Inflammatory Bowel Disease Diet and Treatment

Inflammatory bowel disease (IBD) is an umbrella term for chronic conditions marked by gastrointestinal tract inflammation. Two of the most common conditions are ulcerative colitis and Crohn’s disease. Ulcerative colitis is more localized than Crohn’s disease but in both cases, the immune system responds abnormally to normal substances in the intestines, such as food and bacteria. To fight off the invader, your body sends white blood cells into the lining of the intestines, and the result is chronic inflammation, which causes symptoms such as bloody stools, cramping, diarrhea, and appetite loss.

Nutrition Connection
While diet doesn’t cause IBD and can’t cure it, some foods may ease symptoms while others may trigger flare-ups. These are different for each person, so you may need to do a little detective work to tailor an eating plan that works for you. The following suggestions may help:
-Eat 5 to 6 smaller meals. Spacing smaller meals throughout the day, rather than having three large meals, puts less strain on your intestinal tract.
-Drink lots of fluids but avoid alcohol. This can help prevent dehydration, kidney problems, or gallstones. Alcohol can worsen intestinal bleeding, lowers the body’s immunity, and may contribute to malnutrition. Taking in liquid at the same time as food, though, may sometimes cause diarrhea, so do your drinking in between meals.
-Identify your trigger foods. Try eliminating any foods that seem to create problems, such as dairy, fried foods, artificial sweeteners, or spices. Add them back in one at a time, and keep a diary of symptoms.
-Stick to your safe foods. While these are different for everyone, most people find that the classic BRAT (bananas, rice, applesauce, toast) diet works to soothe symptoms. Chicken, turkey, and other white meat is also usually well tolerated.
-Limit foods high in fiber. High-fiber foods are often improperly digested and passed through to the colon where they can be digested by bacteria. This may cause bacterial overgrowth, which in turn can exacerbate the disease, irritate the intestines, and make diarrhea worse. Insoluble fiber, such as that found in bran, whole grains, nuts, and dried fruits, tends to be more irritating than soluble fiber, such as that found in oats.
-Discuss other ways of obtaining nutrition. The most severe cases of Crohn’s may require total parenteral nutrition (TPN), in which all nutrients are given intravenously. TPN is most beneficial for patients who need to rest their intestinal tract or are unable to absorb nutrients from eating. This approach also benefits children whose growth is being stunted by inadequate nutrition. Because it can be administered at home, TPN allows for a more normal lifestyle.

Beyond the Diet
Because ulcerative colitis is usually localized to the colon, surgery to remove the colon is considered a cure. For patients with Crohn’s disease, however, while surgery to remove diseased parts of the bowel may provide some relief, the disease usually recurs. Some medications, such as 5-ASA medications and corticosteroids, are used to treat both conditions. In addition, try the following:
-Stop smoking. Smoking is a risk factor for Crohn’s disease and can actually worsen your symptoms. Ask your doctor for help in quitting.
-Practice relaxation techniques. Stress can worsen IBD symptoms, so mind-body exercises such as yoga, meditation, and tai chi can be helpful.
-Move your body. Although exercise is the last thing you may feel like doing, try to be more active. Doing so eases stress in addition to helping maintain overall health.
-Consider hypnosis. At least one study suggests that hypnotherapy can help reduce IBD symptoms.
-Get psychological support. Depression and anxiety are common among people with IBD, especially children. Cognitive behavioral therapy can help deal with symptoms and improve your coping skills.
-Talk to your doctor about taking supplements. Even Crohn’s patients who maintain a normal diet may develop nutritional deficiencies because of poor nutrient absorption. High-dose vitamins should only be taken under a doctor’s supervision; for example, those who develop vitamin B12 deficiency often need to take it by injection if they lack the intestinal substances to metabolize it. Patients with severe symptoms or those who have had extensive surgery may need a special high-calorie liquid formula, either as a nutritional supplement or as a meal replacement. In unusual cases, an elemental diet—a low-fat, easy-to-digest formula—may be prescribed.