Diet & Nutrition
It is important to remember that nothing you ate caused your disease, nor will diet cure your disease. However, changes in your diet and nutrition reduce irritation and aggravation of symptoms. The disease varies from person to person, so it is important to customize your diet to fit your own individual needs, while maintaining a healthy nutritional balance.
Concerns
Complications and concerns can arise when diseased intestines do not absorb all the needed nutrients. Whether it is decreased appetite or malabsorption you should be aware of what could happen to your body. Dehydration can be caused by chronic diarrhea and inadequate fluid intake. To ensure you stay hydrated it is important to keep drinking liquids throughout the day, especially if you are having complications.
Secondly, there is a concern for malnourishment or weight loss. Due to nausea, abdominal pain, and/or altered taste sensation an inadequate amount of food may be consumed or loss of appetite may occur. During times of active disease there is a tendency to need more calories or energy intake for the body, which might not occur because of aggravation. Another cause of malnutrition is the lack of absorption that goes along with these two diseases, especially when it is located in the small intestine. Food might be consumed, but not enough of it is being absorbed/digested.
Some items like spicy foods and alcoholic beverages might worsen or irritate your disease so you should consider eliminating or reducing these if they bother you.
Supplementation
Supplementation might need to occur because of the lack of absorption of essential nutrients during a flare-up or from the use of a medication. Only use supplements under the orders of your doctor.
Here is some common supplementation, what foods you can find the nutrients in, and the possible causes:
| Vitamin |
Dietary Source |
Comments |
| Vitamin B-12 |
Meat, poultry, fish |
Special concern for patients who have Crohn's disease affecting the last part of the small intestine (terminal ileum) or who have undergone surgery to resect the ileum since this is where B-12 is stored. |
Folic Acid |
Liver, beets, corn, legumes, green leafy vegetables |
Special concern if you are taking sulfasalazine. |
Vitamin D |
Liver, fortified food products, (e.g. milk, butter, and cereal) |
If you are suffering from maldigestion or have had intestinal surgery. It is one of the most common deficiencies associated with Crohn’s and is needed for bone formation and metabolism of calcium.
This is also a fat-soluble vitamin that is not easily absorbed. |
Vitamin A
Vitamin
E
Vitamin
K
|
Liver, eggs, dairy products, fish liver oils, dark green leafy vegetables
Nuts, spinach, carrots
Bananas, cereals, milk, leafy green vegetables
|
These are fat-soluble vitamins that are not easily absorbed. |
Iron |
Red meat, eggs, poultry, fish |
Blood loss might result in anemia or low levels. |
Potassium
|
Bananas, cereals, milk, leafy green vegetables
|
There can be deficiencies caused by chronic diarrhea. |
Magnesium |
Cereals and nuts |
There can be deficiencies caused by chronic diarrhea. |
Calcium |
Milk, yogurt, cheese, ice cream |
Frequent steroid (prednisone) use might cause bone loss, it is recommended to get at least 1,500 mg per day. |
Zinc |
Animal protein (e.g. beef or chicken)
plant foods (e.g. bran and legumes) |
|
Vitamin C |
Fruits (e.g. citrus, apples, bananas) |
|
Support
Nutritional support might be needed when:
- An adequate amount of nutrition cannot be obtained
- There is a need for bowel rest
- You are too sick to eat and food only causes irritation
- You have severe pain and/or inflammation
Some alternative ways are:
Total Parental Nutrition (TPN) – The patient has a catheter inserted in a blood vessel and receives nutrients intravenously. This method can be used as a supplement or to allow for bowel rest.
Nasogastric (NG) Tube – A tube is passed through the nose and down into the stomach. This type of method is usually used in the hospital and allows the patient to receive supplemental nutrients with little interference.
Dobhoff Tube – This is a thin plastic tube that is passed through the nose into the stomach. It is similar to an NG tube but tends to be left in place for a longer duration of time and is thinner in size.
Gastrostomy tube (G-tube) – This is a surgically created opening through which a feeding tube is passed into the abdominal wall and directly into the stomach.
Supplementary Food – Shakes, such as Ensure®, and other special drinks are sometimes recommended to add additional calories and nutrients.
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