CROHN'S DISEASE​
CROHN'S DISEASE
Crohn’s disease is considered as an autoimmune disease, it is a chronic, inflammatory condition characterized by inflammation of the gastrointestinal tract. It is one of the two main forms of inflammatory bowel disea, the other being ulcerative colitis. Unlike ulcerative colitis, which primarily affects the colon and rectum, Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus. However, it most commonly affects the end of the small intestine (ileum) and the beginning of the large intestine (colon).
Types of Crohn’s disease
Crohn’s disease can manifest in different types or patterns, depending on the location and extent of inflammation within the gastrointestinal tract. Here are some common types of Crohn’s disease:
- Ileo colitis: This is the most common type of Crohn’s disease, affecting the ileum and the colon.
- Ileitis: In this type, inflammation is confined to the ileum.
- Jejuno ileitis: This type involves inflammation of the jejunum (the middle part of the small intestine) and the ileum.
- Gastro duodenal Crohn’s disease: In rare cases, Crohn’s disease may affect the stomach and the first part of the small intestine (duodenum).
- Crohn’s Colitis: In this type, inflammation is confined to the colon.
- Perianal Crohn’s disease: This type involves inflammation around the anus and perianal area.
Symptoms:
- Abdominal Pain
- Diarrhea
- Rectal Bleeding
- Weight Loss
- Fatigue
- Fever
- Other Symptoms: Nausea, vomiting, loss of appetite, rashes, eye inflammation, kidney stones, osteoporosis, skin tags and joint pain can also occur.
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Complications
Crohn’s disease can lead to various complications, some of which can be serious and impact a person’s quality of life. Here are some common complications associated with Crohn’s disease:
- Intestinal Strictures: Chronic inflammation can lead to the formation of scar tissue, which may cause the intestinal walls to narrow and thicken. This narrowing, known as a stricture, can obstruct the flow of digested food through the digestive tract.
- Fistulas: Inflammation in the intestinal wall can create abnormal connections between different parts of the intestine or between the intestine and other organs, such as the bladder, skin, or vagina.
- Abscesses: Pockets of pus may develop in the intestinal wall or surrounding tissues as a result of infection and inflammation.
- Perianal Complications: Crohn’s disease can affect the area around the anus, leading to complications such as anal fissures (tears in the lining of the anus), and skin tags.
- Malnutrition and Weight Loss: Chronic inflammation and damage to the intestinal lining can impair the absorption of nutrients from food, leading to malnutrition and unintended weight loss.
- Bowel Obstruction: Strictures, inflammation, and scar tissue in the intestine can cause partial or complete blockages (obstructions) that prevent the normal passage of food and stool.
- Nutritional Deficiencies: Malabsorption of nutrients due to inflammation and intestinal damage can lead to deficiencies in vitamins, minerals, and other essential nutrients. Common deficiencies in people with Crohn’s disease include iron, vitamin B12, vitamin D, calcium, and folic acid.
- Osteoporosis: Chronic inflammation, malnutrition, and corticosteroid use can increase the risk of osteoporosis (bone thinning) and fractures in people with Crohn’s disease.
- Colon Cancer: People with Crohn’s disease involving the colon (Crohn’s colitis) have an increased risk of developing colon cancer.
Extra intestinal Manifestations: Crohn’s disease can affect other parts of the body outside the digestive tract, leading to complications such as arthritis, skin rashes, eye inflammation, liver disease, and kidney stones.
Causes
The exact cause of Crohn’s disease remains unclear, but it is believed to involve a complex interaction between genetic predisposition, environmental factors, and an abnormal immune response. Potential factors include:
- Genetics: Family history plays a significant role, with certain genetic mutations increasing susceptibility.
- Immune System Dysfunction: An inappropriate immune response to gut bacteria or other triggers may lead to chronic inflammation.
- Environmental Factors: Smoking, diet (particularly high in refined sugars and saturated fats), stress, and certain medications may influence disease development and exacerbation.
Diagnosis
Diagnosis typically involves a combination of medical history, physical examination, laboratory tests, imaging studies, and endoscopic evaluation. These may include:
- Blood Tests: A protein in liver makes called the C-reactive protein (CRP) and high white blood cell count maybe elevated due to active inflammation, low levels of red blood cells may be because of anemia.
