Jonny Bowden, Ph.D., C.N.S.
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 What Is ibd?
IBD is the collective name for two diseases in which the intestines become deeply inflamed: Crohn's disease and ulcerative colitis. Unlike irritable bowel syndrome (IBS—see page 230), in both forms of inflammatory bowel disease there is active pathology in the tissues. If you have ibd, a biopsy of your tissue would come back with visible, active inflammation, which would not be the case in irritable bowel syndrome. |
| As of this writing, about 1 million people are thought to have ibd in the United States. Both can cause extreme bouts of watery (Crohn's) or bloody (ulcerative colitis) diarrhea and abdominal pain.
The exact cause of ibd is not known, but like most multifaceted, highly complex disorders, it probably has a genetic component and is certainly made worse by trigger foods, bad nutrition in general, and stress. It's more common among whites, and it's higher in Ashkenazi Jews than in other groups, and slightly higher rates are seen in females. |
John A. McDougall
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 Thus, for prevention and treatment of ibd, your diet should be low in all kinds of fats.
Sulfur compounds may also play an important role in the cause of ibd. Hydrogen sulfide is toxic to the cells of the colon. This substance is produced in the bowel by the action of bacteria on dietary sources of sulfur—more specifically, sulfur-containing amino acids. Animal products are the main sources of these kinds of amino acids. |
Joan Liebmann-Smith, Ph. D., and Jacqueline Nardi Egan
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 Or it can be an indication of some serious GI conditions such as gallstones, IBS, or ibd. (See A Gurgling Stomach, above.) Excess flatulence may sometimes signal cancer of the esophagus, colon, or rectum.
SIGNIFICANT FACT
VFor hundreds of years,cases of people bursting into flames for no apparent reason—a phenomenon known as spontaneous combustion—have been reported. Some scientists believe these unfortunate events are the result of static electricity igniting farts.
FEELING BLOATED
Have you ever felt like—or even looked like—you've swallowed a balloon? |
| It can signal IBS, ibd (see Floating Feces, and Red or Maroon Stools, above), or a partial bowel obstruction—possibly from an adhesion, polyp, tumor, or cancer. Indeed, pencil-thin stools are an important early warning sign of colon cancer.
YOUR URINE
Our mothers likely spent many weeks, months, or in some cases even years potty-training us. |
| These fatty, fetid feces can be a sign of ibd (see Red or Maroon Stools, above) or may mean that your diet is too rich in fat and/or that your body isn't properly absorbing fat. Indeed, persistent steatorrhea often signals malabsorption syndrome, a condition in which fat and absorbed in the digestive tract. an oily coating and are frothy and
SIGNIFICANT FACT tarar/ Many people believe that if they don't have a bowel movement every day, it's a sign of constipation. But for some, it's perfectly normal not to have one for several days in a row. |
| And, as with fatty stools, they can also indicate GI tract problems such as bacterial infections, bowel obstructions, IBS, and ibd. (See Red or Maroon Stools, above).
Slimy stools sometimes signal the intestinal bacterial infection shigellosis or the parasitic infection giardiasis. Finally, mucus in the stool can be a telltale sign of rectal problems such as proctitis, an inflammation of the lining of the rectum.
SKINNY STOOLS
Skinniness isn't always a desirable state. If you've noticed that your stools have become narrow or ribbon-like, it's not a good sign. |
Mike Adams, the Health Ranger
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 Then I'm going to get fast-track FDA approval on drugs to treat ibd. I'll buy full-page ads in medical journals, bribe a few psychiatrists with "consulting fees," and whip out some press releases that will be faxed to all the national newspapers and magazines. Drug sales will skyrocket in no time! Invest in my ibd company now, and we'll all get rich!
Sounds like a con, right? Yet it's exactly what's happening right now with Restless Legs Syndrome, Road Rage Disorder, Social Anxiety Disorder and even Attention Deficit Hyperactivity Disorder. Every one of these is utterly bogus. |
Joan Liebmann-Smith, Ph. D., and Jacqueline Nardi Egan
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| In the past, when most people harbored these and other parasites, the incidence of ibd was much lower.
Beets, tomato juice, red gelatin, and red fruit punches and ice pops are all common culprits.
On the other hand, if you see bright red streaks or spots on your stool— medically known as hematochezia—or on your toilet paper or in the toilet bowl, it can be a tip-off that you have bleeding hemorrhoids or anal fissures (tears) or other rectal or anal injuries. These injuries can result from childbirth, constipation, anal intercourse, or the insertion of objects into the rectum. |
John A. McDougall
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| In practical terms, modern medicine fails patients with ibd for one primary reason—most practicing doctors refuse to consider the obvious connection between diet and these kinds of digestive ailments. ibd patients are told by their doctors, "Diet has nothing to do with this disease." Consider this—all doctors will readily admit that inhaling toxic elements from cigarettes damages the lungs, and drinking a quart of whiskey daily will destroy the liver. |
Jonny Bowden, Ph.D., C.N.S.
