When you or your loved one was first diagnosed with IBD, you probably felt like your life and taking a sudden spiral downward. You may have found yourself in the state of utter confusion, a deep-seated feeling of loneliness and depression taking root in the very core of your being. This may sound dramatic, but too many sufferers of both Crohn’s disease and ulcerative colitis feel this way in response to their diagnosis. The good news is that the better informed you become about your newly diagnosed condition, the better off you will be in the long run.
One problem that many people with IBD know all too well, is that these diseases, especially Crohn’s disease, can reoccur. Although therapies can reduce signs and symptoms, often the hope for full remission is stymied by widely varying factors.
Treatment options often include hospitalizations, surgery, and medications, but they rarely include a holistic approach that incorporates acupuncture, a new diet (potentially wheat-and-dairy-free), stress reduction, psychotherapy, yoga and meditation, naturopathic medicine, and a special protocol in detoxification.
When the proper groundwork is set for healing, the treatments, lifestyle practices, and even pharmaceutical medications, are much more effective at reducing symptoms and promoting healing. Our bodies were meant to function as a whole, and treatment plans should always be directed at the whole body to achieve the desired effect of wellness.
For me, as a Crohn’s disease patient, I benefit so much from going to see my regular doctor (an M.D.), and my naturopath (and ND), as well as my IBD specialist at the clinic at Dartmouth. I hope that someday soon, all three will be able to work together seamlessly. Until that time, I have to be the instigator, and make sure that my medical records are sent to all three places, and I have to be very proactive to stay on top of my appointments, asking my questions, doing my own research, and creating my own support system. All of the specialists and doctors are very busy people (as most of us are), and it is imperative for those of us with IBD, or our caregivers, to be very motivated.
Sometimes it can feel overwhelming. But make a list of things to do:
- Walk every day—start small, and gradually add miles. . . . A walk on the beach, like my friend in the photo, really releases stress. Do a short yoga stretch before or after!
- Buy a new water bottle—I love my 22-ounce LifeFactory glass water bottle with the rubber exterior!), and take one step at a time.
- Find a recommended naturopath in your area.
- Make sure you have at least yearly appointments with all the doctors on your “team.”
- Embark on the new dietary guidelines in this book.
- Take a high-potency probiotic (I take 1 capsule daily, called VSL#3, that really seems to be helping by bowel movements), or one that is recommended by your team.
- Consider asking your MD or ND to do a complete blood work-up, and also to test your adrenal function.
- (Last, but not least,) Work with a naturopath, preferably, to balance the immune system to achieve homeostasis that is promoting wellness in your mind and body.
Happy Spring Detox and Motivation….. And Happy Almost Summer!
Our new cookbook is out and Dede would like to give away a free copy to the first two people who comment on this post — tell us a bit about yourself, are you a caregiver, do you have Crohn’s, or colitis, or IBS, or some other autoimmune disease? When you receive your book (send email in PM to firstname.lastname@example.org), please post a review on Amazon for us and we will be eternally grateful!
We are excited to share these gut-friendly recipes from the book and there is a long introduction about how to live with IBD and tips to help.
For the millions of people afflicted with irritable bowel disease (IBD), including Crohn’s and colitis, it can be a daily struggle to find nutritious meals that won’t aggravate symptoms or cause a flare-up. The Living with Crohn’s & Colitis Cookbook is your essential nutrition guide with over 100 recipes and meal plans expertly designed to improve daily functioning and help relieve symptoms of Crohn’s and colitis.
The Living with Crohn’s & Colitis Cookbook contains everything you need to plan your meals, balance your diet, and manage your symptoms, including:
• A guide to keeping a food journal
• Sample meal plans
• Tips for shopping for an IBD diet
• Gentle and nutritious recipes to help soothe flare-ups
…and much more!
The Living with Crohn’s & Colitis Cookbook features over 100 recipes, including Zucchini Buckwheat Banana Bread, Homemade Almond Milk, Dr. Lang’s Healing Soup, Garlic-Herbed Scallops, Coconut Curry Chicken over Brown Rice, Mushroom Risotto with Cashews and Parmesan, Crabapple Walnut Cake, and many more. The book also features Paleo recipes.
Enjoy these photos from our book!
I would definitely recommend getting another opinion. I got two!
One of our readers wrote to say her doctor told her she “shouldn’t feel any pain from UC.”
Pain is a bi-product of both Crohn’s disease and ulcerative colitis. My disease caused pain when I flared—it even felt like labor pains! I have Crohn’s. My disease is characterized by scarring—called fibro stenotic disease. UC does not usually go through the outer wall of the large intestine the way Crohn’s does with the small… So some people don’t have pain, but have diarrhea instead.
Remember, everyone is an individual, and we have different symptoms and react differently to different foods, or stress, for example. I (Dede) always say this: listen to your own body, ease off on trigger foods, like dairy or wheat, be proactive in your health care and do research and ask questions. Bring a list, and a partner or a friend, to your doctor’s appointments.
One time, I brought my husband, and he had done all this research (he’s an English professor ;)… at one point in the meeting, the gastroenterologist leaned over his desk and said to my husband, “Hey, what do you have on that drug?”
