1. Naturopathic Treatments for Chronic Inflammatory Disease Presented by Stacey Munro, N.D.

2. Learning Outcomes For electrologists to gain a better understanding of the philosophy and practice of naturopathic medicine. How naturopathic medicine can be applied to the treatment of chronic inflammatory diseases such as Crohn’s disease and arthritis. Role of the gastrointestinal (GI) tract in inflammatory processes. Dietary and lifestyle influences on chronic inflammation.

3. Naturopathic Philosophy 1. The Healing Power of Nature (Vis Medicatrix Naturae) 2. Identify and Treat the Cause (Tolle Causam) 3. First Do No Harm (Primum Non Nocere) 4. Doctor as Teacher (Docere) 5. Treat the Whole Person 6. Prevention

4. Goals of Naturopathic Treatment Nourish the body Intake, digestion, and absorption of nutrients Remove the obstacles to cure Physical, mental, emotional, or spiritual blocks Optimize elimination Lungs, colon, skin, kidney Stimulate the body’s healing force Acupuncture, homeopathy, spinal manipulation, herbs, energy medicine Step aside and let the body heal itself!!

5. Role of the GI Tract in Health The gastrointestinal (GI) tract is about 9 meters long. It is one continuous tube exposed to the outside world, just like our skin. It acts as a first line of defense against ingested pathogens. The digestive tract is important for several reasons. Digestion and absorption of nutrients and water Elimination/ waste removal Major site of immune and neurological function

7. Healthy Gut Innermost layer provides protection and has many functions: Mucosa- secretes mucous, enzymes, and hormones Gut Associated Lymphatic tissue (GALT) Microorganisms “good bacteria” Cell integrity- physical barrier

8. Healthy Gut Other layers of the gut: Submucosa- loose connective tissue which contains blood vessels, nerves, and glands Muscular layer Serosa- outermost layer

9. Protection The protective mucosa of the digestive tract acts as a filter to prevent toxins and harmful microorganisms from entering our bodies and to let vitamins and nutrients in.

10. Healthy Gut There are several hundred types of bacteria in the human digestive tract. They exceed the the number of human cells (10 trillion) by 10 times. Until a baby is born and exposed to the outside world, their digestive tract is sterile. They are quickly colonized by bacteria from the mother during vaginal delivery and breastfeeding.

11. Healthy Gut Good bacteria in the gut provides benefit to our health by: Fermentation of indigestible carbohydrates Production of vitamins Protection from pathogenic bacteria and viruses Priming the immune system

12. Healthy Gut Babies born by C-section and bottle-fed have fewer beneficial bacteria in their intestines versus those who are breast- fed. They are more prone to colonization by disease-causing bacteria. By age two, the gut bacteria resembles that of an adult.

13. Unhealthy Gut POOR DIET ALCOHOL CHEMICALS STRESS INFECTION DAMAGE TO GOOD BACTERIA LACK OF NUTRIENTS FOR CELL REPAIR INVASION OF “BAD” BACTERIA LOSS OF CELL INTEGRITY “LEAKY GUT” COMPROMISED IMMUNE SYSTEM FOOD ALLERGY IMPAIRED DIGESTION AND ELIMINATION DISEASE

14. What is Inflammation? Inflammation is the basic way that a body reacts to irritation, injury, or infection. Acute Inflammation occurs at the site of injury or infection. Removal of injurious stimuli halts the inflammation. Chronic Inflammation is a pathological condition where the body makes continued attempts to repair and contain the source of irritation or injury.

15. What is Inflammation? Body brings repair nutrients to the area to clear debris and waste, and neutralize infectious organisms. Blood vessels become more open to allow blood and immune cells to penetrate the area. Causes classic signs of inflammation: Redness, swelling, and heat.

16. What is the Connection? Chronic inflammation occurs when the usual things that the body does to heal itself don’t work due to: Accumulation of waste or toxicity in tissues Dysfunctional immune system Nutritional deficiencies

17. Types of Chronic Inflammatory Diseases Asthma Autoimmune disease Chronic prostatitis Glomerulonephritis Inflammatory bowel disease Pelvic inflammatory disease Rheumatoid arthritis Transplant rejection Vasculitis

18. The Four “R’s” Remove Replace Re-inoculate Repair

19. Functional GI Testing Comprehensive digestive stool analysis with parasitology (CDSA) Lactulose/ Mannitol test: urine test that measures abnormal GI permeability and malabsorption. Secretory IgA: salivary levels estimate immune function in the GI tract. It is affected by high stress, poor nutrition, and by unhealthy gut bacteria.

20. Functional GI Testing Food Allergy Testing: blood test that measures both immediate (IgE) and delayed (IgG) immune response to food allergens. Food allergy elimination with re-challenge.

