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Inflammatory bowel disease

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Related Terms
  • Anal fissure, Anti-diarrheals, barium, bowel, bowel disease, CD, colitis, colon cancer, colonoscopy, constipation, diarrhea, digestive tract, endoscope, endoscopy, fistulas, gastroenterologist, gastroenterology, gastrointestinal tract, IBS, inflamed colon, inflammation, intestine, immune disorder, immune system, irritable bowel syndrome, large intestine, laxative, MAP, megacolon, mycobacterium avium subspecies, paratuberculosis, obstruction, sigmoidoscopy, small intestine, spastic bowel, toxic megacolon, UC, ulcer.

Background
  • Inflammatory bowel disease (IBD) refers to two chronic diseases that cause inflammation of the intestines - ulcerative colitis and Crohn's disease. The symptoms of these two illnesses are very similar, which often makes it difficult to distinguish between the two. In fact, about 10% of colitis (inflamed colon) cases cannot be diagnosed as either ulcerative colitis or Crohn's disease. When physicians cannot diagnose the specific IBD, the condition is called indeterminate colitis.
  • Inflammatory bowel disease is not the same as irritable bowel syndrome, or IBS. Irritable bowel syndrome is characterized by cramping, abdominal pain, bloating, constipation and diarrhea. IBS causes discomfort and distress, but it does not permanently damage the intestines, and it does not cause serious diseases, such as cancer. Inflammatory bowel disease, on the other hand, causes chronic inflammation in the gastrointestinal tract and may lead to complications like colon cancer.
  • Researchers estimate that about one million Americans have inflammatory bowel disease. While IBD can develop at any age, it is most prevalent among individuals aged 15 to 30.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Chronic Pain Foundation. . Accessed April 6, 2009.
  2. Becker JM. Surgical therapy for ulcerative colitis and Crohn's disease. Gastroenterol Clin North Am. 1999 Jun;28(2):371-90, viii-ix.
  3. Crohn's and Colitis Foundation of America. About Crohn's Disease. . Accessed April 6, 2009.
  4. National Women's Health Information Center. Inflammatory Bowel Disease. . Accessed April 6, 2009.
  5. Natural Standard: The Authority on Integrative Medicine. . Copyright © 2009. Accessed April 6, 2009.
  6. Nemours Foundation. Inflammatory Bowel Disease. . Accessed April 6, 2009.

Causes
  • The cause of inflammatory bowel disease remains unknown. However, current research indicates that the inflammation in IBD patients involves a complex interaction of factors, including heredity, the immune system and antigens in the environment.
  • Environment: Since IBD occurs more often among people who live in cities and industrialized nations; it is possible that environmental factors, including a diet high in fat or refined foods, may play a role.
  • Heredity: Individuals are more likely to develop IBD if there is a family history of the disease. Therefore, researchers believe that an individual's genetic makeup may be a contributing factor to development of the disease.
  • Immune system: Some evidence suggests that a virus or bacterium may cause IBD. When the immune system attacks the invading substance, the gastrointestinal tract becomes inflamed. Other researchers speculate that the inflammation may stem from the virus or bacterium directly.
  • Mycobacterium avium subspecies paratuberculosis (MAP) may be involved the development of Crohn's disease and ulcerative colitis. This microorganism is known to cause intestinal diseases in cattle. In addition, researchers have found MAP in the blood and intestinal tissue of individuals diagnosed with Crohn's disease, but rarely in individuals with ulcerative colitis.

Symptoms
  • The severity of IBD symptoms varies among patients, and they may develop gradually or come on suddenly. Some individuals will experience long periods with no symptoms, while others may experience chronic or recurrent symptoms.
  • The most common symptoms of both ulcerative colitis and Crohn's disease are diarrhea (ranging from mild to severe), abdominal pain, decreased appetite and weight loss. If the diarrhea is extreme, it may lead to dehydration, increased heartbeat and decreased blood pressure. As food moves through inflamed areas of the gastrointestinal tract, it may cause bleeding. Continued loss of blood in the stool may result in anemia.
  • In addition, Crohn's disease may also cause intestinal ulcers, fever, fatigue, arthritis, eye inflammation, skin disorders and inflammation of the liver or bile ducts.

