If you have any unexplained pain, change in bowel habit or have black/tarry stools you need to consult your medical practitioner immediately.
Inflammatory bowel disease (IBD) such as Crohn’s or ulcerative colitis, involves inflammation of the digestive tract. IBD is a serious condition and needs ongoing medical supervision alongside any natural therapies aimed at helping your body to heal itself.
In IBD the body’s immune system actually attacks itself (it is an auto-immune condition) and the causes are many. Inflammatory bowel disease is rare in cultures where people eat a natural wholefood diet. We also know that there is a higher incidence of IBD in people who eat low fibre diets, smoke, eat fast foods or eat a lot of sugar. A study published in the Americal Journal of Gastroenterology found that low consumption of essential fatty acids, vegetables and fruits were associated with risk for Crohn’s disease1.
The following are issues you will probably need to explore if you want to reduce the number and severity of flare-ups of Crohn’s and ulcerative colitis:
- Rule out Infectious agents and parasites.
This is usually done via a combination of stool tests and your case history. Pathogenic agents in the gut can damage the lining of the gut wall and this can also lead to food sensitivities. In inflammatory bowel disease the balance of good bacteria in the intestines is usually out of kilter in favour of gut pathogens. Nutritional therapists usually advise on stool testing, which is always encouraged in inflammatory bowel disease. If you have had to take antibiotics or were not breast-fed you will not have a healthy balance of bacteria in the gut and will be at higher risk of Crohns or colitis. Healthy bacteria produce a substance called butyric acid, which is crucial for repairing the bowel.
- Do you have good micronutrient status?
Because malabsorption and diarrhoea are a feature of Crohn’s and colitis, sufferers are usually short of the very nutrients that help heal the gut. Good zinc levels are needed to heal the bowel but are usually low in patients with IBD. Zinc was shown to help heal damage to the gut in animal models of colitis2. Folate is needed to repair and maintain the intestines but Irish diets tend to be low and common IBD drugs asulfadine and methotrexate deplete it further. Deficiency of vitamin D may also trigger Crohn’s and Colitis, both of which tend to start or relapse more in the winter when vitamin D levels are low. In animals the active form of vitamin D inhibits the onset of artificially induced inflammatory bowel disease3
- Are you eating anti-inflammatory foods?
Omega 3 oils from cold-water fish in your diet act as natural anti-inflammatories. Thousands of research papers support their use in a wide variety of inflammatory conditions, including ulcerative colitis. If you eat oils that increase inflammation (most vegetable or seed oils, commercial confectionery, fried foods, margarine) they increase the disease process4. Studies have shown supplementation with pure uncontaminated omega 3 can be very helpful in ulcerative colitis though surprisingly not in Crohn’s. In Crohn’s its more appropriate to have omega 3 in your diet but NOT FROM SUPPLEMENTS. You also need enough of the minerals and B vitamins needed in order for the body to utilise these anti-inflamatory oils. High grain carbohydrate/processed diets and stimulants deplete these. Increased sugar intake and excessive total carbohydrate consumption may also trigger colitis and Crohn’s5. There is also a well established link in the scientific research between antibiotic use and subsequent development of IBD.
- Food sensitivities/coeliac disease
These can play a part in colitis and Crohn’s. You can find out if these are affecting you by cutting edge blood tests or if this isn’t an option for you by doing a 2-3 week elimination diet, after which you gradually re-introduce foods and monitor any reaction in order to identify “problem” foods. Milk (“dairy”) products and gluten grains are the most common culprits for many people with Crohn’s and colitis but other foods such as yeasts and soya are often problematic. The increased intestinal permeability present in food sensitivities predates the onset of frank disease6
This is linked to relapses. Nutritional and easy-to-do lifestyle measures can be implemented in order to help reduce relapses. Did you know that if certain nutrients are missing from your diet you are more likely to feel stressed? Stress also uses up anti-inflammatory nutrients!
- Do you have coeliac disease/non-coeliac gluten sensitivity? Coeliac disease is a genetic condition that affects many Irish people. Most people are not diagnosed (if ever) until after age 50 and a lifetime of ill health. Standard tests available throughout Europe can definitively diagnose Coeliac Disease BUT cannot rule it out*. This is because biopsy only shows coeliac disease when the gut surface is almost completely destroyed (which might take many decades) and a negative blood test does not guarantee you are not coeliac. The only definitive way to know if you are gluten sensitive is to do sophisticated blood tests or to remove it COMPLETELY from the diet for a period of time. When doing an elimination, even tiny traces of gluten will skew your results so it is crucial to do the elimination 100% for the test period. For some years now I have been able to organize comprehensive and reliable gluten sensitivity testing from Cyrex Laboratories for patients and non-patients alike. For more information on the range of tests available in Irish hospitals please see the coeliac section of this website.
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[1} Amre, d’Souza et al, 2007
 Sturniolo et al, 2002, J Lab Clin Med
 Friocu et al, 2007. BMC Immunol.
Persson, Ahlbom et al, 1992. Epidemiology)
 Reif, Klein et al, 1997. Eur J Gastroenterol Hepatol
 Buhner et al, 2006. Gut; D’Inca et al 2006. Aliment Pharmacol Ther.)