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Crohn's Disease- Pathophysiology and Conventional and Alternative Treatment Options

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Crohn's Disease- Pathophysiology and Conventional and Alternative Treatment Options

Kathleen A. Head, ND- Technical Advisor, Thorne Research
Julie S. Jurenka, MT (ASCP)- Research Assistant

Alternative Medicine Review . Volume 9, Number 4 . 2004

Crohn’s disease, a subcategory of inflammatory bowel disease, contributes to significant morbidity, particularly in industrialized nations. It can affect people of any age, but is more commonly diagnosed in adolescence and young adulthood. Inflammation and ulceration occur primarily in the terminal ileum and colon, although any portion of the intestinal tract can be affected. No etiology has been identified for Crohn’s disease, although a number of factors contribute to its etiopathogenesis, including genetic, microbial, inflammatory, immune, and permeability abnormalities. Conventional medications are not curative but can contribute to resolution of acute flare-ups and help maintain remission. Because significant side effects are associated with many of these medications, more natural interventions to help maintain remission should be considered. Associated nutrient deficiencies, dietary interventions, and nutrient and botanical supplementation are discussed.

Crohn’s disease (CD) is one of two main forms of inflammatory bowel disease (IBD), the other being ulcerative colitis (UC). Crohn's Disease is a chronic, relapsing, transmural (affecting all layers of the intestine) inflammation of uncertain etiology that can affect any portion of the digestive tract from mouth to anus, but is predominantly seen in the terminal ileum and/or colon. Intestinal inflammation and ulceration in Crohn's Disease is asymmetrical and occurs in "patches" with areas of healthy tissue interspersed, and extends deeply into the intestinal wall, forming granulomatous lesions. The disease is named after Dr. Burrill B. Crohn who, with his colleagues Ginzburg and Oppenheimer, published a landmark paper in 1932 describing the features of what is known today as Crohn’s disease. Several categories of Crohn's Disease have been described, defined by the portion of the digestive tract involved and the presenting symptomatology (Table 1).

Current statistics indicate 1-2 million Americans suffer from IBD, with approximately half of those cases diagnosed as Crohn’s disease. Crohn's Disease affects men and women equally, with a majority of cases diagnosed in adolescents and young adults ages 15-35 years. The disease, however, can affect people at any age and approximately 10 percent of cases are under age 18. Crohn’s disease predominantly affects Caucasians; with a prevalence rate of 149 per 100,000, although there has been a steady increase in reported cases of Crohn's Disease and Ulcerative Colitis among African Americans. IBD is largely a disease of the industrialized world, especially the United States and Europe, and is more common in urban areas and northern climates. Crohn's Disease has a known genetic component, with 25 percent of Crohn’s patients having a family member with some form of IBD. Statistics also indicate those with a sibling with IBD are 30 times more likely than the general population to develop IBD.1

Signs and symptoms of Crohn's Disease are similar to Ulcerative Colitis, making diagnosis difficult. For a complete comparison of Crohn’s and UC signs and symptoms, see Table 2. Patients diagnosed with Crohn's Disease present with some or all of the following symptoms: frequent diarrhea, abdominal pain in the lower right quadrant appearing soon after meals, fatigue, loss of appetite, weight loss, fever, stomatitis, and perianal fistula or fissures. Some patients also present with rectal bleeding, arthritis, and erythema nodosum lesions on the extremities.1 In pediatric cases of Crohn's Disease, growth failure is observed in 75 percent of patients.2


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