Crohn’s Disease Causes, Symptoms, Treatment, Ayurveda Concept

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Crohn’s Disease is a type of inflammatory bowel disease. In different people different parts and regions of the digestive system are inflamed and involved in disease process. It is associated with pain abdomen, diarrhea, blood in stools, loss of appetite, malnutrition, loss of weight and fatigue. It is also called regional enteritis and ileitis. It is difficult to compare any one condition explained in Ayurveda with Crohn’s Disease. The Ayurveda basics of certain disease condition, pathogenesis and treatment plan therein shall be put side by side contextually with the explanation of Crohns Disease and studied in correlation with a hypothetical approach so as to facilitate treatment of Crohn’s Disease with Ayurveda interventions. The results of Ayurveda treatment of Crohn’s Disease are promising provided the disease is properly diagnosed as per Ayurveda.
Read – Colitis In Ayurveda: Pathogenesis, Causes, Treatment, Diet

Crohn’s Disease – Ayurveda Concept

High pitta in the intestine / colon – Crohn’s disease is inflammatory bowel disease. Inflammation is caused by high pitta in the body. Therefore the intrinsic cause for this disease is high pitta in the intestines. The extrinsic causes will be all those which tend to vitiate pitta. Seats of pitta are the navel, stomach and rasa tissue. Navel relates to the structures around the navel and also points towards the small intestine. Navel is also the chief seat of pitta. Rasa i.e. the nutritive juices following proper digestion of food and which further forms the first tissue i.e. rasa tissue and consequently nourishes the other tissues is formed in the stomach. We can also find signs of nutritional deficiency, indigestion, anemia, weight loss and severe debility among the symptoms of Crohn’s disease. The same are caused due to improper digestion of food in stomach and intestine, formation of ama, formation of less quantity of nutritive juices and subsequent deficit formation of tissues including blood according to Ayurveda. This happens when the organs of digestion are afflicted by the impact of high pitta.
Read – IBS: Ayurvedic Treatment, Home Remedies, Lifestyle Tips

We can also see the inflammation of skin, eyes, liver and bile ducts among the symptoms of Crohns disease. Eye, skin and liver are also the seats of pitta and these symptoms reflect the presence of highly reactive pitta in these seats.

Atisara / Pittaja Atisara – Crohn’s disease can also be correlated to pittaja atisara i.e. diarrhea caused by high pitta since diarrhea is the main symptom of Crohn’s disease.

Raktatisara – Crohn’s disease wherein there is excessive bleeding in stools shall be considered to be Raktaja Atisara i.e. diarrhea caused by vitiated blood.

Pittaja Grahani – Grahani is a disorder wherein the small intestine especially the duodenum is afflicted by vitiated doshas. The diseased intestine throws away most of the food in the undigested form. Sometimes it throws away the digested food along with severe pain in the abdomen. There is diarrhea and intermittent constipation in this disease. Grahani caused by vitiated pitta i.e. pittaja grahani is often correlated to inflammatory bowel disease, which includes Crohn’s Disease.
Read – Charaka Grahani Dosha Chikitsa 15th Chapter

Ashayapakarsha of pitta – This is a condition wherein normal pitta is pulled down by strongly aggravated vata into its seat i.e. colon. There is also an association of low kapha in this condition. Though pitta is normal it is foreign element for the colon. This pitta causes burning sensation, inflammation and ulcers in the colon causing inflammatory bowel conditions which may include Crohn’s Disease and Ulcerative colitis. Diarrhea and other conditions can also be manifested due to displaced pitta. Since pitta and blood have resident and abode relationships, high pitta in the colon can also cause damage of blood vessels in the colon leading to bleeding from lower passages. Since pitta has been displaced there may be inflammatory changes in many parts of the body. Since pitta is displaced from the upper gut which is the normal seat of pitta there will be signs of deficiency of pitta including loss of appetite and indigestion. This will further cause ama and trigger the symptoms of the disease.
Read – Ashayapakarsha By Vata: Displacement of Pitta, Kapha Dosha

Ayurveda Treatment

Crohn’s disease may be treated using the principles of treating any of the above mentioned conditions.

There is no universal principle or fixed strategy to treat Crohn’s disease. Treatments of various conditions need to be mixed and matched and an effective protoco shall be prepared for treating Crohn’s disease. Very importantly the disease needs to be treated with various interventions used skillfully considering various stages of the disease.

