By: Dr. George Stanton
In 2015, an estimated 3 million U.S. adults had inflammatory bowel disease (IBD).1 Two common conditions include:
• Crohn's disease
• Ulcerative colitis
Continue on to learn more about IBD; or you can skip to the bottom of this article to learn what you can do to address IBD conditions.
Crohn’s disease is an inflammatory bowel disease characterized by chronic inflammation of the gastrointestinal tract. Symptoms are a later step to a disease process, so once you are experiencing discomfort or pain, it is safe to say this has been going on for a while in the body, and is not just one instance of GI disturbance.
The GI tract is from the mouth to the anus, and includes the esophagus, stomach, small intestine, large intestine. These organs are crucial to help to break down food into usable nutrients, energy, aide in nutrient absorption, immune system function, and helping to rid the body of metabolic waste. When it is chronically inflamed, the intestines/organs are damaged and can lead to “leaky gut” (which can spiral into a myriad of issues).
Crohn’s most often affects the ileum (the last part of the small intestine) and the beginning parts of the colon (large intestine), but has the potential to affect anywhere in the GI tract (remember – mouth to anus). It can traverse through the layers of the intestine, where as other IBD’s usually only affect one layer. It has “skip” lesions, meaning it can affect one part of the GI tract, then skip to a different area, rather than be continuous.4 Ulcerative Colitis is also a long-term inflammatory bowel disease, but unlike Crohn’s, it is only in the colon. Crohn’s is more prevalent in the age groups of 16-25, whereas Ulcerative colitis is more prevalent in the age groups of 30-40.3
Possible Complications from IBD (taken from Mayo Clinic’s website)5:
Bowel obstruction. Crohn's disease affects the thickness of the intestinal wall. Over time, parts of the bowel can scar and narrow, which may block the flow of digestive contents. You may require surgery to remove the diseased portion of your bowel.
Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).
Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind. When fistulas develop in the abdomen, food may bypass areas of the bowel that are necessary for absorption. Fistulas may occur between loops of bowel, into the bladder or vagina, or out through the skin, causing continuous drainage of bowel contents to your skin. In some cases, a fistula may become infected and form an abscess, which can be life-threatening if not treated.
Anal fissure. This is a small tear in the tissue that lines the anus or in the skin around the anus where infections can occur. It's often associated with painful bowel movements and may lead to a perianal fistula.
Malnutrition. Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. It's also common to develop anemia due to low iron or vitamin B-12 caused by the disease.
Colon cancer. Having Crohn's disease that affects your colon increases your risk of colon cancer. General colon cancer screening guidelines for people without Crohn's disease call for a colonoscopy every 10 years beginning at age 50. Ask your doctor whether you need to have this test done sooner and more frequently.
Other health problems. Crohn's disease can cause problems in other parts of the body. Among these problems are anemia, skin disorders, osteoporosis, arthritis (Joint pain), and gallbladder or liver disease. [The bold ones are some common symptoms we see in our office.]
Medication risks. Certain Crohn's disease drugs that act by blocking functions of the immune system are associated with a small risk of developing cancers such as lymphoma and skin cancers. They also increase risk of infection. Corticosteroids can be associated with a risk of osteoporosis, bone fractures, cataracts, glaucoma, diabetes and high blood pressure, among others. Work with your doctor to determine risks and benefits of medications.
Diagnosis:
Diagnosis of IBD is a little tricky and involves mostly ruling everything else out first. There are, however, a few blood markers to evaluate:
IgA and IgG antibodies for Saccharomyces Cervevisiae – nearly 80% of Crohn’s disease patients are positive for either the IgA or IgG markers of these
Atypical ANCA – this is positive in a significant percentage of UC patients
P-ANCA antibodies – found in 50-70% of UC, but only 20% of Crohn’s patients.
Other testing includes colonoscopy with biopsy, X-rays of the abdomen, Barium enema, and upper endoscopy. At this time, there is not one test that is conclusive for the diagnosis of Crohn’s or UC, but the combination of present symptoms and testing is the best course to follow for a diagnosis.
According to the CDC, “IBD is the result of a defective immune system”2. This is due to autoimmunity, which means your body is mounting an immune attack against your colon. It basically thinks the colon is a bacterial infection and is fighting it. Refer to the chart below from a study reviewing causative factors of IBD.3
What can be done about IBD?
Traditional treatment includes:
Aminosalicylates – an aspirin-like compound
Corticosteroids (such as prednisone)
Immunomodulators (which will cause an inability to maintain an inflammatory response)
If the condition becomes severe enough, a possible course of treatment is bowel resection. Realize that there are many long-term complications to corticosteroids (such as osteoporosis and more, which will be left for another blog post), so this option isn’t ideal. Generally, traditional treatments are often trading one problem for another, and not addressing the causes of the disease process. We must look deeper into these issues to find relief.
At Prairie Sage, we believe in identifying and addressing the root cause of an issue. We need to ask:
What is causing this immune system confusion?
How can we bring the body back into balance?
How can we modulate the inflammation without compromising other organs and systems?
With any autoimmune condition, there are 3 things we need to address:
1. Genetics – There is a gene that is switched on that was normally off. When the right environment presented itself, the gene expressed itself (this is called epigenetics).
2. “Leaky gut” (intestinal permeability) – This is a precursor to autoimmune conditions. Basically, it is the intestine letting molecules through the lining which are normally not able to do so. This process is causing inflammation.
3. Triggers – This is where it gets more individual. Triggers can be anything from stress, infections, food intolerances, blood sugar imbalances, heavy metals, environment (chemicals, plastics, mold, etc), and more. Identifying triggers is a process and usually it takes time to get to the bottom of these. In most autoimmune conditions, multiple triggers are involved. We educate our patients and walk them through protocols to help rid the body of toxins and infections. We also educate and provide proper lifestyle recommendations to help bring balance to the body and keep the immune system in check.
It is important to assess every case individually and proceed according to each patient’s specific needs. Assessments in our office includes tests like:
Stool testing for microbes, inflammation, and occult blood. Organisms like Klebsiella and Mycobacterium may be contributing to gut disruption and leading to autoimmunity.6,7
Urine Organic Acids testing (OATs) for yeast/fungal overgrowth, bacterial, and mitochondrial function
Blood tests to evaluate underlying inflammation, anemias, electrolytes, infections, and other patterns of dysfunction
Hair mineral analysis to assess the heavy metal burden
IgG/IgA food sensitivity testing to identify the inflammatory burden on the intestine
We also utilize symptom questionnaires, as there is currently no reliable testing for parasites, and they can contribute to intestinal and systemic dysfunction as well.
While waiting on test results, we can begin addressing the drainage pathways (check out our post on drainage here). We also work on reducing inflammation and developing a more specific protocol together once we have more information. Remember that UC and Crohn’s are multifactorial3, which means that there are multiple issues that are contributing to the autoimmune condition – So don’t give up on your health journey!
If you or someone you know is struggling with Crohn’s, Ulcerative Colitis, Colitis, IBS, or any other digestive issues, share this article with them and give our office a call. We can set up a consultation to discuss whether Prairie Sage can help improve the health of your family, your friends, and you!
1. https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a4.htm?s_cid=mm6706a4_w
2. https://www.cdc.gov/ibd/what-is-IBD.htm
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734944/
4. https://www.crohnscolitisfoundation.org/what-is-crohns-disease