Crohn’s disease is one of the conditions of Inflammatory Bowel Disease (IBD) collectively with Ulcerative Colitis (UC). It occurs when there is inflammation in the wall of the digestive tract1 The major difference between the two conditions is the area of inflammation, UC is limited to the large bowel while those with Crohn’s may experience inflammation in any area of the digestive tract from mouth to anus1. Usually, it is last section of the small bowel (ileum) and colon which becomes inflamed. This inflammation can extend into the entire thickness of the bowel wall1. Generally, it is characterised by periods of flare up and remission; disease flare-ups can be very severe and debilitating.
Crohn’s can develop at any age but more commonly in young people aged 15-30 years and is slightly more prevalent in women than men2.
While the exact cause of IBD is not well understood it is theorised to be a result of a combination of genetic and environmental factors. It is often referred to as an autoimmune disease as inflammation within the body often occurs via the process of an autoimmune pathway in response to a foreign substance2. It is possible that environmental triggers such as viruses, bacteria and proteins may prompt this immune reaction. Ongoing inflammation causes damage to the walls of the gastrointestinal tract causing the symptoms of Crohn’s disease2.
Nutrition and dietary management of Crohn’s Disease
The small and large bowel are responsible for the digestion and absorption of nutrients. Food is initially broken down by the mouth and the stomach through mechanical and chemical processes1. The food then enters the small bowel where it is further digested, and nutrients form the food absorbed. Waste products are then pushed into the large bowel which draws in the water helping to form stools and eliminate the waste through the anus. The inflammation that occurs in Crohn’s disease can impair both the digestion of food and the absorption of nutrients as well as water resulting in micronutrient deficiencies and diarrhoea.
Some dietary modifications may help improve the symptoms of Crohn’s Disease. Some suggestions include trialling a low fibre (low residue) diet to help reduce inflammation in those that have a narrowed small bowel as well as a low-fat diet, especially in those who are suffering from fat malabsorption1. Some individuals have benefited from limiting the milk sugar lactose in their diet through choosing lactose-free dairy or non-dairy substitutes. In severe cases, a liquid diet may be temporarily indicated to help reduce inflammation.
In some cases following a low FODMAP diet can help manage the symptoms of Crohn’s disease. An Inertia Accredited Practicing Dietitian can provide further information on the FODMAP diet and assist you with food elimination and challenges.
Inertia Dietitians can assist with education and information for dietary supplementation when necessary – Can Dietary Supplements help you manage your Crohn’s?
Usually, dietary supplements are not indicated unless an individual has a vitamin or mineral deficiency. Occasionally a vitamin B12 injection may be necessary or an iron supplement if deficiency occurs due to blood loss or poor absorption from food.
For an individual experiencing fat malabsorption a calcium and magnesium supplement may be indicated.
If you suffer from Crohn’s Disease or Ulcerative Colitis and need help with managing your diet make an appointment with an Accredited Dietitian at Inertia Health Group today.
References and Useful Websites:
Department of Health and Human Services 2014, Crohn’s Disease and Ulcerative Colitis, State Government of Victoria, viewed 8 February 2018, <https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/crohns-disease-and-ulcerative-colitis>
Crohn’s and Colitis Australia 2017, About Crohn’s and Colitis, viewed 8 February 2018 <https://www.crohnsandcolitis.com.au/about-crohns-colitis/>