Conquering Crohn’s and Ulcerative Colitis

Crohn’s and ulcerative colitis are auto-immune inflammatory diseases that can actually be diagnosed by the presence of inflammation along the digestive tract.

Inflammatory Bowel Disease – A Complex Equation

While there is no one universal therapy for inflammatory bowel disease a complex picture is emerging of a number of causative factors which, together, lead to inflammation of the bowel.

These factors include:

  • Genetically inherited tendency towards inflammation
  • Certain food allergies or sensitivities
  • Dysbiosis including bacterial imbalance and infections
  • Increased intestinal permeability
  • Eating too many pro-inflammatory foods and not enough anti-inflammatory foods.

Are You Auto-Immune?

Your immune system is designed to react to, not only unwelcome substances from the outside world, such as a viruses, harmful bacteria, pathogens and food allergens, but also to misbehaving cells such as cancer cells. But sometimes the immune system can attack healthy cells. This results in auto-immune diseases such as Crohn’s disease and ulcerative colitis. Wrongly, many people think that since the immune system seems to be over-reacting that anything that could ‘boost’ the immune system, for example, vitamin C, could make matters worse. But auto-immune diseases are a ‘system-control’ problem and many of the foods and nutrients that help an immune system to work make matters better not worse.

In relation to ‘cause’ there are two sides of equation, being the cell and the cell’s environment. A classic example is coeliac’s disease, an extreme form of wheat allergy that is very common among sufferers of Crohn’s and ulcerative colitis and should always be screened for. This is an extreme reaction to gluten, and usually the gliadin protein, which is in wheat, rye and barley, but not in oats. (80% of coeliacs don’t react to oats). Susceptibility to coeliac’s is, in part, genetically inherited. For example, if your mother, father, brother or sister have coeliacs you have a one in four chance of having it too. It is far more common than most think. Many medical textbooks say in affects 1 in several thousand. However, studies involving a new diagnostic test called anti-tissue transaminase (ATG), finds that it affects 1 in 111. But for coeliacs to ‘cause’ disease you have to eat gliadin.

So that’s the other side of the equation – what you expose your cells to. For this reason, for any auto-immune disease, especially those of the gut, I always recommend a proper allergy blood test to find out both if a person is ATG positive and also to find out if their body is producing IgG antibodies or IgE antibodies, indicating intolerance to certain foods. The theory is that if the immune system becomes hyper-alert against foods it ‘cross-reacts’ against certain body tissues. So, the goal is to eliminate the food and lessen the immune system’s belligerent attitude. What’s interesting is that 80% of coeliacs don’t react to oats, which are not only gliadin-free but also a rich source of beta-glucans.

Beta-glucans, which are especially rich in oat fibre, may help lessen auto-immunity and improve general health in a counter-intuitive way. One of the prevalent theories as to why auto-immune diseases are on the increase is that we live in too clean environments and don’t get enough exposure to early bugs and bacteria. Most such microbes have beta-glucans present in their cell walls and beta-glucans consequently stimulate the immune system and help to build up normal, strong immunity. Many known immune enhancers – from shiitake mushrooms to Echinacea, are rich sources of beta-glucans. Beta-glucans appear to act as an immune system modulator and may also help auto-immune diseases.

As well as eating more oats and shiitake mushrooms you can get supplements of purified beta-glucans. Choose those that contain (1-3) (1-6) beta-d-glucans. Some colitis sufferers are rightly wary of eating high fibre foods but oat fibres are so-called soluble fibres and much more gentle on the digestive tract. If you soak oats, or saturate them as in porridge all the better.

One of the biggest promoters or demoters of gut-associated immune reactivity is the balance of omega3/6 fats in your diet. By increasing the proportional amount of omega 3 you literally switch off the gut’s over-reactivity. Being overweight, or insulin resistant also increase the gut’s inflammatory potential. So, a low GL diet really does help auto-immune diseases. One clear reason for this is the damage caused by too high sugar levels, called glycosylation, to proteins so that they may start to misbehave, or no longer be recognised as friend, but rather foe, by the body’s immune system.

