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9 Steps for Managing Crohns

While there is no known cure for Crohn's disease, you may be able to avoid going on medication with potentially harmful side effects by following these steps to manage the disease naturally.
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Bowel disorders are an uncomfortable topic in today’s world, but many people suffer in silence. One of the worst forms of bowel disorders is Crohn’s disease. Crohn's disease affects up to 700,000 of Americans, according to the Crohn's & Colitis Foundation of America. This disease is a chronic inflammation of the intestines that can lead to pain, intestinal blocks, cancer, and other serious diseases.

What is Crohn’s Disease?

Crohn’s disease is classified as an autoimmune disorder. Most medical professionals don’t know a lot about the disease. According to Web MD, Crohn’s disease is chronic inflammation in the digestive tract ranging from the small intestine or colon. There are five types of Crohn’s disease, which include ileitis, ileocolitis, jejunoileitis, gastroduodenal Crohn’s disease, and granulomatous colitis.

The 5 Types of Crohn’s Disease

Ileocolitis: This is the most common form of the disease. It affects the small intestine. Usual symptoms include weight loss, cramping, pain, and diarrhea- particularly on the lower right of the abdomen.

Ileitis: This form of Crohn’s disease has the same symptoms as Ileocolitis, but it affects the ileum. It may also have symptoms including fistulas or inflammatory abscesses.

Gastroduodenal Crohn's disease: This version of the disease affects the first part of the small intestine- the stomach and duodenum. Symptoms of this disease include weight loss, vomiting, bowel obstruction, loss of appetite, and nausea. Bowel obstructions can occur with this form of the disease as well.

Jejunoileitis: The upper half of the small intestine is known as the jejunum. This form of the disease affects that area. Symptoms include inflammation, abdominal pain, cramps, fistulas, and diarrhea.

Granulomatous colitis: This version of the disease affects the colon. Individuals with this This form of Crohn's disease involves version of the disease will have symptoms like rectal bleeding, joint pain, ulcers, fistulas, abscesses, and skin lesions.

According to the crohn’s advocacy website, Crohn’s and Me, the issue of Crohn’s arises when cells in your GI tract start attacking healthy cells. These cells do not know the difference between good invaders and bad invaders. This throws the body into a state of constant stress and attack, which leads to painful bowel issues, like irritability, frequent bowel movements, abdominal cramps, and a wide range of digestive problems from gas to constipation.

Crohn’s disease can also lead to other, less common symptoms. Some individuals suffering from the disease also show the following symptoms:

  • Gallstones
  • Inflammation of the eyes or mouth
  • Kidney stones
  • Arthritis
  • Skin rashes
  • Liver disease
  • Fever and night sweats
  • Skin inflammation
  • Eye inflammation
  • Joint inflammation
  • Cancer in the intestines

Possible Causes

The medical industry is unaware of the exact cause of Crohn’s disease. Since the disease is an autoimmune disorder, there could be a number of causes ranging from allergies to diet, to a simple cell mix-up. However, according to Web MD, many medical professionals agree that factors like genetics, environmental issues, and a person’s immune system are the most likely culprits. Smoking can also make any existing Crohn’s symptoms much worse.

An overactive immune system is one likely cause for Crohn’s disease, although there is no scientific data proving that an overactive immune system will lead to Crohn's or what causes an overactive immune system in the first place.

Nutritionists have theorized that nutritional factors could be in play for the disease. Main suspects are Omega-6 fats, grains and gluten, processed foods, or dairy products (for lactose-intolerant individuals).

Triggers for Crohn's Disease

Crohn's disease is not something that most individuals have to face every moment of every day. Typically, the disease lies dormant until a trigger occurs. Triggers can vary from person to person, but according to Web MD and the Crohn’s and Colitis Foundation of America, common triggers can include:

Triggers for Crohn's Flare-Ups

Aspirin and other medications: Some medications will cause gastronomical stress, including some NSAIDs, Aspirin, and antibiotics. Discuss the potential gastronomical side effects of medications with your doctor before taking any.

Stress: For some reason, stressful situations and emotions can lead to flare-ups. Trying to manage daily stress can help lead to a reduction in flare-ups from this cause.

Smoking: Smoking is a direct link to Crohn’s disease flare-ups. If you want to avoid the discomfort of Crohn’s disease, do not smoke. Some foods: According to the CCFA, not all people will see diet-related flares, and not all foods will cause the same reaction in everyone. The best way to keep food-related flares in check is by keeping a food diary and avoiding any foods that cause you pain.

Managing Crohn's Disease

Because there is so little known about this disease, managing Crohn’s disease is a life-long process. While it may be possible to reduce total inflammation in the body, your gut sensitivity to inflammation will remain. This means that you will always have to be mindful of the disease even when you have flare-ups under control. In some cases, flare-ups happen for no discernable external reason.

