Friday, December 4, 2015

{Crohn's Awareness} :: IBD and Nutrition

Proper nutrition is important for everyone, but especially for people who suffer from IBD. Paying attention to what you eat can drastically help in reducing your symptoms and promoting healing. Good nutrition is how the body restores itself to health.

IBD can cause a loss of appetite, which directly affects your nutrition. Crohn's specifically is associated with poor digestion and malabsorption. And medications tend to work better in conjunction with proper nutrition. For these reasons, it's important that good nutrition is a major component of managing IBD.

Is there an IBD-Specific Diet?
People with IBD should eat a well-balanced diet with a lot of variety. There is no IBD-specific diet, and unfortunately, the "right" foods are different for everyone. It's important to talk with your doctor about the appropriate diet for you. Even consulting a nutritionist could be helpful in developing an appropriate food plan.

When I was first diagnosed, I worried that I would no longer be able to eat the things I liked. And there are some things that I have had to let go. But it should be comforting to know that you don't necessarily have to cut out ALL of the good stuff. However, you should be prepared to cut out some of the things that you love if it turns out to be a food trigger. It stinks, but it is absolutely worth it. Some people find the consequences worth eating the favorite food; I personally have no issue with letting go of my favorite foods to not experience the consequences. 

A few things to be mindful of when managing your diet:
  • Calories: Often, IBD patients struggle with maintaining a healthy weight. During flares, inflammation and poor appetite can lead to decreased calorie intake. 
  • Protein: In some IBD patients, loss of protein mass can occur. This is due to decreased food intake and increased intestinal losses. It can also be caused by certain medications.
  • Fluids: IBD patients experience bouts of diarrhea, and therefore need to be aware of their fluid and electrolyte intake.
  • Vitamins/Minerals: There is an increased risk for deficiencies of vitamins/minerals. Crohn's patients are more prone to these deficiencies than UC patients, but a conversation with your doctor can help you identify which vitamins you need to increase in your diet or with supplements.

Identifying Food Triggers
I highly recommend keeping a food journal to help identify your food triggers. When you know which foods aggravate your symptoms, then you know which foods to avoid. And then you know which areas in your diet are lacking. For example, I can't eat beef or beans, so I have to be mindful of my protein.

I found the IBD Healing Plan and Recipe Book to be incredibly helpful. She helps walk you through identifying food triggers, allergies, and intolerances and how to manage all of them. It was so helpful to see the nutritional value of many foods and how they play a role in IBD. And I have enjoyed trying her recipes. I highly recommend this book {it also helps with celiac disease}.

Inactive vs. Active
There are definitely different foods to eat when your IBD is inactive and when it is active. When your disease is inactive, it is important to focus on proper nutrition. Some ideas {as you are able to eat them}:
  • 8-10 glasses of water a day
  • Carbohydrates with more soluble fiber {bran, legumes, barley}
  • Proteins with lean meats {fish, eggs, nuts, poultry, soy}
  • Healthy fats {omega-3 fatty acids, olive oil, canola oil}
  • Deeply colored, skinless and seedless fruits and cooked vegetables
  • Vitamin and mineral supplements {talk to your doctor}
  • Dairy and calcium

When your disease is active, it can be difficult to eat. I don't want to eat anything when I am having a flare because it seems to only make things worse. Some ideas on what you can choose when you are having a flare {again, as you are able to eat them}:
  • Fruit juices
  • Applesauce and bananas
  • Bland, soft foods
  • Plain cereals, white rice, refined pastas
  • Fully cooked vegetables and potatoes without the skin
  • Small, more frequent meals
  • Nutritional supplements {talk to your doctor}
  • Protein, as tolerated {lean meats, fish, soy}
It may be difficult, but it's important to pay attention to your food intake when you are having a flare. Keeping up proper nutrition will definitely help heal your body, get/keep it in remission.

Can Diet Control IBD?
I am often asked if diet alone can help manage IBD symptoms. I am not a doctor. I don't have all of the answers, and I am still learning how to manage this disease. There are stories of people who say they healed their IBD with diet change alone {even the author of the book I mentioned above makes this claim}. I cannot deny their success. I am definitely jealous that that was all it took for them, and I wish that I could do that as well. 

But IBD is so complex, and the disease just doesn't respond the same way with everyone. What triggers my Crohn's symptoms may not trigger someone else's. Researchers are still trying to figure out what exactly causes IBD, and there simply is not clinical or scientific data that supports the idea that diet causes, prevents, and/or cures IBD. If they find it, you can bet I will be the first to follow the diet, no matter how restrictive or difficult it may be.

Foods certainly play a major role in IBD symptoms and flare ups, and that role should not be dismissed. I think too many IBD patients skip over the nutritional component in their treatment and just want a quick reduction of symptoms. I think to have a long term outlook on your health, you have to have a holistic approach. I think all factors: diet, activity/exercise, stress, environmental/genetic factors, and medication should all be considered as you develop a plan that works for you. Follow the time-tested research, learn about the disease, develop a plan you are comfortable with alongside your doctor, and be mindful of what will get you well for the long term, not just the short term. 

For me, I avoid my food triggers and try to eat healthy. I try to exercise and keep my stress levels low. I see my doctor every year and use medication to help manage my Crohn's. And I have had great success. No approach is perfect, and I have to be disciplined. But it's definitely worth it to be as healthy as I possibly can.

*Research/information taken from NCBI, UCSF Medical Center, CCFA, the IBD Healing Plan and Recipe Book

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