Crohn's Disease - Diet

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What diet changes did you have to make, or continue to make to control the symptoms of your Crohn's disease?

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Are there any recommendations for diet, supplementation, or vaccinations for Crohn's disease?

Dietary changes and supplementation that may help control Crohn's disease.

  • Since fiber is poorly digestible, it can worsen the symptoms of intestinal obstruction. Hence, a low fiber diet may be recommended, especially in those patients with small intestinal disease.
  • A liquid diet may be of benefit when symptoms are more severe.
  • Intravenous nutrition or TPN (total parenteral nutrition) may be utilized when it is felt that the intestine needs to "rest."
  • Supplementation of calcium, folate and vitamin B12 is helpful when malabsorption of these nutrients is apparent.
  • The use of anti-diarrheal agents (diphenoxylate and atropine [Lomotil], loperamide [Imodium]) and antispasmotics also can help relieve symptoms of cramps and diarrhea.

Vaccination recommendations for individuals with Crohn's disease

It is recommended that adults with inflammatory bowel disease generally follow the same vaccination schedules as the general population.

They should receive a single dose of Tdap, then Td booster every 10 years.

Women between the ages of 9 and 26 should receive 3 doses of HPV vaccine (and consideration should be given to older patients who are HPV negative on Pap smear). Men in the same age range should also consider being vaccinated given the increased risk of HPV with immunosuppression.

The influenza (flu) vaccine should be given annually to all patients (though the live intranasal vaccine is contraindicated in patients on immunosuppressive therapy).

One dose of pneumococcal vaccine should be given between age 19-26 and then revaccination after 5 years.

If not previously vaccinated, all adults should receive 2 doses of hepatitis A vaccine and 3 doses of hepatitis B.

Meningococcal vaccine is only recommended for patients with anatomic or functional asplenia, terminal complement deficiencies, or others at higher risk (college students, military recruits, etc).

Mumps/measles/rubella, varicella, and zoster vaccines are contraindicated for patients on biologic therapy, as they are all live vaccines.11

Other factors that may affect Crohn's disease

A recent study found that active smoking is a risk factor for Crohn's disease, and passive smoking can also contribute to a worse prognosis. Therefore, smoking cessation should be advised among patients with Crohn's disease.11

Osteoporosis with markedly reduced bone mineral densities has also increasingly been recognized as a significant health problem in patients with inflammatory bowel disease. Screening with a bone density study is recommended in postmenopausal woman, men > age 50, patients with prolonged corticosteroid use (> 3 consecutive months or recurrent courses), patients with personal history of traumatic fractures with minimal trauma, and patients with hypogonadism11. Most patients with inflammatory bowel disease should be taking calcium and vitamin D supplements.

Return to Crohn's Disease

See what others are saying

Comment from: just_me, 35-44 Female (Patient) Published: January 16

I was diagnosed with Crohn's 18 years ago. I have had one bowel resection surgery (removed 18 inches of small intestine, 12 inches of my large). I have received every treatment under the sun including extensive medications including prednisone, Imuran, Entocort, Remicade, Humira and Cimzia. The side effects from all of these medications and others, have taken their toll and my body, simply stated, has begun to rebel/fight back. Approximately 6 months ago, I made a couple of back to back trips to the emergency room with severe upper abdominal pain along with significant weight loss in a short window of time. Initially I was told it was unconfirmed celiac disease and quickly switched to a gluten-free liquid diet. After 3 weeks, multiple tests including biopsies and blood work, we came to the conclusion it was not celiac disease but pancreatitis, most likely caused by long-term Imuran treatment. I had begun seeing some improvement from my diet so continued with the gluten-free and slowly introducing solids. Throughout this long endeavor I have been able to wean off all medications for Crohn's and shift to a daily life of no abdominal pain, no joint pain and the majority of my days feeling better than ever, all as a result of a strict gluten-free diet. In speaking with my doctor in a follow up visit recently, I was told 3 other Crohn's patients have had similar results by going gluten-free. I just wish someone had suggested this 18 years ago!

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Comment from: Tregaron, 35-44 Male (Patient) Published: March 19

I suppose I got off pretty lightly. I was diagnosed with Crohn's when I was 15, having lost about 50% of my body weight in about 3 months. I was off school for a further 3 months. I used to get terrible stabbing pains just below the ribs on the right hand side. I still do. Breathing exercises help with this. I haven't had a normal stool since then, but rarely have diarrhea. I"m just regular, twice a day. I"ve not let it rule my life at all, I have a pretty stressful job as a civil engineer, I travel a lot, and up until my 40th birthday I was playing rugby in the national 2nd division. At 1.87 m I weighed 100kg (that's 6"2" and 220 lbs). I avoid fats, but everything else is OK. I can't eat big portions, so little and often. I have been prescribed steroids, but to be honest, I find the side effects (especially depression) worse than the symptoms, especially with my kids around.

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