Crohn's Disease: Most Effective Dietary Supplements

Crohn's disease is a chronic inflammatory bowel condition that can affect the entire digestive tract, with a preference for the terminal ileum and colon. It affects about 1 in 200 people in Western countries, mainly young adults aged 20 to 40. Urban populations and Ashkenazi Jews are more impacted, and rates are rapidly increasing in Asia and South America due to industrialization.

Symptoms

Crohn's disease presents varied intestinal and extra-intestinal symptoms, sometimes making diagnosis complex. Chronic diarrhea is the main symptom, occurring 5 to 8 times a day, sometimes accompanied by bleeding. Unlike ulcerative colitis (UC), which often limits itself to the left colon and progresses in flares, Crohn's disease can affect any part of the digestive tract and follows a more chronic evolution. Abdominal pain, primarily localized in the terminal ileum region, is frequent, often associated with moderate fever and weight loss. In case of complications, ulcers, fistulas, or strictures may occur, sometimes requiring emergency surgery. In addition to these digestive issues, extra-intestinal manifestations include:  Joint: peripheral arthritis, ankylosing spondylitis, sacroiliitis.  Skin: erythema nodosum, pyoderma gangrenosum, mouth ulcers.  Eye: uveitis, scleritis, episcleritis.  Hepatobiliary: primary sclerosing cholangitis, gallstones.  Vascular: thrombosis, pulmonary embolism.  Bone: osteoporosis, even in the absence of corticosteroid therapy.

Etiology and Diagnosis

The exact causes of the disease remain unknown, but several factors are involved. Genetic mutations, notably on the NOD2 gene, disrupt the immune response, leading to chronic inflammation. An intestinal dysbiosis, characterized by a reduction of anti-inflammatory bacteria like Faecalibacterium prausnitzii, contributes to the pathology. Modern diets high in processed foods, as well as early exposure to antibiotics, also increase risk. Dr. Seignalet suggests that gluten and milk proteins might disrupt the intestinal barrier and activate autoimmune mechanisms. Diagnosis relies on inflammatory markers, such as CRP and fecal calprotectin, as well as on endoscopy and biopsies, revealing characteristic ulcerations and transmural inflammation. MRI and ultrasound help detect complications like fistulas and abscesses.

Treatments

The management of Crohn's disease combines several approaches:  Conventional treatments: corticosteroids, immunosuppressants (azathioprine, methotrexate), and targeted biotherapies (infliximab, adalimumab).  Surgery: reserved for severe strictures or complications. Dr. Seignalet proposes a hypo-toxic diet, excluding gluten and dairy products, which might restore the intestinal barrier. While this approach is not yet scientifically verified on a large scale, it has shown encouraging results for some patients. Finally, plants like German chamomile and boswellia, as well as a diet rich in soluble fibers, probiotics, and antioxidants, can support intestinal regeneration and reduce inflammation.