Crohn’s Disease is one of the diseases collectively called Irritable Bowel Disease (as opposed to Irritable Bowel Syndrome, which is primarily a collection of symptoms.) Both Crohn’s and Ulcerative Colitis, the other Irritable Bowel Disease, are characterized by ulcerations in the GI tract leading to blood and/or mucus in the stools. Unlike Ulcerative Colitis, though, which only occurs in the colon, Crohn’s can occur anywhere from the mouth to the anus, with stretches of healthy bowel in between lesions.
Autoimmunity Causes in General
Irritable Bowel Diseases are autoimmune conditions, which means instead of attacking foreign invaders, the immune system gets confused and starts producing antibodies against itself. This usually happens in a progression. There are almost always food allergies involved, and antibodies against a friend (food) that the body thinks is a foe then leads to the body thinking that you are the foe.
Another possible cause for many autoimmune conditions is molecular mimicry—that is, when the immune system mistakes one antigen (or potential pathogen) for another.
According to this recent study, though, three new causative agents have been proposed for Crohn’s: candida overgrowth, and two dysbiotic (pathogenic) bacteria species, Serratia marcescens and Escherichia coli.
The Vicious Cycle of Crohn’s
I’m not a bit surprised at these findings, as people with any significant gut inflammation almost always have candida overgrowth and dysbiosis as well—but whether they are a cause or an effect of the pathology of Crohn’s is the question.
According to Elaine Gottschall, whatever the original trigger, once the cycle of inflammation begins, it proceeds something like this. Think of carbs as sugar (which essentially they are—your body converts them into sugar). Your body can absorb simple (single) sugars directly, but complex sugars have to be broken into simple sugars by enzymes, which are found on your intestinal lining, before absorption becomes possible. Then the newly-minted simple sugars can be absorbed.
If complex carbs don’t get broken down (for whatever reason), then they don’t get absorbed, and they travel on down through your intestines. Then they come in contact with the bacteria in your gut. These bacteria break down the carbs for you, but they produce two major byproducts: gas (so you feel distended) and acid (which causes inflammation in your intestines). It’s at this point in the process that your gut flora gets disrupted, because whatever you feed, grows. Candida is part of your normal gut flora, and so is E.Coli; furthermore, the more disrupted your normal gut flora is, the less it can protect you against opportunists (like S. marcescens).
Your body then responds to the inflammation produced by these dysbiotic bacteria and fungi by producing mucus to protect itself. The problem is, the mucus blocks the enzymes in your intestines from coming in contact with other complex carbs you eat. So more complex carbs get turned into gas and acid, producing even more mucus.
In a nutshell: inflammation (from autoimmunity or anything else) leads to mucus, which leads to inability to break down complex carbs, which leads to gas and acid, which leads to more inflammation, which leads to more mucus… and round and round we go.
In my experience, treating candida or dysbiotic bacteria is necessary but not sufficient for treating severe gut inflammation. You also have to interfere with the vicious cycle at the only place where you have some control. And the only part you are directly in control of is what you eat.
Gottschall’s Specific Carbohydrate Diet is a great place to start for Crohn’s and Ulcerative Colitis specifically. In some cases this isn’t enough either, because excessive gut inflammation tends to lead to increased intestinal permeability, or “leaky gut syndrome”, and the Specific Carbohydrate Diet may allow some foods that are a problem for certain individuals. The Autoimmune Protocol is more comprehensive, and generally covers most major allergenic offenders and allergenic molecular mimics.
The best approach is always tailored to the individual, of course!
Great article on SCD, Lauren. She was on to the dysbiosis issues and IBD back in the nineties! Best, Sheila Shea
Thanks Sheila! Yes, I very much admire her!