Diagnosis
  • General: The diagnosis of IBD is based on a combination of exams. A colonoscopy is the standard diagnostic test for IBD. In order to determine whether the IBD is ulcerative colitis or Crohn's disease, tests such as capsule endoscopy, upper endoscopy, barium study or CT-scan may be conducted. These tests help the gastroenterologist determine whether there is inflammation in gastrointestinal areas other than the colon. If there is inflammation in areas other than the colon, the patient is diagnosed with Crohn's disease.
  • Colonoscopy: A qualified healthcare provider may observe the colon with an endoscope. The endoscope is a thin tube, which is inserted through the anus and attached to a television monitor. The physician looks for inflammation, bleeding or ulcers on the colon wall.
  • Capsule endoscopy: Capsule endoscopy may be performed if an individual experiences symptoms of Crohn's disease, but other diagnostic tests are negative for the disease. The patient swallows a capsule that has a camera inside. The camera photographs the gastrointestinal tract. The pictures are then subsequently transmitted to a computer screen. The healthcare provider will then look for abnormalities in the gastrointestinal tract, including inflammation and ulcers. Once the device has traveled through the digestive tract, it will pass painlessly in the stool.
  • Barium study: During a barium study, the patient drinks a barium solution before X-rays of the intestines are taken. The barium will appear white on the X-ray film, which allows the physician to see possible problems, such as inflammation.
  • Computerized tomography (CT-scan): A CT-scan, which provides more detail than a standard X-ray, may also be performed. This test shows the entire gastrointestinal tract, and tissues outside of the bowel. This test may help the healthcare provider detect complications, such as blockages, abscesses or fistulas.
  • Flexible sigmoidoscopy: A qualified healthcare provider may perform a sigmoidoscopy. During this procedure, the physician uses a slender, flexible tube to examine the last two feet of the colon, known as the sigmoid. The test is usually completed in a few minutes. However, it is slightly uncomfortable, and there is a slight risk that the colon wall may become perforated. In addition, this test may not detect problems higher in the colon or small intestine.
  • Upper endoscopy: An upper endoscopy may be performed to check the esophagus, stomach and upper small intestine for bleeding, inflammation or ulcers associated with Crohn's disease.

Treatment
  • Anti-inflammatories:
  • There is no known cure for IBD. However, many medications may help to relieve the symptoms.
  • Sulfasalazine (Azulfidine®): Sulfasalazine (Azulfidine®) has been used to treat the symptoms of Crohn's disease. Adverse effects include nausea, vomiting, heartburn and headache. Individuals should avoid this medication if they are allergic to sulfa medications.
  • Mesalamine and olsalazine: Mesalamine (like Asacol® or Rowasa®) and olsalazine (Dipentum®) have been used to decrease inflammation in the gastrointestinal tract caused by IBD. They are typically taken orally or rectally in the form of enemas or suppositories. Olsalazine may cause or worsen existing diarrhea in some people.
  • Balsalazide (Colazal®): Balsalazide (Colazal®) has also been used to decrease inflammation in the gastrointestinal tract caused by IBD.
  • Corticosteroids: Corticosteroids have shown to effectively reduce inflammation of the gastrointestinal tract in IBD patients. They may also be used in conjunction with other forms of medications. For instance, in some cases, a physician may prescribe steroid enemas to treat symptoms in the lower colon or rectum. Corticosteroids should only be used as short-term medication. Treatment generally lasts about two weeks.
  • Immunosuppressive medications:
  • Azathioprine and mercaptopurine: Azathioprine (Imuran®) and mercaptopurine (Purinethol®) have been used for years to treat Crohn's disease. However, their efficacy for ulcerative colitis is still being researched. Since these medications are slow-acting, they are occasionally combined with a corticosteroid.
  • Cyclosporine: Cyclosporine (like Neoral® or Sandimmune®) is usually only prescribed to individuals who are not responding to other medications. Cyclosporine begins working within one to two weeks. However, severe side effects may include kidney and liver damage, fatal infections and an increased risk of lymphoma.
  • Infliximab (Remicade): The U.S. Food and Drug Administration approved infliximab (Remicade®) in September 2005 for the treatment of ulcerative colitis. The drug neutralizes a protein produced by the immune system, known as tumor necrosis factor (TNF). Infliximab removes TNF from the bloodstream before it can cause inflammation in the gastrointestinal tract.
