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Crohn's Disease Diet

Crohn's Disease Diet

Crohn's disease is a chronic inflammatory bowel disorder (IBD) that causes abdominal pain and severe diarrhea. Its treatment options include medications and surgery. However, certain changes in diet and lifestyle can help in managing the symptoms and also pave way for long-term remission. This HealthHearty article gives some useful dietary guidelines for those dealing with this disease.
Reshma Jirage
Last Updated: Mar 22, 2018
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A Wise Tip!
As there is no standard diet for Crohn's disease, each individual will have to use a trial-and-error method to chalk out what suits best in his/her case. For this, it is highly recommended to maintain a food diary and note down which food soothes/aggravates the symptoms associated with this disease. A written record would also help the dietitian to determine if appropriate nutrition is being supplied to the body or not.

Crohn's disease (CD) is an inflammatory bowel disease and can affect any part of the digestive tract―most commonly the colon and the ileum (the last portion of the small intestine). The exact cause of Crohn's disease is unknown. However, it has been linked with genetics as one commonly sees it among those with a family history of this disease. Also, it is speculated that a certain virus or bacterium may trigger an abnormal immune response, leading to the development of this disease. Ethnicity can also be a contributing factor as CD is seen more among whites and people of Eastern European (Ashkenazi) Jewish descent. Smoking and use of non-steroidal anti-inflammatory medications can increase the inflammation and make the condition worse.
The symptoms associated with Crohn's disease include fatigue, low-grade fever, diarrhea, abdominal pain, nausea, vomiting, cramps, presence of blood in stool, loss of appetite, mouth sores, and weight loss. While this disease has no cure, the treatment is aimed at reducing inflammation of digestive tract, managing the debilitating symptoms, and providing adequate nutrition to the body. A combination of medications such as anti-inflammatory drugs, immune system suppressors, antibiotics, antidiarrheals, nutritional supplements, and pain relievers are used to treat the symptoms. Oftentimes, a surgery may also be needed to remove a damaged portion of the digestive tract. However, to manage this condition efficaciously, dietary changes are of crucial importance. The following section throws light on the same.
Dietary Advice for those with Crohn's Disease

Diet plays an important role in relieving the inflammatory symptoms. Since this condition can lead to loss of appetite and poor absorption of vitamins and minerals, it is very important to include adequate amounts of varied nutrients and calories to prevent malnourishment. According to the Crohn's & Colitis Foundation of America (CCFA), one of the most common nutritional deficiencies―observed in 68 percent of people with this disease―is that of vitamin D. Also, 40 percent of CD patients are unable to absorb carbohydrates properly. In addition to that, vitamin B12 deficiency is bound to occur in those who have this disease affecting the ileum (the intestinal area responsible for absorbing this vitamin). All these facts just substantiate the need of a well-planned diet all the more.
What Foods Should be Included