21. Types of Arthritis Arthritis means “inflammation of a joint” There are over 100 different types. In adults the most common are: Osteoarthritis Auto-immune Arthritis (Rheumatoid, Ankylosing Spondylitis, Lupus, Psoriatic) Gout

22. Naturopathic Treatment of Arthritis Anti-inflammatory diet Anti-inflammatory herbs, such as curcumin, boswelia. Omega 3 fatty acids Exercise Detoxification 4 R’s

23. Anti-inflammatory Diet Reducing pro-inflammatory foods such as meat, sugar, alcohol, caffeine, refined carbohydrates, trans-fats and saturated fats. Increasing anti-inflammatory foods and herbs such as omega 3 and omega 6 fatty acids, fresh fruit and vegetables, whole grains, ginger, tumeric, garlic, green tea.

24. Commonly Allergenic Foods Wheat, dairy, soy, eggs, peanuts, citrus, nightshade vegetable family (tomato, potato, eggplant, peppers)

25. Naturopathic Treatments for Inflammatory Bowel Disease Inflammatory bowel disease (IBD) is a group of diseases characterized as chronic inflammation and ongoing activation of the immune system of the GI tract. The two primary types are ulcerative colitis (UC) and Crohn’s disease (CD). It is treated with salicylic acid compounds, corticosteriods, immunosuppresive medications, and surgery.

26. IBD The disease is likely the result of impaired barrier function of the intestinal lining and dysfunction of the immune system.

27. Case Study: 38 y/o Male with Crohn’s Disease First seen in my office 7/2007 Patient presented with a history of Crohn’s disease for 21 years Recently treated for several months with Prednisone Nuts and stress bring on attacks Symptoms are diarrhea, constipation, and severe abdominal pain

28. 38 y/o Male with Crohn’s Disease Past medical history: Chronic left hip, knee, and ankle pain from work-related injuries, anxiety, and depression. Medications: Effexor XR 75 mg, Clonazepam 1 mg, Hydrocodone/APAP 5-500 mg, Asacol 4 TID 400 mg. Diet: “fairly healthy”, eats at work cafeteria. Snacks on cookies and chocolate milk nightly. 20-40 oz of water daily and two cups of coffee or tea. GI: Bowel movements every 2-3 days

29. Treatment Plan GI Revive Powder Curcumin Multivitamin/ mineral Omega 3 fatty acids Vitamin C with bioflavinoids US Biotek Food Allergy Panel

30. Supplement Facts Serving Size: 1 teaspoon (7.5 grams) Servings Per Container: 30 L-Glutamine 1500 mg N-Acetyl Glucosamine 1000 mg Citrus Pectin 1000 mg Deglycyrrhizinated Licorice (DGL) (Glycyrrhiza glabra) 400 mg Aloe Vera (Leaf Extract 200:1) 300 mg Slippery Elm (bark)(Ulmus pulmila) 200 mg Mucin 200 mg Marshmallow (root)(Althea officinalis) 100 mg Chamomile (Matricaria chamomilla) 100 mg Okra (pod) (Hibiscus esculentus) 100 mg Cat's Claw (TOA free) (bark)(Uncaria tomentosa) 100 mg Methylsulfonylmethane (MSM) 100 mg Quercetin 100 mg Prunus (Concentrate) 100 mg PepZin GI® (Zinc-Carnosine) 75 mg Other Ingredients: Peach Powder, natural flavors, soy lecithin, stevia and talin.

31. Follow up 8/07 Patient could not tolerate GI Revive because of the taste. Feels more energy since starting the supplements. Normal to loose stool daily. Patient d/c Asacol on his own, decreased pain medication.

33. Treatment plan Avoid dairy in all forms! Discussed strategies for dairy-free diet. Increase fish oil to 3 grams per day.

34. Follow up 9/07 Had a couple of cramping episodes, but very minor. Drinking Silk soymilk instead of milk, still using ½ and ½ in coffee. Lost a couple of pounds. Carbohydrate cravings have decreased. Still taking supplements.

35. Treatment Plan Probiotics and butyrate (replacing GI Revive) Continue dairy-free diet Patient continued in remission from Crohn’s disease

36. Conclusion Naturopathic medicine is aimed at stimulating the bodies innate healing ability and providing the building blocks for optimal function. The digestive tract is the site of many crucial functions crucial, including digestion and absorption of nutrients, waste elimination, and immune function. Inflammatory diseases can be improved by healing the digestive tract, and by making important dietary and lifestyle changes.

37. How to Contact Me www.NaturesHelperMedical.com Nature’s Helper Medical Clinic 96 Poquonock Avenue Windsor, CT 06095 (860) 688-2275 Thank You!