  • Other medications:
  • Anti-diarrheals: A fiber supplement like psyllium powder (Metamucil®) or methylcellulose (Citrucel®) may help relieve symptoms of mild to moderate diarrhea. For more severe diarrhea, loperamide (Imodium®) may be effective.
  • Laxatives: Inflammation may cause the intestines to narrow, resulting in constipation. Laxatives may be taken to relieve symptoms of constipation. Oral laxatives like Correctol® and sigmoidoscopy® have been used.
  • Pain relievers: A qualified healthcare provider may recommend acetaminophen (Tylenol®) for mild pain. Avoid nonsteroidal anti-inflammatories (NSAIDs) like aspirin, ibuprofen (like Advil® or Motrin®) or naproxen (Aleve®). Researchers have found a strong relationship between NSAIDs and IBD flare-ups. Therefore, NSAIDs should not be taken.
  • Surgery: If all other treatments fail to relieve symptoms, a qualified healthcare provider may recommend surgery. Surgery is more commonly performed in ulcerative colitis patients because inflammation is limited to the colon.
  • During the procedure, the entire colon and rectum is removed (proctocolectomy). A new procedure, known as ileoanal anastomosis eliminates the need for recovered patients to wear a bag to collect stool. This new procedure involves attaching a pouch directly to the anus, allowing the patient to expel waste normally. However, the patient may have as many as five to seven watery bowel movements a day because there is no longer a colon to absorb water. Between 25 and 40% of patients with ulcerative colitis eventually need surgery.
  • Some Crohn's patients may experience blockages in the intestine that require surgery to remove the diseased portion of the gastrointestinal tract.

Integrative therapies
  • Good scientific evidence:
  • Probiotics: E. coli Nissle 1917 appears to be as effective as the drug mesalamine in the treatment of ulcerative colitis. However, it is not currently available in the United States. A variety of Bifidophilus preparations have shown effects of preventing relapse or maintaining remission. These include Bifidophilus alone, Bifidophilus in fermented milk products, and a synbiotic preparation. A probiotic combination consisting of VSL#3 plus balsalazide may be more effective than balsalazide or mesalamine alone. More studies are needed to more clearly determine what outcomes can be expected.
  • Probiotics are generally regarded as safe for human consumption. Long-term consumption of probiotics is considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
  • Unclear or conflicting scientific evidence:
  • Acupuncture: Preliminary study has used acupuncture for acute and chronic colitis. More study is needed before a recommendation can be made.
  • Avoid acupuncture in patients who have valvular heart disease, infections, bleeding disorders or with drugs that increase the risk of bleeding (anticoagulants), medical conditions of unknown origin, neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with pulmonary disease (like asthma or emphysema). Use cautiously in the elderly or medically compromised patients, diabetics or with history of seizures.
  • Aloe: There is limited but promising research of the use of oral aloe vera in ulcerative colitis, compared to placebo. However, it is not clear how aloe vera compares to other treatments used for ulcerative colitis.
  • People with known allergy to garlic, onions, tulips, or other plants of the Liliaceae family may have allergic reactions to aloe. Individuals using aloe gel for prolonged times have developed allergic reactions including hives and eczema-like rash. Although topical (skin) use of aloe is unlikely to be harmful during pregnancy or breastfeeding, oral (by mouth) use is not recommended due to theoretical stimulation of uterine contractions. It is not known whether active ingredients of aloe may be present in breast milk. Breastfeeding mothers should not consume the dried juice of aloe leaves.
  • Ayurveda: Ayurveda is a form of natural medicine that originated in ancient India more than 5,000 years ago. It is an integrated system of techniques that uses diet, herbs, exercise, meditation, yoga, and massage or bodywork to achieve optimal health on all levels. Preliminary evidence suggests that the gum resin of Boswellia serrata may improve or alleviate symptoms in patients with chronic colitis with minimal side effects. More studies are needed to confirm this finding.
  • Ayurvedic herbs can interact with other herbs, foods, and drugs. A qualified healthcare professional should be consulted before taking. Ayurvedic herbs should be used cautiously because they are potent and some constituents can be potentially toxic if taken in large amounts or for a long time. Some herbs imported from India have been reported to contain high levels of toxic metals. Avoid Ayurveda with traumatic injuries, acute pain, advanced disease stages, and medical conditions that require surgery.
