Fighting the fatigue, stress, and pain of Crohn’s disease with mind-body medicine techniques can bring more than just symptom relief — it can have a positive impact on how well you manage Crohn’s disease and your overall health in general.
People with Crohn’s disease and other inflammatory bowel diseases often have what medical experts call “psychophysiological vulnerability.” This means that stress, emotional health, and poor coping strategies can affect the progression of their disease as well as their overall quality of life — and the idea is backed up by research published in the journal Gastroenterology in 2013. Although medication and medical interventions are necessary for healing the physical symptoms of Crohn’s disease, ignoring the emotional and cognitive aspects that accompany the disease can be harmful too.
The Stress-Crohn’s Connection
Stress doesn’t cause Crohn’s disease, but it can trigger flares, which in turn make the disease harder to manage. A study in the journal Clinical Gastroenterology and Hepatology in 2012 confirmed the link between stress and gastrointestinal (GI) function, specifically between stress and reactivation of inflammation in the GI tract. Left unmanaged, stress negatively affects the course of inflammatory bowel disease, the study found.
One approach to manage this may be mind-body medicine, which can help resolve stress associated with having Crohn’s disease. By promoting emotional well-being and teaching you effective coping skills, the techniques of mind-body medicine may help you maintain a sense of control when flares occur.
“Mind-body medicine helps ease physical symptoms by identifying and treating underlying psychosocial stresses,” says David D. Clarke, MD, president of the Psychophysiologic Disorders Association and a clinical assistant professor of gastroenterology emeritus and assistant director at the Center for Ethics at Oregon Health & Science University. “The value of mind-body medicine as an essential component of traditional medicine has been recognized for ages. Unfortunately, over the last century, the growth of technology in health care has reduced recognition of the importance of psychosocial issues as a contributor to illness.”
However, with stress continuing to be a factor in most adults’ lives, Dr. Clarke says that the benefits of mind-body medicine are being re-explored by researchers, medical professionals, and individuals who are looking for ways to feel better.
Mind-Body Medicine Techniques for Crohn’s Disease
If you have Crohn’s disease and want to add a mind-body therapy to your treatment plan, consider these approaches:
- Psychotherapy. Talk it out. Multi-convergent therapy (MCT) is a form of psychotherapy that combines cognitive behavioral therapy with mindfulness meditation. A study published in the February 2014 issue of the Journal of Crohn’s & Colitis showed that MCT may be a useful tool for symptom management in people with inflammatory bowel disease or high stress levels.
- Deep breathing. Take a deep breath. Deep and slow breathing is a component of various relaxation techniques. But according to research published in the journal Cognitive and Behavioral Practice in 2013, even just breathing deeply and slowly on your own may help lessen abdominal pain.
- Yoga. Grab that mat. Yoga seems to enable changes in perception of and response to pain. A study in the Scandinavian Journal of Caring Sciences in 2011 explored the connection between pain management and yoga. Participants who completed an eight-week Hatha yoga program reported that the sensory aspects of pain didn’t change, but that they were less bothered by it and better able to control the extent to which pain interrupted their daily life.
- Hypnosis. Check your gut reaction. Gut-directed hypnotherapy might improve quality of life and your ability to cope with having a chronic disease, although research on this is limited. A study published in the journal Biological Research for Nursing followed 43 people with inflammatory bowel disease who participated in gut-directed hypnotherapy through an outpatient clinic. Researchers concluded that the small study supported future clinical trials testing gut-directed hypnotherapy as a tool to prevent relapses in people with inflammatory bowel disease.
- Religion and spirituality. Lean on your faith. A study in the journal Pain Medicine in 2009 surveyed 580 chronic pain sufferers and reported that dependence on religion and spirituality was a beneficial coping process.
As you explore different mind-body approaches for managing Crohn’s disease, seek out practitioners who are familiar with the disease. For instance, a psychotherapist who understands the emotional impact of Crohn’s disease is probably well suited to help you process your thoughts and feelings. A yoga instructor or meditation coach with knowledge of the type of pain associated with Crohn’s disease may be better able to guide you as you learn these new skills.
Plus, the Crohn’s & Colitis Foundation of America has information on its website to help you find practitioners in your area.
Get Your Gut Back On Track!
An estimated 110,000 people consume antibiotics daily in Ireland, between December/March. (Source: Health Protection Surveillance Centre).
We asked Nutritional Therapist Rosanna Davison for her Top Tips to get your gut back on track after an illness.
1. Take time out
Don’t push yourself too quickly. Remember your body needs time to rebuild its reserves and regain strength.
Take more rest than usual. If you need to sleep longer, go to bed earlier.
Cut back on non-essential activities; they can wait until you are feeling 100%.
- Embrace fibre-rich foods full of protective nutrients
Fresh vegetables and fruits are rich in dietary fibre, vitamins and antioxidants. Try eating seven to nine portions over the course of each day. Choose different colours so that you nourish your body with a variety of phytonutrients.
Eat a portion of complete protein at each meal, such as poultry, fish, eggs, beans, pulses or tofu.
Consume essential omega-3 fatty acids daily. Avocados, seeds (flax, chia) and oily fish (mackerel, wild and organic salmon), are naturally rich in anti-inflammatory fats.
- Go ‘fermented’
Fermented foods are rich in ‘friendly’ bacteria. Sauerkraut is simple to make at home or buy kefir or kimchi in your local health store.
- Reduce or eliminate sugary foods
Processed foods often contain refined sugars to enhance taste. Excess refined sugar and processed foods may encourage the growth of ‘unfriendly’ bacteria, so aim to buy and eat fresh food.
If you have a sweet tooth, try eating berries (strawberries, blackberries, blueberries, raspberries). They are rich in antioxidants and naturally low in sugar.
