Dr. Eisner Answers your IBD Questions: Diet and Inflammatory Bowel Disease
I have Crohn's disease and am constantly having cramping and diarrhea after meals. What can I do?
There are certain dietary tips that may help curb symptoms of inflammatory bowel disease when you are experiencing a flare. First, try eating more frequent smaller meals. Next, limit the amount of milk and milk products in your diet. There frequently is a component of lactose intolerance in patients with inflammatory bowel disease. Thirdly, restrict the intake of foods that are high in fiber. You most likely will not be able to digest them completely if your small intestine is inflamed, and once they enter the colon, they will likely cause an increase in contractions and therefore cramping. Finally, small bowel Crohn's disease is frequently associated with malabsorption of fat. Ingestion of greasy and fatty foods can lead to symptoms of gas and diarrhea. You should check with your doctor about seeing a dietician to see if getting you on an appropriate diet can get you on the road to feeling better.
My friend and I both have Crohn's disease. While she can eat anything without worsening in symptoms, my symptoms are very affected by diet, and I have a very difficult time gaining weight. Why is that the case?
The symptoms of Crohn's disease can vary dramatically based on the location of disease. Patients with Crohn's disease can have involvement of the small intestine, colon or both. As absorption of nutrients occur in the small intestine, patients with small bowel involvement will experience bloating, gas and diarrhea and evidence of malabsorption, while patients with only involvement of colon will not. Patients that have had resection of the terminal ileum will be at particular risk as that is where absorption of fat and vitamin B12 occur. Other nutrients involved in the proximal small bowel include iron and folate.
I have Crohn's disease. Should I be taking any vitamin supplements?
Patients with inflammatory bowel disease are frequently deficient in vitamins and minerals. While blood levels should be checked by your primary physician, iron, calcium, potassium and magnesium supplements are frequently required. This is varying and depends on location of disease and symptoms. Diarrhea and vomiting frequently lead to decreased levels of potassium and magnesium. Iron can be low as a result of malabsorption or blood loss. Calcium can be low due to both malabsorption, as well as a decreased intake of calcium as patients will typically avoid dairy products that are rich in calcium.