|
|
|
Description
Ulcerative colitis , properly, is confined to chronic inflammation and ulceration of the lining of the descending colon and rectum.
Crohn's disease is a chronic inflammatory disease which may affect any part of the digestive tract but usually the junction of the small and large intestines. It usually involves the last part of the small intestine (ileum). The intestinal wall thickens and ulcers may form. The damaged portion may be surgically removed. (Unfortunately, the recurrence rate is high.)
Causes
It may represent an allergic reaction, including infectious agents. Some patients find that certain foods exacerbate their symptoms.
Signs & Symptoms
In young people the ileum is usually involved, causing pain and malabsorption. In the elderly, the rectum is typically involved, producing bleeding. Both groups may develop fissures and fistulas. If the colon is involved there may also be bloody diarrhea.
Abscesses may form and infection is an ever-present threat, especially if perforation occurs. Other complications include severe arthritis (ankylosing spondylitis) and skin disorders (eczema).
A bowel resection for Crohn's disease is the most common reason why patients have a short bowel.
Patients with Crohn’s disease also have a high prevalence of gallstones.
Nutritional Supplements
Structure & Function: Intestinal Health
---------------------------------
General Supplements
---------------------------------
| Bee Propolis | |
| Calcium* | 200 - 600 mg |
| Fish oil* | 4 - 10 gm |
| Folic acid* | 400 - 1,000 mcg |
| Iron* | 10 - 20 mg |
| Magnesium* | 400 - 800 mg |
| Pantothenic acid* | 5 mg |
| Vitamin A* | 10,000 iu |
| Vitamin E* | 200 - 400 iu |
| Vitamin K* | 200 - 600 iu |
| Zinc* | 10 - 20 mg |
* Please refer to the respective topic for specific nutrient amounts.
Note:
All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.
Discussion:
Caffeic acid esters, present in the propolis of honey bee hives, are potent inhibitors of human colon tumor cell growth, suggesting that these compounds may possess antitumor activity against colon carcinogenesis.
Dietary Considerations
Since the early 1970s there has been considerable debate over the role of nutritional support in the treatment of patients with acute inflammatory bowel disease. Therapies can, therefore, be rather novel and contradictory: it is fairly standard to recommend a high vitamin, low fiber diet; another protocol involves high fiber but low sugar.
Even when an elemental diet is incorporated, one study suggests that the beneficial action is not due to an improvement in nutritional status. In another study, a whole protein containing diet proved less effective than one in which food antigens were excluded, suggesting food antigens as the central mechanism.
Overall, it seems safe to anticipate that a combination of factors contributes to the efficacy of nutritional protocols: decreased antigenic exposure, improved immune function, and provision of essential nutrients and calories needed for bowel regeneration.
Nutritional support has been primarily used pre- and post-operation and as an adjunct to drug therapy (corticosteroids and antiobitoics). Conflicting results have been reported in the literature, whereby both corticosteroids are more effective and elemental diet is as effective as corticosteroid treatment but most patients relapse soon after resumption of a normal diet.
Emphasis, then, needs to be in long-term remission.
Recent studies in adults, with some confirmation for the same benefit in children, have shown that polymeric (whole protein) diets are as effective as semi-elemental and elemental formulae for the induction of remission in small bowel Crohn's disease. Whole protein diets are more palatable and cheaper. Other forms of protein have also been used successfully, including: hydrolysed protein and amino acids.
Noted deficiencies include: essential fatty acids, vitamin D and selenium.
Recommended vitamins have included: folic acid, riboflavin, thiamine, vitamin A, vitamin B6, vitamin B12, vitamin C, vitamin D and vitamin K.
Recommended minerals have included: calcium, iron, magnesium, selenium and zinc.
From the outset, it is important to rule out food sensitivities. Food sensitivities tend to follow familiar paths, including: milk, wheat and soy. Nuts, raw fruit and tomatoes have also been implicated so it is dangerous to generalize. Patterns also vary according to whether patients have an ileostomy, or not.
At a basic level, it seems prudent to exclude foods which disagree with a patient, however, some authorities dismiss food sensitivities as being too variable, often do not persist, and not worth putting the patients through, with possible individual exceptions.
One study from Peru reports a related technique, whereby the bowel is cleansed: the standard method of liquid diet and enemas, or with the oral administration of saline solution 9% for optimal results.
One popular hypothesis remains that: macromolecular absorption of food and microbial antigens (which is enhanced in the intestine under pathological conditions) is the cause of Crohn’s and other pathological diseases of the bowel.
Homeopathic Remedy
The emphasis is on detoxification and major symptoms like diarrhea.
Arsenicum Album
Chamomilla tinct.
Ipecacuanha
Nux vomica
Podophyllum pancreatic involvement
Treatment Schedule
Over-the-counter homeopathic remedies may be single strength (of fairly weak potency e.g. 6X) or a blend of several weaker strengths (6X, 8X, 10X).
