Crohn disease and ulcerative colitis treatment with PEA

PEA is a new product with a pain relieving and anti-inflammatory effect. It is a substance produced by the body, with the difficult name palmitoylethanolamide (PEA). It appears to have a very positive effect on a variety of annoying pain syndromes that are difficult to treat. We also got the idea to use PEA for patients with abdominal pain, diarrhoea and intestinal disorders, such as Crohn disease and ulcerative colitis. This is how it went. We treated a patient with a brain infarct in the brainstem, the so-called Wallenberg syndrome.

This patient suffered from severe pain, virtually untreatable with Lyrica®. After the administration of PEA, the pain intensity decreased with 50%. Also the symptoms of a chronic intestinal inflammation, ulcerative colitis, were reduced with 50%. This came as a great surprise, but it fits in treatment with PEA, because this endogenous pain reliever also has an anti-inflammatory effect.

The brand name in the Netherlands is PeaPure. The starting dose is 3 times 400 mg a day. You could increase to three times 800 mg per day. The positive effects are to be expected between 2 and 8 weeks.

PeaPure in the case of ulcerative colitis, Crohn disease and irritable bowel syndrome

Inflammation of the intestines, such as ulcerative colitis, Crohn disease and also IBS, the irritable bowel syndrome, show derogations in which the mast cell and neuropathic problems play a role. That is why we are aware that a substance as palmitoylethanolamide (PeaPure) can be a useful treatment for all these annoying diseases. Not only because of the analgesic effect, but also because it has an anti-inflammatory effect. And without the unpleasant side effects. Recent literature clearly shows that PEA can deliver a very useful contribution for certain forms of colitis. [1]

The efficacy and safety of PEA has been proved in a whole series of studies, even randomized double-blind study initiated and carried out with more than 600 patients that shows all the beneficial properties, in particular a rapid pain reduction in the event of severe neuropathic pain caused by pressure on the leg bones due to a hernia. In addition, there are dozens of clinical studies, all widely reported on the Dutch website [2] [3] [4] [5][6][7][8][9][10][11][12][13][14][15]

Because so many studies have been carried out, and because it is an endogenous pain reliever with anti-inflammatory effect that has no problematic side effects, PEA gets a green orange light for the treatment of abdominal pains caused by Crohn, ulcerative colitis and the irritable bowel syndrome. Not entirely green, because there are no large clinical studies for these indications.

PEA discovered as a pain-relieving and anti-inflammatory product by Nobel Prize Winner Montalcini

Around 1990, Nobel Prize Winner Professor Rita Levi-Montalcini indicated that palmitoylethanolamide (PEA) is an exceptional substance that can be used for the treatment of pain. It was her work in the field of metabolism, and growth factors, for which she received a Nobel Prize in 1986, that led to that understanding. Palmitoylethanolamide gives us a new means to treat chronic inflammation and pain, directly via the deregulated metabolism.

Palmitoylethanolamide is an endogenous molecule, which is produced in insufficient quantities to fight the pain and inflammatory processes that occur in metabolic disorders such as chronic pain. That is why the replenishment of the local palmitoylethanolamide-stock within the cell seems to be a logical principle based on the ideas of the above mentioned Nobel Prize Winner Professor Dr. Rita Levi-Montalcini. This was recently reconfirmed. [16]

Taking palmitoylethanolamide, whether as a powder under the tongue or as a tablet, helps the body to normalize the disordered metabolism of the cells on location, which in turn leads to pain reduction and reduction of the inflammation.

More about Crohn disease and ulcerative colitis

We quote the Crohn and Ulcerative Colitis Association of the Netherlands:

Ulcerative colitis is a chronic inflammation of the lining of the large intestine. The disease occurs only in the large intestine (colon). Together with Crohn, ulcerative colitis falls under the heading of Inflammatory Bowel Diseases (IBD). There are currently more than 55,000 people with chronic intestinal inflammation. More than 30,000 of them suffer from ulcerative colitis.

As with the Crohn disease, the cause of ulcerative colitis is not known. Each year an estimated number of fifteen hundred new patients are diagnosed with this disease. Although the disease can occur at every age, most cases are established between 15 and 40 or during midlife. The disease is slightly more common among men than women. The Crohn disease is a chronic intestinal inflammation in the whole digestive tract (or ‘mouth to ass’), first described in 1932 by the American doctor Burrill B. Crohn. The inflammation can affect all layers of the intestinal wall. The inflammation can sometimes expand slowly and go hand in hand with the formation of scar tissue in the intestinal wall. It is a disease that especially occurs in western countries. Together with ulcerative colitis, Crohn disease falls under the heading of Inflammatory Bowel Diseases (IBP).

There are currently more than 55,000 people with chronic intestinal inflammation. More than 20,000 of them have Crohn’s disease.

In The Netherlands, approximately one thousand new patients are diagnosed with Crohn’s disease each year. The disease is usually detected on people between 15 and 30 years old. Young people have a greater chance to develop the disease than the elderly. Women obtain the disease slightly more often than men.

Diagnosis and treatment of Crohn disease and ulcerative colitis

This often involves a long period of uncertainty, varying complaints and a lot of research prior to the provision of the final diagnosis of Crohn’s disease.

Despite intensive research, the cause of both diseases is still not known. It is not an infection, because the infections are not caused by a virus, bacterial or parasite. Possibly, bacteria and viruses do play an indirect role in the creation of the inflammation. There is not likely to be one apparent cause, but do different pathogenic mechanisms lead to appendicitis.

