Hello and Happy December! This post is going to be a bit of a departure from the fun holiday theme of our past few posts, but we want to take the opportunity to highlight Crohn’s and Colitis Awareness Week, which is occurring now  (December 1-7). It is not always a fun topic to talk about, so you may not realize that anyone in your life is affected by these diseases, but 1.7 million people in the United States are affected by Crohn’s disease or ulcerative colitis, two types of inflammatory bowel diseases (IBDs). If you do know that someone in your life has been diagnosed with either of these two conditions, or any IBD, it is a great time to reach out to them and let them know you care. It can be quite uncomfortable to live with these diseases, so taking time this week to let them feel your support can help more than you know!

Ulcerative colitis and Crohn’s disease are two types of inflammatory bowel diseases that present with very similar symptoms. While the specific symptoms may vary between patients, they are caused by inflammation in the GI tract and include pain and various uncomfortable digestive issues. Although these diseases present with similar symptoms, they vary in the area of the gastrointestinal tract that is affected. Crohn’s disease can affect any part of the GI tract, but most commonly affects the small intestine. Ulcerative colitis, on the other hand, affects only the large intestine, known as the colon.

Although there is considerable amounts of research being done to understand IBD, scientists do not fully understand the cause yet. It is suspected that it may be due to an infection of the colon, from either a virus or bacteria, and the body’s resulting natural immune response. Scientists have, however, identified the reactions that are occurring in the body to produce the symptoms that are observed with IBD. Crohn’s disease and ulcerative colitis result from the body’s abnormal response to the immune system in the GI tract. As in all types of IBD, the immune system kicks into overdrive when it mistakes food or other substance in the intestine for a harmful substance, and the resulting reaction produces inflammation of the intestine.

You may be wondering how a dietitian can help people affected by IBD. These conditions require the diagnosis and ongoing consultation with a medical doctor, and patients with Crohn’s disease and ulcerative colitis have to pay special attention to their diets for many reasons. Although these diseases are not the direct reaction to ingesting certain foods, IBDs may cause a decreased appetite, which presents a challenge to consume adequate nutrients and recommended daily amounts of important vitamins and minerals. These conditions increase the body’s inherent caloric and energy need, cause the body to lose nutrients more rapidly, and inhibit the body from absorbing nutrients efficiently. Finally, and perhaps most importantly, a conscious diet can help to reduce symptoms and promote healing of the GI tract.

Patients who have been diagnosed with Crohn’s disease or ulcerative colitis each have to develop an individualized plan with the help of a medical team. There is no specific IBD diet, since the symptoms, potentially triggering foods, and general nutrition needs of each patient are so unique. With the guidance, help, and support of a dietitian, finding a diet that works for each individual has been seen to alleviate symptoms and greatly improve quality of life. Many people diagnosed with Crohn’s disease or ulcerative colitis find that adopting a gluten free diet has helped to mitigate their symptoms. Since this diet plan is so extensive, we will discuss this in an upcoming post (stay tuned!). Although there is no true “one size fits all” approach to diet recommendations as the approach is very individualized and customized to each patient’s needs, smaller, more frequent meals are often recommended, as is decreasing the intake of foods high in fiber and greasy foods. In order to alleviate the two most common symptoms (cramping and diarrhea), patients are typically recommended to maximize the intake of the following foods:

• Bananas
• Liquids: broths, Gatorade or fruit juices diluted with water
• Simple starches: white bread, white rice, crackers made with white flour, plain cereals, refined pastas, potatoes (skin removed)
• Cheese (unless lactose intolerant)
• smooth peanut butter
• soft, bland foods
• broiled or steamed fish
• fruits and vegetables (as tolerated)

Elimination diets are often utilized for Crohn’s disease and ulcerative colitis patients in order to identify potentially triggering foods. A common approach for tailoring an individual diet plan for patients with IBD is to perform a Mediator Release blood test (MRT), which identifies hidden inflammatory responses to various foods. The MRT assessment can be beneficial even for people who have not been diagnosed with IBD and are experiencing a variety of other digestive issues. A dietitian can interpret the results of the test and customize a lifestyle eating and performance (LEAP) diet for each individual to identify their unique best foods to help them live healthier, more enjoyable lives. This is an area in we can offer extensive help and support as this is a service that is offered at Red Dietitians. Please contact us if you are interested in learning more about the benefits of the MRT.

Natural supplements have been seen to be effective treatments for managing Crohn’s disease and ulcerative colitis. For more information on how these supplements can be integrated into your diet to help manage IBD, please contact Red Dietitians today as these should be used as part of a balanced diet and individualized treatment plan. Below is a list that may be helpful for you, however, be sure to speak with a professional before using.

• Aloe Vera gel: effective in healing inflammation in the intestine
• Curcumin: a natural substance derived from turmeric;  promotes colon health and reduces inflammation
• Glutamine: as the major fuel source for the small intestine, supplementing with this amino acid has been seen to have healing effects on the gut
• Omega 3 fats: reduce inflammation to the intestine
• Zinc carnosine: has been used in wound healing and has been seen to show improvements in various digestive conditions, including IBDs
• Probiotics: encourage the growth of good bacteria in the gut and block harmful bacteria from adhering to the intestines by supporting the mucous layer on the intestines. Probiotics also stimulate the body’s response to harmful bacteria by enhancing the immune response of the intestines. Probiotic VSL#3 is especially effective in treating IBDs as it contains 8 different probiotic live culture strains.
• Cannabidiol (CBD): a cannabis compound that has significant medical properties, without causing mind altering effects has emerged as a leading research avenue in digestive health because the compound suppresses the body’s immune system from attacking the gut

If you have not been diagnosed with Crohn’s disease or ulcerative colitis and you are still interested in learning more, please take Crohn’s and Colitis Awareness Week as a reminder to be conscious of your own gut health. Our GI tract, or “gut,” is the selective barrier within our intestines that allows healthy nutrients and water to be absorbed, while ensuring that harmful substances are excreted. A healthy diet strengthens and promotes this barrier to help our bodies digest foods and promote a healthy immune system. Consider adding the following fermented foods to your diet to receive the benefits that these naturally probiotic rich foods provide for gut health

• Yogurt
• Kefir
• Aged cheeses
• Kimchi
• Sauerkraut
• Miso
• Tempeh

Are you or someone you know affected by Crohn’s disease or ulcerative colitis? We would love to help. Please reach out to us today so we can help you learn to understand and manage the symptoms. Do you have any questions regarding these diseases, or IBD in general? Let us know in the comments! Also, take the time this week to visit www.ccfa.org to learn more about these diseases.