This may comprise a single remedy, or several remedies.
Doses are administered on a 3 times daily (tid), between meals,schedule and continued for 3 days.
Liquid preparations usually use 8-10 drops per dose.
Solid preparations are usually 2 or 3 pellets per dose.
Children use 1/2 dose i.e. 1 pellet.
If there is aggravation of the symptoms, stop taking the remedy and consult a homeopath.
References
Murphy, R. : Homeopathic Medical Repertory. Hahneman Academy, Pagosa Springs, Colorado. 1993.
Murphy, R. : Lotus Materia Medica. Hahneman Academy, Pagosa Springs, Colorado. 1995.
Pert, J.C.: Homeopathy for the Family. The Homoeopathic Development Foundation, London. 1985 edition.
Herbal Approaches
----------
Herbs
-----------
Aloe vera
Lobelia
Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.
Aromatherapy - Essential Oils
Colitis:
Intestinal spasm:
Related Health Conditions
Cancer
Gallstones
Hemorrhoids
Inflammatory bowel disease
Irritable bowel syndrome
Irritable colon syndrome
Spastic colon
Irritable bowel syndrome, Irritable colon syndrome and Spastic colon are synonymous terms.
References
Baum, C.L. et al: Antifolate actions of sulfasalazine on intact lymphocytes. J. Lab. Clin. Med. 1981, 97(6): 779-784.
Beattie-RM & Walker-Smith-JA Treatment of active Crohn's disease by exclusion diet. J-Pediatr-Gastroenterol-Nutr. 1994 Jul; 19(1): 135-6.
Beattie-RM et al: Polymeric nutrition as the primary therapy in children with small bowel Crohn's disease. Aliment-Pharmacol-Ther. 1994 Dec; 8(6): 609-15.
Belluzzi-A et al: Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Dig-Dis-Sci. 1994 Dec; 39(12): 2589-94.
Bennett, J.D.: Use of a-tocopherylquinone in the treatment of ulcerative colitis. Gut, 1986, 27: 695-697.
Bowling-TE: Inflammatory bowel disease. Eur-J-Gastroenterol-Hepatol. 1995 Jun; 7(6): 521-7.
Brignola, C. Et al: Dietary allergy evaluated by PRIST and RAST in inflammatory bowel disease. Hepatogastroeneterology, 1986, 33(3): 128-130.
Carruthers, L.B.: Chronic diarrhea treated with folic acid. Lancet, 1946, 1: 849.
Celestino-A et al: [Colonoscopic diagnosis (published erratum appears in Rev Gastroenterol Peru 1994 Sep-Dec;14(3):247)]. Rev-Gastroenterol-Peru. 1994 May-Aug; 14(2): 115-22.
Cosnes-J et al: Effects of cigarette smoking on the long-term course of Crohn's disease. Gastroenterology. 1996 Feb; 110(2): 424-31.
Dibble, J.B. et al: A survey of vitamin D deficiency in gastrointestinal and liver disorders. Quart. J. Med. 1984, 53: 119 - 134.
Dronfield, M.W. et al: Zinc in ulcerative colitis: a therapeutic trial and report on plasma levels. Gut, 1977, 18(1): 33-36.
Ellestad-Sayed, J.J. et al: Pantothenic acid, coenzyme A, and human chronic ulcerative and granulomatous colitis. Am. J. Clin. Nutr. 1976, 29: 133-1338.
Elsborg, L. & Larsen, L.: Folate deficiency in chronic inflammatory bowel disease. Scand. J. Gastroenterol. 1979,14: 1019 - 1024.
Elsborg, L. & Larsen, L.: Folate deficiency in chronic inflammatory bowel disease. Scand. J. Gastroenterol. 1979, 14: 1019-1024.
Elsborg, L.: Vitamin B12 and folic acid in Crohn’s disease. Dan. Med. Bull. 1982,29(7): 362 - 365.
Fernandez-Banares-F et al: How effective is enteral nutrition in inducing clinical remission in active Crohn's disease? A meta-analysis of the randomized clinical trials. JPEN-J-Parenter-Enteral-Nutr. 1995 Sep-Oct; 19(5): 356-64.
Frieri, M. Et al: Preliminary investigation on humoral and cellular immune responses to selected food proteins in patients with Crohn’s disease. Ann. Allergy, 1990, 64: 345 - 351.
Fukuda-Y et al: Efficacy of nutritional therapy for active Crohn's disease. J-Gastroenterol. 1995 Nov; 30 Suppl 8: 83-7.
Galland, L.: Magnesium and inflammatory bowel disease. Magnesium, 1988,7(2): 78 - 83.
Gardiner-KR et al: Enteral and parenteral anti-endotoxin treatment in experimental colitis. Hepatogastroenterology. 1994 Dec; 41(6): 554-8.
