Treatment of Crohns Desease

• Welcome
• Gastro-Intestinal Tract
• Inflammation and Immunity
  • Inflammation
  • Organization
  • Defense Structure
  • Cells involved
  • Cytokines
  • Functional Components
  • Role of TNF- a
• Crohn's Disease and Ulcerative Colitis
• Inflammatory Bowel Disease
  • Causes
  • First line drugs
  • TNF-alpha targeting therapies
  • Herbal Alternative SedaCrohn
  • Surgical Intervention
• Challenges in the Management

Herbal Alternative SedaCrohn

Artemisia absinthium, commonly known as wormwood is the only herb that has shown anti-inflammatory properties by suppressing cytokines such as TNF-a involved in the inflammatory process not only in laboratory experiments,the so called in vitro studies, but also on Crohn's Disease patients.Wormwood,is described in the pharmacopoeia books of all European countries and is an approved herbal medicine to treat reduced appetite in European countries (European Pharmacopoeia on Wormwood - Escop Monographs.

Recent studies on wormwood have shown that its extracts suppress inflammatory cytokines such as TNF-a and NFkB, both in vitro and in Crohn's disease patients.In a double-blind controlled study on Crohn's disease patients,a thujone free wormwood preparation SedaCrohnTM not only showed steroid sparing effect, but also improved depressive symptoms commonly associated with this disease. These findings provide an argument to supplement this herb in Crohn's Disease patients.

The leaves and flowering tops of the plant are gathered when the plant is in full bloom, and dried naturally or with artificial heat.Its active substances include silica,two bitter elements (absinthin and anabsinthine),thujone,tannic and resinous substances,malic acid,and succinic acid.Its use has been claimed to remedy indigestion and gastric pain,it acts as an antiseptic, and as a febrifuge.The etheric oils of wormwood contain thujone and thujyl alcohol and other terpene-derivatives that are neurotoxic at high doses but at proper dosage pose no danger.The WHO codex restricts the use of thujones to the maximum levels of 5 ppm (500 mg/kg) in products for human consumption.Wormwood encapsulated powder being marketed under the name of SedaCrohnTM are thujone free preparations of wormwood sold by Noorherbals.com.

SedaCrohn as TNF-a and Virus Targeting Therapy

SedaCrohn was tested in a controlled trial on patients with Crohn's Disease who were receiving stable doses of corticosteroids. The aim was to determine whether wormwood could reduce the patients' dependence on corticosteroids. The secondary objective of this study was designed to assess whether wormwood would improve symptoms of depression as well as quality-of-life. One group of 20 patients were administered the herbal blend containing wormwood and another group of 20 patiens were given a placebo, as 3 capsules twice a day for 10 weeks. Patients were assessed for steroid-sparing effects, remission-inducing properties, and quality-of-life improving effects.

After 8 weeks of treatment with SedaCrohn, there was almost complete remission of symptoms in 13 (65%) patients, as compared with none in the placebo group. This remission persisted until the end of the observation period, and the addition of steroids was not necessary.

In the placebo group, 16 patients (80%) showed Crohn's Disease exacerbation due to reduction in steroid dose, whereas there were only 2 (10%) such patients in the wormwood group. The exacerbation of CD symptoms necessitated the resumption of steroids in 11 patients in the placebo group and 2 patients in the SedaCrohn group.

Self-assessment of the patients showed almost no change in subjective feelings of illness in the placebo group, whereas, in the SedaCrohn group the evaluation indicated significant improvement. The patients treated with SedaCrohn reported a gradual improvement in mood that was statistically significant at weeks 10 and 12 (P<0.01).

The results of this study suggest that SedaCrohn may have a steroid-sparing effect, in addition to an effect on the mood and quality-of-life in patients with Crohn's. No conclusion can be drawn about the psychological findings because the selection of the patients was not based on depression criteria, but on the criteria of Crohn's Disease severity.

The authors conclude that the preparation has not only steroid-sparing effect in patients with Crohn's disease, but that this effect continues for several weeks after the end of the 10-week treatment period. Also, they suggest that there is a subgroup of patients which is resistant to the treatment, since 5 patients showed little response. Although no definitive conclusion can be drawn from this study, the results are promising and warrant further trials in order to understand the observed efficacy of this herb.

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