Nutrition & IBD
In addition to the choice of medications to treat IBD, nutrition, an area which is relatively neglected, is of critical importance in Crohn’s disease and ulcerative colitis. As these are gastrointestinal diseases, it makes intuitive sense that nutrition, or what you put into your intestine ought to have some in influence on the disease.
The optimal diet though remains to be determined. At times, particularly when presenting in childhood or adolescence, the first symptoms of the disease can be poor growth and weight loss. While there are some guidelines and recommendations for how to manage the nutritional aspects of IBD, more research is needed. Malnutrition and weight loss can be significant problems in IBD.
The problem of weight loss is that the body’s needs are increased because of the inflammation. In most people, it is not the case that the intestines are unable to absorb the necessary nutrients. The small intestine is as long as 22 feet in most people (before surgery).
In Crohn’s disease it is unusual to have such severe inflammation and/or to have had so much surgery that there is an inadequate or an insufficient amount of functional small intestine left to interfere completely with absorption of nutrition. Nutrition counseling for IBD is often limited to a brief bit of advice. Like the guy who goes to the doctor saying it hurt when he moves his arm and the doctor advises him, “Then don’t move your arm”. Or for nutrition advice, “If a particular food makes you feel poorly, then don’t eat it”.
Advice from a nutritionist, particularly one familiar with Crohn’s disease and ulcerative colitis, can be more helpful than that. While we do not have a specific diet that is ideal to help control these diseases, understanding what is a healthy diet and what foods might exacerbate symptoms can be a useful guide.
Some supplements can be helpful when people with IBD need more calories than they can take in such as:
- Modulen IBD
- Boost nutritious pudding
- Boost or Boost Plus
- Boost Breeze
- Peptamen OS
One tailored diet that has been developed to try to moderate the disease process itself is the Specific Carbohydrate Diet (SCD). It was popularized by the biochemist and author, Elaine Gottschall. The SCD restricts the use of complex carbohydrates and eliminates refined sugar, all grains and starch from the diet. The purpose of the SCD is to break the ongoing cycle caused by an overpopulation of harmful bacteria in the gut. When the body is able to absorb the proper nutrients from simple sugars and other carbohydrates that are easy to digest, the inflammation and other complications caused by many autoimmune or inflammatory diseases can be lessened.
The goal is to rid the body of complex saccharides so the gut will be able to heal itself and enable further healing to occur. There have been no clinical trials to prove or disprove efficacy, so no conclusions can yet be drawn about the diet. If you choose to go on this restrictive diet, while it is likely safe to do so, we recommend that you do it under the guidance of our nutritionist.
Some people find that even though they do not have an allergy to wheat or gluten or have celiac disease, they benefit from a gluten free diet. Gluten is the protein “glue” that gives wheat, barley, and rye flours their stretchy texture when kneaded into dough.
Gluten is not unhealthy unless someone has a true sensitivity. Again, since going gluten free can be restrictive, we recommend that you do it under the guidance of our nutritionist.