Coping with Crohn's disease and ulcerative colitis

People who have an inflammatory bowel disorder, such as Crohn's disease or ulcerative colitis, cannot absorb nutrients properly and so are at risk of nutrient deficiencies and becoming underweight.

Getting enough nutrients

If you have an inflammatory bowel disorder, make sure you get enough nutrients. A dietitian can help you in dealing with deficiencies, which can develop because the damaged intestine is not absorbing nutrients effectively. This is very important for children, who are growing and developing.

Symptoms such as nausea, diarrhoea, and recurrent abdominal pain can occur at mealtimes, which often leads to decreased appetite and food intake. In Crohn's disease, inflammation of the intestine can result in overgrowth of bacteria. This, combined with the effects of any previous surgery to remove diseased sections of the bowel, can decrease the absorptive surface area of the intestine and reduce the absorption of essential nutrients. People who have undergone surgery may have problems absorbing fats and this, coupled with frequent bouts of diarrhoea, may also cause deficiencies to develop.

It is crucial to increase the amount of protein you eat as inflammatory bowel disorders can cause excessive intestinal secretion of protein-rich fluids through the inflamed wall of the intestine. Good sources include lean meat, poultry, oily fish, and pulses (see Healthy Protein Sources).

Protective foods

Complex carbohydrates from whole grains, vegetables, and fruits are a good source of fibre, which helps the intestine function properly. If the extra fibre causes wind, you can take an over-the-counter product to reduce this.
Drink lots of fluids, mainly water, but avoid caffeinated drinks. Green tea is thought to be beneficial.
Eat plenty of foods containing omega-3 fatty acids, such as linseeds, rapeseed oil, soya beans, and oily fish.
The herb sage may be helpful too.

Foods to avoid

Certain foods may cause symptoms. Common things to avoid are: alcohol, sugary foods, including sweet fruit such as grapes and pineapple, and caffeine, as they can all cause inflammation; foods containing gluten, which is found in wheat, oats, and barley; milk and dairy products; foods that are common causes of allergic reactions, such as soya, eggs, and peanuts; and vegetables of the brassica family, such as Brussels sprouts, cabbages, and broccoli.

Taking supplements

People who have Crohn's disease or ulcerative colitis are advised to take a multivitamin supplement. Deficiencies of the fat-soluble vitamins (A, D, E, K), vitamin B12, and folate are common. A folate supplement is vital for anyone taking sulfasalazine (a drug prescribed for chronic inflammation), which can interfere with folate's absorption. Some patients may need injections of vitamin B12. Persistent, watery diarrhoea may require supplementation with the minerals zinc and magnesium.

Lisa Hark, PhD RD & Dr Darwin Deen

Posted 14.02.2011

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