Though diarrhea and inflammatory symptoms in the upper and lower gut are common in Crohn’s disease, different symptoms are manifested at various stages of the disease. This again is different from person to person. Therefore the treatment strategy would change from person to person.

The below mentioned aspects need to be considered while treating Crohn’s disease –

Doshas involved in the pathology
Association of feces with ama or blood
Symptoms and its severity
Periodicity of the symptoms
Strength of the disease and the diseased
The channels of the body afflicted by the disease apart from the food and feces carrying channels
Strength of associated symptoms
Signs and symptoms of prognosis
Read – 37 Ayurveda Home Remedies For Diarrhea And Dysentery

Principles of treating Crohn’s Disease

b. Treatment approach

Consider agni and ama – Digestive fire and ama need to be corrected by ama destroying measures and later the digestive fire should be kindled. This will lay the foundation for the future course of treatment and start giving relief in symptoms. Diet too should be formulated so as to help the process of healing while not disturbing the digestive fire. The appetite of the person will be less and there will be indigestion. The feces should be checked for presence or absence of ama. If there is ama it will be relieved by these said measures.

Treat on the lines of atisara or grahani – If there is diarrhea you need to treat it after considering the nature of diarrhea. If diarrhea is not accompanied by troublesome symptoms you need to let it happen since the body is trying to expel unwanted water and toxins from the body. Later, treatment of diarrhea shall be administered after having considered the causative doshas. If the patient is feeling tired and exhausted and if there are symptoms like pain, discomfort etc the digestive fire should be corrected after taking control of ama as said above. Later the principles of diarrhea treatment shall be administered. Diet should be in the form of light, digestible and liquid / semi-solid. Foods processed with fire kindling herbs or ama digesting herbs shall be administered. Graduated dietetic protocol as explained in treatment of fever or in samsarjana krama i.e. post-operative procedure of therapeutic emesis and purgation shall be followed here. Medicated foods called pramathyas explained in treatment of diarrhea shall be administered as and when needed. They not only treat diarrhea and dysentery but also provide nutrition and support the organs of digestion (small and large intestine) and help in their recovery. If there is altered constipation and diarrhea or symptoms are related to both upper and lower intestines then it shall be treated on the lines of grahani. If the symptoms are related to only colon it shall be treated on the lines of atisara. If there is excessive bleeding it shall be treated on the lines of raktatisara. Raktaprasadana Chikitsa i.e. medications to enhance and nourish blood tissue and also to strengthen the blood carrying channels shall be administered after the bleeding and diarrhea have been checked. It is better to administer this after having administered therapeutic purgation.

Use of Pravarthana, Pramathyas and Langhana – These 3 strategies should be administered skillfully in diarrhea of Crohn’s disease.

If doshas are in excess, the doshas should be expelled.
If the doshas are of moderate quantity pramathyas (liquid diet – paste or dough prepared by boiling any medicinal substance in water) prepared with fire kindling and ama digesting medicines should be administered.
If doshas are aggravated in smaller quantities, fasting should be administered.
Read – Atisara – Charaka Chikitsa Sthana 19th Chapter

Administration of Panchakarma – Once the ama is digested and the acute symptoms of diarrhea and symptoms related to the small intestine and colon are controlled, panchakarma treatment shall be considered.
Mainly virechana is very beneficial in expelling high pitta from the system and also to expel the contaminants of blood.
This should be done in the avegavastha of the disease i.e. stage of the disease which doesn’t have active symptoms, mainly diarrhea and bleeding. Even in this stage the disease has not gone away, it has just taken a break. When purgation is administered in this stage the relief will be for prolonged periods. This will also avoid the recurrence of the disease and its symptoms. Therapeutic emesis may be administered if there is association of high kapha. Graduated dietetic protocol should be followed in either case. Therapeutic enema will control vata and help in rehabilitation and rejuvenation of not only the colon but also the entire system. It will also take care of the mental symptoms associated with the disease.

