Crohn's disease is a chronic inflammatory condition involving the small intestine, most often the lower part called the ileum. However, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix or anus. Crohn's disease is also called ileitis or enteritis. Crohn's disease affects a half million Americans, many aged 15 to 35 years.

Exercise of benefit in Crohn's disease
Light exercise such as walking may be helpful for some people with Crohn's disease. People with mild Crohn's disease who take a walk a few times per week notice an improved sense of well-being and quality of life.

Supplements that may be helpful in Crohn's Disease
Research regarding the use of dietary supplements in the treatment of Crohn's disease is limited. I continue to update this page as I come across more studies regarding the natural treatment of this condition.

Curcumin is an extract found in turmeric which has anti-inflammatory properties.
Fish Oils have beneficial fatty acids called EPA and DHA.
Vitamin D - many patients with Crohn's disease are deficient in vitamin D.
Probiotics may be helpful in some people. The combination of prebiotics and probiotics could offer some relief for patients with Crohn's disease.
Vitamin B12 abnormalities are common in patients with Crohn's disease. Patients with a prior ileal or ileocolonic resection are at particular risk for vitamin B12 deficiency.
Mastic could be considered.

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Curcumin and Crohn's disease
Curcumin therapy in inflammatory bowel disease: a pilot study.
Dig Dis Sci. 2005 Nov;50(11):2191-3. Holt PR, Katz S, Kirshoff R. St. Luke's Roosevelt Hospital Center, Columbia University and Strang Cancer Center Research Laboratory, New York, New York.
Curcumin has been shown to have anti-inflammatory and antioxidant properties in cell culture and animal studies. A pure curcumin preparation was administered in an open label study to five patients with ulcerative proctitis and five with Crohn's disease. All proctitis patients improved, with reductions in concomitant medications in four, and four of five Crohn's disease patients had lowered CDAI ( crohn's disease activity index ) scores and sedimentation rates. This encouraging pilot study suggests the need for double-blind placebo-controlled follow-up studies.

Fish oil and Crohn's disease
Fish oil and antioxidants alter the composition and function of circulating mononuclear cells in Crohn's disease.
Am J Clin Nutr. 2004 Nov;80(5):1137-44.
Crohn's disease is associated with osteoporosis and other extraintestinal manifestations that might be mediated by cytokines from circulating (peripheral blood) mononuclear cells (PBMCs). Fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) reduces disease activity in patients with Crohn's disease. We investigated the effect of fish oil plus antioxidants on cytokine production by PBMCs from patients with Crohn's disease with raised C-reactive protein concentrations or erythrocyte sedimentation rates (>/=18 mm/h). A randomized placebo-controlled trial of fish oil (2.7 g EPA and DHA/d) or placebo (olive oil) for 24 weeks was conducted in patients with Crohn's disease. The fish-oil group additionally received an antioxidant preparation (vitamins A, C, and E and selenium). Exclusion criteria included corticosteroid use. Fish-oil plus antioxidant dietary supplementation was associated with higher EPA and DHA incorporation into PBMCs and lower arachidonic acid and lower production of IFN-gamma by mitogen-stimulated PBMCs and of PGE(2) by lipopolysaccharide-stimulated PBMCs. Dietary supplementation with fish oil plus antioxidants is associated with modified PBMC composition and lower production of PGE(2) and IFN-gamma by circulating monocytes or macrophages. The response of extraintestinal manifestations of Crohn's disease should be investigated in a randomized controlled trial.

Vitamin D and Crohn's disease
Vitamin D status in children and young adults with inflammatory bowel disease.
Pediatrics. 2006 Nov;118(5):1950-61. Pappa HM, Gordon CM, Saslowsky TM, Zholudev A, Horr B, Shih MC, Grand RJ. Center for Inflammatory Bowel Disease, Division of Gastroenterology and Nutrition, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
Previous studies of vitamin D status in pediatric patients with inflammatory bowel disease have revealed conflicting results. We sought to report (1) the prevalence of vitamin D deficiency (serum 25-hydroxy-vitamin D concentration < or = 15 ng/mL) in a large population with inflammatory bowel disease, (2) factors predisposing to this problem, and (3) its relationship to bone health and serum parathyroid hormone concentration. Vitamin D deficiency is highly prevalent among pediatric patients with inflammatory bowel disease. Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohn's disease. The long-term significance of vitamin D deficiency for this population is unknown at present and merits additional study.

