Inflammatory Bowel Disease (IBD) is a term that describes chronic inflammation disorder of the small and/or large intestine. The mucous membranes lining the colon become inflamed and develop ulcers, causing bloody diarrhea, pain, gas, bloating, and sometimes hard stools.

Included within the area of colitis is Crohn's disease and ulcerative colitis. Crohn's disease is characterized by inflammation through the entire thickness of the bowel wall; whereas Ulcerative colitis a nonspecific inflammatory response limited largely to the lining of the colon. The factors causing the two problems appear to be parallel. Since so many similarities exist the details of differences will not be covered here.

In general the cause of most cases is unknown, but contributing factors have been identified as poor eating habits, stress, food allergies, and overuse of antibiotics. Some genetic association appears to exist since IBD is two to four times more common in Caucasian whites than in non-Caucasians, and four times more common in Jews than non-Jews. However, no specific genetic marker has yet been identified.

"Antibiotics, especially if taken for a period of more than two weeks, may provoke a form of colitis. Antibiotics kill the [good] bacteria that normally live in the intestine and may allow another type [of bad] bacterium, clostridium difficile, to proliferate and produce an irritating toxin.

Very commonly, prolonged use of antibiotics is associated with diarrhea that may be a direct irritative effect of the drug itself (antibiotic-associated diarrhea). "... Most infections that can cause colitis resolve without treatment ... are sometimes treated with antibiotic drugs ... or by a special diet and vitamin supplements." [The American Medical Association Encyclopedia of Medicine, 1989, p. 289.]

Inflammation of the colon (colitis) may also be due to viral or bacteria infection, for example campylobacter. These infectious agents produce toxins that irritate the intestinal lining and if persistent and not overcome by the body, will directly infect the colon lining.

Dietary implications are hardly considered in most standard medical and gastroenterology texts, but several lines of evidence support dietary factors as being the most important causative factor of IBD. One major statistic is that Crohn's disease is increasing in countries where a Western diet (diet high in refined carbohydrates, sugar, and saturated fats) is consumed, but is virtually nonexistent where people consume a more "primitive" diet (high in raw foods and fiber). [Jarnerot, et. al. "Consumption of Refined Sugar by Patients with Crohn's Disease, Ulcerative Colitis, or Irritable Bowel Syndrome." Scandanavian Journal of Gastroenterology. Vol 18. (1983) pgs.999-1002]

The implication of food is logical because food impacts the digestive system and intestinal environment to a greater degree than any other internal or external factor. Studies exist that analyze the pre-illness dietary intake of individuals with IBD. Although these studies are criticized because they are founded on the pre-illness dietary intake "memory" of an IBD patient, they do substantiate the dietary association of high levels of refined sugars and carbohydrates. For example, in one study the pre-illness intake of refined sugar in Crohn's disease patients was nearly twice that of controls (122 g per day versus 65 g per day). [Heaton, et al. "Treatment of Crohn's Disease with an Unrefined-Carbohydrate, Fiber-Rich Diet." Britain Medical Journal. Vol 279. (1984) Pgs 1859-1862.]

Another important dietary factor is food allergies. Clinical studies using an elimination diet (diet of foods that have a lower tendency to produce allergic reactions) have provided significant IBD improvements with no side effects. [Workman, et al. "Diet in the Management of Crohn's Disease." Human Nutrition: Applied Nutrition Vol 38A. (1984) Pgs. 469-473]

ADDITIONAL DISEASES

Over 100 disorders are known to be systemic complications of IBD. The most common is arthritis, which afflicts about 25 percent of IBD patients. The arthritis tends to flare up with a flare in IBD activity most commonly affecting the knees, ankles, and wrists. Less frequently, but still found is a spinal low back pain and stiffness that is almost indistinguishable from ankylosing spondylitis (rheumatoid arthritis of the spine). These arthritic symptoms may be mild and may precede the IBD symptoms by several years. In fact, there may be a consistent underlying factor in the onset and progression of both ankylosing spondylitis and IBD.

High levels of toxins that result from IBD cause several other symptoms, for example recurrent canker sores, skin boils, slow healing of wounds, or even gangrene. High levels of toxins also cause serious liver disease in 3 to 7 percent of people with IBD (chronic active hepatitis, cirrhosis, etc). Also, inflammation of blood vessels, impaired blood flow to fingers or toes, inflammatory eye problems, kidney stones, and gallstones, are identified complications from IBD.

