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.

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See what others are saying

Comment from: Hot Wheels, 75 or over Female (Patient) Published: July 21

My low potassium was just temporary, but I am subject to having hypokalemia again. I had taken an extremely long, hundred plus mile bike ride in very hot Texas summer weather, about 108 degrees that day. I did take plenty of water and a bottle of sport drink, but it wasn't enough to keep my electrolytes up. I was sweating like mad, so I drank water to keep hydrated. However, I was losing minerals (including potassium) through my sweat, and water alone wasn't enough to replenish all of my losses. The sport drink was also pretty weak in electrolytes, under those conditions. When I got home, I drank more water and showered to cool down, then I felt okay. However, I then went to a friend's house for dinner. I should have had a snack at home first. Well, we were all sitting around chatting at the table when I began to feel weird. It was hot in that house, as they don't have central AC. I felt myself drifting off, feeling extremely weak and tired, and I got up to go lie down in the spare room and I dropped like a rock and hit the floor. What was odd was that I could still hear what was going on, I could hear my friends calling my name and trying to revive me but I just could not move or answer them. Slowly I woke up, still on the floor. Then they got me to the cool room, stripped my shorts and tunic off, and packed my legs and arms in wet towels and brought some low-salt V8, and within minutes I felt just fine. Then I had some baked potatoes and guacamole and beans for a snack, all great potassium sources.

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Comment from: Mics, 13-18 Female (Patient) Published: September 21

I had big plantar warts for 2 or 3 years a few years back. The underarm and foot deodorant powder I used, Milcu (potash alum, hydrated magnesium silicate) helped remove the wart. I wasn't sure if it was the reason at first but when my sister, who got infected with warts used it too, her warts disappeared as well. It hasn't returned for both of us since. It took a few months to disappear.

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