After the stomach and gut are evacuated of their impurities through monitored administration of fasting, ama digesting medicines and cleansing therapies (purgation or emesis or both), gruels, drinks or light food prepared with decoction of Panchakola should be served.
Read – Ayurvedic Panchakarma Treatment: Introduction, Benefits, Dosha Relation

Controlling Vata – Aggravated vata is responsible for pulling down pitta from its seat into its territory leading to inflammation of colon and manifestation of symptoms of Crohn’s Disease. Vata controlling measures, medicines and therapies shall be administered right from the beginning considering it to be a case of ashayapakarsha. This can be diagnosed on the basis of inflammatory signs in the colon, rectum, anus, bladder and lower parts of the body and also with manifestation of boils, fissures, fistula and piles. It will also be associated with indigestion, loss of appetite and low pitta symptoms in upper gut and also signs of inflammation in other parts of the body.
Read – Vata Dosha – Introduction, 40 Things To Know

Rasayana and Ghrita – Since pitta and vata play a main role in the manifestation of this symptom medicated ghee shall be administered in low quantity for long periods after having analyzed the capacity and tolerance of the patient.
Dadimadi Ghrita is ideal.

Other treatment strategies

Pandu Roga Chikitsa and Balya medicines – Anemia and fatigue can occur due to longstanding symptoms and also as complications of the disease. They may be treated on the lines of treatment of blood loss and anemia and also on the lines of treating the ‘channels of transportation of rasa and blood tissue’. Strengthening medicines too shall be administered until the person regains strength and endurance.

Bhagandara, Nadivrana Chikitsa – Treatment on the lines of fistula and sinus shall be administered if these conditions are manifested in the form of complications.

External Therapies – Stress is a trigger for inflammatory bowel diseases. On the other hand, mind symptoms are also manifested in the inflammatory bowel diseases including Crohn’s Disease. Relaxing therapies like Shirodhara – stream pouring of medicated oils and milk over the head or entire body or Shirovasti – pooling of medicated oil over the head shall be done. These therapies not only relieve stress but will also balance the physical doshas and relieve symptoms of Crohn’s Disease.

Nabhi Vasti (pooling of medicines around the navel) and Nabhi Lepa (application of medicinal pastes around the navel) will also help in controlling diarrhea and digesting ama. Since navel is the main seat of pitta these therapies will work in an effective way. They can be considered in the earlier part of the treatment or in those patients wherein stronger medicines and therapies cannot be started straight away due to their low strength, tolerance and endurance.

Pathya-Apathya – Dietetic regimen forms an important aspect in the treatment of Crohn’s disease. Foods to be consumed and ‘those to be avoided’ as explained in the contexts of diarrhea and grahani shall be adopted.
Read – Importance Of Diet (Pathya) For Specific Diseases

Traditional medicines

Panchakola Churna – Useful in earlier stages of the disease. This helps in enhancing the digestion capacity. Foods and gruels can be prepared using this formulation. If the doshas show tendency to get expelled and are found agitated in the gut, they should be flushed out with purgation or emesis as and when needed. Panchakola shall be administered after the gut has been cleansed. If the patient is weak and the doshas are not agitated, and if the strength of the disease is not great enough to trouble the patient, panchakola shall be given without processed with food and without having administered the cleansing therapies. This rule holds good for administration of formulations which tend to increase digestion capacity and also destroy ama.

Chitrakadi Vati – This is an important formulation to bring about destruction of ama and also to kindle the digestive capacity. Both the objectives are obtained with single medicine. The choice shall be made in accordance to the ama and strength of digestive fire. If doshas are in excess and are ready to get expelled, cleansing therapies are the first choice always.

Other formulations to digest ama

One of these formulations shall be taken with hot water –
Decoction or paste of Ginger, Aconitum heterophyllum and Cyperus rotundus
Powder of Terminalia chebula
Ginger powder

Bilwadi Churna – Powder of the below mentioned should be taken with Vid salt and juice of sour pomegranate –
Fruit pulp of Aegle marmelos
Plumbago zeylanica
Ginger

This is a cure for colic caused by feces associated with ama.

Haritakyadi Churna – This should be administered when there is nausea, vomiting, piles, fissure and colic. The ingredients include –
Haritaki, rock salt, cumin seed, Black pepper

Ativishadi Churna – This should be administered when there is unformed feces and colic. The powder should be mixed in hot water. The ingredients are –
Aconitum heterophyllum
Piper longum
Black pepper
Ginger
Rock salt
Alkali of barley
Asafetida fried in ghee

Useful formulations – The powder of the below mentioned herbs shall be taken mixed with honey and rice washed water –

1. Kiratatikta, Musta, Kutaja, daruharidra
2. Ativisha, Kutajabeeja, Kutaja Twak
3. Lotus, Dhataki, Pomegranate and Ginger

Pramathya (semisolid diet prepared by boiling medicines in water) – Dough or paste prepared with long pepper, ginger, coriander, Terminalia chebula, Acorus calamus and carom seeds should be administered.

