If you’re looking for natural ways to treat IBD, this article will surely help you. Inflammatory bowel diseases (IBD) affects the patient’s quality of life. It affects the gastrointestinal tract.
IBD 101 (Crohn’s & Ulcerative Colitis)
Inflammatory Bowel Disease (IBD) is an autoimmune condition where body inappropriately attacks commensal bacteria (i.e. normal bacteria) in your gut microbiome and inflames the GI tract.
The two best known forms of IBD include Crohn’s and Ulcerative Colitis, and are characterized by altered gut bacteria, inflammation, and intestinal permeability (“leaky gut”).
Who Gets IBD?
It is estimated that only 1.3% of people (3-million) in the U.S. have the condition. The disease usually is diagnosed in people ages 15-35.However, given that gut disorders and pathologies often go undiagnosed for years (if not a lifetime), or people simply call gut issues, “IBS,” believing they are something they just need to “deal with,” it is likely that more people do struggle with this condition.
Symptoms of IBD
Symptoms of IBD vary, and are often more specific to the type of IBD you have. Some of them may include:
- Abdominal pain
- Loose stools/diarrhea
- Weight loss
- Lack of appetite
- Unwanted weight loss
- Rectal bleeding
- Rectal pain
- Bloating after meals
- Urgency to go #2
- Bloody diarrhea
- Abdominal cramps
- Bowel obstruction
- Intestinal and stomach ulcers
Other non-gut related symptoms may also include other symptoms associated with impaired gut health and autoimmune conditions including:
- Low white blood cell counts
- Fatigue or low energy
- Inflammation and “flares” with stress (such as mental stress, food triggers, weather changes, etc.)
- “High” total cholesterol (sign of inflammation)
- Other autoimmune conditions
- Mouth ulcers
- Skin conditions
- Arthritis and joint pain
- Mood disorders, anxiety, depression
- Loss of appetite
- Weight Loss
- Night sweats
- Loss of normal menstrual cycle
IBD Differences: Crohn’s vs. Colitis
Do you have Crohn’s Disease or Colitis?
The presentation of both conditions can seem similar, including , but the roots of the disease are different, along with a few key differences in symptoms.
Affects only the inner lining of the colon (the large intestine). People typically experience their abdominal pain confined to the left side of their abdomen
- Tend toward loose, urgent, and/or watery stools
- Persistent diarrhea accompanied by abdominal pain and blood in the stool
- Stool is generally bloody
- Crampy abdominal pain
Inflammation can appear anywhere in the digestive tract, from the mouth to the rear end. Crohn’s generally affects all the layers of the bowel walls (not just the inner lining). Disease sufferers may experience abdominal pain anywhere in the abdomen.
- Tend toward constipation
- Persistent diarrhea when they do “go”
- Rectal bleeding
- Urgent need to move bowels (“IBS” symptoms)
- Abdominal cramps and pain
- Sensation of incomplete evacuation
WHAT CAUSES IBD?
Conventional medicine states they don’t know what officially causes IBD, however, like other autoimmune conditions, IBD is a combination of stress (from environmental, lifestyle and diet factors) coupled with genetic predisposition and hereditary factors for the disease. (Fun fact: Genetics contribute to about 5-10% of all disease, and the rest is related to the exposome–external factors).
There is not one cause of IBD. Risk factors for IBD include:
- Genetic predisposition for autoimmunity and/or IBD
- Underlying gut pathology (bacterial overgrowth such as SIBO, fungal overgrowth, gut infection, etc.)
- Environmental toxin exposure (mold, heavy metals, chemicals in plastics, hygiene and cleaning products, fumes)
- Initial diagnosis of IBS and chronic IBD
- Low stomach acid
- Autoimmune conditions
- Western lifestyle (lifestyle factors such as smoking, diet, or pollution)
- Poor diet (conventional meats and dairy, packaged, sugar, artificial sweeteners, processed, trans-fats, industrial seed oils)
- History of antibiotic use
- Lack of fermentable fiber and probiotic foods in the diet
- Lack of food variety and nutrient deficiencies
- Surgical procedures
- Parasite exposure
- C-section and/or formula fed as a baby
- Long term medication use
- Ethnicity. (IBD is more common in whites of northern European decent and in the Ashkenazi Jewish population. These groups are more likely to have genes associated with IBD as well as live in industrialized areas).
