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DESCRIPTION
Crohn's disease is a form of inflammatory bowel disorder (IBD) of unknown origin and is also called ileitis or enteritis. It is characterized by a chronic and long-lasting ulceration of a section or sections of the digestive tract. It usually affects the lowest portion of the small intestine, but it can occur in other parts of the digestive tract, from the mouth to the anus.
The ulceration extends through all layers of the intestinal wall and involves the entire digestive system, from the mouth to the anus, as well as the adjacent lymph nodes. It can cause deep ulcers and small, firm sores called granulomas. The inflamed parts heal, leaving scar tissue that narrows the passageway (strictures that partially obstruct the bowel). These strictures can cause bowel obstruction, which occurs when food cannot pass through the bowel. People also may develop fistulas, abnormal tunnel-like connections, openings or passages that lead from one loop of intestine to another, or even to other organs (such as the bladder or vagina), or between the intestine and the skin. A fistula may be the first sign of Crohn's disease. People with Crohn's disease also suffer from nutritional deficiencies.
A relatively small percentage of people (1.2 to 15 cases per 100,000 people in the United States) is affected by Crohn's disease. It affects men and women equally and tends to run in families. According to the Crohn's and Colitis Foundation of America (CCFA), people who have a relative with the disease have at least 10 times the risk of developing Crohn's disease compared with the general population. This disorder affects people of all age groups, but the onset of Crohn's disease typically occurs between the ages of 14 and 30 or between ages 60 and 80, although more and more cases are being reported in children. Children with Crohn's disease may suffer delayed development and stunted growth due to nutritional deficiencies.
Attacks may occur every few months to every few years. In rare cases, it appears once or twice and does not return. If the disease continues for many years, bowel function gradually deteriorates. Left untreated, it can become extremely serious, even life threatening, and it may increase the risk of cancer by as much as 20 times.
FREQUENT SIGNS & SYMPTOMS
The onset of Crohn's disease can be dramatic with alarming symptoms:
Chronic diarrhea. Some people may have diarrhea as many as 10 to 20 times a day. They wake up at night and need to go to the bathroom. People with ulcerative colitis usually have bloody diarrhea, but people with Crohn's disease may or may not have blood in their stools. People with IBD may have rectal pain and an urgent need to empty their bowels.
Constipation. People with IBD sometimes have constipation, depending on what part of the intestine is affected.
Persistent vomiting accompanied by a cessation of bowel movements.
Significant rectal bleeding.
Inflammation. Ulceration of the intestinal wall. If the ulcerated intestinal wall leaks, peritonitis can result.
Pain in the upper and lower abdomen, or anywhere in the abdomen. Severe abdominal pain that persists for more than an hour at a time. Sometimes Crohn's disease is misdiagnosed as appendicitis because the pain it causes may be centered in the same location. The pain is often described as cramping. The abdomen may be sore when touched.
Mouth ulcers or cracks (fissures) and anal sores or large skin tags near the anus may be present when the disease is active. Fistulas between organs, parts of the intestine, or between the intestine and the skin.
General malaise.
Loss of appetite. Because of pain, diarrhea, nausea and sometimes severe headaches and even vomiting, the person with Crohn's disease may dread eating.
Weight loss, malabsorption, malnutrition. The ongoing (chronic) symptoms of IBD, such as diarrhea, can lead to weight loss (of more than 5 pounds in a few days). Nutritional deficiencies, such as lowered levels of vitamin B-12, folic acid, iron, and fat-soluble vitamins, because the intestines may not be able to absorb nutrients from food.
Fever. In severe cases of IBD, fever or other symptoms that affect the entire body may be present.
Headaches.
Steatorrhea (the presence of excess fat in the stool, which results in pale, bulky stools that float).
Chronic bleeding may cause iron deficiency anemia. Too few red blood cells develops because of low iron levels caused by frequent diarrhea or bloody stools.
Crohn's disease is similar to ulcerative colitis in many respects. Both involve loss of appetite, abdominal pain, general malaise, weight loss, diarrhea, and rectal bleeding. Crohn's disease is more likely than ulcerative colitis to cause vague symptoms of abdominal pain, fatigue, and weight loss. The primary difference between the two conditions is the degree of involvement of the wall of the intestinal tract. Ulcerative colitis is limited to the mucosa and submucosa, the first two layers of the lining of the bowel, whereas Crohn's disease affects these layers and the adjacent tissues which also involves the next two layers, the muscular layer and the connective tissue layer below it.
Areas of the intestine that are ulcerated may be next to areas that are normal. This gives the intestinal lining a characteristic cobblestone appearance that health care providers use to diagnose Crohn's disease. The pattern results from repeated ulceration and healing.
Crohn's Disease VS Ulcerative Colitis
The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.
Comparisons of various factors in Crohn's disease and ulcerative colitis:
Crohn's Disease Ulcerative Colitis Terminal ileum involvement. Commonly. Seldom. Colon involvement. Usually. Always. Rectum involvement. Seldom. Usually. Involvement around the anus. Common. Seldom. Bile duct involvement. No increase in rate of primary sclerosing cholangitis. Higher rate. Distribution of Disease. Patchy areas of inflammation (Skip lesions). Continuous area of inflammation. Endoscopy. Deep geographic and serpiginous (snake-like) ulcers. Continuous ulcer. Depth of inflammation. May be transmural, deep into tissues. Shallow, mucosal. Fistulae. Common. Seldom. Stenosis. Common. Seldom. Autoimmune disease. Widely regarded as an autoimmune disease. No consensus. Cytokine response. Associated with Th1. Vaguely associated with Th2. Granulomas on biopsy. Can have granulomas. Granulomas uncommon. Surgical cure. Often returns following removal of affected part. Usually cured by removal of colon. Smoking. Higher risk for smokers. Lower risk for smokers.
Wikipedia.org: Crohn's Disease
CAUSES
This disorder is not contagious. It's cause is still uncertain, although it known that a history of food allergies increases the risk of developing it; conversely, eliminating allergenic foods often relieves the symptoms.
