Symptoms of Crohn’s and Colitis

As the lining of the intestine becomes inflamed and ulcerated, it loses its ability to adequately process food and waste or absorb water, resulting in loose stools (diarrhea), and in severe cases weight loss. Most people with Crohn’s disease or Ulcerative Colitis experience an urgency to have a bowel movement and have crampy abdominal pain. Inflammation can cause small sores (ulcers) to form in the colon and rectum. These can join together and become large ulcers that bleed, resulting in bloody stools. Blood loss can eventually lead to anemia if unchecked.

The symptoms of IBD vary from person to person, may change over time, and can range from mild to severe. People with IBD often go through periods when the disease is quiet with few or no symptoms (remission), alternating with times when the disease is active and causing symptoms (flares).

Symptoms related to inflammation of the GI tract include:

• Diarrhea
• Bloody diarrhea
• Abdominal pain
• Rectal bleeding
• Urgent need to move bowels
• Sensation of incomplete evacuation

General symptoms that may also be associated with IBD:

• Fever
• Loss of appetite
• Weight loss
• Fatigue
• Nausea and Vomiting
• Night sweats
• Anemia
• Joint Pain / Soreness
• Skin changes that involve red, tender bumps under skin
• Eye Redness / Pain
• Loss of normal menstrual cycle

How Crohn’s and Colitis are Diagnosed

To help confirm a diagnosis of IBD, you will need a combination of tests and procedures:4

• Lab Tests: Your provider may suggest blood tests to check for anemia — a condition in which there aren't enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection from bacteria or viruses.
• Stool Studies: You may need to provide a stool sample so that your provider can test for hidden (occult) blood or organisms, such as bacteria and parasites, in your stool.
• Endoscopic Procedures:
  • Colonoscopy. This exam allows your provider to view your entire colon using a thin, flexible, lighted tube with a camera at the end. During the procedure, small samples of tissue (biopsy) may be taken for laboratory analysis. A biopsy is the way to make the diagnosis of IBD versus other forms of inflammation.
  • Flexible sigmoidoscopy. Your provider uses a slender, flexible, lighted tube to examine the rectum and sigmoid, the last portion of your colon. If your colon is severely inflamed, your provider may perform this test instead of a full colonoscopy.
  • Upper endoscopy. In this procedure, your provider uses a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum). While it is rare for these areas to be involved with Crohn's disease, this test may be recommended if you are having nausea and vomiting, difficulty eating, or upper abdominal pain.
  • Capsule endoscopy. This test is sometimes used to help diagnose Crohn's disease involving your small intestine. You swallow a capsule that has a camera in it. The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body painlessly in your stool. You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn's disease. Capsule endoscopy should not be performed if a bowel obstruction is suspected.
  • Balloon-assisted enteroscopy. For this test, a scope is used in conjunction with a device called an overtube. This enables the technician to look further into the small bowel where standard endoscopes don't reach. This technique is useful when a capsule endoscopy shows abnormalities, but the diagnosis is still in question.
  • Imaging Procedures:
    • X-ray. If you have severe symptoms, your provider may use a standard X-ray of your abdominal area to rule out serious complications, such as megacolon or a perforated colon.
    • Computerized tomography (CT) scan. You may have a CT scan — a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel. CT enterography is a special CT scan that provides better images of the small bowel. This test has replaced barium X-rays in most medical centers.
    • Magnetic resonance imaging (MRI). An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. An MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike CT, there is no radiation exposure with MRI.

Types of Crohn’s and Colitis

There are six main types of Crohn's disease, each with its own set of symptoms. Doctors define each type by the location of inflammation in your gastrointestinal tract (GI tract):5

Ileocolitis:Inflames the end of the small intestine (ileum) and a portion of the large intestine (colon). This is the most common type of Crohn's disease. Symptoms you might have:

• Considerable weight loss
• Diarrhea
• Cramping
• Pain in the middle or lower right part of your abdomen

Ileitis:Inflames the last section of the small intestine (ileum). Symptoms you might have:

• Considerable weight loss
• Diarrhea
• Cramping
• Pain in the middle or lower right part of your abdomen
• Fistulas, or inflammatory abscesses, may form in the lower right section of your abdomen.

