IBD best managed by an expert
Dear Doctor: I am 59 and recently received a diagnosis of mild to moderate Crohn’s disease. Having been quite healthy my entire life, I find the treatment options to be overwhelming. It seems as if drug treatment — e.g. Humira — has as many detractors as supporters, and I’ve read plenty of horror stories about folks who have used it. The same can be said of Remicade and some of the other treatments. I have family members who are pushing me to consider natural treatments such as diet modification, essential oils and the like. What course of action would you recommend? – T.T.
A Crohn’s disease is an inflammatory bowel disease of unknown cause. Unlike ulcerative colitis — the other form of inflammatory bowel disease that affects only the colon — Crohn’s disease can affect the gastrointestinal tract anywhere from the lips to the anus.
The variability of the disease is immense. I trained in an institution with special expertise in IBD and saw its full spectrum in the days before medications like infliximab (Remicade) and adalimumab (Humira) were introduced, and I promise you that for many people, these medications are literally life-saving. They clearly are not for everyone, however, and should be used only for carefully chosen patients after a thorough evaluation by an expert. Inflammatory bowel disease should be taken very seriously and I can’t emphasize enough how important it is to have an expert managing this condition.
Initial treatment does consist of dietary modification. Lactose is so frequently a problem that a trial of a lactose-free diet usually is recommended. Many experts also recommend an elimination diet, meaning removing the likely triggers for IBD flares, then slowly adding them back in to see whether they cause a problem. Probiotics have been shown to be beneficial in some cases.
Since you asked specifically about natural or complementary treatments, I would advise you to use these in addition to, not instead of, the standard therapies recommended by an IBD expert. They can help reduce perception of discomfort and side effects.