Crohn’s Disease: Root Causes, Tests, Natural Therapies

Crohn's disease is a chronic inflammatory bowel disease (IBD) that primarily affects the gastrointestinal tract. It is a complex condition with a wide range of symptoms and can vary in severity from mild to severe.

Symptoms of Crohn’s Disease

Crohn's disease can cause a wide range of symptoms that vary in severity from person to person.

Abdominal Pain: Pain in the abdomen is a hallmark symptom. It is often cramp-like and can occur anywhere along the digestive tract, depending on where the inflammation is located.
Diarrhea: Chronic or recurrent diarrhea is common in Crohn's disease. The stool may be loose, watery, and may contain mucus or blood.
Fatigue: Many individuals with Crohn's disease experience fatigue, which can be attributed to inflammation, nutrient malabsorption, and other factors.
Weight Loss: Unintentional weight loss is often seen, as the disease can interfere with the body's ability to absorb nutrients from food.
Loss of Appetite: Reduced appetite is a common symptom and is often associated with weight loss.
Fever: Low-grade fevers may occur during flare-ups of the disease.
Rectal Bleeding: Bleeding from the rectum is a common symptom, especially in cases where the colon or rectum is affected.
Mouth Sores: Some people with Crohn's disease may develop sores in the mouth.
Joint Pain: Joint pain and inflammation, arthralgia or arthritis, can occur in some individuals with Crohn's disease.
Skin Problems: Skin issues such as rashes, red nodules, or ulcers can occur as a result of Crohn's disease.
Eye Inflammation: Inflammation of the eyes, known as uveitis or episcleritis, may develop in some cases.
Bowel Obstruction: In severe cases, Crohn's disease can cause blockages or strictures in the intestine, leading to symptoms like nausea, vomiting, and abdominal distension.
Perianal Symptoms: Inflammation around the anus can cause pain, itching, or drainage of pus.

Crohn's disease can affect different parts of the digestive tract, and this can lead to a wide variety of symptoms. Some individuals may experience mild symptoms, while others may have more severe and debilitating ones. Crohn's disease often has periods of remission when symptoms improve and periods of flare-ups when they worsen.

Causes of Crohn’s Disease

The exact causes of Crohn's disease are not fully understood, but it is believed to result from a combination of genetic, environmental, and immune system factors.

Genetics: Family history plays a significant role in the development of Crohn's disease. Individuals with a first-degree relative (such as a parent or sibling) who has Crohn's disease are at a higher risk of developing the condition. Multiple genes have been implicated in the development of Crohn's, including NOD2 and ATG16L1.

Immune System Abnormalities: Crohn's disease is characterized by an abnormal immune response in which the immune system mistakenly attacks and inflames the digestive tract. This immune response involves an overproduction of certain immune cells and inflammatory proteins.

Environmental Factors: Certain environmental factors may trigger or exacerbate Crohn's disease in genetically susceptible individuals. These factors include:

Diet: While diet is not a direct cause of Crohn's disease, it can influence the course of the disease. Some individuals find that certain foods can trigger or worsen symptoms.
Smoking: Smoking is a known risk factor for Crohn's disease, and it can worsen the course of the disease.
Infections: Some researchers believe that certain infections may contribute to the development of Crohn's disease or trigger flare-ups.

Microbiome Dysregulation: Changes in the composition of the gut microbiome, the community of microorganisms that inhabit the intestines, have been observed in people with Crohn's disease. An altered microbiome may play a role in the development and progression of the condition.

Autoimmune Response: Crohn's disease is considered an autoimmune disease, as the immune system attacks the body's tissues. However, it is not a typical autoimmune disease, as it also involves non-autoimmune factors.

Unknown Triggers: There may be other, as-yet-undiscovered factors or triggers that contribute to the development of Crohn's disease.

Root Causes of Crohn’s Disease

Functional medicine is an approach that seeks to identify and address the underlying root causes of a disease, including chronic conditions like Crohn's disease.