Ama digesting processed water – Water processed with Acorus calamus and Aconitum heterophyllum should be given to drink.

Diet in Crohn’s Disease

Gruel prepared with one of the below mentioned cures diarrhea, diarrhea altered with constipation, piles, complications of Crohn’s i.e. sinus and fissures, liver and spleen enlargement –
Juice of Feronia limonia, Oxalis corniculata, Garcinia indica and sour pomegranate

Soup should be prepared with –
Green gram and Panchakola
Radish soup mixed with pepper powder

Avidahi anna – Foods which do not produce burning sensation and are light to digest should be served with edibles prepared with bitter tasting herbs. Food should also be served with soup of meat of animals and birds living in desert like regions or green gram soup or pomegranate juice prepared with fire kindling and constipating herbs and ghee.

Light to digest food – should be administered with one or more of the buttermilk, sour gruel, thin gruels, nourishing drinks, wine or honey.

Ghee / medicated ghee is the best medicine to kindle the digestive fire. In high pitta condition which is generally found in and causal for Crohn’s disease ghee medicated with bitter herbs shall be administered. Tiktaka Ghrta is said to be the best to combat pitta and also the disease symptoms. Dipana ghrta – ghee which kindles digestive power should be used in presence of indigestion and excretion of unformed feces. This ghee should be used after having considered the strength of the patient.

Management of bleeding diarrhea

This condition shall be treated on the lines of treating pittaja type of diarrhea and bleeding diarrhea. In Raktatisara i.e. diarrhea caused by vitiated blood complications like severe thirst, colic, burning sensation and severe suppuration in the anal region (similar to fissures and sinus explained in Crohn’s disease complications) are formed.

In such condition cold milk of goat mixed with sugar and honey should be used for drinking and also as a food inclusion. The same formulation shall be used for washing the anal region. Food consisting of boiled red rice should be served with the same milk.

Meat juice of animals and birds living in desert like regions and whose meat has cold potency should be served mixed with ghee and sugar.
Blood of deer or goat fried in ghee should be given to drink.
Soup of Gambhari mixed with sour pomegranate juice and sugar should be served.
Shatavari – Paste of Asparagus racemosus mixed in milk and consumed. Alternatively ghee or milk processed with paste or decoction of Asparagus racemosus should be used.
Indrayava – ghee prepared with seeds of Holarrhena antidysenterica mixed in gruels.
Paste of black sesame and sugar mixed in goat’s milk should be consumed.
Sandalwood powder mixed with sugar, honey and mixed in rice washed water should be consumed.

Pichcha Basti – When bleeding diarrhea is not controlled and presents with severe complications, pichcha basti enema shall be administered. It is the best treatment for all types of stubborn diarrhea and grahani disorders.
Read – Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Useful Formulations

Muktapanchamrita Rasa
Chandraprabha Vati
Kutaja Ghana Vati
Sutasekara Rasa
Punarnavadi Mandura
Grahani Kapata Rasa
Suvarna Rasaparpati
Panchamrita Parpati
Loha Bhasma
Shanka Bhasma
Kapardika Bhasma
Panchakola Churna
Gangadhara Churna Laghu
Gangadhar Churna Vriddha
Pushyanuga Churna
Dadimashtaka Churna
Grahanyamayantaka Ghrta
Shatavari Ghrta
Tiktaka Ghrta
Changeri Ghrta
Kutajarishta
Takrarishta
Mustarishta
Jeerakarishta
Dadimavaleha
Kutajavaleha
Dadimashtaka Leham

Modern view

Crohn’s Disease is a type of IBD – Inflammatory Bowel Disease. It causes irritation and inflammation in the intestines. Different regions and parts of the digestive system are inflamed in different people in this disease. Most often the disease roots deeper into the layers of the intestine. (Read more)

It causes pain in the abdomen, severe diarrhea, malnutrition, loss of weight and fatigue. Some therapies are found to reduce signs and symptoms of Crohn’s Disease to an extent but there is actually no known cure for the disease. When promptly treated the symptoms will ease out, inflammation would heal and there would be long term remission and the persons will be able to function well.
Other names –
Regional enteritis
Ileitis

Incidence of the disease and people who might probably suffer from Crohn’s disease
It is estimated that at least half million Americans suffer from this type of inflammatory bowel disease which includes men, women and children.
It typically afflicts younger persons often in their late teens – 20s or early 30s to be precise.
Crohn’s disease can also occur at any age in spite of being common in younger people.
It equally afflicts men and women and is also seen in young children.
Risk of Crohn’s disease is usually higher in smokers than in non-smokers.
Read – How To Know That Your Digestion System Is Working Fine?

