Method 1
Changing the Way You Eat
Visit a doctor or dietitian. He or she will be able to help you formulate a diet specifically for you. Keep in mind that your body and your symptoms will respond differently to foods than others who also suffer from Crohn’s disease. Part of finding the right diet will be trial and error at the beginning, but your doctor or dietitian can help you make a plan to begin.
Eat smaller meals at more frequent intervals. Try eating 5-6 meals per day rather than 3. Some areas of the inner surface of the small intestine are damaged due to inflammatory processes. As a result, the effective length of the intestine is reduced (effective length means the functional part of the intestine that can handle food effectively for digestion and absorption). Thus, the diseased intestine cannot handle the same volume of food as a normal intestine can. If you eat a large meal, a significant portion will remain undigested and will pass into the colon. This portion will be fermented by colonic bacteria causing bowel gas, flatulence, bloating etc. This will also cause you to retain water in the intestine, causing diarrhea.
Drink adequate amount of water. Most Crohn’s disease patients experience repeated bouts of diarrhea, making them prone to dehydration. From this, many patients develop kidney stone due to concentrated urine. Dehydration also makes you weak and lethargic.A simple way to assess whether you have dehydration is the feeling of thirst. Drink at least 2–3 liters (0.5–0.8 US gal) of water daily to prevent dehydration. Sports drinks that provide electrolytes can also help replenish your system after a bout of diarrhea.
Method 2
Eating the Right Foods
Try to avoid or reduce your consumption of fatty foods. Fat just goes through your intestine and can make diarrhea worse during a flare-up.These undigested fats produce gas and lead to diarrhea and frothy stool. These symptoms are more severe in patients who have had a significant length of small intestine removed.
Limit your consumption of dairy products. Many who suffer from Crohn’s disease find that this can help reduce diarrhea and gas. Keep in mind that difficulty digesting dairy might also mean that you are lactose intolerant. Talk to you doctor if you believe this might be a possibility.
- Almond milk may be a good alternative to cow’s milk. It contains substantial amounts of protein, vitamin D and E, but no cholesterol or saturated fat. It can be fortified with calcium to meet daily needs.
Reduce your consumption of high-fiber foods. Fibers are actually complex carbohydrates that humans cannot digest. They pass unchanged into the colon and bulk up the stool. Fiber also retains water in the intestine that may worsen diarrhea. If needed, you should cut them into tiny chips and cook well (making them soft) to ease their passage through the intestine. Keep in mind that this advice is specifically for during a flare-up of the disease. When the incident has passed, eating a healthy high-fiber diet is a good idea.In Crohn’s disease some parts of the intestine may become narrowed due to inflammation and fibrosis. Fiber containing foods cannot pass easily through these constrictions. Therefore, you may experience cramps and abdominal pain due to vigorous contraction of the intestine.
- Green leafy vegetables
- Nuts
- Seeds
- Prunes
- Whole grains -- oats, quinoa, rye, farro, etc.
Follow a low-residue diet. Residue refers to the undigested portion of food that is excreted as stool. Low residue foods are soft and are easily digested. They also pass easily through the narrowed parts of intestine. This way, you will have less abdominal pain and cramps. Again, this advice is for during a flare-up of the disease -- it’s not healthy to only eat these soft, often refined foods as the constant basis of your diet.
- Cooked cereals
- Pastas (not whole grain)
- Skinless potatoes
- Soft white bread
- Canned vegetables without seeds.
Consume more omega-3 fatty acids. These can be found in fish and some eggs (labeled that they contain omega-3 fatty acids). There is evidence to suggest that these foods can help reduce inflammation.
Method 3
Keeping Track
Keep a food and symptom diary. While food has nothing to do with the actual pathogenesis of the disease, certain foods may aggravate your symptoms due to their effects on digestion, absorption and allergy. These depend on which part of your bowel is affected and your particular sensitivity to different foods (food allergy). Therefore, your diet should be absolutely individualized and custom made. No single diet will do the trick for everybody. Try the online food tracker and app listed below, specifically for Crohn’s disease.
Find your “trigger foods.” A great way to see what your “trigger foods” are is to keep a food and symptom diary. This is particularly helpful during a flare up. At the end of each day, note down every food item you consumed under the corresponding day/date. Also, note the symptoms of Crohn's disease you experienced that day. For example, you may write: three loose bowel movement, mild/moderate/severe cramps, feeling of abdominal gas, bloating for 2 hours, nausea etc. After 2-3 weeks you should be able to identify food item(s) that triggers your symptoms.
Remove potential trigger foods from your diet one by one. Next, try to avoid one item from your diet (which you suspect is a trigger for your symptoms) at a time for one or two weeks while keeping your food and symptom diary.If you feel no change, that particular food is unlikely to be causing your symptoms. Start avoiding another item for a further one or two weeks. This way, you will most likely find your trigger foods by a process of elimination.
Don’t completely avoid trigger foods. Finding your trigger foods does not mean you need to avoid them completely. Total elimination may lead to deficiency of particular nutrients. Rather, you may try different methods of preparing those foods like steaming, boiling or stewing. Familiarize yourself with some common triggers. Keep in mind that every person with Crohn's disease is different and what works for you may not work for someone else. However, common food items that provoke symptoms include: dairy products, uncooked vegetables, fresh fruits, breads, cereals, nuts, coffee, tea, carbonated drinks, prunes, beans, fatty foods, etc.
Method 4
Addressing Vitamin and Mineral Deficiencies
Discuss vitamin and mineral supplements with your doctor or dietitian. It is very common for people who suffer from Crohn’s disease to suffer from specific vitamin and mineral deficiencies. This is often due to the diet of soft and refined foods that can alleviate symptoms, yet does not provide enough of some essential vitamins. Discuss your diet with your doctor or dietitian and ask them for recommendations of vitamin and mineral supplements, and in what form you should be taking them.
Make sure you are getting enough folate. ASA medications such as sulfasalazine (inflammation reducer) which are used for the treatment of Crohn’s disease may impair the absorption of folate. A folate deficiency can lead to megaloblastic anemia. Green leafy vegetables are good sources of folic acid, but you might be intolerant to them as they contain a lot of fiber. Therefore, the supplement might be a better option for you. You can take a 5 mg tab of folic acid once daily to prevent this type of anemia.
Receive injections of vitamin B12. Oral tablets will not work because of failure to absorb. Vitamin B12 is absorbed from terminal part of small intestine (terminal ileum). This part is commonly affected in Crohn’s. Sometimes, this part is even surgically removed to relieve narrowed intestine. This often results in a vitamin B12 deficiency, which can lead to megaloblastic anemia.
Take vitamin D supplements. You may develop a vitamin D deficiency due to poor absorption (particularly after bowel surgery). This deficiency may cause low calcium absorption, resulting in bone weakness and potential fractures. Take vitamin D supplements in capsule form. One 0.25 mg capsule of vitamin D daily is sufficient to meet your daily needs. Alternatively, you may take cod liver oil, which can be found in capsule form. Take one capsule daily to supplement vitamin A and D.
Supplement with calcium. Calcium deficiency may arise from avoidance of dairy products, poor absorption and steroid intake. Bones become brittle and thin in calcium deficiency. As a result you may incur fractures with only minor traumas or falls. You should take a 500 mg calcium tablet two to three times daily to avoid this deficiency.
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