Leaky Gut Syndrome: Functional medicine often focuses on the concept of "leaky gut," which refers to increased intestinal permeability. Some believe that an impaired gut barrier may contribute to the development of autoimmune conditions like Crohn's disease. Factors such as dietary choices, stress, and imbalances in gut bacteria are explored in the context of a leaky gut.

Diet and Nutrition: Functional medicine may assess dietary triggers or sensitivities that could exacerbate Crohn's symptoms. Specific diets, such as the low-FODMAP diet, anti-inflammatory diets, or elimination diets, to identify and eliminate trigger foods may recommended.

Gut Microbiome: Dysbiosis, or an imbalance in the gut microbiome, is a potential root cause that functional medicine may address. Strategies might include probiotics, prebiotics, and dietary changes to promote a healthier gut microbiota.

Stress and Emotional Well-being: Stress and emotional factors can exacerbate Crohn's symptoms. Techniques like mindfulness, meditation, and counseling may be recommended.

Toxic Exposures: Functional medicine may assess whether environmental toxins or heavy metal exposures are contributing to the condition. Reducing toxin exposure and supporting the body's detoxification processes may be part of the approach.

Infections and Pathogens: Some functional medicine practitioners may investigate the presence of chronic infections or pathogens in the gut as potential triggers. This might involve specialized testing and targeted treatments.

Immune System Dysregulation: Functional medicine may explore factors that contribute to immune system dysregulation and autoimmunity. This could involve supporting the immune system with lifestyle changes and specific supplements.

Nutrient Deficiencies: Nutrient deficiencies are common in Crohn's disease due to malabsorption and dietary restrictions.

Crohn's disease is a complex condition that requires medical supervision. A collaborative approach that combines functional medicine with conventional medical care can be a more comprehensive strategy for managing Crohn's disease and addressing its potential root causes.

Laboratory Tests for Crohn’s Disease

Diagnosing Crohn's disease typically involves a combination of laboratory tests, clinical evaluation, and imaging studies. While no single laboratory test can definitively confirm Crohn's disease, these tests and markers can provide important information to aid in the diagnosis and assessment of the condition.

Blood Tests

C-Reactive Protein (CRP): Elevated levels of CRP in the blood can indicate inflammation in the body. It is a nonspecific marker of inflammation and is often used to monitor disease activity in Crohn's disease.
Erythrocyte Sedimentation Rate (ESR): It is also a nonspecific marker of inflammation and is used to assess disease activity.
Complete Blood Count (CBC): A CBC measures different components of the blood, including red and white blood cells.

Stool Tests

Fecal Calprotectin: This test measures the level of calprotectin, a protein released by white blood cells, in the stool. Elevated levels are indicative of intestinal inflammation and can help differentiate between IBD and other conditions.
Stool Culture: This test can rule out bacterial or parasitic infections that may mimic the symptoms of Crohn's disease.

Serum Antibodies

Anti-Saccharomyces cerevisiae antibodies (ASCA): Some individuals with Crohn's disease have elevated levels of these antibodies.
Anti-neutrophil cytoplasmic antibodies (pANCA): Elevated levels of pANCA are associated with a different type of IBD called ulcerative colitis, so this test can help differentiate between the two conditions.

Serum inflammatory markers: These include serum levels of interleukin-6 (IL-6) and tumor necrosis factor (TNF), which are associated with inflammation.

Nutritional Tests: Malnutrition is common in Crohn's disease due to malabsorption, so nutritional assessments, including measurements of vitamin and mineral levels, may be conducted to identify deficiencies.

Genetic Testing: Genetic testing for specific genes associated with Crohn's disease, such as NOD2, can provide additional information and may help identify individuals at higher risk.

It's important to note that while these laboratory tests can provide valuable information, a definitive diagnosis of Crohn's disease often requires a combination of clinical evaluation, endoscopic procedures (colonoscopy or upper endoscopy) with biopsies, and imaging studies (such as MRI or CT scans) to directly visualize and assess the extent of inflammation in the digestive tract.