Types of Crohn’s Disease

Depending on the site of manifestation –

1. Ileo-colitis – Here inflammation will occur in the small intestine and part of large intestine / colon. This is the most common type of the disease.

2. Ileitis – disease develop in the ileum i.e. part of the small intestine.

3. Gastro-duodenitis – affect the stomach and duodenum

4. Jejuno-ileitis – found developing in the jejunum and ileum parts of small intestine

Signs and symptoms of Crohn’s Disease

Location of the disease, inflammation and lesions
The disease mainly affects the digestive system.
Small or large intestines or both can be involved in the disease. Either the entire length of intestine is involved or multiple segments of intestines are involved.
In some people only colon is seen to be afflicted. Periods of flare-ups wherein severe symptoms are experienced followed by remission i.e. periods of no or very mild symptoms are seen in Crohn’s disease. The remission can last up to many weeks and even for many years. In this disease the time of flare-ups can be seen but not predicted.

Nature of signs and symptoms
They may either be mild or severe and varies from person to person
They may come on suddenly and sometimes the symptoms appear suddenly
Periods of remission wherein no signs or symptoms are seen is also found in the disease

Signs and Symptoms of active disease include –

Diarrhea / chronic diarrhea
Fever
Pain and cramps in the abdomen
Blood in stools
Feeling of fullness
Sores in the mouth
Low appetite
Fatigue
Weight loss
Fistula in the anal region along with pain and drainage
Anal fissures
Rectal bleeding
Abnormal skin tags, mainly in the butts

Other signs and symptoms –
Inflammation of skin, eyes, joints, liver and bile ducts.
Anemia – iron deficiency type
Delayed growth in children
Delayed sexual development in children
Read – Koshta: Understanding Gut Behaviour And Gut Reactivity

Right time to seek consultation
Persistent changes in your bowel habits
Severe pain in the abdomen
Blood in the stools
Constipation
Nausea
Vomiting
Uncontrollable diarrhea
Inability to fart
Extreme weight loss
Fatigue (may be signs of anemia)
Unexplained fever which lasts for more than two days
Signs of flare-up
Read – Ayurveda Ulcerative Colitis Diet Tips, Home Remedies

Causative Factors of Crohn’s Disease

The exact causes for Crohn’s Disease are unknown till date. Diet and stress which were previously considered as causes of the disease are now considered as aggravating factors but not the actual causes. There are some factors which might increase your risk of developing this condition-
Heredity factors / genes – You are more likely to get Crohn’s Disease if you have family members suffering from the same disease.

Immune system – The possibility of a virus or bacterium triggering the disease is also considered but not yet proved. If this happens your immune system will try to fight off the invading organisms. As a consequence an abnormal immune response might cause the immune system to attack the cells of the digestive tract and pave way for the manifestation of Crohn’s Disease. Autoimmune disorders too have a role.

Smoking – This is one cause which will double the risk of you getting Crohn’s disease.
Read – Effect of Stress, Anxiety on Stomach And Intestines: Remedies

Risk Factors of Crohn’s Disease

Mostly affects the young, most often before 30 years of age
Can affect any ethnic group
Whites are at highest risk (Eastern European Jewish descent people)
Incidence of the disease is also found increasing amongst black people living in UK and North America
Those having a first degree relative with Crohn’s are at greater risk of getting the disease
Almost 1 in 5 people having Crohn’s disease has a family member who has this disease
Cigarette smoking
Those habituated to taking NSAID like ibuprofen, naproxen sodium, diclofenac sodium etc
Read – Role Of Doshas In Gastro Intestinal Tract