Studies also suggest that free radical damage may be involved, and that a lack of vitamin C and E may play a role.
Heredity may play a role as inflammatory bowel disease can run in families. Having a family history of IBD increases the risk if an immediate family member such as a parent, brother, or sister, also has the disease.
Health care providers believe that Crohn's disease has a genetic basis, but that it does not appear until triggered by the presence of bacteria or virus that provokes an abnormal activation of the immune system. Studies in animals suggest that Crohn's disease my result from an abnormal response by the body's immune system to normal intestinal bacteria.
Smoking cigarettes increases the risk of Crohn's disease but lowers the risk of ulcerative colitis.
DISEASE COURSE
The course of Crohn's disease varies considerably from one person to another. It is described as mild, moderate, severe, or in remission (not active). It also is defined by the part of the digestive tract involved, such as the rectum or anus (perianal disease) or the end of the small intestine where it joins with the large intestine (ileocecal disease).
- Some people have one or two mild episodes and never have symptoms again.
- Nearly all people have a relapse within a year of the first episode. More than 60% of people with Crohn's disease probably will need surgery within 5 years after they are diagnosed because of severe disease that does not respond to nonsurgical treatment.
- Other people have long periods of constant symptoms that do not get better or worse. They may have occasional flare-ups. At these times, symptoms may suddenly get worse and then subside.
- About 15% of people who have Crohn's disease may need surgery every year over a 15 year period for ongoing symptoms or complications.
Since Crohn's disease can cause inflammation in parts of the intestine that absorb nutrients from food, it can cause deficiencies in vitamin B-12, folic acid, or any other nutrient. By causing abnormal absorption, it can increase the risk of gallstones, kidney stones, and certain uncommon forms of anemia.
In long-term Crohn's disease, scar tissue may replace some of the inflamed or ulcerated intestine, forming blockages (bowel obstructions) or narrowed areas (strictures) that can block the intestine and prevent stool from passing through it. This is the most common complication of Crohn's disease. Blockages in the intestines also can be caused by inflammation and swelling, which may improve with medical treatment. Sometimes blockages can be treated only with surgery.
- If the ulcers in the intestines break through the wall of the intestine, abnormal connections or openings (fistulas) may develop between two parts of the intestine, between the intestine and other organs (such as the bladder or vagina), or between the intestine and the skin.
COMPLICATIONS
Complications of inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis can include:
- Arthritis in 10% to 15% of people. Some people may develop colitis-related arthritis, which may resemble rheumatoid arthritis. In people who have ulcerative colitis, inflammation limited to the lower joints of the spine (sacroiliitis) is more common than ankylosing spondylitis, another type of arthritis that affects the spine and lower back.
- Eye symptoms such as cataracts, ulcers on the cornea, and inflammation of the iris and blood vessels (uveitis). Eye problems occur in less than 10% of people with IBS.
- Skin conditions such as painful nodular lesions - usually on the legs - that are thought to be an allergic or immune reactions, ulcers on the legs that heal without scarring, and mouth ulcers. These problems occur in less than 10% of people.
- Disorders of the liver and gallbladder, including gallstones (more likely in Crohn's disease than in ulcerative colitis), cirrhosis of the liver, bile duct inflammation and scarring (sclerosing cholangitis), or bile duct cancer (rare but more likely in ulcerative colitis than in Crohn's disease).
- Urinary tract complications, which are more common in Crohn's disease than in ulcerative colitis. Kidney stones may develop because of changes in how the body absorbs nutrients, such as calcium or oxalate, from the intestines.
- Growth problems in children. Affected children may not grow as quickly or as tall as they would if they didn't have the disease. Children with IBD need attention to their diet to ensure that they get enough nutrients.
- Problems with blood clots in the legs or other areas of the body.
DIAGNOSIS & TREATMENT
DIAGNOSIS
A series of tests may be required to confirm Crohn's disease. Blood tests may be done to check for anemia and/or a high white blood cell count. A health care provider may do an upper gastrointestinal x-ray series to look at the small intestine, or a colonoscopy, in which the health care provider inspects the interior of the large intestine using a long, flexible lighted tube linked to a computer and monitor. If the tests show the presence of Crohn's disease, the health care provider may do more x-rays or diagnostic scans of both the upper and lower digestive tract to find out how much is affected by the disease.
TREATMENT
Inflammatory bowel disease (ulcerative colitis or Crohn's disease) is a chronic condition that may flare up many times during your life. You may have long periods without symptoms, or you may have only mild symptoms. A few people have symptoms that are more persistent and severe, in some cases requiring treatment with medications or surgery. Treatment depends on the severity of an attack and the person's age. Children and older people may have nutritional problems that require special care.
Since there is no cure for Crohn's disease, the goals of treatment (for all types of IBD) include:
- Relieving symptoms caused by the disease and ending sudden (acute) attacks as quickly as possible.
- Relieve and control inflammation.
- Treat and correct complications, such as anemia, infection, or bowel problems, all of which can help keep Crohn's disease in remission. Treatment may include taking nutritional supplements to restore normal growth and sexual development in children and teens.
- Preventing or delaying new attacks.
If you don't have any symptoms of or if your disease is not active (in remission), you may not need treatment. Although IBD cannot be cured (except for surgical removal of the colon in ulcerative colitis), symptoms usually can be managed with medications that may help keep the disease in remission. It often is easier to keep the disease in remission than to try to treat a flare-up of symptoms.
Mild symptoms may respond to anti-diarrheal medications and changes in your diet. Anti-diarrheals should be used only in mild cases and after talking with your health care provider. Prescription medications may be used to treat mild symptoms and keep the disease in remission.
Moderate to severe symptoms may require treatment with one or more prescription medications. A supplemental diet may be needed.
Severe, persistent symptoms that do not get better with first-line treatment may need more aggressive medications or surgery. Surgery is used only for people with severe symptoms that fail to respond to medication or who develop complications, such as bleeding or perforation of the intestine. In some cases, people who have precancerous changes in their intestines may need surgery to prevent cancer even if they have no symptoms.
