Inflammatory Bowel Disease

Ulcerative colitis (UC) and Crohn’s disease (CD) are ongoing gut problems that have periods of symptoms and times when they improve and times when they are worse i.e. relapsing and remitting. In both conditions, the intestinal wall is infiltrated by acute and chronic inflammatory cells that cause IBD lesions.

UC mainly impacts the colon, while CD can affect any part of the digestive tract from the mouth to the bottom. In UC, the inflammation only affects the inner lining of the gut, leaving the deeper layers alone, unlike Crohn’s. In CD, the entire gut wall gets swollen and thickened, with deep sores. These sores can go through the gut wall and cause problems like abscesses or fistulas, which are abnormal connections between organs like the bowel, bladder, or skin.

Because of the gut damage, people with these conditions might have trouble absorbing nutrients from their food.

IBD happens more often in people who have certain genes that make them more prone to inflammation. This may be triggered in response to emotional stress, infection, gastroenteritis, antibiotics, non-steroidal anti-inflammatory drug (NSAID) therapy or bacterial dysbiosis (adverse bacterial overgrowth in the bowel).

UC CD
Course: Initial onset/flare of IBD is usually the most severe, followed by less severe relapses.
Cardinal signs of active UC:
– Rectal bleeding with mucus and bloody diarrhoea.
– Frequent, small-volume fluid stools or dry stools due to constipation upstream of the inflamed rectum.		Cardinal signs of active CD:
– Abdominal pain.
– Diarrhoea associated with pain.
– Weight loss.
– Bowel motions usually watery and do not contain blood or mucus.
– Eating provokes pain.
– Patients present with features of fat, protein or vitamin deficiencies. Malabsorption may also lead to the development of osteoporosis.
– Perianal skin tags, fissures or fistulae are found in at least 50% of patients.
Advanced/severe symptoms:
Bowel frequency >6 stools/day
Pulse: ≥ 90 beats/min
Temperature: ≥ 37.8°C
Anorexia, malaise, weight loss, abdominal pain, fever, tachycardia, and signs of peritoneal inflammation in addition to cardinal symptoms.
Triggers: Emotional stress, infection, gastroenteritis, antibiotics or NSAID therapy may all provoke a relapse. 

How a Naturopath Consultation with Lisa can help

At the initial consultation Lisa will:

  • Perform a thorough health history to identify relevant drivers, including dysbiosis, autoimmune disease, history of current and past infection (particularly gastrointestinal infection), dietary factors (i.e. low fibre intake and high sugar intake) and lifestyle factors (i.e. smoking) also looking at any links with family history. She will also look at
    what drivers may be associated with recurrent IBD flares, or what factors have been associated with achieving remission in the past, if relevant.
  • She will assess current and past medication use, as some medications can trigger or exacerbate IBD (i.e. NSAIDs).
  • If necessary she will refer you for pathology testing including gut microbiome testing or blood tests.
  • She will assess your current and/or past stress levels as this can be a trigger or sustaining factor of IBD.
  • Sleep patterns will also be considered as sleep disruption can further increase inflammatory load and prevent tissue repair.
  • The macro and micro nutrient composition and quality of your diet will be assessed to determine any nutritional adequacy in those who have maintained IBD remission.

At the next appointment she will present her findings outlining a specific treatment plan for you which will include diet, lifestyle and supplement recommendations along with any pathology result findings and appropriate recommendations.

Recommendations will also be based on your current status i.e. are you in a flair or remission?

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