- History anorexia
- From a functional medicine (whole body system’s) perspective, it’s imperative to view IBD similar to how we look at other diseases, particularly autoimmune disease, in functional medicine: IBD is an expression of the interaction between our genetics, health status/body and the “exposome” (our lifestyle and environment).
A collision of all of these, over times, leads to pathologies, like IBD and the symptoms that go along with it.
Your doctor may order various tests in order to make a diagnosis of IBD and help identify whether you have Crohn’s disease, ulcerative colitis, or indeterminate colitis (IC) if your symptoms indicate you may have IBD.
Tests fall into two categories, including:
Invasive—performed inside the body: Endoscopy (specifically colonoscopy or sigmoidoscopy) with a biopsy
Non-invasive: Blood or stool samples; radiographic images of the suspected disease site.
Endoscopy is the gold standard for officially diagnosing IBD, an invasive procedure that lets your doctor look inside your body. It uses an instrument called an endoscope, or “scope,” with a tiny camera attached to a long, thin, flexible tube.
When you have an endoscopy, your doc is able to see images of your intestine magnified on a screen during the procedure, allowing him to evaluate different areas of the GI tract, assess the intestinal lining, and take a biopsy of multiple tissues to evaluate for microscopic inflammation.
The Gold Standard Test: Colonoscopy
Given that the colon and end of the small intestine are the most frequently involved in IBD, colonoscopy is the type of endoscopy most often performed to both diagnose, continually monitor, and treat IBD. Typically the patient is sedated while the doc inserts a colonoscope into your rectum and the entire length of the colon to your small bowel (terminal ileum).
Other types of endoscopic and invasive tests can be ordered to evaluate patients with suspected or established IBD. These include:
Endoscopic evaluation of the lower one-half to one-third of the colon to confirm the presence of inflammation in this segment of the colon. Since inflammation begins in the rectum in people with ulcerative colitis, a sigmoidoscopy can be a good diagnostic test to confirm the disease and to monitor your response to therapy.
2. EGD or upper endoscopy
A common procedure that evaluates the first one-third of the small bowel by inserting an endoscope down your esophagus. EGD is used to evaluate a wide variety of symptoms such as: upper abdominal pain, nausea, vomiting, and difficulty swallowing. Since Crohn’s disease can occasionally affect the esophagus, stomach, and upper small bowel, this test can help further confirm a Crohn’s diagnosis.
3. EUS or endoscopic ultrasound
A relatively new technique that uses an ultrasound probe attached to an endoscope to obtain deep images of the gut below the surface. For IBD, physicians use EUS to look at fistulas in the rectal area. Fistulas are abnormal connections from the intestine to another part of the intestine, another organ of the body, or the surface of the skin.
1. Blood Tests
There are no blood tests that can officially diagnose IBD. However, blood analysis can determine inflammation in the body connected to it and help treat IBD. Some markers of IBD inflammation include:
- Iron Panel (to detect infection, anemia or iron overload)
- Inflammation markers (C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR))
- Electrolyte Panel (BUN, Creatine, Sodium, Potassium, Magnesium)
- Liver Panel Screening (particularly AST, ALT)
- Vitamin B12
- Abnormal pANCA, ASCA, CBir1, and OmpC markers
2. Stool Tests
Comprehensive stool analysis through a reputable testing method (PCR-DNA + MaLDI-TOF MS) can help identify inflammatory markers that may contribute to IBD and lowered immunity including:
- Dysbiotic gut bacteria
- Low Secretory IgA markers
- Occult blood in the stool
- Yeast overgrowth)
Images and pictures of the inside of the body to see if there is any inflammation or scarring, including:
- Barium enema
- CT scan and CT enterography (CTE)
- Leukocyte scintigraphy (white blood cell scans)
- MRI and MR enterography (MRE)
- Small bowel follow-through and small bowel enteroclysis
- Leukocyte Skintigraphy (White Blood Cell Scan). This test evaluates where in your body white blood cells gather, and can help tell how much inflammation is present. Since the main characteristic of Crohn’s disease and ulcerative colitis is inflammation in the gut and white blood cells are attracted to sites of inflammation, if you have a lot of white blood cells in your gut region, inflammation is indicated.
Note: Non-invasive tests will not necessarily reveal what’s causing the inflammation, but they serve as confirmation and indicators of the presence of disease.
The conventional way to treat IBD typically involves a combination of prescription medications for symptom management, including:
- Anti-inflammatory meds (like NSAIDS)
- Alpha 4 Integrin inhibitors and anti-diarrheal agents.