Several medications are used to treat the various types of inflammatory bowel disease, depending on the severity and location of the disease. These medications may be used in combination for the most effective control of symptoms:
- Aminosalicylates.
- Corticosteroids.
- Medications that affect the immune system (immunomodulators).
- Antibiotics.
MEDICAL EXAMS & TESTS
The symptoms of ulcerative colitis and Crohn's disease may be similar, but there are features of each disease that can help health care providers diagnose which condition you have.
- Ulcerative colitis is relatively easy to diagnose, because it normally affects the colon and rectum. It often causes an obvious change in daily bowel habit, such as blood or mucus in stools and more frequent stools. The colon and rectum can be examined with flexible sigmoidoscopy or colonoscopy.
- Crohn's disease can be difficult to diagnose. Early symptoms or its only symptoms may consist of joint aches and a general feeling of fatigue. Because symptoms usually come on gradually, Crohn's disease may go undiagnosed for years.
The following exams and tests may be used to evaluate both types of inflammatory bowel disease (IBD):
- History and physical exam. The medical history includes questions about your bowel function, including how many bowel movements you have per day or per week, whether you have constipation or diarrhea, blood or mucus in your stool, and recent changes in bowel habits or the shape of your stools. You will be questioned whether your bowel movement patterns have any relationship to your abdominal pain (if passing a stool relieves your pain); family history of similar symptoms; laxative and antacid use; increased risk factors of an intestinal infection (foreign travel, untreated water, antibiotic use); and your sexual history regarding sexually transmitted diseases. The standard physical exam consists of: feeling the abdomen; a digital rectal exam; listening to bowel sounds with a stethoscope; examination of eyes, skin, joints, and inside of mouth; and a pelvic exam for women.
- Flexible sigmoidoscopy. The sigmoidoscope is a flexible lighted tube that is about 0.5 in (1.27 cm) wide and 2 ft (60.96 cm) long with hundreds of light-conducting fibers attached to a lighted lens system. This instrument allows the health care provider to see around bends in the colon. A flexible sigmoidoscope allows a more complete view of the lower colon and usually makes the examination more comfortable than a rigid scope. The flexible sigmoidoscope has generally replaced the rigid sigmoidoscope. Your health care provider may also a remove small growths and collect samples (biopsy) through the sigmoidoscope. Sigmoidoscopy requires the use of enemas or laxatives (or both) to empty the colon before the test is done.
- Colonoscopy. The colonoscope is a thin, flexible scope that ranges from 48 in. (121.92 cm) to 72 in. (182.88 cm) long. A small video camera is attached to the colonoscope so that photographic, electronic, or videotaped images of the large intestine can be made. The colonoscope may use fiber optics or digital video technology. The colonoscope can be used to view the entire colon as well as a small portion of the lower small intestine. A biopsy may be taken during the procedure.
- Abdominal X-ray. X-rays are a form of radiation that can be focused into a beam that can pass through most objects, including the human body. When X-rays strike a piece of photographic film, they can produce an image. Dense tissues, such as bones, will appear white, since they absorb (block) may of the X-rays. Less dense tissues, such as organs and muscles, block fewer X-rays (more pass through these structures) and appear as shades of gray. An abdominal X-ray provides pictures of structures such as the large and small intestines, stomach, liver, and spleen, and the diaphragm (the sheet of muscle that separates the abdomen from the thoracic portion of the body containing the lungs and heart). The abdominal X-ray may be one of the first tests used to investigate the symptoms of abdominal swelling, pain, nausea, and/or vomiting.
- Upper gastrointestinal (GI) series. The upper GI examines the upper and middle portions of the GI tract. This includes the esophagus, stomach, and the first part of the small intestine called the duodenum. The person being tested swallows a barium "shake" of barium, water, and gas producing crystals. Barium is a contrast material (dye) that allows the health care provider to tract the progress of the "shake" from the esophagus through the stomach and small intestine using fluoroscopy connected to a video monitor. Several X-rays are usually taken at different times and from different angles or directions. If you have allergies to barium, other common contrast material include iodine and gadolinium. The contrast material will allow the health care provider to see specific organs and types of tissue (tumors) more visible on the X-rays.
- Upper gastrointestinal endoscopy. Endoscopy allows the health care provider to look at the interior lining of the esophagus, stomach, and the first part of the small intestine through a thin, flexible viewing instrument called an endoscope. The tip of the endoscope is inserted through the mouth and then is gently moved down the throat into the esophagus, stomach and upper duodenum (small intestine. Using the endoscope, your health care provider can look for gastric problems (ulcers, inflammation, tumors, infection or bleeding) and tissue biopsies can be collected, polyps removed, and bleeding treated. Endoscopy can reveal problems that do not show up on X-rays and may eliminate the need for exploratory surgery.
- Barium enema. The barium enema is a contrast dye used in a lower GI exam that uses X-rays to diagnose problems that affect the colon (large intestine). Making the intestine visible on an X-ray involves filling the colon with a contrast material (barium) through a tube inserted into the anus (enema). The barium blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray picture. This procedure should show structural defects and inflammation of the colon that may be present in Crohn's disease (IBD).
- Computed tomography (CT) scan. This is a special type of X-ray that can produce detailed pictures of structures inside the body. It is also called a computerized axial tomography (CAT) scan. The CT scanner directs a series of X-rays through the body that are analyzed by a computer to produce a detailed picture of a portion (slice) of an organ or area being examined. Each X-rays pulse last only a fraction of a second and it takes only a few seconds for the machine to record each slice. A CT scan produces clearer pictures than regular X-rays do. The information obtained from a CT scan can be saved and stored on a computer for further study and photographs of selected view can be made. For an abdominal CT scan, a contrast material is usually given orally (by mouth) prior to the test. A CT scan of the abdomen can help detect several conditions, including cysts, abscesses, infection, bleeding into the abdominal cavity, tumors, aneurysm, enlarged lymph nodes, foreign objects, diverticulitis, IBD, the spread of cancer, and appendicitis.
