Crohn's is the pits and anyone who has it would agree with me and probably say "the pits" is an understatement! I don’t have Crohn’s, but know people with it, and I remember thinking treating it was so difficult, complicated, and sort of a crap shoot because different treatments worked for some people but not others. There was no clear cut answer. There is no magic pill. There’s no way around it and people with Crohn’s have to learn to live with it and manage it day-to-day.
What is Crohn’s Disease?
It’s a form of Inflammatory Bowel Disease (IBD) that causes chronic inflammation and irritation of the digestive tract. There isn’t a known cause, but it is known to run in families. A person’s immune system and environment appear to also play a role in developing Crohn’s. A recent study published in October 2013, claims scientists have discovered Crohn’s disease can originate from a specialized intestinal cell type called Paneth cells. This is great news and provides a possible new target for treatment.
What happens with Crohn’s Disease?
In a majority of patient’s, Crohn’s starts in early adulthood, and involves cramping pain, diarrhea, weight loss, low grade fever, and has a profound impact on quality of life. Crohn’s disease is often associated with maldigestion and malabsorption of dietary protein, fat, carbohydrates, water, and a wide variety of vitamins and minerals. As a result, much of what a person with Crohn's eats may never truly get into the body.
What is Nutrition’s Role?
Nutrient deficiency is a common concern since inflammation from this condition interferes with nutrient absorption. As a result, people with Crohn’s disease need a nutrient-rich diet with adequate calories, protein and healthy fats. Current science also advocates nutrition to enhance the body's immune system, provide antioxidants to reduce inflammatory stress, and improve a patient's feeling of strength, stamina, and well-being.
Eat to Reduce Inflammation
- Let fruits and vegetables make up at least half your plate at meals. Make a point to regularly fit in fresh, frozen or dried berries and cherries. Be sure to eat a variety of vegetables, including leafy greens like kale, chard, spinach, and Brussels sprouts.
- Select more plant-based sources of protein like beans, nuts and seeds.
- Choose whole grains instead of refined ones. Avoid the ingredient, “Enriched.” Swap brown, black or wild rice for white rice; whole oats or barley for instant oatmeal and cream of wheat; and 100% whole-wheat bread instead of white. For some individuals, eliminating wheat may reduce inflammation. Talk to your doctor before going gluten-free and a registered dietitian can help you accomplish this.
- Swap heart-healthy fats for not so healthy ones. Olive oil, avocados, nuts and seeds are a few delicious choices.
- Choose fatty fish like salmon, sardines and anchovies to get a heart-healthy dose of omega-3 fatty acids.
- Season your meals with fresh herbs and spices. They pack a flavorful and antioxidant-rich punch.
- Free your diet of processed foods, artificial sweeteners, added sugars, and unhealthy fats are always very important.
Eat to Improve Strength and Stamina
- Vitamin D supplements may help overcome fatigue and decreased muscle strength associated with Crohn’s. Besides boosting bone growth and remodeling, vitamin D is thought to improve neuromuscular and immune function, reduce inflammation and help with other bodily tasks. Discuss your vitamin D status with your primary gastroenterologist to determine whether or not vitamin D supplementation is indicated in your particular situation. It’s an easy blood test to measure your levels.
- Eat small meals or snack every 3 to 4 hours.
Other Tips and Guidelines for Crohn’s disease
- Stay hydrated. Drink small amounts of water throughout the day. Remember to avoid plastic bottles and choose stainless steel or glass instead.
- During times when you don’t have symptoms, include whole grains and a variety of fruits and vegetables in your eating plan. Start new foods one at a time, in small amounts.
- When you have symptoms, such as diarrhea or abdominal pain, foods to avoid may include high fiber foods, raw and gas-producing vegetables, most raw fruits and beverages with caffeine.
- Some common symptom-provoking foods are dairy, high fiber grains, alcohol and hot spices.
- Discuss with your doctor about the possibility of experimenting with a gluten free diet. It may improve your symptoms slightly.
- Consider taking a probiotic. Seventy percent of your immune system is based in your intestines so you want a very strong immune system to keep your body functioning efficiently. I highly recommend ProBiota 12. Because of the potency, start by taking 1/4 tsp., about 5-10 minutes after dinner for one week. After that, increase to 1/2 tsp. until the bottle is gone. Once the bottle is gone, continue taking the probiotics, but consider changing to the capsule form and take 1 capsule/day after dinner.
Your gastroenterologist may recommend dietary supplements such as iron, calcium, vitamin D, folate, zinc and vitamin B12 to prevent or treat deficiencies.
Crohn’s Patients at Higher Risk for Stroke, Heart Attack
In an analysis of over 150,000 patients with IBD in nine studies, researchers estimated the risk of stroke and heart disease in patients with IBD, as compared to the general population. The results of the comparison pointed to a 10-25 percent increased risk of stroke and heart attacks in patients with IBD. The increased risk was especially more prominent in women.
Nutrition seems to be the cornerstone of Crohn's disease and the effort put into following the correct diet is well worth it. Have meaningful conversations with your gastroenterologist and seek help from a registered dietitian nutritionist.
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
Adolph, TE et al. Paneth cells as a site of origin for intestinal inflammation. Nature. Oct. 2013.
Academy of Nutrition and Dietetics. Inflammation and Diet. Aug. 2013.
Academy of Nutrition and Dietetics. Crohn’s Disease and Diet. July 2013.
Mayo Clinic. Patients with inflammatory bowel disease at higher risk for stroke, heart attack. Science Daily, 14 Oct. 2013. Web. 6 Jan. 2014.