The Essential Guide to Living with Crohn's Disease
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Crohn’s disease, which affects almost 780,000 Americans, is a medical condition characterized by chronic inflammation of the gastrointestinal (GI) tract. Although it can affect any part of the GI tract, Crohn’s disease most commonly affects the small and large intestines.
The cardinal symptoms of Crohn’s disease are abdominal pain and diarrhea, which can range from mild to severe. This disease also may be accompanied by fever, rectal bleeding, unexplained weight loss, and fatigue.
Doctors agree that food doesn’t cause Crohn’s disease — as a matter of fact, no one knows what exactly causes the disease. However, food can definitely make the symptoms worse and contribute to flare-ups of the disease.
To help track what foods trigger flares of the disease, you may want to start by keeping a food diary. It is a record of what you eat and how it makes you feel.
As there are at least six types of Crohn’s disease, the diet that works for one patient may not work for another. Outside of a food diary, there are some general guidelines that can be considered for individuals with Crohn’s disease, including:
- Pay Attention to Fiber: Some patients have no trouble with a high fiber diet, while other patients find it aggravates their symptoms, necessitating a switch to a low fiber diet.
- Take It Easy on the Fat: Excess fat intake can aggravate symptoms, as the disease affects the breakdown and absorption of fats, leading to bouts of diarrhea.
- Take It Easy on the Diary: While individuals with Crohn’s disease are not necessarily lactose intolerant, consumption of excess dairy products may set off symptoms.
- Stay Hydrated: The best way to stay hydrated is to drink plenty of water, as your colon’s ability to absorb water is already compromised and symptoms, such diarrhea and bleeding, can quickly lead to dehydration.
- Consider Vitamin and Mineral Supplementation: Decreased absorption of vitamins and minerals is not uncommon, which is why it may be sensible to consider supplementation after discussing with your doctor.
Additionally, you should be eating small, frequent meals and avoid or limit your intake of caffeine, alcohol, spicy foods, artificial sweeteners, and nicotine.
Identifying and Avoiding Triggers
The course of Crohn’s disease tends to wax and wane. You may be going along with a minimum of symptoms or in remission, and all of a sudden, you may feel like you’re back at square one with a flare-up of your disease. This makes identifying and avoiding triggers for your disease all the more important.
Dietary triggers have already been discussed above, but other triggers for the activity of Crohn’s disease may include:
- Smoking: Not only can it induce flare-ups of Crohn’s disease but also can increase the need for surgical procedures for the management of your disease.
- Certain Medications: It is well established that certain non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen, and some antibiotics may cause an uptick in your symptoms.
- Infections: Not only are they suspected of causing Crohn’s disease but are also suspected of triggering the disease.
- Changes of Season: You may find that your symptoms flare-up during certain times of the year, which may have to do with seasonal allergies or having respiratory infections, such as the common cold or influenza.
Reducing Stress Levels
Although the connection between stress and Crohn’s disease flare-ups has not been clearly elucidated, doctors agree that excess stress levels can definitely be detrimental to the disease.
None of us are worry-free. However, the following tips to de-stress may calm your disease and prevent flare-ups:
- Regular Exercise: Strive for at least 30 minutes on most days of the week, which does not have to be continuous and can be intermittent.
- Biofeedback: Utilizes electrical sensors to provide information about bodily functions in hopes of decreasing your symptoms.
- Cognitive Behavioral Therapy: Strives to change negative thinking patterns that can have a positive effect on mood.
- Meditation: As little as a few minutes of meditation per day can provide significant reductions in stress and anxiety.
- Deep Breathing Exercises: Can significantly decrease stress and anxiety and techniques such as meditation and tai chi inherently incorporate deep breathing.
Along with prescription medications for your Crohn’s disease, many patients with the disease incorporate natural treatments from the realm of complementary and alternative medicine. Although the safety and effectiveness of natural treatments for Crohn’s have not been established, you should consider:
- Probiotics: Strains of live bacteria that aim to restore the gut balance of beneficial bacteria.
