Over The Counter Treatments For Inflammatory Bowel Disease

-Crohn’s Disease
by Royce Bailey M.D., M.P.H., F.A.A.C.

Crohn’s disease is caused by inflammation (the body is attacking itself-auto-immune), sores and ulcerations of the bowel cause scaring, especially of the ileum (the last portion of the small bowel). One in every 1000 people in western countries have this disease. Some researchers, including me, believe Crohn’s disease is from a form of tuberculosis called MAP (Mycobacterium Avium Para-tuberculosis). We all agree that what ever causes Crohn’s disease has to be a combination of both genetic and environmental factors that give rise to this gut problem. Whatever it is, everyone in western society is exposed to it equally, but only those predisposed genetically get the disease (runs in families, communities, etc).

Crohn’s disease is a hyper-immune state with too many helper T cells and not enough balance of suppressor T cells. Therefore, I’ve found that herbs that increase the immune response, like Echinacea, make me worse.

There are three regions on the chromosomes that have been identified (12, 14, 16) as containing faulty genes contributing to Crohn’s disease. Scientists believe there are at least six chromosomes involved. People with one copy of the defective gene, which alters the immune system’s response to bacteria and food in the gut, have twice the normal risk of developing Crohn’s disease, while those with two copies of the gene have 15 to 20 times the risk and so on.

One of the cytokines that is abnormality high in Crohn’s disease (pro-inflammatory-causes inflammation) is Tumor Necrosis Factor-Alpha (TNF-α). This can be down regulated to normal levels and can cause remission in Crohn’s disease patients.*

The following treatment options will not effect an acute flare of disease, this will requirement prescription help; but, these options may help keep you in a longer remission between flares. Consult your Health Care Provider with any of these therapies.

All suggestions I have found in the medical literature. I have tried all of these at one time or another. One thing I’ve found is that all Crohn’s disease patients respond differently to treatments. Here are a few to try, but not all at once please.

** Omega-3 (sources include: fish oil, walnuts, borage oil, primrose oil and flax seed) Requires 3-4 months for effect. Omega-3 normalizes TNF-α and COX-2 pathways.* Grind fresh two tablespoons of flax seed a day (best source).

** Avoid dehydration-drink plenty of water. Minimum ounces of water required each day should be: your weight in pounds, divided by 2.2=ounces of water needed/day.

** Avoid milk products. All Crohn’s patients are lactose intolerant. Milk is the carrier for para-tuberculosis, if this is the cause of Crohn’s. Some scientists suggest that exposure to the measles virus during pregnancy may be the cause of the faulty DNA/genes.

** Sublingual (under the tongue) vitamin B12 500 mcg weekly or daily during a flare.

** Stinging Nettle leaf 1000mg a day, contains trace minerals and has an astringent property that cuts down on secretions like blood and mucous.

** Transfer Factor 500mg a day. This can be found in colostrum (cow’s first milk). Yes, you do risk Mad Cow Disease in a couple of years, but my philosophy is you need to feel good now, for you may not be here in a couple of years.*

** Vitamin C two grams (2000mg) a day; more during a flare. I believe fistulas (draining tracts) are primarily from Vitamin C deficiencies. I’ve closed my fistulas with large daily doses.

** Vitamin K 10 mg a day. Vitamin K prevents bleeding and acts as an anti-inflammatory. Don’t take if you are on coumadin/warfarin.

** Vitamin D 2000 IU a day. Acts as a anti-inflammatory and helps thin bones. Best taken with calcium/magnesium 2:1 ratio (ie, Caltrate with D). Most Crohn’s patients have thin bones from malnutrition and steroid treatments. Sun exposure, to as much skin exposed as possible, of 45 minutes minimum, a day, (even sun through a window) can produce up to 10,000 IU of vitamin D.

** Smoking worsens Crohn’s disease.

** Barley Green/Wheat Grass etc. (Vitamin K and minerals) daily vs juicing fresh veggies daily. Juicing adds an extra H+ ion to neutralize toxins in your body.

** Activated charcoal for bad gas/diarrhea. Don’t use this regularly, because this absorbs the good (medicines/nutrients etc.) and the bad.

** For yeast overgrowth, eat a med-large clove of raw garlic, minced, with a large glass of distilled water 30 minutes before each meal (three times a day for a week).

** Probiotics (lactobacillus acidophilus). Probiotics help stabilize the good bacteria in your bowels and helps resolve bad breath and decreases gas. If you have very smelling stools or changing smell of your stools, this may help the sometimes wild bacterial overgrowth of unwanted bacteria in the intestines. Acidophilus or like product and digestive enzymes each day.

** Turmeric powder 1-3 capsules (300mg) three times a day for inflammation. Many people cannot take turmeric because it is too spicy and upsets the stomach. Turmeric blocks the inflammation pathway through COX-2, thus blocking TNF-α.*

** Melatonin up to 10mg a day for short periods of time has been shown to help irritable bowels.

** Peppermint Essential Oil can block smooth muscle abdominal cramping. One drop in a cup of warm water up to four times a day or as needed. Does come in capsules too. This can worsen acid reflux!

** Caraway Oil relaxes the gut wall and thus reduces diarrhea. One drop with water three to four times a day or as needed. Phytotherapy Research, 2000;14:20-23.

** During Crohn’s flares 1-2 grams of glutamine (amino acid) fuels the nutrition of the intestinal lining, three times a day. Max six grams a day. Found in the weight lifting section of the Health Food Store. Am J Clin Nutrition 2002;75:789-808. Note: If you are healthy, glutamine has been shown to act as an excitotoxin in the brain.

** Chamomile tea has anti-inflammatory, anti-bacterial and anti-spasm properties, one cup three times a day as needed.

** Slippery Elm Bark can reduce spasms. 400mg three times day or as needed.

** Aloe Vera juice six ounces three times a day helps soothe bowel inflammation. Aloe promotes healing of the intestinal lining via bradykininase and relaxes the capillaries for increased blood flow and healing.

** Boswellia Serrata (Indian Frankincense) 300 mg three times a day.* Boswellia’s acids inhibit a key enzyme involved in the formation of TNF-α.

** Growth Hormone precursors-spray under your tongue as described on the bottle.* NEJM 2000;342(22):1633-1637.

** Liquid trace minerals daily. Crohn’s patients are notorious for having zinc and trace mineral deficiencies.

** A heating pad to the abdomen helps reduce spasm pain.

** Two Coconut Macaroon cookies (Archway) has decreased diarrhea from all causes in many patients. I believe the reason is the Propylene Glycol in the cookies.

** DHEA (dehydroepiandrosterone) 25 to 100 mg a day (from Mexican Yams) is a precursor to many of our hormones (including cortisol- prescribed as prednisone). Have your blood level checked (DHEA-S) and take to keep your levels high normal.*

No other disease responds as well as Crohn’s to nutritional and alternative therapies.

* lowers (down regulates) high levels of TNF-α.

NEJM 1999;340:253 states that down regulation of TNF-α puts Crohn’s disease in remission.

Prescriptions that down regulate TNF-α to more normal levels include: Steroids, Trental, Statins, ACE/ARBs, Amiodarone, Coreg and Plavix.

Prescription drugs that bring TNF-α to zero levels: Remicade (Infliximab) and Thalidomide. I would reserve this treatment only if you are about to die.

By Crohn’s patient, Royce K. Bailey, M.D., M.P.H.