Inflammatory Bowel Disease 

Both are types of Inflammatory Bowel Disease (IBD)—chronic, immune-mediated inflammation of the gut—but they have key differences:

• Crohn’s can affect any part of the GI tract (mouth to anus), often with “patchy” areas of inflammation, and may go deep into the bowel wall.
• Ulcerative colitis (UC) sticks to the colon (large intestine) and rectum only, with continuous areas of superficial inflammation in the inner lining.

Symptoms and treatments overlap, but the location, depth, and risk for complications differ.

Short answer: All of the above.

IBD is a “perfect storm”: a genetically primed immune system overreacts to normal gut microbes, sometimes triggered by infections, antibiotics, ultra-processed foods, or environmental exposures (like urban living or pollution). Diet isn’t to blame—or a cure—but can influence symptoms and gut health.

IBD: Chronic diarrhea (may be bloody), cramping, urgency, fatigue, weight loss, anemia. Think alarming and un-ignorable symptoms.

IBS: Discomfort, bloating, and bowel changes, but no bleeding or tissue destruction.

If you ever see blood, drop weight, or wake up at night to “go”—see your doctor, stat.

Diagnosis = detective work:

• Blood tests: anemia, inflammation (CRP, ESR)
• Stool tests: infections, calprotectin (inflammation marker)
• Colonoscopy: the gold standard, lets your gastroenterologist look and biopsy directly
• Imaging: MRI or CT for Crohn’s, as it can affect parts the colonoscope can’t reach.

While you can’t “stress yourself into” Crohn’s or Ulcerative Colitis, stress is like gasoline on the gut’s smouldering fire—higher stress can worsen symptoms, slow healing, and even change the gut microbiome in ways that promote inflammation. Major life events, job stress, and even relationship drama have been linked (in research and real-life clinic stories) to increased flare frequency and severity.

Smoking is a notorious villain for Crohn’s—smokers are more likely to flare, need surgery, and have complications. Oddly, nicotine (not the cigarettes themselves) seems to slightly soothe UC, but the harms always outweigh any gut benefit—so quitting is a universal gut-friendly move.

Food:

• In flares, the inflamed gut lining is more sensitive. High fiber, nuts, seeds, raw veggies, and spicy foods can worsen cramping, urgency, and loose stools.
• Dairy/lactose often becomes hard to tolerate for many IBD patients.
• High FODMAP foods may worsen bloating or pain.
• Greasy, highly processed foods can drive symptoms for some.

There’s no one-size-fits-all IBD diet, but eliminating foods that worsen your own symptoms and slowly reintroducing during remission is the gold standard. We can guide you here.

Lifestyle:

• Poor sleep is linked to higher flare risk and increased inflammation.
• Physical inactivity increases fatigue and reduces quality of life; gentle movement and exercise help regulate inflammation and mood.
• Alcohol (especially beer and wine) and caffeine may worsen symptoms in some but not all.

Finally—a mind at peace (hello, mindfulness, yoga, counselling!) is backed by strong evidence to help reduce anxiety, support pain coping, and even reduce inflammatory markers. A calm mind, balanced plate, and active lifestyle: the “whole-person prescription” for gut resilience.

Medical Treatments:

• Aminosalicylates (5-ASA): These include mesalamine, sulfasalazine, and related meds—first-line for mild to moderate ulcerative colitis, and sometimes Crohn’s affecting the colon. They work to “cool off” surface inflammation and help many patients maintain remission. 
• Corticosteroids: Prednisone, budesonide, and hydrocortisone are “flame extinguishers” for moderate or severe flares. Their rapid anti-inflammatory effects quiet the gut storm, but they’re not a long-term strategy due to side effects with chronic use. 

At Gravity, we can prescribe 5-ASA medications, and we can  prescribe courses of steroids for flares.

• Immunomodulators: Azathioprine, 6-MP, and methotrexate tamp down immune activity for those not controlled by first-line agents. Close monitoring and routine labs are a must. 
• Biologics: These advanced, targeted therapies (e.g., infliximab, adalimumab, vedolizumab, ustekinumab) block specific immune pathways and are game-changers for moderate-to-severe or treatment-resistant IBD. 
• Surgery: Occasionally needed, especially in Crohn’s with strictures, fistulas, or non-healing inflammation, and in severe UC not controlled with medication. Surgery may involve removing a diseased portion or, rarely, the entire colon.

