Chronic inflammatory bowel disease (IBD) is a complex condition with various potential causes, ranging from genetic factors to environmental influences and lifestyle choices. While conventional treatments focus on managing symptoms, holistic approaches aim to address the underlying causes, offering long-term relief and potentially even recovery. This article explores the possible contributors to IBD, emphasizing the importance of identifying and eliminating triggers to promote healing, rather than merely suppressing symptoms. By understanding these factors, patients can take informed steps toward improving their gut health and overall well-being.

Possible causes of chronic inflammatory bowel disease

Holistic measures can often alleviate the symptoms of chronic inflammatory bowel disease (IBD) and prolong the symptom-free phases, so they should always be used as an adjunct. In some cases, IBD patients have been permanently symptom-free with naturopathic measures.

In order to find the right individual solution, it is important to look at the possible causes of chronic inflammatory bowel disease. This is because holistic healing is best achieved by eliminating causes and not by suppressing or treating symptoms. As with many diseases, there is still official speculation about the causes of intestinal inflammations in the IBD group. It is likely that each affected person has an individual combination of different causes, which together lead to the outbreak of the disease.

Genetic Makeup of IBD

Genetics play a role in IBD, with children of affected parents being more likely to develop the condition. However, genetic factors contribute only 8–13% to the disease, and even identical twins may not both develop IBD (1). Environmental, lifestyle, and dietary factors are primarily responsible for IBD, which is viewed as a disease of civilization.

Intestinal Flora Disorder as a Cause of IBD

IBD is associated with disrupted intestinal flora that damages the intestinal wall and impairs barrier function, triggering abnormal immune responses. This disruption is a consequence of modern lifestyles rather than a direct cause of IBD, with factors like diet significantly promoting conditions like Crohn’s disease and ulcerative colitis.

Psychosocial Factors in IBD

The gut-brain axis connects the digestive system and brain (2), allowing mental stress to impact gut health and vice versa. Long underestimated, psychosocial factors can increase the risk of IBD flare-ups. Stress from IBD symptoms can lead to anxiety, shame, and fear, creating a vicious cycle that patients can mitigate through relaxation techniques, support groups, and psychotherapy.

Antibiotics: Risk Factor for Intestinal Inflammation (IBD)

Antibiotics are a risk factor for IBD, altering gut flora and damaging the intestinal mucosa. While not everyone with a “leaky gut” develops IBD, those with a genetic predisposition may. A 2020 study showed that early childhood antibiotic use increased IBD risk by 88% (3). Additional studies indicate a combined effect with high-fat diets, worsening the risk of intestinal diseases.

Mercury Promotes Chronic Inflammatory Bowel Diseases

Mercury exposure, particularly from dental fillings, is linked to autoimmune diseases and can increase IBD flare-up risks. Avoid amalgam fillings and reduce mercury exposure if you have or are at risk for IBD.

Plasticizers Worsen IBD

Research from 2018 indicated that plasticizers negatively affect gut flora and worsen chronic inflammatory processes, contributing to IBD.

Vitamin D Deficiency in Chronic Inflammatory Bowel Diseases

Vitamin D deficiency is a significant risk factor for IBD, with limited dietary sources and insufficient sunlight exposure leading to deficiencies, especially in winter. Low vitamin D levels correlate with more severe IBD symptoms, and supplementation is crucial for prevention and management (4).

Vitamin C Deficiency in Chronic Inflammatory Bowel Diseases

Vitamin C acts as an antioxidant and anti-inflammatory agent, with studies showing it reduces inflammation in IBD. IBD patients often have a deficiency, leading to various health issues. Supplementation may help restore immune balance and improve symptoms.

Correcting Nutrient Deficiencies in Chronic Inflammatory Bowel Diseases

Chronic IBD can stem from various nutrient deficiencies, necessitating regular monitoring of vitamin and mineral levels. Patients should address deficiencies through dietary supplements to support overall health and disease management.