  • Barley: Germinated barley foodstuff (GBF) has been suggested as possibly helpful in patients with ulcerative colitis. Scientific evidence in this area is preliminary, and further research is needed before GBF can be recommended for ulcerative colitis.
  • Patients who are allergic to barley flour or beer should avoid barley products. Severe allergic reactions (anaphylaxis) and skin rashes have been reported from drinking beer made with malted barley. Patients with allergy/hypersensitivity to grass pollens, rice, rye, oats or wheat may also react to barley. Barley appears to be well tolerated in non-allergic, healthy adults in recommended doses for short periods of time, as a cereal or in the form of beer. Avoid consuming large amounts of barley sprouts if pregnant. Avoid if breastfeeding.
  • Betel nut: Currently, there is a lack of satisfactory evidence to recommend the use of betel nut for ulcerative colitis. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.
  • Avoid if allergic to betel nut or other plants of the Palmaceae family. Avoid if pregnant or breastfeeding.
  • Boswellia: Boswellia has been noted in animal and laboratory studies to possess anti-inflammatory properties. Based on these observations, boswellia has been suggested as a potential treatment for ulcerative colitis and Crohn's disease. At this time, however, only a limited number of poor-quality human trials have evaluated this use of boswellia, with inconclusive results. Therefore, there is inadequate evidence for or against this use of boswellia.
  • Avoid if allergic to boswellia or other herbs in the Burseraceae family (like myrrh or garuga). Boswellia is generally believed to be safe when used as directed, although safety and toxicity have not been well studied in humans. Indian literature suggests that boswellia may promote menstruation and induce abortion. However, there is insufficient scientific evidence regarding the safety of boswellia. Therefore, pregnant or breastfeeding women should avoid boswellia.
  • Bovine colostrum: Bovine colostrum is the pre-milk fluid produced from cow mammary glands during the first two to four days after birth. Bovine colostrum confers growth, nutrient, and immune factors to the offspring. Preliminary evidence suggests that bovine colostrum may improve gastrointestinal health and may be an effective treatment for colitis. More studies are needed.
  • Avoid if allergic to dairy products. Use bovine colostrum cautiously because toxic compounds, such as polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), and dichlordiphenyldichloroethylene (DDE), have been found in human colostrum and breast milk. Thus, it is possible that these agents may be found in bovine colostrum. Avoid with, or if at risk of, cancer. Use cautiously with immune system disorders or atherosclerosis (hardening of the arteries). Use cautiously if taking medications, such as anti-diarrheal agents (e.g. Imodium®), insulin, or CNS agents (such as amphetamines, caffeine).
  • Chlorella: Clinical study indicates that chlorella may increase the ulceration associated with ulcerative colitis. Although the results are promising, more high quality studies are needed to confirm these studies' findings.
  • Avoid in patients with known allergy/hypersensitivity to chlorella, its constituents, mold, or members of the Oocystaceae family. Avoid long-term supplementation or with manganese supplementation. Avoid in patients using warfarin or other anticoagulant therapy. Use cautiously in patients with hypotension or taking antihypertensives, or in patients taking immunomodulators or with altered immune function. Use cautiously in patients with cancer. Use cautiously in patients with photosensitivity, taking photosensitizers, or in those exposed to the sun.
  • Dandelion: Early study suggests that a combination herbal preparation containing dandelion may improve chronic pain associated with colitis. Because multiple herbs were used, and this study was not well-designed or reported, the effects of dandelion are not clear.
  • Avoid if allergic to chamomile, feverfew, honey, yarrow, or any related plants such as aster, daisies, sunflower, chrysanthemum, mugwort, ragweed, or ragwort. Use cautiously with diabetes or bleeding disorders, gastroesophageal reflux disease (GERD), kidney or liver diseases, or a history of stroke or electrolyte disorders. Potassium blood levels should be monitored. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures. Avoid if pregnant or breastfeeding.
  • DHEA: Initial research reports have shown that DHEA (dehydroepiandrosterone) supplements are safe for short-term use in patients with Crohn's disease. Preliminary research suggests possible beneficial effects, although further research is necessary before a clear conclusion can be drawn.
