Inflammatory Bowel Disease, herbs, vitamins, supplements, diet and food, natural and alternative treatment by Ray Sahelian, M.D.
Feb 22 2014

The cause of inflammatory bowel disease IBD is not fully known, but it probably involves an autoimmune disease reaction of the body to its own intestinal tract. Rates of depression, and possibly some types of anxiety disorder, are high among people with inflammatory bowel disease or IBD. Stress can trigger this condition in some patients. People taking the acne drug isotretinoin appear to run an increased risk of developing inflammatory bowel disease. Living in a sunny climate appears to reduce one's risk.

Types of IBD
The 2 major types of inflammatory bowel disease are ulcerative colitis and Crohn's disease. As the name suggests, ulcerative colitis is limited to the colon; Crohn's disease can involve any segment of the gastrointestinal tract from the mouth to the anus.

Natural treatment for Inflammatory Bowel Disease
The nutritional treatment of this condition is underused by many doctors and we hope that additional research will provide more concrete answers. Before you make any changes to your prescription medication treatment, talk to your doctor.

Curcumin has been found to potentially be of benefit
Curcumin therapy in inflammatory bowel disease: a pilot study.
Dig Dis Sci. 2005. St. Luke's Roosevelt Hospital Center, Columbia University and Strang Cancer Center Research Laboratory, New York, New York.
Curcumin, a natural compound used as a food additive, 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.

Lyprinol has been tested in mice.
Aloe Vera has been tested in ulcerative colitis. See study below.
Polyphenol plant substances could be helpful
Probiotics have been shown at times to be helpful when given as a supplement.
   Acta Gastroenterol Belg. 2013. The pathophysiology of inflammatory bowel disease is still incompletely understood. While the development of the immune system and the establishment of the microflora take place during infancy young patients often have a more severe and extensive disease. The differences in composition and concentration of intestinal microbiota and aberrant immune responses towards the luminal bacteria prompted the concept of an 'ecological' approach to control the disease course. Probiotics, living, non pathogenic micro organisms with a beneficial effect on the host, and prebiotics, oligosaccharides promoting the growth of the beneficial microflora, have been studied to this effect. Results have so far been disappointing for Crohn's disease but encouraging for ulcerative colitis.
Pycnogenol is a marina pine bark extract

Vitamin D deficiency may be possible
A vitamin D deficiency can make the condition more severe and worsen the quality of life for affected individuals.

Vitamin D status in children and young adults with inflammatory bowel disease.
Pediatrics. 2006. Center for Inflammatory Bowel Disease, Division of Gastroenterology and Nutrition, Children's Hospital Boston, Boston, MA, 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 hypovitaminosis D for this population is unknown at present and merits additional study.

Polyphenols and Inflammatory bowel disease
Polyphenols in the treatment of inflammatory bowel disease and acute pancreatitis: the missing ingredient in enteral and parenteral nutrition formulas?
Gut. 2006; Tel Aviv Sourasky Medical Center, Israel.
Polyphenols are phytochemicals that are abundant in food and beverages derived from plants. Although no deficiency- state has been described for them, increased intake of polyphenols appears to protect against disease in virtue of their anti-inflammatory and vasculo-protective properties. This article focuses on four polyphenols with established anti-inflammatory properties: resveratrol, epigallocatechin gallate, curcumin and quercetin. In rodents, ingestion or systemic administration of these agents inhibits Nuclear Factor Kappa B-dependent gene expression and induces Phase II anti-oxidant and detoxifying proteins. Conditions prevented and/or ameliorated by these polyphenols include inflammatory colitis and acute pancreatitis. Enteral nutrition plays an important role in the management of inflammatory bowel disease - mainly of Crohn's Disease, and of acute pancreatitis. Parenteral nutrition is reserved for refractory cases and disease-associated complications. Artificial nutrition attempts to safely administer the essential and otherwise beneficial constituents of food to patients with an impaired ability to ingest or digest food, yet polyphenols are not included in the formulas. We suggest that the addition of polyphenols to artificial nutritional formulas would improve the outcome of patients with inflammatory bowel disease and acute pancreatitis in need of enteral or parenteral nutrition.