Functional Medicine Laboratory Tests for Crohn’s Disease

Functional medicine practitioners may utilize various specialized laboratory tests to investigate underlying factors and imbalances that could contribute to Crohn's disease or exacerbate its symptoms.

Intestinal Permeability Assessment

Lactulose-Mannitol Test: This test measures the permeability of the intestinal lining. Increased permeability, often referred to as "leaky gut," is sometimes associated with Crohn's disease. Serum and stool Zonulin measurement is an alternative.

Food Sensitivity Testing

IgG Food Sensitivity Testing (TrophoScan®): This test measures immunoglobulin G (IgG) antibodies to various foods. It can help identify potential trigger foods that may worsen Crohn's symptoms.

Comprehensive Stool Analysis

Microbiome Assessment (EnteroScan®): This test examines the composition of the gut microbiome, looking for imbalances in the types and quantities of bacteria present in the digestive tract. This assesses also, the presence of intestinal parasites and pathogens that could be contributing to gastrointestinal symptoms.

Nutrient and Micronutrient Testing

Nutrient and Micronutrient Panel: These panels assess levels of essential vitamins, minerals, and antioxidants, which can be deficient in individuals with Crohn's disease due to malabsorption and dietary restrictions.

Hormone and Stress Markers:

Adrenal Function Testing (AdrenalScan®): Assessing adrenal hormones and the body's stress response may be relevant, as stress can exacerbate Crohn's symptoms.
Thyroid Function Tests: Imbalances in thyroid hormones can impact overall health, including the gut.

Inflammatory Markers:

In addition to the commonly used CRP and ESR, functional medicine may explore a broader range of inflammatory markers, such as interleukins and TNF-alpha.

Heavy Metal and Toxin Testing:

Heavy Metal Testing: This assesses the presence of toxic heavy metals, which could contribute to inflammation or immune system dysregulation.
Chemical and Environmental Toxin Testing: Identifying exposure to environmental toxins may be part of a comprehensive evaluation.

Hormone Assessment

Sex Hormone Panels: Imbalances in sex hormones can sometimes contribute to symptoms experienced by individuals with Crohn's disease.

Crohn’s Disease Conventional Therapies

Conventional therapies for Crohn's disease aim to manage the condition by reducing inflammation, relieving symptoms, and inducing and maintaining periods of remission.

Medications

Anti-Inflammatory Drugs: These are often the first-line treatment for mild to moderate Crohn's disease and may include aminosalicylates (e.g., mesalamine) and corticosteroids (e.g., prednisone) to reduce inflammation.
Immunomodulators: Medications like azathioprine, 6-mercaptopurine (6-MP), or methotrexate are used to suppress the immune system's response and maintain remission.
Biologics: These are targeted therapies that block specific proteins involved in inflammation, such as tumor necrosis factor (TNF).
JAK Inhibitors: Janus kinase (JAK) inhibitors, such as tofacitinib, may be used to control inflammation in some cases.
Antibiotics: Antibiotics can be used to manage bacterial overgrowth or treat complications like abscesses or fistulas.
Pain Relievers: Over-the-counter pain relievers or prescription pain medications may be used to manage pain, but these are typically not recommended for long-term use due to potential side effects.

Nutritional Support

Nutritional therapy may be used to provide adequate nutrition in cases of malnutrition or growth impairment, often through specialized enteral (tube feeding) or parenteral (intravenous) nutrition.
Some individuals with Crohn's disease may benefit from dietary modifications, including low-residue, low-FODMAP, or specific carbohydrate diets.

Surgery

Surgery is considered in cases where medication and other treatments are ineffective to treat complications. Common surgical procedures include resection (removal of damaged intestine) and the creation of an ostomy (ileostomy or colostomy) to divert the flow of stool.