Natural Measures for IBD

The above possible causes already provide the first measures for alleviating intestinal inflammations from the IBD group, namely:

• Good stress management
• Avoid things that can harm the intestinal flora or intestinal mucosa (unhealthy diet, such as fried foods (e.g. fish fingers ), white flour products, alcohol, sweets, smoking, antibiotics, etc.)
• Avoid plasticizers
• Take vitamin C and vitamin D as needed
• Check and correct nutrient deficiencies
• Have possible mercury contamination checked and, if necessary, remove mercury (or other heavy metals) and consult a dentist (in the case of amalgam fillings) and/or environmental physician.

In addition, the following measures can be implemented:

Curcumin in chronic inflammatory bowel diseases

Turmeric, or the active ingredient from the yellow root called curcumin, is a well-known anti-inflammatory substance that can accompany the treatment of almost any chronic inflammatory disease, including the treatment of chronic inflammatory bowel diseases.

Curcumin alleviates the inflammatory processes in the mucous membrane of the digestive system, supports the healing of the intestinal barrier, and in some cases, leads to a more favorable course of the disease overall—not least because curcumin also has a regulating effect on the immune system and can thus inhibit overactive reactions of the immune system.

Even though IBD is no longer considered an autoimmune disease, characteristics reminiscent of autoimmune diseases can be observed, such as the TH1-TH2 imbalance. In the case of IBD, TH1 cells, certain pro-inflammatory cells of the immune system, predominate. In rat studies (30 mg curcumin per kilogram of body weight), curcumin was able to promote the formation of TH2 cells and inhibit the formation of TH1 cells (12).

Curcumin has also shown positive effects in human studies: In a small study from 2005, for example, participants suffering from ulcerative colitis experienced an improvement in their flare-ups over the course of two months after taking 1,100 mg of curcumin daily in the first month and 1,650 mg of curcumin in the second month (13).

In another study (2006), 89 IBD patients with ulcerative colitis received 2,000 mg of curcumin daily (in addition to treatment with sulfasalazine). Compared to the placebo group, the curcumin group fared better (14).

In May 2020, a study was published in Phytotherapy Research in which 70 ulcerative colitis patients were prescribed 1,500 mg of curcumin or a placebo daily for 8 weeks – in addition to conventional medication. Significant improvements were observed in the curcumin group compared to the placebo group (25).

Curcumin significantly reduced the inflammatory marker hs-CRP and also the erythrocyte sedimentation rate.

If you cannot tolerate curcumin, it could be because it often contains piperine (an active ingredient in black pepper), which further irritates the already irritated intestinal mucosa. In this case, try curcumin without piperine.

Resveratrol for IBD

Resveratrol could also be helpful in IBD. It is a powerful antioxidant and anti-inflammatory plant substance that is found in blue grapes and red wine, for example. In 2010, mice were shown to not only improve intestinal inflammation, but also reduce the risk of colon cancer. Without resveratrol, 80 percent of the mice developed colon cancer in the long term due to their intestinal inflammation, while with resveratrol, the figure was only 20 percent (17).

Five years later, a study was published with 50 human patients suffering from ulcerative colitis. They were given a capsule containing 500 mg of resveratrol or a placebo daily. After six weeks, taking resveratrol led to a significant reduction in inflammation levels (CRP and TNF-α), which significantly improved the quality of life of the IBD patients. Nothing of the sort was seen in the placebo group (26).

In 2019, Brazilian researchers published a review on the effects of resveratrol on inflammatory bowel disease. They summarized:

“Oxidative stress damages the intestinal barrier and increases its permeability, which can lead to chronic inflammatory bowel disease. The body’s own antioxidant defense systems can usually counteract oxidative stress by fighting the damaging free radicals or preventing their formation. Resveratrol is suitable for the treatment of chronic inflammatory bowel disease because it reduces the formation of these free radicals and at the same time promotes the formation of the body’s own antioxidant enzymes. In addition, resveratrol can inhibit pro-inflammatory messengers (e.g., TNF-α and interleukins). We can therefore recommend resveratrol as an adjunct to the treatment of IBD, especially since it is inexpensive and effective and has no side effects” (27).

