Inflammatory Bowel Disease (IBD)

What is IBD?

IBD is the name given to a group of disorders that cause the intestines to be chronically inflamed. Crohn's Disease (CD) and Ulcerative Colitis (UC) are two very common types of IBD. In CD, ulcers (open sores) are seen along the length of the large and small intestines. CD usually spares the rectum. In UC, ulcers are present in the lower part of the large intestine (often affecting the rectum). It is estimated that both of these diseases affect up to 1.4 million people in the U.S. and, although IBD can affect people of any age, they are most commonly diagnosed in adolescence and young adulthood. Once diagnosed, IBD usually lasts throughout a person's lifetime. However, with proper lifestyle recommendations, you may be able to experience a better quality of life. Typically, patients experience long periods of time without symptoms, but acute attacks occur from time to time.

What are the symptoms of IBD?

Symptoms may include:

• Abdominal cramping and pain
• Inability to have a bowel movement despite the urge to do so
• Bloody diarrhea
• Rectal bleeding
• Weight loss

What causes IBD?

Researchers have not been able to identify a single common cause in all individuals who develop IBD. Because of this, you must be treated as an individual with a unique set of circumstances that may have predisposed you to develop a condition labeled as IBD by conventional medicine. The most common factors that are thought to be involved in the development of IBD include:

• Certain lifestyle habits
  o Diets high in trans-fats (such as margarine and fast foods) and refined sugar can increase your risk of developing CD and UC.
  o Smoking
• Immune Function
  o It is thought that people with IBD have an abnormal immune response, which can be a result of poor lifestyle choices and frequent antibiotic use. With IBD, the immune system is over-reactive to the normal bacteria and flora in the gut and fails to shut off, resulting in inflammation. Chronic inflammation causes damage to the GI tract, resulting in the symptoms experienced during the course of the disease.
• Genetics
  o There is a higher genetic predisposition of developing CD as opposed to UC. There is a 5-8% risk of developing CD if a family member has it, but again...you inherit your body type AND how you cope with stress, eat, and many habits from your family of origin. These habits can be unlearned too.

How is IBD diagnosed?

Based on your symptoms, your medical provider may suspect that you have CD or UC. You will be sent to have a colonoscopy so the digestive tract can be visualized by a GI specialist. This is essential for diagnosis, but little help when it comes to treatment and prognosis. Assessing the key functions of your digestive system (Digestion, Elimination, Microflora, Gut Integrity) helps direct your medical provider to the underlying cause of your IBD. A colonoscopy and a Comprehensive Diagnostic Stool Analysis (CDSA) are both important diagnostic tools for uncovering the root cause and focusing treatment for IBD.

Treatments for IBD

Conventional Medicine focuses on reducing inflammation and providing symptom relief. There are a variety of medications that are prescribed that do this, but none address root causes.

• Sulfasalazine for inflammation
• Prednisone for inflammation
• Azathioprine and mercaptopurine for immune response suppression
• Metronidazole (an antibiotic) may be used for CD

In addition, symptomatic relief of diarrhea, constipation and pain will be addressed with anti-diarrheals, laxatives, and pain relievers.

All of these medecines have serious known side effects, and some may not be tolerated. Surgery is used for severe cases. This explains why half of all patients with IBD use some kind of alternative medical therapy. Natural therapies, when used alone, or in conjunction with conventional therapies, have been shown in studies to lower the risk of side effects and help patients attain remission for a longer period of time.

