Sometimes you may feel helpless when facing inflammatory bowel disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.
There's no firm evidence that what you eat causes inflammatory bowel disease. But certain foods and beverages can aggravate your symptoms, especially during a flare-up. It's a good idea to try eliminating from your diet anything that seems to make your signs and symptoms worse. Here are some suggestions:
- Limit dairy products. If milk or other dairy products aggravate your symptoms, you may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods. If so, you may want to try an enzyme product, such as Lactaid, to help break down lactose. In some cases, you may need to eliminate dairy foods completely. Keep in mind that with limiting your dairy intake, you'll need to find other sources of calcium, such as supplements.
- Experiment with fiber. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. Check with your doctor before adding significant amounts of fiber to your diet.
- Avoid problem foods. Eliminate any other foods that seem to make your symptoms worse. These may include "gassy" foods, such as beans, cabbage and broccoli, raw fruit juices and fruits, popcorn, caffeine, and carbonated beverages.
- Eat small meals. You may find that you feel better eating five or six small meals rather than two or three larger ones.
- Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
- Consider multivitamins. Because inflammatory bowel disease can interfere with your ability to absorb nutrients and because your diet may be limited, vitamin and mineral supplements can play a key role in supplying missing nutrients. They don't provide essential protein and calories, however, and shouldn't be a substitute for meals.
- Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Smoking increases your risk of developing Crohn's disease, and once you have it, smoking can make the condition worse. People with Crohn's disease who smoke are more likely to have relapses, need medications and repeat surgeries. Quitting smoking can improve the overall health of your digestive tract, as well as provide many other health benefits.
Although stress doesn't cause inflammatory bowel disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one.
When you're stressed, your normal digestive process can change, causing your stomach to empty more slowly and secrete more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.
Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:
Dec. 13, 2012
- Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
- Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.
- Regular relaxation and breathing exercises. An effective way to cope with stress is to perform relaxation and breathing exercises. You can take classes in yoga and meditation or practice at home using books, CDs or DVDs.
- Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional can teach you how to enter a relaxed state.
- Other techniques. Set aside time every day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.
- Ulcerative colitis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/. Accessed July 1, 2011.
- Living with ulcerative colitis. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/livingwithuc52010.pdf. Accessed July 1, 2011.
- Ulcerative colitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018c.html. Accessed July 1, 2011.
- Shale M, et al. Isotretinoin and intestinal inflammation: What gastroenterologists need to know. Gut. 2009;58:737.
- Burakoff R, et al. Inflammatory bowel disease. In: Greenberger NJ, et al. Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=6200149. Accessed June 20, 2011.
- Peppercorn MA, et al. Medical management of ulcerative colitis. http://www.uptodate.com/home/index.html. Accessed June 30, 2011.
- Ulcerative colitis practice guidelines in adults. Bethesda, Md.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/UlcerativeColitis.pdf. Accessed June 20, 2011.
- Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
- IBD and pregnancy: What you need to know. Crohn's and Colitis Foundation of America. http://www.ccfa.org/about/news/pregnancy. Accessed July 2, 2011.
- Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
- Fact sheet: Complementary and alternative medicine. Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/FactSheets/CAM.pdf. Accessed July 1, 2011.
- Taylor RA, et al. Curcumin for inflammatory bowel disease: A review of human studies. Alternative Medicine Review. 2011;16:152.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 22, 2011.
- Colorectal cancer screening guidelines. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm. Accessed July 12, 2011.
- Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/Crohns.pdf. Accessed June 20, 2011.
- Management of Crohn's disease in adults. Bethesda, Md.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/CrohnsDiseaseinAdults2009.pdf. Accessed June 20, 2011.
- Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 20, 2011.
- Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018b.html. Accessed June 20, 2011.
- Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Smoking and your digestive system. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/smoking/DD-52.pdf. Accessed June 23, 2011.
- Ford AC, et al. Glucocorticosteroid therapy in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:590.
- Colombel JF, et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. New England Journal of Medicine. 2010;362:1383.
- Farrell RJ, et al. Medical management of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Ford AC, et al. Efficacy of biological therapies in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:644.
- Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
- Stenson WF. Inflammatory bowel disease. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed July 12, 2011.
- Reddy D, et al. Possible association between isotretinoin and inflammatory bowel disease. American Journal of Gastroenterology. 2006;101:1569.
- Crockett SD, et al. A causal association between isotretinoin and inflammatory bowel disease has yet to be established. American Journal of Gastroenterology. 2009;104:2387.
- Crockett SD, et al. Isotretinoin use and the risk of inflammatory bowel disease: A case-control study. American Journal of Gastroenterology. 2010;105:1986.
- Bernstein CN, et al. Isotretinoin is not associated with inflammatory bowel disease: A population-based case-control study. American Journal of Gastroenterology. 2009;104:2744.
- Margolis DJ, et al. Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease. American Journal of Gastroenterology. 2010;105:2610.
- Loftus EV (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2011.