Natural Treatments for IBD in Children

Inflammatory bowel disease, or IBD, is an umbrella term that refers to specific conditions that cause inflammation of the gastrointestinal tract – the most common being Crohn’s disease and ulcerative colitis. About 3 million people in the U.S. are living with IBD, and roughly 25 percent of IBD cases are diagnosed in childhood. IBD is a chronic condition, meaning there’s no cure. But patients with IBD can manage the disease and control symptoms by working closely with their provider and finding a therapy or combination of therapies that works for them.

Families of children with IBD have many treatment options to explore, from medications to diets to alternative therapies. Whatever treatment plan you choose is highly individualized and based on a number of factors, including the severity of the disease, how your child responds to the treatment, and your family’s overall lifestyle.

IBD Causes, Symptoms and Diagnosis

Experts are not exactly sure what causes IBD, but it’s believed to be a combination of genetics, environmental triggers and immune system features, says University Hospitals pediatric gastroenterologist and director of the Pediatric Inflammatory Bowel Disease Program, Jonathan Moses, MD. There is also some evidence that your microbiome, or the population of bacteria in the gut that is individual to each person, might play a role in IBD.

Symptoms of IBD include:

• Abdominal pain
• Blood in stool
• Diarrhea
• Weight loss

To diagnose IBD, your child’s doctor will start with ordering blood tests, stool tests and other screenings. If the results indicate IBD, the diagnosis can be confirmed with an upper and lower endoscopy under general anesthesia. Sometimes magnetic resonance imaging (MRI) or other imaging tests may be used to help make the diagnosis.

Medications and Diet

Traditional medical treatments for IBD in children includes the use of medications that suppress the immune system. Your child’s gastroenterologist may first order a short-term course of steroids or exclusive enteral nutrition (EEN) – a formula-based diet with no solid foods – to get the IBD symptoms under control, then transition to maintenance medications. This can include drugs such as infliximab (Remicade) or adalimumab (Humira).

Medical diets can also be very effective at fighting inflammation and can be used in place of steroids in mild to moderate cases of IBD, says Dr. Moses. These diets work by eliminating certain foods that are known to exacerbate IBD symptoms, along with incorporating whole foods that are beneficial to gut health. Examples of these diets include the specific carbohydrate diet and Crohn’s disease exclusion diet.

A Holistic Approach

Some parents may be interested in a more holistic approach to treating IBD in the context of their child’s entire health outlook. While most children will need a combination of both medications and natural or alternative treatments, the goal is to minimize the need for medication, explains David W. Miller, MD, LAc, medical director of pediatric integrative health at University Hospitals.

Holistic therapies begin with a focus on building up the foundational elements of health: “Without these foundational, cornerstone treatments it’s like trying to build a house on an unstable foundation,” says Dr. Miller.

These foundational elements include:

Nutrition. Making sure a child is getting the best nutrition possible and is not deficient in nutrients such as vitamin D can make a big difference in controlling IBD symptoms and flare-ups.

Sleep. Optimizing sleep and minimizing sleep disruptions is important because problems with sleep are associated with immune disorders.

Psychological and emotional health. There is a strong link between emotion and GI activity – this is why you get an upset stomach when you are anxious.

Supporting the Body’s Microbiome

A healthy microbiome is a key component of controlling IBD symptoms and flare-ups. This can be achieved by consuming foods that promote the health of certain bacteria in the gut. Patients with IBD can incorporate the following into their diet to help with balancing the body’s microbiome:

• Probiotics: Probiotics are beneficial bacteria strains that help maintain a healthy immune system and protect us from infections. Probiotic foods include fermented foods such as sauerkraut, yogurt, kimchi and miso. Adding a probiotic supplement is also an option. Dr. Miller cautions that many supplements are low quality and will not have a clinical impact, so work with your provider to identify a high-quality product.
• Prebiotics: Prebiotics stimulate the growth of the good bacteria in your gut and are found in many fiber-rich fruits and vegetables. Food that are good sources of prebiotics include artichokes, asparagus, bananas, apples, garlic and onions.

Products that fight inflammation and support gut lining health can also be beneficial for patients with IBD. These include supplements such as omega 3 fatty acids, glutamine, ginger root, turmeric and other herbal extracts. Working with your provider is critical to determining which supplements to use, what dose to use, and how to gauge safety and value.

Diet modifications that can help with IBD symptoms may include limiting simple carbohydrates – found in sweets and processed foods – and incorporating more complex carbohydrates, such as those found in whole grains and vegetables. Families can also try eliminating things such as gluten or dairy to see how the child reacts – and adjust their diet accordingly. Not every child needs to limit any specific food, so this is a process of calculated removal and exposure to determine what has an impact.

Other Natural Therapies for IBD

Additional treatment options include therapies that focus on the mind-body connection. These can include:

• Acupuncture: While more studies are needed, the data is promising for the use of acupuncture for IBD.
• Biofeedback: Uses electrodes to monitor and help patients learn to self-regulate certain body functions.
• Chinese herbal medicine: Make sure to find a trusted practitioner who is certified in Chinese Herbal Medicine.
• Diaphragmatic breathing (belly breathing)
• Hypnosis
• Meditation and mindfulness practice
• Yoga

Dr. Miller says the overall goal of a holistic treatment plan for IBD is to help the patient and their family contextualize IBD in their life.

“We look at the patient as a whole person to help them be as healthy and happy as possible – and not let their IBD slow them down. While we may not be able to completely cure them, working collaboratively, we can help assure that their IBD doesn’t define them,” Dr. Miller says.

With any therapy your child undertakes, whether involving medications or alternative approaches, it is important that you continue to follow up with your child’s gastroenterologist on a regular basis.

“We still want to monitor your child and make sure they are responding well to the treatment, so follow up every three to four months is recommended,” says Dr. Moses.

Related Links

The University Hospitals Rainbow Pediatric Inflammatory Bowel Disease Center is the first of its kind in the region, where children and adolescents with inflammatory bowel disease (IBD) can receive the most advanced care possible.