An Integrative Approach to Crohn’s Disease: Exploring Autoimmunity in the Gut. You and your Healthy Belly- Part 3


Written by Clare Abercrombie, Lauren Houser, CRNP and Georgia Tetlow, MD Our last segment on integrative medicine approaches to digestive disorders explores autoimmune conditions, particularly Crohn’s Disease. While we are just beginning to understand the link between the digestive tract and the body’s immune response, recent research indicates certain digestive disorders are caused by autoimmune malfunction. An integrative lens is uniquely suited to identify and treat the root causes of autoimmunity and, specifically, inflammatory bowel disease.

What is Crohn’s Disease?

Crohn’s Disease is a type of Inflammatory Bowel Disease (IBD) that causes chronic inflammation in the gastrointestinal tract. Inflammation can be localized to the ileocecal region of the bowel, where the small intestine meets the large intestine, but as Crohn’s sufferers will tell you, painful ulcerations can arise anywhere between mouth and anus. While the specific cause of Crohn’s is undetermined, we do know that the illness is mediated by inflammation caused by an autoimmune response in the body. Autoimmune means our immune system mistakenly attacks our own tissues, and for those with Crohn’s that means pain, cellular damage as well as visible lesions in the bowel.

In Crohn’s disease, our immune system attacks our gastrointestinal tract thus damaging the villi (the valleys and troughs of our GI tract) that increase the surface area of our gut so we can best absorb nutrients. Symptoms include but are not limited to unexplained weight loss, fever, abdominal pain, chronic and bloody diarrhea, a bloated feeling in the abdomen, and rectal bleeding. Due to chronic inflammation within the gastrointestinal tract, inflammation can also cause the formation of gallstones and/or kidney stones.

What Causes Autoimmunity in the gut?

Even though we are still discovering what causes Crohn’s, we do know several factors play a role including autoimmune reactions, genetics, and environmental factors. Viruses, bacteria, and certain foods are also potential triggers for the inappropriate immune response that is central in Crohn’s pathophysiology.

The specific role of genetics in the development of Crohn’s disease is still unclear but having an affected relative certainly increases your risk. Approximately 20% of people with Crohn’s have a family member, particularly a sibling or parent, with Crohn’s or another inflammatory bowel disorder called Ulcerative Colitis. The link between environmental or external factors and the development of the Crohn’s have been noted. The use of nonsteroidal anti-inflammatory drugs, antibiotics, and oral contraceptives leave a patient at an increased risk of developing Crohn’s disease. High fat diets may also contribute to the development of the disease.

Integrative Approach to Crohn’s Disease

Purely conventional treatments for Crohn’s include medications such as corticosteroids, antibiotics, antidiarrheal drugs, immune system modifiers such as methotrexate or azathioprine, anti-inflammatory drugs and a variety of pain medications for this extremely painful illness. As Crohn’s is not considered curable, the goal of treatment is symptom management. As with many autoimmune conditions, symptoms tend to reoccur periodically and flare-ups range in severity.

An integrative approach to any autoimmune condition, and certainly in the case of Crohn’s, is to find the root causes of inflammation and address them by supporting the body’s natural healing mechanisms. Utilizing specialized testing, such as a validated comprehensive stool study or reproducible food sensitivity testing, an integrative practitioner can work with a patient to identify inflammation triggers. Such triggers, which can cause or worsen exacerbations, can include particular foods, disturbances in the microbiome involving bacteria, yeast, parasites or viruses, increased intestinal permeability (sometimes referred to as leaky gut) or insufficient beneficial bacteria. Individualized, patient specific testing informs a personalized and targeted plan of care that emphasizes lifestyle changes such as nutrition, exercise, mind body practices and supportive supplements.

Commonly recommended diets for Crohn’s include the Specific Carbohydrate Diet (SCD) and the Elimination Diet. Both these nutrition programs focus on removing food triggers and focusing on healthy foods that do not exacerbate symptoms. Incorporating a mind body practice is also essential in any autoimmune treatment plan. Science has shown that mind body practices decrease sympathetic nervous system stimulation (our fight or flight response) and allow our body’s innate healing systems to be active.

There are many supplements that research shows are effective in the treatment of Crohn’s disease, especially anti-inflammatory agents like Omega 3 fatty acids and curcumin-based products. Zinc glycinate, N-acetyl glucosamine and Vitamin D3 also help repair and restore our gut lining. Contact your local integrative provider to discuss a safe and effective strategy that is personalized for you.