Crohn's Disease

Crohns disease is a disease of the bowel that is closely related to ulcerative colitis. The two are grouped in a category called inflammatory bowel disease (IBD), because they both involve inflammation of the digestive tract.

The major symptoms of Crohns disease include fever, non-bloody or (less frequently) bloody diarrhea, abdominal pain, and fatigue. The rectum may be severely affected, leading to fissures, abscesses, and fistulas (hollow passages). Intestinal obstruction can occur, and over time fistulas may develop in the small bowel. Other complications include gallstones, increased risk of cancer in the small bowel and colon, and pain in or just below the stomach that mimics the pain of an ulcer. Arthritis, skin sores, and liver problems may develop as well.

Crohns disease tends to wax and wane, with periods of remission punctuated by severe flare-ups. Medical treatment aims at reducing symptoms and inducing and maintaining remission.

Sulfasalazine is one of the most commonly used medications for Crohns disease. Given either orally or as an enema, it can both decrease symptoms and prevent recurrences. Corticosteroids such as prednisone are used similarly, sometimes combined with immunosuppressive drugs such as azathioprine. In severe cases, partial removal of the bowel may be necessary.

Another approach involves putting individuals with Crohns disease on an elemental diet. This involves special formulas consisting of required nutrients but no whole foods. Sometimes, after a period on such a diet, whole foods can be restarted one at a time.

Principal Proposed Treatments for Crohns Disease:

Individuals with Crohns disease can easily develop deficiencies in numerous nutrients. Malabsorption, decreased appetite, drug side effects, and increased nutrient loss through the stool may lead to mild or profound deficiencies of protein, vitamins A, B12, C, D, E, and K, folate, calcium, copper, magnesium, selenium, and zinc. Supplementation to restore adequate body supplies of these nutrients is highly advisable, and may improve specific symptoms as well as overall health. We recommend working closely with your physician to identify any nutrient deficiencies and to evaluate the success of supplementation to correct them.

Other Proposed Treatments for Crohns Disease:

A 1-year double-blind trial involving 78 participants with Crohns disease in remission who were at high risk for relapse found that fish oil supplements helped keep the disease from flaring up. However, a double-blind placebo-controlled trial that followed 120 individuals for 1 year found that fish oil did not reduce the relapse rate as compared to placebo. Negative results were also seen in a smaller double-blind trial.

Glutamine has been suggested as a treatment for Crohns disease, as have probiotics, but as yet the evidence that either works is highly preliminary at best.

Finally, food allergies might play a role in Crohns disease.