Weight loss is prevalent in 65 to 75 percent of IBD patients, mainly because of a continual decline in food intake and resultant malnutrition. It is the most common reason IBD patients require hospitalization. Malnutrition can occur because of digestive pain (so don't want to eat), medical dietary restrictions without supplementation, malabsorption of nutrients through a defective digestive tract, shortened digestive tract (through surgery), drugs that excessively deplete nutrient levels, electrolyte loss from diarrhea, and infection. Most particularly, the loss of blood proteins across damaged and inflamed mucosa may exceed the liver's ability to replace that blood protein, leading to iron depletion and anemia.

If not corrected, nutrient deficiencies can lead to altered gastrointestinal function/structure and may result in a vicious cycle of declining ability to properly digest and absorb nutrients.

NUTRITION AND LIFESTYLE, DRUG PRECAUTIONS

In their book "Encyclopedia of Natural Medicine," Doctors Michael Murray and Joseph Pizzorno state, "It is absolutely essential that patients with IBD take a high-quality multiple-vitamin-and-mineral supplement that provides all of the known vitamins and minerals." In addition, specifically associated nutrients are listed below.

Vitamins and Minerals/Product Recommendations:

Vitamin C, Vitamin E, Vitamin B12 (antioxidants promote healing and prevent damage associated with bowel cancer), zinc (essential for breakdown of proteins and carbohydrates). We recommend Ultra Body Toddy which contains 16 vitamins, 72 minerals, and 18 amino acids as a full spectrum liquid supplement. Essential Fatty Acids are necessary for cell formation and can protect the lining of the colon. We recommend EFA Plus. Pancreatin Enzymes are digestive enzymes which are necessary for nutrient breakdown and digestion. We recommend Enzyme Plus.

Elimination Diet

Clinical studies using an elimination diet (diet of foods that have a lower tendency to produce allergic reactions) have provided significant IBD improvements with no side effects. [Workman, et al. "Diet in the Management of Crohn's Disease." Human Nutrition: Applied Nutrition Vol 38A. (1984) Pgs. 469-473]

The success of these studies indicates that an elimination diet should be a primary choice for the treatment of chronic IBD. The most common offending foods that are eliminated are wheat and dairy products.

For example, one standard elimination diet consists of lamb, chicken, potatoes, rice, banana, apple, and a cabbage-family vegetable. This diet is maintained for at least one week and up to one month. Symptoms related to food sensitivity will typically disappear by the fifth or sixth day; if not, it is possible that one of the above-listed foods is also a problem. In that case, an even more restricted diet must be utilized. After the restrictive time period, single foods are added back into the diet program and their effect monitored.

For many people using an elimination diet to identify problematic foods is the most viable means of detection and correction. The downside is that it is time-consuming and requires record keeping discipline and motivation. Often the assistance of a physician or other professional with experience in isolating and identifying allergenic foods is helpful.

High Fiber Diet

In Britain several studies have been conducted treating IBD through diet. Specifically, a high fiber diet was clinically successful in the treatment of IBD. But interestingly, this type of diet is the direct opposite of the old traditional "low-fiber medical diet" prescribed for years and years. Another example of a conventional medical treatment being completely reversed; with the understanding we now have of the beneficial value of fiber, this is not a surprising reversal. [Heaton, et. al. "Treatment of Crohn's Disease with an Unrefined-Carbohydrate, Fiber-Rich Diet." Britain Medical Journal. Vol 279. (1984) Pgs 1859-1862.]

Of course a combination of elimination diet and high fiber diet is better than either one alone.

DRUG OPTIONS AND PRECAUTIONS

Corticosteroid drugs (e.g., prednisone) are most commonly used in "traditional medical" treatments, but these drugs stimulate and increase protein breakdown/loss, and depress protein synthesis; which means loss of lean tissue and additional complications for the liver to replace blood proteins. Corticosteroid drugs are also known to decrease the absorption of calcium and phosphorus, increase urinary excretion of vitamin C, calcium, potassium, and zinc; increase levels of blood glucose, serum triglycerides, and serum cholesterol; increase the requirements for vitamin B6, C, folate, and vitamin D; decrease bone formation; and impair wound healing.

We have zeroxed information from a couple of reference books that we have. In addition to full coverage nutrition products, we now have fiber capsules which help bulk and effectively move food through the intestine and colon. If you are interested in a product recommendation from our product offering please e-mail us back.

