---
title: "A Naturopathic Guide to Crohn's Disease and Ulcerative Colitis"
entity: "blog"
canonical_url: "https://www.drdanwool.com/blog/ibd-crohns-ulcerative-colitis-naturopathic-guide"
markdown_url: "https://www.drdanwool.com/llms/blog/ibd-crohns-ulcerative-colitis-naturopathic-guide"
lastmod: "2026-11-10T10:00:00.000Z"
---

Written and Medically Reviewed by [Dr. Dan Wool, NMD](/about)
Arizona-Licensed Naturopathic Physician and Gastroenterology Specialist
Updated: November 10, 2026

## Quick Summary

- Crohn's disease and ulcerative colitis are the two main forms of inflammatory bowel disease (IBD). About 2.39 million Americans carry a diagnosis. Both need a gastroenterologist. Naturopathic care works alongside that treatment and targets the factors that keep symptoms and flares coming back.
- A healed scope does not always mean you feel well. About one in three people with IBD in remission still have IBS-type symptoms such as urgency, bloating, and pain. Low iron, low vitamin D, and stress often sit underneath those symptoms.
- Seven drivers come up again and again in the research: ultra-processed food, antibiotics, frequent NSAIDs, low vitamin D, stress, a weakened gut barrier, and hormonal birth control. Each one can be identified, and most can be changed.
- Food is a real therapy in Crohn's disease. A structured exclusion diet kept 75.6% of children in remission at 12 weeks in one trial, and a Mediterranean diet matched a much stricter diet in adults. Diet works best inside a plan your GI knows about.
Danielle (not her real name) is 29 and works night shifts in an ICU.

She was diagnosed with ulcerative colitis at 24 after weeks of bloody diarrhea. Mesalamine brought her into remission. Her colonoscopy last spring showed healed tissue, and her gastroenterologist told her the disease was under control. He was right about the inflammation.

The report didn't capture the rest of her day.

She still mapped every bathroom on her drive to work. She was bloated by mid-afternoon, slept badly on her days off, and felt drained in a way coffee couldn't touch.

She had stopped bringing it up at follow-ups because her numbers kept coming back good.

I see some version of Danielle often in my Scottsdale practice. Her medication was doing its job. Nobody had asked what else was going on. That question is where naturopathic care for inflammatory bowel disease begins.

## What Inflammatory Bowel Disease Means

Inflammatory bowel disease (IBD) is a group of chronic conditions in which the immune system keeps the lining of the digestive tract inflamed. The inflammation cycles between flares and remission. Over time it can scar, narrow, or damage the bowel. That's why IBD is treated firmly and monitored for life.

- Crohn's disease: Inflammation can appear anywhere from mouth to anus, most often where the small intestine meets the colon (i.e. ileum). It shows up in patches and can run through the full thickness of the bowel wall. That depth is why Crohn's can cause strictures, fistulas, and abscesses.
- Ulcerative colitis (UC): Inflammation stays in the colon's inner lining. It starts at the rectum and extends upward in one continuous stretch. Bleeding and urgency are the signature symptoms.
- IBD-unclassified: Some colon inflammation has features of both, and the label may wait until the pattern is clear.
IBD is a different condition from IBS (Irritable Bowel Syndrome). IBS causes real symptoms without visible tissue damage. IBD causes damage a scope can see and a biopsy can confirm. The two can overlap in the same person.

## Where Naturopathic Care Fits with IBD

I'll be direct. Supplements cannot stand in for medical treatment of IBD.

The medications your gastroenterologist prescribes (mesalamine, steroids, immunomodulators, biologics, and newer small-molecule drugs) are the tools that bring the inflammation under control and protect the bowel from permanent damage.

The goal is symptom control and these meds do the job. The longer term goal is flare prevention: how do we stretch out the time between flares or create the conditions so it theoretically won't happen again?

The naturopathic therapeutic order puts the least invasive tools first. In IBD, I apply that order alongside the medication plan your GI builds.

