Crohn's Disease

Debbie Maier asks us on the Upcoming Topics page to address Crohn’s Disease.

I don’t know too much about it except that it’s an autoimmune disease and has a complex, multi-causal etiology and pathology.  In my reading on autoimmune diseases in general there seems to be a direct link between latitude an incidence.   Specifically, the farther from the equator you live the more likely you are to get Crohn’s, Type 1 diabetes, rheumatoid arthritis, and so on.

This being our wont in Western society, we try to isolate it down to a single cause: farther from the equator means less sunlight, which means vitamin D deficiency, so it must be vitamin D.  So we try to feed people vitamin D, but this doesn’t cure the condition since it’s notoriously hard for your body to get utility from vitamin D supplements (and in fact it’s easily toxic) and even hard to get enough in food.  Plus there’s the issue that maybe it’s not just the vitamin D itself but some combination of biochemistry that happens when you expose yourself to sunlight (the main way humans have gotten a majority of their vitamin D throughout history).  But wait, what about skin cancer?  Let’s put on sunscreen and go outside for 15 minutes a day.  Nope.  Sunscreen blocks vitamin D production.  Plus in northern climates it’s very hard to get enough sunlight to produce enough vitamin D, especially in the winter months.  A number of studies suggest that over half of Americans are deficient.

My guess is that vitamin D is not the issue, but more generally sunlight is.  Or more precisely, given your ethnic background, there’s a range for optimally healthy sunlight exposure, and if you go too far out of that range in one direction or the other, you end up with health problems.  Autoimmune and other disease on one end, cancer and poor skin health on the other.  But I doubt it’s even that simple because lifestyle in general can predispose you or provide resilience — diet, exercise, exposure to environmental insults, and patterns of activity that affect emotional and mental state.

One thing that I think is overblown is the portion of the equation that is genetically predetermined.  The pendulum in science has swung too far towards genetics in terms of explanation in general, and this completely contradicts the evidence.

If I were diagnosed with Crohn’s or any other autoimmune condition, here’s what I would do personally.  First, devote several hours a day to physical fitness and conditioning, as if I were a professional athlete.  Second, experiment with diet like a mad scientist: try every supposed “good health” diet out there, but mixing it up and listening to my body and mental state.  Third, I would experiment with daily sunlight exposure, using guidelines based on my natural skin tone (darker = need more sun).  Next, I would examine my interpersonal relationships and eliminate/reduce contact with anyone who I even suspected of being a “net negative” emotionally in my life.  Finally, if I didn’t see dramatic results, I would move closer to the equator and to a locale that’s very different from my current one (different culture, different daily patterns, etc), and change up my daily routine, esp. if I spent more than a few hours a time doing the same thing (like staring at a computer screen).

  • Daniel

    Isn’t a lot of this good advice for most people?

  • I’m very afraid about crohn’s disease. I have some symtoms in abdominal pain, often in the lower right area, and diarrhea. Should I go to see the doctor? Please help.

  • I agree that there’s a correlation between these diseases and distance from the equator, but does it remain after controlling for whether you live in a developed country? If not then there are a slough of etiological explanations as plausible as lack of sunlight. (Eg, preservatives, antibiotics, lack of intestinal parasites, any number of dietary differences, etc etc.)

    By the way, I think you’re going overboard in the last paragraph. You’d be amazed what the latest fancy drugs can do for these diseases.

    Reminds me of Homer Simpson’s toast: “To alcohol! The cause of — and solution to — all of life’s problems.”

    • Rafe Furst

      Here’s the correlation between another autoimmune disease (MS) and latitude:

      Now, it’s clear there are other factors besides sunlight involved:

      However, you can see that there is something left over if you were to factor out the animal product consumption. I totally agree that disease is multi-causal, and that’s why I’d make drastic changes that greatly impact the known causes. And also why I would not rely on a single intervention (like a drug).

      But to answer your first question, yes, the correlation remains even within one single developed country:

  • Concerned MOM

    My daughter has Crohn’s disease. We live in a very sunny climate – in South Florida. She has a very low stress life, we eat an extremely healthy diet and always have,and she is involved in dance & gymnastics so she is in great physical condition.

    Until about 2 years prior to being diagnosed with Crohn’s at the age of 9, she was rarely ill. She had not taken many antibiotics, etc. She had never been hospitalized.

    Even with all of the above…doing all the “right” things…I believe that it would be entirely possible that my daughter would not be with us today without the medication she is currently on.

    At her lowest, she was losing about 1 pound per week, until she was (at age 9), at the same weight she had been at age 7. She was unable to make it though a day without a nap – very anemic.

    My point is, until you have the experience of personally dealing with this disease, I do not believe you can completely understand it. There are many people out there who have “self diagnosed” themselves as having Crohn’s. These same people then claim to have “cured” themselves with diet and lifestyle changes. I am certainly not discounting the benefits of this, however, I want people to understand that Crohn’s is NOT CURED. There is NO CURE OF CROHN’S. It can be MANAGED, but not cured. This misunderstanding makes it very difficult to deal with Crohn’s, especially for a young child. It is a serious disease, that can be life threatening.

    For those inquiring about symptoms, please know this: abdominal pain, chronic diarrhea, fatigue, unexplained weight loss, joint pain, etc can all be symptoms of Crohn’s. If you have these types of symptoms on an ongoing basis, you should consider seeing a doctor for a proper diagnosis.

    My daughter had all of the symptoms above and saw 3 pediatricians who said… 1)drinking too much juice!!, 2) suggested and tested her for lactose intolerance 3) tested for gluten allergy 4) told the symptoms must be due to childhood stress 5) we can’t find anything, it must be her diet…try changing her diet (which we did many, many, many times with no improvement)

    FINALLY…the 4th doctor asked if she had been tested for UC or Crohn’s. Tests confirmed that she did in fact have Crohn’s. After several tries with different meds, she is on Remicade (infusions every 7 weeks).

    She is now happy and feeling pretty great most of the time! :)

    Last…get all of the information and be your own health advocate!!

    • Rafe Furst

      Thanks for an excellent first-hand account, you bring up some great points. I should probably have concluded my post with the following:

      And if none of this works, I would take the prescribed medications and evaluate to the best of my ability the tradeoffs between the benefits and the long-term risks.

      I am curious though, what do you consider a “very healthy diet”? Could you compare it to what Fuhrman recommends in Disease-Proof Your Child and Eat to Live?

    • stephanie melnick

      My daughter was diagnosed with Crohn’s this week, one week after her 10th birthday. I was soooo encouraged to see that yours does gymnastics and dance, as mine has been involved her entire life, and they are her passions. the stories on line about Crohn’s are all so depressing and sad. I really want her to continue to live a normal, fulfilling, sunny life. Please keep sharing happy stories to encourage those of us hoping and praying for the same!

  • Anonymous

    I was diagnosed with type 1 diabetes on my 19th birthday in 2011, and i
    gotta say it sucks i used to be a really out-going person but i hardly
    ever now due to the amount of low sugars i had, about 5 weeks ago i
    started going on the insulin pump and it actually made a big difference
    of what i was able to do with my diabetes i can now do a lot of stuff i
    would never of been able to do on the insulin injections.thanx!~ISABELLA:)