Gastroduodenal Crohn’s: Inflames the stomach and the start of the small intestine (duodenum). Symptoms you might have:

• Nausea
• Weight loss
• Loss of appetite
• Vomiting (if narrow segments of bowel are obstructed)

Jejunoileitis: Inflames the middle part of the small intestine (jejunum). Symptoms you may have:

• Cramps after meals
• Fistulas
• Diarrhea
• Abdominal pain that can become intense.

Crohn's (granulomatous) colitis: Inflames only the colon. Symptoms you may have:

• Skin lesions
• Joint pain
• Diarrhea
• Rectal bleeding
• Ulcers, fistulas, and abscesses around the anus

Perianal Crohn's disease (PCD): ): Is a common type of Crohn's disease that causes inflammation around the anus. It can cause tags, fissures, fistulae, abscesses, or stenosis. Symptoms include:

• Pain
• Itching
• Bleeding
• Purulent discharge
• Incontinence of stool

There can be an overlap between these types of Crohn's disease. Sometimes, more than one area of your digestive tract is affected. The disease can be further divided by phenotypes, or physical traits, as it gets worse.

For Crohn’s, these are based on:

Your age when you were diagnosed:

• Child
• Young adult
• Elderly

The affected body part:

• Terminal ileum
• Colon
• Ileocolon
• Upper gastrointestinal tract

How the disease behaves:

• Stricturing: The disease causes swelling and scarring on the walls of your intestine. This makes the walls thicker and can form strictures, or narrowed areas, that lead to blockages.
• Penetrating: Crohn’s causes fistulas, perianal ulcers, inflammatory masses, or abscesses.
• Uncomplicated

There are three types of Ulcerative Colitis, each with their own set of symptoms.6

Ulcerative Proctitis - In ulcerative proctitis, bowel inflammation is limited to the rectum. This condition typically affects less than six inches of the rectum, and it is not associated with an increased risk of cancer. Symptoms may include:

• Rectal bleeding
• Rectal pain
• Urgency in your bowel movements

Left-Sided Colitis - In this form of ulcerative colitis, continuous inflammation begins at the rectum and extends as far into the colon as the splenic flexure, which is a bend in the colon near the spleen. Left-sided colitis also includes proctosigmoiditis, which affects rectum and the lower segment of colon located right above the rectum known as the sigmoid colon. Symptoms may include:

• Loss of appetite
• Weight loss
• Bloody diarrhea
• Pain on the left side of the abdomen

Extensive Colitis - This type of ulcerative colitis affects the entire colon. Continuous inflammation begins at the rectum and extends beyond the splenic flexure. Symptoms may include:

• Loss of appetite
• Bloody diarrhea
• Abdominal pain
• Weight loss

Traditional Medical Treatment for Crohn’s and Colitis

There is currently no cure for Crohn's disease, and there is no single treatment that works for everyone.

One goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. Another goal is to improve long-term prognosis by limiting complications. In the best cases, this may lead not only to symptom relief but also to long-term remission.

Anti-Inflammatory Drugs -Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease. They include:

• Corticosteroids. Corticosteroids such as prednisone and budesonide (Entocort EC) can help reduce inflammation in your body, but they don't work for everyone with Crohn's disease. Corticosteroids may be used for short-term (3 to 4 months) symptom improvement and to induce remission. Corticosteroids may also be used in combination with an immune system suppressor to induce the benefit from other medications. They are then eventually tapered off.
• Oral 5-aminosalicylates. These drugs are generally not beneficial in Crohn's disease. They include sulfasalazine (Azulfidine), which contains sulfa, and mesalamine (Delzicol, Pentasa, others). Oral 5-aminosalicylates were widely used in the past but now are generally considered of very limited benefit.

Immune System Suppressors - These drugs also reduce inflammation, but they target your immune system, which produces the substances that cause inflammation. For some people, a combination of these drugs works better than one drug alone. Immune system suppressors include:

• Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan). These are the most widely used immunosuppressants for treatment of inflammatory bowel disease. Taking them requires that you follow up closely with your doctor and have your blood checked regularly to look for side effects, such as a lowered resistance to infection and inflammation of the liver. They may also cause nausea and vomiting.
• Methotrexate (Trexall). This drug is sometimes used for people with Crohn's disease who don't respond well to other medications. You will need to be followed closely for side effects.