  • Avoid if allergic to DHEA products. Avoid if pregnant or breastfeeding because DHEA is a hormone.
  • Gamma linolenic acid (GLA): Clinical study suggests that a combination of GLA plus eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) does not prolong the period of disease remission in ulcerative colitis. Further well-designed clinical trials are required in this area before recommendations can be made.
  • GLA is generally considered nontoxic and well tolerated for up to 18 months. Avoid if pregnant or breastfeeding due to insufficient evidence.
  • Glucosamine: Preliminary research reports improvements with N-acetyl glucosamine as an added therapy in inflammatory bowel disease. Further scientific evidence is necessary before a recommendation can be made. Avoid if allergic to shellfish or iodine. In most human studies, glucosamine sulfate has been well tolerated for 30 to 90 days. Avoid if pregnant or breastfeeding.
  • Lemon balm: Limited clinical evidence is available supporting the use of lemon balm for the treatment of chronic colitis. Based on available research, lemon balm taken by mouth has been reported to be relatively well tolerated when taken for up to eight weeks.
  • Avoid if allergic or hypersensitive to lemon balm. Avoid with Grave's disease or thyroid hormone replacement therapy. Use cautiously in glaucoma because lemon balm may increase eye pressure. Use caution when operating heavy machinery. Lemon balm preparations may contain trace amounts of lead. Avoid if pregnant or breastfeeding.
  • Melatonin: Based on preliminary study, melatonin may be a promising therapeutic agent for irritable bowel disease. Further research is needed before a recommendation can be made.
  • Case reports raise concerns about risks of blood clotting abnormalities (particularly in patients taking warfarin), increased risk of seizure, and disorientation with melatonin overdose. Melatonin supplementation should be avoided in women who are pregnant or attempting to become pregnant, based on possible hormonal effects. High levels of melatonin during pregnancy may increase the risk of developmental disorders.
  • Moxibustion: Moxibustion is a healing technique employed across the diverse traditions of acupuncture and oriental medicine for over 2,000 years. Moxibustion uses the principle of heat to stimulate circulation and break up congestion or stagnation of blood and chi. Moxibustion is closely related to acupuncture as it is applied to specific acupuncture points. Evidence from several small studies suggests that moxibustion with acupuncture may have potential in treatment of colitis and Crohn's disease. However, there is insufficient evidence on which to base concrete recommendations at this time.
  • Use cautiously over large blood vessels and thin or weak skin. Avoid with aneurysms, any kind of "heat syndrome," cardiac disease, convulsions or cramps, diabetic neuropathy, extreme fatigue and/or anemia, fever, inflammatory conditions, over allergic skin conditions or ulcerated sores, or skin adhesions. Avoid if pregnant or breastfeeding. Avoid areas with an inflamed organ, contraindicated acupuncture points, face, genitals, head, inflamed areas in general, nipples, and skin adhesions. Avoid in patients who have just finished exercising or taking a hot bath or shower.
  • Omega-3 fatty acids: It has been suggested that effects of omega-3 fatty acids on inflammation may be beneficial in patients with ulcerative colitis or Crohn's disease when added to standard therapy, and several studies have been conducted in this area. Better research is necessary before a clear conclusion can be drawn.
  • Avoid if allergic to fish. The U.S. Food and Drug Administration classifies low intake of omega-3 fatty acids from fish as GRAS (Generally Regarded as Safe). Caution may be warranted, however, in diabetic patients due to potential (albeit unlikely) increases in blood sugar levels, patients at risk of bleeding, or in those with high levels of low-density lipoprotein (LDL). Fish meat may contain methylmercury, and caution is warranted in young children and pregnant/breastfeeding women.
  • Probiotics: There is not enough evidence on which to form conclusions for the use of probiotics in collagenous colitis or inflammatory bowel disease. Study results are mixed. Saccharomyces boulardii, E. coli Nissle, probiotics, yogurt, and high doses of probiotics have shown the most promise. More research is needed.
  • Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.
  • Psychotherapy: Psychotherapy may not improve the course of Crohn's disease, although patients undergoing psychotherapy tended to have fewer operations and relapses. More research is needed in this area.
  • Not all therapists are sufficiently qualified to work with all problems. The client or patient should seek referrals from trusted sources and should also inquire of the practitioner's training and background before committing to work with a particular therapist. Some forms of psychotherapy evoke strong emotional feelings and expression. This can be disturbing for people with serious mental illness or some medical conditions.
