While drug therapies continue to be the mainstay of treating inflammatory bowel disease, natural and food remedies have an important role.
Scientific data support the use of a variety of natural substances in managing IBD and improving the quality of life for those suffering from inflammatory bowel disease. Before starting any natural remedy, it is generally a good idea to involve your physician.
What is Inflammatory Bowel Disease (IBD)?
Inflammatory Bowel Disease (IBD), a condition where the intestines become inflamed, consists of two major disorders: Ulcerative Colitis and Crohn’s Disease. These disorders have unique, but also some overlapping features.
Ulcerative Colitis is an inflammation limited to the large intestine (colon). It always involves the rectum and usually extends towards the mouth in a continuous fashion. It can affect part or the entire colon.
Crohn’s Disease causes inflammation of all layers in the intestinal wall and usually skips around. Crohn’s disease leads to scarring and blockage or obstruction of parts of the bowel.
Crohn’s can also result in sinus tracts that may penetrate through the intestine and even create fistulas that communicate to the outside of the body. 80% of Crohn’s patients have small bowel inflammation; 50% also have involvement of parts of the colon and 20% have disease only of the rectum.
Overall, about one third of Crohn’s patients have disease around the anus such as skin tags, fistula or abscess (pus pockets).
What are the symptoms of IBD?
- Intermittent rectal bleeding
- mucus discharge from rectum
- crampy abdominal pain
- skin tags and fistulas around anus
- growth failure in children
The lab findings for those suffering from IBD:
- elevated white blood count (WBC)
- anemia - low hemoglobin (oxygen carrying cells)
- elevation of inflammatory markers (ESR, CRP)
- vitamin and other nutrient deficiencies
- low albumin (protein)
How to Treat IBD?
As the goals of this treatment are to manage and control symptoms, decrease inflammation, ensure nutrition, monitor for complications, and improve quality of life, then a perfect way to effective IBD treatment will involve:
- drug therapy,
- alternative or complementary remedies from natural sources,
- some nutritional support, and
- supplementation with vitamins and minerals.
It is unlikely that using only ONE of the above approaches will provide the quality of life and treatment response patients need.
Drug Therapy for IBD
Anti inflammation drugs are often the first step in the inflammatory bowel disease treatment. They include:
- Sulfasalazine (Azulfidine).
- Mesalamine (Lialda, Asacol), olsalazine (Dipentum), and balsalazide (Colazal).
Immune system suppressors
These drugs work by acting on the immune system directly to decrease inflammation.
- Azathioprine (Imuran, Azasan) and mercaptopurine (Purinethol)
- Infliximab (Remicade)
- Cyclosporine (Neoral, Gengraf, Sandimmune)
Many of the prescribed medications listed above have the potential for serious consequences such as kidney damage, seizures, fatal infections, bone marrow suppression, inflammation of the liver & pancreas, increased risk of developing some types of cancer.
Complementary and Alternative Medicines for IBD
Complementary medicines are an important component to treatment as it is unlikely that targeting only one area (diet, risk factors, inflammation) or relying on a single prescription drug would result in adequate management of IBD.
This is when the anti-inflammatory medicines from natural sources can be very helpful in the treatment of Inflammatory Bowel Disease. Although they work through a variety of mechanisms, the overall goal is to decrease inflammation that in turn allows the body’s natural ability to heal itself take place. The end result is decreased symptoms and improved quality of life.
Here are some useful natural anti-inflammatories for treating this condition:
Aloe is one of the most widely used medicinal plants to treat IBD and other health concerns. Aloe Vera has been shown to reduce stomach acid production and also inhibit inflammation as well as promote healing within the G.I. tract.
Aloe Vera stimulates several types of cells (fibroblasts and collagen synthesis) to repair the damage caused by IBD.
A 2004 study showed benefit for the group of patients consuming 100ml of aloe vera gel twice a day. There do not appear to be any major side effects from aloe vera, however, excessive doses will cause diarrhea due to some of the laxative properties of aloe vera.
Potential drug interactions include: cisplatin, cyclophosphamide, methrotrexate, paclitaxel and docutaxel.
Tumeric / Curcumin
Another natural remedy includes the use of Tumeric, a spice, in cooking. Patients may also take 1-2 capsules daily as a supplement. Curcumin is the anti-oxidant extract and a major component of Tumeric. Through its chemical and anti-oxidant properties is to help maintain cardiovascular and colon health.