Complications

Bowel obstruction
Ulcers – formed anywhere in the digestive tract. They may occur in the mouth, anal region or genital area / perineum too.
Fistulas – Fistulas are created in the intestinal walls when the ulcers extend deep into them. They are tunnel-like openings in the intestinal walls.
Abscesses – are infected pus pockets in the abdomen or inside the digestive tract.
Anal Fissure – It is a tear in the tissue that lines the anus.
Malnutrition
Colon Cancer
Anemia, arthritis, skin disorders, liver disease, gallbladder disease and osteoporosis are some of the diseases which occur as complications of Crohn’s Disease.
Medication – Some drugs prescribed for Crohn’s Disease disturb the functioning of the immune system. They may also cause cancers such as skin cancers and lymphoma. They also increase risk of infection. Corticosteroids used in the treatment of this disease are associated with risk of osteoporosis, high blood pressure, diabetes, cataracts, bone fractures, glaucoma etc.
Blood clots
Pregnancy risks – Crohn’s disease flare-ups during pregnancy may cause miscarriage, premature labor and low birth weight of the born child.
Read – Understanding Digestion Process From An Ayurveda View

Diagnosis of Crohn’s Disease

We don’t have any single accurate test to diagnose Crohn’s disease. Below mentioned tests may be used in combinations as and when required to make a diagnosis of Crohn’s Disease.

Lab Tests-
Blood tests – are done to check for anemia or to check for infection, to check for increased count of WBC (which indicates inflammation or infection), to check for anemia, about 1 in 3 people with this disease have anemia
Stool examination – is done to test for occult blood or for presence of organisms such as parasites in the stool. This is also done to rule out infections that cause chronic infections.

Procedures
Colonoscopy
CT, MRI
Upper GI Endoscopy
Capsule endoscopy
Balloon assisted enteroscopy

Preventive measures

Actually there are no ways to prevent Crohn’s disease. In fact the symptoms and flare-ups can be reduced by following some healthy lifestyle changes which include –

Keeping away from smoking
Eating healthy foods especially low-fat diet
Exercising regularly
Effectively managing the stress
Read – Gastro intestinal Bleeding Causes, Symptoms, Differential Diagnosis

Treatment

There is no proven cure for Crohn’s disease. There are some treatments which are tried over for relief from Crohn’s disease and its symptoms but no single treatment works for anyone. Therefore an integrated approach is needed to provide relief if at all any.

Factors to consider for treatment –
Depends on what is causing your symptoms
How severe the symptoms are

The goal of the treatment is
Reduce inflammation and formation of complications
Provide symptomatic relief
Induce remission, provide long term remission and to maintain remission
Manage the complications of the disease

Medicines
Anti-inflammatory drugs
Corticosteroids – usually prescribed when other treatments do not respond, doesn’t help everyone suffering from this disease. They are sometimes used along with immune system suppressor. They help in improvement of symptoms and induce remission.
Oral 5-aminosalicylates – have limited benefits, were used adequately in the past
Read – Shothahara Gana Of Charaka – Anti Inflammatory Group Of Herbs

Immune System Suppressors
Immunomodulators – They calm inflammation by suppressing an overactive immune system.

These drugs may reduce inflammation but they target your immune system on the other hand. This eventually produces substances that cause inflammation. They include –
Azathioprine and mercaptopurine
Methotrexate

Biologics
This therapy targets proteins made by the immune system. Below mentioned are the types of biologics used in treating Crohn’s disease –
Natalizuman and Cedolizumab
Infliximab, adalimunab, certolizumab pegol etc
Ustekinumab
These medications include monoclonal antibodies so as to suppress immune response.

Antibiotics
They are used to treat infections.

Corticosteroids
The inflammation caused by autoimmune diseases responds to cortisone, prednisone and other corticosteroids and the symptoms get eased with their use.

Anti diarrheal medicines
Bowel rest – The doctors may recommend patients not to have food or drink for several days or longer to provide rest to your bowel and intestines. This will provide a chance for these organs to heal.
Nutrition therapy
Special diets administered through mouth or feeding tube or nutrients infused into veins might help in Crohn’s disease. This will help in improving one’s nutritional status and allows the bowel to recover from the inflammation.

Surgery
Surgery is generally recommended as last resort.
Read – Traditional Ayurvedic Diet Recipes For Dysentery And Diarrhoea

Prognosis

When the disease is in control most people having Crohn’s disease will lead active and healthy lives. In spite of not having a known cure for Crohn’s disease, remission and complications can be prevented by following the treatments regularly and getting suitable lifestyle changes introduced and followed with dedication.

