National Center for Integrative Primary Healthcare

What is Inflammatory Bowel Disease (IBD)?

IBD refers to two different gut problems: Ulcerative Colitis and Crohn's Disease.

What is the difference between Ulcerative Colitis and Crohn's Disease?

Both problems cause the gut to get sores or inflamed. Ulcerative Colitis always occurs at the end of the gut. Crohn's Disease can occur anywhere between the mouth and the end of the gut, but is most often in the small intestine. Both diseases can affect other places like the liver, joints or eyes. There is no cure but there are many ways to help the body heal.

What does it feel like?

IBD can cause diarrhea and pain. It may make you feel tired. Sometimes blood is seen in your bowel movements. Some people lose weight. IBD can be very serious. It can lead to bleeding, gut blockages, or infections. It can also cause malnutrition. IBD also increases the risk of colon cancer.

What causes IBD?

We don't know what causes IBD. It might be an immune system problem triggered by the environment (perhaps pollutants), changes in gut flora, poor diet, and our genes.

What can I do?

Get good health care!

Work with your health professional to get the right care. Sometimes medication or surgery is needed. Talk about the benefits and risks.
Ask when to get tested for colon cancer.

Diet:

Watch what you eat and drink: Some foods and drinks can worsen how you feel, especially during a flare-up. Avoid processed foods, sugar, and greasy meals. Limit dairy and high-fat foods because they are hard to absorb when the gut is damaged. High fiber and citrus fruit are protective. Avoid spicy foods, caffeine, and alcohol. Eat soft foods while the gut heals. Steam or sauté vegetables instead of frying. After having IBD for a long time some people need more diet changes. Work with a dietician.
Follow an anti-inflammatory diet. Studies show that this diet leads to feeling better and is well-balanced. Check out "Anti-Inflammatory Diet" at /resources.html.
Low FODMAPs and Specific Carbohydrate Diet. These diets, which avoid certain starches and grains as well as some other carbs can be very helpful in some people with IBD. These should usually be done with advice from a nutritionist or dietician.

Exercise:

Exercise regularly. Exercise lowers stress, improves mood, and regulates the gut. It can stabilize weight, prevent bone loss, and lessen IBD flare-ups. However, excessive exercise can cause short-term inflammation in the body.

Lower stress:

Reduce Stress: Stress may worsen IBD. Reduce stress with yoga, breath work, meditation, and acupuncture. These also lower pain and anxiety, and help with overall wellbeing.

Supplements:

Vitamin D: Patients with low Vitamin D are more likely to need medicine, trips to the hospital and even surgery. If you do not regularly spend time in the sun (which helps your body make Vitamin D), you should consider taking 1000 IU of Vitamin D3 every day.
Probiotics: Helpful with diarrhea in Ulcerative Colitis.
Vitamin B12: Many people with IBD are low in B12 due to gut damage.
Iron: Low iron is very common in IBD because of blood loss and gut damage. However, taking in too much iron can irritate the gut too. Eat foods that naturally have iron in them, like dark green vegetables, meats and beans. Talk to your provider about the best way to get enough iron.
Curcumin: Found in turmeric, this helps decrease inflammation and may help prevent the growth of cancer cells.
Other common deficiencies: folic acid, vitamin B6, vitamin B1, selenium, zinc, vitamin K, and magnesium.
Boswellia: shown in small studies to encourage IBD remission.
Fish oil: taking 3-4 grams daily can help some people reduce symptoms of IBD.
Others: aloe vera can be anti-inflammatory but can also worsen diarrhea.

Support:

A chronic disease can be difficult to handle. Try journaling, join an IBD support group, or think of what you are thankful for daily. Also learn about your disease. Consider talking with a therapist.

Print Version

Download the Print Version (PDF)

References/Resources

MORE INFORMATION:

National Center for Complementary and Integrative Medicine

Mayo Clinic

REFERENCES:

Bilski J, Mazur-Bialy A, Brzozowski B, Magierowski M, Zahradnik-Bilska J, Wojcik D, et al. Can exercise affect the course of inflammatory bowel disease? Experimental and clinical evidence. Pharmacol Rep. 2016;68(4):827-36. Doi:10.1016/j.pharep.2016.04.009.

Gallo A, Passaro G, Gasbarrini A, Landolfi R, Montalto M. Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate. World J Gastroenterol. 2016;28;22(32):7186-202. PMID: 27621567.

Gerbarg PL, Jacob VE, Stevens L, Bosworth BP, Chabouni F, DeFilippis EM, et al. The effect of breathing, movement, and meditation on psychological and physical symptoms and inflammatory biomarkers in inflammatory bowel disease: A randomized control trial. Inflamm Bowel Dis. 2015;21(12):2886-96. PMID: 26426148.

"Inflammatory bowel disease." Natural Medicines Comprehensive Database. Sept 28,2016. http://naturaldatabase.therapeuticresearch.com.ezproxy2.library.arizona.edu/nd/Search.aspx?cs=CEPDA&s=ND&pt=&sh=15&fs=ND&id=63&r=3&searchid=58310445&txt=inflammatory+bowel+disease#selected. 9/28/16.

Kabbani TA, Koutroubakis IE, Schoen RE, Ramos-Rivers C, Shah N, Swoger J, et al. Association of vitamin D level with clinical status in inflammatory bowel disease: A 5-year longitudinal study. Am J Gastroenterol. 2016;111(5):712-9. PMID: 26952579.

Knight-Sepulveda K, Kais S, Santaolalla R, Abreu MT. Diet and inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2015;11(8):511-20. PMID: 27118948.

Martin TD, Chan SS, Hart AR. Environmental factors in the relapse and recurrence of inflammatory bowel disease: a review of the literature. Dig Dis Sci. 2015;60(5):1396-405. PMID: 25407806.

Owczarek D, Rodacki T, Domagala-Rodacka R, Cibor D, Mach T. Diet and nutritional factors in inflammatory bowel diseases. World J Gastroenterol. 2016;22(3):895-905. PMID: 26811635.

Sreedhar R, Arumugam S, Thandavarayan RA, Karuppagounder V, Watanabe K. Curcumin as a therapeutic agent in the chemoprevention of inflammatory bowel disease. Drug Discovery Today. 2016;21(5):843-9. DOI: 10.1016/j.drudis.2016.03.007.

Rogler G, Zeitz J, Biedermann L. The search for causative environmental factors in inflammatory bowel disease. Dig Dis. 2016;34 Suppl 1:48-55. PMID: 27548430.

Sharma P, Poojary G, Dwivedi SN, Deepak KK. Effect of yoga-based intervention in patients with inflammatory bowel disease. Int J Yoga Therap. 2015;25(1):101-12. doi:10.17761/1531-2054-25.1.101.

Weisshof R, Chermesh I. Micronutrient deficiencies in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care. 2015;18(6);576-81. PMID: 26418823.