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Diet Advice

I live in the UK and have had crohns for 4 years.

I have been on all meds and had one resection.
Currently on Humira(started 12 weeks ago) and not really feeling any benefits.

I suppose I have always knew that one day I would have to change my lifestyle/diet ect and I know that day is now here (like many of us I wanted a quick fix). But as we all know there are no such things when dealing with Crohns.

I have looked around ALOT about various diets however it is so confusing.

I was hoping somebody could outline the dieting options and what I should be looking at?

Thanks
 

CrohnsChicago

Super Moderator
May I ask what types of diets you are interested in and what types of diets you have actually tried for crohn's?

What is your purpose for dieting:
  • do you suffer from severe malabsorption of nutrients?
  • are you trying to gain weight?
  • are you trying to lose weight? (some people are)
  • are you trying to avoid foods that may be causing you pain?
  • are you wanting to learn some basic guidelines for eating during a flare in general?
  • are you nearing remission and want to learn a healthy lifestyle in general?
  • is it difficult/painful to eat/drink at all?

Your answers to the above can help you narrow down what type of diets you should consider.
 
Paleo or some variation of ancestral diets (SCD/GAPS/PerfectHealthDiet/Archivore) is worth a look.
They are all variations of the idea that food is either
- responsible or contributing to the disease or
- responsible or contributing to the inability to heal from the disease.
While they might seem confusing you just want to start reading and you will find the common threads. SCD and GAPS start with the idea that the problem is carbs, Paleo it is 'NADS' (Neolithis Agents of Disease Including most carbs), Perfect Health Diet and Archivore (Paleo2.0), well, some things are bad for some people so don't eat them.

There is a big overlap, so once you have given up processed foods, gluten and sugar it is pretty easy to switch between the diets.

The key is understanding why you are doing things, and sticking to it.

Great series of talks on paleo and IBD by Dr. Joseph Brasco of the Huntsville Center for Colon and Digestive Disease and a few of his patients.
part 1
[youtube]C8xLkEHZxDg[/youtube]

Great Series of posts from Paul Jaminet (Perfect Health Diet)
part 1
http://perfecthealthdiet.com/2010/07/ulcerative-colitis-a-devastating-gut-disease/
 
Crohn'sChicago asked good questions. I would add another: are you interested in alternative, more extreme diets, or something less experimental?

I would avoid any diet that tries to sell you something (books, supplements, special foods, etc.) and any diet that promises to cure you or to allow you to go off all medication and/or avoid surgery.


It's important to be able to assess the source providing dietary information: what type of evidence is being used, etc.

I would suggest being careful of any diet that calls for extreme restrictions on what you can eat unless there is a clear and specific reason for doing so, and any overly-complicated diet that consists of numerous rules of what, when and how much you can eat.
 
I'm in the same boat, overwhelmed with all the diets, wondering if I actually need to jump headfirst into doing one or if I need to start adjusting my diet (eliminating grains and sugar) without a specific structured diet.
 

CrohnsChicago

Super Moderator
Nancye50 you should also refer to the questions I posted above. if you answer those questions, it will bring you closer to an idea of the type of diets you should consider. And if you are going the elimination route then consider an Elimination Diet:

This diet works by cutting out foods to find out which ones aggravate your symptoms and which are 'safe'. There are two ways to do this. The first way is more accurate but also harder. You cut out all possible allergens and stick to a very restricted diet until symptoms disappear. Common substances to eliminate while on the diet include dairy, gluten, sugar (either sucrose which is table sugar or also including fructose which is also found in fruit), caffeine and alcohol. You then reintroduce foods, waiting 3 days after each addition before adding the next. If symptoms reappear, drop the latest added food and try it again later. If symptoms reappear again, you have found an offending food.

The second way is quicker but can miss foods. You keep a food diary to identify possible suspects. Eliminate one suspect food for a week. If symptoms disappear, reintroduce the food. If the reintroduction causes symptoms again, the suspect food must be responsible.

