- Crohn’s Colitis Solutions
- I Beat my Crohn’s through Diet
- Crohn’s Disease Diet: Which Foods to Eat and Which to Avoid
- NUTRITION AND DIET
Crohn’s Colitis Solutions
I Beat my Crohn’s through Diet
(An article by one of our patients)
Five years ago I was diagnosed with Crohn’s disease, a chronic inflammatory disorder that produces diarrhoea, abdominal pain, bloating, fever and a range of other unsettling symptoms. Conventional treatment consists of steroids and, if eventually necessary, surgery to remove sections of the bowel.
In my case, I was also suffering from most unpleasant sinus headaches and catarrh – again a long-standing condition. These latter symptoms were becoming more and more obviously related to food, and would come on with or immediately after virtually every meal. So, as my activities were becoming curtailed and I was feeling rather desperate, I decided to consult the IBS and Gut Disorder Centre to see just how much any or all of my symptoms might be linked with food.
I was asked to complete three detailed questionnaires and after some further questions pronounced that I was suffering from an overgrowth of Candida, a yeast organism which we all have in our intestines and which, in some people, grows out of control, producing a host of unpleasant symptoms. It was suggested that I follow a diet involving the exclusion of all wheat, all cereals (oats, rye, etc.), all yeast, all sugar and foods containing sugar, and anything that had been fermented. This meant excluding wine, beer, cider and whisky. I was also prescribed tablets to kill off the yeast and special probiotics to replenish my gut with friendly bacteria. My natural colonies of the latter, was suggested, had been destroyed by a lengthy dose of antibiotics I had taken in my teens.
I initially doubted whether I could manage such a strict dietary regime. Yet radical though the measures were, my resolve was strong, given the scale of my problems. I was sent me away with a sheet of suggested menus and I began my six-week treatment.
I lived on my new diet for six weeks before going back for my next appointment, and I have to say that I implemented it very strictly. I think I had a glass of champagne during that time, but that was about the only lapse. And I probably ate better during this period than for many years. I rediscovered what it was like to cook and to have a varied diet rather than relying on one thing all the time. And, of course, I was forced to read labels. Snacks were the most difficult part because all the things I would usually reach for were now out of bounds. Rice cakes, nuts and carrots ended up doing duty instead.
What surprised me was how rapidly I saw the beneficial effects on my digestive system. And it was only then that I fully realised how much I had been suffering. I had often assumed that the problem was that I couldn’t tolerate fibre but, with a large chunk of my diet now comprising vegetables and salads, this was evidently not the case. All those bowel and stomach symptoms – the constant discomfort – vanished like magic. No more getting up in the night, or gritting my teeth through meetings, or worrying about travel. No more athlete’s foot either, and I had (despite the most scrupulous hygiene) been plagued by that seemingly intractable condition for as long as 25 years!
My energy levels improved markedly. I particularly noticed that the afternoon dips in energy and the flaking out in the early evening tended to disappear. I felt hungry and unsatisfied for a lot of the time at first, but this was, after all, a period of adjustment. Somehow I knew that the feeling of emptiness was not ‘genuine’ but more a function of withdrawal. Also my skin condition generally improved, something that several people commented on. And the excessive catarrh on eating was much reduced.
It is amazing how transient one’s memories of discomfort can be. I returned to see Victoria Tyler and the results were no surprise to her; the way forward was for me to continue to adhere to the diet. And yet after a while temptation crept back in: a slice of cake here, a biscuit there, a piece of bread. And along with these lapses my symptoms returned, reminding me of just how much improvement there had been and how awful I had felt before the diet. The answer, in particular, was to keep off wheat and cereals. If I started having sugar again, my skin condition deteriorated and my athlete’s foot came back.
In my case, the answer to Crohn’s and my other symptoms has been both easy and difficult. Although I continue to take anti-inflammatory medication, the whole constellation of unpleasant symptoms has been eliminated by mere attention to diet. For me this is a fact and it’s a simple and straightforward one. But changing your diet can be an initially traumatic process, and thereafter not easy to maintain. We are surrounded by debased and degraded foods laden with sugar, and we tend to rely on a single substance – wheat – day in and day out. Breaking free from this is, in practical, social and even cultural terms not easy, but the rewards in terms of health have been, in my case, extraordinary.
Crohn’s Colitis Solutions
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Crohn’s Disease Diet: Which Foods to Eat and Which to Avoid
In addition to your genes and stress, the Crohn’s and Colitis Foundation also identifies smoking, antibiotic use, non-steroidal anti-inflammatory drug (NSAID) use, and appendicitis as potential risk factors for the development of IBD.
