Crohn’s Disease and Ulcerative Colitis

These two autoimmune diseases do not appear to be significantly helped by fish oil or omega-3 fatty acids, but there might be a small positive effect.  Avoiding other animal and meat protein and using vegetable protein instead seem much more beneficial.

High Level of Fish Oil Helps: In a University of Bologna study of 78 Crohn's patients with high risk relapse, half were randomized to 9 fish oil capsules/day (200 mg EPA 100 mg DHA). Over the 1 year of the study, 69% of controls but only 28% of the fish oil group relapsed. Andrea Belluzzi, NEJM 334:1557-60 6/13/96

Fish Oil Doesn’t Help Significantly: A 7 month DB trial with 3.2 g of omega-3/day for 39 patients found no benefit for Crohn’s disease although there were some non-significant benefit for Ulcerative Colitis. Lorenz, Munich, J Int Med Suppl ’89;225:225

Fish Oil Helps Distal Procto-Colitis: 18 patients in a DB study for 6 months of 6.6g/day of EPA/DHA fish oil vs. placebo. Improved clinical and endoscopic with suppression of natural cytotoxicity. Almallah, U Aberdeen, Am J Gastroenterol 5/98;93:804

Japan Epidemiological Study: Animal Protein Bad, Fish Not Related to Crohn's Disease: Diet changes over a 20 year period of time in Japan found a strong association between an increase in Crohn’s disease and an increase in animal and milk proteins and a simultaneous decrease in vegetable proteins. Fish proteins were not related to the incidence of Crohn's disease and the n-6/n-3 ratio was only weakly related although it was still a factor. Shoka, Toyko, Am J Clin Nutr 5/96;63:741

Fish Oil No Help Ulcerative Colitis: 64 pt in remission DB 8g/d n-3 fish oil no benefit other than a very minimal delay of relapse. Loeschke, Munchen, Dig Dis Sci 10/96;41:2087

Fish Oil Helps Ulcerative Colitis: DB PC 8month study 11 pts cross-over design with 56% disease improvement with fish oil vs. 4% with placebo. Aslan, Am J Gastroenterol 92;87:432

Fish Oil Helps Ulcerative Colitis: 1 yr DB PC study. Hawthorne, Gut ’92;33:922-8 

Fish Oil No Help but Low Carbohydrate Diet Might Have Helped a Little: 206 patients in remission after acute relapse were treated for the 1^st 8 week of study with continuing corticosteroid and in a DB PC fashion some received 5 g/day of fish oil vs. placebo vs. a low carbohydrate diet of <84 g/day of carbohydrates for 1 year. There was no difference between the fish oil and placebo groups with the 30% each group going without relapse. The low carbohydrate group had 40% go without relapse but this failed to be a significant difference. However, if only patients adhering to diet were included, 53% went without relapse which would be a significant difference although there is still an unlikely possibility that drop-outs sensed they were going to relapse and that this was reason for abandoning the diet. Lorenz-Meyer, Germany, Scand J Gastroentero 8/96:31:778