Prebiotics and probiotics for Crohn's disease
High dose probiotic and prebiotic cotherapy for remission induction of active Crohn's disease.
J Gastroenterol Hepatol. 2007 Aug;22(8):1199-204. Third Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
This study assessed the clinical usefulness of combined probiotic and prebiotic therapy in the treatment of active Crohn's disease. Ten active Crohn's disease outpatients without history of operation for Crohn's disease were enrolled. Their mean age was 27 years and the main symptoms presented were diarrhea and abdominal pain. Patients' initial therapeutic regimen of aminosalicylates and prednisolone failed to achieve remission. Patients were thus initiated on both probiotics (75 billion colony forming units [CFU] daily) and prebiotics (psyllium 10 g daily). Probiotics mainly comprised Bifidobacterium and Lactobacillus. Patients were free to adjust their intake of probiotics or prebiotics throughout the one year trial. Seven patients had improved clinical symptoms following combined probiotic and prebiotic therapy. Six patients had a complete response, one had a partial response, and three were non-responders. Two patients were able to discontinue their prednisolone therapy, while four patients decreased their intake. High-dose probiotic and prebiotic cotherapy can be safely and effectively used for the treatment of active Crohn's disease.

Crohn's disease diet
Although diet may affect the symptoms in patients with Crohn's disease, it is unlikely that diet is responsible for causing the disease. But it is possible that diet could influence the course of Crohn's disease. If you find a particular diet helps your Crohn's disease symptoms, stay with it.

Children and Crohn's disease
Children who don't consume enough vegetables and fruits are more likely to have Crohn's disease than children to eat a good amount of fresh produce. Children who eat lots of vegetables, fruits, fish and dietary fiber are significantly more protected from Crohn's disease compared with those with the lowest intake of these foods. American Journal of Gastroenterology, September 2007.

Enteral feeding
While total enteral nutrition with a liquid formula can suppress gut inflammation and induce remission in Crohn's disease, partial enteral nutrition using a liquid supplement does not appear have the same effect. In the United States, currently, the treatment of choice for Crohn's disease is steroids. Outside of the US, however, there is interest in using a nutritional liquid diet, which has become the first line of treatment in the United Kingdom. The total liquid enteral nutrition approach is free of the side effects associated with heavy repetitive steroid therapy. However, it is a difficult treatment for children, requiring them to take all nutrients in liquid form for a 6-week period. However, partial enteral nutrition is not as effective as total enteral nutrition.

Cause of Crohn's disease - could it be a bug?
The cause of Crohn's disease is not fully understood. Perhaps an infection by certain bacteria, such as strains of mycobacterium, may be the cause of Crohn's disease, but scientists are still trying to find out.
   In Sardinia, Italy, the majority of patients with Crohn's disease harbor Mycobacterium avium subspecies paratuberculosis in their intestinal mucosa, according to a report in the July, 2005 of the American Journal of Gastroenterology. Dr. Leonardo A. Sechi and colleagues from Universita degli studi di Sassari, Italy, detected M. avium subspecies paratuberculosis (MAP) in fresh intestinal mucosa biopsies from 30 patients with Crohn's disease and 29 control patients. Twenty-five patients (83%) with Crohn's disease tested positive for MAP by PCR compared with only 3 control patients (10%). Two additional patients with ulcerative colitis tested negative for MAP. 
   Dr. Kenneth W. Simpson, from Cornell University in Ithaca, New York, and colleagues used DNA analysis to compare the intestinal microbial flora in patients with Crohn's disease and in healthy subjects. They found an increase in the intestinal levels of a new type of infectious Escherichia coli bacteria, along with a depletion of Clostridium bacteria. The severity of the disease in the small intestine was directly related to the number of E. coli present. These findings suggest that a new group of E. coli contains opportunistic pathogens that might be the cause of chronic intestinal inflammation in susceptible individuals, The ISME Journal: Multidisciplinary Journal of Microbial Ecology, July12, 2007.

Crohn's disease and MMR vaccine
Since the introduction of the measles-mumps-rubella (MMR) vaccine in the UK in 1988, there has been no increase in the occurrence of the inflammatory bowel condition, Crohn's disease, according to a report in the May 2005 issue of the British Medical Journal. In 1998, gastroenterologist Dr. Andrew Wakefield published a study linking MMR vaccination to the occurrence of autism and an inflammatory bowel disease similar to Crohn's disease in several children. Numerous studies have since discounted the association with autism, but less attention has been given to the purported connection to Crohn's disease.

Crohn's symptom
Symptoms of Crohn's disease include digestive problems such as abdominal pain, abdominal cramping, abdominal swelling, abdominal tenderness, nausea and vomiting, diarrhea, gastrointestinal or rectal bleeding, weight loss, fever, and anemia. Crohn's disease is an inflammatory bowel disease.

Chron's disease and cancer
Patients with Crohn's disease face a higher risk of both colorectal cancer and small bowel cancer.

Crohn's disease treatment in children
In May 2006, the Food and Drug Administration approved Remicade (infliximab) to treat children with active Crohn's disease, a chronic, inflammatory condition of the bowel that can be severely debilitating. Remicade is a genetically engineered monoclonal antibody, which reduces inflammation (swelling/redness) by blocking the action of tumor necrosis factor-alpha (TNF-a), that was initially approved in 1998 to treat Crohn's disease in adults.

