Crohn's disease and ulcerative colitis

A holistic view of Crohn’s disease

When looking at Crohn’s disease and ulcerative colitis through osteopathic eyes, inflammation is the immune system’s tool for repairing damage and should disappear when the damage is healed.

Inflammation over a long period of time can thicken the intestinal tract due to scar tissue that forms during inflammation. This creates strips of fibrous tissue that bind the tissues of the organs together, which can lead to the organs not moving optimally. This can cause ischemia (lack of oxygen supply), accumulation of waste products, and in the worst case, intestinal obstruction (blockage of the intestine, so that the intestinal contents cannot pass).

These conditions can inhibit digestion, cause abdominal pain and pain in the musculoskeletal system, typically the back and pelvis. Osteopathic treatment aims to improve the mobility of the organs and create good nerve and blood supply to the area.

Crohn’s disease and ulcerative colitis and heredity

Heredity plays a major role in the development of Crohn’s disease and ulcerative colitis. A family history of inflammatory bowel disease is the most important factor in being at increased risk of developing Crohn’s disease or ulcerative colitis.
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Crohn’s disease, ulcerative colitis and work

Our work has a major impact on chronic inflammatory bowel diseases. The digestive system is controlled by a superior system, namely the autonomic nervous system (ANS).

This system is divided into the sympathetic, which is our natural stress system, and the parasympathetic, which is our natural relaxation system.

Both systems are always active at the same time, but different situations can cause the amount of one system to increase/decrease. In a stressful situation, the amount of sympathetic will increase and parasympathetic will decrease.

When the sympathetic nervous system is most active, we need to use the body’s blood in our arms, legs, and head to cope with the challenges we are currently facing. When the parasympathetic nervous system is most active, the blood vessels to the digestive system dilate so that we can absorb the nutrients we have consumed.

Our digestion is most active when we are relaxed and at ease.

Stress and sedentary work

If you live a life with a stressful job, the body will tend to be in the sympathetic nervous system a lot, which over time can reduce blood flow to the digestive system, further straining the system.

It is therefore important to be able to stimulate the parasympathetic nervous system when you have time off.

​Sedentary work can also negatively affect the gastrointestinal system. This is because the digestive system relies on our breathing as a motor for intestinal peristalsis.

Our diaphragm moves up and down when we breathe. This rhythmic movement triggers the peristaltic movements of the intestines, which helps keep the digestive system moving.

Sedentary work can make it difficult to breathe deeply into the stomach due to the working position, which can make the digestive system stiff, slowing down digestion and thus also visits to the toilet.

Autoimmune disease, Crohn’s disease and ulcerative colitis

Crohn’s disease and Ulcerative Colitis are two of the so-called autoimmune diseases. An autoimmune disease is a disease that arises when the body’s own immune system mistakenly considers the body’s healthy tissue dangerous and attacks it.

When the immune system attacks the body, the immune system’s B cells make antibodies that recognize antigens in the body’s own tissues, proteins, or DNA and attack them. Recent research shows that the immune system’s attack on its own body only increases in strength over time.

Source: Videnskab.dk

Crohn’s disease, ulcerative colitis and stoma

Ulcerative colitis is the most common cause of permanent stoma placement. Patients who do not have sufficient effect from their treatment can have their colon removed and an iliostomy placed, which makes them healthy.

​In Crohn’s disease, a stoma can serve as an emergency solution during periods when the disease flares up and medical treatment is not effective enough. The stoma can then be closed again when the digestive system calms down again.

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Crohn’s disease and ulcerative colitis and elevated liver function tests

The body’s digestive system consists of various organs. The intestines themselves break down the food we eat and absorb it into the blood and then to the liver.

The liver stores the nutrients and energy we get from our diet. The liver must clean the blood before it runs up to the heart to be pumped around the body again.

Chronic inflammatory bowel disease will put more work on the liver, leading to elevated liver function tests, which are an indication of liver function. The liver is involved in many tasks that keep the body’s internal environment in balance. If this is disrupted, it can cause many different symptoms throughout the body, including problems with the skin and our joints. including problems with the skin and our joints.

Ulcerative colitis, Crohn’s disease and alcohol

As written above, the liver is strained when there is an inflammatory condition in the intestines. The symptoms that you may have with Crohn’s and colitis depend on whether the liver can compensate for the lack of function of the intestines. The liver cleans our blood, and after consuming alcohol, it is especially the left lobe of the liver that must break down the alcohol. An increased strain on the liver when consuming alcohol can therefore worsen the body’s condition and thus the symptoms that have arisen in connection with Crohn’s and colitis. It is therefore recommended for patients with chronic inflammatory bowel diseases to limit their alcohol intake.

