A new look at fish oil for treating Crohn's disease

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Physicians have long been hopeful that because fish oil is known to decrease inflammation, it might help forestall flare-ups of Crohn's disease--a chronic problem characterized by intermittent episodes of intestinal inflammation. Symptoms include cramping, abdominal pain, and rectal bleeding. Unlike other medications traditionally used to treat Crohn's, which can cause side effects ranging from weight gain to bone loss to diabetes, fish oil is relatively innocuous.

Yet until now, few studies have shown fish oil to be very effective in Crohn's disease. What's more, patients advised to take fish oil pills tend to quit because of such antisocial consequences as bad breath, gas, belching, and a fishy body odor.

The good news is that a team of Italian researchers may have come up with a solution. They have developed a coated fish oil-based tablet with a unique formulation of omega-3 fatty acids, the component of fish oil thought to quell inflammation of the intestine. The new formulation appears to promote better absorption of the omega-3 fatty acids, rendering them more effective. It also reduces unpleasant side effects.

In a recent study with the new tablets, nearly 60 percent of a group of Crohn's patients who had mild inflammation of the intestine but were symptom free at the start of the trial remained in remission the entire year they took the pills. On the other hand, only about 25 percent of patients with similar traits who were given placebos, or "dummy" pills, stayed symptom free during that year-long trial.

While the preliminary results are positive, they don't indicate that fish oil is a cure-all for Crohn's disease. More research needs to be conducted on people with different degrees of disease severity to see whether fish oil is helpful across the board.

In the meantime, the researchers caution against self-prescribing fish oil pills. Fish oil can thin the blood and promote excessive bleeding, so it should be taken only with the advice and supervision of a physician. Furthermore, the tablets used by the Italian researchers are not available in the United States. The effectiveness and side effects of fish oil pills that are on the U.S. market vary from formula to formula.

CROHN'S FACTS AND FIGURES
Every year, some 30,000 Americans are diagnosed with Crohn's disease. While it is usually detected before the age of 30, Crohn's can also strike older adults. Early signs include diarrhea and abdominal pain below the navel. Decreased appetite, weight loss, joint pain, fever, and sores in the anal area are other symptoms.

Most people with Crohn's can eat a wide variety of foods. When the lower portion of the small intestine becomes inflamed and its passageway narrows, however, sucking with a low-fiber diet and avoiding foods like popcorn and seeds can help keep irritation to a minimum. During severe flare-ups, a patient might be advised to drink products called elemental formulas. These formulas contain nutrients broken down into basic, "elemental" forms, which eases absorption by the beleaguered intestine.

For more information about the disease, contact the Crohn's & Colitis Foundation of America, 386 Park Avenue South, 17th R., New York, NY 10016; (800) 343-3637.

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