A nutritional approach
Ulcerative colitis is a severe inflammatory bowel disease of the colon that produces bloody diarrhea. Taking a mixture of several probiotic bacteria reduces symptoms in patients with ulcerative colitis that doesn't respond to conventional medications. The probiotic mixture contained four strains of Lactobacillus, three strains of Bifidobacterium and one strain of Streptococcus salivarius -- all well-known species of good bacteria. Researchers from the University of Alberta in Edmonton, Canada enrolled 34 patients with active ulcerative colitis who were treated with the probiotic mixture twice daily for 6 weeks. A variety of standard treatments had been tried on the patients first, with no help. Remission occurred in 53 percent of the patients and an additional 24 percent experienced some degree of improvement in symptoms. A few patients experienced no improvement or worsening of their symptoms. The only apparent side effect from the probiotic mixture was increased bloating. Testing of sampled colonic tissue provided direct evidence that the probiotic bacteria had, in fact, reached the diseased sites of the colon.  American Journal of Gastroenterology, 2005.

Diet and food
Eating lots of animal protein appears to increase women's risk of developing IBD. Dr. Franck Carbonnel of the Centre Hospitalier Universitaire de Bicetre in Paris followed more than 67,000 women participating in a long-term study of risk factors for cancer and other common illnesses. The women were 40 to 65 years old when they enrolled in the study. During follow-up, which averaged about 10 years, women who consumed the most protein were at more than triple the risk of being diagnosed with IBD; animal protein accounted for most of the risk. Risk was specifically associated with high intake of meat and fish, but not with dairy products or eggs. While experts have long suspected that diet might play a role in inflammatory bowel disease, Dr. Franck Carbonnel says the only links identified previously were with eating a lot of fats and certain kinds of sugars. Another recent prospective study found that a diet high in omega-3 fatty acids decreased inflammatory bowel disease risk, while eating lots of omega-6 fatty acids increased it. Omega-3s are found in fish oil, flax seed oil, and a few other sources. Meat could contribute to inflammatory bowel disease risk because digestion of animal protein produces many potentially toxic "end products," such as hydrogen sulfide and ammonia. A high-protein diet could alter the mix of bacteria that live in the colon. American Journal of Gastroenterology, online May 11, 2010.

Reduce your consumption of concentrated milk fats which are used widely in processed and confectionary foods. Concentrated milk fats alter the composition of bacteria in the intestines. These changes can alter the fragile truce between the immune system and the complex but largely beneficial mix of bacteria in the intestines. Harmful bacteria can trigger an unregulated tissue-damaging immune-system response that can be difficult to turn off.

Physical activity, exercise
BMJ. November 14 2013. Physical activity and risk of inflammatory bowel disease: prospective study from the Nurses' Health Study cohorts. In two large prospective cohorts of US women, physical activity was inversely associated with risk of Crohn's disease but not of ulcerative colitis.

Symptom
An inflammatory bowel disease symptom may be mild or severe. The most typical Inflammatory bowel disease symptom, particularly ulcerative colitis, is bloody diarrhea. Pain is uncommon but may occur. A common Inflammatory bowel disease symptom is fatigue, which is often related to the inflammation and anemia that accompany disease activity. Other Inflammatory bowel disease symptoms that are often reported include fever, loss of appetite, and weight loss.
   The most common Inflammatory bowel disease symptom of Crohn's disease is fatigue, followed by abdominal pain and diarrhea.
   Because this condition has periods of flare-ups and remissions, there may be times when there is no Inflammatory bowel disease symptom. Not uncommonly, patients have been diagnosed with irritable bowel syndrome before being diagnosed with inflammatory bowel disease.

Women and pregnancy
Women with inflammatory bowel disease have an increased risk of delivering premature and low-birth-weight infants.

Cause
Acute stomach infections may increase the risk of developing inflammatory bowel disease such as ulcerative colitis or Crohn's disease. A previous episode of infectious gastroenteritis is associated with a 40 percent greater risk of inflammatory bowel disease. Gastroenterology, 2008.