These damaged proteins are called AGEs (advanced glycation end-products) and the more you have the more your immune system is likely to react. Particularly bad is fructose (fruit sugar) which the body finds harder to burn, or turn directly into fat than glucose. That’s why fructose is a bit more ‘slow-releasing’ because the body can’t process it as smoothly as glucose. This sounds like good news but more and more evidence is suggesting that high fructose diets, principally from fructose sweetened fizzy drinks, are messing up the body’s control functions. Small amounts are not so much of a problem because the body can metabolise fructose, but once it’s limit is exceeded fructose becomes a dangerous sugar. If you follow my low GL diet you will naturally be limiting your fructose intake to healthy levels. Another successful diet approach to auto-immune diseases is a ‘paleo’ diet, or a Stone Age diet. Before we became peasant farmers, so to speak, humanity lived on lean meat, seafood, plants, fruit, and nuts. We weren’t yet eating grains or dairy products and many people with auto-immune diseases report great improvements eating an essential grain and dairy-free diet. A paleo-diet is also naturally high in omega 3 fats.

Another difference between modern living and paleo-living would have been vitamin D exposure. Given that we are originally designed to be naked, outdoors and living a lot further South than Watford our intake of vitamin D, primarily made in the skin in the presence of sunlight, but also in oily fish, has drastically declined. Vitamin D deficiency is linked to increasing risk of auto-immune diseases. We need at least 30mcg a day and eating oily fish and exposing a decent part of yourself for 30 minutes might give you 15mcg, so it’s best to supplement at least another 15mcg a day.

Healing the Gut

The digestive tract is the size of a small football pitch and the cells that make up your inner wall can easily become damaged and hence more permeable, allowing incompletely digested food particles through. In a study of children in the Newcastle district researchers from the Royal Victoria Infirmary found that those with Crohn’s disease had a sixfold increase in intestinal permeability. In another study at St Bartholomew’s’ Hospital in London children with Crohn’s disease and intestinal permeability were fed a diet of pure nutrients, not food as such, for six weeks. As a consequence there was both a substantial improvement in their symptoms and in their intestinal permeability. Indeed, many researchers have found that low-allergenic diets can produce significant relief both from Crohn’s and ulcerative colitis. The most common offending foods are wheat, milk and yeast, although the ideal diet varies from person to person.

The first step in its correction therefore lies in identifying offending foods and eliminating them. The next step is to correct dysbiosis and reinoculate the digestive tract with the right beneficial bacteria. There is some evidence that the wrong balance of bacteria may generate toxins that then damage the intestinal wall. The wrong bacterial imbalance can also affect immune function leading to increased inflammation in the digestive tract, so balancing this is important. The amino acid glutamine is especially important in healing the digestive tract. Look for supplements that combine digestive enzymes with probiotics and glutamine.

Understanding Inflammation

The main medical treatment is the use of anti-inflammatory drugs to actually calm down the inflammation or medication to turn off the body’s immune reactions. These drugs are effective but do nothing to address the actual causes of the inflammation. Instead of thinking ‘pain means drug’, inflammation is the body’s way of saying something is wrong. Inflammation is a ‘systemic’ problem, not just a localised phenomenon, in which the body’s physiology is shifted into an ‘alarm’ state.” It’s as if there is a series of underlying imbalances in the body’s chemistry that build up and then burst forth once the body can no longer cope with a set of circumstances. The actual symptoms, or pain, is the wave breaking, although the wave is a long time coming. Just taking anti-inflammatory drugs fails to address the underlying causes. From this perspective, there are several factors that set the scene for inflammation, and then those which trigger the manifestation of symptoms. So often it’s the ‘last hair that broke the camel’s back’ that gets the blame. ‘My colitis started when my marriage was breaking up’ or ‘ever since I had that bout of flu I started to get abdominal pain’. These triggers are important and may include a trauma, an allergy, an infection, a toxin or exposure to too many oxidants.

Indeed, some research has suggested that the triple vaccine for measles, mumps and rubella (MMR), which effectively induces all of these infections, can increase the risk of developing Crohn’s in susceptible people. One would hope that a healthy person could rise to such challenges, but if there are underlying weaknesses, such as a genetic predisposition or poor nutritional status, the person may have no reserves in the health bank and so the slightest stress cannot be accommodated and tips them over into an inflammatory state. All these factors need to be considered to restore health.