Derived from various plants and herbs from southern China, YunNan BaiYao (YNBY) is available in powder and capsule forms. This natural remedy promotes healing and decreases inflammation in the intestinal lining.
The mechanism of this potent herbal remedy is felt to be similar to many of the more toxic pharmaceuticals used to treat inflammatory bowel disease.
This is an Ayurvedic medicinal that has been used for hundreds of years due to its potent anti-inflammatory effects.
Boswellia serrata is essentially Indian frankincense and has shown positive effects in IBD and has been well studied as a promising alternative to NSAIDS. It has even demonstrated some anti-tumor properties in laboratory studies.
German research has noted that Boswellia serrata extract is among the top three alternative medical therapies used in that country to treat IBD. Acupuncture and probiotics were also high on the list of complimentary alternative medicines.
Another study noted that the gum resin of Boswellia serrata resulted in improvement in patients suffering from chronic colitis and also showed that it was comparable or better than drug therapy with sulfasalazine.
Nutritional support for patients with IBD has been shown to reduce inflammation, eliminate food triggers and improve overall functioning. Case studies regarding specific natural remedies and nutritional interventions maybe small, but the conclusions are highly valuable.
Proper nutrition through the consumption of whole foods and nutrients is felt to be the best option.
Probiotics are substances that promote the growth of healthy bacteria in the intestinal tract. Probiotic use has been shown particular promise in restoring normal intestinal bacteria and managing symptoms.
With the increased use of antibiotics in Western medicine, probiotic use has an increasing importance as an adjunct to treatment.
High Fiber Diet
Fiber has a beneficial effect on the normal gut bacteria. It also stimulates water and sodium absorption promotes healing of the intestinal lining. In fact, one study showed that diets high-fiber help maintain remission of IBD for 12 months compared to a low fiber control group.
Omega-3 Fatty Acids
Given the anti-factory effects of omega-3 fatty acids it is logical that this type of food will also be helpful in dealing with the inflammation occurring in IBD. Fish are natural sources of omega-3.
While the existing data does not clearly show omega-3 benefits IBD, we know that these are potent anti-inflammatory substances from fish oil. There’re plenty of studies showing that omega-3 supplementation reduces inflammation in general. While no clear-cut data showing benefit it is unlikely to cause harm.
Plant Based Diet
Plants contain potent substances that promote natural healing. One such substance is PEITC (phenethylisothiocyanate). This substance is found in cabbage, cauliflower, broccoli and watercress.
Land cress (Barbarea verna) is a commonly used herb in salads and soups that has been shown to have anti-cancer properties and has shown some benefit in IBD.
A growing body of evidence has linked certain types of carbohydrate to a variety of medical conditions and diseases. Foods can be rated on a glycemic index scale with those ranking higher on the scale having more negative health effects. There is evidence that low carbohydrate diets may also improve life functioning in patients with IBD.
Vitamins & Minerals Supplementation
Patients with IBD should have supplementation with vitamin D along with proper amounts of calcium. Levels of B12, folate, vitamin A, D and E, magnesium calcium phosphorus and zinc should be monitored.
Folate supplementation provides a protective effect against developing colorectal cancer in patients with ulcerative colitis.
Vitamin K is an important vitamin for the clotting system and bone density. Vitamin E is a free radical scavenger and very potent antioxidants that goes around the body preventing damage from harmful substances (free radicals).
Some caution is advised as the adage - “If a little is good, more is better” does not apply to some supplements. For example, medical researchers and doctors know that excessive vitamin E supplementation can have some negative health effects on the cardiovascular system.
Many patients with inflammatory bowel disease are anemic and iron supplementation may be necessary to promote the genesis of new red blood cells. Many nature foods and remedies contain iron and are beneficial in helping the body replace blood loss.
Physicians know that Zinc plays a key role in immune function. Patients with diarrhea and fistulas often loose excessive amounts of Zinc. There’s also data and several smaller studies that show Zinc supplementation is useful in controlling chronic diarrhea.
Calcium supplementation along with a multivitamin is essential. Specific micronutrients are often also required including folic acid.
- 9 to 18 years - 1300 mg daily
- Men and premenopausal women - 1000 mg daily
- Postmenopausal women and men older than 70 years - 1200 mg daily