Treating any species conventionally for inflammatory bowel disease involves risks from medications that often fail to resolve the problem. Those caring for animals with chronic diarrhea, vomiting and malnutrition continue to seek alternatives. Fortunately, many methods offer reasonable safety and potential effectiveness. IBD takes place on the intestinal battleground, where pro-inflammatory cytokines and reactive oxygen and nitrogen species overwhelm colonic antioxidant defenses.1 Signal transducers and activators of transcription (STAT) proteins may enter the fray by inducing transcription of proinflammatory genes that encode for inducible nitric oxide synthase (iNOS) or adhesion molecules.2 Putting an end to the crisis without medications requires that natural healing methods can, in some way, successfully interfere with the inflammatory cascade. Acupuncture makes this happen neurophysiologically; herbs and supplements achieve this biochemically. Acupuncture Offsetting inflammation with acupuncture occurs through neuromodulation of the autonomic nervous system. With a neuroanatomically directed needling protocol, acupuncture treatments augment parasympathetic function and reduce inflammation.3,4 Herbs and Supplements New research points to several supplements that may benefit IBD patients. This list includes food components and spices, such as omega-3 fatty acids found in fish oils, the amino acid glutamine, curcumin from turmeric, licorice, plantain and clove or cinnamon oils. In addition, emerging evidence suggests that probiotics have a role in preventing and treating gastrointestinal problems like IBD.5 An impressive review by Clarke and Mullin concerning where and how natural products interplay with immune modulation to control IBD appeared in the journal Nutrition in Clinical Practice.6 Omega-3 Fatty Acids IBD ranks high among the many conditions benefited by the omega-3 fatty acids in fish oils. Furthermore, fish oils appear to afford protection against chemotherapy-induced gastrointestinal toxicity.7 Boswellia Serrata The boswellic acids in Boswellia serrata inhibit 5-lipooxygenase and other pro-inflammatory mediators. A German study found that in a double-blind, verum-controlled parallel group comparison, a boswellia extract performed at least as well as standard medication for the treatment of Crohn’s disease, a form of IBD in humans.8 Glutamine A 2008 article in the online journal Inflammatory Bowel Disease showed that glutamine significantly countered the generation of colitis in a rat model by affecting pro-inflammatory gene expression and activation.9 Curcumin This compound in turmeric that makes curries yellow controls inflammation by down-regulating pro-inflammatory cytokines, suppressing iNOS, and blunting neutrophil recruitment.10 It also reduces lipid peroxidation and tissue injury. Licorice Glabridin, found in licorice, confers anti-inflammatory effects on the colon by reducing colonic myeloperoxidase activity and the production of nitric oxide, prostaglandin E2 and pro-inflammatory cytokines.11 Plantain One of plantain’s active constituents ameliorates intestinal inflammation by down-regulating interferon-alpha and inhibiting oxidative burst activity, thereby reducing mucosal tissue damage in a murine model.12 Clove and Cinnamon Oils A naturally occurring sesquiterpene found in clove and cinnamon oils significantly suppresses levels of interleukin-6 in serum and IL-6 mRNA in tissue.13 Probiotics Three distinct cellular and molecular mechanisms characterize how probiotics benefit patients with IBD.14 First, they block the pathogenic effects of other bacteria through bactericidal chemicals and by competing with toxins and pathogens for intestinal epithelial adhesion. Second, they regulate and improve innate immune function and modulating inflammatory reactions to pathogens. Finally, they promote homeostasis of the intestinal epithelium by promoting cell survival, strengthening barrier function and stimulating protective responses. Raw-Meat Diets Seductive Web-based testimonials advocate raw rabbit diets for cats with IBD.15 In an effort to provide factual information on raw meat diets, a Winn Feline Foundation report showed that cats preferred ground, whole, raw rabbit over a premium commercial food.16 Cats’ coats improved, as did stools, which became extremely firm, non-odorous and well-formed. In contrast, stools from cats fed the premium cooked brand