- Prebiotics: Natural compounds in plants that aim to restore the gut balance of beneficial bacteria.
- Fish Oil: Has omega-3 fatty acids, which have anti-inflammatory properties.
- Acupuncture: The traditional Chinese technique of inserting very thin needles into certain points on the body)
- Turmeric: Its active ingredient curcumin is thought to be a potent natural anti-inflammatory compound.
If you are diagnosed with Crohn’s disease, you are most likely going to be under the care of a gastroenterologist, a specialist in the study of the stomach and intestines.
Unfortunately, there is no known cure for Crohn’s disease. Most of the drug treatments for the disease target inflammation, the main driver of this medical condition. The primary classes of drugs used to treat Crohn’s disease include:
- Anti-inflammatory drugs, including steroids (prednisone and budesonide) and 5-aminosalicyclic acid derivatives (sulfasalazine and mesalamine );
- Immunosuppressant drugs, including azathioprine (Imuran), cyclosporine (Neoral), 6-mercaptopurine, methotrexate (Rheumatrex), and tacrolimus (Prograf);
- Biologics, including infliximab (Remicade), adalimumab (Humira), natalizumab (Tysabri), and vedolizumab (Entyvio).
- Antibiotics, including metronidazole (Flagyl) and ciprofloxacin (Cipro);
- Antidiarrheals, including loperamide (Imodium A-D) and diphenoxylate with atropine (Lomotil), and;
- Iron, vitamin B12, calcium, and vitamin D supplements.
Many people with Crohn’s tend to stick close to home, as they fear a sudden attack of abdominal pain, cramping, and diarrhea. However, with a little planning, this doesn’t have to be the case.
When venturing out and about, mapping the location of public restrooms through an app like Sit or Squat is extremely helpful and may allay some anxiety, as you will already know where to go if the urge strikes. Just in case, consider packing an emergency kit with items like a clean change of underwear, toilet tissue or wet wipes, zip lock bags, and deodorizer.
Other useful tips include:
- Reading food labels;
- Never skipping meals;
- Avoid overheating, and;
- Bring your own food to parties or gatherings.
Sometimes, despite your best efforts, you still will manage to have a flare-up of your Crohn’s disease. The following are some self-care tips to deal with flare-ups of disease:
- Do not skip any doses of your prescribed medication;
- Pay attention to your body as realizing your flare symptoms early may help you head off or minimize future bouts;
- Avoid extra stress, as it’s a well-established trigger for flare-ups;
- Get adequate rest, as fatigue is definitely linked to upticks in Crohn’s activity, and;
- Tweak your diet by eating bland foods and smaller meals as well as drinking plenty of water.
Creating a Support Network
If you have Crohn’s disease, you may want to isolate yourself for obvious reasons.
Resist this urge, as you are not alone. Stay in touch with family and friends, and by all means, don’t be afraid to ask for help when you need it.
Lastly, consider joining a Crohn’s disease support group, whether online or in person. You may find the sharing of experiences in a community of individuals with similar challenges as yourself refreshing and comforting.
By now, you have the confidence to venture outside of your home and comfort zone. Why not extend this to travel at home or abroad?
Beyond the Sit or Squat app and your emergency kit, consider the following travel tips:
- Take your medications (prescription and non-prescription) as scheduled and pack them in a carry-on as opposed to a checked bag;
- Check with your doctor regarding recommended immunizations/vaccinations, depending on your region of travel;
- If traveling internationally, consider purchasing travel insurance to cover medical care in the case it is needed, and;
- Plan ahead by locating a local doctor, hospital, and/or pharmacy at your destination.
Living with Crohn’s disease can be difficult. Although the disease is rarely life-threatening, it can be physically and psychologically taxing.
It’s not all bad news though. Being armed with the information in this guide will help you live your best life while having Crohn’s disease. You will have the potential to reduce the severity of your disease, impact flare-ups of the disease, and mitigate complications.
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