One thing to be aware of: getting off Prednisone. Did your doctor tell you to taper off slowly? My GI did. I love my team at Dartmouth Hitchcock in NH, it’s important to find a clinic and doctor you can trust who really listens to you!
Diet—yes, can cause pain and symptom flares. Don’t let a doctor fool you! Listen to your own body!
There is an excellent website-forum called www.ihaveuc.com and you should “tell your story,” and pose any questions you have there, also.
It is amazing how much a positive attitude can help. In our book, there is a section when I am despairing and a doctor comes and sits with me and holds my hand—no kidding! He said, “Think positive.” Well, on that note, I want to write a post today about that and helping the body adjust to the changing season and of course living with IBD in general. I also want to share the news that I am writing a cookbook, called Living with Crohn’s & Colitis Cookbook (good title, too!)…my publisher is the wonderful Hatherleigh Press, which is distributed by Random House. I couldn’t ask for a better team! Publisher, Andrew Flach believed in this book from the very start, associate publisher, Ryan Tumanbing is always there when I need things, and my editor, Anna Krusinski is da Bomb!
My book with Jessie is a good overview and a way to understand how the body chemistry and immune response works. I am not denying the benefits of medication, but we do offer an alternative, and if you are someone who has to stay on meds, you can do both—no matter what, it is important to keep the body tuned and in a balanced state of homeostasis.
Getting a full work up from a medical professional is the first step—go to a specialist at a GI clinic (Dartmouth is the best in my area), and have a colonoscopy, blood work (really important as many patients are anemic due to blood loss, or low in B-12 as in my case), a physical exam (a patient will no doubt be embarrassed by this like I was, but this is a very important exam because the doctors can determine a lot when they examine the anus and rectum, and palpitate the abdomen—they could feel the mass in my case), and what is called enterography: a MRI or CAT scan (I don’t recommend CAT scans too frequently for younger people) will reveal areas of disease inflammation.
Crohn’s typically presents in the lower right abdominal quadrant (often confused with the appendix!) of the small intestine, but it can strike anywhere from the mouth to the anus. Colitis presents throughout the large intestine only. Crohn’s really cannot be cured, and has a tendency to skip to infect the next section of the bowel even after the diseased section has been removed (as in my case). Colitis can be cured through surgery if nothing else (drug therapy or naturopathic-holistic-alternative) works. They take out the large colon, and connect the stomach-duodenum-small bowel through a J-pouch internally, or an external ostomy bag. Not a great thing for anyone to have an ostomy bag; however I have met many people with colitis who don’t mind the bag at all, and love the fact that they are pain-free.
The Crohn’s & Colitis Foundation of America is the best organization! I love everyone there, and run in their half marathons with Team Challenge to help raise money for research; plus it is a community of fellow patients, young and old, and we are a surprisingly close-knit group. Join, and sign up for a walk and a support group (they even have a new college group!) as soon as you can.
The other thing to do, is have a poop sample tested (this is no fun, but can tell a lot—bacterial infections, or something called C-Diff). In addition to going to a GI clinic, make an appointment for a work-up with a recommended naturopath, a trained naturopathic physician with a four-year degree from a well-known college (Bastyr University, for example) and get right in there for a checkup and a plan of action. My naturopath did allergy testing to see if there were specific foods (most common culprits are wheat and dairy), that I needed to eliminate, and she ordered an endocrine hormone test to see if I may have had a hormone imbalance.
I also give a lot of credit to my acupuncturist who is trained in Chinese medicine, and I go once a month. It is all in our book, but make sure you stay on top of the disease and get regular check ups with your medical doctor to rule out any other complications. I had a dangerous abdominal fistula, that didn’t show up on the CAT scan and was attaching itself to another organ—sorry to bring in the drama, but IBD (Inflammatory Bowel Disease) can be life threatening. No question, it is vitally important to be proactive, especially as a parent.
My weight was so low, I was dangerously thin—ironic, because our society places such status on being thin! I am now a healthy 140 pounds, and I work hard every day to stay healthy. Once I get busy with work, and let things slide, I start to feel run down… I can tell right away! Being in tune with your body is very helpful—keeping a food and daily journal, getting some good private counseling, and doing stress reduction exercises (Tai Chi or yoga) daily is also a big part of managing the disease.
I think I have covered the basic tenets of my book with Dr. Jessie. Oh, one more thing, join the online groups— http://www.ihaveuc.com, and The Crohn’s Journey Foundation for starters, also Intense Intestines, Girls With Guts, the Crohn’s Forum, Healing Well, and others. We are a strong and awesome group—always there to support each other! Let’s face it, the doctors are so busy, they can’t spend and hour with each patient, and it is the patients themselves who are doing great research and offering support. If a doctor tells you stress or diet have nothing to do with IBD, find another doctor! Oh, and second opinions are a good plan as well.
I have eliminated SUGAR, and ALL grains from my diet and ALL dairy. It is awesome! I feel so much better… I eat baked chicken or grilled fish, locally-raised, antibiotic-free, grass-fed hamburger steak once in a while when my body craves red meat, all served with yummy vegetables on the side and tons of fruit and nuts and eggs… I take extra calcium-magnesium, along with daily probiotics, turmeric, Omega 3, Vitamin D, herbal adrenal support, extra vitamin C, and a good multi-vitamin (I buy only organic food and supplements—it’s more expensive, but then I don’t spend a lot of money on clothes and makeup!).
