Bloating, weight gain, discomfort

[Myfriendisill!]

Hi, my friend has Crohns and is at his wits end. He is male, 46 and diagnosed 6 months ago. Certain foods make him so ill, eggs, cream, ice cream, onions have him ill for 7 days - chronic fatigue, depression and lethargy with incredible bloating. He has gained 2 stones in a year and eats far less than he used to. Currently following a low fodmap and gluten free diet. His consultant had him on a course of antibiotics and some granules (sorry don’t know name) nothing has worked so far, next step is steroids. The bloating is now horrendous and he is so uncomfortable, none of his clothes fit. The CD is in his terminal ileum and the bloating is like a huge egg in his lower abdomen. He has just been to see a dietician who said symptoms are not diet related and he needs to eat more and vary what he eats (he is very restricted now as he is terrified food will make him ill and have to tae time off work) He is a testicular cancer survivor of 10 years and I wonder if this is down to long term radiotherapy damage. Do others recognise any of these symptoms and if so does anything work to alleviate the discomfort? Are steroids the answer? He is anxious about taking this path. Any help you can give would be appreciated.

 

[UnXmas]

I'd agree with the dietician that leading a diet that's too restrictive isn't a good idea. Has he tested positive for coeliac disease? If not, there's no reason he should need to be gluten-free. I don't know much about the Fodmap diet - is that something a professional recommended to him, or is he doing it by himself? How did he work out which foods he can't tolerate? Sometimes symptoms just happen, regardless of what has been eaten.

Steroids can in some cases be extremely effective for treating Crohn's. The only way he'll find out is by trying them, but even if they don't work right away his consultant might be able to try different medications or adjust the dosage.

Crohn's can cause bloating, and although in some cases this can be reduced by diet changes, sometimes it can't. If the steroids are effective for him, the bloating may reduce if it's being caused by his Crohn's. If the bloating is unrelated to Crohn's, it might be worth while to begin by asking his GP of other possible causes.

 

[shamrock15]

Depending on how serious the inflammation is in his terminal ileum, he may be significantly narrowed or partially obstructed. Both of these can cause the bloating you are describing. If the narrowing hasn't scarred, it is possible the prednisone could significantly reduce this issue for him. Give the prednisone a try - it worked wonders for me initially with my disease.

 

[Myfriendisill!]

Thank you UnXmas - Rob (my friend) didn’t test positive for coeliac but was told he was genetically predisposed to the condition and his consultant suggested the fodmap and gluten free diet which he has stuck to for about 2 months. We kept a food diary for 6 weeks and logged foods and their effects and it became obvious which ones caused the greatest problems. Early on in this process he was prescribed mebeverine for IBS (Pre the Crohns diagnosis) and he seemed better on that and a more varied diet. He has to see his GP in a couple of weeks for a Vit D injection; maybe she can shed some light on things. Thank you!

 

[Myfriendisill!]

Thank you Shamrock15, I will tell Rob to ask about prednisone, your advice is most welcome - just feel so in the dark and desperate.