A balanced diet is important to lead a disease free, healthy and happy life. It must be kept in mind that during Crohn’s disease, inflammation occurs in the small intestine and it is from here that the nutrients from the food are absorbed into the body.
Thickening of intestinal linings leading to ulcer (sores) and thus damage and necrosis (destruction) of healthy intestinal tissues and in severe cases fistula formation are common Crohn’s disease symptoms of intestines.
There is no fixed diet for a Crohn’s patient. This is because intestines of people diagnosed with Crohn’s disease are incapable of absorbing nutrients as easily as intestines of a normal person. So certain alterations should be made in the diet for Crohn’s patient so that they can be certain that they are getting a healthy, balanced diet.
Diarrhea is yet another common Crohn’s diease symptom which in severe cases causes malabsorption and slowly results in malnutrition and dehydration. Malabsorption is the inadequate absorption of fats, proteins, carbohydrates and other minerals from the small intestine.
Crohn’s patients need to do experiments with their foods. Some foods tend to worsen the Crohn’s disease symptoms whereas other foods don’t; however this varies from patient to patient.
Special attention should be given while constructing a Crohn’s diet for oneself as a proper Crohn’s diet promotes healing of inflamed intestine and is vital for medicinal management of Crohn’s disease. Below are some tips for ensuring that body is receiving adequate amount of nutrients even after making alterations in diet.
Increased fluid intake:
Water is best fluid for Crohn’s patients. In severe Crohn’s disease case, chronic (severe) diarrhea is seen which can result in dehydration. If amount of fluid lost is more than amount of fluid intake then it may cause kidney malfunction. So Crohn’s patients should have ample amount of fluid daily.
Low fiber foods, when felt necessary:
Fiber foods include fruits and vegetables. In general vegetables like cauliflower, broccoli, cabbage, spinach, nuts, peas and beans, absorb water from the intestine and cause contractions of intestines. In Crohn’s patients such contractions may result in painful abdominal cramps and this may even lead to severe diarrhea. These foods also produce gas.
So during active stage of the disease such foods are avoided (see “Crohn’s diet: Foods that should be avoided”). In case of Crohn’s patients who are in severe diseased condition and have Crohn’s disease symptoms like constriction of bowel, for them fruit juice and vegetable juice, with small amount of pulp or no pulp, is mostly recommended.
However, Crohn’s patients who are in the inactive stage of Crohn’s disease, they can have fruits and vegetables if inflammation is not triggered on intake of these foods. It is seen that baked or steamed vegetables are more tolerable for Crohn’s patients than raw vegetables.
Low fat intake:
Crohn’s patients usually experience steatorrhoea (diarrhoea containing undigested dietary fats) and malabsorbtion of fat. In Crohn’s disease the small intestine can not absorb fat (see “Crohn’s diet: Foods that should be avoided”).
For this reason foods like cream, oil, butter, margarine and fast foods are classified as “problem foods” for Crohn’s patients. Crohn’s patients in whom part of the small intestine has been surgically removed should have low fat content in their Crohn’s diet. To make up for this low fat intake a physician or a dietitian can be consulted for alternative forms of fat.
Currently some liquid diets containing predigested fat are available. Some low fat foods include low-fat and fat free dairy products like bread, cereals, pretzels, crackers, plain pasta, plain rice, unbuttered popcorn, oatmeal, pancakes made without fat, low-fat muffins, lean beef, chicken or turkey without the skin, fresh ham, lean pork, fish, boiled eggs, soups based on broth, diet margarine, and fat free salad dressings.
Omega-3 fatty acids found in fish oil have anti-inflammatory effects and can reduce Crohn’s disease symptoms. These fats also help prevent colon and pancreatic cancer type complicated Crohn’s disease symptoms from occurring. Studies concluded that consuming fish oils enabled Crohn’s patients to lower their intake of anti-inflammatory medications.
Avoid milk-based products if needed:
Milk sugar, lactose, is broken down in the small intestine with the help of the enzyme, lactase. Lactase is secreted from the lining of the small intestine. In Crohn’s disease intestinal linings are damaged so there is no chance of secretion of lactase.
Moreover many people show lactose intolerance i.e. their lack lactase enzyme. In such cases lactose remains undigested in the intestine and can cause bowel cramps, gas and severe diarrhea in Crohn’s patients. So Crohn’s patient should avoid lactose intake altogether.
However patients who can digest lactose for them intake of milk and milk containing products should be encouraged.Almond milk, rice milk, and hazelnut milk are some milk alternatives that are seen to be better for Crohn’s patients (see “Crohn’s diet: Foods for Crohn’s patients.”).
Fewer intakes of diary products:
Dairy products contain milk and fat. So reasons behind lower intake of diary products in Crohn’s diet are similar to the reason discussed above in “Lactose intolerance” and in “Avoid milk-based products if needed”.
Have small meals and between meal snacks:
It is necessary to keep nourishing the body even during a flare-up. A proper nutritional diet is essential for healing of inflamed portion of bowel. Instead of pressurizing the stomach with large meals it is beneficial for Crohn’s patients if they have small meals and also, if required, between meal snacks like predigested nutritional drinks or low-fat diary products.
Limit caffeine and gas-producing foods:
Caffeine like coffee and tea; carbonated drinks like cold drinks or sodas; and vegetables like cabbage, cauliflower, broccoli, peas, beans are known to produce abdominal pain, gas and diarrhea in Crohn’s patients. These are “problem foods” for Crohn’s patients and should be avoided particularly during a flare up of Crohn’s disease.
Vitamin and mineral supplements:
Presence of vitamins (A, D, C, B-12 and folic acid) and minerals (calcium, iron, and zinc) are vital to maintain a nutritional Crohn’s diet. If there is low intake of fibrous foods (fruits and vegetables) in a patient’s Crohn’s diet then supplements of vitamin C and folic acid is required.
If a Crohn’s diet indicates low fat intake then calcium and magnesium supplements are required for that patient. If part of the small intestine (ileum) is resected then that patient requires vitamin B-12 supplements. It is often advised to Crohn’s patients that they may take multivitamin tablets if they think their diet lacks proper amount of vitamins.
Avoid sugar, soy and fast foods:
Many bacteria feast on sugar and they tend to be harmful for the digestive system. Many high -sugar fruits like grapes, pineapple, and watermelon can increase inflammation. So any kind of sugar containing food should be avoided as much as possible.
Soy is the major ingredient in many products like cereals, chips and chocolates. Soy oil, soy milk, soy lecithin or any kind of soy containing product should be specifically avoided since all these products have unfermented soy that is toxic to colon and prevents absorption of necessary minerals like copper and calcium and also blocks enzymes responsible for protein digestion. Fast foods contain fats, soy and sugar. All these make Crohn’s disease symptoms worse so keep away from fast foods.
If you continue losing weight and feel extremely tired most of the time or if you think that you are not getting appropriate nutrients from your planned Crohn’s diet and that your diet has become really limited, visit and consult with a dietitian. You can even take nutritional tests to see whether your constructed Crohn’s diet is lacking in any particular nutrient.