Gateway Health News

Inflammatory Bowel Disease (IBD) (Crohn's/Ulcerative colitis)

2015-08-06
Inflammatory Bowel Disease (IBD)
(Crohn’s/Ulcerative colitis)

Fish Oils

Studies suggest a role for omega 3 fatty acids in various inflammatory conditions,
including Crohn’s and ulcerative colitis. One study attributed an improvement in IBD
symptoms to the inflammation-inhibiting properties of fish oils. The study established
that the laboratory tests for inflammatory processes had been significantly reduced in
the fish-oil group in comparison with the placebo group. It is also important to note
the beneficial influence on intestinal cell growth. Fish oil supplementation may lead to
an increase of the intestinal mucosal surface area, thereby increasing the absorption of
nutrients and improving the nutritional status of the patient.

Multi nutrient formula
A variety of nutrient deficiencies are common in IBD, mainly because of malabsorption
issues relating to the condition. This situation is compounded by the use of
corticosteroid drugs, candida overgrowth, a restrictive diet, and increased nutrient
requirements. Common nutrient deficiencies include folic acid, pantothenic acid,
vitamins A, D, E, K and B12, zinc, magnesium and iron (due to blood loss in stools). A
multi nutrient formula is therefore essential in IBD, and should provide nutrients in
forms that are easy to absorb and utilise (e.g. amino acid chelated minerals).

Zinc
Zinc, B12 and folic acid are especially important. Zinc deficiency is found in
approximately 45% of IBD patients, and many of the issues associated with IBD such
as impaired healing, fissures, depressed immunity and loss of appetite are probably
attributable to poor zinc status.

Folic Acid

Folic acid deficiency is also common in IBD which can affect the absorptive ability of
intestinal cells, causing further nutrient deficiency. Folic acid deficiency is also
associated with diarrhoea.

Vitamin B12
B12 is absorbed in the part of the intestinal tract most often affected by Crohn’s so
deficiency is common and traditional supplements may not help. Sublingual B12
supplements are the best form of oral B12 administration.

Probiotics

The intestinal microflora in IBD patients is known to be greatly disturbed, which may
have implications for the health of the intestinal cells. Probiotic bacteria are responsible
for the production of various organic acids that are a direct source of metabolic fuel for
the cells lining the gastrointestinal tract. Research shows that supplementation with
probiotics can promote a healthy intestinal environment. A broad spectrum of
organisms is advisable, but the most relevant are the Bifidobacteria strains, which are
primarily inhabitants of the colon, the part of the intestinal tract affected by IBD.

Quercetin

Research suggests that quercetin may be especially valuable for those with IBD.
Quercetin inhibits the release of inflammatory chemicals such as histamine by
influencing two enzymes involved in their release. Additionally, quercetin is known to
inhibit synthesis of inflammatory compounds from fatty acid metabolism, specifically
leukotrienes. Quercetin is therefore relevant to a variety of inflammatory conditions,
but has shown to be particularly valuable in IBD.

Proteolytic Enzymes (pancreatin, bromelain)

Proteolytic enzymes have been shown to inhibit various inflammatory processes, such
as those that occur in IBD. Pancreatin has been the subject of considerable clinical
research highlighting it’s effectiveness in inhibiting inflammation and facilitating
healing. Proteolytic enzymes should be taken away from food to derive antiinflammatory
benefits, but can also be used with food to promote proper protein
digestion.

Inflammatory Bowel Disease Summary

Nutrient/Herb Typical intake range
Fish oil1 1200 – 4800mg per day
High potency multi nutrient formula As per manufacturer’s directions
Zinc (as picolinate)2 15 – 45mg per day (incl. multi nutrient)
Folic acid3 400 – 600ug per day (incl. multi nutrient)
B12 (sublingual) – mainly in Crohn’s 1000ug per day
Probiotics 5 – 15 billion organisms per day
Quercetin 1000 – 2000mg per day (between meals)
Pancreatin (4x concentrate) 750 – 1500mg per day (between meals)

Reduce/avoid

Common allergens (wheat and/or dairy)
Trans/hydrogenated fats
Refined/processed foods
Alcohol
Caffeinated beverages
Sugar

Increase

Complex carbohydrates
Fibre (Not from wheat)
Green leafy vegetables
Fruit
Nuts and seeds
Oily fish
Legumes

Lifestyle Factors
Take regular exercise
Minimise impact of stress, which may be a trigger for IBD flare-ups (Also, cortisol slows tissue
repair and suppresses the immune system)

Footnotes
1. Concurrent use with anticoagulant medication and Warfarin under medical supervision only.
2. Long term intake >100mg per day may suppress the immune system. Adequate copper intake is
advised with long-term zinc supplementation.
3. Use with schizophrenia under medical supervision only. High doses may increase risk of seizures
in some epileptics. Concurrent use with methotrexate under medical supervision only.