So that is the basic overview—I am always there for my readers, and want to offer as much support as possible!
Oh, this just in, Dede will be on The Doctor Oz show this coming Monday, October 14th, in a spot on how common bloating is. They found me through the Crohn’s-Colitis book on “Help a Reporter Ou”t (HARO), and asked me to show how hard it is to buckle my jeans when I am bloated, which is what “used to happen” when I ate too much dairy or wheat…now, I don’t have bloating much AT ALL! Watch the segment if you want a laugh 😉 as “laughter is the best medicine.” I don’t mind embarrassing myself to help others…
Be well, and take care of yourself… don’t be afraid to ask for help!
Below, you can see some recent dinners… My husband and I have a grill we use a lot, and here you can see grilled marinated swordfish (fresh ginger root, white wine, wheat-free tamari, lime, and a dash of brown sugar for the marinade and let sit for a half hour before grilling) with grilled garden-fresh small eggplants (some people may have trouble with seeds…always introduce new foods slowly and note the reaction by your body in your journal right away….like I tried polenta this summer….noooooo! Not good for me, but may not bother someone else—we are all different!), and baked chicken with a sesame glaze (it was so good!) and steamed broccoli.
Greetings from Vermont. I am the co-author of Living With Crohn’s & Colitis: A Comprehensive Naturopathic Guide for Complete Digestive Wellness (with a nationally-known naturopath, Jessica Black, ND). Our book has helped so many people afflicted with Inflammatory Bowel Diseases, part of the growing auto-immune diseases that cause diarrhea, bloating, nausea, vomiting, and cramping. These inflammatory bowel diseases, and other auto-inmmune disease are on the rise exponentially across the world, especially in the developed countries where processed food is available.
Think about it: There are certain behaviors that cause body/mind stress: We address this in the book, but I want to tell you that I am a patient/survivor of a stress-induced flare-up in 2006 that almost killed me. On my 5 foot 8 frame, I weighed 117 pounds. I spent a month at Dartmouth Hitchcock Medical Center. I was 45 and very sick, with 3 children at home and a business to run.
Stress was the way I worked, and I was on autopilot without taking time for myself. That has all changed, and I have been in clinical remission for the last 7 years! Let me tell you more….
As many readers know, I went to the Mayo Clinic in Rochester, Minnesota this past May to have a complete second opinion. I spent two days of my weeklong stay, at the wonderful stress reduction clinic.
Here are some of my tips gained from my research, and how I try to keep my disease in remission:
A lot of us have low level stress. Most of us don’t live in the hyper-aware world, and we suffer the autopilot behaviors that contribute to what I call “the slow burn of stress response.” Our heart rate and blood pressure might be elevated, and our breathing and muscle tension is like this — shallow breathing and knots in muscles. There is an area at the base of the brain called the amygdala. This is the seat of our emotional reactions, or “flight of fight” response to stress. Many Americans live with this elevated, but low level elevation daily… a little bit of “Flight of Fight” stress is really okay, but not on autopilot.
Look at our brains — In our pre frontal cortex, there is an area responsible for relaxation, and it is not easy to stimulate and not an adrenal release, as per the amygdala part of the brain.
First we need to be aware of this pre frontal cortex We have to explore our own behaviors and habits, break out of autopilot, and participate in a personal practice. There are some things you can’t control, like weather or traffic jams; however there are some things we can control, and are important… An example from the workshop was if you have an overbearing mother (don’t worry, Mom, not YOU!), and how you need to take care of yourself first and use the excuse of health, and scale down. Awareness helps, and limit your exposure to stressful people and situations. It’s a process… keep boundaries in your mind, but “caring boundaries.”
Unhealthy responses to stress in our life are anger, etc. It is important to develop a healthy exercise routine, learn and use relaxation techniques (see below), and take care of yourself. This neural pathway gets easier and easier to tap into (see diagram at right). For example, my body knows and relaxes immediately when I walk into my home “yoga area” where I have a TV, and a carpet with a yoga mat. I use Rodney Yee’s DvD, “AM/PM Yoga,” and do the exercises every day… it gets easier and easier to tap into the relaxation part of my brain, and it is replenishing.
After a stressful day:
- Call a friend
- Read a book
- Walk the dog
- Ride a horse
- Volunteer at a soup kitchen
- Play the piano
- Do some gardening
In order to break out of autopilot, do a few things on this list on a regular basis.
Benefits: Concentration, Problem solving, Sleep…
We need to be participants: This involves “letting go of the wheel,” loosening your grip, and takes time and experimentation.
In the wonderful workshop, our instructor gave the analogy of flying on an airplane, and how you put the oxygen mask first, then help the child.
Talk therapy is another way to help relinquish the autopilot lifestyle… A regular monthly session with a trained, recommended therapist will do wonders for helping to care for yourself, establish boundaries, and feel safe.
Evaluate your stressors and prioritize your time, as you move forward in the break from autopilot.
Give yourself permission eg., “Be kind to yourself and ask for help.”
Often we don’t think about our career as a choice made for healthy reason, and it might be time to reevaluate what we do for work.
It is important to spend time with friends, develop hobbies…. Hanging out with people who make me laugh is a goal. A hospital study involved a control for two groups with the same malady: One group watched funny movies every day, and got out of the hospital faster.