Because GI disorders are such a personal issue, there is a lot of emotional management that also goes along with the disease. The best way to manage the disease is to use management techniques from a wide variety of sources.

Conventional Treatments

The Crohn’s advocacy site, Crohn’s and Me lists several conventional treatments for Crohn’s disease. These include:

Anti-inflammatory medication (5-ASAs): These help prevent inflammation in the intestines. This form of medication is helpful in preventing pain and frequent flare-ups. Usually, the medication is available in tablet or suppository form.

Antibiotics: Antibiotics are sometimes prescribed to reduce the bacteria levels in the intestine. This is believed to help reduce flare-ups, by keeping the intestines bacteria-free. However, this treatment option can backfire, as a lack of bacteria in the gut can also lead to an increased immune response in the body, which will lead to greater overall inflammation. Antibiotics are also prescribed to heal abscesses and fistulas.

Corticosteroids: Corticosteroids are also traditional anti-inflammatory medications. Corticosteroids have many unwanted side effects, like breathing problems and weight gain. For this reason, doctors typically only prescribe them if symptoms do not respond to other forms of treatment.

Immunomodulators: Immunomodulators work in conjunction with other medications to reduce inflammation and increase the response time of other medications. When this medication is prescribed, patients see fewer side effects from other medications. Over-the-counter medications: In some cases, a doctor may recommend over-the-counter treatment options. These could include pain reliever, laxatives, or antidiarrheals to help you manage your symptoms at home.

Biologics: A biologic medication is the newest idea for Crohn’s disease. These non-steroid medications contain special antibodies that are designed to bind with specific substances, enzymes, and proteins that affect Crohn’s sufferers. This allows the body to suppress parts of the immune system that are overactive without suppressing the entire immune system. Biologics include TNF inhibitors and integrin receptor antagonists. Surgery: In some cases, surgery can help individuals with Crohn’s disease. Basically, surgery is used to remove an area of the intestine that will not respond to any treatment method. It is also used to remove bowel obstructions.

Managing Crohn’s With Technology

Crohn’s disease is something that requires management and notice every day. This is a large task that can be difficult. The CCFA has created an app that helps Crohn’s sufferers manage their disease. This app allows users to track signs and symptoms, triggers, and keep a food log to determine if they have food sensitivities. This app is called the “GI Buddy” and is available free of charge. The app is designed to work along with other treatment methods to manage the disease and keep flare-ups at bay. A similar app, Crohn's Wellness Widget, offers similar tools.

Regular Exercise

Exercise is an important part of maintaining a healthy body and immune system. Exercise can help reduce stress, strengthen the body, and even improve immunity. Exercise is important for Crohn’s sufferers because it can help reduce depressive symptoms, according to Web MD. Exercise will also reduce stress, improve bone strength, and if done outdoors, increase vitamin D exposure.

Alternative Therapies

Since the medical industry is unaware of the precise cause of the disease, there is little in conventional medicine that tries to address the problem at the source. If you do not want to take medication daily, then alternative therapies might be the best option for you. Several alternative methods are available for Crohn’s sufferers:

Acupuncture: Acupuncture is used to reduce inflammatory bowel diseases in China. According to a 2004 study conducted by University of Erlangen-Nuremberg in Germany, acupuncture offers benefits beyond placebo for IBD symptoms. It offers improved quality of life, a decrease in blood-bound inflammatory markers, and general well-being.

Herbs: One form of herbal supplement has been proved to help individuals with Crohn’s disease. A 2001 study from Heidelberg University indicated that the herb boswellia was just as effective as mesalazine in the management of Crohn’s symptoms. The researchers concluded that the boswellia herb was a more effective and viable treatment option because the herb has no side effects.

Diet

There has been some research that suggests that diet may contribute to Crohn’s symptoms and flare-ups. However, not all patients respond to the same foods. The best way to determine the best diet to control your symptoms is to keep a food journal and report what foods contribute to flare-ups and which foods do not. In addition to this method, it is also helpful to eat smaller, more frequent meals throughout the day to manage feelings of nausea.

According to US News and Crohn’s and Me, there are five common diet approaches in the management of Crohn’s disease. These diets include:

Diets for Crohn's Disease

Low-fiber diet: Fiber is suspected of leading to irritation in the bowel, leading to constipation and blockages. Fiber is difficult to digest, which can worsen intestinal obstruction. The liquid intake for this diet is high to prevent intestinal blocks.

Enteral nutrition: This diet is a liquid-based diet that contains necessary nutrients that are easy to digest. According to US News, elemental or enteral diets may be effective in decreasing Crohn’s-induced inflammation and increasing remission.

