Can lifestyle changes help those with Crohn's disease ?

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Sometimes you may feel helpless when facing Crohn's disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up.

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It can be helpful to keep a food diary to keep track of what you're eating, as well as how you feel. If you discover some foods are causing your symptoms to flare, you can try eliminating them. Here are some suggestions that may help:

Foods to avoid

• Limit dairy products. Many people with inflammatory bowel disease find that problems such as diarrhea, abdominal pain and gas, improve by limiting or eliminating dairy products. You may be lactose intolerant - that is, your body can't digest the milk sugar (lactose) in dairy foods. Using an enzyme product such as Lactaid may help as well.


• Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Try avoiding butter, margarine, cream sauces and fried foods.


• Limit fiber, if it's a problem food. If you have inflammatory bowel disease, high-fiber foods, such as fresh fruits and vegetables and whole grains, may make your symptoms worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them.
  

  In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and nuts, seeds, corn and popcorn. You may be told to limit fiber or go on a low residue diet if you have a narrowing of your bowel (stricture).

  
  


• Avoid other problem foods. Spicy foods, alcohol, and caffeine may make your signs and symptoms worse.

Other dietary measures

• Eat small meals. You may find you feel better eating five or six small meals a day rather than two or three larger ones.


• Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.


• Consider multivitamins. Because Crohn's disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful. Check with your doctor before taking any vitamins or supplements.


• Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.

Smoking

Smoking increases your risk of developing Crohn's disease, and once you have it, smoking can make it worse. People with Crohn's disease who smoke are more likely to have relapses and need medications and repeat surgeries. Quitting smoking can improve the overall health of your digestive tract, as well as provide many other health benefits.

Stress

Although stress doesn't cause Crohn's disease, it can make your signs and symptoms worse and may trigger flare-ups. The association of stress with Crohn's disease is controversial.

When you're stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acid. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself. Although it's not always possible to avoid stress, you can learn ways to help manage it.

Some of these include:

• Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.


• Biofeedback. This stress-reduction technique may help you reduce muscle tension and slow your heart rate with the help of a feedback machine. The goal is to help you enter a relaxed state so that you can cope more easily with stress.


• Regular relaxation and breathing exercises. One way to cope with stress is to regularly relax and use techniques such as deep, slow breathing to calm down. You can take classes in yoga and meditation or use books, CDs or DVDs at home.
  
  
  

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Comment: Each of us is a unique combination of environment, genetics, and personality. Food that causes problems for one patient, has little effect on another. Stress triggers and responses might differ considerably among individuals.

You may be unique, and yet, you are not alone. There are people in line in front of you, and those in line behind you. Those in front of you have been where you are and managed to work though it. They are your hope. Those behind you are where you have been, you are their hope. Connect with others, reach out and find a local support group or visit our forum .