Simple Steps to Manage Crohn's

There is no cure for Crohn's disease, but there are many ways to manage the disease—both naturally and with medication.

Nutrition

There is no evidence that has found a connection with the foods you eat and the development of Crohn's disease. However—as anyone with Crohn's will tell you—certain foods may trigger a flare-up of symptoms.

Though trigger foods can vary for different people, there are high culprit trigger foods that doctors recommend people with Crohn's disease try to limit, or eliminate, from their diet, says Faten N. Aberra, M.D., Assistant Professor of Medicine, Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania. They include:

  • Lactose. Milk and dairy products may produce symptoms such as gas, abdominal pain, and diarrhea.
  • Non-absorbable sugars like sorbitol (found in apple juice) and artificial sweeteners (found in candy and gum).
  • Fiber. "Even though the condition has one name, there are a huge variety of disease types within Crohn's," says Aberra. "Some people may have what's called structuring disease, and for those patients we recommend a diet that's low in insoluble fiber because they are at risk of developing an obstruction." But, it's wise for all Crohn's patients to avoid insoluble fiber during flares. You don't have to have a stricture, says Aberra, but having a flare can cause more cramping and diarrhea.

Other Wise Food To-Dos

  • Determine your high-culprit foods. If it's not clear what your food triggers are, keep a diary to help identify any possible triggers. Aberra recommends keeping a food journal for at least one week—longer if your symptoms don't happen on a daily basis.
  • Drink plenty of fluids. There is no rule of thumb for an adequate amount of water. Plain water is your best bet, and beverages with electrolytes are a good choice if you have diarrhea. Aberra notes if your diarrhea is severe, you need to consult your doctor.
  • Do a bowel rest. For Crohn's disease, inpatient management may include bowel rest (not taking nutrition in by mouth, and getting fluid and nutrition in through IV). During a flare, consuming broth and clear liquids at home for a 24-hour period can help. However, stresses Aberra, you can't really maintain proper nutrition for a long period of time. "It's really meant for [an] acute scenario under the supervision of your doctor."

Stress Reduction

When stressed, your digestive system produces more acid—and may speed or slow motility.

"Though stress doesn't cause the disease, there is some data that suggests it may contribute to causing a flare-up," says Aberra. While stress is tough to avoid, there are some simple things you can do:

  • Exercise. Even walking for 30 minutes a day is helpful in relieving anxiety and mild depression due to stress. However, you may want to keep the intensity dialed down. "In some people, intense exercise may cause symptoms of having to go to the bathroom more frequently," says Aberra. "Physical activity induces movement in the GI tract. And while it may not necessarily induce a flare, it can increase motility," she explains.
  • Sleep. Getting adequate amounts of sleep is important in alleviating anxiety due to stress.
  • Meditation and yoga. You don't have to join an ashram—many hospitals offer courses in mindfulness meditation to manage stress.

Supplementation

A multi-vitamin, in general, is great for Crohn's disease, says Aberra. But additional supplements are based on the patient's specific disease. The location of Crohn's, the medications prescribed, and more factor in on deciding specific supplements and how much you need. Your physician will be able to determine the right supplement—and the right amount.

That said, the more common supplements for Crohn's patients include:

  • Calcium
  • Vitamin D
  • Iron
  • Vitamin B12
  • Folate
  • Fat-soluble vitamins like A, E, and K

Again, the use of supplements is very individualized. Consult your doctor to determine if you are deficient and in need of supplementation.

Medication

So far, there isn't a cure for Crohn's—all the therapies help treat the disease, but they do not cure it. So when you stop the medical therapy, the disease will come back, even if the disease is in remission," explains Aberra. "The key of medical therapy is to help induce remission and also maintain remission. The medications address both aspects of therapy."

 


 

Sources:

Faten N. Aberra, MD, Assistant Professor of Medicine, Division of Gastroenterolgy, Perelman School of Medicine at the University of Pennsylvania / Hospital of the University of Pennsylvania.

The Crohn's & Colitis Foundation of America. http://www.ccfa.org/

The Mayo Clinic. Crohn's Disease: Lifestyle and Home Remedies. Web. http://www.mayoclinic.com/health/crohns-disease/DS00104/DSECTION=lifestyle%2Dand%2Dhome%2Dremedies