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Gastrointestinal Disorders
Question #19933
1 year ago
4,678

Crohn disease - #19933

Rehman
$1.17

Age 34, IT consultant work all day and some time night on laptop, less mobile. Had weight of 90 kg and height 5.9. Had habit of lying down after eating. Used to have lassi, cold drinks, fast food, biscuits and continuos eating all the day very foody person. Then suddenly one day after having homemade paratha diarrhea begun, also had bleeding and Hb level was falling, endoscopy colonoscopy showed lesions and patchy inflammation but Biopsy didn't confirm crohn. Symptoms improved after removing glutton and lactose from diet. But due to persistent diarrhea anal fissures, outside anal tag and piles issue. Crp level showed 99 and calprotectin 1000. Steroids made improvement and reduced crp. But got flare-up from most of the things in fodmap diet. Still on steroids. Pls suggest. His symptoms appears as excess burps, bloating, and too much gurgling and type 6 diarrhea in stool chart once daily. If anyone moderate to high fodmap food is taken, it becomes watery and frequency to 4 5 times in a day. pls suggest.

Age: 34
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Doctors' responses

Avoid spicy,packed,fermented and processed food. Regular use of buttermilk. Cap.Florasante 1-0-1 Cap.Mebarid 2-0-2

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Rehman’s symptoms suggest a severe inflammatory response in the gut, likely an undiagnosed Inflammatory Bowel Disease (IBD), possibly Crohn’s or severe IBS with gut dysbiosis. Given his history, persistent diarrhea, high CRP (99), and calprotectin (1000), his gut is in a chronic inflammatory state

Since he flares up with moderate to high FODMAP foods, he should follow a strictly low-FODMAP, gluten-free, and lactose-free diet while gradually reintroducing foods: Safe Foods for Now: Carbs: White rice, boiled potatoes, millet (bajra), and tapioca. Proteins: Well-cooked lentils (mung dal), soft-boiled eggs, skinless chicken, and fish. Vegetables: Carrots, spinach, bottle gourd (lauki), ridge gourd (turai), and peeled zucchini. Fruits: Ripe banana, papaya, dragon fruit. Fats: Small amounts of coconut oil, ghee (if tolerated). Fluids: Cumin (jeera) water, ginger tea, buttermilk made from lactose-free yogurt. Avoid: Dairy, gluten, processed foods, fast food, carbonated drinks, and sugary snacks. High-FODMAP Foods: Onion, garlic, cauliflower, beans, wheat, and artificial sweeteners. Spicy & Acidic Foods: Avoid chillies, pickles, and sour foods. No lying down immediately after meals (wait at least 1-2 hours). Gentle exercise like walking after meals to aid digestion. Adequate sleep (6-8 hours) and stress management (yoga, meditation). Jatyadi Oil: Apply externally to fissures. Sitz Bath with Neem Water: Twice daily. Since steroids have helped, he may need a long-term gut management plan with a gastroenterologist. Regular CRP & Calprotectin monitoring to assess inflammation. Consider probiotics (like Saccharomyces boulardii) if tolerated. I am not added any internal medicines we will wait ,once ez getting stabilised slowly we can introduce medicines

Let me know if he has additional symptoms or specific concerns

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Hello Rehman, Your condition needs constant monitoring so will not advise a lot of medication. It seems like the symptoms you described are indicative of a chronic inflammatory condition of the digestive tract, possibly resembling inflammatory bowel disease (IBD), even though Crohn’s wasn’t confirmed. The elevated CRP (C-reactive protein) and Calprotectin suggest ongoing inflammation.

persistent diarrhea, bloating, and sensitivity to high FODMAP foods further point toward an aggravated Pitta and Vata dosha imbalance in Ayurveda.

The focus should be on reducing inflammation, healing the intestinal lining, and balancing digestive fire (Agni). Continue avoiding gluten, lactose, and high-FODMAP foods. Prefer well-cooked, easily digestible meals like rice, moong dal khichdi, and steamed vegetables. Use buttermilk (Takra) instead of lassi, prepared by diluting fresh yogurt with water annd churning it and adding a pinch of cumin powder. It’s beneficial for gut health. Avoid raw salads and heavy-to-digest foods as they may aggravate Vata. Use cooling herbs like coriander, fennel, and mint in meals to reduce Pitta.

