Are Bowel Diseases Like Crohn’s Only Treatable with Medicine?

When I sit across from someone newly diagnosed with Crohn’s disease or ulcerative colitis, the first thing I usually notice isn’t their lab results. 

It’s the look of confusion, often mixed with relief and fear. 

Relief that there’s finally a name for what they’ve been experiencing, and fear because that name comes with uncertainty.

Bowel diseases like Crohn’s and Ulcerative Colitis (UC) don’t appear overnight.

They develop slowly, often quietly, after years of your body being exposed to potential agitants (as well as when your genetics predispose you to development).

By the time people’s symptoms demand attention, the process has usually been unfolding for years.

At least this is the case for most people.

Understanding how these diseases develop and, of course, how we can support the body alongside conventional treatment,  is where integrative medicine can be especially valuable.

And it’s why I love helping people resolve their suffering.

What These Diseases Are and How They Develop

Crohn’s disease and ulcerative colitis fall under the umbrella of inflammatory bowel disease (IBD).

Both involve chronic inflammation driven by an autoimmune response to the intestinal environment, but they differ in a few important ways.

Ulcerative colitis affects the colon and rectum and involves continuous inflammation of the mucosal lining.

Crohn’s disease can affect any part of the gastrointestinal tract from the mouth to the anus and often involves deeper, patchy inflammation that extends through multiple layers of the bowel wall.

Neither of them is pleasant to deal with…

Despite their differences, they share a core mechanism: your body has been reacting to what you feed it, and this has created chaos in your gut.

Basically, what happens is your immune system begins reacting to components of your intestinal microbiota, not because those microbes are inherently dangerous, but because the regulatory systems that normally maintain balance have broken down through constant exposure to inflammation produced by diet, stress, and more.

Large genetic studies confirm that susceptibility genes are involved, particularly those related to immune signaling and microbial sensing.

But genes alone don’t explain the rapid rise in IBD over the past several decades.

Environmental exposures, dietary patterns, antibiotic use, infections, stress physiology, and disruptions to the gut microbiome appear to act as triggers in genetically vulnerable individuals.

These are the things I like to point patients and readers to, because they can be addressed head-on to help alleviate symptoms. 

And while auto-immune response is part of the puzzle, it’s not the only thing. 

A comprehensive review in Nature Reviews Gastroenterology & Hepatology outlines this multifactorial model, emphasizing that IBD is best understood as a disorder of host–microbe interaction, not simply a hyperactive immune system

IBD is now considered a global disease.

In North America and Europe, prevalence exceeds 0.3% of the population, and incidence is rising rapidly in newly industrialized countries.

A large epidemiological analysis published in The Lancet documents this global expansion and highlights the role of westernized lifestyle factors
(Publisher page): 

The Problem With Conventional Treatment

I think that because I write articles about the merits of functional and integrative health and often point a finger at “Big Pharma,” people might believe I’m against conventional treatments.

I’m not at all.

I believe God has given men the power to create medicine to help in all kinds of circumstances.

Standard medical care for IBD focuses on controlling inflammation and preventing complications. This includes aminosalicylates, corticosteroids, immunomodulators, and biologic therapies targeting cytokines such as TNF-α or integrins.

These therapies can transform outcomes for many patients and reduce rates of hospitalization and surgery.

At the same time, conventional treatment often focuses on suppressing immune activity without fully addressing why immune dysregulation developed in the first place, or why some patients respond incompletely despite aggressive therapy.

That gap is where integrative strategies can provide meaningful support.

Not by overriding the immune system, but by working with the body’s regulatory biology.

There Are Integrative Approches that Work

In practice, I think of autoimmune bowel disease less as an enemy to defeat and more as a signal that regulation has been lost.

The goal becomes restoring tolerance, resilience, and repair capacity while respecting the role of medications.

The intestinal lining is more than a passive wall. It’s an active, intelligent interface that educates the immune system every day. Research shows that increased intestinal permeability is common in IBD and may precede clinical disease in some individuals.

A review in Clinical Gastroenterology and Hepatology describes how barrier dysfunction and immune activation reinforce one another in a self-perpetuating cycle

Nutrients such as glutamine, zinc, and short-chain fatty acids are biologically necessary for epithelial repair. While supplementation studies are mixed and not curative, supporting barrier integrity is biologically plausible and increasingly supported by mechanistic data, particularly in conjunction with medical therapy.

IBD is consistently associated with reduced microbial diversity and loss of beneficial commensal species. Whether dysbiosis is a cause or consequence of inflammation remains debated, but it clearly influences immune behavior.

Human studies suggest that certain probiotic formulations can help maintain remission in ulcerative colitis, though evidence is weaker in Crohn’s disease. A Cochrane review notes modest benefit in specific contexts and stresses strain-specific effects

This is why I rarely frame probiotics as a stand-alone solution.

Diet, medication exposure, stress hormones, and sleep all shape microbial ecology far more powerfully than any capsule.

As many of my readers knowFood is one of the most misunderstood aspects of autoimmune disease. Diet does not “cause” IBD in a simplistic sense, and no single eating pattern works for everyone.

But food is also one of the most constant signals the immune system receives.

Clinical trials suggest that exclusive enteral nutrition (medically supervised therapy in which all—or nearly all—daily calories come from a nutritionally complete liquid formula, with no solid foods consumed for a defined period of time), can induce remission in Crohn’s disease, particularly in pediatric populations, underscoring that immune activity is responsive to dietary inputs
(PMC): 

Other dietary strategies, such as the specific carbohydrate diet or Mediterranean-style anti-inflammatory patterns, have encouraging but still limited human data.

I don’t necessarily have clinically rigid approaches for curing these diseases, but I do my best to frame dietary change as therapeutic experiments that can help patients.

Stress Physiology and the Brain–Gut Axis

It needs to be made clear that stress does not cause IBD, but it definitely can worsen symptoms and can precede flares.

As you may remember The gut and brain are connected through neural, hormonal, and immune pathways.

Experiencing stress can alter gut permeability, microbial composition, and inflammatory signaling.

Mind–body interventions such as mindfulness-based stress reduction and cognitive behavioral therapy do not replace medication, but randomized trials show they can improve quality of life and, in some cases, reduce symptom burden.

One of the hardest truths to communicate (and to accept) is that autoimmune bowel disease is rarely about quick fixes.

Healing happens over time, and in layers.

Medications can help, and integrative strategies support the rebuilding of tolerance, resilience, and metabolic reserve.

From a prevention standpoint… particularly in people with family history or early immune symptoms… minimizing unnecessary antibiotic exposure, supporting microbiome diversity, addressing chronic stress, and maintaining metabolic health are biologically sensible strategies, even if definitive prevention trials are still lacking.

I always lean towards recommending therapies with strong evidence of improvement, experiment cautiously where evidence is emerging, and never confuse plausibility with proof.

A Final Word

If you live with Crohn’s disease, ulcerative colitis, or another immune-mediated bowel condition, your body is not broken.

Integrative approaches, when combined with excellent medical care, can help many people feel more stable, more informed, and more hopeful over the long term.

Talk soon,