You're right; all the commonly used medications to treat Inflammatory Bowel Disease (IBD) are known to have different side effects (such as mesalamine which can cause abdominal pain and headache and sulfasalazine may cause infertility in men). Fortunately, you may be able to improve your condition with minimal use of these medications or even no medication if you are willing to make changes to your diet and lifestyle. Increasing evidence suggests that animal protein may both cause and worsen IBD, and that replacing animal protein with plant protein may help significantly. Also, increasing fiber intake and avoiding hydrogenated oils have been found to have beneficial effects.
Steroids may be the best option when IBD gets out of control (also known as flares). Steroid courses may be used for short time--from a few days to a few weeks. However, in some difficult cases, long term use of steroid pills may be necessary. These medications can have serious side effects, so your concern is understandable. The key to minimizing the side effects from steroids is to not to need them in the first place, so I recommend that you focus on prevention of flares through regular exercise and a whole food plant-based diet high in fiber. For more tips, please see the "What You Can Do About IBD" section toward the bottom of this page.
I would like to share with you a simple analogy. Imagine a country ravaged by a civil war--unfortunately not so uncommon in many parts of the world. The distressed leader of the country has just appointed a new commander, who is expected to suppress the internal strife. That means he has to turn his army against his own people for the greater good. However, since there are limited resources at his disposal he is forced to leave his international borders weaker and vulnerable to attack for his enemies. It is a similar effect that these immune suppressing medications have on our body's defenses when we take them to stop a flare. We are therefore more vulnerable to external threats like common viruses and bacteria that can cause diseases ranging from a simple flu to serious bacterial or fungal infections in the blood.
So the key is to discuss with your doctor whether the benefits of immune suppressive medication outweigh the risks.
Unfortunately, as the disease worsens, and when medical therapy is not sufficient to control the disease (in 25-50% of the patients) surgery to remove the colon becomes the only option. Again the way to minimize the need for surgery would be to make lifestyle changes like exercising regularly and adopting a whole food plant-based diet to prevent the progression of the disease. See the "What I Can Do" section toward the bottom of this page for more non-medical strategies for treating IBD.
That's right, the more stressed out you are, the more likely you'll suffer a flare which in turn may make you feel even more stressed! The key is to break this vicious cycle as early as possible. While your physician's focus is on medication, your focus needs to be stress prevention and management. Many patients find yoga, meditation and/or psychotherapy sessions to be helpful, especially when things are getting out of hand. Establishing real connections with other patients and sharing your experience can also provide a big boost in morale. For additional resources check out the Crohn's and Colitis Foundation of America website for more information on community support that may be available to you. You should not fight this battle alone! There is power in numbers!
New research indicates that diet and lifestyle change can be effective in helping patients manage their Inflammatory Bowel Disease (IBD). These changes alone may be sufficient to manage IBD or they can also work in conjunction with medication.
- Substitute animal protein with plant protein--the more the better: there is increasing evidence that animal protein has both causative and provocative effect on Inflammatory Bowel Disease (IBD)
- Replace milk from cows, goats, etc. and other dairy products with soy or almond milk
- Stay away from fast foods options rich in hydrogenated oils and instead choose wholesome low fat plant based foods
- Increase your fiber intake by consuming an abundance of vegetables and fruits
- Avoid oral iron supplements but plant based foods rich in iron are fine
- Exercise! Physical activity has been shown to reduce the risk of flares
Here are a few other things to keep in mind:
- When switching to an exclusively plant-based diet you may need vitamin supplementation to avoid deficiencies of vitamins B6 and B12
- Increase green leafy veggies to 3 servings per day to prevent deficiency of vitamin K from IBD medication
- Take care of your emotional health! Connect with other IBD patients to learn what worked for them, find strength in their victories and learn from their mistakes