Giaffer, M.H. et al: Controlled trial of polymeric versus elemental diet in treatment of active Crohn’s disease. Lancet, 1990, 1: 816 - 819.
Gmoshinskii-IV & Mazo-VK : [Disordered permeability of the gastrointestinal tract barrier for macromolecules and the possibilities for its experimental dietetic correction]. Fiziol-Zh-Im-I-M-Sechenova. 1993 Jun; 79(6): 115-27.
Griffiths-AM et al: Meta-analysis of enteral nutrition as a primary treatment of active Crohn's disease. Gastroenterology. 1995 Apr; 108(4): 1056-67.
Grimes, D.S.: Refined carbohydrate, smooth-muscle spasm and disease of the colon. Lancet, 1976, 1: 395-397.
Harig, J.M. et al: Treatment of diversion colitis with short-chain-fatty acid irrigation. NEJM. 1989, 320: 23-38.
Harries, A.D. & Heatley, R.V.: Nutritional disturbances in Crohn’s disease. Postgrad. Med. J. 1983,50: 690 - 697.
Harries, A.D. et al: Controlled trial of supplemented oral nutrition in Crohn’s disease. Lancet, 1983,1: 8330.
Heaton, K.W. et al: Treatment of Crohn’s disease with an unrefined-carbohydrate, fibre-rich diet. BMJ 1979,2: 764 - 766.
Hendricks, K.M. & Walker, W.A.: Zinc deficiency in inflammatory bowel disease. Nutr. Rev. 1988, 46(12): 401 - 408.
Hendricks-KM et al: Dietary intake of adolescents with Crohn's disease. J-Am-Diet-Assoc. 1994 Apr; 94(4): 441-4.
Hodges, P. Et al: Vitamin and iron intake in patients with Crohn’s disease. J.A.D.A. 1984,84(1): 52 - 58.
Hodgson, H.J.F.: Inflammatory bowel disease and food intolerance. J. Royal College Physicians(London): 1986,20(1): 45 - 48.
Hood, R.P.: Nonspecific ulcerative colitis: successful treatment with D-alpha tocopherol. Dig. Chiropractic Ec. 1984 (Sept-Oct).
Hughes, R.G. & Williams, N.: Leukocyte ascorbic acid in Crohn’s disease. Digestion. 1978,17:272.
Jewell, D.P. & Truelove, S.C.: Circulating antibodies to cow’s milk in ulcerative colitis. Gut, 1972, 13: 796.
Jones, V.A. et al: Crohn’s disease: Maintenance of remission by diet. Lancet, 1985, 2: 177-180.
Koga-H et al: [Long-term efficacy of low residue diet for the maintenance of remission in patients with Crohn's disease]. Nippon-Shokakibyo-Gakkai-Zasshi. 1993 Nov; 90(11): 2882-8.
Krasinski, S.D. et al: The prevalence of vitamin K deficiency in chronic gastrointestinal disorders. Am. J. Clin. Nutr. 1985, 41(3): 639 - 643.
Kruis, W. Et al: Influence of diets high and low in refined sugar on stool qualities, gastrointestinal transit time and fecal bile acid excretion. Gastroenterology, 1987, 92: 1483.
Lauritsen, K. Et al: Does vitamin E supplementation modulate in vivo arachidonate metabolism in human inflammation? Pharmacol. Toxicol. 1987, 61(4): 246-249.
Leo, S. Et al: Ulcerative colitis in remission: is it possible to predict the risk of relapse? Digestion, 1989, 44(4): 217-221.
Levo, Y. Et al: Serum IgE levels in patients with inflammatory bowel disease. Ann. Allergy, 1986, 56(1): 85-87.
Levy-JB et al: Selenium deficiency, reversible cardiomyopathy and short-term intravenous feeding [see comments]. Postgrad-Med-J. 1994 Mar; 70(821): 235-6.
Lewis-JD & Fisher-RL: Nutrition support in inflammatory bowel disease. Med-Clin-North-Am. 1994 Nov; 78(6): 1443-56.
Lorenz, R. Et al: Supplementation with n-3 fatty acids from fish oil in chronic inflammatory bowel disease: a randomized, placebo-controlled, double-blind cross-over trial. J. Intern. Med. Suppl. 1989, 225(731): 225-232.
Main, A.N.H. et al: Vitamin A deficiency in Crohn’s disease. Gut, 1983,24(12): 1169 - 1175.
Mansfield-JC et al: Controlled trial of oligopeptide versus amino acid diet in treatment of active Crohn's disease. Gut. 1995 Jan; 36(1): 60-6.
Matsui-T et al: Indications and options of nutritional treatment for Crohn's disease. A comparison of elemental and polymeric diets. J-Gastroenterol. 1995 Nov; 30 Suppl 8: 95-7.
