Someone I know was recently diagnosed with Crohn’s disease and as a result isn’t eating all sorts of things. He often feels like crap.
I’d sure like to help him, but there aren’t a lot of clear answers about this disorder involving inflammation of the gastrointestinal tract.
Symptoms include diarrhea, cramping, fatigue and general low energy, though these can range from mild, easily managed discomfort to a severe condition with a serious impact on quality of life.
Treatments vary widely, and in intractable cases doctors sometimes perform surgery to remove part of the intestine or the entire colon.
Prescriptions for less intense symptoms often include antibiotics, corticosteroid medication or immunosuppressive agents.
Some advocate special diets like the Gottschall (also called the Specific Carbohydrate Diet), but unfortunately, evidence that changing your eating habits can help is inconclusive.
What the experts say
“A lot of people who develop Crohn’s are young. Those with the disease sometimes feel very weak and don’t have energy or joy. That’s the symptom we have to fight against. Diarrhea is usually controllable. The cramping requires different strategies – sometimes antispasmodic drugs or applying heat to the abdomen. There are several books devoted to diet therapy. I’m sure that for every book that’s written there’s a patient who did very well on that particular diet, while for others it didn’t work. We spend our lives looking for the magic diet. Most of the time there isn’t one.”
ALVIN NEWMAN, gastroenterologist, Mt. Sinai Hospital, Toronto
“None of the theories regarding the specific cause of Crohn’s disease have been proven. Those with a Jewish heritage are three to six times more likely to develop it, along with those of European, particularly Scandinavian, ancestry. Other risk factors are family history of inflammatory bowel disease, cigarette smoking, living in an urban area, a diet high in sugar and hydrogenated fats and low in fruits and vegetables, and stress. There is no known way to prevent the disease, but relapses can be reduced with lifestyle changes. Exercise can help prevent stress and depression. Fish oil, which contains omega-3 fatty acids, and a bland diet also show promise.”
SUSHMA SHAH, Nature’s Intentions Naturopathic Clinic, Toronto
“Classical thoughts on the causes include environment, emotional imbalance, unregulated eating habits or poor eating, and excessive long-term fatigue. All these can produce damp heat that builds up and pours downward into the large intestine. Traditional Chinese medicine treats this by eliminating dampness and clearing heat. One useful herbal formula is Bi Xie Shen Shi Tang.”
ROBERT McDONALD, TCM practitioner, Toronto
“When patients have flare-ups, we suggest lowering fibre foods and avoiding nut and seed skins, anything that could cause aggravation or gas. As well, avoid dairy during flare-ups. When people are healthy, we encourage them to eat what they can tolerate and maintain good nutritional status so it’s easier to fight off future episodes. Diet can minimize symptoms, but you should still see a health professional.”
ANDREA CLARK, registered dietitian working with Crohn’s and colitis patients, Mt. Sinai Hospital, Toronto
“Crohn’s, like other autoimmune diseases, is caused partly by genetics and partly by environment. We don’t understand any of the environmental triggers, but we know about five of the genetic changes that predispose to Crohn’s. Bacteria in the intestines play key roles, and at least one of the proteins produced by the disease genes appears to transport damage-producing bacteria into gut cells. Anyone might have those bacteria, but only certain people may be genetically incapable of handling them so the bacteria cause unchecked inflammation.”
KATHERINE SIMINOVITCH, senior scientist, genomic medicine, Toronto General Research Institute