Symptomatic Relief

Medications such as anti-diarrheal drugs or anti-spasmodic agents can provide symptomatic relief for diarrhea and abdominal cramping.
Supplements like iron may be prescribed to address anemia caused by chronic bleeding.

Monitoring and Follow-up

Regular monitoring of disease activity and potential side effects from medications is crucial to manage Crohn's disease effectively.
Periodic colonoscopies and imaging studies are often used to assess the condition of the intestine and monitor for complications.

The choice of therapy depends on the severity and location of the disease, individual patient factors, and the response to treatments. The goal is to achieve and maintain remission, minimize symptoms, and improve the patient's quality of life. Managing Crohn's disease often involves a combination of therapies tailored to the patient's specific needs.

Crohn’s Disease Natural Therapies

While conventional medical therapies are often the primary approach to managing Crohn's disease, some individuals explore complementary and natural therapies to complement their treatment plans.

Dietary Modifications

Probiotics: Probiotic supplements may help promote a balanced gut microbiome. Some strains, such as Lactobacillus and Bifidobacterium, have shown promise in clinical studies.
Prebiotics: Prebiotics are dietary fibers that support the growth of beneficial gut bacteria. Foods like garlic, onions, and asparagus are natural sources of prebiotics.
Fiber: Dietary fiber can be beneficial, but for some people, a low-fiber diet may be recommended during flare-ups to reduce irritation of the gut lining.
Omega-3 Fatty Acids: Omega-3 fatty acids found in fatty fish (e.g., salmon, mackerel) and flaxseeds have anti-inflammatory properties and may be helpful for managing inflammation.
Low-FODMAP Diet: Some individuals find relief from Crohn's symptoms by following a low-FODMAP diet, which restricts fermentable carbohydrates that can exacerbate digestive symptoms.

Herbal and Nutritional Supplements

Curcumin: Curcumin, the active compound in turmeric, has anti-inflammatory properties and may be beneficial for managing inflammation in Crohn's disease.
Aloe Vera: Aloe vera may have anti-inflammatory effects and has been studied for its potential to reduce symptoms in some individuals.
Vitamin D: Some people with Crohn's disease have lower vitamin D levels. Supplementation may be considered to address deficiencies.
Zinc and Iron: These supplements can help address nutrient deficiencies that often occur in Crohn's disease.
Boswellia (Indian Frankincense): Boswellia serrata, a resin extract from the Boswellia tree, has been studied for its anti-inflammatory effects and potential in managing Crohn's disease. It is available as a supplement.
Marshmallow Root: Marshmallow root has demulcent properties that can help soothe irritated mucous membranes in the digestive tract. It is sometimes used to relieve gastrointestinal discomfort.
Slippery Elm Bark: Slippery elm has mucilaginous properties, which can help coat and protect the lining of the digestive tract. It may be used to relieve digestive discomfort.
Chamomile: Chamomile has anti-inflammatory and soothing properties and may help reduce gastrointestinal symptoms such as cramping and discomfort.
Ginger: Ginger has anti-inflammatory and anti-nausea properties and can help alleviate gastrointestinal discomfort.
Peppermint: Peppermint oil may help relieve symptoms such as abdominal pain, bloating, and gas in some individuals with Crohn's disease.
Probiotic Herbs: Some herbal blends, such as berberine-containing plants, have been used as antimicrobial and anti-inflammatory agents in managing gastrointestinal conditions.

Mind-Body Therapies

Stress Reduction: Techniques like mindfulness, meditation, yoga, and relaxation exercises can help manage stress, which can exacerbate Crohn's symptoms.
Acupuncture: Some individuals find relief from Crohn's symptoms through acupuncture.

Physical Activity

Regular exercise can help maintain overall health, reduce stress, and support a sense of well-being.

Vasilis J. Sideris
Biologist
Medical Doctor, Biopathologist (Microbiologist)
Certified Functional Medicine Practitioner, CFMP^®