IBD: Inflammatory Bowel Disease

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Most people wake up each morning and go to the washroom without much thought about it. However, when you start getting severe pain in your stomach, and looser and looser stool, especially when there is blood in the toilet bowl, waking up and going to the washroom can be an intensely stressful experience. People who have inflammatory bowel disease (IBD), including Crohn’s Disease and Ulcerative Colitis, often go through this experience on a daily basis.

Inflammatory Bowel disease is an umbrella term referring to chronic diseases (crohn’s and ulcerative colitis) causing inflammation of the intestines. It is often confused for’ IBS’ which stands for Irritable bowel syndrome.
Crohn’s disease is characterized by inflammation and sometimes ulcers in the gut lining that can affect anywhere from the esophagus to the anus. Ulcerative colitis on the contrary affects the large intestine alone. In ulcerative colitis, there can be healthy tissue amongst the inflamed and diseased.

What causes IBD?
Although the precise cause for IBD remains elusive, our current understanding is that IBD is caused by an interaction between immune, genetic, and environmental factors.

Immune:
1. Both the conditions involve activation of the immune system and production of antibodies suggesting that they have an autoimmune component. Similar to any autoimmune disease, IBD is characterized by chronic inflammation, marked TH1 dominance and inflammatory cytokines.

2. It is thought that that GI inflammation is preceded by increased intestinal permeability, disrupted intestinal flora or infections that can subsequently disrupt mucosal immunity. There is evidence that IBD have one or more genetic predispositions to mount an inappropriate inflammatory response towards commensal microflora (imbalanced flora) which can result in a disruption to the physical and chemical barriers that protect from further penetration and adherence of unwanted microbes.
3. Antibodies to the commensal sacromyces cerevsiae for eg, are strongly associated with Crohn’s disease. 6
4. A variety of patterns of dysbiosis has been observed in patients with IBD further evidence that the composition of intestinal bacteria or fungus may play an important role in the in the disease process of IBD. 3

Genetic Factors:
1. Genetic mutations in The NOD2 gene (which coordinates response to bacterial pathogens) increase succeptiblity to Crohn’s disease. 8
2. Increased expression of CEACAM6 mediates adhesion of pathogenic E.coli to lesions on the surface of ileum in patients with crohn’s disease. 2
3. Polymorphisms in CARD15, a gene that activates Th17 response to fungi, predispose to both Crohn’s and ulcerative colitis. 7

Environmental factors:
Environmental factors Influence intestinal microflora and the integrity of barrier function.
1. PPI (proton pump inhibitors) are implicated in the development of microscopic colitis by altering the microbial flora by decreasing gastric acid. 5
2. NSAIDS can induce colitis by increasing intestinal permeability and promoting inflammation. 4
3. Stress modulates the protective barrier function of the Gut via activation of the HPA axis (hypothalamic- pituitary- adrenal axis). Elevated cortisol from stress change intestinal permeability and increase the reactivity of T cells in the intestinal mucosa thereby increase the inflammatory responses. 1

How is IBD managed with conventional protocols and how an integrative Functional approach differs?
The goal of any treatment for IBD is to control Gastro intestinal inflammation. Anti inflammatory medications like aminosalycylates and corticosteroids are first line drugs used which generally offer some control over mild disease. The other categories used are Immune suppressive agents (azathioprinem methotrexate etc). These stronger medications are not without consequences. They may be absolutely required in severe condition where they can provide remission but they do not cure the disease. A last resort is surgery can be a radical curative step for ulcerative colitis but not for crohns.
The goal of functional and integrative therapies is to achieve remission without dependency on stronger medications. A functional (Naturopathic approach) has the ability to manage symptoms, control disease progression and prevent long term complications of IBD. In my experience, there is a lot of hope for improvement in patients facing inflammatory bowel disease from an integrative naturopathic perspective. Considering that it’s effecting younger children these days, it is important to even prevent its development in the first place.

Related Published Research:
1. Bai A, Chen J, Liao W, Lu N, Guo Y. Catecholamine Mediates Psychological Stress-Induced Colitis Through a2-Adrenoreceptor. J Interferon Cytokine Res. 2015;35(7):580-584. [abstract]

2. Barnich N, Darfeuille-Michaud A. Abnormal CEACAM6 expression in Crohn disease patients favors gut colonization and inflammation by adherent-invasive E. coli. Virulence. 2010;1(4):281-282. [abstract]

3. Bringiotti R, Ierardi E, Lovero R, Losurdo G, Di Leo A, Principi M. Intestinal microbiota: The explosive mixture at the origin of inflammatory bowel disease. World J Gastrointest Pathophysiol. 2014;5(4):550-559. [abstract]