Smoking is a risk factor for the emergence of Crohn’s disease and slows down the process of healing. A survey of 1,000 patients shows that people with Crohn disease significantly smoke more often than people with colitis.

A treatment which definitively removes the cause does not exist. Up to now, medication is used to end the active inflammation as soon as possible. If complaints increase and the patient does not respond well to a treatment with medicines, surgery will be carried out. Fifty to seventy per cent of all patients with Crohn’s disease have to undergo surgery once in their life.*

In the case of colitis, if complaints increase and a patient does not respond well enough to a medicinal treatment, surgery will follow. It is rare for ulcerative colitis to start so violently that a patient must be taken to hospital immediately. In five per cent of the cases, the large intestine is so severely infected that an operation must be carried out at once.

Twenty-five to forty per cent of all patients with ulcerative colitis have to undergo surgery at least once in their life. This is always a proctocolectomy (a removal of the colon including the rectum).



[1] Capasso R1, Orlando P, Pagano E, Aveta T, Buono L, Borrelli F, Di Marzo V, Izzo AA. | Ultramicronized palmitoylethanolamide normalizes intestinal motility in a murine model of post-inflammatory accelerated transit: involvement of CB1 receptors and TRPV1. | Br J Pharmacol. | 2014 May 12. doi: 10.1111/bph.12759. [Epub ahead of print]

[2] G. Guida, A. de Fabiani, F. Lanaia, A. Alexandre, G.M. Vassallo, L. Cantieri, M. de Martino, M. Rogai, S. Petrosino | La palmitoiletanolamida (Normast) en el dolor neuropatico cronico por lumbociatalgia de tipo compresivo: estudio clinico multicentrico. | Dolor | 2010, 25:35-42

[3] Biasiotta A, La Cesa S, Leone C, Di Stefano G, Truini A, Cruccu G. | Efficacy of palmitoylethanolamide in patients with painful neuropathy. A clincial and neurophysiological open study. Preliminary results. | , Volume 4, Issue 1, May 2010, Page 77.

[4] Assini A, Laricchia D, Pizzo R, Pandolfini L, Belletti M, Colucci M, Ratto S. | P1577: The carpal tunnel syndrome in diabetes: clinical and electrophysiological improvement after treatment with palmitoylethanolamide | Eur J Neurol | 2010: 17(S3):295.

[5] Bortolotti F,Russo M, Bartolucci ML, Alessandri Bonetti G, Gatto MR, Marini I. | Palmitoylethanolamide vs NSAID in the treatment of TMJD Pain | Journal of Dental Research | 2010: 89(Special Issue B)

[6] Phan NQ, Siepmann D, Gralow I, Ständer S. | Adjuvant topical therapy with a cannabinoid receptor agonist in facial postherpetic neuralgia. | J Dtsch Dermatol Ges. | 2010 Feb;8(2):88-91. doi: 10.1111/j.1610-0387.2009.07213.x. Epub 2009 Sep 10.

[7] Indraccolo U, Barbieri F. | Effect of palmitoylethanolamide-polydatin combination on chronic pelvic pain associated with endometriosis: preliminary observations. | Eur J Obstet Gynecol Reprod Biol. | 2010 May;150(1):76-9. doi: 10.1016/j.ejogrb.2010.01.008. Epub 2010 Feb 21.

[8] Calabrò RS, Gervasi G, Marino S, Mondo PN, Bramanti P. | Misdiagnosed chronic pelvic pain: pudendal neuralgia responding to a novel use of palmitoylethanolamide. | Pain Med. | 2010 May;11(5):781-4. doi: 10.1111/j.1526-4637.2010.00823.x. Epub 2010 Mar 22.

[9] Rasková H, Masek K, Linèt O. | Non-specific resistance induced by palmitoylethanolamide. | Toxicon. | 1972 Aug;10(5):485-90.

[10] Hurych J, Holusa R, Effenbergerová E, Mirejovská E. | Attempt to influence silicotic fibrosis by means of N-(2-hydroxyethyl) palmitamide (Impulsin). | Czech Med. | 1980;3(3):218-25.

[11] Masek K, Perlík F, Klíma J, Kahlich R. | Prophylactic efficacy of N-2-hydroxyethyl palmitamide (impulsin) in acute respiratory tract infections. | Eur J Clin Pharmacol. | 1974 Oct 4;7(6):415-9.

[12] Kahlich R, Klíma J, Cihla F, Franková V, Masek K, Rosický M, Matousek F, Bruthans J. | Studies on prophylactic efficacy of N-2-hydroxyethyl palmitamide (Impulsin) in acute respiratory infections. Serologically controlled field trials. | J Hyg Epidemiol Microbiol Immunol. | 1979;23(1):11-24.

[13] Wiedermannová D, Wiedermann D, Lokaj J. | [Prophylactic administration of impulsin to clinically healthy children.–effect on the serum proteins and metabolic activity of granulocytes (author’s transl)]. | Cas Lek Cesk. | 1978 Aug 18;117(33):1030-4.

[14] Eberlein B, Eicke C, Reinhardt HW, Ring J. | Adjuvant treatment of atopic eczema: assessment of an emollient containing N-palmitoylethanolamine (ATOPA study). | J Eur Acad Dermatol Venereol. | 2008 Jan;22(1):73-82. doi: 10.1111/j.1468-3083.2007.02351.x.

[15] Pulvirenti N, Nasca MR, Micali G. | Topical adelmidrol 2% emulsion, a novel aliamide, in the treatment of mild atopic dermatitis in pediatric subjects: a pilot study. | Acta Dermatovenerol Croat. | 2007;15(2):80-3.

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