Ulcerative colitis and Crohn's disease are two common forms of inflammatory bowel disease. Inflammatory bowel disease is believed to be the result of the immune system mistakenly attacking the bowel. It is characterized by a sudden, unpredictable bout of diarrhea and abdominal pain. Diet plays a major role in the management of ulcerative colitis and Crohn's disease.
Crohn's or Colitis
No single cause for inflammatory bowel disease has been established. One theory is that the body reacts aggressively to an unidentified virus or bacteria causing inflammation of the intestine. Genetics also appear to play a role in the development of the disease. A patient who has a relative with the disease is 10 times more likely to develop the disease than someone who does not. Diet is not the cause of the disease, but dietary modifications can help control the symptoms.
Symptoms
Although Crohn's disease and colitis are both forms of inflammatory bowel disease, the symptoms are different. Symptoms associated with Crohn's disease may include, abdominal cramps, decreased appetite and weight loss, malnutrition and persistent bouts of diarrhea. Patients with colitis present with diarrhea, abdominal cramping and rectal bleeding. The abdominal pain is usually relieved following a bowel movement. Patients with Crohn's disease are often more affected by foods they consume than are those with colitis. According to "Nutrition and Diet Therapy," both patients with Crohn's or colitis have reported that bananas, carrots and potatoes, rice and roast chicken did not worsen the symptoms and made them feel good.
Diet Modifications
As noted in "Nutrition and Diet Therapy," dietary modification for patients with Crohn's or colitis is usually based on the patients tolerance and avoidance of irritating foods. Despite patients belief that food affected their disease course, no reported dietary behavior has reduced the incidence of the illness. Foods that are suspected of increasing a patients symptoms should be tried in small amounts to determine tolerance levels.
Dietary Recommendations
Foods high in fiber, fat and lactose may increase the diarrhea and abdominal pain. According to "Better Nutrition," the most common problem foods may include seeds, nuts, raw fruits and vegetables, and leafy greens. Additionally, products containing caffeine and spicy foods may aggravate the symptoms. An adequate intake of calories and nutrients are important for patients with Crohn's or colitis. Protein from meats, fish, poultry and eggs are recommended. Cooked fruits and vegetables without the skin or seed are generally well-tolerated.
Nutritional Deficiencies
Patients with inflammatory bowel disease are at risk for malabsorption and malnutrition. Vitamin deficiencies include vitamins A, C, D, E, K and B12 due to malabsorption. Iron, magnesium, calcium and phosphate are also affected due to malabsorption. When vitamin B12 is not adequately absorbed, carbohydrates, proteins and fats cannot be metabolized and the risk of malnutrition increases. The overall nutritional recommendations for patients with inflammatory bowel disease are based on the extent of the disease. Foods should be given a fair trial before eliminating any particular food from the diet, and consultation with your physician is advised.
References
- "RN"; Inflammatory Bowel Disease; J. Veronesi; May 2003
- "Better Nutrition": Nutritional Rx for Crohn's and Colitis; Figueras; May 2010
- "Nutrition and Diet Therapy"; F.A. Davis; 2011