  • Psyllium: There is limited and unclear evidence regarding the use of psyllium in patients with inflammatory bowel disease.
  • Serious allergic reactions including anaphylaxis, difficulty breathing/wheezing, skin rash, and hives have been reported after ingestion of psyllium products. Less severe hypersensitivity reactions have also been noted. Cross-sensitivity may occur in people with allergy to English plantain pollen (Plantago lanceolata), grass pollen, or melon. Psyllium appears to be safe during pregnancy and breastfeeding.
  • Relaxation therapy: Early research in humans suggests that relaxation may aid in the prevention and relief of irritable bowel disease symptoms. Large, well-designed trials are needed to confirm these results.
  • Avoid with psychiatric disorders such as schizophrenia/psychosis. Jacobson relaxation (flexing specific muscles, holding that position, then relaxing the muscles) should be used cautiously with illnesses such as heart disease, high blood pressure, or musculoskeletal injury. Relaxation therapy is not recommended as the sole treatment approach for potentially serious medical conditions and should not delay the time to diagnosis or treatment with more proven techniques.
  • Saccharomyces boulardii: Early evidence supports mild improvement of symptoms and quality of life in patients with Crohn's disease who use Saccharomyces boulardii, although studies have been small. More clinical trials are required before recommendations can be made.
  • Avoid if allergic to yeast, Saccharomyces boulardii, Saccharomyces cerevisiae, or other species in the Saccharomycetaceae family. Saccharomyces boulardii has been generally well tolerated in human studies for up to 15 months. However, Saccharomyces boulardii fungemia does occur. Multiple case reports describe fungemia in patients taking Saccharomyces boulardii. Avoid if pregnant or breastfeeding.
  • Soy: Due to limited human study, there is not enough evidence to recommend for or against the use of soy as a therapy in preventing Crohn's disease. Further research is needed before a recommendation can be made.
  • Soy can act as a food allergen similar to milk, eggs, peanuts, fish, and wheat. Soy has been a dietary staple in many countries for over 5,000 years, and is generally regarded as not having significant long-term toxicity. Limited side effects have been reported in infants, children, and adults aside from allergic reactions. Soy as a part of the regular diet is traditionally considered to be safe during pregnancy and breastfeeding, although scientific research is limited in these areas.
  • Thiamin (vitamin B1): Decreased serum thiamine levels have been reported in patients with Crohn's disease. It is not clear if routine thiamin supplementation is beneficial in such patients generally.
  • Allergic reactions to thiamin supplements are rare. A small number of life-threatening anaphylactic reactions have been observed with large parenteral (intravenous, intramuscular, subcutaneous) doses of thiamin, generally after multiple doses. Thiamin is generally considered safe and relatively nontoxic, even at high doses. Thiamin appears to be safe at recommended doses during pregnancy and breastfeeding.
  • Wheatgrass: Clinical study reported potential benefits of wheatgrass in the treatment of ulcerative colitis. However, further research is needed to confirm these findings.
  • Wheatgrass is generally considered safe, but should be avoided in patients who are allergic to it. Because it is grown in soils or water and consumed raw, wheatgrass may be contaminated with bacteria, molds or other substances. Because it is grown in soils or water and consumed raw, wheatgrass may be contaminated with bacteria, molds or other substances. Theoretically, women who are pregnant or breastfeeding should use wheatgrass cautiously.
  • Zinc: Preliminary research of zinc supplements in patients with Crohn's disease has yielded positive results. Well-designed clinical trials are needed to confirm these results.
  • Zinc is regarded as a relatively safe and generally well tolerated when taken at recommended doses, and few studies report side effects. Occasionally adverse affects such as nausea, vomiting, or diarrhea has been observed. Zinc acetate should only be used during pregnancy if clearly needed. Zinc appears to be safe in amounts that do not exceed the established tolerable upper intake level. Zinc chloride should be given to a pregnant woman only if clearly needed under medical supervision.
  • Fair negative scientific evidence:
  • Zinc: Early studies have found that zinc supplementation does not seem to improve inflammatory bowel disease.