Crohn’s Disease and Ulcerative Colitis Treatment

Both Crohn’s disease and ulcerative colitis are chronic conditions that cannot be cured by diet, medication, or osteopathic treatment. The goal is to improve the function of the digestive system as much as possible to reduce the patient’s symptoms.

​As mentioned earlier, over time, inflammation can form fibrous tissue that binds organs together. Ideally, organs should be able to slide up and down without resistance, but this is not possible if the organs are stuck together. This reduces the peristalsis of the intestines, which reduces intestinal function.

What can you do yourself? Good advice

There are several things you can do yourself to improve the condition of your digestive system.

• • Deep breathing where the lower part of the stomach (near the navel) bulges out when we breathe in. Try to avoid only the upper part of the chest moving when you breathe. You can do 15 deep breaths 5 times a day to stimulate the movement of the organs.

• • Create good mobility around the chest, so that the blood from the gastrointestinal system has free passage up towards first the liver and then the heart. This can be done by lying on your back on a yoga ball, with the back of your head resting on the ball and your arms out to the sides, so that it stretches the chest. This position should be held between 30-120 seconds, 1-2 times daily.

• • Our psychological system has a lot to say. It is important that you can limit your stressful everyday life and work, so that you limit the sympathetic nervous system at times and instead stimulate the parasympathetic nervous system. Here our emotions are of great importance. Feelings such as happiness, desire, love, motivation, etc. stimulate certain hormonal production, such as oxytocin, dopamine, serotonin, etc. These hormones have a positive effect on the rest of the hormonal system, as well as many of the body’s chemical processes. Being happy, positive and satisfied thus stimulates the body’s parasympathetic nervous system, which optimizes healing and improves the functioning of the digestive system.

• • Regular exercise is important to create the best conditions for the liver. Cardio training of at least 30 minutes duration provides good conditions for the liver, which is the purification station for the digestive system.

The role of diet and Crohn’s disease

Diet plays a role in the condition of the gastrointestinal system.

You can try limiting the following things for a period of time to see if it has an impact on your digestion.

• An anti-inflammatory diet can reduce inflammation in the body. For some people, dairy products can be difficult to digest. If this is the case, you can limit the amount of these.
• Refined sugar can increase inflammation in the intestinal tract.
• Gluten in many cases shows increased inflammation in the gastrointestinal system.
• Beef and other red meat can be difficult to break down if you have a weak gastrointestinal system.
• Things you can try instead are dietary supplements or diets that increase the good gastrointestinal bacteria, which gives a stronger gastrointestinal system. This includes the dietary supplement L-glutamine, which can give a stronger intestinal mucosa and thereby help repair damage from the inflammation.

What is Crohn’s disease?

Crohn’s disease is a chronic inflammatory condition (chronic intestinal inflammation) of the gastrointestinal system.

Crohn’s can affect any part of the digestive system, meaning it can be anywhere from the stomach to the rectum, but is typically seen in the lower right part of the abdomen, where the small intestine and large intestine meet. This area is called the iliocecal valve.

The gastrointestinal system consists of various parts, namely the mouth, esophagus, stomach, duodenum, small intestine, large intestine and rectum.

In Crohn’s disease, the inflammation affects segmentally, which means that parts of the intestinal system with inflammation are adjacent to healthy parts of the system that are not affected by inflammation. This means that only parts of the gastrointestinal system are affected by Crohn’s disease. The symptoms can therefore vary from person to person, depending on where the disease is located and how bad the condition is.

Crohn’s Disease Symptoms

The most common symptoms of Crohn’s disease are abdominal pain, bloating, digestive problems, fever and weight loss. The abdominal pain and bloating can be located throughout the abdomen. Digestive problems typically manifest as frequent visits to the toilet – 3-6 times a day with a thin stomach or diarrhea, which can lead to weight loss. If the colon is inflamed, there may be bloody stools.

In Crohn’s disease, inflammatory conditions tend to break through the intestinal wall itself, which can cause fistulas and abscesses.

​Many patients also experience back or pelvic pain, which is referred from the organ system. The explanation for this is that we do not have pain receptors in our organs – these are largely located in our muscles. An organ that is not feeling well, e.g. ischemia (lack of oxygen supply), scar tissue or inflammation, will send signals to its neurological area to the back, and will thereby increase the sensitivity of bones, ligaments, muscles and increase the tension of the muscles in the area. This means that a chronic inflammatory condition in the intestinal system will make us more prone to back pain. Due to the structure of the nervous system, our different organs therefore have different parts of the back to which they can send pain signals.