typically appeared unformed to soft-formed. However, the unexpected death of one cat from dilated cardiomyopathy linked to severe taurine deficiency caused the researchers to evaluate the surviving cats. Seventy percent of those fed raw rabbit exhibited cardiac muscle changes compatible with taurine deficiency, although they outwardly appeared normal. The authors concluded, “The results of this study have shed further light on the creation of an optimal natural diet for maintaining feline intestinal health. This represents a step towards the creation of a ‘gold standard’ diet that may be of benefit for the management of IBD in the cat. The key take-home message for cat owners and breeders is that a natural diet may not always be as healthy as imagined, and that even measuring nutrient values may not predict how a diet will perform after being fed for many months.” <HOME> FOOTNOTES: 1. Hausmann M, Obermeier F, Paper DH, et al. In vivo treatment with the herbal phenylethanoid acteoside ameliorates intestinal inflammation in dextran sulphate sodium-induced colitis. Clinical and Experimental Immunology. 2007;148:373-381. 2. Kretzmann NA, Fillmann H, Mauriz JL, et al. Effects of glutamine on proinflammatory gene expression and activation of nuclear factor kappa B and signal transducers and activators of transcription in TNBS-induced colitis. Inflammatory Bowel Dis. 2008;Jul 11 [Epub ahead of print]. 3. Oke S and Tracey K. The inflammatory reflex and the role of complementary and alternative medical therapies. Annals of the New York Academy of Sciences. 2007 Sep 28 [Epub ahead of print]. 4. Tian L, Huang Y-X, Tian M, et al. Downregulation of electroacupuncture at ST36 on TNF-α in rats with ulcerative colitis. World J Gastroenterol. 2003;9(5):1028-1033. 5. Vanderpool C, Yang F, and Polk DB. Mechanisms of probiotic action: Implications for therapeutic applications in inflammatory bowel disease. Inflammatory Bowel Disease. 2008. Jul 11. [Epub ahead of print]. 6. Clarke JO and Mullin GE. A review of complementary and alternative approaches to immunomodulation. Nutrition in Clinical Practice. 2008;23:49-62. 7. Mitsugi K, Nakamura T, Kashiwabara N, et al. Protection against methotrexate toxicity by a soybean protein- and omega-3 fatty acid-containing diet: comparative study with a casein-containing diet. Oncol Rep. 2004;12:41-45. Cited in: Cleland LG, James MJ, and Proudman SM. Review – Fish oil: what the prescriber needs to know. Arthritis Research Therapy. 2006;8:202. 8. Gerhardt H, Seifert F, Buvari P, et al. Therapie des aktiven Morbus Crohn mit Boswellia serrata Extract H 15. Z Gastroenterol. 2001;39:11-17. Cited in: Ammon HPT. Boswellic acids in chronic inflammatory diseases. Planta Med. 2006;72(12):1100-16. 9. Kretzmann NA, Fillmann H, Mauriz JL, et al. Effects of glutamine on proinflammatory gene expression and activation of nuclear factor kappa B and signal transducers and activators of transcription in TNBS-induced colitis. Inflammatory Bowel Dis. 2008;Jul 11 [Epub ahead of print]. 10. Ukil A, Maity S, Karmakar S, et al. Curcumin, the major component of food flavor turmeric, reduces mucosal injury in trinitrobenzene sulphonic acid-induced colitis. British Journal of Pharmacology. 2003;139:209-218. 11.Kwon H-S, Oh S-M, and Kim J-K. Glabridin, a functional compound of liquorice, attenuates colonic inflammation in mice with dextran sulphate sodium-induced colitis. Clinical and Experimental Immunology. 2007;151:165-173. 12. Hausmann M, Obermeier F, Paper DH, et al. In vivo treatment with the herbal phenylethanoid acteoside ameliorates intestinal inflammation in dextran sulphate sodium-induced colitis. Clinical and Experimental Immunology. 2007;148:373-381. 13. Cho JY, Chang H-J, Lee S-K, et al. Amelioration of dextran sulfate sodium-induced colitis in mice by oral administration of β-caryophyllene, a sesquiterpene. Life Sciences. 2007;80:932-939. 14. Vanderpool C, Yang F, and Polk DB. Mechanisms of probiotic action: Implications for therapeutic applications in inflammatory bowel disease. Inflammatory Bowel Disease. 2008. Jul 11. [Epub ahead of print]. 15. Obtained at http://www.redmaredesign.com/FelineNutrition/before_after.html on 07-24-08. 16. Glasgow AG, Cave NJ, Marks SL, et al. A Winn Feline Foundation Report on…Role of diet in the health of the feline intestinal tract and in inflammatory bowel disease. Obtained at http://www.cfa.org/articles/health/role-of-diet.html on 07-24-08.
