both. Poultry is high in protein and easy to digest, which makes it excellent for anyone with Crohn’s or other kinds of inflammatory bowel disease.
Avocado – These are high in fat, but it’s of the monounsaturated variety, meaning the ‘healthy fat’ that may lower LDL (bad) cholesterol. Avocado is smooth, soft, rich in nutrients, including B vitamins, vitamin E and potassium. More over, it’s one of the few fruits with both soluble and insoluble fiber.
Roasted Red Peppers – With their awesome levels of carotene and vitamin C (not to mention their ability to boost metabolism!), it would be a shame not to indulge in red peppers. The solution may be to remove their skins and roast them, which may be easier on your stomach. Experiment, as they may trigger flare-ups in some patients. If they don’t, be sure they’re in your diet, whether in a sandwich, soup, salad or other.
Peanut Butter – You’d never think it, but peanut butter is a seriously unappreciated source of nutrition, with high levels of monounsaturated fats, protein and vitamin E. Choose smooth peanut butter (or almond or cashew butter) over the chunky variety and, of course, don’t eat peanut butter if you’re allergic to peanuts.
Remember, Crohn’s disease is a finicky creature. What triggers symptoms in some patients may be fine for others. So experiment. Play with these foods and different ways of preparation. If they work, great. If not, try them another way.
You may also find this website a useful starting point, save their recommendation of rice, of which white rice is nutritionally void and, speaking from experience, can take your blood sugar on a ride you may do without. Try brown rice instead, which is higher in fiber and retains more nutrients, or if you insist on white rice, try basmati white rice.
While they won’t cure Crohn’s, there is evidence that fish oil can help patients in remission and reduce the chance that flare-ups will occur. Consider this Italian study, of 78 Crohn’s patients, of whom all were in remission and at high risk of relapse.
In the year-long, double-blind study, participants took either nine fish oil capsules or nine placebo pills each day. On the study’s conclusion, 28% of the patients in the placebo group remained in remission. And the fish oil group? An encouraging 69%.
The results build on research linking omega-3 fatty acids to reduced inflammation, which, you may recall, is a common factor in both psoriasis and Crohn’s disease. Fish oil may also reduce existing symptoms, and make it easier to cope with this often debilitating condition.
Ponder that won’t cure Crohn’s. Nothing will, in fact. New treatments are on the way, but, as with many issues of the human physiology, treatment for Crohn’s is primarily of symptom reduction, knowing your triggers, and how to live with them both.
Still, it’s a promising study. Any way to keep Crohn’s in remission is welcome news, and the fact that the best route to this destination may be natural is a bonus.
Try OmegaDaily, a fish oil offered right here at Natural Health Source. In addition to being a convenient source of omega-3 fatty acids, it’s formulated with green-lipped mussel powder. A popular treatment in New Zealand for joint pain, the latter is a non-polar lipid that some believe may even reduce risk of heart disease.