  • Zinc is regarded as a relatively safe and generally well tolerated when taken at recommended doses, and few studies report side effects. Occasionally adverse affects such as nausea, vomiting, or diarrhea has been observed. Zinc acetate should only be used during pregnancy if clearly needed. Zinc appears to be safe in amounts that do not exceed the established tolerable upper intake level. Zinc chloride should be given to a pregnant woman only if clearly needed under medical supervision.

Prevention
  • Since the cause of IBD is unknown, there is currently no known method of prevention.
  • Individuals who are diagnosed with IBD should consult their qualified healthcare providers before becoming pregnant or fathering a child. Some IBD medications have the potential to cause birth defects or may be passed to the infant during breastfeeding. Active IBD increases the risk of fetal death or premature labor.
  • Individuals who are diagnosed with IBD should consult their gastroenterologists regularly to monitor the condition and prevent complications.

Complications
  • Anal fissure: An anal fissure is a cleft in the anus or in the skin around the anus where infection may occur. This is commonly associated with painful bowel movements.
  • Fistulas: Ulcers may extend through the intestinal wall, creating a fistula (an abnormal opening). If an internal fistula develops, food may not reach the area of the intestine involved in absorption. External fistulas may result in continuous bowel drainage onto the skin. Fistulas may also become infected, a condition that can be life threatening, if left untreated.
  • Malnutrition: Diarrhea, abdominal pain and cramping may make it difficult to eat. The body may not be able to consume a sufficient amount of nutrients.
  • Obstruction: Individual's who have Crohn's disease may experience blockage in the intestine. Food contents may become lodged in areas of the intestine that are inflamed. Some cases may require surgery to remove the diseased portion of the gastrointestinal tract.
  • Toxic megacolon: Toxic megacolon is a rare, but potentially life-threatening complication of severe IBD. Toxic megacolon is characterized by a dilated colon (megacolon), abdominal distension (bloating), and occasionally fever, abdominal pain or shock. In severe cases, the condition may cause the colon to become paralyzed. Toxic megacolon prevents the individual from having bowel movements. If the condition is not treated, the colon may rupture, resulting in peritonitis, a life-threatening condition that requires emergency surgery.
  • Ulcers: Ulcers (open sores) may develop anywhere there is chronic inflammation in the gastrointestinal tract, including the mouth or anus.
  • Other: Many individuals who have had long-standing Crohn's disease may develop osteoporosis (weak, brittle bones). Researchers speculate that this may be related to low levels of vitamin K, which is involved in binding calcium to bone.

Crohn's disease
  • Dr. Burill B. Crohn and two of his colleagues, Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer, discovered Crohn's disease in 1932. Crohn's disease is a chronic disorder, which causes inflammation of the gastrointestinal tract.
  • Although it can cause inflammation in any area of the gastrointestinal tract from the mouth to the anus, it most commonly affects the ileum (small intestine) and/or colon.
  • Unlike ulcerative colitis, Crohn's disease may affect any layer of the intestine, and it often spreads deep into the layers of affected tissues. Also unlike ulcerative colitis, the inflammation is not consistent throughout the bowel. There may be healthy bowel (tissue/mucosa) in between areas of diseased bowel.
  • An estimated 500,000 Americans have Crohn's disease, which may develop at any age.

Ulcerative colitis
  • Ulcerative colitis is different from Crohn's disease because inflammation is limited to only the colon. Also, ulcerative colitis only affects the superficial layers (the mucosa) of the colon. With more than 500,000 Americans living with ulcerative colitis, the condition is slightly more prevalent than Crohn's disease. However, it is sometimes difficult to differentiate between the two diseases. Also, the early stages of Crohn's disease may be mistaken for ulcerative colitis because the disease starts in the colon and progresses throughout the gastrointestinal tract.
  • Ulcerative colitis may develop at any age.

Ibd and colon cancer
  • Individuals who have IBD are more likely to develop colon cancer, even if the condition is managed with treatment. The risk of colon cancer is related to the extent and duration of disease, not its activity. The risk is the greatest among individuals who have had IBD for more than eight years, and if it has spread throughout the entire colon. Despite the increased risk, more than 90% of individuals with IBD do not develop cancer.
  • Individuals who have had IBD for more than eight years should visit a gastroenterologist at least once a year. Regular colonoscopies may also be recommended.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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