My role is co-management. I look at diet, nutrients, gut microbes, stress, sleep, hormones, and medications that may be adding fuel, and I share what I find with your gastroenterologist. When patients ask me to help them get off a biologic, my answer starts with a call to their GI.

## How IBD Shows Up

Gut symptoms depend on where the inflammation sits. Ulcerative colitis tends to bring bloody stools, urgency, and cramping before bowel movements. Crohn's disease more often brings lower right abdominal pain, diarrhea, weight loss, and pain after meals.

IBD also reaches beyond the gut. In my practice, the complaints that bring IBD patients in are often whole-body ones: fatigue that sleep doesn't fix, joint aches, mouth sores, skin flares, and brain fog. I check iron and [vitamin D](/blog/vitamin-d) in every IBD patient.

IBD is more common than most people assume. A 2023 analysis of national insurance data estimated that about 2.39 million Americans have a physician diagnosis of IBD, roughly 721 of every 100,000 people. [1] New diagnoses peak in one's twenties. [1]

## Warning Signs That Need a Conventional Workup First

If you haven't been diagnosed and any of these apply, see a gastroenterologist before anything else. If you already have IBD and these appear, call your GI promptly.

- Blood in your stool, or black and tarry stools
- Unintended weight loss
- Iron deficiency anemia
- Symptoms that wake you up at night
- Fever with diarrhea
- Trouble swallowing or persistent vomiting
- A family history of colon cancer, IBD, or celiac disease
- New changes in bowel habits after age 50
- For those already living with IBD, add severe abdominal pain, a swollen or rigid belly, or frequent bloody stools through the day. Those need same-day care.
Conventional gastroenterology diagnoses and stages IBD and protects the bowel. That work comes first.

## What a Normal Scope and Normal Labs Don't Measure

For someone with IBD, a good result usually means the scope shows healing and that a stool marker called fecal calprotectin is low. Those numbers track the inflammation that damages tissue. They don't account for everything that can keep you feeling sick.

A 2020 meta-analysis of 3,169 people with IBD in remission found that 32.5% still had symptoms meeting criteria for IBS. [2] That's roughly one in three people whose disease looks quiet on paper while their gut stays loud.

Here is what a routine IBD follow-up often leaves out:

- Ferritin and iron stores, which in my practice I often find low even when the blood count looks normal
- Vitamin D, B12, folate , and zinc status
- [Small intestinal bacterial overgrowth (SIBO)](/blog/siboguide), which I find often in Crohn's patients whose main complaint is bloating
- [Bile acid diarrhea](/blog/bile-acid-diarrhea-malabsorption) after ileal disease or surgery
- Microbiome: How your gut microbes are functioning
- [Stress, sleep, and nervous system](/blog/stress-gut-motility-bloating) load
- Thyroid and sex hormone patterns

## How I Test When You Have Crohn's or Colitis

Your gastroenterologist owns diagnosis and disease monitoring. Colonoscopy with biopsy, imaging, C-reactive protein (CRP), and fecal calprotectin tell us whether the inflammation is active.

My additional workup usually includes:

- Fecal calprotectin, if it hasn't been checked recently, so we share a current baseline
- CBC, ferritin, iron saturation, B12, folate, vitamin D, and zinc
- [Celiac disease](/celiac-disease-treatment) blood testing if it was never done, since the symptoms can overlap
- Stool testing for infections and parasites during any new flare
- A SIBO breath test when bloating and gas dominate the picture
- Thyroid labs, plus testosterone or estrogen and progesterone when symptoms point that way
- A DNA-based stool panel such as the GI-MAP in selected cases
One thing I am clear about with patients: A functional stool panel cannot diagnose IBD, measure how active it is, or replace calprotectin and colonoscopy.

I use it for narrower questions, such as whether an infection or overgrowth is adding to symptoms while inflammation markers look calm.

