Inflammatory Bowel Disease
This includes two diseases: Ulcerative colitis and Crohn’s disease. Typically Crohn’s disease affects the small intestine and Ulcerative Colitis affects the large intestine but there is some overlap. They are normally regarded as auto immune diseases (in which it is thought that the body attacks itself). Steroids and other drugs are used to suppress the inflammation and control the disease. However conventional treatment is not curative and not aimed at the cause of the disease. The drugs are powerful and side-effects can be a problem.
Alternatives are not only useful but they have good science behind them.
Landmark studies by Hunter (1,2,3), the Cambridge gastro-enterologist, showed that Crohn’s disease can be brought into remission by an elemental diet and that avoiding food allergens can lead to prolonged remission. Nearlyall patients with Crohn’s disease are intolerant to grains. In the 1920sRowe (4) showed that 50% of cases of ulcerative colitis could be controlled by food avoidance. Truelove(5) found 20% of ulcerative colitis patients got better on excluding milk. Clinical ecologists (who deal with food and other allergies) have found patients with severe ulcerative colitis who have been advised to have colectomies (surgical removal of the colon) have recovered without surgery once their allergies have been dealt with. A trial of EPD (6) (enzyme-potentiated desensitisation) showed a marked improvement in ulcerative colitis (though the benefit took one year to become noticeable). An exclusion diet in Crohn’s disease is recommended but should be done with care. In ulcerative colitis this has to be done with great care because of the danger of relapse. However finding and dealing with food allergies can make a huge difference so these are always worth considering.
Other Dietary Approaches
Elaine Gottschall in her ground-breaking book Breaking the Vicious Cycle describes how she cured her daughter’s ulcerative colitis through diet. The diet is called a specific carbohydrate diet and eliminates sugars, grains, starchy vegetables such as potatoes and dairy products but allows most vegetables, nuts, some fruits (mainly berries), meat, fish and eggs.
Others have used this approach and recovered from both ulcerative colitis and Crohn’s disease following a change of diet. Jordan Rubin in The Maker’s Diet describes how he cured himself from Crohn’s disease as did David Klein in the book Self-Healing Colitis and Crohn’s. Tom Gardiner recovered from ulcerative colitis using a paleo diet. Dane Johnson co-founded the Crohn’s and Colitis Nutrition Foundation after he recovered from ulcerative colitis using diet and supplements (he has a forthcoming book: Going with your Gut). These diets vary but all eliminate refined sugar and most grains. All include healthy oils such as flaxseed and coconut oil.
Several studies back this approach up and link sugar with inflammatory bowel disease (7) and a study using a high fibre, low sugar diet led to a 79% reduction in hospital admissions in Crohn’s disease. (8). In another study patients with Crohn’s disease were taking twice as much sugar as matched healthy people. Please note that a high fibre diet could make things worse in the not uncommon situation of an allergy to wheat or yeast.
Perfluorinated chemicals are a known cause of ulcerative colitis. These chemicals known as PFAS (perflouroalkyl substances) include perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid(PFOS).
They are toxic at incredibly low concentrations (1 part per billion –equivalent to one drop of water in an Olympic swimming pool). We are all exposed to these in a variety of ways but from the perspective of ulcerative colitis the most important form of these is dental floss. Most types of floss contain these chemicals. Unfortunately absorption through the mouth is rapid and efficient. Because of this I would strongly recommend avoiding these types of floss (there are alternatives like bamboo). Also avoid cooking in Teflon (non-stick) pans.
Because inflammatory bowel disease damages the gut lining, deficiencies of certain nutrients are common. Folic acid deficiency occurs in 50% of patients (10). Vitamin A is also crucial for normal functioning of the gut. Dr Jonathon Wright, the renown natural health physician, uses high doses of Vitamin A : 50.000iu in Crohn’s and up to 150,000iu in ulcerative colitis (if any chance of pregnancy go down to 15,000iu) and 25 grams of folic acid. He also uses 30 mg of Zinc daily and 400iu of Vitamin E.
Dr Robert Atkins (best known for the Atkin’s diet) found that the (expensive) supplement Pantethine 900mg daily matched by an equal amount of Pantothenic acid (vitamin B5) caused a dramatic improvement in the vast majority of his patients with inflammatory bowel disease. He found improvement occured in just one week –something he had never experienced before. He also uses 30-60mg of folic acid, 15-30,000iu of Vitamin A, essential fats, zinc and other nutrients.
Double blind trials have shown that fish oils reduce inflammation and the need for anti-inflammatory drugs in ulcerative colitis (11). Another study in Crohn’s disease showed 28% relapsed in the year with fish oils whereas 69% of controls relapsed. (12)
Professor Cicero Coimbra, a neurologist and professor of neuroscience at the Federal University of Sao Paulo, Brazil, has pioneered the use of high-dose Vitamin D in auto-immune disease including multiple sclerosis, psoriasis, Crohn’s disease, vitilgo, ankylosing spondylitis and rheumatoid arthritis. Vitamin D is one of the most important immune modulators in the body and he believes that in auto-immune diseases there is resistance to Vitamin D and high doses are needed.
His results have been remarkable and it may be one of the most exciting breakthroughs in auto-immune disease for decades. The doses he uses are typically 50-200,000 IU daily. His regime requires special monitoring with regular blood and urine tests. Adverse effects are rare and typically the treatment gives a feeling of well-being.
However doses of up to 10,000 IU of Vitamin D daily are known to be safe. Dr Michael Holick, author and expert on Vitamin D has stated that there has never been any adverse affects found with doses of 10,000 IU daily even when taken long-term. In fact this is the amount you would get if you were sunbathing. I believe many people with inflammatory bowel disease would benefit from this dose of Vitamin D. Some would require higher doses but that would need careful monitoring (see www.coimbraprotocol.com).
The herb Boswellia gum was found to be as effective as Suphasalazine in patients with ulcerative colitis in one study. (13). Goldenseal is also very useful and is available at health food shops. Aloe vera juice or powder is also useful but quality varies – look for stabilized on the label.
These are preparations of good bacteria which can colonise the gut and make it more resistant to attacks of inflammatory bowel disease. Lactobacillus Planatarum has marked anti-inflammatory properties and Lactobacillus Acidophilus has shown benefit in ulcerative colitis.
Fecal microbial transplantation has cured cases of inflammatory bowel disease (see gut bacteria leaflet). Transplanting gut bacteria is a relatively new field but has become a recognised treatment for severe clostridia infection. It has been successfully used in inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis but has not always been successful.
1) Foods and the Gut, Balliere Tindall 221-37 1985 2) Lancet 1993;342 1131-4
3)Lancet 1985;2:177 4) Archives Int Med 1921;28:151-65 5)BMJ 1965;138:138-41
6) Clinic Ecol 1987;5:47-51 7) Gut 1996;40:754-60 8) BMJ 1979;2 (6193) 764-6
9) Med Hypoth 1999;52(4):297-301 10) Scand J Gastroent 1979;14;1019-24
11) Am J Gastroent 1992;87:432-7 12) N Eng J Med 1996;334:1557-1560
13) Eur J Med Res 1997;2:37-43