Crohn’s Disease and Diet
Featured Recipe:s Lemon-Herb Salmon with Caponato & Farro
Because Crohn’s disease symptoms vary from person to person and because the disease impacts various parts of the GI tract, there is no general recommendation when it comes to diet. The GI tract has many functions, including digestion and absorption of nutrients and water, elimination of waste, and maintenance of a bacterial balance in the gut microbiome. To better understand what the nutrient needs are in a person with Crohn’s disease, you must know which part of the GI tract is affected.
“Where a person has active Crohn’s disease in their GI tract affects what nutrients they may have difficulty absorbing,” Garrett says. The anatomy of the GI tract matters because each portion of the tract has a different and specific role in the digestion and absorption of nutrients from food.
“People with upper GI Crohn’s disease are at an increased risk of nutrient, vitamin, and mineral deficiencies. If the disease is in the last portion of the ileum (small intestine), then there is increased risk for B12 deficiencies,” Garrett says.
Crohn’s is also characterized by periods of disease flares and periods of remission which impacts nutrient needs. “During periods of active disease flares, a low-fiber diet is recommended, which is a diet that avoids foods that would add bulk to stool. A few examples of high-fiber foods we ask our patients with Crohn’s disease to avoid during flares are raw fruits, raw vegetables, seeds, and nuts.”
Nutrient needs are further complicated if portions of the GI tract have been removed due to strictures or narrowing of the GI tract from chronic inflammation.
Keep Reading: How Gut Bacteria Impacts Obesity, Allergies, Happiness and More
Crohn’s disease, diet, and remission
Featured Recipe: Roasted Buffalo Chickpea Salad
Crohn’s disease never goes away completely-there is no cure-but patients do experience periods of remission, or times with the disease is less active. When in remission, a person should be able to eat a diet that ensures they’re meeting their nutrient needs through food.
“Some people have foods that just don’t agree with them, and they avoid those. These foods might include dairy, spicy foods, or foods high in fiber, but again, it is person specific,” Garrett says. These are called trigger foods, and identifying trigger foods can help you avoid uncomfortable symptoms.
Rebecca Greer, a registered dietitian based in Chattanooga, TN agrees. “There are no blanket rules or recommendations. The goal is to find out which foods makes each patient’s symptoms worse and avoid those,” she says.
Greer goes on to say that there are no specific foods that either cause or exacerbate Crohn’s. “Each patient differs in what foods aggravate the symptoms of their Crohn’s, but there is no evidence that these foods actually worsen the inflammation. At this point, we only have patient testimonies, but no systematic studies for certain diets,” she says.
How to identify triggers
Feature Recipe: Chipotle Chicken Quinoa Burrito Bowl
One approach to identifying “trigger” foods is to follow an elimination diet. Barmmer suggests working with a registered dietitian in this case. During this time, groups of food will be stripped from your diet. You will eat a very simple diet and give your body time to adjust.
“It’s fairly common to see particular food(s) causing an inflammatory immune response in the body, so a comprehensive elimination diet is usually helpful,” she says.
The elimination period is then followed by periods of reintroducing foods to see if they result in an inflammatory response, but that isn’t the only focus, says Barrmer. “The goal after removing inflammatory foods is always to also look at bacterial balance and other stressors on the body.”
This process may also help to identify food allergies, too, but it should be noted that food allergies are not the same as food intolerances. A food allergy results in an immune response. Sometimes these immune responses are life-threatening, such as what is seen with nut allergies, and require immediate medical attention. A food intolerance, however, is not life threatening. It results in a GI symptom or response, such as upset stomach or stomach cramps.
Elimination diets have the potential to result in nutrient deficiencies. That’s why they should be conducted under the supervision of a registered dietitian or a doctor to ensure all nutrient needs are met.
The Bottom Line:
People with IBD must seek individualized treatment. In general, people with Crohn’s disease should ensure their nutrient needs are met when the disease is in remission. This includes avoiding “trigger” foods and eating greater amounts of nutrient-rich foods from a variety of sources. During flares, it’s important to modify the diet to avoid excess fiber and prevent further exacerbation of symptoms.
In college, before she was diagnosed with Crohn’s, a kind of inflammatory bowel disease (IBD), Shelby Slenkamp sat in the cafeteria picking at cucumbers while her friends ate dinner. Then she’d retreat to her dorm room to eat a meal of crackers in private. “I equated my symptoms with pain and embarrassment, so I was too afraid to eat in public,” says Slenkamp.