Biologics -This class of therapies targets proteins made by the immune system. Types of biologics used to treat Crohn's disease include:

• Vedolizumab (Entyvio). This drug works by stopping certain immune cell molecules — integrins — from binding to other cells in your intestinal lining. Vedolizumab is a gut-specific agent and is approved for Crohn's disease. A similar medication to vedolizumab known as natalizumab was previously used for Crohn's disease but is no longer used due to side effect concerns, including a fatal brain disease.
• Infliximab (Remicade), adalimumab (Humira) and certolizumab pegol (Cimzia). Also known as TNF inhibitors, these drugs work by neutralizing an immune system protein known as tumor necrosis factor (TNF).
• Ustekinumab (Stelara). This was recently approved to treat Crohn's disease by interfering with the action of an interleukin, which is a protein involved in inflammation.
• Risankizumab (Skyrizi).This medication acts against a molecule known as interleukin-23 and was recently approved for treatment of Crohn's disease.

Antibiotics - Antibiotics can reduce the amount of drainage from fistulas and abscesses and sometimes heal them in people with Crohn's disease. Some researchers also think that antibiotics help reduce harmful bacteria that may be causing inflammation in the intestine. Frequently prescribed antibiotics include ciprofloxacin (Cipro) and metronidazole (Flagyl).

Other Medications - In addition to controlling inflammation, some medications may help relieve your signs and symptoms. But always talk to your doctor before taking any nonprescription medications. Depending on the severity of your Crohn's disease, your doctor may recommend one or more of the following:

• Anti-diarrheals. A fiber supplement, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), can help relieve mild to moderate diarrhea by adding bulk to your stool. For more severe diarrhea, loperamide (Imodium A-D) may be effective. These medications could be ineffective or even harmful in some people with strictures or certain infections. Please consult your health care provider before you take these medications.
• Pain relievers. For mild pain, your doctor may recommend acetaminophen (Tylenol, others) — but not other common pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). These drugs are likely to make your symptoms worse and can make your disease worse as well.
• Vitamins and supplements. If you're not absorbing enough nutrients, your doctor may recommend vitamins and nutritional supplements.

Nutrition Therapy - Your doctor may recommend a special diet given by mouth or a feeding tube (enteral nutrition) or nutrients infused into a vein (parenteral nutrition) if you have Crohn's disease. This can improve your overall nutrition and allow the bowel to rest. Bowel rest may reduce inflammation in the short term.

Your doctor may use nutrition therapy short term and combine it with medications, such as immune system suppressors. Enteral and parenteral nutrition are typically used to get people healthier prior to surgery or when other medications fail to control symptoms.

Your doctor may also recommend a low residue or low-fiber diet to reduce the risk of intestinal blockage if you have a narrowed bowel (stricture). A low residue diet is designed to reduce the size and number of your stools.

Surgery -If diet and lifestyle changes, drug therapy, or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery. Nearly half of those with Crohn's disease will require at least one surgery. However, surgery does not cure Crohn's disease.

During surgery, your surgeon removes a damaged portion of your digestive tract and then reconnects the healthy sections. Surgery may also be used to close fistulas and drain abscesses. The benefits of surgery for Crohn's disease are usually temporary. The disease often recurs, frequently near the reconnected tissue. The best approach is to follow surgery with medication to minimize the risk of recurrence.

Ulcerative Colitis treatment usually involves either medication therapy or surgery. Several categories of medications may be effective in treating Ulcerative Colitis. The type you take will depend on the severity of your condition. The medications that work well for some people may not work for others. It may take time to find a medication that helps you. In addition, because some medications have serious side effects, you'll need to weigh the benefits and risks of any treatment.7

Anti-Inflammatory Medications - Anti-inflammatory medications are often the first step in the treatment of Ulcerative Colitis and are appropriate for most people with this condition. These include:

• 5-aminosalicylates. Examples of this type of medication include sulfasalazine (Azulfidine), mesalamine (Delzicol, Rowasa, others), balsalazide (Colazal) and olsalazine (Dipentum). Which medication you take and how you take it — by mouth or as an enema or suppository — depends on the area of your colon that's affected.
• Corticosteroids.These medications, which include prednisone and budesonide, are generally reserved for moderate to severe Ulcerative Colitis that doesn't respond to other treatments. Corticosteroids suppress the immune system. Due to the side effects, they are not usually given long term.