I also avoid breath testing soon after antibiotics or a bowel prep, because in my experience the results get harder to read.

## What Pushes IBD Toward a Flare

Genes set up the susceptibility for IBD. They can't explain why diagnoses have climbed over recent decades. [1] These are the seven environmental factors I look for first.

- 1. Ultra-processed food. A prospective study followed 116,087 adults in 21 countries for a median of 9.7 years. People eating five or more servings of ultra-processed food a day had an 82% higher risk of developing IBD than people eating less than one serving. [3] Soft drinks, sweetened foods, salty snacks, and processed meat each carried higher risk, while fruit, vegetables, legumes, and unprocessed meat did not. [3] More on the dietary side: [https://drdanwool.com/blog/fried-foods-seed-oils-gut-health](https://drdanwool.com/blog/fried-foods-seed-oils-gut-health)
- 2. Antibiotics. In a Swedish national study of nearly 24,000 people with new IBD, three or more antibiotic courses raised the odds by 55%, and broad-spectrum drugs carried the strongest link. [4] I never ask patients to refuse an antibiotic they need. I do help them rebuild afterward: [https://drdanwool.com/blog/antibioticsandguthealth](https://drdanwool.com/blog/antibioticsandguthealth)
- 3. Frequent NSAIDs. In the Nurses' Health Study, women who took NSAIDs such as ibuprofen or naproxen on at least 15 days a month had a higher risk of both ulcerative colitis and Crohn's disease. [5] Clinically, I see NSAIDs set off flares in people who already have IBD, so I review every pain reliever a patient takes: [https://drdanwool.com/blog/nsaids-gut-health](https://drdanwool.com/blog/nsaids-gut-health)
- 4. Low vitamin D. In the same cohort, women with predicted vitamin D levels above 30 ng/mL had a 62% lower risk of developing Crohn's disease than women below 20 ng/mL. [6] Many of my IBD patients test low despite the Arizona sun: [https://drdanwool.com/blog/vitamin-d](https://drdanwool.com/blog/vitamin-d)
- 5. Stress and major life events. In a 12-month prospective study, a major life event in the prior three months raised the odds of a flare by 81%. A new spike in perceived stress nearly tripled them. [7] In my practice, a hard stretch at work or at home is one of the triggers patients name most often: [https://drdanwool.com/blog/ibdandstress](https://drdanwool.com/blog/ibdandstress)
- 6. A weakened gut barrier. A Canadian study measured gut permeability in 1,420 healthy relatives of people with Crohn's disease. Those with a leakier barrier at the start were about three times more likely to develop Crohn's during follow-up, and the link held even when testing happened more than three years before diagnosis. [8] Barrier problems can be present before Crohn's appears. My leaky gut guide covers the repair side: [https://drdanwool.com/blog/leaky-gut-causes-testing-repair](https://drdanwool.com/blog/leaky-gut-causes-testing-repair)
- 7. Hormonal birth control. In two large cohorts of U.S. women, current users of oral contraceptives had about 2.8 times the risk of Crohn's disease compared with women who had never used them. Past users carried a smaller increase. [9] For a woman with IBD or a strong family history, that's worth raising with whoever prescribes her contraception: [https://drdanwool.com/blog/birthcontrolandbloating](https://drdanwool.com/blog/birthcontrolandbloating)

## The Hormone Connection

IBD and hormones push on each other. Gut microbes help recycle estrogen through a set of bacterial genes called the estrobolome, so microbial shifts during inflammation can change how much estrogen stays in circulation. I explain that system in my master guide to gut health: [https://drdanwool.com/blog/gut-health-what-it-is-and-how-it-breaks-down](https://drdanwool.com/blog/gut-health-what-it-is-and-how-it-breaks-down)

In my practice, women with IBD often tell me their symptoms worsen in the days around their period, and some find that perimenopause unsettles a gut that had been stable for years. In men, I check testosterone when fatigue and low drive show up alongside Crohn's or colitis, especially after steroid courses or significant weight loss.