It’s a process, and it is important to practice positive self talk.
Start a simple practice of Tai chi and chi gong
Walk around with a gentle smile on your face and try to share it with strangers—you use less muscles and tension when you are not frowning, which can contribute to an overall sense of well-being and a way to focus on releasing the internal stress caused by being on autopilot…
I have found this “small smile” technique that is practiced by Amit Soud, MD, the head of the Eastern Medicine Section of the Mayo Clinic to be essential as a way to lessen internal stress.
TAI CHI AND CHI GONG: These ancient exercises are easy and relaxing, often available in small towns across the United States. For example:
We breathe with about 40% of our lungs. If we can learn to take slow diaphragmatic breaths, we can effortlessly lesson our stress levels. These exercises are the foundation and essential for relaxed breathing.
A simple exercise I learned at the Mayo Clinic:
Take in a slow deep breath,
and fill your lungs so even your belly sticks out;
hold for a couple of seconds;
pretend you have a lit candle and exhale
so that the candle flickers.
Note to reader: it might take 8 weeks or so to start seeing results.
A New Diet…. Begun just over four weeks ago, is really helping! I am inspired by my friend, and fellow Crohnie, Katy Haldiman, RN, MS, The Paleo Nurse, and my consultants, Jordon Reasoner, and Steve Wright of SCD Lifestyle, to try a simplified diet to help my recent recurrence of Crohn’s from spreading.
Crohn’s is not easily deterred. I was so lucky to have seven years of clinical remission. It was only in the last year, that my disease spread. My last seven years have been filled with hope and health, and it is easy to fall into despair when the doctors tell you that your disease has gone from nonexistent to “severe.”
Rather than saying “Woe is me,” and spending time feeling sad and useless (I did a lot of that, believe me), I decided to take action, and try to live the words of the Dalai Lama:
“Scientists say that a healthy mind is a major factor for a healthy body,” His Holiness said. “If you’re serious about your health, think and take most concern for your peace of mind. That’s very, very important.”
That said, I am on my way to health, for sure—no time to sit on my cushion meditating (I do that daily for a few minutes still); rather, I need to stay focused and take care of my body: better food, sleep, stress relief, education, awareness, team building, satisfying work, making money enough to live on, giving back to my community and the world…working for peace, justice, and environmental sustainability. According to His Holiness the XIV Dalai Lama, peace of mind is essential for health—words to live by.
This new diet, very much like The Paleo, is giving me strength and vitality. It is not for everyone—and I always tell people you must proceed with a doctor’s knowledge, for Crohn’s and UC can be serious, even fatal, if not managed correctly. I have worked really hard to form a collaborative team—my own book’s co-author, Jessica Black, ND, is my stalwart supporter and her book, The Anti-Inflammation Diet and Recipe Book has just come it in a second edition and has sold almost 100,000 copies! Jessie is an amazing health practitioner.
I have eliminated ALL grains and dairy from my diet—woohoo! What a difference. I found this great site, and I can use almond meal flour (also coconut flour), and I eat fruits and veggies, nuts and animal protein pretty much non-stop. I had an adjustment for the first week, as I really missed my oatmeal in the morning, but as you can see from the photo, my morning meal is wonderful and tasty, too.
I hope this post inspires people to look at their own diets, and proceed with caution (this diet is not recommended if you have flare-up symptoms of Crohn’s or ulcerative colitis). I began this diet with no symptoms, and after the first week, I started to feel like I had more energy, and my stress levels are kept low by walking 4 miles a day and sleeping 8 hours per night.
I’ll post some more photos of my wonderful meals… Summer is the best time to do this diet: only organic fruits and veggies and meat must be antibiotic-free, grass-fed…that whole thing! I buy all local meat, eggs, fruits and veggies… And I plan on putting up and preserving a lot of them this summer so I can continue summer’s bounty from my freezer (and canning room) during the cold Vermont winter!
I also have a nice little garden growing…. Kale, and more kale! Plus, tomatoes, green beans, lettuce, spinach, onions, asparagus, etc. growing your own food is another way to reduce stress and get physically fit—gardening is good for upper body strength!
Inflammatory Bowel Disease (Crohn’s & Ulcerative Colitis)
Our first-ever “guest post” on Dede’s blog! Drew and I “met” through Dede and Jessica Black, ND’s Facebook page, and Dede invited him to educate our readers and followers about the benefits of accupuncture. WTG, Drew! This is like a new book we should publish! A very thorough examination of signs and symptoms of Crohn’s and ulcerative colitis, along with specific treatment plans for acupuncture. Since Dede (seriously) is a wimp when it comes to needles (also, working on this using Ayurvedic treatment to help with this possible symptomatic “sensitivity” on the skin, which is very likely bowel, related, since the skin and the bowel ARE related!~)…Please welcome Drew, and share this, and come visit him if you live in the Southern California region—like our friends at the CrohnsJourneyFoundation.
Inflammatory Bowel Disease is a heading/umbrella that has other diseases underneath it. You may have heard of Crohns Disease, Ulcerative Colitis and Irritable Bowel Disease. You may know someone who’s been diagnosed with one of these or you may have had one of these unfortunate afflictions. In any case these can be serious debilitating conditions that sometimes require extreme care for severe cases but all require long term care. In this article I will discuss the differences and similarities between the three.
