Introduction
Patients with Crohn’s disease must pay special attention to their diet for several reasons. Firstly, this disease causes nutrients to be insufficiently absorbed in the intestine, which means that malnutrition and malabsorption can develop (malassimilation). Some people affected also avoid some foods that they subjectively feel worsen their symptoms.
This behavior increases the malnutrition even more. In addition, the body is in an acute phase in a state characterized by inflammation (fever, diarrhea, etc). Among other things, this results in an increased energy requirement and a disturbed iron metabolism. In addition, some of the drugs used in the therapy of Crohn’s disease also intervene in the energy metabolism. For example, the frequently used glucocorticoids lead to an increased need for calcium, as they can otherwise lead to osteoporosis.
Nutritional therapy in the different phases of the disease
In Crohn’s disease, the exact nutritional therapy advised depends on the phase in which the patient is in. In general, alcohol and especially nicotine should be avoided. Patients should take care to eat several small rather than a few large meals in order not to put an excessive strain on the bowel.
In addition, food should always be eaten slowly and chewed well. A relapse in Crohn’s disease usually lasts 3-6 weeks. During this time it is particularly important to pay attention to nutrition.
The body loses a lot of fluid and important nutrients due to severe diarrhoea. However, since the intestine is inflamed and particularly sensitive during this time, it is advisable to take a closer look at the diet during this phase. In the inflammatory phase, the acute episode, you should therefore eat a slightly different diet than in the remission phase.
The latter is to be regarded as the recovery phase. During the acute phase, the intestinal mucosa should only be gently touched by the food. It is therefore advisable to eat an easily digestible diet.
It is therefore important not to consume too much dietary fiber, so raw vegetables and grains would be unsuitable. Here you can see an overview of the most important nutritional recommendations: Drink plenty of fluids: Still water, tea, with lighter phases also diluted juice spritzers Fat-reduced nutrition White bread (better than wholemeal bread), grey bread, wheat or semolina porridge, rice flakes, white noodles and rice, mild skimmed milk products (yogurt, curd cheese, cottage cheese), strained fruit (bananas, apples, berries), gruel soups, vegetable broth, potato or carrot soups, parsnips, zucchinis, baby food, oat or millet flakes, seeds, nuts, soy products High-protein diet Fish, meat, eggs In addition, the temperature of the food should be lukewarm. Spicy food, such as food that is too sour or sweet, should also be avoided.
However, in the case of a very severe inflammatory phase, the above-mentioned diet may also be contraindicated, as it is also not tolerated. In this case, a high-caloric sip feed is recommended. In a few severe cases, normal food intake via the intestine may no longer be possible, making artificial nutrition (parenteral nutrition) necessary.
- Drink plenty of liquid: still water, tea, and in case of lighter phases also diluted juice spritzers
- Fat-reduced nutrition
- White bread (better than wholemeal bread), brown bread, wheat or semolina porridge, rice flakes, white noodles and rice, mild skimmed milk products (yogurt, curd, cottage cheese), strained fruit (bananas, apples, berries), gruel soups, vegetable broth, potato or carrot soups, parsnips, zucchini, baby food, oat or millet flakes, seeds, nuts, soy products
- Protein-rich food: fish, meat, eggs
In the remission phase, the main focus is on supplying the body with all the important nutrients and vitamins and also on stimulating intestinal peristalsis through dietary fiber. It is therefore recommended to eat vegetables, fruit and potatoes, for example, as they contain many important vitamins and minerals. Depending on the circumstances, sometimes supplements to the normal diet, such as iron or calcium tablets, can also be useful.
Soy and wholemeal products should also be on the menu in remission. If possible, animal fats (i.e. lean meat) and sugar should be avoided.Other foods that are not well tolerated by many Crohn’s disease patients are eggs, milk, bananas, yeast, wine and caffeine. However, there are sometimes considerable differences between these foods, which is why the menu should always be prepared individually.
Additional intolerances, such as lactose intolerance, which often accompany Crohn’s disease, must of course be taken into account if they are present. A diet tailored to the disease is an important therapeutic component in Crohn’s disease and can optimize drug treatment. If all therapy recommendations are followed, life expectancy in Crohn’s disease is hardly or not at all limited.
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