Managing Crohn's Disease
Updated on 6/4/09
Since there is no cure for Crohn's disease, management of the disorder is critical. Most Crohn's patients have a good quality of life and an excellent prognosis for long-term survival.
This section contains more on:
Diet
There is no current data that specific diets cause or cure Crohn's disease. In general, there are no adequate controlled trials to show that specific diets can induce remission. The exception to this is giving nutrition via elemental formulas, in which food is pre-digested. However, proper diet and nutrition can certainly impact the symptoms and prevent complications. Crohn's patients with intestinal narrowing and symptoms of partial bowel obstruction often do better with frequent smaller meals and avoidance of hard-to-digest foods and those that cause bloating and gas. In addition, vitamin supplementation is very important in patients with Crohn's disease in the small intestine, where nutrients are absorbed.
Low-fiber, low-fat, bland, or lactose-free diets: These different types of diets may be recommended by physicians for Crohn's patients depending on the nature of the inflammatory tissue damage and the extent of the Crohn's disease involvement. The idea is to provide nutrition while minimizing the risk of triggering symptoms. The rationale for a low-fiber diet, for example, is that fiber is poorly digested and can worsen the symptoms of intestinal obstruction. In some people, both fats and lactose can worsen inflammatory response in the intestines. Highly seasoned food and dairy products stimulate bowel activity, while bland and lactose-free diets do not tax the digestive system.
Fluids: Because of diarrhea, the risk of dehydration can be high. Drinking plenty of fluids, particularly during warm weather, is a key to managing Crohn's disease.
Elemental diets and enteral nutrition: These are special, liquid meals that contain nutrients necessary for the body to function but do not tax the digestive system. They are offered in several formulations, depending on whether patients are lactose intolerant or need certain dietary ingredients. There are a number of commercially prepared elemental diets and enteral feeds. There is evidence that elemental diets can be effective in decreasing Crohn's disease inflammation and inducing remission.
Total parenteral nutrition (TPN): TPN is an intravenous nutritional support in which nutrients, vitamins, and minerals are given through a thin, flexible tube that goes directly into a large vein. This nutrition support is used for Crohn's patients who are unable to digest foods or to provide bowel rest while medical therapies take effect. However, this means of nutritional support is more expensive than enteral nutrition and has a higher risk of complications, including intravenous line infections and liver abnormalities.
Depression
Crohn's disease is an unpredictable, chronic illness that has a major impact on life. Most patients with Crohn's disease have a good quality of life when treated with current medical and surgical therapies. But those who suffer severely compromised function of their small intestine, or require multiple surgeries or removal of their colon, may become depressed or anxious. Patient support groups, educational materials, or psychotherapy can improve management of Crohn's disease. For information about support groups in your area, contact: Crohn's & Colitis Foundation of America (800-932-2423; info@ccfa.org).
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