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The Honolulu Advertiser
Posted on: Thursday, August 13, 2009

Crohn's patients can join study


By Amy C. Brown
Special to The Advertiser

Q. I've had a problem with recurring stomach aches and they think I may have Crohn's disease. What is it, and what can I do about it?

A. Crohn's disease is an autoimmune disease causing patches of inflammation in the small intestine, colon (last part of large intestine), or anywhere along the digestive tract.

Over half a million people suffer from Crohn's disease, with approximately 6,000 living in Hawai'i. The disease is a chronic and as yet incurable inflammatory condition.

The University of Hawai'i John A. Burns School of Medicine is researching the possible role of diet in Crohn's disease by conducting a dietary study sponsored by The Broad Foundation.

People 18- to 75-years old living on O'ahu with Crohn's disease can participate in this study that may help other people with the same condition. To sign up for the study, call 692-0907.

Common symptoms include diarrhea, abdominal pain, weight loss, malnutrition, fatigue, anorexia, fistula (abnormal passageway between two organs), perianal abscesses, rectal bleeding and unusual symptoms such as eye inflammation (iritis, which can lead to blindness if not treated). These symptoms range from mild to severe and may develop gradually or come on suddenly, without warning.

Standard treatments of Crohn's disease consist of drugs and surgery. Resections are common, with about 57 percent of those diagnosed undergoing surgery within the first eight years.

Some complementary and alternative medicine practitioners have reported some success with dietary approaches.

The well-established nutrition support for people suffering from severe or acute Crohn's disease is a temporary treatment that must take place under strict medical supervision and involves being fed through a tube via the gut or vein. The nutrients are "predigested" or already broken down into their smallest units of digestion, which are amino acids, monosaccharides, fatty acids, vitamins and minerals (also known as elemental form). Liquid nutrition through a can of the same balanced nutrients is used in research to induce remissions (with a 50 percent to 70 percent response rate) before testing other treatments.

Drinking predigested nutrients is not a long-term or practical solution, but there are reports of alleviation of symptoms with the use of certain diets that eliminate food sensitivities. Only 1 to 4 percent of adults experience food allergies and 5 to 25 percent are prone to food intolerances. About 60 percent of people with Crohn's disease exhibit food sensitivities. However, less than 15 studies have been published on reducing foods suspected of causing food sensitivities — such as wheat, dairy, yeast, corn, and many other foods — or the careful selection of carbohydrate type. Testimonials with no research support exist for the Specific Carbohydrate Diet, macrobiotic diet, and others. Some studies are published on the use of supplements such as probiotics, omega-3 fatty acids, curcumin (curry), and a few herbs (boswella and cios mastic gum).

Not enough studies have been conducted, so no official diet is available for patients with Crohn's disease, although diet is important to patients with Crohn's disease because a diseased digestive tract alters the digestion and absorption of the nutrients. About 10 to 20 percent of patients develop osteoporosis and nutrient deficiencies such as in iron, zinc, folic acid, vitamin D and vitamin B12.