Crohn’s Disease And Nutrition

What is Crohn’s disease?

Crohn’s disease is a type of Inflammatory Bowel Disease (IBD), where any parts of the gastrointestinal (GI) tract can become inflamed. This can include your mouth, oesophagus, stomach, small intestine and large intestine.¹ It is suggested that the swelling and inflammation are caused by an autoimmune reaction, where the immune system mistakenly attacks parts of the GI tract which results in symptoms of Crohn’s disease. Crohn’s disease tends to affect younger adults, the most common age of diagnosis being early 20’s and 30’s.²

Symptoms

The symptoms of Crohn’s include inflammation, fatigue, diarrhoea (which may result in dehydration), loss of weight, abdominal pain and cramps.³ It is important to note that these symptoms may vary between individuals depending on the location of the inflammation. Individuals with Crohn's disease also experience periods of remission when the disease is inactive and the symptoms are absent. The symptoms can be aggravated due to stress or by consuming certain foods, however, there is no evidence to show that specific diets cause Crohn’s Disease.⁴ 

Crohn’s disease affects digestion

In more serious cases, inflammation of the entire thickness of the bowel wall can cause an abscess (buildup of pus) formation or scar on the bowel walls. Individuals will experience pain when they eat due to swelling of the lining and obstruction in the bowel. The narrowing of the gut can result in bloating and cramping which leads to nutrient malabsorption during digestion.⁵ The organ’s ability to absorb nutrients effectively is impeded which in turn leads to further complications such as nutrient deficiencies. Malabsorption can be tackled by avoiding certain foods that can make diarrhoea and flare-ups worse, supplementation and in some cases reducing high-fibre food in the diet during an intestinal blockage.⁴ 

How is diet related to Crohn’s disease?

A combination of genetics, impairment of  the immune system, gut bacteria and environmental factors such as food and stress are likely to contribute to the cause of Crohn’s.² Each individual with Crohn’s may react differently to certain foods, hence why it is advised to work alongside your GP or dietitian to identify your own nutritional needs. 

Dietary interventions which target the intestinal microbiome have been identified as effective ways of managing Crohn’s disease.⁶ A balanced, nutrient-dense diet is advised to control and better manage the symptoms.¹

Diet is one of the best ways to manage Crohn’s disease

Some foods, such as dairy, carbonated drinks and alcohol may cause flare-ups of symptoms for certain individuals. It is advised to keep a food diary and avoid these foods to see if symptoms ease. There is evidence to show that diets with a high intake of total fat and meat consumption are associated with an increased risk of Crohn’s. Meanwhile, diets high in fruit and fibre are encouraged as they are less likely to be associated with the risk of Crohn’s Disease.⁷

Find out what your dietary trigger is

It is advised to monitor your food intake to identify your dietary triggers. Eliminating certain foods that cause flare-ups may help to manage symptoms of Crohn’s Disease,  however, it is recommended to seek further advice from a dietitian before making any drastic changes to the diet. 

It is also strictly encouraged for individuals with Crohn’s to limit alcohol intake  (below the recommended guidelines) because those who are more frequent drinkers are more likely to have flare-ups.² 

Additionally, individuals may find that a low FODMAP diet may relieve their Crohn’s symptoms like diarrhoea, bloating and discomfort.⁸

Consuming fibre-rich foods

Dietary Fibre can be found in foods such as fruit, vegetables, whole grains and beans. Fibre aids with digestion increases beneficial gut bacteria and reduce inflammation in the gut. There is evidence to show that a high-fibre diet has been beneficial for those with Crohn’s and supports immunity to inflammatory disorders.⁹ However, during flare-ups, where the intestine is more narrow, dietary fibre can exacerbate irritation in the gut.¹⁰

Protein-rich diet

Protein is a macronutrient that contributes to normal bodily functions such as; muscle growth and repair, maintenance of the cellular structure, immunity and enzymatic activity.¹¹ After inflammation of the GI tract, the body’s demand for protein increases so it is essential to ensure an adequate amount of protein is included in the diet for overall health, especially for those avoiding certain foods (such as dairy) that naturally have a high content of protein.¹²  

Stay hydrated

Crohn’s disease can increase the risk of dehydration because of water loss due to diarrhoea, which may lead to  dizziness, headaches and even constipation. Dehydration can also worsen Crohn’s symptoms, so staying hydrated is vital. To rehydrate the body, the lost salts and sugars as well as water need to be replaced. This can be achieved by drinking a rehydration solution (available at local pharmacies) or eating a salty snack and drinking some water.²

Regularly check for nutritional deficiencies

The Academy of Nutrition and Dietetics informs that the elimination of specific foods and malabsorption during digestion may lead to deficiencies in vitamins K, C, B12 and folic acid, zinc and iron.¹³ It is vital to conduct regular checks with your GP or dietician to ensure any deficiencies are prevented or treated through dietary supplements or diet. 

Conclusion

Crohn’s Disease is a lifelong condition that causes parts of your GI tract to become inflamed. The role of the GI tract is to absorb vitamins, minerals and water from our meals. The inflammation of the intestinal lining, which occurs due to Crohn's disease, hinders this process resulting in symptoms such as weight loss, diarrhoea and deficiencies in vitamins and minerals. Dietary intervention may aid individuals to manage and control certain symptoms of Crohn’s disease. For some individuals, implementing a diet high in fibre, fruits and vegetables has been proven to be beneficial. It is also encouraged to limit alcohol intake and undergo checks to monitor vitamin or mineral deficiencies.