Immune System Suppressors - These medications also reduce inflammation, but they do so by suppressing the immune system response that starts the process of inflammation. For some people, a combination of these medications works better than one medication alone. Immunosuppressant medications include:

• Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan). These are commonly used immunosuppressants for the treatment of inflammatory bowel disease. They are often used in combination with medications known as biologics. Taking them requires that you follow up closely with your provider and have your blood checked regularly to look for side effects, including effects on the liver and pancreas.
• Cyclosporine (Gengraf, Neoral, Sandimmune). This medication is typically reserved for people who haven't responded well to other medications. Cyclosporine has the potential for serious side effects and is not for long-term use.
• "Small molecule" medications.More recently, orally delivered agents, also known as "small molecules," have become available for IBD treatment. These include tofacitinib (Xeljanz), upadacitinib (Rinvoq) and ozanimod (Zeposia). These medications may be effective when other therapies don't work. Main side effects include the increased risk of shingles infection and blood clots. The U.S. Food and Drug Administration (FDA) recently issued a warning about tofacitinib, stating that preliminary studies show an increased risk of serious heart-related problems and cancer from taking this medication. If you're taking tofacitinib for Ulcerative Colitis, don't stop taking it without first talking with your health care provider.

Biologics -This class of therapies targets proteins made by the immune system. Types of biologics used to treat Ulcerative Colitis include:

• Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi). These medications, called tumor necrosis factor (TNF) inhibitors, work by neutralizing a protein produced by your immune system. They are for people with severe Ulcerative Colitis who don't respond to or can't tolerate other treatments. TNF inhibitors are also called biologics.
• Vedolizumab (Entyvio). This medication is approved for treatment of Ulcerative Colitis for people who don't respond to or can't tolerate other treatments. It works by blocking inflammatory cells from getting to the site of inflammation.
• Ustekinumab (Stelara). This medication is approved for treatment of Ulcerative Colitis for people who don't respond to or can't tolerate other treatments. It works by blocking a different protein that causes inflammation.

Other Medications - You may need additional medications to manage specific symptoms of Ulcerative Colitis. Always talk with your health care provider before using over-the-counter medications. Your provider may recommend one or more of the following.

• Anti-diarrheal medications.For severe diarrhea, loperamide (Imodium A-D) may be effective. If you have Ulcerative Colitis, do not take anti-diarrheal medications without first talking with your health care provider. These medications may increase the risk of an enlarged colon (toxic megacolon).
• Pain relievers. For mild pain, your provider may recommend acetaminophen (Tylenol, others) — but not ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and diclofenac sodium, which can worsen symptoms and increase the severity of disease.
• Antispasmodics. Sometimes health care providers will prescribe antispasmodic therapies to help with cramps.
• Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia and be given iron supplements.

Surgery -Surgery can eliminate Ulcerative Colitis and involves removing your entire colon and rectum (proctocolectomy). In most cases, this involves a procedure called ileoanal anastomosis (J-pouch) surgery. This procedure eliminates the need to wear a bag to collect stool. Your surgeon constructs a pouch from the end of your small intestine. The pouch is then attached directly to your anus, allowing you to expel waste in the usual way. This surgery may require 2 to 3 steps to complete.

Cancer Surveillance - You will need more-frequent screening for colon cancer because of your increased risk. The recommended schedule will depend on the location of your disease and how long you have had it. People with inflammation of the rectum, also known as proctitis, are not at increased risk of colon cancer.

If your disease involves more than your rectum, you will require a surveillance colonoscopy every 1 to 2 years. This begins as soon as eight years after diagnosis if the majority of colon is involved. Or 15 years after diagnosis if only the left side of your colon is involved.

Complications of Crohn’s and Colitis

In addition to the signs and symptoms of IBD described on the preceding pages, some people develop complications that may require urgent medical care.

Complications of Crohn’s disease include:

• Fistula—ulcers on the wall of the intestine that extend and cause a tunnel (fistula) to another part of the intestine, the skin or another organ.
• Stricture—a narrowing of a section of intestine caused by scarring, which can lead to an intestinal blockage.
• Abscess—a collection of pus, which can develop in the abdomen, pelvis, or around the anal area.
• Perforated bowel—chronic inflammation of the intestine may weaken the wall to such an extent that a hole develops.
• Malabsorption and malnutrition, including deficiency of vitamins and minerals.

