Information » Diseases » IBD - Crohn’s and ulcerative colitis
It is estimated that these disorders affect 170,000 Canadians. Their impact on everyday living is major and the health problems they can cause are serious. Although there are differences between the two, they share a lot in common and are likely related. The basic problem in both is that the immune system has gone awry, and begins to attack the tissues lining the intestine itself. This is why they are called autoimmune diseases.
Conventional wisdom holds that there is no known cause or cure, but as you will see, there are clues that can guide a knowledgeable doctor to good treatments. There are many rational therapies that make scientific sense and are supported by some clinical evidence. While many people with IBD or inflammatory bowel disease – as these conditions are called – have only mild symptoms, others are not so fortunate. Treatments can be toxic and have serious side effects, so it is important to consider all your options.
While it is clear that the immune system is the problem in virtually every case, there are many ways this can happen. Twin studies have confirmed a genetic link – found on chromosome 12 and 16 – and 1 in 6 patients have a family member who is affected. There is not much you can do about your genes, but they are only part of the story.
IBD is more common at higher latitudes, which makes sense now that we know about the critical role of vitamin D on the immune system. A recent study from Boston reported that over 35% of children and young adults have vitamin D deficiency.1 Supplementing with vitamin D has been shown to prevent multiple sclerosis, diabetes and many other autoimmune diseases. Because it is safe, cheap and deficiency is so common, we recommend that all our patients take 2000 units of vitamin D3 per day – and blood tests identify those who need more.
Damage to the lining of the gut is an important trigger for the disease, probably allowing bacteria to cross a barrier that normally keeps them contained in the gut and not inside the body. This is supported by the fact that anti-inflammatory drugs, which are very toxic to the intestinal lining, can trigger disease flares.
The role of bacteria in this process is critical. Mice with germ-free intestines never develop colitis. Some studies have shown benefits with antibiotics, but probiotics are likely to be far more important. Many studies suggest that probiotics can keep improve symptoms, maintain remission and even trigger remission.2 This is because good bacteria not only maintain the health of the gut, they affect the entire immune system. Seventy percent of your immune cells are attached to your gut.
The central role of the immune system has been the basis for almost every medical treatment for IBD. Asacol and other pills affect prostaglandins, which are like the soldiers of the immune system – they are everywhere. Corticosteroid drugs like prednisone are even more potent – they can seem miraculous in the short-term, but their legendary harmful side effects make them a treatment of last resort.
The big news for sufferers of ulcerative colitis in recent years has been infliximab, an ultra-expensive intravenous therapy that has demonstrated impressive results. They were studied in large clinical trials, where three treatments were given over six weeks. After one year, 45% of patients were in remission as compared to 20% of patients given placebo.3 The cost is several thousand dollars, but this is an excellent option for some patients.
Much more exciting, however, is a little-known therapy that is gaining huge momentum in the treatment of IBD and other autoimmune diseases. It is called naltrexone, and it was used to treat heroin addiction in the 1970s because it affects endorphins. Because of the known link between endorphins and the immune system, it has become enormously popular among a small group of doctors in the know. Recently, a small study of seventeen Crohn’s sufferers showed that 67% went into remission after twelve weeks of therapy.4 Not bad for a therapy that costs pennies a day and is almost completely without side effects.
There is another clue that comes from the timing of the illness. It tends to strike at times when hormone levels are at their peak – in the teenage years and at menopause (or andropause). This, combined with the fact that women are more affected than men, points to hormones as a clue. Many men and women suffer from hormone imbalances that can be safely treated with bio-identical hormone therapies.
Diet is a big concern for most people with IBD, and the standard recommendation is that there is no standard ‘best diet’ to be on. While this is true, there are definitely some things you should do to find out what you should and should not eat. This is just one part of a concerted effort apart from treating the immune system – an effort to heal the gut. Many of these strategies are also used to treat irritable bowel syndrome:
The final piece of the puzzle may be the most important for some patients. If the immune system is not working properly, the reason may be a chronic infection. Although no single organism has been linked to IBD, many have been implicated in this and other autoimmune diseases. If you experience occasional fevers, joint pains or chills for no apparent reason, it is a reason to suspect chronic infection.
Although it is controversial, we and many other clinics have had excellent results with intravenous hydrogen peroxide. This delivers oxygen to tissues, which kills viruses and other pathogens. It is similar to other oxidative therapies like hyperbaric oxygen and ozone therapy, and for some patients it can treat the root cause of the problem.
These strategies are given virtually no attention in the mainstream medical literature, but they are a critical part of any strategy to treat Crohn’s disease and ulcerative colitis. These are not usually lethal diseases, but they affect quality of life – this is what you will gain with an integrative approach.