- Stool analysis, including a test for blood in the stool is almost always done to look for blood, signs of bacterial infection, malabsorption, parasites, or the presence of white blood cells. It may be done during a flare-up of IBD if there is concern that new symptoms are caused by another problem. You may collect the stool sample or your health care provider may obtain a sample during sigmoidoscopy or colonoscopy.
- Standard blood and urine tests to check for anemia, inflammation, or malnutrition. Depending on the symptoms, an erthrocyte sedimentation rate (ESR or sed rate) or C-reactive protein (CRP) blood test may be done. These tests can help determine if there is infection or inflammation that may be caused by IBD.
- Biopsy of a sample of tissue from the lining of the intestine. Biopsies are collected during upper endoscopy, sigmoidoscopy, or colonoscopy. A biopsy is done to confirm the diagnosis of IBD and to determine the type of inflammatory bowel disease you have (ulcerative colitis or Crohn's disease). A biopsy also may be done to assess inflammation and tissue damage or to find out if a tumor is present. Multiple biopsies for cancer screening often are done in people who have had ulcerative colitis for more than 8 to 10 years. Bowel biopsies are painless and involve removing only a tiny piece of tissue.
There is no early detection screening test for inflammatory bowel disease at this time. However, people who have had ulcerative colitis for 8 to 10 years or longer should discuss with their health care provider how often they will need screening tests for colon cancer, based on the extent of their disease and how long they have had it. For people who have ulcerative colitis or colon cancer, screening usually involves taking multiple-tissue biopsies during routine sigmoidoscopy or colonoscopy.
CONSIDERATIONS
DIETARY CONSIDERATIONS
There are not consistent dietary rules that apply to everyone, but people with Crohn's disease are generally encouraged to eat a healthy diet to help the body replace lost nutrients. Moreover, some nutrients, such as essential fatty acids and the amino acid glutamine, have been show to help maintain a state of remission.
It is important that nutrition deficiencies be corrected for healing. Persons with inflammatory bowel disorders require as much as 30 percent more protein than normal. If chronic diarrhea is present, electrolyte and trace mineral deficiencies should be considered. Chronic steatorrhea (fatty stools resulting from improper digestion of fats) may result in deficiencies of calcium and magnesium.
Antioxidants have been shown to decrease the risk of developing Crohn's disease. The intestinal walls normally contain small amounts of the antioxidant enzymes superoxide dismutase (SOD), catalase, and glutathione peroxidase, but their ability to fight free radicals may be overwhelmed during periods of active inflammation, resulting in tissue damage.
To reestablish a proper healing environment, it is necessary to maintain a generally alkaline bodily pH (greater that 7.0 bodily pH).
MoonDragon's Health & Wellness: Acidosis
Adhering to an allergen-free diet, replacing lost nutrients, and using selected herbs can speed healing and may prevent future disturbances. Studies have proven that when a person who has achieved remission goes back to his or her former diet, Crohn's disease returns. Other things that have been implicated in this disorder include prolonged stress, trauma, and psychosomatic and vascular factors.
Nutritional deficiencies resulting from malabsorption may weaken the immune system, in turn prolonging the time required for the inflammation and ulcers to heal.
MEDICATIONAL CONSIDERATIONS
People with inflammatory bowel diseases should avoid using non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen). Studies may have linked the pain relievers with flare-ups of IBD. Discuss it with your health care provider before taking these medications.
Drugs such as corticosteroids and sulfasalazine (Azulfidine), which are prescribed for inflammatory bowel diseases, and cholestyramine (Questran), which is prescribed to lower cholesterol levels, increase the need for nutritional supplements. Corticosteroids depress protein synthesis and inhibit normal calcium absorption by increasing excretion of vitamin C in the urine. Deficiencies of other nutrients, such as zinc, potassium, vitamin B-6 (pyridoxine), folic acid, and vitamin D, decrease bone formation and slow healing. Sulfasalazine inhibits the transport of folic acid and iron, causing anemia.
Most people with Crohn's disease are initially treated with drugs, particularly corticosteroids, such as Budesonide, to help control inflammation. This newer drug has fewer side effects than the older corticosteroids. Drugs that suppress the immune system are also used, but they can increase susceptibility to infection. Currently, the drugs methotrexate (Rheumatrex) and cyclosporine (Neoral, Sandimmune, SangCya) are being tried along with the traditional immunosuppressive drugs.
The Food and Drug Administration (FDA) has now approved under an accelerated program a genetically engineered product called infliximab (Remicade). Remicade is an intravenously administered drug for people with moderate-to-severe Crohn's disease who have not responded to traditional treatments. Remicade works specifically against a protein that promotes inflammation and has been shown to reduce intestinal inflammation. In drug trials, one dose relieved many of the symptoms for 2 to 4 weeks, after which the benefits waned. Because the long-term toxic effects of the drug are unknown, scientists are still trying to better define risks and benefits.
Natalizumab is another experimental drug that appears to reduce symptoms and improve quality of life. This drug decreases inflammation by binding to immune cells and preventing them from getting to the intestines to cause inflammation. Antibiotics are used to treat the bacterial infections that often accompany Crohn's disease.
Interleukin-10 is a cytokine that suppresses inflammation. It has shown some promise in treating Crohn's disease.
Anti-TNF (Anti-Tumor-Necrosis-Factor) is a substance that finds a protein in the bloodstream called TNF, then binds to and removes it. TNF may be a principle cause of inflammation. Anti-TNF has been particularly successful in the treatment of fistulas.
CROHN'S DISEASE-RELATED CONSIDERATIONS
Many microorganisms have been considered as possible causes of Crohn's disease, including fungi, bacteria, viruses, mycobacteria, pseudomonas-like organisms, and chlamydia. However, the cause of Crohn's disease has not yet been established. It is likely that multiple factors are involved.
Antigenic reactions may result from "leaky gut syndrome," in which minute particles of undigested or partially digested food pass through the swollen and inflamed mucosal wall into the bloodstream, where they cause reactions. The mucosal wall must be repaired to avoid this. Avoiding foods that cause a reaction is important. Treatment with butyric acid, a mono-saturated fatty acid, reduces inflammatory conditions, reduces seepage of undigested food particles, and aids in repair of the mucosal wall. N-Acetylglucosamine (N-A-G) prevents leaky gut syndrome.
