Hello, I'm a chiropractor with a background in nutrition and lifestyle modification as well as physical medicine. I have dealt with Crohn's cases in the past utilizing nutrition, dietary modification, and physically working on post surgical scar tissue, however I am not very well versed in medication. Let me know what your questions are.
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Answers are for educational purposes only and do not constitute a doctor patient relationship. The question you have asked does not really have a simple answer. Different approaches work for different people. Some people never have full remission of symptoms. It really depends on what your symptoms are now to help identify what should be done. In general, Crohn's patients typically benefit from an anti-inflammatory diet. The basis of the anti-inflammatory diet is plant strong (lots of produce, primarily in the form of vegetables) with occasional lean meats, nuts, and seeds. As already having had surgery, I do not know how your body currently tolerates fiber, as this may be an issue. Some people who have issues with fiber choose to juice their produce. Glutamine seems to be helpful in a subset of the Crohn's population, and in my experience chiropractic treatment has been helpful for some people when interference is removed from their nervous system. Please let me know what follow up questions you have.
As you may have explored, other supplements that seem to provide some benefit are essential fatty acids, probiotics, and there are many others as well. What have you tried already?
Fiber does not cause issue for me. I only have small bowel remaining. I've already tried Glutamine, EFAs, pro/pre-biotics, juicing, anti-inflammatory diet, turmeric, etc.
I too believe that immune suppression may not be the best solution, because some aspects of the immune system are over-reactive and some are under-reactive in Crohn's. Some herbs and supplements can actually target different aspects of the immune system to affect some reactions and not others. Another avenue to try is Aloe vera as it has a healing effect on the digestive tract, however be wary of which aloe product you choose so that beneficial compounds are retained.
The most important aspect of management is typically diet. It is also the hardest aspect to maintain for people in terms of compliance. The diet needs to be very clean with lots of produce, preferably organic and clean sources of protein ie. wild caught fish, wild game, organic grass-fed beef, etc. It is also important to understand that changes made through the diet will not occur overnight. It can take weeks or even months to see a very noticable difference. In my experience, the quick fixes also seem to be very temporary ones.
You can at best alleviate symptoms through diet, as well as any other treatment, however as I stated before, many people with Crohn's do not achieve a full state of remission.