Louise Chang, MD
Because Crohn's disease affects the gut and symptoms often occur after meals, you may wonder if certain foods cause or contribute to the disorder. Many experts wonder about this too and research looking into the connection between diet and Crohn’s is ongoing.
“At this point, we don’t have an ideal diet for Crohn’s, but we do know that certain types of foods can make symptoms worse or better,” says Joshua Korzenik, MD, assistant professor of medicine at Harvard Medical School. Korzenik is the director for the Crohn’s and Colitis Center at Massachusetts General Hospital in Boston. To help ensure that you are eating a balanced diet and getting enough calories while avoiding symptoms, you can take these steps:
It’s a good idea to talk with your doctor about your nutritional needs and what you can do to ensure you are meeting them. You may want to ask your doctor about working with a registered dietitian (RD). This person can help you track what you eat, work with you to adjust your diet to help reduce symptoms during flares, and make sure you are getting all the nutrients and calories you need. “We always recommend that our patients work with an RD,” says Korzenik.
Depending on the extent and location of your disease, you may need to take nutritional supplements. Having Crohn’s disease can make it difficult to get the nutrients you need for a number of reasons:
It’s a good idea for everyone with Crohn’s disease to take a daily multivitamin, and your doctor or RD may also recommend supplements, either as an injection or by pill or liquid, to help replace one or more of the following nutrients:
Some studies are looking at the role of probiotics as a therapeutic option for Crohn’s disease. These are “friendly” bacteria in the intestines that help maintain GI health by keeping harmful bacteria in check. When the balance between helpful and harmful bacteria is thrown off, for example because of taking antibiotics, it can cause diarrhea and other problems.
Researchers have been studying the use of probiotics to help reduce symptoms and achieve remission of Crohn’s disease flares. At this point, studies are inconclusive about whether these substances can help, but research is ongoing.
Because your nutritional needs may vary depending upon whether or not you are in a flare and where you are in the progression of the disease, it’s best to consult with your dietitian or doctor before taking supplements or altering your diet in any way. That way you can be sure your nutritional needs are being met at all phases of your disease.
There may be times when your doctor may recommend nutritional support. This is the use of a nutrient-rich formula that is administered directly into your stomach or small intestine, called enteral nutrition.
The supplement is usually given at night through a feeding tube that leads from your nose to your stomach, or by an opening created in the abdominal wall where a tube can be placed. This allows you to get all the nutrition you need while you sleep and then go about your daily activities during the day.
In some cases, a different type of nutritional support may be used that bypasses the stomach and intestines. Total parenteral nutrition is delivered through a large blood vessel.
Joshua Korzenik, MD, assistant professor of medicine, Harvard Medical School; director, Crohn’s and Colitis Center, Massachusetts General Hospital, Boston.Crohn’s and Colitis Foundation of America: “About Crohn’s Disease,” “Living With Crohn’s Disease,” “Managing Flares and Other IBD Symptoms.”National Digestive Diseases Information Clearinghouse: “Crohn’s Disease,” “Diet and Nutrition.”Shafran, I. Digestive Diseases and Sciences, April 2010; vol 55, no 4: pp 1079-1084.Feller, M. Clinical Infectious Diseases, Feb. 15, 2010; vol 50, no 4: pp 473-480.American College of Gastroenterology: “Management of Crohn’s Disease in Adults.”Doherty, G. Alimentary Pharmacology and Therapeutics, April 31, 2010; vol 8: pp 802-809.Morris, J. The Journal of the Louisiana State Medical Society, May-June 2009; vol 161, no 3: pp 155-159.Chiba, M.World Journal of Gastroenterology, May 28, 2010; vol 16, no 20: pp 2484-2495.Rajendran, N.World Journal of Gastroenterology, March 28, 2010; vol 16, no 12: pp 1442-1448.
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