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  • Q&A with Australian Health Practitioners

    What alternatives are there for treating crohns disease?

    I've been taking pentasa for Crohns for about a month but I've started getting anything from mild headaches to migraines that are lasting days now.

    I switched from sulfasalazine because of the same symptoms.

    Are there any alternatives that you could suggest? Any other medications, diet or alternative therapies?

    My gastroenterologist seems to think something steroid based is the next option but I'd prefer to avoid steroids.

    Any suggestions would be appreciated!
  • Find a professional to answer your question

  • For more than 25 years, Crohn’s & Colitis Australia™ (formerly the Australian Crohn’s and Colitis Association) has been making life more liveable for more than … View Profile

    Discuss the problem with your gastroenterologist and ask about other drug treatment options including the use of immunomodulators, which can be very effective as a maintenance medication in keeping the disease stable.  Steroids might still be needed in the short term.

  • Mel Haynes

    Nutritionist

    Chef, Scientist and Nutritionist. I specialise culinary nutrition and disease prevention with plant based diets. www.culinetica.com.au View Profile

    As a nutritionist I could suggest some dietary alternatives that have been proven to assist with reducing and preventing Crohn's flare ups.  Whist fibre is always an ongoing issue, especially with severe and/or chronic flare ups there is little disgussion on the impact of meat.

    This small but very postiive study showed a semi vegetarian diet maintained remission in 92% of patients compared to the control group who had a relapse rate of 63% after two years. (1)

    You can read the diet used in the link below to see if that helps you.

    Turmeric has been shown to effectively and safely treat IBD / UC & CD (2)

    2 Kiwifruit per day (3)

    Avoid Titanium Dioxide (whitening nanoparticles found in hard chewing gum coating) (4)


    Good luck, hopefully some of these suggestions can help.


    (1)http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877178/pdf/WJG-16-2484.pdf
    (2)  http://pubs.rsc.org/en/content/articlelanding/2012/fo/c2fo30097d#!divAbstract
    (3) Hammerle CW, Surawicz CM. Updates on treatment of irritable bowel syndrome. World J Gastroenterol. 2008 May 7; 14(17):2639-49.
    (4)http://www.ncbi.nlm.nih.gov/pubmed/10648120





  • 2

    Thanks

    Elizabeth Newsham-West is committed to optimising the health and well-being of people across all ages within the Mount Tamborine community.  She works as a domicillary … View Profile

    To help you with your information gathering for the best treatment to follow for Crohns disease, I would like to add some information which you might find helpful in your journey.

    With respect to the previous post, it is really important to know that IBS ( irritable bowel disease) is a completely different disease to IBD ( inflammatory bowel disease) therefore treatments and reason for the treatments are quite different. While some aspects of the dietary recommendations may seem similar the reasons for these recommendation will be quite different.

    It is also important to know that IBD is a term used for both Crohns disease and Ulcerative colitis (UC) which have quite different medical and nutritional treatments. So any information given for IBD needs to be looked at to see what is true for Crohns disease. Although for both diseases the bowel is involved ,the part of the bowel that is diseased is different in both and influences the medical and nutritional treatment required. It is therefore important to ensure that the dietary advice or treatment advice you get is specific for your disease and where the inflammation is in your bowel.

    When you are looking for complementary medicine ( CM) it is always important to know how much research is behind it and how frequently this research has been repeated in different groups to come up with the same benefits. Usually randomised control trial are considered the best making sure the outcome is not due to chance or bias in the group studied.
    With the study on Tumeric (Curcuma longa Linn) posted it suggests this benefit is more for people with UC but goes onto say that large randomized controlled clinical investigations are required to fully understand the potential of oral curcumin for treating IBD. This suggests the body of research around this area is still small.
    If you make a decision to trial CM for yourself remember that the CM you can buy may not be anything like that which is used in the studies even if it has the same name and genus. It may not have the same potency, may have other substances added which may affect how it works, maybe in a different form etc and may not provide the same benefits as some research suggests. Most CM have AUST L on the label which tells you the CM has not been independently tested or used in any research to prove it can do what you may think it can do or says on the label. The TGA ( Therapeutic Goods Australia) consider it a low risk supplement so taking it should not be harmful to you, hence the AUST L labelling.
    Whether the CM provides the benefits to you is up to you.

  • 1

    Thanks

    Mel Haynes

    Nutritionist

    Chef, Scientist and Nutritionist. I specialise culinary nutrition and disease prevention with plant based diets. www.culinetica.com.au View Profile

    Hi Elizabeth,

    I agree with all the information you provided about the care in taking complementary medicines, all very valid information.

     In respect to my post regarding IBS /IBD - of course I am very aware there is a difference, however the studies on kiwifruit have been shown to assist both, so the reccomendation is still quite valid.

    here is an extract:

    “Cell-based assays have been used to determinewhether green and gold kiwifruit extracts could modulate pathways associated with IBD.69 It was reported that extracts from both types of kiwifruits strongly inhibited the production of the proinflammatorycytokine tumor necrosis factor > (TNF->) from a macrophage cell line stimulated with purifiedlipopolysaccharide. Moreover, these extracts were able to suppress TNF-> production stimulated byspecific ligands of the intracellular receptor NOD2, encoded by a gene that is one of the most commonand highest-risk genetic variants in Crohn’s disease”

    I was providing suggestions the few CM treatments which currently have evidence backing their reccomendations, as the person asking the question seems to have a medical team providing her with suitable evidence based practice and I didnt want to cover information he/she has already received.

    Cheers,

    Mel

  • 3

    Thanks

    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    There is increasing evidence that differences in the kinds of bacteria which normally live in the gut (the “gut microbiome”) may be causally associated with Crohn's disease.

    There is a popular account of the most recent paper here: http://www.sciencedaily.com/releases/2014/03/140312132617.htm . The full (technical) paper is available as a free PDF here: https://www.cell.com/cell-host-microbe/abstract/S1931-3128(14)00063-8 .

    This is at the “basic science” stage now but, with more hard work, it may lead to new therapies.

    My inclination (as a scientist, not as a clinical professional) is to avoid antibiotic therapy for Crohn's disease unless there are compelling clinical reasons for it - antibiotics could distort the gut microbiome, making things worse, not better.

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