- Stool Tests: To check for infection and inflammation caused by bacteria or parasite.
- Colonoscopy and Endoscopy: To visualize the GI tract and take tissue samples for biopsy.
- Imaging: X-rays, CT scans, MRI, or capsule endoscopy may be used to assess the extent of inflammation and complications.
Treatment
Treatment aims to reduce inflammation, control symptoms, induce and maintain remission, and prevent complications.
- Medications: Anti-inflammatory drugs, immune modulators, biologic therapies, and antibiotics may be prescribed.
- Dietary Modifications: Certain diets, such as low-residue or low-FODMAP diets, may help manage symptoms, although individual responses vary.
- Lifestyle Changes: Stress management techniques, regular exercise, and smoking cessation can help reduce symptom severity and improve overall well-being.
- Surgery: In severe cases or complications such as strictures, fistulas, or abscesses, surgical intervention may be necessary to remove damaged portions of the intestine or alleviate obstructions.
Prevention
- Low-Residue Diet: Similar to a low-fiber diet, a low-residue diet limits foods that are hard to digest and may leave behind residue in the intestines. This can help reduce the frequency and severity of bowel movements. Foods to include are refined grains, lean protein sources, and well-cooked vegetables and fruits without seeds or skins.
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- Low FODMAP diet:The low FODMAP diet is a dietary approach often recommended for managing symptoms of crohns disease and other gastrointestinal disorders. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharide, and Polyols, which are short-chain carbohydrates that can be poorly absorbed in the small intestine, leading to symptoms like bloating, gas, abdominal pain, and diarrhea in some individuals.
The low FODMAP diet involves restricting foods high in these fermentable carbohydrates for a period of time, typically around 2 to 6 weeks, to help alleviate symptoms. After this initial elimination phase, high-FODMAP foods are gradually reintroduced to identify which specific types and amounts trigger symptoms in individual patients.
Foods that are commonly restricted or limited on a low FODMAP diet include:
- Fruits: Apricots, pears, mangoes, cherries, watermelon, fig, etc.
- Vegetables: Garlic, onions, cauliflower, broccoli, mushrooms, Brussels sprouts, etc.
- Legumes: Beans, lentils, chickpeas, pistachios, etc.
- Dairy products containing lactose: Milk, yogurt, paneer, kefir, etc.
- Wheat and rye-based products: Bread, pasta, certain cereals, etc.
- Sweeteners: High-fructose corn syrup, sorbitol, honey, molasses etc.
- Artificial sweeteners like sorbitol, mannitol, xylitol, and maltitol.
It’s essential to work with a dietitian who is knowledgeable about the low FODMAP diet and Crohn’s disease to ensure that nutritional needs are met and that the diet is tailored to individual preferences and tolerances.
Monitoring Symptoms throughout the process, it’s important to pay attention to how different foods affect symptoms and to make adjustments as needed.
- Limiting Fatty and Fried Foods: Foods high in fat can worsen symptoms for some people with Crohn’s disease. Limiting or avoiding fried foods, fatty meats, and creamy sauces may help reduce symptoms such as diarrhea and abdominal pain.
- Hydration: It’s important to stay hydrated, especially if diarrhea is a symptom of Crohn’s disease. Drinking plenty of warm water throughout the day can help prevent dehydration and may also help soften stool.
- Probiotics: Some people with Crohn’s disease find that probiotics, which are beneficial bacteria that can help support gut health, may help alleviate symptoms. Probiotics can be found in foods like yogurt or taken as supplements.
- Avoid Trigger Foods: Keep a food diary to identify specific foods that seem to worsen your symptoms, and try to avoid or limit these trigger foods.
- Exercise: 30 minutes Light to moderate exercise can be recommended, stretching and yoga exercises help increase the elasticity of the muscles. Swimming has also been shown to help reduce inflammation and relieve joint pain. Those in remission or experiencing mild disease activity can safely perform low to moderate intensity
- Lifestyle modification: While diet alone cannot prevent Crohn’s disease, maintaining a healthy diet and lifestyle may help support overall gastrointestinal health and reduce the risk of inflammation. This includes consuming a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, as well as staying hydrated, getting regular exercise, and managing stress.
