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Diet and Bowel Disease (Crohn's Disease)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 20 in the August 20-21, 2005 issue of
The Mississauga News under the feature: Health & Wellness, Medical Matters.
Dr K

There seems to be a confusion at times about how to classify bowel problems and what the differences are. Crohn's Disease is an entity which we seem to be encountering more often and in younger people. Both Crohn's Disease and Ulcerative Colitis are distinct diseases that fall within the realm of Inflammatory Bowel Disease (IBD). Both entities share many symptoms in common which make them difficult to tell apart until one takes a much closer look. IBD symptoms include abdominal pains and cramping, diarrhea, watery or bloody stools. A change in appetite, bloating and even joint pains can be seen in both diseases. Diagnosis starts with keeping careful track of the symptoms to look for patterns. Blood and stool testing is usually a starting point. The best way to make a diagnosis is to take a close look at the bowels with a colonoscopy and then biopsy any suspicious area. But colonoscopy is a limited resource in our neck of the woods.

The common denominator seems to be that both diseases involve inflammation. Ulcerative Colitis is characterized by documenting inflammation largely confined to the inner layer of the colon, and is more restricted to the anal and colon area. The inflammation in Crohn's Disease can penetrate through all the layers of the colon. The disease can jump throughout the digestive tract affecting areas here and there ranging from the mouth to the anus. It is most commonly found in the last part of the small intestine and the first part of the colon or large intestine. Crohn's Disease usually causes more damage and may require surgery to remove damaged sections. It also seems to strike at the young adult population.

Inflammation is a process mediated by our own bodies designed to identify and repel foreign threats. It occurs on auto-pilot without much control. Most current theories about these two diseases suggest that they begin when a foreign substance called an antigen which is repeatedly presented to the absorptive layer of the gut. It is thought that we somehow misidentify the substance and trigger an inflammatory response which leads to damage. It is the rampant inflammation produced by our bodies that defines the condition. Our best treatments aim to control the inflammation. There is some substance in this theory in the recent characterization of a gene mutation called NOD2/CARD 15. It also suggests that the tendency to induce these diseases runs in families, an association that is clinically seen. So the great challenge lies in finding the identity of the mysterious antigen or antigens that start the spiral response. Many researchers feel that this could be a bacteria or virus. My personal view sides with those who believe that it is within the food chain. I see a recurrent pattern of bowel problems beginning in the college age population. It seems like more than a coincidence that for many reasons this is a time when diets get atrocious. Processed foods full of additives forced in excessive amounts in haphazard intervals, downed with toxic elixirs in varying amounts and random time sequences are at the top of my list when searching for a trigger.

Crohn's and Ulcerative Colitis are diseases that have only been defined for less than 70 years and seem to be popping up in developed countries. The increase in their numbers seems to parallel our increasing reliance on processed foods. Eating a healthy diet has become a financial burden punctuated with time constraints and guilt. Rearranging your life style from its current reliance on processed foods requires a large investment in time, education and money. All things considered, quitting smoking is probably easier than learning to rebalance your eating habits. Early childhood programming has a major impact. Those of us who can remember the days when mothers and grandmothers toiled in the kitchen for hours to produce a meal starting with raw products, can also recall that children would be repeatedly rewarded with a "treat" of chips, a pop or a cookie. Those "treats" slowly evolved to frozen dinners, freshly-baked doughnuts, and then to take-out foods. With time, the subliminal programming just took over and "treats" became a permanent way of eating. This problem becomes compounded when we spend our resources buying "supplements" to make up for the deficiencies, and perhaps the guilt we feel for poor nutritional practices. In my view, these are simply processed items in pill form. By my definition, healthy eating is the ability to understand which food substrates can be combined with others, in what proportion, and in what interval. It is a dynamic concept. Few mammals consume the same diet year round. If you feel compelled to balance the guilt of purchasing cheap processed food by ingesting some "natural" products, then at the very least be certain that Mother Nature hands it to you personally. It may not look pretty or be packaged the way you are used to, but with Mother Nature, the hefty mark-ups don't exist, and there is no need for guarantees.


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