For example, the liver can cause pain and tension between the shoulder blades on the right side, while the colon can cause pain in the lower back.

Causes of Crohn’s disease

The cause of the disease is unknown. Hereditary factors likely play a role, as your risk of developing the disease increases by 30 times if your brother or sister has the disease.​

How does Crohn’s disease develop?

• The disease can debut in all age groups, but typically between the ages of 15-30.
• Crohn’s disease often has a variable course. The disease causes no symptoms for long periods, but in most people it will cause periodic attacks with symptoms.
• If you have the disease as a child, you typically have a more severe course than if you get the disease as an adult.
• Over 50% of people with the disease will need surgery in the gastrointestinal system at some point in their lives. Surgery is indicated if there are strictures in the gastrointestinal tract that make it difficult for the free passage of gastrointestinal contents.

How is Crohn’s disease diagnosed?

The diagnosis is made by your doctor. Various examination methods are used for this – including blood tests, stool tests and endoscopic examination of the intestine.

Osteopathic approach to Crohn’s disease

As an osteopath, you examine the motility of the intestines from a manual point of view – with your hands you feel for stiffness and tension in the abdomen, the mobility of the chest, back and pelvis.

By knowing the anatomy of the abdomen and how it can affect the rest of the body, it is possible to improve the organs’ starting point for functioning better.

This is done through mobilization techniques for the organs and their attachment points to surrounding structures. In addition, it is important to optimize the blood supply to the organs.

This is done, among other things, through the treatment of the chest, to improve venous return from the organs, create good mobility in the diaphragm, which is the pump for the movement of the digestive system, release tension around the liver and kidneys, and treat the peritoneal mesenteries, which are a kind of bag that the intestines are located in, so that blood can more easily get to and from the organs.

​The nerve supply must also be optimized.

​The nerve supply must also be optimized. The organ system is generally controlled by the parasympathetic nervous system. This is represented in 2 places in the body – the vagus nerve that comes from the upper area of the cranial border and the sacrum (S2-S4). If these are either locked or tense, e.g. after a trauma or bad posture, these can be treated to stimulate the digestive system to function optimally.

Ulcerative colitis symptoms

The main symptoms of ulcerative colitis are bloody stools and diarrhea, which may contain mucus. You may experience bloating, malaise, and a feeling of being sick.

The disease does not necessarily cause abdominal pain in the same way as Crohn’s disease. One of the tasks of the large intestine is to drain the gastrointestinal contents that come from the small intestine before it is excreted as feces.

The contents of the stomach are liquid when they reach the colon. An inflamed colon will have difficulty performing its task optimally, which often results in diarrhea with blood in it.

​Many patients also experience back or pelvic pain, which is referred from the organ system. The explanation for this is that we do not have pain receptors in our organs – these are largely located in our muscles. An organ that is not feeling well, e.g. ischemia (lack of oxygen supply), scar tissue or inflammation, will send signals to its neurological area to the back, and will thereby increase the sensitivity of bones, ligaments, muscles and increase the tone of the muscles in the area. This means that a chronic inflammatory condition in the intestinal system will make us more prone to back pain. Due to the structure of the nervous system, our different organs therefore have different parts of the back to which they can send pain signals.

Due to its neurological connection, the large intestine will cause pain in the lower back, typically on one side.

Why do people get ulcerative colitis?

The cause of the disease is unknown, but there is much evidence that hereditary and environmental, as well as genetic factors, play a role. The body’s psychological balance is something that affects the condition of the gastrointestinal system, but cannot be attributed as a cause. Food sensitivities also play no role in the cause of the disease, but can worsen the inflammatory condition.

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How is Ulcerative Colitis diagnosed?

​The diagnosis is made by your doctor, who will perform a blood test and a colonoscopy. Symptoms such as repeated blood in the stool, diarrhea and malaise may lead to suspicion of the disease.

Osteopathic approach for ulcerative colitis

The treatment involves the same components as Crohn’s disease.

Osteopathic treatment is aimed at regaining as much normal mobility of the organs as possible. In addition, the blood and nerve supply to the organs must be optimized. This is done, among other things, via treatment of the neck to stimulate the vagus nerve. With osteopathy, you can treat the chest and diaphragm to improve venous return from digestion.

Without optimal blood flow, waste products can accumulate around the digestive tract, which can lead to inflammation and bloating. With osteopathy, you can mobilize the organs through their attachment points, so that the organs can slide optimally between each other again.

We cannot eliminate diseases like Crohn’s, but we can reduce the symptoms and attacks by reducing the inflammatory state.