Adaptation to diet – because of changes in appetite owing to low digestion capacity, improper absorption of nutrients due to ongoing diarrhea and intolerance to certain foods. These people often need to adapt to their diets and get their schedules to a balance so that they get enough calories on day to day basis. Many people can also have lactose intolerance.
Read – Lifestyle Tips For Healthy People And Patients In Ayurveda

Home remedies and lifestyle changes

There is no sure care or remedies for Crohn’s disease. But some changes in diet and lifestyle might help in control of the signs and symptoms of Crohn’s disease. It will also help in lengthening the time gap between symptom flare-ups.

Diet

There is no strong evidence which can prove that the foods we eat can cause inflammatory bowel disease, including Crohn’s disease. Some foods and beverages can undoubtedly aggravate the signs and symptoms of the disease, especially during a flare-up.

People with Crohn’s disease should be advised to maintain a food diary to keep a track on what she or he is eating regularly and the effect of foods on their symptoms. At the same time they should also be advised not to stress themselves by monitoring the foods they eat because stress too can trigger the symptoms of the disease. The patient should be encouraged to identify the foods which cause symptoms to flare up and eliminate them from their diet.
Read – Importance Of Diet (Pathya) For Specific Diseases

Important food related tips for patients of Crohn’s Disease

Eat meals in small quantities in split schedules – Instead of eating large quantity of food at a time, food in small quantities shall be taken in multiple servings, say for example 5-6 small servings in a day against traditional 2-3 large quantity of meals.

Reduce intake of dairy products – Many people suffering from Crohn’s disease / inflammatory bowel observe relief and improvement of symptoms of the disease once they stop taking or limit the intake of dairy products. Many people may be lactose intolerant in dairy foods and these people should take extra caution in terms of intake of dairy products.

Drink plenty of liquids – Hydration is important in Crohn’s disease. The patient should be told to drink plenty of fluids daily. Water is the best fluid to be taken. Alcohol, beverages containing caffeine or carbonated drinks shall be kept away.

Consider taking multivitamins – The vitamins will not get absorbed properly when you are having Crohn’s disease. When combined with deficit diet intake the body will be short of vitamins. In this case the multivitamins and mineral supplements would help. They should be taken in consultation with doctor.

Keep in touch with your dietician – It is important for the patients of Crohn’s disease to keep in touch with their dietician and keep them updated regularly about the foods they take and the food interactions they are observing and any symptom flare-ups due to foods. You should also report any abnormal findings related to your foods, weight loss if any or if your diet intake has drastically reduced.
Read – How Much Food To Eat Per Day As Per Ayurveda?

Smoking Habits, avoiding it

Smoking is related to Crohn’s Disease in three ways –
It increases the risk of developing this disease and hence a risk factor
For those having Crohn’s disease already smoking can worsen the disease and disease symptoms – and hence is a trigger
Relapses are common in those people who smoke while having Crohn’s disease, these people would need repeated medication and surgeries in the form of interventions

So patients of Crohn’s disase should quit smoking. When they would quit smoking the overall health of the digestive system would improve. The intensity and frequency of the symptoms too would come down and the patients start feeling better.
Read – Stress Causes, Types, Tips On How To Handle Stress

Stress management

Stress trigger flare-ups and make the signs and symptoms of the disease worse. Effective ways of managing stress –

Regular exercising – Milder exercises are also better in managing stress.

Breathing exercises and regular relaxation
Yoga asanas and Pranayama too may be tried under the guidance of Yoga experts. Biofeedback – This is one of the best stress reduction techniques. This will help in decreasing the muscle tension and slowing your heart rate with the help of a feedback mechanism. This will enable you to enter a state of relaxation and will thus help you in coping up with stress effectively and more easily.
Read – 24 Stress Management Tips: Pranayama, Meditation, Lifestyle Changes

Points of interest for patients of Crohn’s disease

Crohn’s disease affects the patient physically, mentally and emotionally. A constant need to rush to the toilet, frequent formation of gases and abdominal pain may make one’s life miserable, especially so when the signs and symptoms of the disease are severe. All these things will take a toll on your life and make you lead a life of depression. To deal the disease in a better way you may do one or more of the below mentioned –

Be informed and aware of the disease you are suffering from

Join a support group – ‘Support groups’ help you get valuable information about the disease and also will provide you with the most needed emotional support. At the same time you will be in a group of people suffering from the same condition you are suffering from and that will help you in realizing that you are not alone, that there are people who are trying hard to get rid of the problem and that you too can try and keep the disease at bay.

