Inflammatory Bowel Disease: Crohn’s Disease & Ulcerative Colitis

Understanding Crohn’s Disease, Ulcerative Colitis, and Inflammatory Bowel Disease

Introduction: In today’s world, where lifestyle changes and dietary habits are constantly evolving, it’s essential to shed light on chronic diseases affecting the digestive system. Among them, Crohn’s disease, ulcerative colitis, and inflammatory bowel disease (IBD) are three major conditions that impact millions of individuals worldwide. In this section, we will explore the characteristics, symptoms, causes, and management of these conditions, providing a comprehensive understanding of these debilitating diseases.

  1. Crohn’s Disease: Crohn’s disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. It can develop anywhere from the mouth to the anus but is most commonly found in the small intestine and the beginning of the large intestine. The exact cause of Crohn’s disease is unknown, but it is believed to result from a combination of genetic, environmental, and immune system factors. Symptoms of Crohn’s disease include abdominal pain, diarrhea, weight loss, fatigue, and sometimes rectal bleeding. Complications can range from malnutrition to the formation of ulcers and strictures. Treatment involves a multidisciplinary approach, including medications to suppress the immune system, dietary modifications, and, in severe cases, surgical intervention.  Medical Hypnosis has also been shown to help patients with Crohn’s Disease.
  2. Ulcerative Colitis: Ulcerative colitis is another type of IBD that causes chronic inflammation and ulcers in the lining of the colon and rectum. Unlike Crohn’s disease, which can affect any part of the digestive tract, ulcerative colitis is limited to the colon and rectum. The exact cause remains unclear, but factors such as genetics, immune system dysfunction, and environmental triggers may contribute to its development. Symptoms of ulcerative colitis include abdominal pain, bloody diarrhea, urgency to have bowel movements, and fatigue. Treatment aims to reduce inflammation and manage symptoms, typically involving medications, lifestyle changes, and, in severe cases, surgical removal of the colon. Medical Hypnosis has also been shown to help patients with Ulcerative Colitis.
  3. Inflammatory Bowel Disease (IBD): Inflammatory bowel disease (IBD) is an umbrella term that encompasses both Crohn’s disease and ulcerative colitis. Despite having similarities, the two conditions have distinct differences in terms of affected areas, symptoms, and treatment approaches. Both conditions involve an abnormal response of the immune system, leading to chronic inflammation in the gastrointestinal tract. Common symptoms of IBD include abdominal pain, diarrhea, rectal bleeding, weight loss, and fatigue. The management of IBD aims to reduce inflammation, control symptoms, and improve the patient’s quality of life. This typically involves a combination of medications, dietary adjustments, stress management (this would include medical hypnosis and Cognitive Behavioral Therapy), and, when necessary, surgical intervention.

Interestingly, medical hypnosis and cognitive behavioral therapy (CBT) have been shown to improve these illnesses.

Hypnosis has been shown to decrease inflammation in the GI tract.

Furthermore, CBT has been shown to alter the gut microbiome. For more on this, click here.

When you think about it, it’s pretty remarkable that the power of the mind can change the course of biopsy-proven, medical diseases.

References:

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  1. Crohn’s and Colitis Foundation. (n.d.). Crohn’s Disease. Retrieved from https://www.crohnscolitisfoundation.org/what-is-crohns-disease
  2. Crohn’s and Colitis Foundation. (n.d.). Ulcerative Colitis. Retrieved from https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis
  3. Mayo Clinic. (2021). Crohn’s disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304
  4. Mayo Clinic. (2021). Ulcerative colitis. Retrieved from https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326
  5. National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Inflammatory Bowel Disease. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/inflammatory-bowel-disease
  6. Lee, Amanda∗; Moulton, Dedrick†; Mckernan, Lindsey‡; Russell, Alexandra∗; Slaughter, James C.§; Acra, Sari∗; Walker, Lynn||. Clinical Hypnosis in Pediatric Crohn’s Disease: A Randomized Controlled Pilot Study. Journal of Pediatric Gastroenterology and Nutrition 72(3):p e63-e70, March 2021. | DOI: 10.1097/MPG.0000000000002980

Treating Inflammatory Bowel Disease: Crohn’s Disease, and Ulcerative Colitis

Hypnosis as an adjunctive treatment for Inflammatory Bowel Disease and Crohn’s Disease 1,2

In patients with Ulcerative Colitis (UC), Crohn’s Disease and Inflammatory Bowel Disease (IBD), studies indicate that hypnosis can:

  • Decrease use of steroids
  • Decrease inflammation2
  • Decrease disease severity as demonstrated by 57% fewer office visits and emergency room visits.
  • Decrease school absences.3

In addition, hypnosis can help treat the associated features of inflammatory bowel disease (IBD), including positively influencing coping behaviors, reducing stress, facilitating sleep, modulating depression and/or anxiety, and contributing positively to overall wellness.4

Medical hypnosis and cognitive behavioral therapy (CBT) have been shown to be effective in treating irritable bowel syndrome (IBS) and functional abdominal pain (FAP), both of which, of course, are considered to be functional disorders.4  Functional disorders are those in which all tests, including biopsies, are negative.  

Functional GastroIntestinal Disorders, also known as FGIDs, are those in which all tests, including biopsies, are negative. The new term for FGID’s is Disorders of Gut-Brain Interaction, or DGBI.

In contrast, organic diseases have changes in the cells or tissues of a body part.

Of course, there is a strong mind-body connection, particularly when it comes to our gastrointestinal system. When we feel unwell physically, it affects us emotionally, and vice versa.

So that any illness causes physical, emotional, biological, and social changes!

Many patients with organic disease also have functional symptoms. For example, a patient with ulcerative colitis that is in remission may still experience abdominal pain, even when the biopsies and blood tests are normal.

What’s exciting is the efficacy of behavioral therapy in the treatment of biopsy-proven organic disease! I find this absolutely remarkable!  That the power of the mind can actually change the course of a biopsy-proven medical disease is astounding!

References:

1.    Keefer, L., J. L. Kiebles, Z. Martinovich, E. Cohen, A. Van Denburg, and T. A. Barrett. 2011. Behavioral interventions may prolong remission in patients with inflammatory bowel disease. Behav Res Ther 49:145-150.

2.    Mawdsley, J. E., D. G. Jenkins, M. G. Macey, L. Langmead, and D. S. Rampton. 2008. The effect of hypnosis on systemic and rectal mucosal measures of inflammation in ulcerative colitis. Am J Gastroenterol 103:1460-1469.

3.  Lee A, et al.  (2020) Clinical Hypnosis in Pediatric Crohn’s Disease:  A Randomized Controlled Pilot Study. JPGN Nov. 3, 2020

4.    Keefer, L. 2013. Presentation at American Society of Clinical Hypnosis Annual Scientific Meeting.