However, while these treatments can help you manage symptoms, in the long run, they do not cure or reverse the condition.
Instead, sending IBD into “remission,” involves an anti-inflammatory, whole body healing approach to the disease including:
4 Steps to Treat IBD and Send it into Remission
1. Identify Underlying Pathologies
IBD is highly correlated with other underlying pathologies—making researchers question: Which came first, the chicken or the egg? To fully treat IBD, it is vital to work with a skilled health practitioner to explore other underlying markers known to drive disease, autoimmunity and inflammation. For the IBD sufferer, this may include:
- SIBO (small intestinal bacterial overgrowth)
- Fungal overgrowth
- Environmental toxic exposure
- Parasitic infection
- Chronic stress
- Food intolerances
Further testing to identify other pathologies may include: Comprehensive stool testing, SIBO breath testing, urine organic acids testing, heavy metals testing (hair/urine), autoimmune blood marker testing, food intolerance testing and
other blood analysis (such as thyroid function, iron overload or deficiencies, lipid panel, etc.)
2. Address Autoimmunity
Considering this is an autoimmune disease, similar holistic treatment measures that treat and reverse other autoimmune diseases can be highly effective. The top methods of calming autoimmune flares or IBD include:
Eat an anti-inflammatory diet, such as the Autoimmune Protocol (“AIP) to treat IBD. Eliminate the biggest inflammatory foods including: grains, gluten, dairy, nuts/seeds, eggs, beans/legumes, soy, sugar, hydrogenated oils, conventional meats, and processed, refined foods.
3. Bust Stress (mentally and physically)—including:
- Sleeping 7-9 hours
- Not overtraining or leading a sedentary lifestyle
- Busting circadian rhythm dysfunction by minimizing screen and light exposure at night
- 30-60 minutes natural sunlight daily
- Connection to socializing, hobbies and passions you enjoy
- Taking breaks from work to stretch, move, play and rest
- “Talking about it”—instead of bottling stress inside
- Going on a news or social media fast, and avoiding negative people or people who stress you out
4. Take Daily Probiotics & Prebiotic
Several probiotics have been shown to be effective for managing IBD. (Not just any probiotic—but pharmaceutical grade strain and researched probiotics, since many probiotics on shelves do NOT contain the probiotics they claim on labels).
Top probiotics for IBD include:
- Elixa DS
- E Coli Nissle 1917
- Soil-Based Organisms
Also eat 1-2 servings fermented foods daily (pickled veggies, sauerkraut, kefir, yogurt) to treat IBD naturally.
Top prebiotics for IBD include:
- Fermentable fiber (“prebiotics”) helps your probiotics “stick” in your gut.
- Partially hydrolyzed guar gum
- citrus pectin
- Short-chain fatty acids (like sodium-potassium butyrate), especially during flares or active disease states (helps with bowel regularity and electrolyte balance)
Eat 1-2 prebiotic foods daily (cooked & cooled potatoes/sweet potatoes, green tipped bananas/plantains, soluble veggies, like winter squash, cooked carrots and steamed beets)
Elemental or GAPS Diet
If symptoms of IBD are still severe after a 30-60 day anti-inflammatory diet (AIP) trial, consider a 2-week Gaps Diet OR Elemental Diet to manage and reverse active IBD flares. This is an effective approach to treat IBD.
Fecal microbiota transplant (FMT)
The “ultimate probiotic” treatment. FMT is not approved by the FDA in the U.S. for anything other than antibiotic-resistant C- diff. However, there are some clinics outside of the US like the Taymount Clinic.
Low dose naltrexone (LDN)
A medication to discuss with your doctor that can be a helpful method to treat IBD. LDN is most often used for autoimmune disease, and believed to reduce inflammation and boost endorphin production, when endorphins have been observed to be low in autoimmune disease.
Rifaximin (gut antibiotic)
Rifaximin shows promising results in inducing remission of both Crohn’s Disease and Ulcerative Colitis (Rifaximin at a dose of 1,600 milligrams per day for 12 weeks led to remission in 100 percent of patients with Crohn’s initially, and nearly 80% still in remission 6 months later; other studies show greater than 70% remission for both colitis and Crohn’s) (Prantera et al, 2012; Guslandi, 2011)
The Bottom Line
Remission of IBD is possible. With time, consistency and a focus on an anti-inflammatory, de-stressing diet and lifestyle, sufferers can treat IBD naturally. They can experience freedom from symptoms and normalized bowel function as inflammation flares.