Total parenteral nutrition (TPN): This is a nutritional supplement that is entered by an IV directly into the bloodstream. This is used for patients who cannot absorb food and nutrients on their own in a hospital. Usually, this method is used when patients have an intestinal block. There are greater risks associated with this method than other diet methods.


The Mediterranean diet: This diet follows eating patterns of the traditional Mediterranean diet. The foods used in this diet include, Fish, fruits, vegetables, legumes, whole grains, olive oils, red meat and dairy (only if there are no signs of lactose intolerance).
Bland diet: The bland diet is designed to prevent immune triggers in the bowel. A person in the bland diet would avoid spicy foods, dairy, difficult-to-digest foods, and foods with sharp flavors, such as tomatoes and alcohol.

Dietary Cautions

While following a healthy diet is essential for managing Crohn’s symptoms, it is important not to block out entire food groups in the quest to reduce flare-ups. For example, if you notice that red meat causes a flare-up, replace it with a different form of protein to ensure you still receive the nutrients that you need. Otherwise, you will end up deficient in some necessary nutrient, which can be detrimental to your health.

Foods to Avoid

You should avoid a few substances if you suffer from Crohn’s disease. These foods include caffeine, alcohol, trans fats, processed grains, and any foods that you know are triggers for your flare-ups.

Reduce Stress

Stress can be a trigger for Crohn’s disease. You will see fewer flare-ups if you try to maintain a stress-free life. You can reduce your stress by getting educated about your disease, engaging in stress-reducing activities like exercise and meditation, packing an emergency bag in case of flare-ups, and avoiding known triggers for the disease.

Dietary Supplements

Some supplements have been shown to help manage Crohn’s symptoms. In addition to some supplements helping with the disease, you may also need supplements to replace vital nutrients that you are missing from foods. The following supplements may be helpful:

  • Iron: Chronic bleeding often leads to low iron levels. An iron supplement can help you prevent anemia.
  • Vitamin B12: Vitamin B12 is useful for the prevention of anemia and it also regulates nerve function, aids cell growth, and regulates hormone development.
  • Vitamin D: Many patients with Crohn’s disease are deficient in Vitamin D, sometimes from medications prescribed for the disease. A vitamin D supplement will help support healthy immune function and release stress from the body.
  • Probiotics: A probiotic is able to help restore the natural balance of healthy bacteria in the gut. In some cases, this may help reduce flare-ups, but in others, it might make symptoms worse. Try taking probiotics, but discontinue their use if your symptoms get worse.
  • Calcium: Crohn’s patients on medication are often at-risk for a calcium deficiency. A calcium supplement can help restore the natural balance of calcium in the body.
  • Folate: Persons on methotrexate medication are likely at risk for a folate deficiency. Take extra folate if you are on methotrexate medication.
  • Fish Oil: According to a 1996 study from the University of Bologna in Italy, fish oil supplements can help reduce Crohn’s flare-ups. In a year-long study of 78 patients, a year after the study 23 patients who took fish oil supplements had no flare-ups. These patients took 2.7 g of fish oil each day for one year.
  • Vitamin A, E, K: Individuals with gastrointestinal problems, vitamin deficiency is common. The most frequent culprits are vitamin A, E, and K. Supplementing these vitamins will help maintain a healthy immune system.
  • Magnesium: A 1983 study published in Scand J Gastroenterol Journal showed that may Crohn’s patients are deficient in magnesium. The greater the small-bowel resections that a patient had, the greater magnesium deficiency. A magnesium supplement will help restore muscle mass and improve the body’s functions.
  • Zinc: A 2001 study from the University of Padova in Italy indicated that zinc can help control Crohn’s flare-ups. In a study of 12 Crohn’s sufferers, the patients were given 110 mg of zinc three times a day for two months. A year later, the researchers contacted the patients to determine the results of supplementation. After a year, 10 of the patients had normal intestinal permeability. According to the study, “Improving intestinal barrier function may contribute to reduce the risk of relapse in Crohn's disease.”

Managing Crohn’s Disease in Everyday Life

Crohn’s disease is an autoimmune disease that is not fully understood by the medical industry. There is currently no cure for the disease. Crohn’s patients usually have to discover triggers and resolution methods on their own. There are some medical treatments available to help control Crohn’s symptoms. There are also several natural options that may provide relief as well. It is up to each individual patient to determine the right treatment method for him or her. That is the only way to truly manage the disease.

Sources


http://www.webmd.com/digestive-disorders/features/crohns-disease-54-tips-to-help-you-manage?page=2

http://health.usnews.com/health-conditions/digestive-disorders/crohns-disease/managing

http://www.ccfa.org/assets/pdfs/flares_brochure_final.pdf

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