Keep in touch with a therapist – Keep a mental health consultant in the list of your contacts. Speak to them and keep your worries updated to them.

Gastroenterologist – These specialists will be efficient in handling your condition comprehensively and hence you should have at least one specialist in the list of your contacts.

Research

Harvard University Study – People who ate foods linked to inflammation are at greater risk of getting Crohn’s.

Fructose and processed foods might be a problem for those with Crohn’s. Study in mice found that a high-fructose diet could make symptoms of inflammatory bowel diseases (IBD) like Crohn’s worse. (read more)

Mediterranean diets high in vegetables, fruits, beans and nuts have shown to reduce inflammation and improve Crohn’s symptoms.
Read – Special IBD diets

Research on baby teeth – Researchers analyzed the baby teeth of 30 adults in Portugal. There is a tradition of saving these teeth in Portugal. The teeth which had been exposed to lead, copper, zinc and chromium soon before and after birth were more likely to have Crohn’s.

Biomarkers – Researchers found 51 characteristics called biomarkers in blood. They were 76% accurate at predicting whether someone would get Crohn’s or not 5 years before their diagnosis.

Tight Control – In this approach doctors treat both ‘the symptoms of Crohn’s Disease’ and ‘the inflammation’ that causes those symptoms. According to a study doing this combined approach early on helped in healing the intestinal linings in Crohn’s. In this study some people achieved ‘deep remission’ which meant that the people felt well and had no signs of disease activity. In the same people who had reached deep remission Crohn’s disease was much less likely to have gotten worse when looked for by researchers 3 years later. (Read more)

Creeping Fat – Scientists found out why abdominal fat sometimes gets into the intestines of people with Crohn’s. It is called creeping fat which can cause intestinal scars that would require surgery in future. This condition happens when Clostridium innocuum bacteria leak from the small intestine which has been damaged by Crohn’s. Researchers say that the fat wraps around the intestine to keep the bacteria from getting into the bloodstream. In later times the creeping fat itself causes problems to the intestine. This opens up doors for new therapies targeting these bacteria in future days. These interventions might prevent creeping fat or reduce its damage. (Read more)

Biomarker monitoring device – Researchers are looking at possibilities of predicting and tracking Crohn’s flare-ups. A wearable device that monitors biomarkers in your sweat will be used.

More researches in Crohn’s Disease

A study in 2020 found a microscopic marker that can help in identifying people who are likely to have recurrence of inflammation. This could allow therapeutic intervention of Crohn’s Disease at an earlier stage.  

2016 research – An infection with Mycobacterium avium paratuberculosis (MAP) bacterium may contribute to Crohn’s disease.

2018-19 study (UK) was designed to study the safety of an anti-MAP vaccine for humans in Crohn’s Disease.

A study in 2020 on bone-marrow derived mesenchymal stromal cell therapy showed long term improvement in perianal Crohn’s disease fistulas. More studies are needed in this direction to prove the effect of stem cells on Crohn’s disease symptoms.

Links between the gut microbiome and inflammation have been established.

IBD-Anti-inflammatory Diet (IBD-AID) – A recent study of IBD-AID, a microbiome targeting diet, showed that 61.3% patients reported a dramatic decrease in severity of symptoms of Crohn’s disease when they followed this diet for at least 8 weeks. The diet includes use of probiotic and prebiotic foods. It also advocates avoiding trans-fats, dairy products, processed foods and foods containing refined sugar, wheat, lactose and corn.

Mucosal healing – predicts sustained clinical remission in patients with early stage Crohn’s Disease – Complete mucosal healing in patients with early stage Crohn’s disease is associated with steroid-free remission rates 4 years after the beginning of therapy.

Fact Check

1 in 15 people diagnosed with Crohn’s are younger than 20 years of age.

Most common areas of the gastrointestinal tract that is affected by Crohn’s are Ileum and Colon.

In comparison to men, women are at 17% higher risk of developing Crohn’s Disease. On the other hand this disease is seen to afflict boys more than girls. Therefore boys are at greater risk than girls.

This disease is commonly diagnosed between 20-30 years of age.

In comparison to non-smokers (those who have never smoked), smokers have double the risk of getting this disease.

There are 50-50 odds that both identical twins will have Crohn’s Disease if one of them has it. This proportion is higher than the odds among the non-identical twins. This probably suggests a possible genetic link. (Read more)