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In 1932 the American doctor Burrill B Crohn and his associates first offered the description of a disease characterized by an inflammatory reaction of the bowel, usually affecting the ileum, the colon, or another part of the gastrointestinal tract. The diseased segments may be separated by normal bowel segments, which give it the characteristic 'skip lesions'. The inflammation may extend to other areas of the bowel or to the stomach, duodenum or mouth. In the advanced stages of the disease complications may include arthritis, ankylosing spondylitis, kidney and liver disease, and skin and eye disorders. The formation of fistulas from the diseased bowel to the anus, vagina, skin surface, or other loops of the bowel is common. The diagnosis of Crohn's disease is based on established clinical signs, radiographic studies using a contrast medium, and endoscopy.[1]

Crohn's disease is characterized by frequent attacks of diarrhoea, severe abdominal pain, nausea, fever, chills and weakness. Children with the disease often suffer retarded physical growth. It is children and young adults who are most likely to be sufferers. The age incidence is 15 to 30 years, equally divided between the sexes. There are an estimated 30,000 to 40,000 with Crohn's disease according to the National Association for Crohn's and Colitis (NACC), though some sources offer higher statistics. The cause of Crohn's disease is unknown from the Western Medical view.

History

The prevalence of inflammatory bowel disease and the expected rising of the incidence of ulcerative colitis and Crohn's is noted in the study by S M Mongomery et al.[2] Many researchers acknowledge the incidence of these diseases being prevalent in the 20th Century Western societies where the diet is predominately animal produce, refined foods, high sugar and fat intake. Those people of simple dietary habits, called 'primitive', escape Crohn's disease.[3] Observations suggesting that people of higher socio-economic backgrounds are more prone, living in better equipped and cleaner environments, may be a consideration. Familial predispositions show a 10-fold increase if a first degree relative has the disease. That there is no abatement in the number of new cases, estimated at 4,000 to 5000 per year[4] makes Crohn's a disease that needs greater attention. The fact that most sufferers are born after 1950, suggests this as a 'disease of civilization'.

The media published two reports[4] of research linking Crohn's disease with the organism called MAP (Mycobacteriun avium subspecies paratuberculosis) found in milk. Professor Hermon Taylor is quoted. "If there was no MAP, though difficult to detect and destroy, there would be no Crohn's." The theory has been the subject of debate for some years as evidenced in the British Medical Journal (BMJ) Grand Round of 1998.[5] The discussion suggests the finding that Crohn's disease in some patients 'is due to mycobacterial infection'. And 'that infection may precede the onset of gastrointestinal symptoms by many years.'

However, Murray cites L Demming[6] who links antibiotic exposure to the increasing incidence of Crohn's. The disease has spread like an epidemic since 1950. "At this time the annual increase in the consumption of antibiotics parallels the annual increase in the incidence of Crohn's disease."3 In addition, the incidence is increased with early and large quantities of antibiotics, as noted in comparative studies. The use of antibiotics in the animal produce industry has also risen greatly, and the relation of bowel disorders with the ingesting animal products as in meat, dairy and eggs cannot be discounted in the growing avalanche of auto immune and other degenerative diseases.

Various researchers have suggested the implication of vaccination and/or in utero measles.[7] Both have been discounted by study of various cohorts since the introduction of live measles vaccines versus non-immunized. No proof to satisfy the researchers allowed them to conclude the incidence of Crohn's to be greater. However, the debate on the detrimental effects of immunization continues and proof of retrospective studies fails to win orthodox support.

Lars Å Hanson Breastfeeding Stimulates the Infant Immune System[8] states "that the prevalence of Crohn's disease and possibly ulcerative colitis among adults is reduced by breastfeeding". Breast feeding activates the child's immune system. The proponents of breast feeding indicate the child so fed is better equipped to fight infections, suffer less with allergies and asthma. While vaccination has sought to infer immunity, many have shown an altered state of the immune system and infer the rise of many unexplained disorders. Mass vaccinations programmes and the decline in breast feeding have many unexplained implications in the health of those born in the latter part of the 20th century.

Perhaps the Western model of the human body can be better exemplified and understood with the consideration of the Five Element Theory of Traditional Chinese Medicine (TCM). Liver function according to TCM, profoundly affects not only the blood but the spleen-pancreas and stomach functions. When the liver is overburdened it detrimentally affects the digestive organs, thereby causing ulcers, abdominal inflammations, diabetes, gas, and indigestion generally. "Since the spleen-pancreas directly influences the intestines, inflammatory conditions such as colitis and enteritis can also frequently be traced to liver overload in stress-filled, overfed people."[9]

The role of meat and dairy produce, alcohol, other stimulants, 'junk' foods and above all, refined cane sugar are considered to seriously undermine health. The condition of 'liver overload' by the ingestion of these foods, causes inner congestion and stagnation. The consumption of processed foods and sugar in the very young is a late 20th Century phenomenon. Using the understanding of the Five Element theory, all major diseases, of bowel disorders, diabetes, psychological disorders and endemic anger and anxiety, is at least explained in principle. Need it be said that if MAP is indicated in the incidence of Crohn's, that researchers consider the dietary link, consuming dairy with caution or avoiding dairy as the best solution, rather than seek to 'improve' sanitization methods of milk. The progression of Crohn's disease to liver disease, diabetes, arthritis, ankylosing spondylitis, kidney disease, eyes and skin disease all stem from liver imbalance according to TCM.