The Crohn's & Colitis Foundation of America (CCFA) states that almost two-third cases of this disease affect the ileum, thereby leading to the development of a stricture (abnormal narrowing) in the area. For such cases, it is highly advised to go for a low-fiber diet that minimizes the amount of residue in the stool. The aim of this diet is to minimize abdominal discomfort caused due to the strain involved in digesting high-fiber foods, and also to prevent intestinal blockage. The following foods will be helpful in serving the purpose.
✔ Include easy-to-digest foods such as white rice, pasta, and cereals so as to provide relief and aid healing of the inflamed GI tract. Though these foods are not considered completely healthy as such, but they do provide the body with significant calories. Ensure that you also balance your diet with other necessary nutrients mentioned further on this list.
✔ Ripe bananas with milk (include milk if you don't have lactose intolerance) is a great source of providing the much-needed calories in this condition. Bananas are easy to absorb and are loaded with potassium. Vomiting, diarrhea, and being on prednisone therapy, can deprive the body of potassium and magnesium. Hence, this fruit is a must-have for all CD patients. Even mango, papaya, cantaloupe, and avocado serve well in providing the body with various nutrients, without stressing the GI tract.
✔ Steamed, poached, baked, or grilled fishes including salmon, herring, flounder, halibut, and tilapia are great options when it comes to providing the body with the essential omega-3 fats that help in curbing inflammation. Also, being great sources of protein, including fish and lean poultry in the diet also helps the body heal faster. However, ensure that the skin is not consumed.
✔ Although a low-fiber diet cannot include much of fruits and vegetables in their raw forms, you can always include them in your diet in softer forms. Boiling them or making their soup or juice (without including the skin) can provide you with adequate nutrition, without straining your bowel. Puree foods such as chickpeas, lentils, pumpkins, butternut squash, carrots, butter lettuce, and parsnips, and get all the nutrition of these foods without having to worry about abdominal stress.
✔ If you are not lactose intolerant, foods such as Greek yogurt, hard cheese slices, and tofu can help provide ease during flare-ups. Opt for nonfat yogurt and let the healthy bacteria help in soothing your gut. Cheese slices not only provide a great deal of calories but are also rich in calcium, thereby helping in preventing bone-related issues due to the disease. If you are lactose intolerant, alternatives including almond and soymilk are great. These are also fortified with calcium to be as efficacious as cow milk.
✔ You can safely rely on skinless potatoes, as they are highly helpful in maintaining your potassium levels. Use light-cooking methods such as boiling, roasting, steaming, or mash them up to make it easy for your body to digest them.
✔ Nuts are usually restricted for consumption in their natural form, however, you can always consume their softer versions. Nut butters are a great source of healthy fats, proteins, and vitamin E. You can benefit from all their nutrients, provided you consume them in a smooth form, without the chunks.
✔ Eggs, when prepared in a non-greasy manner, can also be included in this diet. They are a great source of protein and also contain a certain amount of dietary iron. The yolk also consists of a fatty acid called lecithin that aids in absorbing fat-soluble vitamins including vitamins A, D, E, and K. However, if you have cholesterol issues, minimize the intake of egg yolk.
What Foods Should Be Avoided

As mentioned earlier, diet plays a crucial role in keeping the symptoms of Crohn's disease at bay. Certain foods can add stress to the digestive tract and aggravate the signs and symptoms. Although there is no hard-and-fast rule for the same, the following are the commonly observed food items that are suggested to be avoided in this condition.
✘ Many people with Crohn's disease are glucose intolerant. Therefore, if symptoms such as bloating, nausea, vomiting, gas, and diarrhea occur after consuming dairy products, it is best to minimize or eliminate them completely.
✘ If Crohn's disease affects the small intestine, then it causes difficulty in digestion and absorption of fats. This can worsen diarrhea and make one feel nauseous. Therefore, it is suggested to avoid high-fat foods such as butter, mayonnaise, margarine, cream, fried foods, and red meat.
✘ High-fiber foods such as fresh vegetables, fruits, and whole grains are considered to be beneficial for digestive health. But, in case of inflammatory bowel disease, these foods may worsen the symptoms. Avoid eating them, especially in a raw and hard form.
✘ Foods belonging to the cabbage family, such as broccoli and cauliflower should be avoided, states Mayo Clinic. Also, nuts, seeds, corn, and popcorn are not advisable to consume, as they are high in fiber and may trigger contractions in the large intestine. They can also lead to diarrhea.
✘ Foods that contain a lot of spice can flare up the symptoms. So can ingredients such as caffeine and alcohol.
Additional Tips

It is not only crucial to know what to eat and what not to eat, but also how to eat. Even if you include the recommended food items in your diet, the symptoms can still bother you if you tend to have the traditional three meals everyday. Experts suggest to have five to six small meals (fist-sized portions) to facilitate normal digestion and absorption of food.
► Crohn's disease leads to loss of fluids and salt level in the body. The Crohn's & Colitis Foundation of America (CCFA) suggests to "drink one half ounce per day for every pound of body weight. That means that if you weight 140 pounds, you should drink at least 70 ounces a day -- or eight and three-quarters glasses. Sip your beverages, rather than gulp them. By introducing air into the digestive system, gulping can cause discomfort."
► Due to dietary limitations and the reduced ability of the small intestine to absorb nutrients, it is essential to consume multivitamin and mineral supplements in the diet. Speak to your doctor about the specific needs and dosages as per your individual case.
Disclaimer: This HealthHearty article is meant for informational purposes only and should not be considered as a replacement for expert medical advice. As the dietary guidelines for Crohn's disease may vary from case to case, kindly consult a registered dietitian for an accurate diet plan. Remember, there is no standard diet for this disease.