If you need a sweetener, try Stevia which is extracted from plant leaves and doesn’t impact blood sugar levels.
Do vegans need to take supplements?
A varied, wholesome vegan diet provides almost all essential nutrients in sufficient quantities. I hear you shouting ‘Noooo! It provides absolutely everything we need!’ and you may be right, but only if you regularly eat certain fortified foods. The sad truth is that modern food production systems and lifestyles make it more difficult for everyone – vegans or not – to get all they need from diet alone. It doesn’t mean a vegan diet is unnatural or unhealthy, in fact the opposite is true. It means that how we grow, produce and consume food has changed and, with an ever-growing population, the demands on the systems that produce our food are so high that certain nutrients become harder to obtain.
I get a lot of questions about supplements and understand why people are confused. Over the years, I’ve worked on many vegan research projects and as science and population studies reveal ever more data, the guidelines and recommendations change and evolve. Hence, what we were told 10 years ago may no longer be up-to-date and that’s why different opinions arise, depending on where and when we got our information. It’s my job to keep up-to-date, so hopefully I can bring some clarity to the supplement discussion!
So what’s needed? The trio of nutrients to keep a close eye on are vitamin B12, vitamin D and iodine. You may not need to supplement with all these, all year long, but it depends on several factors. Read on…
Vitamin B12 naturally comes from bacteria in the soil and both people and animals would traditionally have got it from eating unwashed plants. However, we not only wash vegetables before we eat them (and for good reasons), but food production is now so sanitised that most vegetables are washed in chlorine, or other sterilising solutions, so there’s not a trace of B12 left.
People are not generally aware that most farmed animals are given B12 supplements and this is how the vitamin eventually ends up in their flesh. So, the argument that meat is a natural source of B12 doesn’t really stack up as meat-eaters essentially consume B12 supplements recycled by the animals that were given them!
It is absolutely necessary that we have a reliable source of vitamin B12 for our bodies. We need it to make red blood cells, for a healthy heart and circulation, and it’s essential for the nervous system. It takes years to develop a B12 deficiency, so on one hand, you don’t need to worry about not having taken B12 for a while. On the other hand, you do need to pay attention, as when symptoms develop, it’s usually serious.
To ensure adequate intake, you should have at least 5µg (micrograms) daily from supplements or fortified foods. The B12 used in both foods and supplements is produced commercially by growing bacterial cultures in large vats – and it’s always suitable for vegans.
There are two forms of B12 in supplements – cyanocobalamin (cheap) and methylcobalamin (expensive). Cyanocobalamin is the stable ‘inactive,’ form of B12 and is used in supplements and to fortify foods and drinks. Once ingested, it’s activated by your body so it can be used. Methylcobalamin is the ‘active’ form of vitamin B12 as it does not require any metabolic reactions to be activated. It costs more and is not so stable.
So which one to choose? Unless you’re a heavy smoker, have kidney failure or any other serious condition affecting your metabolism, cyanocobalamin – the cheap form of B12 – is perfectly fine. Intakes up to 2,000µg a day are safe and you can take either a lower dose daily or a higher dose a couple of times a week.
We need vitamin D for healthy bones, teeth and muscles and it also performs other essential functions in our metabolism. It is produced in the skin when exposed to sunlight and this is the main source of vitamin D for most people. However, if you always use sun-block, cover most of your skin or live in a country, like the UK, where we don’t get enough sunlight over the winter, you need a supplement, whether you’re vegan or not.
The UK Government now recommends that we all take a supplement from October to April and, if you protect your skin ferociously over the sunnier spring and summer months, you should take a supplement all year long. Otherwise, just 20 minutes of sunlight on the face and arms is all that is required by the body to manufacture sufficient vitamin D.
Fortified breakfast cereals, bread, plant milks and vegan margarines can be useful sources if exposure to sunlight is not practicable, but may not be enough. When it comes to supplements, there are two types and your body can use both, but it’s advisable to check the source – vitamin D2 is always vegan, but vitamin D3 can be of animal origin. Many vegan foods are fortified with vitamin D2 and labelled so, but if not specified, especially on cereal products, vitamin D tends to be of animal origin. If you choose to supplement your diet, there’s a range of quality and affordable vegan supplements with vitamin D2. There are also those made from algae or mushrooms that contain D3 and these are recommended if you need a higher dose. When deciding on your dosage, 10µg per day is enough and you shouldn’t go above 25µg.
Iodine has been a hot topic lately, especially with plenty of tabloid ‘experts’ warning that vegans are missing out. This mineral is necessary for thyroid function and helps to regulate how energy is produced and used in the body.
The amount of iodine in plants depends upon the iodine content of the soil in/on which they are grown. The closer to the sea, the more iodine and therefore vegans can get enough from plant foods, but there’s no guarantee. Seaweed, which of course grows in seawater, is always a good source and includes nori, laver, dulse and the kelp family (kombu, arame, wakame). But be warned – kelp absorbs far more than other seaweeds and you can get too much iodine from it. So, while seaweed consumption is encouraged, kelp should be used only sparingly.
It’s best to use a kelp supplement so you know exactly how much iodine you’re taking – it’s cheap, reliable and you don’t have to worry about taking too much. The recommended daily intake is 140µg and intakes up to 500µg are considered safe. In many countries, iodised salt is commonly used to ensure iodine intake, but it’s not the norm in the UK.
The dairy industry has been boasting about the iodine content of cow’s milk. What they don’t tell you is that it’s not a natural component of milk, but comes from iodinated cattle feed, supplements, iodophor medication, iodine-containing sterilisers of milking equipment, teat dips and udder washes. Cow’s milk is neither a natural nor the best source of iodine, so we can happily leave all that dairy out of our diet.
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