- Avoiding Smoking: Smoking is a significant risk factor for Crohn’s disease, particularly for developing more severe disease and experiencing more frequent flare-ups.
- Breastfeeding: There is some evidence to suggest that breastfeeding may be protective against the development of Crohn’s disease, particularly in infants who are at higher genetic risk. Breastfeeding provides infants with important antibodies and beneficial bacteria that may help support a healthy immune system.
- Limiting NSAID Use: Nonsteroidal anti-inflammatory drugs (NSAIDs) can exacerbate inflammation in the gastrointestinal tract and may increase the risk of developing Crohn’s disease or worsening symptoms in people with existing Crohn’s disease.
Minimizing Environmental Exposures: While the role of environmental factors in Crohn’s disease is not fully understood, minimizing exposure to certain environmental toxins and pollutants may help reduce the risk of inflammation in the gastrointestinal tract. This includes avoiding exposure to cigarette smoke, air pollution, and other environmental toxins when possible.
How Food & Wellness can help you?
Food n Wellness provides thoughtfully curated packages for crohns disease depending upon the conditions and requirements of the clients. The crohns disease management diet plan will be meticulously designed towards making improvements in your conditions over and beyond our period of our engagement. We shall discuss with you your food preferences, dietary habits, lifestyle, exercise pattern, sleep cycle, and review your medical reports, travel frequencies, cooking restrictions, food allergies and other details. On the basis of the information collected we shall craft a detailed plan for every day of the plan period.
The diet plans and lifestyle counselling that shall be provided by Food N Wellness is designed to reduce the symptoms associated with crohns disease like diarrhoea, weight loss, pain, rectal bleeding etc., and thereby contribute towards improving the quality of overall life.
The diet plans are crafted in a way that it addresses to normalize the often distorted composition of gut bacteria and thereby significantly improve your gut health. Improving gut health will not only help you to manage the symptoms associated crohns disease but also make your gastrointestinal health better.
The diet recommendations shall be flexible and provide you with ample varieties, so that the food you eat won’t be monotonous and you shall be able to follow and embrace it.
Once the programme ends, a maintenance plan is suggested so that you shall be able to implement the learning during the period of programme to plan for a healthy future.
Additionally
A WhatsApp chat group is created after you opt for the plan and daily updates are taken from you and feedback or support provided as needed. One phone call is fixed every two weeks to discuss the progress on Zoom or Whatsapp.
- Petagna L, Antonelli A, Ganini C, Bellato V, Campanelli M, Divizia A, Efrati C, Franceschilli M, Guida AM, Ingallinella S, Montagnese F, Sensi B, Siragusa L, Sica GS.
Biol Direct. 2020 Nov 7;15(1):23. doi: 10.1186/s13062-020-00280-5.
- Overview of Crohn’s disease. Crohn’s & Colitis Foundation. https://www.crohnscolitisfoundation.org/what-is-crohns-disease/overview. Accessed July 7, 2022.
- Feldman M, et al., eds. Epidemiology, pathogenesis, and diagnosis of inflammatory bowel diseases. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 18, 2022.
- Crohn’s disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease. Accessed July 7, 2022.
- Crohn’s disease. American College of Gastroenterology. https://gi.org/topics/crohns-disease/. Accessed July 7, 2022.
- What should I eat? Crohn’s & Colitis Foundation. https://www.crohnscolitisfoundation.org/diet-and-nutrition/what-should-i-eat. Accessed July 7, 2022.
- https://crohnsandcolitis.ca/About-Crohn-s-Colitis/IBD-Journey/Exercise-and-Lifestyle/Therapeutic-Monitoring#:~:text=Light%20to%20moderate%20exercise%20is,not%20worsen%20symptoms%20of%20IBD.
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At Food & Wellness we believe that every individual is different and needs special attention. We adapt our programme to your existing lifestyle and try not to change anything drastically so you can easily transition. Over a period of time we ensure results and help you restore your health.
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