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by Brian Shilhavy
Editor, Health Impact News

A new case study out of Germany just published in The American Journal of Gastroenterology (October, 2018) documents the remarkable recovery of a woman who was recommended to have part of her colon removed, including her anus, due to a severe case of Crohn’s disease and complicated by diversion colitis.

She refused to have a proctectomy (surgically remove a portion of her colon along with her anus) as recommended by her doctors, and requested a natural approach instead.

Therefore, her doctors started daily local administration of 3 and half ounces of prewarmed coconut oil as a rectal enema.

The patient saw immediate results within one week, and after 12 weeks, she was free of pain and returned to work.

images of the rectum

Endoscopic and histopathological findings of diversion colitis. Representative endoscopic images of the rectum prior (left) and after two (middle) and five (right) months of local coconut oil therapy. Before therapy, spontaneous bleeding, erosions, and fibrin indicated moderate mucosal inflammation. Follow-up endoscopies under treatment with coconut oil demonstrated only low-grade inflammation indicated by reduced vasculature and diffuse erythema.

Another Case Where Coconut Oil Beats Pharmaceutical Drugs

In this current case, coconut oil was only used as a treatment after pharmaceutical products failed.

The authors of the study note that originally she found some results from vedolizumab therapy, but it did not last long:

Initially, the patient reported good general condition under vedolizumab therapy, although the fistulae persisted. In late 2016, she noticed looser stools, progressive lower abdominal pain, and passage of mucus and blood via the anus.

Diagnosing her with Crohn’s disease, they switched her to ustekinumab and other drugs, but to no avail:

Suspecting a manifestation of Crohn’s disease, treatment was switched to ustekinumab and, due to non-response, intermittent topical hydrocortisone application was needed.

Subsequently, combination therapy with infliximab and 6-mercaptopurin was initiated. Again, there were no signs of therapeutic efficacy as clinical disease activity persisted.

Local therapy with 5-ASA and glucocorticoids had been ineffective.

The patient’s condition was deteriorating quickly:

Endoscopically, mucosal inflammation was evident in the distal ostomy branch, while the proximal branch was unaffected. Histological evaluation revealed edematous mucosa with lymphoplasmocytic lamina propria infiltration and hyperplasia of local lymphatic tissue.

Together, these findings indicated the presence of diversion colitis.

Apparently looking for an alternative approach, the doctors found earlier research [1,2] that short-chain fatty acids administered locally through enemas had been used to successfully treat colitis.

However, they could find no way to create such a formula:

Intended local therapy with short-chain fatty acid (SCFA) enemas was not possible, as—to our knowledge—no pharmacological formulation of SCFAs is available and we did not find any compounding pharmacy.

So they recommended surgery to remove part of the patient’s colon and anus as the only other available alternative:

Therefore, and in view of the deteriorating condition of the patient, proctectomy was recommended, which was refused by the patient, who instead asked for an alternative conservative therapy.

They decided to use coconut oil as an enema, since its natural fatty acid composition would come close to short chain fatty acids:

This was based on the rationale that coconut oil contains fatty acids with comparatively short chain length.

Although these are not identical with the SCFAs established in diversion colitis therapy, they are commensally produced and reduced in the inflamed mucosa suggesting a positive impact on epithelial metabolism as postulated for SCFAs .

The results were remarkable!

One week after initiation of daily coconut oil administrations, the patient reported decreasing abdominal pain and mucus secretion.

After another 6 weeks of continuous therapy, hematochezia and mucus secretion had completely stopped.

In a sigmoidoscopy performed after 8 weeks of daily therapy, clear improvement of endoscopic and histologic signs of inflammation could be observed.

After 12 weeks of treatment, the patient was free of pain, back to work and physically active 3 to 4 times a week.

Another follow-up endoscopy after 5 months confirmed stable disease with only low-grade inflammation.

Similarly, histology verified maintained improvement.

Daily coconut oil application has been continued by the patient for 6 months with continuous clinical response and without any adverse events.

In the light of currently unavailable pharmacological formulations, local application of coconut oil can be considered as a treatment option in patients with severe refractory diversion colitis.

Full study found here (subscription needed).

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See Also:

Coconut Oil Benefits for Digestive Health

Virgin Coconut Oil for Skin Health


1. Harig JM, Soergel KH, Komorowski RA, et al. Treatment of diversion colitis with short-chain-fatty acid irrigation. N Engl J Med.

2. Vernia P, Cittadini M, Caprilli R, et al. Topical treatment of refractory distal ulcerative colitis with 5-ASA and sodium butyrate. Dig Dis Sci.

About the author: Unlike many people who write about coconut oil by simply reading about it, Brian Shilhavy actually lived in a coconut producing area of the Philippines for several years with his family, observing firsthand the differences between the diet and health of the younger generation and those of his wife’s parents’ generation still consuming a traditional diet. This led to years of studying Philippine nutrition and dietary patterns first hand while living in a rural farming community in the Philippines. Brian is the author of the best-selling book: Virgin Coconut Oil: How it has changed people’s lives and how it can change yours!

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