She isn’t alone in her experience. The three million Americans who live with IBD don’t talk about it much, and there are many misconceptions about the condition, especially when it comes to food. The idea that you’ll be stuck with a bland diet of crackers and white rice for life simply doesn’t have to apply to those living with IBD.
A diagnosis of inflammatory bowel disease (IBD) can devastate anyone, but it can be extra daunting for food lovers. “In a nutshell, IBD is a condition that causes swelling along the gastrointestinal tract,” says Cuckoo Choudhary, MD, a gastroenterologist at Jefferson University Hospital in Philadelphia.
There are two major types of IBD: Crohn’s disease, which can occur anywhere along the GI tract, and ulcerative colitis, which affects only the colon. Colitis affects only the bowel lining, while Crohn’s can affect all the layers of the bowel wall. Otherwise, the conditions are very similar. In either case, the disease and its symptoms are intimately tied to food and eating.
Choudhary says symptoms vary, but none of them makes great dinner party conversation. Gas, bloating, cramping, and diarrhea are common to both forms of IBD. Thanks to the stigma of GI distress, many people with IBD isolate themselves from shared meals so they don’t risk the embarrassment of an emergency trip to the restroom.
“People don’t realize, it’s very common to go into remission—most of my patients do,” says Choudhary. At that point, many of her patients resume whatever diet they enjoyed before getting sick, though if their IBD acts up, they may need to choose foods more carefully to get back on track.
“Before I was diagnosed, I had no reference point for what a normal relationship with food was,” says Slenkamp. Today, she regularly cooks and enjoys meals with others, though it was a long road from dorm room Saltines to where she is now.
It took years for Slenkamp to get an accurate diagnosis. When she talked to doctors about her stomach pain, they didn’t seem to take her seriously. “They said, ‘You probably have a touch of irritable bowel—eat more salad and drink more water,” says Slenkamp. It wasn’t until her gynecologist suggested she get a colonoscopy to try to get the bottom of her persistent abdominal pain that she got some clarity. “The GI doctor took one look at it and said, ‘classic Crohn’s.’”
Colonoscopies, most often thought of as a cancer screening, also show IBD, which can be otherwise tricky to diagnose. “Don’t be afraid of a colonoscopy,” urges Choudhary. She says they aren’t as bad as many people think. And most patients, like Slenkamp, are relieved to have a diagnosis when they’ve suffered for years without answers.
The causes of IBD aren’t well understood, though they are thought to be a combination of genetic and environmental factors. Both Crohn’s and colitis are believed to be overreactions of the immune system. Ongoing treatment, usually a mix of steroids to quell the inflammation and immune suppressants to quiet the immune system, is often required. It’s important for patients to understand that IBD isn’t caused by something they did or something they ate.
That advice Slenkamp had been getting about eating more salads only aggravated her symptoms, as it turned out. “I encourage newly diagnosed patients to see a dietitian, but I do suggest they avoid salads, caffeine, and dairy,” says Choudhary. She also recommends cutting alcohol, which triggers flare-ups in many IBD patients. Beyond that, Choudhary says there’s little research to support specific food recommendations as a one-size-fits-all solution. She advises working with a dietitian on a personalized plan.
These Crohn’s Disease Recipes are all soothing on the gut and easy to digest. Perfect for anyone feeling like their digestion needs a reset.
When I had active Crohn’s Disease, I didn’t have a clue what to eat. It seemed like anything and everything that passed my lips would result in me curled up in the fetal position nursing a stomach ache for the rest of the day. As much as I wanted to write off food completely, I knew my body really needed high quality plant based nutrients in order to heal.
So I took to the internet. You can find everything on there, right?
Wrong. I was bombarded by hundreds of articles, none with any actual recipes to get me started. So, I experimented myself until I found what worked. These 10 Crohn’s Disease Recipes made up the bulk of my diet for months until my body started to heal and I was able to introduce more foods.
All of these Crohn’s Disease recipes are easy on digestion while being packed with the vital nutrients your body needs. They are easy to prepare and most importantly have tons of flavor.
If you don’t have Crohn’s Disease don’t write these recipes off! Now that I am symptom free, I still turn to these Crohn’s Disease recipes whenever I feel like my body needs a reset. If my digestive system feels sluggish or I feel a cold coming on, I immediately retreat to these recipes to fuel my body with nutrients without asking it to spend energy digesting complex foods. These recipes really work wonders in getting you back to feeling your best!
Sweet potatoes get baked until they are sticky sweet and really easy to digest. Then they get stuffed with steamed broccoli and buttery avocado. A sprinkle of salt and pepper brings this simple dish to life!