A study done in Italy found that people with Crohn's disease who took sustained-release fish oil supplements were less likely to suffer relapses than those who did not. Of the subjects in the one-year study who took fish oil, over half remained symptom-free, compared with only a quarter of those who took a placebo.
Researchers have not been able to find a specific genetic marker for Crohn's disease, but they have found that the illness is 4 times more common in Caucasians and Jews than in people of other ethnic backgrounds. In 20 to 40 percent of reported cases, multiple family members have suffered either from Crohn's or ulcerative colitis.
If Crohn's disease continues for many years, bowel function gradually deteriorates. Surgery may be required to remove the disease portion of the intestine. While this surgery doesn't cure the disease, it can relieve symptoms, and 5 years later at least 50 percent of people who undergo it are in good health, can work full time, and enjoy life without being restricted by diarrhea or pain.
People with Crohn's disease have a significantly higher than normal risk of developing colon cancer. If you have this disorder, you should undergo a colonoscopy at least once every 2 years, starting 8 to 10 years after diagnosis.
HERBAL & HOLISTIC RECOMMENDATIONS
HERBS
Aloe Vera is beneficial for Crohn's disease because it softens stools and has a healing effect on the digestive tract. Drink 1/2 cup of aloe vera juice three times daily.
There are many combination herbal products designed to offer gastrointestinal relief. Enzymatic Therapy, Olympian Labs, and Solaray are recommended sources.
Other herbs that are good for this disorder include Burdock Root, Echinacea, Fenugreek, Goldenseal, Licorice, Marshmallow Root, Pau D'Arco, Enteric-Coated Peppermint (do not use any other form), Red Clover, Rose Hips, Silymarin (Milk Thistle Extract), Slippery Elm, and Yerba Mate. These herbs support digestion, cleanse the bloodstream, and reduce inflammation and infection. For best results, use them on an alternating basis.
Caution: Do not use Licorice on a daily basis for more than 7 days in a row, and avoid it completely if you have high blood pressure. Do not take Goldenseal on a daily basis for more than one week at a time, and do not use it during pregnancy. If you have a history of cardiovascular disease, diabetes, or glaucoma, use it only under a health care provider's supervision.
RECOMMENDATIONS
Eat a diet daily consisting mainly of non-acidic fresh or cooked vegetables such as broccoli, Brussels sprouts, cabbage, carrots, celery, garlic, kale, spinach, and turnips. Steam, broil, boil, or bake your food.
Drink plenty of fluids, such as steam-distilled or quality bottled water, herbal teas, and fresh juices. Fresh cabbage juice is very beneficial.
Add a papaya to your diet. Chew a couple of the seeds to aid digestion.
During an acute attack, eat organic baby foods, steamed vegetables, and well-cooked brown rice, millet, and oatmeal.
Try eliminating all dairy foods (including cheese), fish, hard sausage, pickled cabbage, and yeast products from your diet, and see if symptoms improve. These foods are high in histamine. Many people with Crohn's disease are histamine-intolerant. Milk and other dairy products also contain carrageenan, a compound extracted from red seaweed. Carrageenan, which is widely used in the food industry for its ability to stabilize milk proteins, has been shown to induce ulcerative colitis in laboratory animals.
Avoid alcohol, caffeine, carbonated beverages, chocolate, corn, eggs, foods with artificial additives or preservatives, fried and greasy foods, margarine, meat, pepper, dairy products such as milk and cheese, spicy foods, tobacco, white flour, and all animal products, with the exception of white fish from clear waters. These foods are irritating to the digestive tract. Mucus-forming foods such as processed, refined foods and dairy products should also be avoided. Limit your intake of barley, rye, and wheat.
Avoid refined carbohydrates. Do not consume such foods as boxed dry cereals or anything containing any form of sugar. Diets high in refined carbohydrates have been associated with Crohn's disease. These foods must be eliminated from the diet.
Stop smoking if you smoke. Smoking appears to increase the risk that Crohn's disease will worsen.
Check stools daily for bleeding.
As much as possible, avoid stress. Our thoughts, nervous systems, and bodily functions are deeply interconnected. Our bodies are affected by our thoughts and moods. During an attack, rest is important.
Make sure the bowels move daily, but do not use harsh laxatives. Gentle enemas made by adding a dropperful of alcohol-free herbal extract and 1 teaspoon of non-dairy acidophilus powder to 2 quarts of lukewarm water are good. Accumulations of toxic body wastes often become breeding grounds for parasitic infestation. Toxins can also be absorbed into the bloodstream through the colon wall. Psyllium husks should be used daily for fiber; this aids in removing toxins before they are absorbed. Note: Always take supplemental fiber separately from other supplements and medications.
Do not use rectal suppositories that contain hydrogenated chemically prepared fats.
If you are constipated, use a cleansing enema. Use a heating pad to reduce abdominal pain.
NUTRITIONAL SUPPLEMENTS
Unless otherwise specified, the following recommended doses are for adults over the age of 18. For a child between 12 and 17 years, reduce the dose to 3/4 the recommended dose. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended dose.
NUTRIENTS Supplement Suggested Dosage Comments Essential Duodenal Glandular As directed on label. Aids in healing gastrointestinal ulcers. L-Glutamine 500 mg twice daily, on an empty stomach. Take with water or juice. Do not take with milk. Take 50 mg Vitamin B-6 and 100 mg Vitamin C for better absorption. A major metabolic fuel for the intestinal cells; maintains the villi the absorption surfaces of the gut. See Amino Acids for more information.
L-Glutamine, Amino Acid Supplement, NOW Foods, 500 mg, 120 CapsLiver Extract
(Injections)2 cc once weekly or as prescribed by health care provider. Needed for proper digestion. Vitamin B Complex
Or
Injections100 mg 3 times daily.
1 cc once weekly or as prescribed by health care provider.For repair and replacement of lost nutrients; aids in healing. If injections are not available, use a sublingual form. Helps prevent anemia.
Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 CapsAnd
Vitamin B-12
Or
injections200 mcg daily
1 cc twice weekly or as prescribed by health care provider.If injections are not available use a lozenge or sublingual form. Important for proper digestion and to prevent anemia. Deficiency aggravates malabsorption.
Vitamin B-12 / Cyanocobalamin, 2000 mcg, 100 Sublingual Lozenges,
Vitamin B-12 Liquid Supplement, 50 mcg, With Vitamin B-9 (Folic Acid), 400 mcg, 1 fl. oz.,
Vitamin B-12 Lipo Spray, NOW Foods, 2 oz.And
Folic Acid
Or
Injections200 mcg daily.
1/4 cc twice weekly or as prescribed by health care provider.Needed for constant supply of new cells. Injections under a health care provider's supervision are best.
Folic Acid (Vitamin B-9), 100% Natural, Nature's Way, 800 mcg, 100 Caps,
Vitamin B-12 Liquid Supplement, 50 mcg, With Vitamin B-9 (Folic Acid), 400 mcg, 1 fl. oz.N-Acetyl Glucosamine (N-A-G) As directed on label. A major constituent of the barrier layer that protects the intestinal lining from digestive enzymes and other potentially damaging intestinal contents.
N-Acetyl Glucosamine (NAG), Allergy Research Group / Nutricology, 90 CapsOmega-3 Essential Fatty Acids
(Flaxseed Oil, Primrose Oil, and Salmon Oil are good sources)As directed on label, 3 times daily. Needed for repair of the digestive tract; reduces inflammatory processes and is much needed in Crohn's disease.
Barlean's Flax Oil, 100% Highest Lignan Content, Organic, Pesticide & Herbicide Free, 16 fl. oz.,
Salmon Oil Capsule, NOW Foods, 120 EPA/80 DHA, 2000 mg, 250 Softgels,
Evening Primrose Oil With Gamma-Linolenic Acid (GLA), Barlean's, 1300 mg, 120 Softgels,
Ultimate Oil, Essential Fatty Acids Supplement, Nature's Secret, 90 SoftgelsPancreatin
Plus
BromelainAs directed on label, with meals.
As directed on label.To break down protein and assist digestion.
Pancreatin, NOW Foods, 4X 500 mg, 100 Caps,
Bromelain, 2000 GDU, NOW Foods, 500 mg, 90 Tabs,
Super Digestive Enzymes, 90 CapsTaurine Plus
(American Biologics)500 mg daily, on an empty stomach. Take with 50 mg vitamin B-6 and 100 mg vitamin C for better absorption. An important antioxidant and immune regulator. Use the sublingual form. Vitamin C With Bioflavonoids 1,000 mg 3 times daily. Essential in improving immune function, prevents inflammation, and aids in tissue repair. Use a buffered type.
Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz., Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs, Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps, The Right C, Nature's Way, 1000 mg, 120 TabsVitamin K As directed on label. Vital to colon health. Deficiency is common in people with this disorder due to malabsorption and diarrhea.
Chlorophyll With Alfalfa Powder, NOW Foods, 100 mg, 90 Caps,
Chlorofresh Chlorophyll Supplement, Nature's Way, 50 mg, 90 Softgels,
Chlorofresh Liquid Chlorophyll, Mint Flavor, Nature's Way, 16 fl. oz.,
Chlorella Powder, NOW Foods, 100% Pure, 4 oz.,
Vital Greens, Vital Earth, 180 Caps,Zinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Powerful immune system stimulant and needed for healing. Use zinc gluconate lozenges or OptiZinc for better absorption.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges,
Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges,
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 CapsImportant Free-Form Amino Acid Complex 1/4 tsp twice daily. Protein is essential in the healing of the intestine. Use a sublingual form.
AMINO 1000 Complete, NOW Foods, 120 Caps,
Branched Chain Amino Acid Powder, NOW Foods, 12 oz.,
Amino 1500, Chewable Blend of 20 Amino Acids, Predigested, NOW Foods, 150 Tabs,
Branched Chain Amino Acids, Free Form, 120 CapsGarlic Fresh: 2-3 cloves.
with meals 3 times daily.
Kyolic: 2 capsules
with meals 3 times daily.Acts as a natural antibiotic and stimulates the immune system. Combats free radicals in Crohn's disease. Aids healing. Lactobacilli As directed on label. Aids in digestion. Use a non-dairy formula. A product containing both L-acidophilus and L-bifidus organisms is best.
Acidophilus Supplement Powder, Non Dairy, 3 oz. Bulk,
Acidophilus, 3 Billion, NOW Foods, 90 Tabs,
Lactobacillus Acidophilus Supplement, Non Dairy, 100 Caps,
Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose Free, Apple Strawberry Flavor, Dynamic Health, 16 fl. oz.,Or
CapricinAs directed on label. Works in conjunction with butyric acid to reduce inflammation and seepage of undigested food particles. Spirutein
(Nature's Plus)As directed on label. Supplies necessary protein. Helps stabilize blood sugar between meals. Helpful Aloe Vera 1/2 cup of aloe vera juice three times daily. Beneficial for Crohn's disease because it softens stools and has a healing effect on the digestive tract.
Aloe Vera Juice, Herbal Aloe Force, Organically Grown, Unprocessed Whole Raw Aloe Vera, 33.8 fl. oz.,
Aloe Vera Gel, NOW Foods, 32 oz.Calcium 2,000 mg daily. Aids in preventing colon cancer.
Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz.,
Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz.,
Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 GelcapsMagnesium 1,500 mg daily. Aids in preventing colon cancer. Works with calcium.
Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz.,
Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.,
Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 CapsFloradix Iron Plus Herbs 2 tsp daily. To prevent anemia. Floradix is a readily absorbable form of iron that is non-toxic and derived from food sources. Gastro-Calm
(Olympian Labs)As directed on label. A combination of herbs and digestive enzymes to help relieve indigestion and reduce gastrointestinal inflammation. Multi-vitamin & Mineral Complex
With
Copper
And
Manganese
And
SeleniumAs directed on label. Malabsorption is often a result of this disorder. Copper, selenium, and manganese are important for treating this disorder and are often deficient because of absorption problems. Use a liquid, powder, or capsule formula.
Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption),
Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply),
Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz.,
Copper Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.,
Ionic Selenium, 300 mcg, 2 fl. oz., Trace Minerals,
Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.,Plus Extra
Potassium99 mg daily. May reduce surgical complications and also the need for surgery.
Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz.,
Potassium, 100% Natural, Nature's Way, 99 mg, 100 CapsOxy-Caps
(Earth's Bounty)As directed on label. An oxygen supplement to counter nutritional deficiencies caused by Crohn's disease. Quercetin 500 mg twice daily, before meals. Slows histamine release; helps control food allergies. Needed for a variety of enzyme functions.
Quercetin, NOW Foods, 500 mg, 100 VCaps,
Quercetin W/Bromelain, Hypoallergenic Bioflavonoid, NOW Foods, 800 mg, 120 VCapsPlus
Bromelain100 mg twice daily, before meals. Reduces inflammation and swelling; speeds healing. Improves the absorption of quercetin.
Quercetin W/Bromelain, Hypoallergenic Bioflavonoid, NOW Foods, 800 mg, 120 VCaps,
Bromelain, 2000 GDU, NOW Foods, 500 mg, 90 TabsOr
Activated QuercetinAs directed on label. Contains quercetin plus bromelain and vitamin C. Shark Cartilage (Benefin) As directed on label. If you cannot tolerate taking it orally, it can be administered rectally in a retention enema. Fights metastasis of cancerous tumors.
Shark Cartilage, NOW Foods, 750 mg, 100 Caps,Vitamin A 25,000-50,000 IU daily. Caution: If you are pregnant, do not exceed 10,000 IU daily. Antioxidants that aid in controlling infection and in repair of the intestinal tract. Use emulsion forms for easier assimilation.
Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 SoftgelsAnd
Vitamin E200 IU, Up to 800 IU daily. Antioxidants that aid in controlling infection and in repair of the intestinal tract. Use emulsion forms for easier assimilation.
Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels,
Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels,
Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels,
Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels
Vitamin D-3 400 IU daily. Prevents metabolic bone disease from developing as a result of malabsorption.
Vitamin D, Nature's Way, 100% Natural, 400 IU, 100 Caps
CROHN'S DISEASE SUPPLEMENTS & PRODUCTS
Supplements and products for Crohn's disease, an inflammatory bowel disorder that usually affects the lowest portion of the small intestine.
5 HTP Hydroxy Tryptophan, Vegetarian, NOW Foods, 100 mg, 120 VCaps
5-HTP also known as Hydroxy Tryptophan is an Amino Acid and precursor to serotonin, a brain chemical responsible for regulating mood, appetite, behavior, and sleep. 5HTP may help elevate mood, control appetite, and promote better sleep.5 HTP Hydroxy Tryptophan, Natural Serotonin With Vitamin B-6 & C, Nature's Way, 50 mg, 60 Tabs
Nature's Way 5 HTP Supplement is available in an easy to swallow enteric coated tablet.Alive! Whole Food Energizer Multi-Vitamin With Mineral, Nature's Way, 18 mg of Iron Added, 90 Tabs
Nature's Way Alive multi-vitamin with mineral is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands. No other supplement contains more life-giving nutrients than ALIVE, which is just the way it will make you feel.Cat's Claw Extract, Standardized, Nature's Way, 335 mg, 60 Caps
Nature's Way Cat's Claw extract, also known as Una de Gato is derived from the bark of plants wild-harvested in Peru and Brazil.Eating For IBS: 175 Delicious, Nutritious, Low-Fat, Low-Residue Recipes To Stabilize the Touchiest Tummy By Heather Van Vorous
Eating for IBS confirms what every IBS sufferer instinctively knows: that diet plays a direct role in gut function, and that the abdominal pain, diarrhea, constipation, and bloating from bowel disorders can be directly controlled through diet. This is true not just for Irritable Bowel Syndrome, but also for inflammatory bowel diseases (IBD) such as Crohn's and Ulcerative Colitis, plus diverticulosis and diverticulitis. The Eating for IBS diet can make the difference between living a normal, happy, outgoing life versus spending every day stuck in the bathroom enduring pain, bowel dysfunction, and misery.Echinacea Herb, Nature's Way, 400 mg, 180 Caps
Echinacea herb supports the immune system and promotes general well-being in cold and flu season.Garlicin HC, Healthy Circulation Formula, With Odor Free Garlic Supplement, Nature's Way, 90 Enteric Coated Tabs
Garlicin HC garlic supplement supports cardiovascular health with the help of Hawthorn, Cayenne and Vitamin E.Goldenseal Herb, Nature's Way, 400 mg, 180 Caps
Goldenseal herb (hydrastis canadensis), a perennial wild native American herb, is also called Yellow Root. Native Americans used Goldenseal both internally and externally and also derived a dye from the root. Golden Seal is a very important traditional herb.Heather's Tummy Fiber, Organic Acacia Powder, Heather's Tummy Care, 1 lb.
Heather's Tummy Fiber Supplement Acacia is a natural, pure, certified organic, soluble dietary fiber produced from the gum of the Acacia tree (also known as gum arabic). Acacia is a natural plant water-soluble fiber that has been harvested for millennia in Africa; its recorded dietary use dates back to the Egyptian pharaohs.Hypo Allergenic Multiple Vitamin Mineral, 180 Caps
NutriBiotic Hypo-Allergenic Multivitamin Mineral is for people concerned about common food born antigens. This formula is a balanced blend of the purest bio-nutrients available.L-Glutamine, Amino Acid Supplement, NOW Foods, 1000 mg, 120 Caps
L-Glutamine is an important amino acid that helps brain function, as it converts quickly into glucose, the only source of energy to the brain. L-Glutamine promotes better thinking ability, and increases the amount of GABA, another amino acid that aids in proper brain function.Licorice Root Tincture, 100% Organic, 2 fl. oz.
