Sabitri Ghosh with Zoltan Rona, MD
As a youngster, Ferne Sherkin-Langer just couldn't escape the fact that she was different.
As a youngster, Ferne Sherkin-Langer just couldn't escape the fact that she was different. At nine, she had to leave summer camp early after seizing up with cramps and coming down with a severe case of diarrhea.
Then, on a trip with high-school friends to Europe, diarrhea struck again accompanied this time by rectal bleeding. The mortified teenager had to rush home to Toronto.
Doctors thought her problem might be an ulcer, a parasite or even psychosomatic. Few had any inkling as to the real cause: Crohn's disease.
"I was 19 when I first heard the name of my disease," writes Sherkin-Langer in If This Is a Test, Have I Passed Yet?. "I wanted to stand up and yell: 'See, you all doubted me. All this time I have had Crohn's disease.'"
An inflammatory bowel disease (IBD), Crohn's results from an irregular immune reaction to bacteria in the gastrointestinal tract that leaves tissues inflamed and ulcerated. Though few people die from it, the pain is often incapacitating and the blockages created by scarred tissue can be life-threatening if they impede waste materials from passing through to the colon.
Some people in advanced stages of the disease may undergo an ileostomy or colostomy. These surgical procedures reroute the passage of waste materials from the diseased intestine or colon to a new opening in the front of the abdomen called a stoma. Instead of having bowel movements, people with ileostomies or colostomies wear bags over their stomas, disposing and replacing them on an as-needed basis.
Diet and Exercise
Many experts now see Crohn's as an autoimmune disease that arises from a complex interplay of genetic factors and western dietary habits. People with a sibling who has Crohn's have a 30 per cent greater risk of developing it, while those with a close relative have a 10 per cent greater risk. And people who regularly eat processed foods especially those made of white refined sugar and flour-also increase their odds of developing Crohn's.
A few years ago, researchers in Britain linked bacterial contamination in cow's milk to higher-than-usual incidences. Other suspected risk factors include drinking caffeine, smoking and using oral contraceptives.
Since living with Crohn's means living with a digestive system under constant attack, people who suffer from the disease must vigilantly watch what they put into it. In many cases, particular foods may worsen symptoms. Milk and dairy products, wheat, corn, cabbage, tomatoes, citrus fruits and eggs have all been known to create complications in different individuals with Crohn's.
One dietary treatment, known as an elimination diet, excludes all foods from a person's diet and reintroduces them one at a time, monitoring the person's symptoms to determine food intolerances. Sherkin-Langer subsisted on baby food for a few days until she discovered that dairy products seemed to precipitate attacks of the disease. She has now removed them from her diet with positive results.
Besides avoiding foods containing white refined sugar and flour, as well as those to which they have an intolerance, people with Crohn's should steer clear of saturated fats from animal sources, hydrogenated vegetable fats, cooked or heated polyunsaturated fats, artificial colourings and flavourings, and preservatives. A high-protein, low-fat diet consisting of whole-grain bread or unrefined rice, unprocessed meats and fish, beans and lentils, fresh fruit and leafy green vegetables can do wonders for boosting energy and alleviating symptoms.
People with Crohn's can easily succumb to the temptation to lie in bed all day to avoid the ordeal of living with their condition. All the more reason to get up and exercise, according to Sherkin-Langer: "Staying in good physical shape gives you a positive feeling about yourself and decreases your level of stress." She recommends deep breathing, stretching and yoga as great forms of exercise for helping people with Crohn's to feel better physically and emotionally. Just don't overdo it, she cautions. If you decide to join a club or class, let the staff know you may be ill for long stretches at a time and ask for a more flexible arrangement.
The Gift of Illness
Given the social stigma attached to Crohn's symptoms, people with the disease need the understanding and support of the people close to them as much as any other therapeutic regimen. Sherkin-Langer suggests giving friends and family members who want to help specific and doable tasks, such as babysitting or picking up groceries. "Then friends feel better because they can help, and the person with Crohn's feels better because something that needed doing has gotten done."
But even with the understanding and support of friends and family, almost all people with Crohn's will grieve the loss of normalcy. So you have "to learn to cope," she says. As a former nurse and an active member of the Crohn's and Colitis Foundation of Canada, she often counsels teenagers with Crohn's going through many of the same trying experiences she did. "What I talk about is the gift of illness. Whether or not you have a chronic illness, we're all in the continuum of life to death. The question is: How do you live from here on in? People who have a chronic illness have a better appreciation of health and of life in general than those who don't." At 47, Sherkin-Langer feels that's a lesson worth learning, no matter how hard her test may have been.
Supplements to Combat Crohn's
Sterols and sterolins: Two capsules three times daily for one week, one capsule three times daily thereafter. Supports proper immune function and controls inflammation in the digestive tract.
Vitamin B-complex: Use as directed. Supports digestion and neuronal activity, promotes repair mechanisms.
Folic acid: One to five milligrams per day until diarrhea subsides. Stops chronic diarrhea. (Not to be taken in doses higher than 400 mcg by people with epilepsy.)
Vitamin C with quercetin: 1,000 mg vitamin C and 500 mg quercetin. Prevents inflammation and boosts immunity.
L-glutamine: 1,000 mg daily. Supports health of villi, the surfaces that facilitate absorption of the intestine.
Flax seed oil: One to three tablespoons (five to 15 millilitres) per day. Reduces inflammation.
Ground flax seed: One to three tablespoons (five to 15 millilitres) per day, with plenty of water. Controls diarrhea, corrects constipation and soothes intestinal lining.
Calcium and magnesium: 1,000 mg calcium and 500 mg magnesium. Restores possible deficiencies, helps prevent colon cancer.
Plant digestive enzymes: Two capsules with meals. Aids digestion. Iron: 10 mg daily. (Use only if diagnosed with anemia.)
Lactobacillus and Bifidus acidophilus: One teaspoon (five ml) daily. Improves intestinal flora and reduces diarrhea, irritable bowel, diverticulosis and constipation.
Evening primrose oil: 500 mg twice daily. Reduces inflammation by inhibiting inflammatory mediators and prevents zinc deficiency.
Colostrum: One teaspoon (five ml) daily. Contains lactoferrin and enhances immunoglobins in the digestive tract.
Source: Healthy Immunity: Scientifically Proven Natural Treatments for Conditions from A-Z by Lorna Vanderhaeghe, BSc (John Wiley and Sons, 2000).