What Is Nutrition Therapy for Crohn's?

Nutrition therapy is a set of tools to help you manage Crohn’s disease and its symptoms. It has two goals:

  • Make sure you get enough nutrients to stay healthy
  • Help you learn to avoid trigger foods that might cause a flare

It helps you decide what to eat, when to eat it, and if you need supplements. It may include more advanced treatments.

How Does Crohn’s Affect Nutrition?

This inflammatory bowel disease can strike anywhere along the digestive system, from your mouth to your anus. But it’s most likely to affect your small intestine, the organ that takes in most of the nutrients you need.

Crohn’s can inflame your small intestine and leave scars. Sometimes they’re so thick they narrow the passage and create blockages called strictures. All of this makes it harder for your body to absorb nutrients.

During a flare, symptoms like diarrhea and vomiting cause you to lose fluids, nutrients, and weight. You may eat less because of nausea, cramps, and changes in how food tastes. Skipping meals might make you feel better in the short run, but it could be bad news in the long run. Your body needs more protein in a flare-up.

Some of the drugs used to treat Crohn’s change your nutritional profile. Long-term steroid use can weaken your bones and increase your need for calcium and vitamin D.

Surgery also affects nutrition. If the doctor has to remove parts of your small intestine, it’s harder for the organ to do its job. In severe cases, you may need advanced forms of nutrition therapy.

How Do I Eat if I Have Crohn’s?

There’s no such thing as a Crohn’s diet that works for most people. Each person has a unique set of problem foods that can trigger symptoms or make them worse. A food journal is a good tool to help you find your trigger foods. As long as you don’t have symptoms, you should be able to eat a normal, healthy diet.

During a flare, you’ll want to:

  • Avoid trigger foods.
  • Eat smaller meals and eat more often.
  • Eat less insoluble fiber like seeds, nuts, green leafy vegetables, and some fruits.
  • Cook vegetables so they’re easier to digest, and peel the skin off fruit.
  • Eat fewer greasy and fried foods.
  • Drink lots of water.
  • Avoid sugary drinks and caffeine.
  • Drink slowly. Don’t use a straw -- it puts more air into your system.
  • Avoid whole grains. Replace them with refined grains.

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If you take steroids, talk to your doctor or dietitian about how to get more calcium and vitamin D to protect your bones.

If you need surgery, consider more protein to help you heal faster. It’s also a good idea to avoid fiber right after surgery, and then slowly put foods that have it back into your diet.

Keep in mind these are general tips. Talk to your doctor or dietitian about what’s best for you.

Are There Other Types of Nutrition Therapy?

Yes. There’s a mix of things you can do on your own and treatments your doctor may suggest.

Elimination diet: You’ll remove foods from your diet one at a time to see which ones trigger symptoms. If you take one away, replace it with something that provides the same nutrients.

Supplements: You may want to add vitamins and minerals to your diet to make sure you get all the nutrients you need. You could be short on calcium, vitamins, folic acid, iron, zinc, and omega-3 fatty acids. Talk to a doctor before you start them, though. It’s easy to take too many, which causes new problems.

Enteral nutrition: If you don’t get enough nutrients from food, one option is enteral nutrition. This is a special blend of liquid food you can drink or can receive through a feeding tube. You may get some or all of your diet this way. Enteral nutrition is often helpful for children who may have stalled growth or late puberty because of Crohn’s.

Parenteral nutrition: This treatment can help when the other methods don’t work. Liquid nutrients pass through a tube, or catheter, directly into your bloodstream. This skips your intestines and gives them a break, which can help ease symptoms. Your doctor might call it bowel rest. She may suggest parenteral nutrition if you have:

  • Severe flares
  • Extremely poor nutrition
  • Lost much of your small intestine in surgery

Questions for Your Doctor or Dietitian

Healthy nutrition is a complex issue when you have Crohn’s. It’s a good idea to work with a doctor or dietitian to make sure your diet meets all your nutritional needs. Here are some questions to ask:

  • What tests do I need to know if I get enough nutrients? How often do I take those tests?
  • Should I take supplements?
  • Do my drugs affect my nutrition?
  • Do I have strictures or other issues that need a special diet?
  • If I don’t have symptoms, can I change what I eat?
  • Is it OK to drink alcohol?

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Trust Your Gut

There's no one-size-fits-all solution when it comes to your nutrition and Crohn's disease. Only you, along with your doctor or dietitian, will know what's best for you. A well-designed plan can ease your symptoms, help you heal, boost your energy, and improve your quality of life.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on March 24, 2018

Sources

SOURCES:

Crohn’s & Colitis Foundation: “Crohn’s Treatment Options,” “Diet, Nutrition and Inflammatory Bowel Disease,” “Short Bowel Syndrome and Crohn’s Disease,”

 “What is Crohn’s Disease.”

Practical Gastroenterology: “Nutritional Considerations in Inflammatory Bowel Disease.”

Clinical Nutrition: “ESPEN guideline: Clinical nutrition in inflammatory bowel disease.”

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