Complications of Ulcerative Colitis include:

• Heavy, persistent diarrhea, rectal bleeding, and pain.
• Perforated bowel—chronic inflammation of the intestine may weaken the intestinal wall to such an extent that a hole develops.
• Toxic megacolon—severe inflammation that leads to rapid enlargement of the colon.

Complications Outside the GI Tract:

Not all complications of IBD are confined to the GI tract. For reasons that are not entirely understood, some people develop symptoms that are related to the disease but affect other parts of the body. The most common of these complications affect the skin and bones. These extraintestinal complications may be evident in the:

• Eyes (redness, pain, and itchiness)
• Mouth (sores)
• Joints (swelling and pain)
• Skin (tender bumps, painful ulcerations, and other sores/rashes)
• Bones (osteoporosis)
• Kidney (stones)
• Liver (primary sclerosing cholangitis, hepatitis, and cirrhosis)—occurs rarely

Long-Term Side Effects of Crohn’s and Colitis Medicines

If you’ve been diagnosed with Crohn’s or Colitis and your plan is to just take meds for the rest of your life, you need to know there are long term side effects to this strategy. Below is a list of the common medicines patients are put on when they are diagnosed with Crohn’s or Colitis along with the potential side effects of those medicines.

5-ASAs

These medications are also known as aminosalicylates. They lower inflammation in your digestive tract. They’re best for mild to moderate flares and can help you avoid relapses (when your symptoms come back). They usually come in tablets. But they’re also given rectally as an enema or suppository. Examples of 5-ASAs are:

• Balsalazide (Colazal)
• Mesalamine (Asacol HD, Delzicol)
• Sulfasalazine (Azulfidine)

Side effects are most common with sulfasalazine. They include:

• Nausea
• Headache
• Fever
• Rash
• Male infertility that can be reversed

When you first start this drug, you might also have:

• Appetite loss
• Sunlight sensitivity
• Nervousness

It’s rare, but sulfasalazine could also cause inflammation of your pancreas. Other uncommon symptoms include:

• An inflamed liver, kidney, or lung
• Stevens-Johnson syndrome, a serious allergic reaction
• Hemolysis, a disorder where red blood cells are destroyed faster than your body can make them

Other 5-ASA drugs generally have fewer side effects, compared to sulfasalazine. Common ones include:

• Headache
• A feeling of sickness
• Gas
• Cramps
• Less common side effects include:
• Skin rash
• Hair loss
• Worsened inflammation in your colon

Rarely, these drugs can cause inflammation in your lung, pancreas, kidney, or the tissue around your heart.9

Corticosteroids

These anti-inflammatory drugs suppress your immune system. This means they keep your immune system from working the way it should. Corticosteroids are typically used to treat moderate to severe UC. You can take them orally or rectally. They can cause short- and long-term side effects, so you shouldn’t take them regularly. Types of corticosteroids include:

• Budesonide
• Hydrocortisone
• Methylprednisolone
• Prednisone

Because they suppress your immune system, corticosteroids can lead to infections. These include:

• Yeast infection in the mouth
• Yeast infection in female sex organs
• Urinary tract infections (UTIs)

Side effects that usually go away after you stop corticosteroids include:

• High blood pressure
• High blood sugar
• Weight gain
• Stretch marks
• Acne
• Growth interruption in kids
• More facial hair
• Trouble sleeping
• Mood swings
• Psychosis and other psychiatric symptoms

You could also get cataracts or osteoporosis (weakening of your bones). But they won’t just go away after you stop taking corticosteroids. Your doctor will have to treat these conditions.

Immunomodulators

These medications also suppress your immune system so it can’t cause more inflammation. They include:

• Azathioprine (Azasan, Imuran)
• Mercaptopurine (Purinethol, Purixan)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Methotrexate paired with folic acid

Side effects of these drugs include:

• Nausea
• Headaches
• Diarrhea
• General feeling of sickness
• Canker sores
• Rash
• Fever
• Joint pain
• Liver inflammation
• Lowered kidney function
• Hepatitis
• Higher risk of infection
• Diabetes
• High cholesterol
• Sleep issues or fatigue
• Seizure
• High blood pressure
• Tingling in your fingers and feet
• More facial hair
• Low white blood cell count

Rare side effects include:

• Inflammation of the pancreas or lung
• Bone marrow suppression (when fewer blood cells are made in your bone marrow)
• Higher risk of lymphoma
• Scarring of your liver

Biologics

These medications are best for moderate to severe UC. They’re antibodies that stop certain proteins from causing inflammation. Biologics are made from natural substances. Examples include:

• Adalimumab (Humira)
• Golimumab (Simponi)
• Infliximab (Remicade)
• Ustekinumab (Stelara)
• Vedolizumab (Entyvio)

People who take biologics and have a history of hepatitis B could trigger the condition. So, it’s important to get a blood test before starting these medications.