OPC for chronic inflammatory bowel diseases

Grape seed extract is also suitable for IBD. It contains the antioxidant and anti-inflammatory active ingredient complex OPC (oligomeric proanthocyanidins), which belongs to the group of polyphenols and is particularly known for its positive effects on the skin, hair and connective tissue (and thus also on the blood vessels).

However, if a substance has an antioxidant and anti-inflammatory effect, it usually does so not only locally, but throughout the body, including the intestine. An initial study from 2015 found that OPC in an amount of 0.1 percent of the daily ration in mice reduced the TNF-α level after 12 weeks, reduced the permeability of the intestinal barrier, and promoted the regeneration of the intestinal mucosa (28).

In January 2020, Spanish researchers in the journal Nutrients described clinical studies with OPC in addition to cell, in vitro and animal studies. The introduction in the “Clinical Trials” section already states: “According to available evidence of its effects in humans, taking OPC can be a promising and safe addition to current therapeutic procedures for IBD.” (30)

Grape seed extract is considered safe in humans up to 2.5 g per day, as shown by a four-week study on healthy adults.

One of the OPC studies was carried out on children who suffered from Crohn’s disease and were in remission. They received 2 mg of OPC per kilogram of body weight in the form of Pycnogenol ^® (OPC-rich pine bark) for 10 weeks. Although OPC was unable to influence the increased inflammatory markers CRP and calprotectin or the disease activity at this dosage, it was able to increase the activity of the body’s own antioxidant enzymes SOD and glutathione peroxidase and reduce some markers of oxidative stress.

OPC is certainly not a sole remedy for chronic inflammatory diseases, but due to its specific properties it can be very well integrated into a holistic concept for treating them.

Probiotics for IBD

In inflammatory bowel disease, there is undoubtedly a severe disruption of the intestinal flora. In 2017, for example, we reported on a study that showed that the intestinal flora of Crohn’s disease patients was overpopulated with two specific harmful bacterial strains and an intestinal fungus.

However, recommendations for the blanket use of probiotics (beneficial bacterial strains that also occur in a healthy intestinal flora) to regulate these disorders are not possible in IBD, as there are many different probiotic preparations with very different compositions, and each bacterial strain or combination of bacteria can have a completely different effect – possibly depending on the current condition of the IBD patient and that of his or her current intestinal flora.

As early as 1999, a randomized double-blind study was published in the renowned journal Lancet , in which 120 IBD patients with ulcerative colitis received the probiotic Mutaflor or 800 mg of mesalazine three times a day. Mutaflor contains a special variant of Escherichia coli, the E. coli strain Nissle 1917.

The effect of both drugs was almost identical: 75 percent of IBD patients who took mesalazine were able to achieve remission (the disease stopped progressing) (after an average of 44 days), compared to 68 percent in the Mutaflor group. Within 204 to 221 days, 73 percent of participants in the mesalazine group experienced a relapse (relapse/flare-up), compared to only 67 percent in the Mutaflor group (16).

However, it must be noted that the patients had received an antibiotic prior to treatment, which most likely initially almost wiped out the previously existing intestinal flora.

Psyllium for chronic inflammatory bowel diseases

Psyllium (Plantago ovata) could be integrated into the treatment of IBD due to its properties. Psyllium in particular provides soluble fiber, which can have a positive effect on both diarrhea and constipation. Not only does it bind water in the case of diarrhea and reduce the irritation of the (in some cases acidic) stool on the intestinal mucosa, but the use of psyllium can also protect the vulnerable and bleeding intestinal mucosa in the case of temporarily hard stools and thus promote healing.

In a small Japanese study from 2007, Crohn’s patients (with the main symptoms of diarrhea and abdominal pain) took probiotics and prebiotics for an average of 1 year (34). Probiotics are preparations containing live intestinal bacteria, while prebiotics are special fiber (e.g. psyllium) which, in addition to the properties listed above on the intestinal mucosa, also serve as food for the probiotics so that they can settle in the intestine.

These were IBD patients for whom the usual medications (aminosalicylates and cortisone) were not effective. They received 9.9 g of psyllium husk powder and a probiotic with 75 billion colony-forming bacteria (CFU) (mainly bifidobacteria and lactobacilli) every day. However, the patients were allowed to adjust the dose of the preparations according to their condition in order to find the right dosage and combination for each individual.

