Crohn's disease is a chronic inflammatory disease of the intestines. The disease's presentation includes periods of abdominal pain, fever, loss of appetite and bloody or watery diarrhea, followed by periods of remission. It can result in intestinal ulcers, fistulas and intestinal obstructions. Crohn's often causes malnutrition due to lower food intake related to loss of appetite, as well as poor absorption of nutrients resulting from inflamed or damaged intestines.
Incidence and Cause
Two to seven people in 100,000 have Crohn's disease, according to the University of Maryland Medical Center. It is usually diagnosed when a person is between 20 to 40 years old. Genetics may play a role; about a fourth of Crohn's sufferers have a close relative with the disease. Another theory is that bacteria or a virus triggers a faulty immune system response. Since Crohn's is more common in developed countries, a diet high in saturated fat and processed foods may be a contributing factor.
Risk Factors
The University of Maryland Medical Center lists several risk factors not under a person's control. For example, people of Jewish heritage are three to six times more likely to develop Crohn's. People of European, especially Scandinavian, ancestry also are more likely to have Crohn's, as is anyone with a family history of inflammatory bowel disease. Factors under a person's control include cigarette smoking and diet. Diets high in saturated fat and sugar and low in fruits and vegetables appear to be associated with a greater risk of developing the disease.
Digestion and Crohn's Disease
Absorption of nutrients takes place in the small intestine. Water is absorbed in the large intestine. When either of these is inflamed or damaged as a result of Crohn's, malnutrition and dehydration can result. The Crohn's & Colitis Foundation of America says Crohn's is not related to food allergies, nor do specific foods increase intestinal inflammation. However, some foods may aggravate symptoms. Which foods do so varies among individuals.
Fiber and Flare-Ups
During and immediately after a flare-up, it may be necessary to restrict fiber. Unless a person is on liquids only, some low-residue fiber can usually be included. The National Institutes of Health advises avoiding beans and other legumes, whole grains, popcorn, nuts and seeds during this time as these foods, along with raw vegetables and fruit, force the intestines to work harder. Normally people should consume between 20 and 25 g of total fiber each day, but for those on a low-residue fiber diet, the amount should be 10 to 15 g or less.
Fiber and Remission
Tolerance of fiber varies among individuals during remission periods. If the small intestine is narrowed in places, it may be necessary to eat a low-fiber diet to avoid blockages; otherwise, fruits, vegetables and whole grains can generally be tolerated. As during flare-ups, cooking fruits and vegetables may help if raw foods cause problems. Eating five or six smaller meals a day rather than three large ones also helps. Dietary fiber is important for health in general, so the goal is to find what can be tolerated and in what amounts.