Nature’s anti-inflammatories

A diet high in meat and milk, rich sources of the pro-inflammatory fat arachidonic acid, or high in foods you’ve become allergic to, encourages inflammation. However a diet high in omega 3 fats, found in flax seeds (make sure you grind them or use flax seed oil) and oily fish switches off inflammation. Fish oils high in the omega 3 family of fats, particularly EPA, are well established in fighting inflammation. These natural, anti-inflammatory fats are particularly abundant in fish with teeth, which eat fish that eat plankton. Each step up the food chain concentrates them.

Most inflammatory disease respond best to about 1,000mg of EPA. This means taking two high strength omega 3 fish oil capsules a day. There are also a number of natural anti-inflammatory agents found in common foods.

These include:

Turmeric: Curcumin, the active ingredient in the yellow curry spices turmeric, works as well as anti-inflammatory drugs, but without the side effects. Like NSAIDs, it blocks the formation of the pro-inflammatory prostaglandins (PGE2), as well as leukotrienes. In fact, it turns out to be what everyone hoped drugs like Vioxx would be (a mild 5-Lox and Cox-2 inhibitor that not does not affect Cox-1) and has been used for its medicinal properties in Ayurveda (Indian traditional medicine), for hundreds of years. There is no evidence of any downsides, even in high doses of 8g a day.

Olives: The first is hydroxytyrosol – a very powerful antioxidant with anti-inflammatory effects. This is a ‘polyphenol’. Another key ingredient is oleocanthal which is chemically related to ibuprofen, though has none of the negative side effects. This is the ingredient that gives olive oil a throaty bite, like a slight sting at the back of the mouth, just as ibuprofen does. In 2005, a study by researchers at the Monell Chemical Senses Center and University of the Sciences in the US found that oleocanthal was a potent anti-inflammatory painkiller which partially inhibits the activity of the cox-1 and cox-2 enzymes. Like turmeric, olive extract decreases levels of pro-inflammatory substances. Studies on olive pulp extract have shown that it reduces levels of two inflammatory messengers called TNF-alpha and interleukin-8. In fact one study with mice found that the extract reduced TNF-alpha levels by 95%. Some of the newest pain-killing drugs work by reducing TNF-alpha.

An extract of hops: An extract from hops, called isooxygene, is one of the most potent natural COX-2 inhibitors and one of the most effective natural painkillers of all. It works just as well as painkilling drugs. In one study two tablets of ibuprofen inhibited COX-2 by 62 per cent, whereas isooxygene achieved a 56 per cent inhibition. Not only is it almost as effective as ibuprofen but it also doesn’t have the gut-related side effects of anti-inflammatory drugs. This is because ibuprofen also inhibits COX-1 (the so called ‘good’ COX, because it produces prostacyclin, which protects the gut lining), whereas the hop extract does not.

Quercitin – a red onion a day: Many plant foods contain flavonoid compounds, which are known to inhibit inflammation, as research shows. One of the most potent is quercitin. One red onion, or a cup of berries, or three servings of greens provides about 10mg of quercitin. Other good sources of quercitin include red wine, tea, grapefruit, broccoli, squash, red grapes, cranberries and citrus fruits. This is one reason why vegetarian diets have proven highly effective in reducing pain and inflammation. However, taking fifty times this amount, 500mg a day, quercitin becomes a potent anti-inflammatory inhibiting the production of the pro-inflammatory prostaglandins (type 2) and also inhibiting the release of histamine, which is involved in inflammatory reactions. Look for supplements containing concentrates of these natural anti-inflammatory agents.

Improve your methylation

One of the key ‘control’ mechanisms of the body is methylation, dependent on B vitamins and other ‘methyl’ nutrients. It is therefore not surprising to find that those with auto-immune diseases are much more likely to have a raised homocysteine level, which is the best indicator of poor methylation. This can be easily tested on a home-test kit.

If your homocysteine level is high there are specific nutrients (B2, B6, B12, folic acid, TMG, NAC and zinc) that you need to take in specific amounts to normalise your homocysteine level. The right amount to take, depending on your homocysteine level is shown in my Special Report.

This natural approach to conquering inflammatory bowel disease is complex, like the problem itself, and is best effected by working with a qualified nutritional therapist who can run the necessary tests and advise you on diet and supplements for each stage of eliminating the cause of the inflammation, calming it and helping to repair the damaged gut. It is based on an understanding that inflammation and pain are the body’s way of saying “help” and that current diet and lifestyle factors have exceeded the body’s capacity to adapt. Rather than suppressing the inflammation with drugs, this approach works to identify the contributing factors and restore balance.