The majority of IBD patients experienced significant improvement in symptoms. More than half achieved complete remission, which had not previously been possible with the medication. No side effects were observed.

To our knowledge, there are no extensive studies on the specific effects of psyllium on chronic inflammatory bowel disease, but there are studies on the effects of psyllium on general health and intestinal health, as you can read in the previous links.

Psyllium is generally taken in the form of psyllium husk powder with plenty of water, ideally on an empty stomach 30 to 60 minutes before a meal. Stir ½ to 1 level teaspoon of psyllium husk powder into 100 ml of water and drink immediately, otherwise it will become thick like pudding. Then immediately drink 200 to 300 ml of water.

Zeolite for IBD

Zeolite is a mineral clay with a detoxifying, regenerating, and intestinal flora-friendly effect and could therefore be used as a supportive measure in IBD. Zeolite plays an important role in naturopathy as a home remedy for intestinal cleansing . Read the extensive information on zeolite and its properties here. Due to the porous structure of the tiny zeolite crystals, the mineral clay also absorbs excess water and is therefore effective against diarrhea.

A study by the Medical University of Graz in 2015 (35) shows that (in healthy subjects) 1.85 g of zeolite per day after 12 weeks was able to improve the permeability of the intestinal barrier and had a slight anti-inflammatory effect. Studies on mice showed (e.g. 2017 (36)) that zeolite can improve intestinal inflammation.

Nevertheless, studies on the use of zeolite in people with chronic inflammatory bowel disease are few and far between. In June 2020, Italian researchers published a study (37) with 20 IBD patients. Each patient received 6 g of zeolite daily for 56 days and was scientifically monitored for two months after stopping taking zeolite. Most of the IBD patients experienced an improvement in their symptoms, and their calprotectin levels in their stool also fell significantly at the end of the study, indicating a reduced level of inflammation.

*Here you can find zeolite powder

Frankincense for IBD

Indian frankincense (Boswellia serrata) is very well known and its active ingredient is often used in the treatment of chronic inflammatory diseases (IBD), including rheumatism. African frankincense (Boswellia carterii) apparently contains a particularly strong anti-inflammatory boswellic acid, which even exceeds the effect of Indian frankincense. It inhibits the pro-inflammatory activities of TNF-α (tumor necrosis factor, see above).

Cannabis for chronic inflammatory bowel diseases

There is now a lot of evidence (experience reports and studies) that confirms that medical cannabis is effective in treating IBD (9)(10). It is important to note that cannabis products that only contain CBD are not as effective. The cannabis product you choose should therefore also contain THC and is therefore prescription-only.

The relevant studies also noted (9 , 10) that although cannabis alleviates symptoms and thus significantly improves quality of life, it does not appear to cure the disease itself. However, if the symptoms improve, e.g. diarrhea and bleeding subside, then the organism can recover enormously from the typical accompanying illnesses that have resulted from blood loss, lack of appetite, and nutritional deficiencies, and from not being able to leave the house at all, hardly being able to exercise and no longer being able to enjoy a social life.

Many cannabis users can also reduce the doses of the medications they previously used, which in turn reduces the risk of side effects from these medications.

Requirements for Cannabis on Prescription

However, there are various requirements to obtain cannabis on prescription:

• You must be suffering from a serious illness, e.g. cancer, epilepsy, migraine, cannabis , a severe case of chronic inflammatory bowel disease, etc.
• You must have already exhausted all medication treatment options, meaning you have already tried various medications that had no effect on you.
• Find a doctor who is very familiar with cannabis and will be willing to prescribe you cannabis. In addition, your doctor must declare that he will accompany you during cannabis therapy.

But keep in mind that cannabis can also cause side effects when used frequently, such as chronic bronchitis, forgetfulness, depression, anxiety, increased addiction potential that can also be transferred to other addictive substances, increased risk of road accidents and abnormal brain development (in younger people) (11).

The rule here is that the benefit-risk ratio must be weighed up individually for each IBD patient to determine which medication is ideal for which patient.

