The Palm Beach Post

Inflammato­ry bowel disease should be managed by an expert

- To Your Health

Dr. Keith Roach

Question: I am 59 and recently received a diagnosis of mild to moderate Crohn’s disease. Having been quite healthy my entire life, I fifind 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 modififica­tion, essential oils and the like. What course of action would you recommend? — T.T.

Answer: Crohn’s disease is an inflflamma­tory bowel disease of unknown cause. Unlike ulcerative colitis — the other form of inflflamma­tory bowel disease, which afffffffff­fffects only the colon — Crohn’s disease can affffect 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 the full spectrum of the disease in the days before medication­s like inflflixim­ab (Remicade) and adalimumab (Humira) were introduced, and I promise you that for many people, these medication­s are literally lifesaving. However, they clearly are not for everyone and should be used only for carefully chosen patients after a thorough evaluation by an expert. Inflflamma­tory 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 certainly does consist of dietary modififica­tion. Lactose is so frequently a problem in people with Crohn’s disease that a trial of a lactosefre­e diet usually is recommende­d. Many experts also recommend an eliminatio­n diet, meaning removing the likely triggers for IBD flflares and then slowly adding them back in to see whether they cause a problem. Probiotics have been shown to be benefifici­al in some people with Crohn’s disease.

Since you asked specifific­ally about natural or compliment­ary 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 efffffffff­fffects.

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