Licorice Root is taken orally (DGL form) for ulcers, heartburn (esophageal reflux), and mouth sores.Liquid Multi Vita-Mineral, Orange Mango, Trace Minerals, 32 fl. oz.
The most complete all-in-one liquid vitamin daily supplement that combines the benefits of multiple vitamins with the advantages of ionic minerals and trace minerals to replace those needed minerals not found in processed foods.Marshmallow Root (Althaea Officinalis) Powder, 4 oz. Bulk
The German Commission E approved the internal use of marshmallow root for irritation of the oral and pharyngeal mucosa and associated dry cough, and for mild inflammation of the gastric mucosa.Marshmallow Root Tincture, 100% Organic, 2 fl. oz.
The primary use of Marshmallow root is to relieve digestive and respiratory problems, such as coughs, colds, sore throats and asthma.MSM (Methylsulfonylmethane), Pure Lignisul, with Vitamin C, 875 mg / 100 mg, 120 Caps
MSM with Vitamin C offers support for allergies, connective tissue, joint flexibility, immune function, arthritis, osteoporosis, digestive disorders, circulation, bruising, carpal tunnel syndrome, and antioxidant protection.Natural Remedies For Intestinal Health By Conrad LeBeau
Information on increasing appetite and rebuilding mucosal membranes and conditions such as candidiasis, acid-reflux, colitis, Crohn's disease and leaky gut syndrome.Noni Juice, Trace Minerals, 32 fl. oz.
Trace Minerals Noni Juice product may provide nutritional support for Bio-Electric Health and Body Mineral Balancing.Noni Juice Concentrate (Morinda citrifolia), 1 fl. oz.
Noni comes from the family Rubiaceae making it a relative of Samento or Uncaria Tomentosa and complimentary in use.Omega 3 Fish Oil, NOW Foods, Lemon Flavored, All Natural, 7 oz.
Omega 3 Fish Oil is important for mental and cardiac development.Samento (Uncaria Tomentosa), Extra Strength (100 Times More Effective Than Regular Cat's Claw), 0.5% POA, 600 mg, 30 Caps
Samento is beneficial in the treatment of a wide range of immune system related conditions; these include but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.Samento Liquid Extract (Uncaria Tomentosa), 0.5% POA, 1 fl. oz.
Beneficial in the treatment of a wide range of immune system related conditions; these include but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.Slippery Elm Tincture, 100% Organic, 2 fl. oz.
Slippery Elm is used as a cough lozenge and is widely available in pharmacies.Super Digestive Enzymes, 90 Caps
Super Digestive Enzymes contain a complete and balanced digestive enzyme formula.Sutherlandia (Sutherlandia Frutescens), 300 mg, 60 VegiTabs
Sutherlandia powerfully assists the body to mobilize its own immunological physiological resources to cope with diverse physical, mental and chemical stressors.The Miracle of MSM: The Natural Solution for Pain By Stanley W. Jacob M.D., Ronald M. Lawrence MD & Martin Zucker
Learn how to stop the pain of numerous ailments with MSM. How much, when, with what food and in what form to relieve pain in its many forms. Helpful against pain and allergies, this supplement is safe, natural and side-effect-free.True Focus, Targeted Amino Blend, NOW Foods, 90 VCaps
True Focus, an amino acid supplement, is an advanced nutriceutical complex that employs the latest neurotransmitter research to support proper brain chemistry balance.Vitamin C 1000 with Bioflavonoids, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Whole Leaf Aloe Vera Juice, 99.7% Pure, Certified Organic, Nature's Way, 1 Liter
Nature's Way Whole Leaf Aloe Vera Juice offers you the rich benefits of the most potent part of the aloe plant. Whole Leaf Aloe Vera Juice contains an abundance of advantageous components not found in most aloe gel filler products.Zinc Lozenges With Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges
Nature's Way Zinc lozenge boosts cold season defense with zinc, widely recognized as an important nutritional support during the cold season, and echinacea pupurea, clinically shown to support the immune system, and Vitamin C, a vitally important vitamin for general health maintenance.
HerbalRemedies: Crohn's Disease Information
HerbalRemedies: Crohn's Disease Supplements & Products
HerbalRemedies: Colitis / Ulcerative Colitis Information
NOTIFY YOUR HEALTH CARE PROVIDER IF...
You or a family member have not been diagnosed with IBD and you have symptoms of Crohn's disease or any other inflammatory bowel disease such as abdominal pain, blood in your stools, frequent diarrhea, or fever. Putting off visiting your health care provider if you have these symptoms is not appropriate as delaying the diagnosis and treatment may make the disease worse and increase your risk of complications.
People who have inflammatory bowel diseases often have a good sense of how severe their symptoms are. Notify your health care provider if there is a change in your usual symptoms or if your symptoms get significantly worse than usual. If you have persistent diarrhea for more than 2 weeks or have lost weight, notify your health care provider.
Call your health care provider immediately if you have been diagnosed with inflammatory bowel disease, your disease may have worsened significantly if you have any of the following symptoms:
- Fever over 101°F (38.33°C) or shaking chills.
- Lightheadedness, passing out, or rapid heart rate.
- Stools that are bloody for the first time.
- Severe dehydration.
- Severe abdominal pain or severe pain and bloating.
- Evidence of pus draining from the area around the rectum, or pain and swelling around the rectal area.
- Repeated vomiting.
- Not passing any stools or gas.
Some of these symptoms also may be signs of toxic megacolon. Inflammation and ulceration from ulcerative colitis or Crohn's disease sometimes weaken muscles in the colon. This can cause the colon to swell to many times its normal size. This condition is called toxic megacolon. Over time, tiny holes may develop in the colon, and fecal matter (stool) may spill into the abdominal cavity, causing a serious infection. Toxic megacolon is an emergency requiring immediate medical and surgical treatment. If it is not treated, toxic megacolon can be fatal. More people die from perforation of the colon than from any other complication of ulcerative colitis. A medication called neostigmine can be used to treat certain forms of toxic megacolon.
Even when in IBD is not active (in remission), your health care provider may want to see you regularly to check for complications, some of which can be hard to detect. It is always appropriate to call your health care provider's office for advice.
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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