Crohns disease research update
According to a study published in the American Gastroenterological Association journal Clinical Gastroenterology and Hepatology, the addition of popular bone building drugs to calcium and vitamin D therapy to treat bone loss associated with Crohn's disease is not beneficial. Moreover, the study shows that calcium and vitamin D treatment alone can improve bone mineral density (BMD) in Crohn's patients by 3 to 4 percent per year. "Patients with Crohn's often suffer loss of bone mass and an increased number of bone fractures due to treatment with corticosteroids, poor nutrition, active inflammation and calcium and vitamin D deficiencies," said Charles Bernstein, MD, author of an editorial appearing in this month's journal. "Calcium and vitamin D have long been used to enhance bone mass in people with Crohn's, and findings of these studies show it to be sufficient in maintaining BMD in these patients." Crohn's disease is an inflammatory bowel disease that causes chronic inflammation of the intestinal wall. While the cause of Crohn's is relatively unknown, it usually starts during the teenage years or early adulthood and is characterized by pain in the abdomen, diarrhea and weight loss. According to the most recent data from the National Health Interview Survey, there are more than two million prevalent cases of Crohn's disease in the United States. According to results of the study from researchers at the University of Alberta, adding the bone-building drug etidronate (Ditronel) to calcium and vitamin D therapy to treat bone loss in people with Crohn's disease adds no additional benefit. This study aimed to assess the efficacy of etidronate on bone loss in patients with Crohn's disease, an effect that has never before been studied in patients who were not menopausal or on corticosteroid therapy.

Ameliorative effect of IDS 30, a stinging nettle leaf extract, on chronic colitis.
Int J Colorectal Dis. 2004 Aug
Anti-TNF-alpha antibodies are very effective in the treatment of acute Crohn's disease, but are limited by the decline of their effectiveness after repeated applications. The stinging nettle leaf extract, IDS 30, is an adjuvant remedy in rheumatic diseases dependent on a cytokine suppressive effect. We investigated the effect of stinging nettle extract on disease activity of murine colitis in different models.  The long-term use of stinging nettle extract is effective in the prevention of chronic murine colitis. This effect seems to be due to a decrease in the Th1 response and may be a new therapeutic option for prolonging remission in inflammatory bowel disease.

Chrohn's Disease -- A bacterium that causes intestinal illness in cattle and sheep could also be responsible for Crohn's disease. Crohn's disease is an inflammation in the small intestine that affects about a million people worldwide. Scientists are not sure what causes it but they suspect it is due to a reaction by the body's immune system to a virus or bacterium. Dr Saleh Naser and researchers at the University of Central Florida in Orlando believe it is due to a bacterium called Mycobacterium paratuberculosis that is found in cattle, sheep and goats suffering from an illness called Johne's disease.

A preparation of proteins extracted from a person's own colon cells and administered orally leads to disease remission in many patients with Crohn's disease. To produce the preparation, called Alequel, material is taken from a biopsy of the mucosal layer of the large bowel It is then solubilized, prepared with a specific buffer. The patient then takes the preparation orally three times per week.

Crohn's disease questions and emails
Q.  I think probiotics are very good for Crohn's Disease as well as your listed supplements.

Q. Do soil organism supplements help with Crohn's disease symptom relief?
   A. See soil organisms for a review.

Q. I note your pages on Crohn's disease do not address diet quite so much as they perhaps should. I suspect the disease is caused- at least in some people- by an imbalance in the microbial flora. Specifically, it starts with Mycobacterium avium ssp. paratuberculosis, as you note (there are simply too many similarities with Johne's disease to ignore it), but somewhere along the lines, other bacteria get involved- I think. Anyway- net upshot: too much sugar, and the wrong types of carbohydrates. See also: Elaine Gottschall's "Specific Carbohydrate Diet," written in "Breaking the Vicious Cycle." A similar diet, the Paleolithic Diet, excludes many oligosaccharides and eschews added sugar. The main difference is that the Specific Carbohydrate Diet strongly encourages home-made yogurt (which has a number of obvious benefits, but has also been shown to reduce problems on a cellular level- the probiotics are tumor necrosis factor inhibitors, same as the nasty injectibles like Humira and Remicade but without the gross side-effects like, er, death), while the Paleolithic Diet eschews *all* fermented foods. Note too that the Atkins diet reportedly worked for 85% of the people Atkins studied; I do not think he published this anywhere, but the reason is obvious: removal of the excess sugars from the diet. I think it is consistent with the concept that the disease is- at least in some Crohn's sufferers- rooted in a microbial imbalance. Starve the bacteria of their carbohydrates (no wheat, no corn, no potatoes, no rice, no bread, etc.), and the inflammation- mimicking an autoimmune response, same as celiac disease- is greatly reduced. Not all do well on this diet, but for the ones that do, there are some who are driven into a deep remission given enough time and an abstemious diet.
   A. I can't see any harm in reducing sugar intake which benefits many health conditions. Excess sugar causes inflammation.

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Q. Q. Is there any research that mangosteen extract is good for Crohn's disease?
   A. As of August 2009, we have not seen any studies that mangosteen extract has been tested in Crohn's disease.

Some people inaccurately spell Cron's or Chron's disease rather than the correct Crohn's disease