Digestion | February 1, 2018 | Author: Naturopath
Inflammatory bowel disease or IBD is an umbrella term for autoimmune conditions that cause chronic and often debilitating inflammation in the intestines. These conditions are characterised by being relapsing and remitting – they cycle between periods of getting better with fewer symptoms, and relapses where symptoms get worse and the disease may progress.
There are two major types of IBD – Chron Disease and Ulcerative Colitis. Both conditions suffer from inflammation of the GI mucosa, and the causes are unknown. There causative factors appear to be a combination of triggered immune reactions, genetics and an imbalance of gut bacteria .
It affects the small intestines and the right hand side of the colon, rarely the rectum. The inflammation and damage can spread deep into the tissue and cause complications of ulcers, fitsulas, and bowel obstruction.
It doesn't involve the small intestine. Severe bleeding often occurs during flare-ups and can result in anaemia and iron deficiency. 
NOTE: If you have an IBD diagnosis, notify your doctor of any changes to your pattern of symptoms and flare-ups. IBD increases your risk of colorectal cancer and symptoms should be monitored closely.
As inflammatory conditions with autoimmune connections, both forms of IBD can benefit from natural therapies and lifestyle changes that are help to balance the immune system and regulate inflammatory pathways.
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High fibre diets have been linked to reducing the severity and frequency of relapses in IBD, but too much fibre during a relapse can make symptoms worse. Here are the best fibre choices for IBD:
Psyllium husk is a great source of both soluble and insoluble fibres, and has been shown to improve stool bulk and reduce diarrhoea in Chron disease and ulcerative colitis . Soluble fibres are noted for their effects on the stomach and small intestine, while insoluble fibres show most benefit in the large intestine – psyllium has both, so it works well for both IBD conditions .
Psyllium is fermented by the microbiota in the bowel to produce short chain fatty acids which reduces inflammation in the bowel and strengthens the intestinal wall.
NOTE: Because of its high level of insoluble fibre, psyllium husk may not be appropriate during relapses or symptom flare-ups.
Resistant starch feeds beneficial bacteria in the colon to reduce inflammation and pain in IBD . You can create resistant starch by allowing certain foods to cool before eating or reheating them –
potatoes, oats and rice are easy to cook the day before, cool in the fridge, and eat cold or warm. Oats have the added benefit of containing B-glucan, a polysarccharide that has been shown to reduce bloating, flatulence and abdominal pain in IBD .
CAUTION: Increasing fibre is usually safe for IBD patients who are in remission, but can be dangerous if you have strictures of the bowel.
You've heard the hype about turmeric – it's anti-inflammatory, antioxidant and immune-regulating. Perfect for IBD, right? Curcumin is the most active chemical component in turmeric and has been shown to reduce inflammation and damage in IBD, and may be protective against colorectal cancer . In fact, curcumin treats IBD at the root – it helps to modulate the immune system, down-regulates autoimmune reactions and boosts resistance to triggers .
It's easy to include turmeric in your regular diet – the bright orange root is available to buy fresh from many grocers and markets and can be grated into cooking. Dry turmeric powder, turmeric tea and even turmeric lattes have benefit. If you're looking for a potent formulation, curcumin supplements contain the most concentrated forms of active turmeric. Speak to a nutritionist or naturopath for personalised advice on the safety, effectiveness and dosage of curcumin supplements with your condition and medications.
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The frequency and severity of IBD relapse has been associated with eating meat, likely due to the hydrogen sulphide that colonic bacteria release in the presence of meat . This hydrogen sulphide causes inflammation and direct damage to the intestines. Processed meats are particularly nasty on the gut – they contain nitrates, a toxic substance that is highly inflammatory and carcinogenic.
Switch meat for plant-based proteins like tofu, which also contains gut-healing nutrients like zinc, calcium and vitamin E. Legumes such as chickpeas and lentils are appropriate during IBD remissions, but stay away from them during flare-ups are they contain insoluble fibre that might upset the gut.
If a plant-based or completely vegetarian diet isn't sustainable for you, consider the Mediterranean Diet that centres around lots of fresh vegetables, moderate amounts of fish, and a small amount of other meats .
When inflammation occurs in the body, the stomach can struggle to produce enough gastric acid and digestive enzymes to adequately break down food. This results in large, undigested food particles travelling to the intestines where they can contribute to further inflammation and damage to the gut in IBD.
Bitter foods and drinks stimulate the secretion of digestive enzymes and gastric acids before a meal. Try lemon juice in water during symptom flares. Bitter green vegetables like kale, rocket and mustard greens stimulate acid production but because of their fibre content they are only appropriate during remissions.
If these foods aren't cutting it, supplemental enzymes can do the same job as stomach acids – they break down the complex molecules in our food into smaller, absorbable pieces that the intestines can absorb. Supplementing with digestive enzymes can give relief to IBD symptoms and has been shown to switch off inflammatory pathways .
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Boswellia serrata is an Ayurvedic resinous herb traditionally used for IBD. It is gaining popularity in western herbal medicine and research has shown it can reduce inflammation, regulate autoimmune processes, and soothe gut pain as an analgesic . Studies have shown that Boswellia can improve rates of remission with few side effects . It can also help relieving joint pain associated with flare-ups, and may help to reduce the risk of IBD complications .
CAUTION: Speak to a qualified naturopath, nutritionist or integrative G.P. before taking supplements or making diet changes for IBD management.
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