Modern nutrition promotes IBD

As with many widespread diseases that have only become established in western, proper industrial nations in the last 30 to 40 years, nutritional factors also play a crucial role in the development, maintenance, and worsening of chronic inflammatory bowel diseases. Many modern foods lead to changes in the intestinal environment, which in the long term increases the risk of chronic inflammation and immunological reactions.

Studies have long pointed to the connections mentioned, including a study from May 2020, which showed that people who like to eat French fries, cookies, lemonade, sports drinks and energy drinks, as well as cheese, are more likely to suffer from IBD. Junk food is therefore by no means recommended for people with chronic inflammatory bowel disease.

People who love junk food are more likely to have IBD

A 2020 study found that, for example, the frequent consumption of fructose (fruit sugar) in sweets, dips, soft drinks, etc. can promote chronic inflammatory processes in the intestine and thus the development of chronic intestinal inflammation, which is certainly one of the reasons why fast food and convenience foods are so harmful ( 43 ).

Artificial food additives harm the intestines

One reason for the negative impact of industrially processed foods on the intestines could be the artificial additives they contain, many of which have been proven to damage the intestines and can thus promote chronic intestinal inflammation. It is known that many food additives can trigger allergic or pseudo-allergic symptoms (itching, skin rashes, runny nose) or intestinal problems. These include, for example, the following additives:

• Azo dyes (E 102, 103, 110, 122, 123, 124a, 128, 129, 151, 154, 155, 180) ( 31 )
• titanium dioxide (E 171)
• sulfites (E 221 – 228)
• tin chloride (E 512)
• ammonium salts (E 442)
• emulsifiers (E 491 – 495)
• alginates (E 400 – 404)
• Nitrites (= curing salt) (E 249, 250)
• Benzoic acid and its salts (benzoates) (E 210-219)
• boron compounds (E 284 and 285)
• emulsifying salts (E 339, 340, 341, 450, 451, 452)

The right diet for intestinal inflammation IBD

In the case of chronic inflammatory bowel disease, it is better to avoid the usual Western diet. As explained below, it is worthwhile for IBD patients to try gluten-free, dairy-free and plant-based diets:

Gluten-free diet alleviates symptoms of IBD

Gluten is a protein complex found in some types of grain (wheat, rye, spelt, barley, etc.). Many people are hypersensitive to gluten, which can manifest itself in various symptoms, including digestive problems.

In a 2014 study with 1,647 participants, almost 20 percent said they had already tried a gluten-free diet. Over 65 percent of these people experienced an improvement in their digestive problems. Almost 40 percent now had fewer attacks. If an attack did occur, it was less severe than with a gluten-containing diet.

Interestingly, only 5.5 percent of the participants had a diagnosis of gluten intolerance (celiac disease 0.6%, non-celiac gluten sensitivity 4.9%), which means that even people in whom such intolerance could not be proven can benefit from a gluten-free diet ( 32 ).

In a 2020 summary, researchers at the University of North Carolina wrote that one-third of IBD patients reported that they were intolerant to gluten. Many of the patients with chronic intestinal inflammation therefore practice a gluten-free diet. This is entirely understandable, especially since animal studies have shown that gluten promotes inflammatory processes in the intestine and increases the permeability of the intestinal barrier ( 33 ).

Dairy products can worsen intestinal inflammation

Dairy products can also worsen intestinal inflammation and IBD in the case of hypersensitivity/intolerance or contribute to their development. Milk has two components that can be problematic for the digestive system: lactose and milk protein. Many people are familiar with intolerance to lactose (milk sugar). This is called lactose intolerance. This usually results in diarrhea after consuming lactose-rich dairy products.

While lactose intolerance is relatively rare, many more people react sensitively to milk protein – usually unknowingly. Unknowingly because the symptoms do not appear immediately after consumption, but often only the next day and can develop slowly, making it difficult to recognize a connection.

Lactose intolerance is not an allergy but a food intolerance that often only manifests itself a few hours later or the next day in the form of digestive problems, headaches, or mucous in the airways. An increased susceptibility to respiratory diseases can also be observed here, e.g. frequent flu infections, sinus infections, nasal polyps, tonsillitis, asthma or similar.