Other common side effects can include:

• A higher chance of infection
• Shortness of breath
• Chills
• Itchiness
• Redness
• Eye or lip itchiness
• Full body sensitivity or rash

Less common symptoms are:

• Sudden vision issues
• Numbness or tingling
• Swollen ankles or hands
• Shortness of breath
• Heart failure
• Lupus-like syndrome, which includes a rash across your face and arms that gets worse in the sun or new joint and body pain

JAK Inhibitors

JAK inhibitors, or Janus kinase inhibitors, suppress your immune system to block the JAK enzyme. This stops inflammation. You’ll take the JAK inhibitor tofacitinib (Xeljanz) by mouth to treat moderate to severe UC.

If you notice any side effects besides diarrhea, you should call your doctor right away. These can include:

• Black poop
• Bloody or cloudy pee
• A hard time peeing, painful/burning feeling while peeing, or frequently having to pee
• Pain in your bladder
• Blurry vision
• Aches or pains
• Chest tightness, pain, or a hard time breathing
• Cough
• Chills
• Fever
• Dizziness
• Ear congestion or pounding in your ears
• Headache
• Sensitive skin
• Loss of voice
• Pain in your lower side or back
• Nervousness
• Slower or faster heartbeat
• Sneezing
• Sore throat
• Stuffy/runny nose
• Swollen glands
• Fatigue or weakness
• Weight loss
• Yellow skin or eyes

What Traditional Medicine is Not Telling You About Crohn’s and Colitis

The information I am about to share with you was not taught to me during any of my medical training. What medical school, internship, internal medicine residency, and my Gastroenterology fellowship taught me was how to diagnose symptoms, prescribe medicines and do amazing colonoscopies and upper endoscopies. What it didn’t teach was the true reason why people are having symptoms to begin with.

There are many treatments for Crohn’s and Colitis and although they might be helping people get to and stay in remission, they are not addressing the issues caused by the disease. The “other

medicines” patients are put on to deal with the symptoms of Crohn’s and Colitis (such as antidiarrhea or pain meds) are just band aids, they are not actually fixing the problem. The way I see it, although Crohn’s and Colitis is most likely a hereditary disease, it can also be caused by four key issues in the body:

• 1. Nutrient and water absorption issues.
• 2. Microbiome / gut bacteria issues.
• 3. Toxicity build-up / inflammation issues.
• 4. Poor diet / lack of good nutrition issues.

When all four of these occur, it is a recipe for disaster in the gut causing tons of inflammation. And like I said, although there are medicines to stop inflammation receptors, it’s not fixing the problem. If someone is diagnosed with Crohn’s and Colitis, we need to help support the body and fix these four key issues before any true healing is going to happen. To do this, we need to start addressing the following:

• 1. The importance behind digesting and absorbing food properly and the tools to do it.
• 2. The importance of drinking water and that not all water is created equal.
• 3. The importance of good healthy gut bacteria and the tools to replenish it on a regular basis.
• 4. The best way to gently detoxify the body and keep it clean on a day-to-day basis.
• 5. The reason why eating green is so important and how to get people off the Standard American Diet (SAD).

The next sections of this e-book are going to go into major detail on these five topics and why in addition to the IBD medicines available today, these five actions are the key to turning around Crohn’s and Colitis for good.

Why It’s Important to Digest Your Food Properly

When you eat food, it goes into your stomach as a solid. Obviously, we chew it, but we don’t chew it into a liquid. Your body cannot use food in a solid form, it must be broken down into a liquid for your body to benefit from it. This means when you eat, your body is supposed to go to work for you – making enzymes and acid. There is a different enzyme produced to digest all different types of foods:

• • Amylase & Diastase - break down starch into sugars / glucose.
• • Protease- breaks down protein into amino acids.
• • Lipase- breaks down fat into fatty acids.
• • Invertase - breaks sugar down into glucose and fructose.
• • Lactase - breaks down sugar found in dairy products.