Yes, supplementing with amino acids can quickly stress out the kidneys and leave toxins rampaging through your system because of system imbalance. The best form of amino acid (protein) supplementation is with a whey protein powder, and should be used in moderation with good eating patterns.

Supplementing but eating junk food all the rest of the day is counterproductive. But we have found that adding B-vitamins provides for better physical and mental stress handling. The antioxidants help with muscle recovery from training and competition. Calcium and its 13 cofactor minerals and vitamins helps with muscle cramping and coordinated contractions.

For all this we would of course recommend our Ultra Body Toddy that contains over 100 nutrients in each ounce. D-stress has additional B-vitamins and could be added on to the Ultra Toddy. The symptoms your son has experienced should not be ignored!

All the reading and research that I've done shows the importance of EFA with crohn's disease. It's needed for repair of the digestive tract and reduces inflammatory processes. Along with the EFA he needs Vit. K for colon health and Vit. B complex for proper digestion and to prevent anemia. Also a digestive enzyme would be helpful. This could be a reason for his thinness, if he's eating but not digesting properly. Acidophlus is important in retaining proper flora in the intestines.

As far as examples you might go to the library and see if they have any health and nutrition books. I'm sure that they would substantiate all that you have told him. Some of my favorite books are: Prescription for Nutritional Healing by James F. Balch, M.D. and Phyllis A. Balch, C.N.C. and Encyclopedia of Nutritional Supplements by Michael T. Murray, N.D.

Thanks for your confidence in us, we do carry a great essential fatty acid product, and acomplete vitamin/mineral supplement.

Sorry for the delay in answering your message. Celiac is a rare disorder thought to be an autoimmune response to gluten in foods. Grains containing gluten such as wheat, barley, rye, and oats must be completely avoided. Over time the intestinal lining can become damaged and nutrient absorption is compromised. Liquid nutritional products, therefore, are of utmost importance in this situation.

Here's a nutritional program for Celiac disease:

• Full Spectrum LIQUID nutrition
  
• Protein Powder Supplement from rice or soy....25-35 grams per day
  
• Extra B-Complex.................50 mg per day
  
• Vitamin K...........................As directed on product label
  
• Zinc.....................................25 mg per day
  
• Essential Fatty Acids.......... 2-4 grams per day
  
• Vitamin C........................... 1-2 grams extra per day
  
  

We recommend Ultra Body Toddy and EFA Plus.

Celiac Disease works like an auto-immune disease, where the body turns on itself. So you have to be careful not to take any immune stimulant products like ecchinacea, colostrum, etc.

Because of the ulcerative colitis and celiac disease, your body has a hard time retaining any nutrients. You probably know that. There is a great Liquid Full Spectrum Vitamin that we highly recommend. It's called Ultra Body Toddy. You'd have to start slow, and work yourself up to the amounts you need to be taking. Liquid is the best way to go, because you get the greatest absorption. You can look at the website linked below. It does have all the amino acids and every other nutrient your body needs.

The other things that you body needs are:

• Rice or soy protein powder supplements ..........25-35 grams per day
  
• Extra B-Complex..............................................50 mg per day
  
• Vitamin K........................................................as directed on label
  
• Zinc................................................................25 mg per day
  
• Essential Fatty Acids........................................2-4 grams per day
  
• Vitamin C........................................................1-2 grams extra per day
  
  

We recommend Ultra Body Toddy, EFA Plus, and Vitamin C 500.

Crohn's disease is an autoimmune condition. It can be really dangerous if it's not controlled. I'm sure you know all of this. You might also want to be tested for allergies so you can avoid them. Because this disease cause malnutrition and absorption difficulties, Total Toddy or Ultra Toddy are the best way to go since they're liquid.

I don't think there is any place to get it in Israel. There are places in England and the Netherlands as well as Australia and The U.S. where you can get it.

Here's the full nutritional protocol for Chron's:

• Full spectrum Nutrition (Total or Ultra Toddy are the best)
  
• Fiber.....................10 grams per day
  
• Multi-Acidophilus.....8-10 caps per day
  
• Aloe Vera Juice.......6 ounces 3 times per day
  
• Folic Acid................2-5 mg per day
  
• Vitamin B12 (sublingual)...500 mcg 4 times per day
  
• Calcium...................1000 mg extra
  
• Magnesium............... 500 mg extra
  
• Zinc Gluconate........... 50 mg per day
  
  

Along with Ultra and Total Toddy we recommend EFA Plus.