Crohn’s Disease: A chronic inflammatory condition of the intestinal tract was first described by Dr. Burrill B. Crohn in 1932, along with Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer. Mostly affects the end of the small intestine called the “Ileum” and the beginning of the colon/large intestine “Cecum” but can affect the entire length of the GI tract. Crohn’s disease can affect the entire thickness of the bowel wall leaving “skip lesions;” whereas, Ulcerative Colitis only affects the superficial layer of the large intestine.
Ulcerative Colitis: A chronic inflammatory disease that affects only the Large Intestine (aka: colon). The lining of the colon becomes inflamed, and ulcerations occur which bleed and produce pus.The inflammation and the ulceration lead to spasms, cramping/pain and frequent bowel movements.
Like Crohn’s Disease Ulcerative Colitis is an autoimmune disorder where your body attacks itself.
Symptoms related to inflammation of the GI tract:
• Persistent Diarrhea
• Rectal bleeding
• Urgent need to move bowels
• Abdominal cramps and pain
• Sensation of incomplete evacuation
• Constipation (can lead to bowel obstruction)
More severe symptoms:
• Fissures in the lining of the anus (tears)
• Fistulas (tunnel from one loop of intestine to another or connects the intestine to the: bladder, vagina or skin)
Symptoms related to inflammation of the Colon:
• Bowel movements become looser and more urgent
• Persistent diarrhea accompanied by abdominal pain and blood in the stool
• Stool is generally bloody
• Crampy abdominal pain
General symptoms that may also be associated with IBD:
• Loss of appetite
• Weight Loss
• Night sweats
• Loss of normal menstrual cycle
Types of Crohn’s Disease:
• Ileocolitis: The most common form of Crohn’s, ileocolitis affects the end of the small intestine (the ileum) and the large intestine (the colon). Symptoms include diarrhea and cramping or pain in the right lower part or middle of the abdomen. This type is often accompanied by significant weight loss.
• Ileitis: This type affects only the ileum. Symptoms are the same as ileocolitis. In severe cases, complications may include fistulas or inflammatory abscess in right lower quadrant of abdomen.
• Gastroduodenal Crohn’s disease: This type affects the stomach and the beginning of the small intestine (the duodenum). Symptoms include loss of appetite, weight loss, nausea, and vomiting.
• Jejunoileitis: This type is characterized by patchy areas of inflammation in the upper half of the small intestine (the jejunum). Symptoms include mild to intense abdominal pain and cramps following meals, as well as diarrhea. In severe cases or after prolonged periods, fistulas may form.
• Crohn’s (granulomatous) colitis: This type affects the colon only. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers). Skin lesions and joint pains are more common in this form of Crohn’s than in others.
Types of Ulcerative Colitis:
• Ulcerative Proctitis: For approximately 30% of all patients with ulcerative colitis, the illness begins as ulcerative proctitis. In this form of the disease, bowel inflammation is limited to the rectum. Because of its limited extent (usually less than the six inches of the rectum), ulcerative proctitis tends to be a milder form of ulcerative colitis. It is associated with fewer complications and offers a better outlook than more widespread disease.
• Proctosigmoiditis: Colitis affecting the rectum and the sigmoid colon, the lower segment of colon located right above the rectum. Symptoms include bloody diarrhea, cramps, and a constant feeling of the need to pass stool, known as tenesmus. Moderate pain on the lower left side of the abdomen may occur in active disease.
• Left-sided Colitis: Continuous inflammation that begins at the rectum and extends as far as a bend in the colon near the spleen called the splenic flexure. Symptoms include loss of appetite, weight loss, diarrhea, severe pain on the left side of the abdomen, and bleeding.
• Pan-ulcerative (total) Colitis: Affects the entire colon. Symptoms include diarrhea, severe abdominal pain, cramps, and extensive weight loss. Potentially serious complications include massive bleeding and acute dilation of the colon (toxic megacolon), which may lead to an opening in the bowel wall. Serious complications may require surgery.
Causes and who’s affected:
As many as 700,000 Americans may be affected by Crohn’s Disease and Ulcerative Colitis. It is equally common in men and women and while it can affect a person at any age there is a higher risk during the years from 18-35. The cause of IBD is not fully understood but there is a connection between diet and stress; as well as hereditary, genetics and/or environmental factors that play a role in the development of IBD. Studies have shown a greater risk of 5-20% increase in someone acquiring this disease if a “first-degree” relative (parent, child, sibling) has it and an even greater chance if both parents have an IBD. Crohn’s is most common among people with Eastern European backgrounds and it is increasing in number for African Americans. Ulcerative Colitis is more common among Europeans with a Jewish background heritage.
The environment that you put yourself in plays an important role as well. The occurrence is higher in “developed” countries than in “underdeveloped countries, higher in urban areas rather than rural, and in northern versus southern climates.
