Inflammatory Bowel Disease:  There and Back Again

Dr. Juliet Ghodsian, ND

A diagnosis of Crohn’s Disease, Ulcerative Colitis, Ulcerative Proctitis, or Diverticulitis is no small pill to swallow.  It brings with it a heavy weight of possible complications, suppressive medications, invasive procedures, and a massive impact on the quality of your daily life. It can be an overwhelming and helpless feeling to find yourself coming to terms with the reality of this diagnosis. 

Although it may not feel like it once you have entered the world of conventional medical management of chronic disease, there is an important role that Naturopathic Medicine can play in your health journey.  Most important is the fact that we seek to uncover the underlying cause of disease and to restore normal physiology to a de-stabilized system.   As an ND I believe the body has the ability to maintain health and to self-regulate.  If we can remove obstacles to healing and restore balance, the body will bring itself back toward health ( homeostasis).

Here are the Top Five items from my IBD Checklist.  Making sure that these 5 factors are in balance and functioning well are crucial steps on the pathway to remission.

#1

Are you chronically stressed and over-stimulated?

Activation of the Fight or Flight branch of your nervous system (SNS) will result in your entire digestive process being turned off.  Your body considers digestion a non-essential function when in a survival situation.  If we chronically live in SNS dominance, this means we are putting food into a system that is turned OFF. The production of cortisol and cortisone by the stress management gland can become easily disrupted when the body exists in a state of chronic stress.  Depleted levels of these hormones can inhibit our ability to manage and control inflammatory compounds that our body naturally secretes.

The end result of these two imbalances is that you create an environment of mal-digestion, poor elimination and chronic over-activity in the immune and inflammatory responses in the body.  

#2

Do you have an underlying bowel infection?

Undiagnosed low-grade infection or overgrowth of organisms in the small or large bowel can be a major trigger of chronic immune activation in the gut environment.  These can be bacterial, fungal or parasitic organisms, many of which have been picked up either from food, water, direct infection, antibiotic use, animal contact, etc.  When an infection is not immediately detected and treated it can result in low-grade chronic inflammation in the intestinal environment as the body tries to eliminate the organism on its own. This is an underlying factor in many autoimmune conditions, not just with IBD.  If this is an element of your health picture, it absolutely must be addressed first as it is a direct cause of the overactive immune response that triggers the gut mucosa damage associated with IBD.

#3

Are your digestive organs under/ malfunctioning?

If you have an overactive stress response, as mentioned in Checklist Item #1, this can be a cause of your “ underfunctioning” digestive response.  You have simply turned off production.  If this is the case, the answer lies in turning it back ON.  We have many extremely effective herbal and dietary options that function as “bitters”.  These compounds will stimulate the production of salivary amylase, stomach hydrochloric acid, pancreatic enzymes and bile from the liver.  There are other herbal remedies that can help stimulate peristalsis and “motility” in the small intestine and colon. This muscular activity is what helps you to regularly eliminate waste products from the bowel.  There can be other causes of under-functioning digestive organs that your ND can help you work up.  Optimal digestion and elimination is considered a Pillar of Health, meaning without it you cannot be in optimal health.

#4

Are you eating something that is triggering chronic inflammation?

The unfortunate side effect of chronic mal-digestion and low-grade inflammation in the gut environment is that you can become sensitive and reactive to foods that you are eating.  For some patients this is the initial trigger that starts the cascade of chronic inflammation that ultimately results in full-blown IBD.  It is not uncommon for patients with IBD to have significant inflammatory reactions in the intestinal wall when they consume particular foods.  The question of whether the food trigger is a cause of your IBD or if it is simply another symptom of Checklist Items #1,2,or 3 happening in your body, is something that your ND can help you determine.  Not every patient has the same set of circumstances and your specific case will need to be considered.  For many patients with IBD, eliminating a peak allergenic food from the diet is crucial for a full recovery.

#5

Do you have a healthy balance of bacteria in your colon?

The microbiome is the delicate balance of bacteria and fungus that colonize the human intestinal tract.  There is significant research indicating different trends around either the presence or absence of different microbes and its relationship to whether someone will have IBD or if they will not.  There is a growing body of evidence that both probiotic supplementation and Fecal Microbiota Transfer ( FMT) can have a significant impact on helping patients achieve remission of their IBD.

The take home message is that a healthy balanced microbiome is crucial for maintaining a normal immune response and appropriate digestive/elimination function. 

Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882399/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967301/

https://www.ncbi.nlm.nih.gov/pubmed/27383325

https://www.ncbi.nlm.nih.gov/pubmed/28174756

https://www.ncbi.nlm.nih.gov/pubmed/30644982

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