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Inflammatory Bowel Disease Low Dose Naltrexone (LDN)

Inflammatory Bowel Disease (IBD) is a term used to describe disorders which involve chronic inflammation of the gastrointestinal tract inclusive of Crohn's disease (CD) and ulcerative colitis (UC).  It's etiology is unknown but immune system dysfunction is seen as likely in which an abnormal immune response to a bacterial or viral infection initiates an autoimmune response where the immune system attacks the cells of the digestive tract. It is important to note the importance of diet and stress as aggravating factors in disease severity and triggering of flares.

Typical IBD symptoms can involve moderate to severe abdominal pain, severe diarrhea, fatigue, and weight loss, which vary considerably dependent on the severity and location of the inflammation within the digestive trace.  Long term complications include inflammation in the eye, skin and joints, as well as an increased risk of colon cancer.  Acute events include potential bowel obstructions, perforations, and ulcerations. Existing treatment protocols involve antibiotics, anti-inflammatory and immunosuppressant medications, we well as those aimed at symptom relief such as anti-diarrheal medications.  General recommendations include reducing stress and alteration of diet.  Up to 30% of patients with moderate to severe disease are considered refractory to current IBD medications resulting in significant impairment of their ability to function in day to day life. 

This study describes an open-label trail involving 28 Crohn's disease patients and 19 ulcerative colitis patients, each in the active phase of their disease and non-responsive to existing treatment protocols.  4.5mg of LDN taken daily was added to their treatment protocols.  Over the course of 3 months 74.5% were considered to have a positive response, with six patients (25.5%), achieving full clinical remission, including five with complete endoscopically confirmed remission.  Adjunct studies examined the direct effects of LDN on intestinal epithelial cells, noting significantly reduced endoplasmic reticulum stress, along with increased wound healing.  

The authors report that LDN is a novel, effective, safe treatment option for patients suffering from Inflammatory Bowel Disease.

AUTHORS:              

Mitchell R.K.L. Lie, MD
Janine an der Giessen, MD
Department of Gastroenterology and Hepatology
Erasmus MC-University Medical Centre Rotterdam, The Netherlands

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845217/pdf/12967_2018_Article_1427.pdf

 

Written by David Yeazel, MS, MPH