- 1 sweet potato
- 1 cup broccoli floretts
- 1/2 avocado
- Salt and pepper
- Preheat the oven to 425 degrees. Wrap your sweet potato in foil and place it on a baking tray. Bake until the sweet potato is soft to the touch. This could take 45 minutes to 1 hour 30 minutes depending on the size of your sweet potato.
- Once the potato is cooked, add the broccoli to a steamer basket and steam until tender, about 7 minutes. Cut a slit in the sweet potato and stuff the steamed broccoli inside. Top with avocado and salt and pepper to taste. Enjoy!
This tea is loaded with herbs and spices that have potent anti-inflammatory, gut soothing, and healing properties. The taste is something you might have to get used to, but just remember all the good this cup of tea is doing your body! Add honey to taste for extra sweetness and even more benefits.
- 2 tablespoons fennel seeds
- 2 tablespoons coriander seeds
- 2 tablespoons fenugreek seeds
- 1 tablespoon dried ginger pieces
- 1 tablespoon cumin seeds
To make the tea mix:
- Add all the spices to a jar and shake well to combine.
To brew the tea:
- Add 4 cups of water to a pot and bring it to a simmer. Add in 4 teaspoons of the tea mix and simmer the mixture for 15 minutes to extract all the beneficial properties from the seeds. Remove from the heat and strain out the seeds. Sweeten with honey to taste and drink throughout the day.
I buy all these spices in the bulk section of my natural foods store. Make sure all the spices are whole, not ground into powders.
10 Minute Immune Boosting Broth
Sip the quick and easy broth throughout the day for a boost of health. Full of probiotics from miso and anti-inflammatory herbs and spices like ginger, garlic, and turmeric.
Get the Recipe Here
This soup is packed with anti-inflammatory ingredients like turmeric, ginger, and shiitake mushrooms. Plus, it will keep you full with easy to digest rice noodles and tofu.
- 1 recipe 10 Minute Immune Boosting Broth
- 8 oz shiitake mushrooms, sliced
- 1 block extra firm tofu, drained and cubed
- 10 oz white rice noodles
- Bring the 10 Minute Immune Boosting broth to a simmer in a large pot. Add in the shiitake mushrooms, cover, and simmer for 10 minutes.
- Add in the tofu and rice noodles. Cover and simmer until the noodles are tender and the tofu is warmed through, about 7 minutes. Ladle into bowls, top with scallions, and serve.
Breakfast Quinoa Rice Pudding
This creamy and filling rice quinoa and rice pudding is sweetened with bananas and packed with whole rain nutrition. The grains become easier to digest thanks to the long cooking time. Great for any meal of the day.
Get the Recipe Here
This simple recipe couldn’t be easier! I like to switch up the root vegetable in this mash each time in order to get in a wider variety of nutrients! Root vegetables contain prebiotic fiber that help feed our gut bacteria for a healthy digestive system.
- 4 cups cubed root vegetables (all 1 root veggie or a mix of 2)
- A drizzle of extra virgin olive oil
- Salt and pepper to taste
- Add the cubed veggies into a steamer basket and steam until very tender, about 20-25 minutes.
- Place in a bowl and mash well. Top with oil, salt and pepper.
- I like to use squash, celery root, sweet potatoes, purple potatoes (may be a trigger for some people with Crohn’s), carrots, parsnips, or turnips in this recipe. There are so many amazing root vegetables out there. Experiment and find what you like best!
Detox Broccoli Cheese Soup
Packed with health-promoting sulforaphane from broccoli! This silky smooth soup is easy to digest since it is both cooked until tender and then pureed. Omit the cheese toasts as they are much harder to digest.
Get the Recipe Here
Sweet Potato Pie Smoothie
A nutrient-packed low sugar smoothie that can be made in 10 minutes. Plus, it tastes like a slice of pie. Omit the granola to make it easier to digest.
Get the Recipe Here
Homemade Vegan Greek Yogurt
This easy homemade dairy free yogurt is packed with probiotics, free of gums and other artificial ingredients, and is so much more cost effective. I try to get in a daily serving of fermented foods (like this yogurt) to keep my gut bacteria (and therefore myself) thriving.
Get the Recipe Here
Golden Beet Cauliflower Soup
This Golden Beet Cauliflower Soup recipe is a fast and easy 3 step dinner that is full of flavor and veggies! The pureed consistancy makes it easy to digest and absorb all the nutrients from this superfood soup!
Get the Recipe Here
NUTRITION AND DIET
Is it helpful to take more or less fibre than usual in the diet?
