Crohn’s Disease: Why Food Matters
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“Was it something I ate?” For most people, this is the first thought that comes to mind after feeling a sudden twinge of digestive unrest.
Although food doesn’t bring on digestive symptoms for people with Crohn’s disease — or lead to Crohn’s in the first place — what you eat is very important, says Sunanda Kane, MD, professor of medicine in the division of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minnesota. There is no proven Crohn’s disease diet or food cure, but certain foods may have an effect on symptoms and are linked to inflammation. Others may help you heal and regain important nutrients that are lost during flares.
This means that watching what you eat and being aware of how specific foods affect you will go a long way in helping to control your symptoms and promote better overall health. Start here.
Healing Crohn’s Disease From the Inside Out
Each case of Crohn’s disease is different. That said, your dietary recommendations will depend on where you are in your disease process and the type of Crohn’s you have. You should talk to your doctor or a dietitian to determine the best diet for you.
“If you have inflammatory disease of the small intestine, eating easy-to-digest carbohydrates and proteins, and less fat, may help minimize your symptoms,” Dr. Kane says.
If you have a stricture — a narrowing of the intestine — anything that is bulky may get stuck and cause an obstruction. “I tell my patients with strictures to go on a low-fiber diet,” says Arun Swaminath, MD, director of the Inflammatory Bowel Disease Program at Lenox Hill Hospital in New York City. “High-fiber foods bulk up the stool, which can be painful and uncomfortable to pass through a narrow area.” These people may want to avoid nuts, large seeds, and raw vegetables as well.
It’s also a good idea to avoid high-fiber foods if your disease is limited to your colon because these foods may cause bloating and diarrhea, Kane says.
Your Crohn’s diet is particularly important during a flare, when appetite can suffer. Jessica Shapiro, RD, a wellness dietitian at the Montefiore Medical Center in the Bronx, New York, suggests the following meal plan to avoid exacerbating symptoms during a flare: a low-fat, low-fiber, high-protein, high-calorie diet and eating small, frequent meals. “Avoid high-fiber, greasy foods, caffeine, sorbitol, and foods that produce a lot of gas. These include cruciferous vegetables, beans, legumes, onions, peppers, and carbonated beverages,” she says.
“Instead,” says Dr. Swaminath, “eat a bland diet, which is easier on the gut when things are inflamed.” When things calm down, you can go back to your regular diet — but be sure to pay attention to anything that triggers your symptoms. “If you know spicy Indian food sets you off every time, for instance, that’s something to stay away from,” he says.
What to Eat Between Crohn's Flares
Eating well on a regular basis should help you with the daily management of Crohn’s disease. “Good nutrition is important to maintain weight and replenish lost nutrients from flares,” says Nina Eng, RD, chief clinical dietitian at North Shore-LIJ’s Plainview Hospital in Long Island, New York. “The healthier you are when symptoms do occur, the easier it will be for your body to fight infection and heal wounds.”
To keep your digestive system as healthy and nourished as possible, take these smart nutrition steps:
- Power up with protein. During flares, people with Crohn’s disease may not get the protein and nutrients their bodies need due to loss of appetite or poor digestion. And some people with Crohn’s disease take corticosteroids to decrease inflammation, but these medications can cause loss of lean muscle mass. “It’s important to replace lost protein,” Eng says. “Good protein sources include eggs, meat, fish, poultry, milk, cheese, and beans. You can also add milk powder to foods to increase protein content.”
- Avoid intestinal instigators.Aggravators for people with Crohn’s disease often include dairy products, spicy food, and fats. “I recommend all people with Crohn’s disease stay away from nuts, seeds, caffeine, and alcohol,” says Kristi King, MPH, RD, LD, senior dietitian at Texas Children’s Hospital in Houston. “Other trigger foods vary from person to person,” she says. “Try to keep a food and symptom diary so you can spot trouble foods.”
- Make calories count.King recommends eating plenty of foods for Crohn’s that are easily tolerated and packed with nutrition so you can keep up your calorie intake. “Go for eggs, yogurt, creamy nut butters, and lean meats such as baked or grilled chicken and turkey,” she says.
- Fight inflammation.To help combat the inflammation that accompanies Crohn’s disease, try anti-inflammatory foods. “These include foods with phytochemicals, such as colorful fruits and vegetables, and foods with omega-3 fatty acids, such as fish, walnuts, and fish oil supplements,” Eng says. Olive and canola oils, yogurt, kefir, and the spices ginger and curry also have anti-inflammatory properties.
- Focus on nutrients.Choose foods that pack calcium, folic acid, vitamin B-12, iron, zinc, and fat-soluble vitamins A, D, E, and K.
The most important thing to remember when choosing foods for your Crohn’s diet? Good nutrition. “There are no studies that show a particular diet can control Crohn’s disease,” King says.
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