Treatment with Chinese Medicine:
Due to the differential diagnosis that is applied in Chinese Medicine there are different “patterns” that exist when dealing with a disease. This is a similar idea to the different types of Crohn’s Disease and Ulcerative Colitis described above. However, with Chinese Medicine, the patterns are based off of the symptoms the patient is currently experiencing as well as their history, their facial color, body odor, general demeanor, abdominal diagnostic, pulse diagnostic and tongue diagnostic. All of this information is compiled which leads to one of many “diagnostic patterns” to which the according acupuncture points, herbal formula, diet and lifestyle is prescribed. Chinese Medicine is a powerful therapy that can help treat severe cases and help keep mild cases and patients who are in remission stay in remission.
Before we discuss the differential diagnosis, there are a few terms that need to be explained. First one is the “Organ” system. In Chinese Medicine each organ is attributed to specific functions that don’t necessarily match a scientific viewpoint. For example the “Spleen” and “Stomach” are considered to be in charge of the digestive functions and water metabolism in Chinese Medicine. The “Spleen” actually handles some of the function of the “Western” spleen, pancreas and small intestine. The “Liver” has to do with the free flow of qi, which is easily obstructed by stress, emotions, diet and lifestyle. The “Kidney” can be attributed to water metabolism, as well as genetics and our “reserves.” The term “burning the candle at both ends” is a great way to describe how stress and lifestyle can damage the Kidneys. The “Heart” has to do with our emotions and deals with blood. When the digestive system isn’t absorbing food properly we cannot produce the nutrients and blood needed to support these organs. “Heat” refers to inflammation and “Dampness” refers to water metabolism malfunction. Both of these can manifest in numerous ways, as you will see below.
Below are examples of some different patterns that could be “diagnosed” as Crohn’s Disease or Ulcerative Colitis and what the treatment principle should be.
• Spleen Qi Deficiency: Intermittent dull abdominal pain that is alleviated with pressure, abdominal distention, early satiety, nausea, loose stools or diarrhea, loss of appetite, waxy pale or sallow complexion, fatigue, weakness, shortness of breath with exertion, spontaneous sweating, dizziness, and light headedness. Might have mild bleeding of dark, purplish blood, or less commonly, red blood preceding or following a bowel movement; or black, tarry, sticky, unformed stools; or occult blood in the stool discovered upon routine testing. There may be other signs of bleeding, such as heavy menstrual periods or easy bruising.
- Tongue: pale and swollen, with tooth marks (or pale and thin with significant blood deficiency).
- Pulse: Thready and weak or moderate.
- Treatment Principle: Strengthen Spleen, supplement and elevate qi. Nourish Blood and stop bleeding.
• Liver Qi invading the Spleen: Recurrent Diarrhea which may be urgent and preceded by cramping abdominal pain. The pain is relieved following defecation. The diarrhea may alternate with constipation. Symptoms become worse with stress and tension or eating. There is a possibility of mucus and blood in the stool. Other signs and symptoms include abdominal distention, poor appetite, nausea, heartburn, indigestion, borborygmus, flatulence and belching, which relieve abdominal discomfort, hypochondriac discomfort, ache and tightness generally worse on the right side, irritability, depression, moodiness, shoulder and neck tension, temporal or tension headaches, cold fingers and toes, premenstrual syndrome and breast tenderness.
- Tongue: normal or darkish body, or pale, or with slightly red edges: greasy coat especially over the root (depending on the degree of heat, deficiency and Dampness.
- Pulse: Wiry
- Treatment Principle: Harmonize the Liver and Spleen, regulate Liver qi, Support and strengthen Spleen, Alleviate spasm and pain, and stop diarrhea.
• Blood Stagnation: Chronic Diarrhea with a feeling of incomplete evacuation or tenesmus. The stools may be purple or black, sticky or tarry. The diarrhea may alternate with constipation.Fixed and localized, sharp or stabbing abdominal pain (usually in the lower left quadrant) which is worse with pressure. Dark complexion, dark rings around the eyes and purple nails. Spider naevi or vascular abnormalities over the abdomen, face and legs (particularly the inner knee and ankle).
- Tongue: purple or with brown or purple stasis spots; sublingual veins dark and distended
- Pulse: wiry, choppy or thready.
- Treatment Principle: Transform and eliminate stagnant Blood from the Intestines.
• Damp Heat dysenteric disorder: Frequent, foul smelling, explosive diarrhea with blood, mucus and pus: the mixture of mucus and blood will vary depending on the balance of Heat and Damp.Burning anus, tenesmus, colicky abdominal pain, abdominal distention, scanty concentrated urine, red complexion, red eyes, dry mouth, and thirst (maybe with little desire to drink). In the early stages there may be fever and chills, headache and a floating pulse.
- Tongue: greasy yellow coat; with more Heat a red tongue body and a dry coat; with more Dampness, a thick greasy tongue coat
- Pulse: slippery and rapid.
- Treatment Principle: Clear Damp Heat from the Intestines and Regulate Qi and Blood, stop pain.
• Spleen and Kidney Yang Deficiency: Chronic and relentless diarrhea which is thin, watery and mucoid, and may contain pus and blood. In severe cases there may be incontinence of stools and rectal prolapse. The diarrhea is worse from exposure to cold and cold foods. Mild tenesmus or a dragging sensation in the lower abdomen, not relieved by diarrhea. Mild persistent abdominal pain, which is better with warmth and pressure. Loss of appetite, listlessness, fatigue exhaustion, depression. A waxy pale or sallow complexion, cold extremities, cold intolerance, weakness and soreness of the lower back and legs.