The acid that gets produced in the stomach helps to digest protein in addition to killing off germs, viruses or bugs found on our food. Our food is not sterile, so the acid helps to protect us from all the items we consume that the body shouldn’t be exposed to. Producing the appropriate amount of enzymes and acid is a crucial step in the digestive process. For your food to be absorbed and assimilated into the body the food must be broken down properly. If you are lacking enzymes or acid your food will sit around too long in the stomach causing lots of digestive issues but in addition to that you will not be able to benefit from the food itself.

Imagine this – even if you are eating the healthiest diet in the world, if your body is not breaking it down properly, you are not benefiting from what you are eating. This can cause you to be tired, have low energy, have a foggy brain, etc. Anyone out there experiencing any of these symptoms?

In addition, if you are not getting vitamins and minerals from the food you are eating, the body is very smart. It knows you need vitamins and minerals to function and so guess what it does, it starts to rob from itself. And the first place it goes is the bone and the muscle because that is where we have the most vitamins and minerals stored up.

Digesting your food properly is the first step to not only eliminating digestive issues but getting you off of over-the-counter and prescription meds while at the same time giving you your life back. Knowing that one of the key issues with Crohn’s and Colitis patients is the importance of digesting and absorbing food properly, you can see how important taking a good digestive enzyme on a daily basis can be.

Why Hydrating Properly is So Important

The most important thing you can do for your body daily is to drink water. The only thing that hydrates the body is water – everything else dehydrates the body (juices, caffeinated drinks, energy drinks, sodas, lemonade, iced tea, alcohol, etc.) Just to replenish what you lose daily; you need to drink half of your body weight in ounces of water per day. This means if you weigh 200 lbs. you should be drinking 100 ounces of water per day. And if you drink that cup of coffee or two every day (which is caffeine, which is a diarrhetic so it’s going to make you urinate), you need even more water to compensate. Most people do not drink the recommended amount of water every day and wonder why they don’t feel good. Out of all the advice we’ve given patients over the years, this is the one piece of advice patients have mentioned that made the biggest impact on them – that was to drink more water. The more water you drink and the less of everything else you drink, the healthier the body is going to be.

Not only does drinking water keep the body hydrated but it is also the best way to detoxify the body – washing away the toxic build up. And if you want to take your water drinking to the next level you need to consider drinking alkaline water. Especially if you’re the type of person who doesn’t drink a lot of water because it makes you pee a lot. Alkaline water will absorb deeper into the body, detoxing you better and hopefully causing you to pee less often. To learn what alkaline water is and how it works be sure to check out the next section on my approach to Crohn’s and Colitis.

Finally, let’s discuss water additives, especially electrolytes. The big thing in the last couple of years are flavored powders or liquids that can be added to water to give it some taste while at the same time adding some extra vitamins, minerals and sometimes energy boosters to the body. People may use these because they feel water doesn’t have a taste, or they think it’s boring to drink water, or maybe they are trying to supplement something in the diet or give themselves that extra boost they feel they need to get through the day. Let me be clear, most of the powders and liquids on the market today are loaded with chemicals, artificial flavors, artificial sugars and preservatives. Even the ones that say no sugar added, nine times out of ten they will have artificial sugar which is worse for you than regular sugar. I guarantee these are only contributing to your problem, not solving it.

The thing you do need is electrolytes. Electrolytes are salts that are responsible for keeping the body properly hydrated so the muscles and nerves can function properly. The human body is composed mostly of salt water. Have you ever tasted your sweat or your tears? They are salty! Your body is a giant saltwater bag and all day long you are losing salt water, when you urinate, when you sweat or when you talk. If you do not replace this salt water your body becomes very dehydrated (again, a key symptom of Crohn’s and Colitis). Most people who are drinking water are not drinking water with electrolytes. Some might be drinking things like Gatorade, Powerade, etc. but again those drinks are loaded with chemicals, sugar, artificial sugar, preservatives, and dyes. The bottom line, they are not helping the body but hurting it. There is a solution for a good pure, clean, electrolyte powder to use in your water. The next section on my approach will explain it in further detail.

And if you still think water doesn’t taste good, consider adding fresh vegetables or fruit to your water. This is a natural way of flavoring your water without needing store bought products that will add toxicity to the body. Some ideas include lemon, lime, cucumber, watermelon, blueberries, strawberries, etc.