Functional Medicine approaches treatment of IBD differently than the conventional medical model. This type of personalized medicine uses treatments that address the underlying root cause of IBD, instead of just treating symptoms alone. Functional medicine considers the role environmental toxins, diet, and nutritional imbalances play in pre-disposing a person to IBD. The "4 Rs of Digestive Health" will be implemented according to the individual person. The "4 R's" are:

1. Remove (fixing the elimination function of the GI tract): Remove the allergens and toxins causing trouble through detoxification and elimination diet and remove harmful organisms if they are present. A CDSA (Comprehensive Diagnostic Stool Analysis) test will be necessary in the diagnosis to know if harmful organisms are present in the GI.
2. Replace (fixing the digestion function of the GI tract): Replacing stomach acid if it is low or digestive enzymes if they are insufficient.
3. Re-inoculate (fixing the microbial balance function of the GI tract): Re-inoculate with pre and pro-biotics to restore balance to the digestive system.
4. Repair (fixing the gut integrity of the GI tract): Repairing the gut wall is essential to recovery and sustained health with an inflammatory condition in the gut.

Nutritional supplements you are given and the dietary protocol you follow should achieve three main treatment goals: (1)Reduction of inflammation, (2) Nutrition for intestinal cell growth, (3) Strengthening the immune system and liver function

How to screen for GI health related illness:

Take the following questionnaire and score it as instructed. How healthy is your digestive system?
Point Scale:

0 = Never or almost never have the symptom
1 = Occasionally have it, effect is not severe
2 = Occasionally have it, effect is severe
3 = Frequently have it, effect is not severe
4 = Frequently have it, effect is severe

HEAD
____Headaches
___Dizziness
___Insomnia
___Faintness
____TOTAL

EARS
___Itchy ears
___Ringing in ears/ loss of hearing
___Earaches/ ear infections
___Drainage from ear
____TOTAL

EYES
___Bags or dark circles under eyes
___Watery or itchy eyes
___Swollen, reddened, or sticky eyelids
___Blurred or tunnel vision (excluding near- or far- sightedness)
____TOTAL

NOSE
___Stuffy nose
___Sinus congestion, sinus infection
___Constant sneezing
___Hay fever/allergies
___Excess mucus formation
____TOTAL

MOUTH/THROAT
___Chronic coughing
___Sore throat, hoarseness, loss of voice
___Gagging, frequent need to clear throat
___Swollen tongue, gums, or lips
___Swollen lymph nodes
___Canker sores, mouth ulcers
____TOTAL

HEART
___Chest pain
___Irregular or skipped heartbeat
___Rapid or pounding heartbeat
____TOTAL

LUNGS
___Asthma, bronchitis
___Chest congestion
___Shortness of breath
___Difficulty breathing
____TOTAL

SKIN
___Acne or brown "age/liver spots"
___Hives, rashes, cysts, boils
___Eczema or psoriasis
___Itchy skin/dermatitis
___Hair loss, hair thinning
___Body odor
___Excessive sweating
____TOTAL

JOINTS/MUSCLES
___Pain or aches in joints or lower back
___Stiffness or limitation of movement
___Arthritis
___Pain or aches in muscles
____TOTAL

MENTAL/EMOTIONAL
___Poor memory
___Difficulty concentrating
___Mood swings
___Depression
___Anxiety, fear, or nervousness
___Anger, irritability, or aggressiveness
___Insomnia
____TOTAL

ENERGY LEVEL
___Fatigue/low energy
___Restlessness
___Hyperactivity
___Feeling of weakness
____TOTAL

WEIGHT
___Underweight
___Overweight
___Difficulty losing weight
___Crave certain foods
____TOTAL

OTHER
___PMS
___Frequent colds, flus
___Chemical or environmental sensitivities
___Food allergies/sensitivities
____TOTAL

Please add the numbers from each section and write the section total in the spaces
provided, then add all the section totals together and put that total in the space below.

____GRAND TOTAL

Interpreting Your GRAND TOTAL Toxicity Score:

15 or lower: You have a low level of toxicity.
16 to 49: You have a moderate level of toxicity.
50 or higher: You have a high level of toxicity.

Keesha Ewers is the owner of Fern Life Center and is a Certified Advanced Registered Nurse Practitioner (ARNP) with a specialty in primary care or family practice (FNP). She also has a Master's degree in Ayurveda and is a certified Functional Medicine Practitioner.

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