## Why Food Belongs in Your IBD Treatment Plan

Diet has long been the "third rail" of IBD.

Many of the IBD patients who come to me were told that diet didn't matter much as long as they took their medication.

And they advertise this. A commercial for one of the more popular biologic meds shows a couple smiling and getting double scoops of ice cream in a big waffle cone. 🤦‍♂️

I get it: you can enjoy food (and life) again but let's be honest, it's still a processed, gluten, dairy, sugar bomb in your gut. The purpose of these meds is to suppress your immune system and save you from radical surgery, not to enable or absolve poor choices that can create the conditions for breakthrough.

Fortunately, the research has caught up and now supports diet interventions, at least for Crohn's disease.

In a 2019 randomized trial, children with mild to moderate Crohn's disease followed a whole-food plan called the Crohn's Disease Exclusion Diet (CDED) plus a partial formula drink. At 12 weeks, 75.6% were in steroid-free remission. Only 45.1% of children who started on formula alone and then returned to their usual diet were in remission at the same point. [10]

In the adult DINE-CD trial, adults with mild to moderate Crohn's symptoms were randomly assigned to the strict Specific Carbohydrate Diet (SCD) or to a Mediterranean diet. Symptom remission at six weeks was nearly identical: 46.5% on the Specific Carbohydrate Diet and 43.5% on the Mediterranean diet. [11] The authors concluded the easier Mediterranean pattern may suit most patients better. [11]

So my position is this: food is a legitimate treatment lever in Crohn's disease, and the right diet is the one you can follow for years, hopefully with ease. I start most patients with a Mediterranean pattern shaped around what they tolerate and save stricter protocols for situations supervised with their GI and a dietitian. You can read more where the Specific Carbohydrate Diet still fits here: [https://drdanwool.com/blog/specific-carbohydrate-diet-scd](https://drdanwool.com/blog/specific-carbohydrate-diet-scd)

## How I Work Alongside Your Gastroenterologist

- Step 1: Rule out and coordinate. I confirm your diagnosis, disease location, activity, and medication plan from your gastroenterologist's records, and I make sure infection has been ruled out during any new flare. Signs of a severe flare send you back to your GI that day.
- Step 2: Test. I run the workup described above.
- Step 3: Address the drivers. We work through whichever drivers apply to you. That might mean replacing a [daily NSAID](/blog/nsaids-gut-health) with an option your prescriber approves, reviewing contraception, cutting back ultra-processed food, and building a stress plan you'll actually use.
- Step 4: Treat the condition. Diet comes first, usually a Mediterranean pattern, with the CDED as an option in Crohn's when your GI and a dietitian are on board. For ulcerative colitis, curcumin has trial support as an add-on to mesalamine. In a 2015 randomized trial of patients who weren't responding to maximal mesalamine, 53.8% of those given 3 grams of curcumin a day reached clinical remission at four weeks, compared with none on placebo. [12] Research supports doses in this range, worth discussing with your practitioner, and I coordinate it with your GI. In my practice I often recommend [vitamin D3](/blog/vitamin-d) repletion based on your labs, plus iron when ferritin is low. If [SIBO](/blog/siboguide) or [bile acid diarrhea](/blog/bile-acid-diarrhea-malabsorption) turns up, we treat it directly.
- Step 5: Rebuild. Once inflammation is quiet, we widen the diet and add [fiber](/blog/fiber) as tolerated (people with strictures need individual guidance here). We recheck calprotectin and nutrients on a schedule your GI can see.
In my practice, most patients notice better energy and less urgency within 6-8 weeks once nutrient gaps and obvious drivers are handled. Fewer flares across a full year takes longer to judge.

## Specific GI Conditions Hub Directory

Every article in this hub, grouped by what you're trying to figure out.