McDonald, P.J. & Fazio, V.W.: What can Crohn’s patients eat? Eur. J. Clin. Nutr. 1988,42: 703 - 708.
Page, R.C. & Bercovitz, Z.: The absorption of vitamin A in chronic ulcerative colitis. Am. J. Dig. Dis. 1943, 10: 174-177.
Park, R.H.R. et al: Double blind trial comparing elemental and polymeric diet as primary therapy for active Crohn’s disease. Gut, 1988, 30: A1453 - 1454.
Pearson-M et al: Food intolerance and Crohn's disease [see comments]. Gut. 1993 Jun; 34(6): 783-7.
Penny, W.J. et al: Relationship between trace elements, sugar consumption and taste in Crohn’s disease. Gut, 1983, 24(4): 288 - 292.
Prudden, J.F. & Balassa, L.L.: The biological activity of bovine cartilage preparations. Semin. Arthritis Rheum. 1974, 3(4): 287-321.
Riordan-AM et al: Treatment of active Crohn's disease by exclusion diet: East Anglian multicentre controlled trial [see comments]. Lancet. 1993 Nov 6; 342(8880): 1131-4.
Roediger, W.E.: Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man. Gut, 1980, 21: 793-798.
Roediger, W.E.: The colonic epithelium in ulcerative colitis: an energy-deficiency disease? Lancet, 1980, 2: 712-715.
Rosenberg, I.H. et al: Nutritional aspects of inflammatory bowel disease. Ann. Rev,. Nutr. 1985, 5: 463 - 484.
Ruuska-T et al: Exclusive whole protein enteral diet versus prednisolone in the treatment of acute Crohn's disease in children. J-Pediatr-Gastroenterol-Nutr. 1994 Aug; 19(2): 175-80.
Salomon, P. Et al: Treatment of ulcerative colitis with fish oil in n-3-omega fatty acid: an open trial. J. Clin. Gastroenterol. 1990, 12(2): 157-161.
Sanderson, I. R. Et al: Remission induced by an elemental diet in small bowel Crohn’s disease. Arch. Dis. Childhood. 1987, 62(2): 123 - 127.
Segal, I. et al: The rarity of ulcerative colitis in South African blacks. Am. J. Gastroenterol. 1980, 74(4): 332-336.
Siegel, J.: Inflammatory bowel disease: another possible facet of the allergic diathesis. An. Allergy, 1981, 47: 92-94.
Siguel-EN & Lerman-RH: Prevalence of essential fatty acid deficiency in patients with chronic gastrointestinal disorders. Metabolism. 1996 Jan; 45(1): 12-23.
Spiller, G.A. & Freeman, H.J.: Recent advances in dietary fiber and colorectal diseases. Am. J. Clin. Nutr. 1981, 34(6): 1145-1152.
Stolk-MF et al: Gallbladder motility and cholecystokinin release during long-term enteral nutrition in patients with Crohn's disease. Scand-J-Gastroenterol. 1994 Oct; 29(10): 934-9.
Teahon, K. Et al: Ten years’ experience with an elemental diet in the management of Crohn’s disease. Gut, 1990, 31: 1133 - 1137.
Teahon-K et al: Alterations in nutritional status and disease activity during treatment of Crohn's disease with elemental diet. Scand-J-Gastroenterol. 1995 Jan; 30(1): 54-60.
Teahon-K et al: Practical aspects of enteral nutrition in the management of Crohn's disease. JPEN-J-Parenter-Enteral-Nutr. 1995 Sep-Oct; 19(5): 365-8.
Thomas-AG et al: Dietary intake and nutritional treatment in childhood Crohn's disease. J-Pediatr-Gastroenterol-Nutr. 1993 Jul; 17(1): 75-81.
Thomas-AG et al: Selenium and glutathione peroxidase status in paediatric health and gastrointestinal disease. J-Pediatr-Gastroenterol-Nutr. 1994 Aug; 19(2): 213-9.
Vernia, P. Et al: Organic anions and the diarrhea of inflammatory bowel disease. Dig. Dis. Sci. 1988, 33: 1353-1358.
Vogelsang-H et al: Dietary vitamin D intake in patients with Crohn's disease. Wien-Klin-Wochenschr. 1995; 107(19): 578-81.
Wright, R. & Truelove, S.C.: A controlled therapeutic trial of various diets in ulcerative colitis. BMJ, 1965, 2: 138.
Wu-S & Craig-RM: Intense nutritional support in inflammatory bowel disease. Dig-Dis-Sci. 1995 Apr; 40(4): 843-52.
Zurita-VF et al: Nutritional support in inflammatory bowel disease. Dig-Dis. 1995 Mar-Apr; 13(2): 92-107.
| Signup Free Applied Health Journal |
||||
|
FREE Sample Issue Your email address is all we need to start you on a better path to health. We respect your privacy.
|