Crohn's disease: could omega-3s be helpful?
Hello I have been suffering from Crohn's disease for about 12 years and have already undergone intestinal resection surgery, I have also been suffering from myasthenia gravis for two years. I take the following medications daily: Esopral 40mg (1 per di); Enterasin 400mg ( 3x2 per di); Azathioprine 50mg (2 per di); Deltacortene I alternate 50 and 25 mg daily. I would like to know if Omega-3 pills could improve my inflammation and not interact with the medications I take.
Dear Cosimo,
the literature contains some studies regarding the ability of the omega-3 fatty acids EPA and DHA to relieve symptoms and prolong remission time in cases of Crohn's disease (see Belluzzi et al 1996) in patients with Crohn's syndrome.
Before supplementing with omega-3s alongside your current therapy, it is imperative that you consult your treating specialist.
Cordial greetings.
Dr. Rosaria Ramondino pharmacist
Study summary table
| Authors | Patients | Duration | Description | Dosage | Result |
| Tsujikawa et al | 20 patients with Crohn's disease | 1 month | "Open label" study using a diet containing an omega-3 : omega-6 ratio = 0.5 | ND | Reduced CRP levels, increased rate of remission |
| Lorenz et al | 39 patients with IBD (Irritated Bowel Disease) including 29 with Crohn's disease | 7 months | Double-blind, placebo-controlled and crossover with fish oil. | 1.8 g EPA and 1.3 g DHA per day | Reduction in inflammation mediators TXB2 & LTB4, improvement in morphology, no change in disease activity. |
| Hillier et al | 10 patients with IBD | 12 weeks | Open label - fish oil vs. olive oil | 3.2 g EPA, 2.2 g DHA per dì | Reduction of inflammation mediators PGE2, TXB2, & LTB4 |
| Lorenz-Meyer et al | 204 patients with Crohn's disease in remission | 1 year | Placebo-controlled fish oil supplementation or a low-carbohydrate diet. | 3.3 g EPA, 1.8 g DHA per dì | No difference in relapse rates in the fish oil group compared with placebo |
| Belluzzi et al | 78 patients with Crohn's disease in remission | 1 year | Double-blind, placebo-controlled, with fish oil. | 1.8 g EPA, 0.9 g DHA per dì | 41% reduction in relapse in fish oil group; 33% more patients in remission after 1 year. |
| Arslan at al | 10 patients with IBD (5 with Crohn's disease and 5 with ulcerative colitis. | 10 days. | Open study in pilot phase with seal oil | 1.8 g EPA, 2.6 g DHA, 1.0 g DPA per day | Reduction of disease activity, reduction of joint pain. |
List of studies. Kuroki F, Iida M, Matsumoto T, et al. Serum n3 polyunsaturated fatty acids are depleted in Crohn's disease. Dig Dis Sci 1997;42:1137- 1141. Alzoghaibi MA, Walsh SW, Willey A, et al. Linoleic acid induces interleukin-8 production by Crohn's human intestinal smooth muscle cells via arachidonic acid metabolites. Am J Physiol Gastrointest Liver Physiol 2004;286:G528-G537. Tsujikawa T, Satoh J, Uda K, et al. Clinical importance of n-3 fatty acid-rich diet and nutritional education for the maintenance of remission in Crohn's disease. J Gastroenterol 2000;35:99-104. Lorenz R, Weber PC, Szimnau P, et al. Supplements with n-3 fatty acids from fish oil in chronic inflammatory bowel disease , a randomized, placebo-controlled, double-blind cross-over trial. J Intern Med 1989;225:225- 232. Hillier K, Jewell R, Dorrell L, Smith CL. Incorporation of fatty acids from fish oil and olive oil into colonic mucosal lipids and effects upon eicosanoid synthesis in inflammatory bowel disease. Gut 1991;32:1151-1155. Lorenz-Meyer H, Bauer P, Nicolay C, et al. Omega-3 fatty acids and low carbohydrate diet for maintenance of remission in Crohn's disease. A randomized controlled multicenter trial. Study Group Members (German Crohn's Disease Study Group). Scand J Gastroenterol 1996;31:778-785. Belluzzi A, Brignola C, Campieri M, et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med 1996;334:1557-1560. Arslan G, Brunborg LA, Froyland L, et al. Effects of duodenal seal oil administration in patients with inflammatory bowel disease. Lipids 2002;37:935-940.