Conventional Treatment

Persons with Crohn's are hospitalized frequently and often become depressed or have emotional problems caused by the relentless, painful character of the disease. The current treatment options available are corticosteroids to control the inflammation to seek clinical remission. The other favoured option amongst some gastroenterologists is enteral feeding of elemental diets (simple nutritive components that require no further digestive breakdown). There is particular concern with paediatric patients, as nutritional deficiencies reduce growth, and also of the detrimental effects of steroids. Corticosteroid poisoning is a considerable clinical concern.[10] Surgical removal of the diseased segment of the bowel provides some relief, but recurrence after surgery is likely.

Naturopathic Treatment

Pre-illness diet studies of Crohn's sufferers found they habitually consumed more sugar and less raw fruit, vegetables and dietary fibre.3 The overwhelming evidence of a primitive diet of natural foods and attendant lifestyle in the prevention of Crohn's and other degenerative diseases supports the Naturopathic axiom 'prevention in better than cure'.

Murray describes the fact of remission is greatest when conservative non-drug therapy is considered in the clinical trials.3 This is an important consideration in aiding the body to self-heal. As the disease is one of an inflammatory nature, the production of leukotrienes is high in IBD sufferers. The reduction in meat and dairy consumption is advised. The disturbance of intestinal microfloral in Crohn's suffers is also indicative of the modern diet. Faecal flora is greatly disturbed and not necessarily a result of the disease.3 The fact that most people's digestion is fermentative due to denatured foods and sugar ingestion rather than enzymatic through proper chewing and chlorophyll rich foods is a point worth considering.9

Sufferers of Crohn's, even in very advanced conditions, have been brought into remission by Naturopath Stephen G. Langely ND, Dip Ohm, DBM, OMD, Mbar, MRN. His success stems from the use of several therapeutic modalities, which on their own, may fail to help the patient recover. His methodology is a four-pronged approach. (See Table above.)

The assessment of the individual's condition and constitutional considerations needs to be thoroughly reviewed for a successful treatment regimen. As with all diseases, it is as individual as the person. The acute condition is first addressed: debility, pain (severity, location), nausea, blood and mucus in stool.

From Langley's observations the condition of Crohn's often stems from the stomach. The stomach rules the lower functions of the bowel. In cases of Crohn's and Ulcerative Colitis, low gastric activity is often indicated and confirmed by medical tests. This is also a precursor condition for Candida albicans overgrowth and digestive problems.3 A healthy stomach is a healthy bowel. Factors affecting low stomach acid production are principally diet and old age. The mucosa of the stomach needs to be healed and regenerated. Herbs such as Licorice are offered. Apple cider vinegar is also useful in the correction of the bowel pH and is known also to aid the liver functions. Life style changes are very much part of the remedial picture. Moderate exercise is encouraged to stimulate the lymphatics in addition to skin brushing. Reduction of stress in daily life through meditation is advised. Dietary changes are principally by elimination, and detection of problematic foods as cited earlier.

Conclusion

This brief review into the nature of Crohn's disease reveals many diverse opinions as to the causes and treatment options. Naturopathy has implicated widespread use of antibiotics as a probable cause. The incidence of all inflammatory bowel disorders are firmly linked to a diet high in animals products, and refined foods and sugar. The digestive power in the majority of people is severely compromised and constipation/diarrhoea disorders are very common place, indicating fundamentally that we are overloaded with toxins, eat de-natured and anti-nutrient foods. The incidence of Crohn's disease may possibly be addressed in the much wider spectrum of health in mental, emotional and physical aspects. This is the real value of Naturopathy and the use of therapeutic solutions from appropriate modalities to restore health. The focus of thinking in this modern age becomes narrow in the field of specialization. Attention is drawn to the varying symptoms and names of diseases, forgetting the overview and the contributions that can be made from other disciplines.

References

1. Mosby's Medical Dictionary. Mosby, London. Fifth Edition. 1998.
2. Mongomery SM et al. BMJ 316:1058-1059. 4 April 1998.
3. Murray M. Encyclopaedia of Natural Medicine. Little Brown & Co, London. 1998.
4. The Times Newspaper, London. 'Crohn's linked to bacteria in milk'. 25th January 2000.
5. Barnes J, Barnes N. BMJ 317:282. 25 July1998.
6. Demming L. Is Crohn's Disease caused by Antibiotics. HepatoGastoenterol 41:549-51. 1994.
7. Metcalf J. BMJ 316:166. 17 January1998.
8. Lars Å Hanson. Breastfeeding Stimulates the Infant Immune System. Science and Medicine 4(6). 1997.
9. Pitchord P. Healing with Whole Foods. p281. North Atlantic Books, Berkley, California. 1993.
10. Wright N, Scott BB. BMJ:314:454. 15 February 1997.

Further Information

For any questions regarding courses in Naturopathy and Complementary Medicine (Homeopathy, Herbalism, Traditional Chinese Medicine), you are invited to contact the CNM Head Office, at 73 Gardenwood Road, East Grinstead, West Sussex, RH19 1RX. Telephone 01342 410 505; Fax 01342 410 909; e-mail: info@bestcare-uk.com. The CNM has colleges in London, Manchester, Belfast and Dublin.

National Association for Colitis and Crohn's Disease (NACC), 4 Beaumont House, Sutton Road, St Albans, Hertfordshire AL1 5HH. Tel: 01727 844296.
Email: nacc@nacc.org.uk ; www.nacc.org.uk