BC NDs do not prescribe immunomodulators and biologics—your gastroenterologist will manage these medications.

Individualized, collaborative treatment:
Regimens are personalized based on disease severity, location, and response. The highest goal is “deep remission”—long-term quiet gut, symptom freedom, normal lab markers, and minimal medication toxicity. That means working closely with gastroenterologists and your naturopathic doctor to optimize care at every stage.

Botanical & Nutraceutical Therapies:

Curcumin (turmeric):

• Multiple randomized controlled trials (RCTs) show that curcumin—an anti-inflammatory polyphenol from turmeric—can significantly reduce disease activity scores and maintain remission, especially as an add-on to 5-ASA in ulcerative colitis (UC). Doses used in studies are typically 1–3 g/day. Safe for most, but can thin the blood at high doses.

Boswellia serrata (frankincense):

• Boswellia gum resin has been shown in RCTs to induce remission in mild to moderate UC and appears non-inferior to mesalamine, with a lower side effect profile. Doses: 300–350 mg, 3x/day in studies. Less evidence in Crohn’s, but promising.

Aloe vera (inner leaf gel):

• Preliminary studies (small RCTs) in mild-to-moderate UC show that oral aloe vera may improve symptoms. Best used short-term, as data is limited and quality control varies.

Other herbs with some evidence:

• Wheat grass juice, Plantago ovata (psyllium), Andrographis paniculata, and mastic gum have all shown some benefit, generally for symptom reduction or mucosal healing. Always check for possible allergies and herb-drug interactions.

Low-Dose Naltrexone (LDN):

• Originally a medication for opioid dependence, LDN at 1.5–4.5 mg nightly has demonstrated immune-modulating and anti-inflammatory effects in pilot trials. Open-label and small double-blind studies show clinical improvement and endoscopic healing, particularly in Crohn’s disease—though larger studies are still needed for standard-of-care endorsement.

Micronutrients & Dietary Support:

Due to malabsorption, chronic inflammation, or medication side effects, IBD patients often develop deficiencies in:

• Vitamin D (low levels linked to increased flares)
• Iron (chronic blood loss and intestinal malabsorption)
• Vitamin B12 (especially with ileal disease, resection, or metformin use)
• Zinc (wound healing, immunity, gut barrier integrity)
• Omega-3 fatty acids (modest benefit for some, especially for reducing inflammation and joint pain)

Testing and targeted repletion of these nutrients is considered essential naturopathic and mainstream care.

Probiotics & Gut Flora Support:

Probiotics:

• Best evidence is for “multistrain” blends like VSL#3 or E. coli Nissle (for maintaining remission in UC). Benefits in Crohn’s are more modest, though certain strains may help with pouchitis or antibiotic-associated symptoms. Prebiotics (soluble fibers) and fermented foods can benefit microbiome diversity, but individual tolerance must guide recommendations.

Mind-Body Therapies:

• Cognitive-behavioral therapy (CBT): Demonstrated to reduce anxiety, depression, and improve quality of life and sometimes gut symptoms.
• Gut-directed hypnotherapy: RCT-level evidence for improved remission rates and reduced flares.
• Mindfulness-Based Stress Reduction (MBSR), yoga, and guided relaxation: All show improvements in coping skills, pain, and general well-being.

Colorectal cancer risk increases with duration and severity (especially UC); regular colonoscopies are essential.

Crohn’s: Strictures (narrowed areas), fistulas (abnormal connections), abscesses.

Both: Malnutrition, osteoporosis, anemia, and risk for other autoimmune or inflammatory conditions.

Alert your team to new symptoms: severe pain, weight loss, ongoing bleeding, or high fever.

Teamwork = best outcomes. 

Your gastro “quiets the storm” and monitors for complications. A naturopathic doctor offers guidance on pharmaceuticals, nutrition, botanicals, mind-body medicine, and preventative care. Dietitians tailor your nutrition to avoid deficiencies and support gut healing. Mental health support builds resilience and helps tackle any anxiety, depression, or trauma that comes with chronic illness. 

Collaboration means care for your whole you: gut, mind, and beyond.