- Tongue: Pale and swollen with a thin white coat.
- Pulse: deep, thready, weak and slow.
- Treatment Principle: Warm and Strengthen the Spleen and Kidney Yang. Disperse Cold, transform Dampness. Astringe diarrhea and elevate qi.
• Yin Deficiency with Residual Damp Heat : Chronic diarrhea with small quantities of sticky mucus and blood. Frequent urge to defecate but often in vain. Mild lower abdominal pain, tenesmus, loss of appetite, nausea, dry mouth and lips, thirst worse at night, afternoon or tidal fever that’s worse at night. Heat in the palms and soles, nightsweats, flushing , emaciation, weight loss.
- Tongue: red or scarlet and dry, with a greasy or peeled coat.
- Pulse: thready and rapid.
- Treatment Principle: Nourish and supplement yin and clear residual Damp Heat. Nourish and regulate Blood and stop dysentery.
• Heart and Kidney Yin Deficiency: Recurrent mouth ulcers, which appear in clusters and tend to aggregate on the tongue or tongue tip. The ulcers are painful and hot, with a narrow, slightly swollen, mildly red margin. They frequently recur and persist for up to several weeks before resolving. Often of many years duration, the ulcers tend to be provoked or aggravated when the patient is stressed, anxious or upset. Nervous, anxious individual, insomnia, vivid dreaming, panic attacks, palpitations, forgetfulness, dizziness, tinnitus, lumbar ache, sensation of heat in the palms and soles, dry mouth and throat, night sweats.
- Tongue: red with little or no coat, redder at the tip.
- Pulse: Thready and rapid.
- Treatment Principles: Nourish Heart and Kidney yin. Clear Heat, calm the (spiritual) Shen.
Forms of treatment include acupuncture, herbal formulas (which can be taken internal or external), Massage/tuina, dietary therapy, exercise and lifestyle consultation. When we utilize and multiple forms of therapy results are seen at a rapid rate.
*Disclaimer: The information offered in this paper is not intended to diagnose but rather to inform the public about IBD and give a brief look at how Chinese Medicine looks at and treats IBD.
• http://www.ccfa.org /
• Will Maclean and Jane Lyttleton, (2003), Clinical Handbook of Internal Medicine “The
Treatment Of Disease with Traditional Chinese Medicine” Volume 2 Spleen and Stomach, University of Western Sydney
I have used mediation and mindfulness steadily since my bowel resection six years ago, and I have made a daily practice of morning yoga and mediation.
When I sit at the end of my yoga session (I use the gentle Rodney Yee DvD, “A.M. Yoga,” I let Rodney’s soothing voice guide me into a place where my breath is quiet, my mind quiets (that can take a while with me!), and my shoulders and ears and limbs are relaxed (look at statues of sitting Buddhas, and you will notice the elongated ears, the fingers in the lotus position, the downcast eyes…).
I chant “Om,” before and after I sit, and I have a visualization that I let pass through my body from my head down through my spine, and out my lower back—it is a ball of white light. While this luminescent ball moves down my spine, I have a mantra I chant over and over that goes like this: “White light healing inflammation gone.” It is amazing to me how grounded and refreshed I feel after each morning session.
I have recently become influenced by the work of Jon Kabat-Zinn—the founder and former director of the Stress Reduction Clinic at the University of Massachusetts Medical Center. He also travels across the country teaching workshops on stress reduction and mindfulness.
I also like this book, as a good starting point for introducing mindfulness and meditation into your daily lives… As I prepare to go to the Mayo Clinic next week, I will reread this book, and meditate… Just 10 minutes a day for starters, and I hope you will join me. I’d love to hear what others have to say about introducing mindfulness into their lives, and what the do and recommend.
This post was also published by Len Saunders in Your Health Journal, today! I am honored to be a part of this healthy outlook website, and glad they used my meditation tip for #198!
Happy Spring! Time for “a second opinion”
for this Crohnie patient….
The Dartmouth GI team, headed by one of the top IBD doctor’s in the country, Corey Siegel, MD, wants me to take two heavy-hitter drug combos—an immuno-modulator approach that I don’t feel comfortable with taking. Here is my (layperson, granted!) reasoning: since my quality of life is so good, and my symptoms are episodic and stress-induced, mainly (the docs don’t really like talking about stress as a disease-trigger, as it is so hard to quantify I think), my gut is telling me to wait and continue with my naturopathic treatment; and, quite frankly, I almost prefer surgery to the idea of taking such life-affecting medications…
I want to add, that many of my Crohnie and uc-er friends are successfully being treated on these drugs, I have nothing AGAINST the drugs, and if they help and the symptoms are minimal, that is fantastic! Since many of you have asked (!), here is what they want me to take…. Not one, but TWO drugs, given the severity of my disease….. Read on:
According to WebMD, Remicade (or infliximab) is used to treat certain types of arthritis (rheumatoid arthritis, arthritis of the spine, psoriatic arthritis), certain bowel diseases (Crohn’s disease, ulcerative colitis), and a certain severe skin disease (chronic plaque psoriasis). In these conditions, the body’s defense system (immune system) attacks healthy tissues. Infliximab works by blocking the actions of a certain natural substance (tumor necrosis factor alpha) in the body. This helps to decrease swelling (inflammation) and weaken your immune system, thereby slowing or stopping the damage from the disease. Remicade is given by infusions, through the vein (it usually takes 2 hours) every 6-8 weeks.