4. Faucheron JL, Parc R. Non-steroidal anti-inflammatory drug-induced colitis. Int J Colorectal Dis. 1996;11(2):99-101. [abstract]

5. Keszthelyi D, Jansen SV, Schouten GA, et al. Proton pump inhibitor use is associated with an increased risk for microscopic colitis: a case-control study. Aliment Pharmacol Ther. 2010;32(9):1124-1128. [abstract]
6. Giaffer M HClark A, Antibodies to Saccharomyces cerevisiae in patients with Crohn’s disease and their possible pathogenic importance. Gut BMJ 1992 Aug; 33(8): 1071–1075.
7 . Hugot JP, Ann N Y Acad Sci. 2006 Aug;1072:9-18 CARD15/NOD2 mutations in Crohn’s disease.
8. zhernakova A1, Festen EM, 2008 May;82(5):1202-10. doi: 10.1016/j.ajhg.2008.03.016. Epub 2008 Apr 2. Genetic analysis of innate immunity in Crohn’s disease and ulcerative colitis identifies two susceptibility loci harboring CARD9 and IL18RAP

Naturopathic Children’s Health

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A Naturopathic Child is a Healthy Child! Naturopathic medicine and natural remedies work very well in children from infancy through adolescence.

Effective Natural Solutions

Children tend to respond very well to the safe and gentle approach of natural medicine. Because they haven’t been around as long as adults, very often identifying the root cause and reaching an effective solution is much faster than for adults who may have years and years of layers of compounding factors to complicate their health picture. As with most things in medicine, the sooner you deal with a problem, the easier it is to fix!

Start Your Child out on a Healthy Path
Establishing healthy diet and lifestyle habits from a very early age can translate into healthier lives when they become adults. Many chronic diseases and health challenges of adulthood can be traced in part to poor health in childhood. The habits we develop, the food we eat, and the environment we grow up in can have a profound effect on the quality of the rest of our lives. Childhood is the time to get and stay healthy to prevent future problems, and naturopathic medicine can help!

Safety First
As a rule, the therapies used are safe, gentle, and non-toxic. Some therapies, such as homeopathy, can even be safely used with newborn infants! We are trained in knowing which popular adult therapies are contraindicated in children, and know how to recognize and avoid drug-herb interactions.

Including a Naturopathic Doctor on your child’s health Care team
Antibiotics and other pharmaceuticals are often overused in children, when a safer alternative may be available that will restore health. Parents can include a naturopathic doctor on their child’s health care team to ensure that health promotion and wellness are part of their child’s road map to a successful future.
Philosophy and Tools used with our Pediatric Patients
• When it comes to working with children, our philosophy is truly preventative. Our goal is to support the child’s normal healthy processes and interfere as little as possible.
• Our office is not a scary place for children to visit. No shots or painful procedures! Many kids look forward to their appointments with us.
• We really love and enjoy our little patients and take great pleasure in their growth, their development and their happiness.

Natural therapies used that may assist in your child’s health conditions include:
• Homeopathy
• Identification of underlying food, environmental, or chemical allergies
• Dietary counseling
• Herbal or vitamin supplementation

Common childhood conditions helped by naturopathic medicine:
Children respond very well to gentle naturopathic care. We can help kids with a variety of health concerns. Even if you don’t see your child’s condition listed below, please contact us to learn more about how we may be able to help.
Childhood Allergies & Eczema
Childhood Asthma
Frequent Colds and Recurring Ear Infections
Digestive Health
Behavioral and Neuro developmental issues

Naturopathic medicine is a very effective way of dealing with the susceptibility to keep getting sick.
Ear infections are another very common condition in young children. These infections can be very painful and distressing to both the parents and the child. Many times, a pattern develops of recurring ear infections that never seem to fully go away and may recur over and over for years.
Because many of these childhood illnesses are actually caused by viruses, not bacteria, antibiotics may not be fully effective in stopping this cycle. Additionally, frequent use of antibiotics has been linked to digestive disturbances, impaired immunity, and the development of other conditions such as asthma.

Naturopathic medicine offers alternative approaches to break this cycle that doesn’t require the use of antibiotics. We work to identify the cause of these infections to see if an underlying stressor such as a food allergy, food sensitivity, or environmental factor is contributing to these infections. Naturopathic doctors also work toward boosting your child’s own immune system to fight an infection. When your child fights the infection themselves it prevents recurrences and chronic infections.

Infant colic, stomach aches, diarrhea, constipation, and general digestive health are all conditions seen frequently in the pediatric population. Naturopathic medicine is famous for helping to “heal the gut” and we have many safe and effective natural remedies that can help restore normal function to your child’s digestive system.

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