The Importance of Good Healthy Gut Bacteria

Your digestive system is home to trillions of microorganisms, creating an ecosystem called the “gut flora.” Probiotics are the good bacteria, which are needed to create a balance throughout the body.

The body has both good and bad bacteria. The word “probiotic” literally means “good life,” which is fitting since it has been proven to treat many uncomfortable symptoms. For women, an imbalance of bacteria in the vaginal area may lead to a yeast infection. If there is an imbalance of bacteria in the urethra, a urinary tract infection may develop. The gut also needs to have a balance of bacteria, or else diarrhea, constipation, gas, and bloating may be experienced, all common symptoms of someone suffering from Crohn’s or Colitis.

Imbalances of flora in the body may occur for many different reasons. Some common culprits for throwing it off balances include:

• • Aging
• • Eating a nutritionally depleted diet
• • Stress
• • Alcohol consumption
• • Smoking
• • Steroids
• • Birth control pills
• • Antibiotics; keep in mind that a large amount of meat and dairy consumed today have been treated with antibiotics, which affect our flora
• • Chemicals in food, soaps, lotions and perfumes
• • Diabetes; sugar provides food for bad bacteria

Probiotics are needed to fulfil many functions. They act as a barrier to protect us against invaders in the body; bad bacteria, parasites, fungi, viruses, toxins etc.

On a daily basis, we unconsciously consume various microbes that could potentially cause sickness. In a body that has plenty of “good bacteria,” these microbes will pass with no negative effects. However, if bad microbes are ingested in a body with an imbalanced gut flora, these microbes will cause sickness. The “bad bacteria” that are constantly in our system, are kept under control by the “good bacteria.” If the good bacterium becomes imbalanced, “bad bacteria” is given an opportunity to break through the gut walls and invade other parts of the body.

More than half of our immune system is located in the gut wall, so it is vital to keep that part of our body healthy. Many illnesses can be linked back to abnormal gut flora. In addition to aiding our immune system, probiotics support digestion. They aid in producing enzymes, which help to break down food, and transport vitamins, minerals, and other nutrients. Several nutrients cannot survive in the body if they are not quickly absorbed, so without a healthy gut flora, nutrient deficiency is likely. Crohn’s and Colitis have been directly linked to poor gut flora. Taking a good healthy probiotic every day is critical to those suffering from this diagnosis. It will help keep the gut flora strong allowing for healthy digestion and an immune system that can work hard to keep the body well.

Why it’s Important to Detoxify Your Body

If you had asked me 15 years ago about the importance of detoxing the body, I would have referred you to a naturopathic doctor, but today it is my favorite topic to discuss. As a Gastroenterologist one of my favorite organs (the colon) is responsible for much of that detoxification. Our body has many natural mechanisms for detoxing, for example urine, stool, sweat, and breath. As we age, our body slows down, and we aren’t detoxing like we should. Over time, as our body slows down, we hold on to more of these toxins making us experience aches and pains.

I have patients in their early 20’s that are experiencing these issues because this is a generation of kids of that have lived off processed foods, fast foods, energy drinks, fancy coffees, recreational drugs, vapes, etc. Imagine the toxins their bodies take in every day and even though they are young, their body can’t keep up.

Our body is a healing vessel, it wants us to be well, but when we continue to expose it to toxins day in and day out, it can only do so much. At some point it’s going to throw up its hands and say, “enough is enough, you’re on your own!” This is when symptoms like aches, pains, tiredness, low energy, foggy brain, set in. And unfortunately, when this happens the pharmaceutical and food industry will tell us to take pain meds or drink more caffeine. I have several friends that haven’t been to their doctor in decades because they say they “feel fine” yet are drinking energy drinks and taking pain meds every day for one reason or another. In the end, adding more toxicity to the body - it truly is an endless cycle. The more toxic the body, the greater the inflammation, the greater the inflammation the higher likelihood of IBD.

The bottom line is, we are all moving in the same direction, it just depends on how fast you want to get there. Keeping a clean body is one way to slow the process of aging, it can also help you get off unnecessary prescription and over the counter medicines and most importantly reverse those aches and pains. Most importantly, keeping a clean body will reduce inflammation and minimize IBD symptoms and flares.