A low fibre diet which limits the amount of ‘bulk’ in the diet is often used when there is active disease in the large bowel or terminal ileum, to help control symptoms of diarrhoea, bloating and abdominal cramping. As discussed below, most people with IBD can eat a normal or near-normal diet without making diarrhoea or pain worse. The usefulness of the strict, traditional, “low residue” diet is now seriously questioned, though it is recognised that an excess of fruit can make diarrhoea worse, just as it can cause diarrhoea in healthy people. For this reason, most doctors advise their patients to take a normal nutritious diet unless particular foods appear to cause unpleasant symptoms.
For people with Crohn’s disease with small bowel strictures (narrowing), it is advisable to reduce high fibre foods and those which may cause blockages, and abdominal cramping. Discuss this with your dietician.
Is alcohol harmful?
There is no evidence that alcohol taken in moderation makes the inflammation worse. Some healthy people notice bowel looseness after certain wines or beer, and people with IBD who notice the same thing will naturally avoid the types of alcohol that upset them. People on medication for their IBD and associated problems should consult their doctor or pharmacist to ensure that alcohol intake doesn’t interfere with the metabolism of their medication or cause additional side effects.
Do particular foods aggravate diarrhoea?
Watery frequent bowel motions are due to failure of the small intestine and/or colon to absorb fluid because the lining is inflamed and does not absorb fluids or nutrients properly. An excess of fruit or onions in some people, beer, or very spicy or fatty foods, may give healthy people diarrhoea. Such foods may aggravate the diarrhoea in people with IBD, but it is doubtful if any of them do harm. It seems sensible for people to avoid foods that they know cause them diarrhoea, but apart from this they should eat normally. When the capacity of the small intestine to absorb fat is impaired, even a normal amount of fat in the diet may cause diarrhoea. Such people may benefit from restriction of excess fat in the diet.
Many people with ulcerative colitis cannot wait when they feel the urge to go to the lavatory, regardless of whether the stool is liquid or solid. This symptom is generally due to sensitivity of the inflamed rectum and there is no evidence that a change of diet influences this sense of urgency, except in so far as the number of stools can be reduced, as already described.
Do particular foods cause pain?
Abdominal cramps may occur when there is a narrowing of the intestine so that the intestinal muscle has to contract forcibly to push the contents through the narrowed area. In this situation, lumps of indigestible food such as gristle, fibrous vegetables, orange pith, dried fruits, mushrooms or nuts may aggravate the pain because a lump of food lodges at the site of narrowing and the intestinal muscle contracts very strongly to push it through. When one or more narrowed areas of intestine are present, as may happen in Crohn’s disease, pain may be relieved by avoiding large meals and by leaving out these indigestible items of food, and chewing all food to a puree in the mouth before swallowing.
Do particular foods aggravate wind?
Wind largely arises from bacterial fermentation of food residues in the colon. Failure to absorb fat or milk sugar (lactose), as already described, may lead to flatulence. This can be helped by a low-fat or low-milk diet respectively. Food such as cabbage, broccoli and onions can lead to the formation of wind in normal people and therefore should also be taken in moderation in people with IBD. If you find yourself with problematic wind after eating a particular food, you may find it best to avoid it altogether. People will react differently to foods, so it is difficult to provide specific nutritional advice for people with IBD who experience flatulence, to follow.
Everyone needs to have a well-balanced diet for good health, vigour and healing. People with Crohn’s and colitis in particular must eat well in order to avoid problems such as malnutrition and dehydration.
For most people with IBD, emphasis is placed on the known positive benefits of a good mixed diet, rather than on the less certain benefits of restricting what is eaten. People who become ill and lose weight, and especially young people who become ill and stop growing, need more food than average to supply their daily needs. In certain circumstances, restriction of milk, fat or high residue foods can be helpful but restriction should only be taken under medical advice.
Most people with IBD find that they can take a normal mixed diet without difficulty, avoiding only a few excesses or specific foods which can equally upset people who are in good health.
For those interested in pursuing diet ideas, there is more information available now on diet possibilities that may either improve the extent of disease or your symptoms. It is important to remember that diet benefits vary for each person and what work’s for some doesn’t always work for others. But it might be the case that eating a bit more of the foods that are common recommendations of both of the two main diets talked about in the IBD space could help symptoms.
Foods that can reduce inflammation
Here is a video you can watch of Professor Lyn Fergusson’s presentation to our Wellington Support group on foods that can reduce inflammation.
‘You are what you eat’
Food choices low in FODMAPS can help some patients, especially if they also have irritable bowel syndrome. The foods to eat and foods to avoid in this diet are now easily accessible on the internet;
‘Low FODMAP Diet – DYI Beginners Guide’
‘Low FODMAP Blog’