According to Philip B. Miner, Jr., M.D., President and Medical Director of the Oklahoma Foundation for Digestive Research, patients with Inflammatory Bowel Diseases are looking towards the National Center of Complementary Medicine because of:
- the side effects and, in some cases, ineffectiveness of conventional medical treatments,
- concerns around the nutritional value of the processed arid refined foods that have come to dominate the American diet,
- the presumed safety of natural remedies,
- concerns about surgery and
- the need to feel in greater control.
It is precisely because Dr. Miner’s patients are already using the National Center of Complementary Medicine that he supports the selective use of herbal supplements, functional foods, and other biologically-based approaches in a spirit of open, non-judgmental inquiry.
Dr. Miner has tracked hundreds of CAM studies, and his observations are both interesting and surprising. In a presentation he has offered to patients and medical colleagues around the country he focuses on seven biologically-based remedies that have been touted widely on the Internet as helpful in Crohn’s disease and ulcerative colitis, noting their pros and cons along the way:
Capsaicin, the active ingredient in chili peppers, is being used by some patients to relieve pain, cramps, bloating, and diarrhea The scientific evidence supporting its effectiveness has been scant so far, with one important exception: Because capsaicin is known to deplete substance P, a cellular component that’s involved in the transmission of pain from the skin to the spinal cord, and because of strong anecdotal evidence on behalf of its healing potential, Dr. Miner believes further studies of this functional food are warranted.
The Lemonade Diet has been around since 1941, and it has made a recent comeback as a “detox” plan appropriate for everything from weight loss to the alleviation of the symptoms of many chronic diseases. The diet excludes all solid food and requires its adherents to drink an exclusive mixture of mineral water, maple syrup, fresh lemon, and cayenne pepper (which, incidentally, contains capsaicin!). If you want to try the diet, says Dr. Miner, it won’t hurt you as long as you don’t stay on it for longer than ten days—but its benefits are questionable at best.
Garlic continues to be the natural remedy of choice for people suffering from a wide range of conditions. Although it has been shown to improve diarrhea, it can aggravate pain and fever two common symptoms of Crohn’s disease and ulcerative colitis. That’s because it actually activates the immune system—a distinct no-no for people with diseases caused by an immune system that is overactive. Dr. Miner warns that garlic is “high-risk, except in patients with diarrhea and minimal mucosal inflammation.”
Peppermint oil and peppermint tea seem to reduce abdominal pain, bloating, and the frequency of bowel movements in people with irritable bowel syndrome (IBS), according to some preliminary studies. Some believe that peppermint might help ease symptoms common to both IBS and IBD. More solid data exists, says Dr. Miner, around the addition of peppermint oil to barium enema preparations, which has been shown to relax the colon during a barium enema examination. Given these results, and despite its lowly association with gum, candy, and ice cream, peppermint should be the subject of serious scientific investigation, he contends.
Aloe Vera is widely used for wound healing and pain relief, but its benefits have not been confirmed in clinical studies. Some people with mild- to-moderate ulcerative colitis who take aloe vera juice have reported significantly reduced symptoms—but when DL Miner carried out a controlled trial of Acemannan, believed to be the active ingredient in aloe vera for wound healing, the substance did not distinguish itself from placebo and the study was halted. Further; Dr. Miner urges caution in light of aloe vera’s laxative effect and its qualities as an “immune booster.” Remember, he says, a person with Crohn’s disease or ulcerative colitis should be careful about treatments that can boost an already overactive immune system.
Evening primrose oil contains gamma-linolenic acid, an essential fatty acid needed by the body for growth and development. It is reputed to have anti-inflammatory effects, and because some people with rheumatoid arthritis (HA) claim to benefit from taking it, it has grown in popularity among patients with other inflammatory diseases. However; there is some evidence that borage oil, another plant- derived oil that contains gamma linolenic acid, is more effective in reducing the joint pain and swelling associated with RA than evening primrose oil. So if you’re on the fence, he says, choose borage over evening primrose.
Fish oils are the richest known source of omega-3 fatty acids, which have shown promise for the prevention and treatment of cardiovascular disease. They may also prove effective in Crohn’s disease and ulcerative colitis. Says Dr. Miner, “It’s too soon to tell whether their promise will be realized in the form of solid scientific evidence. What we know is that omega-3 fatty acids modulate a key molecular pathway that affects allergic reactions and the inflammatory response. So even though some clinical studies of fish oils have produced disappointing results, it’s a ‘smoking gun’ that’s worth further investigation.”
The more widely used biologically-based products for Inflammatory Bowel Disease:
- nutritional supplements, such as vitamins, minerals, and herbal formulas;
- prebiotics and probiotics;
- proteins and fatty acids;
- animal-derived extracts; and
- functional foods, defined as biologically active components of certain foods that carry potential benefits beyond their basic nutritive value.
Probiotics have entered the mainstream of medical treatment for patients with pouchitis—inflammation of the “neo-rectum” created during proctocolectomy, a commonly performed surgical procedure used for people with severe ulcerative colitis—and for prevention of antibiotic-associated diarrhea.
Dr. Miner is a physician with an attitude of openness and curiosity. Actually, medicinal herbs dating from the early Middle Ages, such as digitalis and quinine, form the basis for widely used modern drugs. As more complementary treatments cross over into mainstream medicine—and many experts predict that some of them will—the story of medicine and healing will continue to unfold.
• U.S. Food and Drug Administration
• Natural Medicines Comprehensive Database