### Living with Crohn's disease or colitis

- The Specific Carbohydrate Diet for IBD: [https://drdanwool.com/blog/specific-carbohydrate-diet-scd](https://drdanwool.com/blog/specific-carbohydrate-diet-scd)
- Microscopic colitis: [https://drdanwool.com/blog/microscopic-colitis](https://drdanwool.com/blog/microscopic-colitis)
- NSAIDs and your gut: [https://drdanwool.com/blog/nsaids-gut-health](https://drdanwool.com/blog/nsaids-gut-health)

### Wondering whether gluten is involved

- Celiac disease: [https://drdanwool.com/blog/celiac-disease](https://drdanwool.com/blog/celiac-disease)
- Non-celiac gluten sensitivity: [https://drdanwool.com/blog/non-celiac-gluten-sensitivity](https://drdanwool.com/blog/non-celiac-gluten-sensitivity)
- Glyphosates and gut health [https://www.drdanwool.com/blog/glyphosate-gut-health](https://www.drdanwool.com/blog/glyphosate-gut-health)

### Dealing with ulcers, infections, or pouches in the colon

- Peptic ulcer disease, conventional and natural treatment: [https://drdanwool.com/blog/peptic-ulcer-disease-pud-conventional-and-natural-treatments](https://drdanwool.com/blog/peptic-ulcer-disease-pud-conventional-and-natural-treatments)
- Bismuth and gut biofilms: [https://drdanwool.com/blog/bismuth-gut-health-biofilm](https://drdanwool.com/blog/bismuth-gut-health-biofilm)
- Intestinal parasites: [https://drdanwool.com/blog/parasites](https://drdanwool.com/blog/parasites)
- COVID-19, diarrhea, and gut health: [https://drdanwool.com/blog/covid19andguthealthdiarrhea](https://drdanwool.com/blog/covid19andguthealthdiarrhea)
- Diverticulitis: [https://drdanwool.com/blog/diverticulitis](https://drdanwool.com/blog/diverticulitis)

### Trying to explain poor digestion or greasy stools

- Exocrine pancreatic insufficiency: [https://drdanwool.com/blog/exocrine-pancreatic-insufficiency](https://drdanwool.com/blog/exocrine-pancreatic-insufficiency)

### Looking at flagged liver labs

- Liver enzymes explained: [https://drdanwool.com/blog/liver-enzymes](https://drdanwool.com/blog/liver-enzymes)
- Metabolic fatty liver disease: [https://drdanwool.com/blog/metabolic-fatty-liver-disease](https://drdanwool.com/blog/metabolic-fatty-liver-disease)
- Cholestasis symptoms, causes, and treatment: [https://drdanwool.com/blog/cholestasis-symptoms-causes-treatment](https://drdanwool.com/blog/cholestasis-symptoms-causes-treatment)

### Connecting a medication or an unusual sign to your gut

- Statin drugs and gut health: [https://drdanwool.com/blog/statindrugshearthealth](https://drdanwool.com/blog/statindrugshearthealth)
- Geographic tongue and gut health: [https://drdanwool.com/blog/geographic-tongue-gut-health](https://drdanwool.com/blog/geographic-tongue-gut-health)

## The Bottom Line on Crohn's Disease and Ulcerative Colitis

IBD needs a gastroenterologist, and many people need more than that to feel well. Medication controls the inflammation that damages the bowel.

Diet, nutrient repair, stress care, and a careful look at medications and hormones address the drivers behind flares and the symptoms that linger after the scope looks good.

If Danielle's story sounds like yours, a full evaluation alongside your GI care is the right next step.

## Related Reading

- Gut Health: What It Is and How It Breaks Down: [https://drdanwool.com/blog/gut-health-what-it-is-and-how-it-breaks-down](https://drdanwool.com/blog/gut-health-what-it-is-and-how-it-breaks-down)
- What IBS Actually Is and Why Standard Treatment Fails: [https://drdanwool.com/blog/what-is-ibs-why-standard-treatment-fails](https://drdanwool.com/blog/what-is-ibs…