Note 'food' can mean a whole type of food, such as dairy or grains.
Source:http://www.crohnsforum.com/wiki/Elimination-Diet
 
Thanks Crohns Chicago. I'm so new to all of this. I wasn't having terrible symptoms (several nagging things ongoing) until I ended up in the hospital with a bowel perforation and a CT revealing likely Crohn's.
I'm keeping a food diary but am on enough new meds at this point that I'm not sure it's helpful since I'm not having much pain. I think 4000mg Pentasa is giving me constant D so that's not a good indicator right now either! GI appt tomorrow, so ready to move forward.

Thank you!
 

CrohnsChicago

Super Moderator
sorry to hear nancy. Talk to your GI tomorrow and ask what his suggestions are regarding diets you should try.

Sticking to soft, bland foods for a while to allow your body time to heal. The intestine has to work hard to break down certain foods including high fiber, and processed foods. the harder it has to work to break down the food (think high fiber broccoli), the more irritated any inflammation/diseased portion of your body can get. Keeping your diet simple for a while makes your intestines work less and allows it more time and energy to focus on healing.

Sample foods to consider eating include
salmon, mashed potatoes, greek yogurt, eggs, avocado, juicing and smoothies are also easier ways to absorb nutrients (damaged parts of the intestine often prevent your body from taking in proper amounts of nutrients thus causing vitamin and mineral deficiencies), chicken breast, mashed sweet potatoes, mashed cauliflower. Just a few things to start with. Just remember: soft and bland and preferably low-fiber to start off and then gradually re-introducing fiber once you start feeling better.
 
Thank you. We've been so lucky in that people have been bringing meals. Lots of noodles and potatoes and a whole lot of chicken. It's been so nice because we haven't resorted to eating out or ordering pizza while I'm trying to recover.

The things that have stuck with me the most in reading about diet is the gut bacteria & leaky gut stuff. That had been resonating with me since before I took a turn for the worse. I was reading It Starts With Food...but we were eating super-clean with lots of veggies. No one (except for here) would ever believe me that all that healthy eating might have been what pushed me over the edge!
 
The things that have stuck with me the most in reading about diet is the gut bacteria & leaky gut stuff. That had been resonating with me since before I took a turn for the worse. I was reading It Starts With Food...but we were eating super-clean with lots of veggies. No one (except for here) would ever believe me that all that healthy eating might have been what pushed me over the edge!
I had a lot of bad experiences with the “leaky gut” idea – it’s used mainly by quack doctors (whether well-intentioned or not), I followed a lot of information I found online and saw a few different nutritionists who subscribed to it who told me that by following the dietary changes they recommended I would heal my supposed leaky gut and feel better. I didn’t, I got sicker.

I'm in the same boat, overwhelmed with all the diets, wondering if I actually need to jump headfirst into doing one or if I need to start adjusting my diet (eliminating grains and sugar) without a specific structured diet.
I would strongly advise against cutting out all grains and all sugar: the cut-out-sugar/processed food/dairy/grains/everything type diets really did not help me. I know some people say "what have you got to lose by trying," but I lost a lot: my health got worse, I spent a lot of money, couldn't join in meals with other people and ended up worrying constantly about why I was failing to get better and about all the foods that I was told were going to harm me.

There are some instances where a strict diet is necessary, or when a whole food group has to be avoided (for example: allergies, coeliac disease, sometimes a medically supervised liquid only diet may be necessary for people with Crohn's) but I don't think you should just give up grains or sugar or whatever for no good reason.

I have found a low-fibre diet to be beneficial, and mainstream medicine recognises that reducing fibre can help in some cases of digestive problems, and though it won’t necessarily help everyone, and is unlikely to result in massive improvements in symptoms, in can provide some relief for many. It doesn't mean cutting out all fibre, but adjusting fibre levels to suit each individual's tolerance.
 
Thanks UnXmas. I had my first GI appt today and he gave me the very same advice. In reading on diet, I think I realized that the desire to lose weight was a higher priority than dealing with this disease. I need to approach it differently.
 
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