The other drug they want me to take is commonly called 6MP. It is taken In pill form. This medication is used with other drugs to treat a certain type of cancer (acute lymphocytic leukemia). Mercaptopurine belongs to a class of drugs known as purine antagonists. It works by slowing or stopping the growth of cancer cells. This drug may also be used to treat Crohn’s disease, ulcerative colitis, and lymphoblastic lymphoma.
In patients using infliximab along with azathioprine or 6-mercaptopurine for the treatment of Crohn’s disease, there have been rare reports of an extremely rare, often fatal cancer (hepatosplenic T-cell lymphoma).
Sounds pretty scary, huh?
Infliximab works by binding to tumor necrosis factor alpha. TNF-α is a chemical messenger (cytokine) and a key part of the autoimmune reaction. Cytokines are proteins that are produced by cells. Cytokines interact with cells of the immune system in order to regulate the body’s response to disease and infection. Cytokines also mediate normal cellular processes in the body.
In our book, Jessica Black, ND, my co-author, discusses the cellular balance in the body to achieve and maintain a balance of homeostasis. In patients with IBD, the need for hormone balance and regulation is also important. In our book, she says,
“Every organ in the body depends on, and influences, other organs—everything is interconnected in the body. This is why whole body approaches to healing often work better than treating just one system, or one symptom.”
This naturopathic approach to whole body, and more holistic/lifestyle, healing is what I aspire to. Since I do not want to take the aforementioned drugs, and my overall health is so good, I feel better able to exlore other options. Emeran Mayer, MD, who wrote the Preface to our “Living With Crohn’s & Colitis” book, recommends a second opinion. (Here is the link LWC_Pages_EmeranMayer to his inspiring write-up.)
I am leaving for the Mayo Clinic in Rochester, Minnesota next Sunday, and I will be there for almost a week. It will be interesting, to say the least (!), to hear what the GI team has to say about my case. i will be seen there at 8:00 a.m. on Monday, April 29th by William Tremaine, MD.
Let the adventure begin. I am not scared, or alarmed—just looking for a more integrative approach to my personal patient care. My gluten-free, sugar-free, diet has been going really well—I feel healthier overall, and my research shows that sugar can create problems in the gut, and may even be linked to leaky gut syndrome, so it has been a great practice to switch to only using honey for sweetener. Here is a great video by Mark Hyman, MD, about why “functional medicine is different than conventional medicine” … it is VERY inspiring, not to mention PRACTICAL!
A group of supportive friends and family . . .
One thing I have going for me, and encourage my IBD-friends to be part of, is the online community of Crohnie and uc-ers that I am privileged to know and appreciate. Sometimes we make each other laugh! Take my Crohnie-friend, Christina . . .she is an awesome survivor of many surgeries and health problems, but when I read her interview with Sarah Chouiery of The Crohn’s Journey Foundation, I laughed out loud at the “embarrassing moments” section! Christina’s blog is a great resource for some welcome humor! I will have it on my iPad as I travel to Minnesota next week….
This photo, below, was taken in my hometown of Brattleboro, Vermont…. Is it a real dog behind the statue of the Buddha you may ask?
One of our readers wrote recently, saying her arthritis pain was really hard to deal with . . . Here is Dede’s answer, and hopefully some tips for others who also suffer from the related symptoms of arthritis.
Arthritis pain? Oh, I have it, too!
Arthritis is such a drag. but remember: We are all in this together . . .
Here’s what you can try:
Daily morning yoga with Rodney Yee DVD called “AM/PM Yoga”
Take Omega 3 fish oil capsules 2 “softgel” caps up to 2-3 daily with food (use best brand, highest quality—Dede uses Metagenics “OmegaGenics/EPA-DHA 720”)
Take a lavender bath with candles nightly before bed and use Epsom Salts in the water
Eat the healthiest diet: no sugar, caffeine (if you must, water down coffee and green tea okay), dairy or red meat
Make an appointment with a physical therapist (insurance usually covers this!)
Go to see an experienced acupuncturist (Chinese medicines best) and have 3-4 treatments in 2 months to see it it helps (make sure it is someone trustworthy with good recommendations)
Get a massage monthly to help cleanse and detoxify
Every time before your bath or shower use a dry Loofa sponge and brush your skin all over briskly to accentuate healthy cellular growth
Get 8-9 hours of sleep nightly
Use a castor oil pack to lay on sore joints—you can buy castor oil at a health food store, and Dede soaks a wool rag with it, to make a compress, then put SaranWrap over that, followed by a small towel, followed by a heating pad—ahhhh! The pain miraculously fades away, and you are forced to sit still and can read a book. Or, even better, you can meditate while you heal.
Walk 3-4 miles every day to clear your mind and keep your joints fluid and muscles strong to support the bones
Ride a bike for cross training — great for quad strength, and it is easier on arthritic knees…
Monday is the “Living With Crohn’s & Colitis Bicycle Challenge”!!! Get out there and start pedaling—post photos of you on a bike on our Facebook wall, and “Thnk Pos!”