Crohn’s disease is an autoimmune condition that causes inflammation in different areas of the digestive system. Along with ulcerative colitis, they are part of the so-called inflammatory bowel diseases (IBD).
The inflamed area is commonly found in the lower area of the small intestine or ileum , in this area is where the small intestine communicates with the beginning of the large intestine. However, swollen areas can also appear anywhere else in the digestive system, including the anus and mouth. Crohn’s disease is chronic , that is, it has no cure. Although it most commonly develops in people between the ages of 15 and 35, it can also appear during childhood or at any other time in life.
Causes of the appearance of Crohn’s disease
The cause of this condition is unknown, although there seems to be a genetic trigger, since a high percentage of people who suffer from it have a family member with some type of inflammatory bowel disease or other autoimmune diseases . What is known is that Crohn’s disease occurs as a result of a disorder of the immune system, in which it attacks the healthy tissue of the affected part of the digestive system. Although the exact cause of its appearance is unknown, there are factors that play a determining role in its development:
- Genetic factor : as I have already mentioned, there is a relationship between the appearance of the disease and genetics. It should be noted that people of Jewish descent have a greater risk of suffering from it. In fact, it was at Mount Sinai Hospital in New York, which historically cared for the Jewish population, that Dr. Burrill B. Crohn discovered this condition.
- Environmental factors: factors such as eating habits, hygiene or stress can favor its appearance. Smoking also appears as a highly relevant factor.
Symptoms of the disease
The symptoms of Crohn’s disease are characterized by not following an established pattern, they can appear causing severe pain and remit at any time. What does happen is that the symptoms vary depending on the area of the intestine affected. The main symptoms are:
- Strong pain in the abdomen area with the appearance of colic.
- Continuous fatigue.
- Lack of appetite
- Joint pain
- Presence of blood in stool
- Gum inflammation
Derived nutritional problems
The lack of appetite of those affected by this disease, usually generates a diet that is too low in both calories and essential nutrients. If you suffer from this condition, it is normal that you feel pain when eating certain foods and this makes you eat less. This can lead to other conditions such as anemia or loss of muscle mass.
In addition, to this is added the fact that there are medications to alleviate the symptoms of Crohn’s, which prevent the correct assimilation of the nutrients from the ingested food. In the case of children, this nutrient deficit can lead to physical development problems. The area of the digestive tract affected will determine a greater or lesser degree of malabsorption of nutrients.
- Corticosteroids : prevent the correct absorption of calcium, in addition to causing kidney failure if the treatment is prolonged over time.
- Cholestyramine : prevents the total assimilation of fats and vitamins.
- Salazopirina : reduces the assimilation of folic acid in the body.
Diet for Crohn’s disease
The unpredictability of reactions to different foods makes it difficult to guide a generic diet for Crohn’s since each person can present a different clinical picture. However, the role of dietitians – nutritionists is key to trying to improve the following aspects in a personalized way:
- Avoid processes of malnutrition derived from a poor diet.
- Correct eating habits that may be harmful.
- Prevent or reverse a state of deficiency of certain nutrients that can lead to other conditions.
- Assess the possible existence of an associated food intolerance.
- Facilitate proper digestion of food by repairing and protecting the internal mucus of the intestine.
- Try to reverse possible existing inflammations.
Try to listen to your body perceiving how each food feels to you. Keep in mind that after having eaten a specific food, such as pasta, you may not feel well, but this may be due to the seasonings used (sauce, cheese, etc.) and not the main ingredient.
I recommend you chew your food well and try to rest for half an hour after eating to help digestion.
It is advisable to eat less food several times a day to have less heavy digestions that produce a smaller reaction in the intestine.
Drink plenty of water and avoid tobacco as it causes irritation.
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Diet in the asymptomatic or remission phase
At times when the disease is under control and no symptoms appear, you should try to eat as balanced a diet as possible, paying special attention to whether or not there may be an intolerance.
Foods to avoid :
- Gas-producing foods such as cauliflower and sodas.
- Try to eliminate alcoholic beverages, coffee, tea, and spicy beverages, as they can be especially irritating.
- Avoid fried foods.
- Milk can aggravate symptoms, if this is the case, try to substitute it with vegetable alternatives based on soy, rice or oats.
- Avoid foods with sorbitol (sugar-free gum and candies, sweetened beverages) as an excess of this substance can cause digestive discomfort such as diarrhea and gauze.
Foods to include in the diet :
- Blue fish, as it is rich in omega 3, a fat with a natural anti-inflammatory effect.
- White fish, white meat and pork, which provide proteins of high biological value and are low in saturated fat.
- Avocado and olive oil for their vitamin E content. This vitamin helps keep the internal mucous membranes of the digestive system hydrated.
- Pumpkin and papaya for their contribution in beta-carotene, an antioxidant that also benefits the mucous membranes of the body.
- Foods fermented with live bacteria with probiotic action such as yoghurts.
Diet during a Crohn’s outbreak
When pain and other symptoms appear, the diet should be adapted to this situation . Generally speaking, the diet should be as high as possible in calories (hypercaloric) and very low in fat (hypolipidic). Consideration must be given to hydration and the reduction of foods that are difficult to digest.
- Foods rich in insoluble fiber such as whole grains or legumes with skin.
- Foods rich in animal and saturated fat: butter, margarine, cream, red meat, cold cuts, pastries, cheeses.
- If the outbreak occurs with diarrhea, it is also advisable to eliminate lactose and gluten from the diet until the outbreak has subsided.
The provision of supplements should always be carried out together with a correct diet supervised by the advice of a dietitian – nutritionist. Some of the supplements that may be indicated as appropriate are: L-Glutamine, soluble fiber, Omega-3, probiotics, zinc, selenium, beta-carotene, lactase enzyme, folic acid, Vitamin D and Vitamin K.