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| If you have ibd, a biopsy of your tissue would come back with visible, active inflammation, which would not be the case in irritable bowel syndrome.
Though there are similarities between Crohn's and ulcerative colitis, there are also differences, mainly in the location of the
Natural Prescription for Inflammatory Bowel Disease
SPECIFIC CARBOHYDRATE DIET
Essential fatty acids: 2-4 g
L-glutamine: 3-6 g
Probiotics: 10-20 billion
Digestive enzymes: Taken as directed with each meal
Boswellia (optional): 1,200 mg, three times a day (extract standardized to 37. |
| It's unlikely that any one factor "causes" ibd, but it's very likely that there's an interaction among factors. That said, it makes sense to support the immune system and to remove as many potential triggers from the diet as possible. It also makes sense to reduce stress and to manage any secondary symptoms like depression.
The Specific Carbohydrate Diet
The Specific Carbohydrate Diet, or SCD, is a dietary intervention that has been used with success by thousands of people. |
Dr. Edward F. Group III, DC, ND, DACBN
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| Individuals with relatives who suffer from some form of ibd also run a much greater risk of developing Crohn's disease. Approximately 20 percent of people coping with Crohn's disease have a close blood relative (most often a brother or sister) with Inflammatory Bowel Disease. Being of Jewish ancestry also appears to significantly increase risk, while being
African American decreases the risk for this condition.
How Does Regular Colon Cleansing Help Prevent Crohn's Disease? |
| Crohn's disease is arguably the more severe of the two forms of ibd. Up to 75 percent of the people who suffer from Crohn's are advised to undergo surgery at least once, however ".. .Crohn's cannot be cured with surgery. Even if the diseased portion of the intestine is removed, the inflammation can reappear in a previously unaffected portion of the intestine."23
In fact, it's not uncommon for patients to undergo multiple rounds of surgery to remove damaged sections of their intestines in an effort to alleviate the symptoms of the disease. |
Joan Liebmann-Smith, Ph. D., and Jacqueline Nardi Egan
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| Other ibd signs may include diarrhea, cramps, nausea, and weight loss, among others.
Reddish stools may also be a reaction to certain medications, including potassium pills and some antibiotics, which can cause bowel ulcerations and subsequent bleeding. Lastly, red stools are often a red flag for colon polyps or colon cancer. The bottom line is that anything that causes bleeding in the GI system, from the mouth to the anus, can result in reddish or bloody stools.
BLACK, TARRY STOOLS
Black stools may seem even more sinister than red stools. |
Ann M. Coulston and Carol J. Boushey
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 In the past, a common hypothesis was that ibd resulted from an inflammatory response to specific pathogens and/or environmental agents.
Specific bacteria and viruses have long been etiologic candidates because of (1) associations between the incidence of inflammatory bowel and community exposure to microbial infections; (2) antibodies in tissues to specific microbial fragments; or (3) similar GI damage provoked by infectious agents in human and animal models. |
James Dowd and Diane Stafford
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 Supplementation of vitamin D in genetically altered mice prevents the development of ibd, and the treatment of diseased animals with additional activated vitamin D clears their inflammation.
Another way your immune system balks is by developing an inflammatory reaction in your bowels when exposed to certain proteins; this is much like an allergy. One of the most common proteins the intestine doesn't tolerate well is gluten, which is found in wheat, barley, rye, and sometimes oats. At least 1 percent of the world's population is gluten intolerant. |
| If you got ibd because of bacterial overgrowth, your bowel contents were contaminated by either invasive bacteria from food poisoning (E. coli, S. typhi) or unfriendly bacteria that grew wildly because of bad diet.
In a normal scenario, contaminated foods will give you fever, inflammation, bloody stools, and diarrhea, but after your body clears the invasive bacteria, those symptoms disappear.
Abnormalities in the immune system also can cause bowel inflammation. That's what happens with Crohn's disease and ulcerative colitis. |
Ann M. Coulston and Carol J. Boushey
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| Other dietary lipids, including gamma linolenic acid and conjugated linoleic acid, may play anti-inflammatory roles by modifying lipid and nonlipid mediators of the inflammatory response [38-40], but additional studies are needed in ibd applications.