Babies treated with antibiotics for middle-ear and other infections may have an increased odds of developing this condition later in childhood. American Journal of Gastroenterology, 2010.

Risks of IBD
People with active forms of a group of conditions known as inflammatory bowel disease, or IBD, seem to be at far greater risk of developing potentially life-threatening blood clots than previously recognized. The Lancet, February 8, 2010.

Research study
Lyprinol ( stabilised lipid extract of New Zealand green-lipped mussel ): a potential preventative treatment modality for inflammatory bowel disease.
J Gastroenterol. 2005. Child Health Research Institute, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Lyprinol (Pharmalink International), the stabilised lipid extract of the New Zealand green-lipped mussel, is currently used to relieve symptoms of arthritis. We investigated the effect of pretreatment with Lyprinol on experimentally induced inflammatory bowel disease in mice. Conclusions: These findings provide preliminary evidence that Lyprinol may be potentially useful in ameliorating symptoms of inflammatory bowel disease. The benefit, however, is unlikely to be due to the omega-3 fatty acid content. Dose-response evaluation of Lyprinol in experimental inflammatory bowel disease is warranted.

Dietary rutin, but not its aglycone quercetin, ameliorates dextran sulfate sodium-induced experimental colitis in mice: attenuation of pro-inflammatory gene expression.
Biochem Pharmacol. 2005.
Oxidative stress has been shown to play a pivotal role in the onset of inflammatory bowel disease and carcinogenesis. We evaluated the effects of two dietary anti-oxidants, rutin and its aglycone quercetin, on dextran sulfate sodium (DSS)-induced experimental colitis in mice. Female ICR mice were fed a diet containing 0.1% rutin or 0.1% quercetin for 2 weeks, and given 5% DSS in drinking water during the second week to induce colitis.  Our results suggest that rutin may be useful for the prevention and treatment of inflammatory bowel disease and colorectal carcinogenesis via attenuation of pro-inflammatory cytokine production.

People with inflammatory bowel disease are more likely to have asthma as individuals in the general population. Patients with ulcerative colitis and Crohn's disease, collectively designated inflammatory bowel disease or IBD, were also more likely to have arthritis, bronchitis, or psoriasis than people without IBD

Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis.
Aliment Pharmacol Ther. 2004.
The herbal preparation, aloe vera, has been claimed to have anti-inflammatory effects and, despite a lack of evidence of its therapeutic efficacy, is widely used by patients with inflammatory bowel disease. AIM: To perform a double-blind, randomized, placebo-controlled trial of the efficacy and safety of aloe vera gel for the treatment of mildly to moderately active ulcerative colitis. Forty-four evaluable hospital out-patients were randomly given oral aloe vera gel or placebo, 100 mL twice daily for 4 weeks, in a 2 : 1 ratio. Oral aloe vera taken for 4 weeks produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe. Further evaluation of the therapeutic potential of aloe vera gel in inflammatory bowel disease is needed.

Therapeutic efficacy of pycnogenol in experimental inflammatory bowel diseases.
Phytother Res. 2004.
Pycnogenol was administered for 10 days by gavage to Sprague-Dawley rats fed an elemental diet, then inflammatory bowel disease (IBD) was induced by intrarectal administration of ethanol 2,4,6-trinitrobenzene sulfonic acid (TNBS). Twelve hours after TNBS treatment, the rats were killed, the colon was assessed by a macroscopic damage score and mucosa homogenate was assayed for myeloperoxidase (MPO) activity. The supplementation of pycnogenol significantly inhibited the macroscopic damage score and MPO activity in a dose-dependent manner. These results suggested that pycnogenol ameliorates TNBS-induced inflammation by radical scavenging activity, and may have beneficial effects as a supplement in enteral nutrition for inflammatory bowel diseases.

Questions
Has there been any research done on turmeric and inflamatory bowel disease? I have been taking about a teaspoon a day for 3-4 weeks and it seems to help my colitis symptoms. Of course it is too early to tell if it is responsible for the decrease in symptoms.
   As of 2012, there has been one small study with curcumin, the extract from turmeric. More research is needed.