Inflammatory bowel diseases (IBD) include Crohn’s disease and ulcerative colitis.  Crohn’s disease involves diarrhea, weakness, occasional bleeding, and a diffuse granulomatous inflammation of the entire bowel membrane. In cases of ulcerative colitis the inflammation is limited mostly to the colon. These cases are very difficult to treat with herbs alone.  The diseases often progress to the point where patients require surgery to remove inflamed areas of the bowel, and since this does not usually solve the problem, they often experience recurrences.

I usually begin treatment of these conditions with a careful history to identify causative factors. My usual first step is a bland diet, eliminating milk products and other potential food allergens. I then add slippery elm/ DGL licorice powder to calm things down mechanically, about six grams per day in divided doses for up to a month.  I sometimes use liquid chlorophyll and acidophillus capsules as well or use a more direct dysbiosis treatment.

Herbs that can be of great benefit in these conditions when used as simples (single herbs in capsules or tablets) include tien chi root, which helps heal the ulcers, and boswellia gum, coptis or DGL licorice root, which control inflammation. Sometimes plain green tea can also be helpful. Inflammatory prostaglandin levels are almost always highly elevated in these diseases, and studies have shown great benefit in using large amounts of flaxseed or fish oils (Stenson, 1992). Tinctures can often work at first when patients cannot tolerate powders. For the same reason, I often employ liquid vitamin and mineral combinations to ensure some absorption.
Because IBD patients are invariably deficient in key nutrients, it is necessary to supplement with a liquid multi-vitamin and liquid multi-mineral.  Studies show that patients are especially prone to elevated homocysteine levels, indicating the need for B-12 and folic acid supplementation (Mahmud et al, 1999). Beet root would also be valuable here.

Vilwa fruit is an important herb for treating colitis. A simple Ayurvedic formula combines vilwa fruit powder (60%) with anise, coriander, a very small amount of ginger root, and an astringent herb such as black tea. I recommend using about two grams two to three times per day.  The Ayurvedic tonic anti-inflammatory formula called Kaishore Guggul can be used with benefit.
 
It is always best to consult a skilled herbalist when writing formulas for serious diseases like this. The thought processes behind the formulas in this case include assessment of both the digestive power and inflammation level, as both types of herbs usually are needed. In cases of weak digestion, herbs like white atractylodes, poria mushroom and ginseng root should be emphasized. If the inflammation is more severe, you might emphasize other herbs in the formula, like scute root, coptis rhizome, boswellia gum and phellodendron root, the latter of which calms down excess immune activity. When bleeding is present, it is important to add tien chi root or another hemostatic.  Cases with fixed pain indicate blood congestion, which requires moving blood herbs like red peony root and salvia root. If the diarrhea is severe, use astringent herbs such as vilwa fruit or white oak bark.