Dr. Schoenfield served as associate professor of medicine and consultant in gastroenterology on the faculty of the Mayo Clinic for seven years. He became a professor of medicine in residence at UCLA from 1972 to 1999 (now emeritus). He was the director of gastroenterology at Cedars-Sinai Medical Center in Los Angeles for 25 years, where he received the chief resident's teaching award, the president's award, and the pioneer of medicine award.
No special eating plan has been proven effective for treating inflammatory
bowel disease (IBD). But for some people, changing the foods they eat may help
control the symptoms of IBD.
There are no blanket food rules. Changes that help one person with IBD may
not relieve symptoms in another. Talk to your doctor and maybe a dietitian about
which foods you should and should not be eating. Their suggestions will depend
on the part of your intestine that is affected and which disease you have.
Your doctor may suggest some of the following changes:
Taking specific nutritional supplements, including possibly vitamin and
mineral supplements
Avoiding greasy or fried foods
Avoiding cream sauces and meat products
Avoiding spicy foods
Avoiding foods high in fiber, such as nuts and raw fruits and vegetables
Eating smaller, more frequent meals
Even though you may have to limit certain foods, you should still aim to eat
meals that give you all the nutrients you need.
Ulcerative colitis (UC) and Crohn's disease (CD) are known as the
inflammatory bowel diseases (IBD). The precise cause of IBD remains unknown.
These diseases are believed to be caused by a combination of genetic and
non-genetic, or environmental factors (for example, infections) that interact
with the body's immune (defense) system. When the intestinal immune system does
not function properly, many white blood cells accumulate in the inner lining (mucosa)
of the gut. The white cells then release chemicals that lead to tissue injury
(inflammation). This inflammation of the mucosa can cause diarrhea, which is the
most common symptom of ulcerative colitis and Crohn's disease, with or without the intestinal complications.
What are the intestinal complications of IBD?
The intestinal complications of IBD occur when the intestinal inflammation is
severe, extends beyond the inner lining (mucosa) of the intestines, is
widespread, and/or is of long duration (chronic). For example, severe mucosal
inflammation can cause ulcers, bleeding, and toxic megacolon (a condition in
which the colon widens, or dilates, and loses its ability to properly contract).
Inflammation that extends beyond the inner lining and through the intestinal
wall is responsible for strictures (scarring that causes narrowing of the
intestinal wall) and fistulas (tubular passageways originating from the bowel
wall and connecting to other organs or the skin). Strictures, in turn, can lead
to bacterial overgrowth of the small intestine (SIBO). If the inflammation of
the small bowel is widespread, malabsorption of nutrients can be a complication.
Chronic inflammation can also be associated with colon cancer.
The majority of
IBD patients experience periods during which their disease intensifies (flares)
or subsides (remissions). Although most patients require medication for IBD,
they are able to live normal, productive lives. Some patients, but certainly not
all, will develop intestinal complications of IBD. When these complications
occur, they should be recognized and usually treated. Some patients with IBD
develop complications outside of the intestine (extraintestinal), such as
certain kinds of arthritis,
skin rashes, eye problems, and liver disease. These
extraintestinal complications are discussed in other articles on IBD.
This
review will describe the various types of intestinal complications that are
associated with IBD, and will also summarize methods for their diagnosis and
treatment. Please note that the terms bowel, intestine, and gut are used
synonymously. The small bowel, or intestines, includes from top to bottom, the
duodenum, jejunum, and ileum. The large bowel is also called the colon.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Pernicious anemia is a blood disorder in which the body does not make enough red blood cells due to a lack of vitamin B12 in the blood. Pernicious anemia can develop from a lack of a protein that helps the body absorb vitamin B12, not getting enough B12 in the diet, and certain intestinal conditions that interfere with the absorption of vitamin B12 such as Crohn's disease, celiac sprue, or ulcerative colitis. There is no cure for pernicious anemia, thus treatment is life-long.
Corticosteroid drugs such as prednisone and prednisolone are commonly used to treat asthma, allergic reactions, RA, and IBD. Steroids such as these do have serious drawbacks such as steroid withdrawal symptoms such as: fatigue, weakness, decreased appetite, weight loss, nausea, vomiting, abdominal pain, and diarrhea. Speak with your healthcare provider prior to tapering off steroid medications.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Liver disease is any disturbance of liver function that causes illness. The
liver is responsible for many critical functions within the body and should it
become diseased or injured, the loss of those functions can cause significant
damage to the body. Liver disease is also referred to as hepatic disease.
Liver disease is a broad term that covers all the potential problems that may
occur to cause the liver to fail to perform its designated functions. Usually,
more than 75% or three quarters of liver tissue needs to be affected before
decrease in function occurs.
The liver the largest solid organ in the body; and is also considered a gland
because among its many functions, it makes and secretes bile. The liver is located in the upper right portion of the abdomen
protected by the rib cage. It has two main lobes that are made up of tiny
lobules. The liver cells have two different sources of blood supply. The hepatic
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