The causes of Crohn's are not well understood. According to the CCFA, cultures that eat a Western-style diet high in sugar, salt, fat and animal foods are more prone to the disease than those that consume mainly fresh fruits and vegetables, grains and legumes; in fact, such cultures hardly ever get Crohn's. Typically, the disease hits adults under 40, and genetics, stress, food allergies, and possibly bacteria and viruses all appear to be contributing factors. A Swedish study published in The Lancet (1994, vol. 344) found that, compared to healthy individuals, Crohn's patients were more likely to have been born during or just after a measles epidemic, implying that exposure, but not necessarily infection, in fetuses or newborns promotes development of Crohn's.
Immune system disturbances are a hallmark of Crohn's, though researchers don't know if they are a cause or result. Any kind of inflammation is a reaction of the immune system; inflammation not only in the GI tract but sometimes also in Crohn's patients' joints (arthritis), skin, eyes and liver suggests that Crohn's may be an autoimmune disorder, in which the immune system overreacts and attacks healthy tissue.
TREATMENT AS USUAL
WHEN TREATING CROHN'S, the aim is for the patient to go into remission and remain there as long as possible, experiencing few symptoms and feeling relatively healthy. Unfortunately, conventional treatment options for Crohn's are limited, says James Romano, Ph.D., CCFA director of research and education, who reports that the No. 1 question people call about is diet. "The problem," he says, "is that there's no one diet for people with Crohn's." Most doctors, both orthodox and alternative, acknowledge the benefits of an elemental diet, a liquid, nutrient-complete food, available by prescription, that replaces all meals during a flare-up or intestinal obstruction, when it can decrease symptoms, and delay or even prevent surgery. Avoiding fiber is a good idea during flare-ups because it irritates the GI tract, and meat--which contains no fiber--is often recommended during remission to replace vastly depleted levels of protein, iron and vitamin [B.sub.1.sub.2]. Sometimes Crohn's patients are lactose intolerant, in which case they should avoid milk products.
No medications approved by the U.S. Food and Drug Administration exist to treat Crohn's, although research is being conducted on some that aren't yet approved. Prednisone, a steroid commonly used to diminish acute bowel inflammation, can dramatically reduce symptoms. However its side effects can include a puffy face, acne, weight gain, increased body hair, mood swings and depletion of calcium, vitamin D and potassium. Sulfasalazine, a sulpha drug, eases low-grade, chronic inflammation, but it interferes with folate metabolism and absorption and can cause nausea, dizziness, headaches, anemia and skin rashes. Immunosuppressive drugs and antibiotics are also used.
About two-thirds of Crohn's patients eventually have surgery when medication no longer manages symptoms or a complication arises, such as a bowel blockage or abscess. While cutting out the affected section of the bowel temporarily solves problems and alleviates symptoms, there's a 95 percent chance the disease will recur, according to The Merck Manual, a standard medical reference for doctors. For this reason, most surgeons put off operating until absolutely necessary.
THE NATURAL WAY
PATRICK DONOVAN, N.D., a naturopathic physician in private practice as well as a professor of gastroenterology at Bastyr University of Natural Health Sciences in Seattle, has seen several dozen cases of Crohn's disease in the past 10 years. Donovan is quick to point out that allopathic medicine plays an important role in managing the disease. "There's a place for prednisone and hospitalization when treating Crohn's," says Donovan. "A person can die from this disease, especially during a flare-up. Conventional treatments can save lives." In fact, Donovan will treat only those Crohn's patients who are also seeing a physician with hospital privileges. He also stresses the need for a correct diagnosis. He recently saw a patient who had been treated unsuccessfully for Crohn's for 10 years; he determined that she in fact had celiac disease, a condition in which gluten, a protein found in various grains, damages the intestinal lining.
When patients experience a flare-up but don't require hospitalization, Donovan typically puts them on an elemental diet for a week or so, until symptoms abate; if absolutely necessary, patients may also be on medication prescribed by their M.D. The next step is a primarily liquid diet, consisting of things like tofu, soymilk, and broth made from vegetables, sea vegetables or miso. At this point, Donovan feels that patients probably can't avoid drinking meat broth. As a doctor of natural medicine he generally recommends vegetarian diets for his patients, but for Crohn's he believes meat is necessary to regaining health. "The nutrients in animal foods are in a form our bodies can use immediately," says Donovan. "Plant constituents [including those in supplements] need to be rearranged to be used by humans. It's very important for Crohn's patients that nutrients are in the most utilizable form, to push them across the malabsorption barrier." He emphasizes that he recommends meat broth only during convalescence; once the Crohn's patient is in remission, he advises a plant-based diet.
But Mary James, N.D., doesn't agree that meat is essential to calming an active phase of Crohn's. James is director of educational services at the Asheville, N.C.-based Great Smokies Diagnostic Laboratory, which specializes in testing and education on the GI tract and digestive function. James points out that Crohn's symptoms and nutrient malabsorption can be aggravated by dysbiosis, a condition in which protective gut bacteria are overwhelmed by undesirable bugs, such as yeast, parasites and pathogenic bacteria. According to James, meat and other animal-based fats lead to the production of the bacteria Bacteroides vulgatus, which produces enzymes that irritate the intestinal lining and promotes inflammation.
James says that an alternative to meat broth is teas made from iron-rich herbs. According to Nutritional Herbology, by Mark Pederson (Pedersen Publishing, 1987), the nontoxic herbs with the highest iron content are devil's claw (290 milligrams [mg.] of iron per 100 grams [g.] of dried herb), chickweed (253 mg./100 g.) and mullein (236 mg./100 g.). If there's a proven iron deficiency, says Donovan, iron pills can be used cautiously, under the close watch of your doctor, because too much iron in supplemental form promotes intestinal inflammation. Vitamin [B.sub.1.sub.2] can also be supplemented, and a protein powder with a high protein-efficiency ratio, which refers to how much protein the body actually is able to use, can replace meat-based broth. "
Source and Full Article for More Research
http://findarticles.com/p/articles/mi_m0820/is_n224/ai_18129327/
No comments:
Post a Comment