Many patients with inflammatory bowel disease, especially Crohn’s disease, due to the chronic nature of the disease, as well as the inconvenience, cost and side effects of treatment seek alternative options with supplements. One such supplement is Omega-3 fatty acid. Omega-3 free fatty acids are anti-inflammatory substances found in oily cold-water fish such as salmon, mackerel, herring and sardines. They are one of the essential fatty acids, but cannot be manufactured by the body and therefore must be ingested. Symptoms of omega-3 fatty acid deficiency include extreme tiredness, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation. The excitement behind the use of supplements of omega-3 fatty acids in Crohn’s disease comes from its use in patients with rheumatoid arthritis and IgA nephropathy, a kidney disorder. They have also been found to be useful in lowering triglycerides.
Two studies in a recent edition of The Journal of The American Medical Association concluded that Omega-3 free fatty acids don’t help prevent relapses in patients with Crohn’s disease. While the authors of the articles believe that these studies are definitive, other experts disagree. One thought is that the dose of Omega-3 fatty acids used was not optimal, perhaps even too high. In the first study, EPIC-1 (Epanova Program in Crohn’s Study), 363 patients in remission with Crohn’s disease were randomly assigned to receive either four grams per day of omega-3 fatty acids or a placebo. In the second trial, EPIC-2, 375 patients who were also taking steroids were treated with either omega-3 fatty acids or placebo. Patients who took the omega-3 fatty acids did so for up to 58 weeks. In both studies, the rates of relapse were the same. This is in contradiction to a previous study in the New England Journal of Medicine that found a 33 percent reduction in the risk of relapse in Crohn’s patients taking omega-3 free fatty acids. That study was a small, single center study of only 78 patients.
While omega-3 fatty acids do not have serious side effects, they can cause flatulence, belching, bloating, and diarrhea, which can be confused with symptoms of Crohn’s disease. They are however, essential for health and therefore might be worthwhile to try as a supplement. You should discuss with your physician whether the use of Omega-3 fatty acids or any supplements are appropriate for you. Whether you decide to take Omega-3 fatty acids or not, it is important to continue to treat your Crohn’s disease with the proven medications that are available.