Do you feel overwhelmed trying to manage your Crohn’s Disease on your own? OnPoint’s approach to managing Crohn’s Disease provides the expertise to help you feel better! We recognize that everyone has different symptoms, caused by a combination of different triggers. Our approach to Crohn’s Disease management is science-based and tailored to your individual circumstance!
Here is the full rundown of how we work to help our clients manage Crohn’s Disease and its symptoms.
Step 1: Assessment
Crohn’s Disease is an Inflammatory Bowel Disease (IBD) that causes inflammation throughout the digestive tract. There are two stages of Crohn’s Disease: the active flare stage and the remission stage. During an active flare, inflammation is heightened and symptoms are active. During remission, there are no symptoms present. The goal of Crohn’s Disease treatment and management is to achieve and maintain remission. Diet therapy plays a major role in Crohn’s management, which is exactly how your Onpoint dietitian can help!
Crohn’s Disease symptoms range from mild to severe. The disease is progressive, meaning that the symptoms may change or get worse over time. Symptoms also vary from person to person depending on what part of the GI tract is inflamed. This inflammatory leads to symptom flares physical discomfort.
Assessing what foods cause flare ups is the first step in treating and managing your symptoms! Here is a list of foods that increase the chances of experiencing a flare-up:
Foods that irritate GI tract:
- Fruits with seeds and skins
- Spicy food
- High-fat foods: fried food, red meat, fast food
Some other factors that can impact a Crohn's Disease flare are:
- Missing, skipping or wrong medication dose
- NSAIDs can lead to bowel inflammation
- Antibiotics alter the bacteria in the intestine. They can cause diarrhea or inflammation
To determine the proper treatment, it’s critical to determine how severe your symptoms are and evaluate your overall disease severity. Your doctor and dietitian will guide you through this process.
Working together with your doctor and dietitian can help you better understand what's happening inside your body and build the right treatment plan for you!
Step 2: Program Personalization
After determining the best treatment plan for you, our dietitians will create personalized materials to help get you started and guide you on your health journey. Because everyone with Crohn’s Disease experiences different symptoms, we personalize your treatment for your to successfully manage your flares!
Crohn’s Disease management is categorized into two stages: Active Flare stage and the Remission stage.
Active Flare Stage
OnPoint recommends a low fiber diet during flare ups. Following a low fiber diet during an active flare limits the stress on your digestive tract as much as possible. The goal is to give your digestive system a rest- this is especially important during a flare up!
- White bread, pasta, rice (foods made with refined white flour)
- Low fiber cereal
- Small amounts of well-cooked fresh vegetables or canned vegetables
- Tender protein sources such as eggs, tofu, chicken and fish
- Low fiber fruits such as canned fruit, melons, nectarines, papaya, peaches, plums and fruit juices without pulp
- Low fiber vegetables such as well-cooked vegetables without skins or seeds. Potatoes without skin, carrots, beets, asparagus tips, string beans, lettuce, tomato sauces, pureed spinach, strained vegetable juice
Foods to avoid during a flare up:
- Raw vegetables, especially cruciferous vegetables (broccoli, cauliflower, cabbage, Swiss chard, kale, brussels sprouts)
- Onion and garlic
- Potato skins
- Beans, peas, lentils, nuts and seeds
- Some raw and dried fruit high in fiber (apples, bananas, oranges, strawberries)
- Whole grain breads, rice and pastas
- Wild or brown rice
- Anything spicy, fried or tough
- Processed or tough meat
OnPoint also recommends drinking plenty of fluids and staying hydrated. We also suggest eating 5-6 small meals rather than 2-3 bigger meals throughout the day.
The ultimate goal of Crohn's treatment is to achieve and maintain remission. They key to remission is controlling inflammation. Symptoms like abdominal pain, diarrhea and bloody stools should become milder or disappear entirely in the remission stage. Periods of remission can last from a few months to several years.
You can best maintain remission through diet therapy! We recommend a varied, nutrient dense diet when your Crohn's is in the remission stage. Once flare up symptoms have subsided, we recommend introducing high fiber foods back into the diet to ensure your body is getting adequate nutrition. It’s imperative that you increase fiber-containing foods slowly and carefully to avoid irritation.
Foods to re-introduce during remission:
- Whole grains: oats, brown rice, whole wheat pasta, whole wheat bread
- Legumes/nuts: beans, nuts, seeds
- Fruits and vegetables: Reach for colorful, fresh fruits and vegetables. It can be helpful to remove the skin and seeds to avoid symptoms.
Some other ways to maintain remission are to manage stress, avoid NSAIDs, limit antibiotics, quit smoking, and continuously watch your diet for triggers. Along with diet therapy, treatment also includes medications such as amino salicylates (5-ASas), Immunomodulators, and biologic drugs.
Step 3: Monitor Outcomes
Whenever possible, try to eat a diet rich in fiber and nutrients. However, when managing a condition like Crohn’s Disease, sometimes it’s important to make temporary dietary adjustments to relieve symptoms. The key is to change your dietary intake based on your evolving circumstances. We will continuously monitor your symptoms and make sure that you have the right guidance and help with managing your personalized treatment plan.
Throughout your program, your nutritionist or dietitian will be constantly checking in to ensure that your program is serving you well!
Kaitlyn Willwerth is a Registered Dietitian at OnPoint Nutrition. Kaitlyn's work focuses on providing individualized health and lifestyle coaching and, most importantly, support. She is a Certified LEAP Therapist and has also completed the Monash University 'Low FODMAP Diet for IBS' online training course for health professionals.