For Ayurvedic support, Kutajarishta (15-20 ml with an equal amount of water twice daily, post meals) is effective for chronic diarrhea and inflammation. Bilwadi Churna (1 tsp with warm water after meals) helps with digestion and controls loose motions. Tab Shaddharan 1/2 tablet twice daily before food.

Avoid lying down immediately after meals. A short walk (10-15 minutes) can aid digestion. Practice stress management through yoga and pranayama (especially Anulom Vilom and Bhramari). Stay hydrated with warm water or cumin-coriander-fennel tea. Follow a regular sleep schedule to support gut health.

Basti chikitsa (Therapeutic enemas) may help in clearing excess Pitta. Basti (Medicated Enema) using soothing oils like Dashmooladi oil can be beneficial in managing Vata and healing the colon.

Since you are currently on steroids, it is essential to work closely with both your gastroenterologist and an Ayurvedic practitioner. Gradual tapering of steroids with Ayurvedic support can be considered. Regular monitoring of CRP and Calprotectin levels is also recommended. Let me know if you’d like further clarification on any aspect.

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Hello Rehman, It seems like you’re dealing with a combination of gut inflammation, digestive imbalances, and possible underlying sensitivities, which could be due to an aggravated Vata and Pitta dosha. The symptoms like bloating, excessive burping, diarrhea, and anal fissures suggest that your digestive fire (Agni) is weak and the gut lining is inflamed. Ayurveda recommends focusing on restoring Agni by adopting a gentle, easy-to-digest diet, avoiding cold, oily, and processed foods. You could benefit from herbs like Guduchi, Licorice, and Triphala to support gut healing, reduce inflammation, and strengthen digestion. Incorporating a warm, cooked food diet with kitchari (a simple dish of rice and lentils) could soothe the digestive system. For diarrhea and gut inflammation, I recommend using soothing herbs like Marshmallow root and slippery elm. Additionally, practicing mindful eating habits—avoiding overeating and lying down after meals—could help. Have you had any follow-up tests to monitor your CRP, calprotectin, or any specific findings from your colonoscopy and biopsy? It’s important to also assess your liver and gut microbiome health, especially since steroid use can sometimes impact digestion. What are your current stress levels, and how are your energy levels overall?

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Based on the information you’ve shared, it seems there’s an imbalance, likely involving Pitta and Vata doshas, most probably triggered by dietary habits and lifestyle factors. Ayurveda focuses a lot on digestive fire (Agni). Given your symptoms, your Agni might be disturbed, leading to Ama (toxins) accumulation.

Firstly, avoid foods that are difficult to digest such as cold drinks, fast foods, and dairy, as they can aggravate Kapha and Ama production. Regular meals, taken at the same time every day can help stabilize Agni.

For diet—stick to simple, easily digestible foods. Khichadi (a rice and lentil dish) cooked until soft, with a small amount of ginger and cumin, can be soothing. Instead of Lassi, opt for a light ginger-infused herbal tea that aids digestion. Avoid FODMAPs as much as possible; replace these with reliably digestible alternatives like ripe bananas and steamed carrots, which soothe Vata and Pitta.

Warm foods are ideal to pacify Vata. Meanwhile, Pitta can be brought into balance with cooling foods, using less spice, salt, or sour elements in the diet. Include some ghee for its soothing and anti-inflammatory properties.

Daily routines are also important. Try to incorporate a gentle yoga practice or pranayama, focusing on slow, calming breaths to settle Vata. Taking a short, gentle walk after eating may aid digestion, but avoid lying down after meals.

For anal fissures and piles, apply a paste of turmeric and coconut oil externally. This can reduce inflammation. Sitz baths with herbal decoctions of Triphala or neem can provide relief.

If digestion remains irregular, consider taking Avipattikar churna to balance digestive acids, but only after consulting with a local practitioner. Virechana (therapeutic purgation) under proper guidance might provide benefit.

Remember, do not discontinue prescribed medications, especially steroids, without consulting your healthcare provider. Address acute symptoms with immediate medical attention where necessary. Prioritize your safety and ensure any Ayurvedic regimen complements existing treatments.

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