4. Sugar and a Refined Diet
In earlier reports, consumption of sucrose, refined cereals, fast foods, and fat was positively associated with either the incidence or onset of inflammatory bowel disease [22, 41, 42]. |
John A. McDougall
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| In practical terms, modern medicine fails patients with ibd for one primary reason—most practicing doctors refuse to consider the obvious connection between diet and these kinds of digestive ailments. ibd patients are told by their doctors, "Diet has nothing to do with this disease." Consider this—all doctors will readily admit that inhaling toxic elements from cigarettes damages the lungs, and drinking a quart of whiskey daily will destroy the liver. |
Ann M. Coulston and Carol J. Boushey
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| In flares of ibd and after significant small bowel resections in CD, losses may be of sufficient quantities and duration to cause dehydration and electrolyte disturbances. Several dietary factors including specific carbohydrates and lipids, magnesium salts, and pre- and probiotics may worsen or attenuate diarrhea and fluid losses [66-69]. Incontinence, increased stool frequency, and the occurrence of anal burning may make the diarrhea even more unpleasant.
3. |
| Some of the therapeutic approaches and differences in response to various interventions, including medical, surgical, and nutritional, may be more accurately targeted toward the specific genetic and clinical profile for individual patients with ibd (Table 1).
1. What May Trigger the Onset or Exacerbations of Inflammatory Bowel Disease? Inflammatory bowel disease is characteristically a disease of relapse and remission. Knowledge of environmental factors that trigger the onset or help maintain remission would be valuable in clinical practice. |
| Although they have been evaluated to some degree in some inflammatory states, neither GLA nor CLA has been evaluated in treatment of ibd.
Medium-chain triglycerides may have little to do with the inflammatory process, but they may be valuable as an energy source in patients with lipid malabsorption. Absorption of long-chain fats may be compromised during prolonged intestinal disease as a result of bile salt malabsorption that comes with ileal resection. Medium-chain triglycerides are known to enter the portal circulation without the more extensive processing that long-chain fats undergo. |
| Energy requirements of persons with ibd are not usually increased except with sepsis and fever, but protein requirements often are. Energy requirements may be increased to restore weight, to return to normal growth curves, or to compensate for malabsorption. The presence of active disease, by itself, however, does not appear to raise energy requirements appreciably [63, 64]. Refeeding severely depleted patients too quickly may result in more harm than good. |
David Hoffman, FNIMH, AHG
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 INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease (IBD) refers to two chronic intestinal disorders: Crohn's disease and ulcerative colitis. ibd affects 2% to 6% of Americans, or an estimated 300,000 to 500,000 people.
Crohn's disease and ulcerative colitis are serious inflammatory diseases that appear to be autoimmune in nature and pose real challenges for practitioners of all modalities. They generally present as a series of attacks of bloody diarrhea that vary in intensity and duration and alternate with symptom-free periods. |
James A. Duke, Ph.D.
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 Seattle naturopathic physician whom I respect, observes that many people with ibd often have underlying food sensitivities that contribute to the condition. He recommends following an elimination diet, under medical supervision, to weed out the offending foods. This seems like good advice to me. I know that if I had ibd, I'd try an elimination diet.
I'd also take lots of herbs that soothe the digestive tract. My top recommendations for ibd are peppermint and ginger, followed by chamomile and fennel. |
Dr. Paula Baillie-Hamilton
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 But whatever the trigger, the overriding opinion is that ibd is autoimmune in nature. At the heart of the problem is a malfunctioning immune system, which for some reason is sent into overdrive, and as a result attacks and inflames the body's own tissues (see chapter 5). This is reflected in the fact that the majority of conventional treatments are targeted at suppressing the immune system. |
James A. Duke, Ph.D.
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| I know that if I had ibd, I'd try an elimination diet.
I'd also take lots of herbs that soothe the digestive tract. My top recommendations for ibd are peppermint and ginger, followed by chamomile and fennel. To make a tea from any of these herbs, simply steep 1 to 2 teaspoons of dried herb in a cup of freshly boiled water for 10 minutes. Then strain before drinking. If you wish, you can combine any or all of these herbs in proportions that suit your tastebuds.
Another herb that may be effective for ibd is asafetida. You may not have heard of this Middle Eastern garlic-scented spice before. |
Dr. Paula Baillie-Hamilton
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| Due to the role that chemicals play in triggering ibd, it would be a sensible move to lower our daily exposure to these autoimmune-triggering chemicals, as well as to improve the body's ability to shift its existing chemical load.
Irritable Bowel Syndrome
Irritable bowel syndrome appears to be one of the most common health problems in the world. In the United States up to one in five people suffer from this condition, and if you suffer from a general range of bowel problems that don't fall under any neat category, chances are that you may have irritable bowel syndrome. |
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