Crohn’s disease is a chronic autoimmune disease of unknown cause, characterized by inflammation of the gut wall triggered by an attack from the immune system. The immune system, which normally attacks invading viruses or bacteria, is somehow stimulated to attack the body’s own tissue (in this case, the gut wall).
A recent survey found there has been no change in the results from conventional treatment for Crohn’s (such as drugs) in the past 40 years.1 But there is hope. Recent medical research has identified several important factors that might trigger or feed the inflammation in Crohn’s disease. In my experience, when herbs and dietary change are used to control or neutralize these factors, the inflammation is more or less alleviated.
There seems to be a genetic cause to Crohn’s disease. The genetic defect linked to Crohn’s disease actually gives us an insight into its cause. The defect is in a gene that encodes the protein known as CARD 15.2 CARD 15 is involved in recognizing and activating the immune response to bacteria. So, a poor immune response to gut microbes could be a key piece in the jigsaw puzzle. This highlights a common misunderstanding about autoimmune disease. It’s not due to a strong immune system that is too powerful. In fact, autoimmune disease, as illustrated above, most likely results when there is some weakness in the immune system. Under-responsiveness in one part of the immune system might lead to an excessive response in another part.
Johne’s disease, which occurs in cattle, is very similar to Crohn’s disease. The main difference is that the cause of Johne’s disease is known: a close relative of the bacterium that causes tuberculosis. This is known as Mycobacterium avium subspecies paratuberculosis or MAP for short. In 1984, a group of Italian researchers began a major scientific controversy when they found MAP in the intestinal tissue of patients with Crohn’s disease.3 The implication was that, like Johne’s disease, Crohn’s disease also was caused by the presence of this micro-organism in the gut. Now, more than 20 years later, the evidence implicating MAP in Crohn’s disease is strong.4 One factor behind this proof is the use of sophisticated gene techniques to find MAP, which are similar to those used by crime labs to identify victims or criminals.
Where does the MAP in humans come from? It seems it originates from consuming the milk from cows infected with Johne’s disease. Pasteurization may not kill this organism, and this has led British food authorities to advise dairy farmers not to release the milk from infected cows into the human food supply.
The amount of MAP found in Crohn’s disease patients is not high, so whether the inflammation is directly caused by the bacterium or by the body’s excessive immune response to its presence is not clear. But what is clear is that some respected medical authorities are now suggesting that eliminating MAP might improve the disease.5
Other gut bacteria such as E. coli have been implicated in Crohn’s and may contribute to the chronic disease process.6 A leaky gut probably enables the breakdown products of such bacteria to enter the general circulation, further stirring up the immune system.7
Crohn’s Disease and Diet
It might seem obvious that diet could be an important factor in Crohn’s disease, since it is after all a chronic inflammation of the digestive tract. This is backed up by the well-known observation that Crohn’s patients placed on an elemental diet (food broken down into its basic components such as amino acids, sugars, vitamins, etc) improve substantially.8 Clinical studies using elimination diets found that symptomatic improvement resulted when patients were placed on diets free of gluten, dairy products and yeast.9
The yeast aspect is particularly fascinating. Several studies have found that Crohn’s disease patients have antibodies in their blood directed towards baker’s or brewer’s yeast (Saccharomyces cerevisiae).10 In fact, these antibodies are so characteristic their presence is now used as a diagnostic test for Crohn’s.11 While some scientists think this association is of no consequence, others feel removal of yeast from the diet could be beneficial.12
Herbs for Crohn’s Disease
One of the key herbs for Crohn’s disease is the Ayurvedic herb known as boswellia. The safety and efficacy of a boswellia extract was compared against mesalazine for the treatment of 102 patients with active Crohn’s disease in an eight-week randomized, double-blind study.13 Mesalazine is a synthetic drug used as the standard anti-inflammatory treatment in Crohn’s disease. The primary clinical outcome measured was the change in the Crohn’s Disease Activity Index. After therapy with Boswellia extract (3.6 g per day), the average index was reduced by 90, compared to a reduction of only 53 for the mesalazine group (4.5 g per day).
Other herbs useful for Crohn’s disease include garlic, golden seal and some essential oils (oregano and anise) to reduce pathogenic bacteria in the gut such as MAP. Either fresh, crushed garlic cloves or garlic powder product can be used. The latter mimics in the digestive tract what happens when you crush a fresh clove. In my practice, I use a bowel flora-rebuilding protocol which is based around these herbs.
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