It can also be worthwhile to try eliminating dairy products for many other chronic illnesses (e.g. osteoarthritis , arthritis, diabetes, Hashimoto, and many more) to see if you belong to the group of people who are milk intolerant. This is because the symptoms often improve significantly. There are (so far) no studies on these connections.

Naturopathic therapists often refer to people who are intolerant to milk protein as the so-called “lymphatic type” (usually people with blue eyes and slightly lighter, sensitive skin). It is therefore up to the individual whether they simply try a milk-free diet – especially if the symptoms do not improve.

While in the case of lactose intolerance it is sufficient to avoid dairy products containing lactose (those affected can consume lactose-free dairy products (lactose-free milk, long-matured cheese, butter), in the case of milk protein intolerance all dairy products are taboo (except butter).

Check histamine intolerance in case of IBD

Especially in cases of histamine intolerance, but also in many people who do not have such an explicit diagnosis, inflammatory bowel symptoms can be exacerbated by foods that contain histamine or promote histamine, such as some sausage and meat products, long-matured cheese, red wine, chocolate, kiwi, bananas, tomatoes, herring, sauerkraut, vinegar, and yeast extracts .

Therefore, if you have an IBD diagnosis, have your histamine intolerance checked.

Plant-based diet for intestinal inflammation (IBD)

A plant-based diet can prolong the intervals between attacks of Crohn’s disease.

While only 25 percent of normal eaters were free of flare-ups and symptoms after two years, almost all of the semi-vegetarians in this study were free of symptoms, namely 92 percent. Semi-vegetarian means that fish was allowed once a week and a portion of meat every two weeks.

Even nuts, which are generally considered difficult to digest, can be integrated into a flare-up-free diet for people with inflammatory bowel disease. In the summer of 2019, a study was published that showed that eating walnuts can help the intestines regenerate lesions that occur during the intestinal inflammation ulcerative colitis. To do this, the nuts are eaten during the remission phase, i.e. not during a flare-up (always chew thoroughly!!).

An interesting case report published in the journal Nutrients in 2019 confirms the healing effect of a plant-based diet on chronic inflammatory bowel disease. The IBD patient suffered from Crohn’s disease and had previously eaten meat, dairy products, white flour products, processed foods and only a small amount of fruit and vegetables every day. Medication only improved his condition slightly.

After changing his diet to mainly fruit, vegetables, whole grain products and legumes, he experienced a complete remission of his intestinal inflammation. The IBD patient was able to stop taking his medication and only experienced relapses when he returned to his old diet as an exception.

Low FODMAP in chronic inflammatory bowel diseases

A low FODMAP diet could also be tried for IBD, as a 2019 study found. With this diet, the 52 participants’ usual digestive symptoms of intestinal inflammation improved noticeably after four weeks, which was not observed in the placebo group. You can read exactly how the low FODMAP diet is practiced.

The diet for IBD should be tailored to the individual

How exactly the diet for intestinal inflammation from the IBD group needs to be put together depends on the individual affected, as each person has very different tolerances and intolerances. Unfortunately, a specific diet plan cannot be presented here. However, in addition to many other types of vegetables, try okra, which forms mucilage when cooked, which protects the gastrointestinal tract. Bone broth is also often recommended, which is said to be able to heal the intestinal mucosa due to the collagen it contains, but is not really an option for a plant-based diet.

Eat as naturally and nutrient-rich as possible

However, the basic rule for IBD is that a natural diet (free from industrially processed foods if possible), rich in vital substances and individually tolerated, can calm the immune system, heal the intestinal barrier and alleviate inflammatory symptoms in the intestine in the long term.

Chew thoroughly and do not drink anything with your meal

If you have intestinal inflammations caused by IBD, remember to avoid drinking anything with your meal. If you do that, especially if you drink sweetened soft drinks, you will not only be tempted to barely chew and “wash down” the food instead, but you will also weaken the enzymes in your digestive tract. As a result, your already weak digestion will become even worse. If you drink nothing or very little with your meals, you will chew better, and the rule is: well chewed is half digested!