Inflammatory bowel disease
Inflammatory bowel disease (IBD) is a broad name used to describe various disorders that present chronic inflammation of the digestive tract. These include ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis, depending on their evolution.
CD is characterized by inflammation of the lining of the digestive tract, generally its deeper layers. The most affected areas are usually the end of the small intestine (ileum) and the beginning of the large intestine (cecum). Instead, UC presents with inflammation and ulcers in the superficial lining of the large intestine (colon) and rectum. In both, the inflammation is the one that produces the symptoms (generally diarrhea, rectal bleeding, abdominal pain, fatigue, decreased appetite and weight loss), which usually occurs in the form of outbreaks that alternate with remission phases (no symptoms occur although the pathology is still present). Indeterminate colitis shows symptoms of CD and UC. It could be considered as an intermediate pathology between the two, so its treatment must be even more personalized and specific. As it evolves, it can become pure UC or EC.
The exact cause of IBD is unknown. In the past, diet and stress were suspected to be the cause, however, today doctors know that these factors can aggravate symptoms, but not cause IBD. A possible cause could be a malfunction of the immune system, since when it tries to fight an invading bacteria or virus, an abnormal immune response is produced that causes the immune system to also attack the cells of the digestive tract.
The objectives of IBD treatment are to normalize the lifestyle (diet and physical activity), allow adequate physical and psychological development and avoid complications. In addition, they require medical and pharmacological treatment tailored to each patient. The medical history, the results of the tests and the symptoms are the ones that will guide the digestive system specialists when it comes to prescribing treatment. Medication in these pathologies serves to treat outbreaks, prevent their reappearance and, in general, to improve the quality of life of patients.
Because some of the consequences of IBD are weight loss, anemia and malnutrition, caused by a decrease in food intake (due to abdominal pain), by problems of assimilation of nutrients and a higher caloric expenditure (because inflammation is an energy-intensive process). The diet aims to prevent and correct these problems. Currently, there are no arguments for diets that exclude food. Therefore, the diet must be the same as for the general population, balanced and personalized (intolerances, allergies, etc.). Next, we will mention some general recommendations that usually have a good tolerance in the diet, when it is in the maintenance and controlled phase:
Divide the intakes into at least 5 small-volume intakes.
Avoid foods that are rich in fat and copious culinary preparations.
Avoid foods and spices that irritate the intestinal mucosa.
Rehydration and electrolyte replacement should be controlled if diarrhea is recurrent. Take oral serum if necessary.
Make a diet diary with foods that feel good and those that cause digestive symptoms.
If no relationship is found between food and digestive symptoms, it is not necessary to eliminate it from the diet. Tolerance to foods may differ depending on whether you are in the "outbreak phase."
The diet must be individualized according to the tolerance of each patient. If you want to introduce a new food, it must be done with others that do not cause symptoms. In this way, you can see which ones are well tolerated and which ones are not.
When a food feels bad, the discomfort usually appears after 6 hours. If the discomfort appears the next day, it is unlikely that it is due to this food.
The symptoms produced by food depend on the amount of it, so it is better to start with small amounts.
Chew well, eat calmly and rest your meals.
The diet must be broad, balanced and very varied.
Perform blood tests to avoid nutritional deficiencies of calcium, iron, Vitamin D, B12, B9, antioxidants, copper and fat-soluble vitamins (A, D, E and K).
Faced with an acute outbreak in which orally it is well-tolerated or not contraindicated, the most recommended would be to follow a diet that is:
In the active phase of the disease, energy needs are higher than in remission, due to psychological, surgical stress or possible infections. The intake of 5-6 meals a day (3 main and 2 snacks) of low volume, spaced and chewing the food very well will help to provide the necessary daily calories.
Hyperprotein, since in the outbreaks you can have blood loss through feces and fever, therefore it is necessary to increase the intake of foods rich in protein (lean meats, white fish, egg whites, etc.). At least the 3 main meals should include protein foods.
It must be hypolipidic, since oils and fatty foods have a lubricating effect on the intestine and facilitate bowel movements. Therefore, the contribution of all types of fats should be reduced (1-2 tablespoons a day) to avoid excess stools.
Limit the intake of foods rich in fiber, especially soluble fiber (whole grains) for its laxative effect. You could ingest small amounts of soluble fiber (carrots, cooked apple, quince, etc.) as it slows down the rate of bowel movements.
Good hydration is very important, since a lot of water will be lost due to diarrhea.
Above all, avoid foods that are rich in saturated fat (fatty meats, sausages, butter, etc.), trans-fatty acids (pastries, precooked, etc.), as they have a pro-inflammatory effect on the body.
Patients as a general rule should eat as varied a diet as possible, paying special attention to adequate intake of protein, iron and calcium. There is no evidence to show that foods can trigger an outbreak, so a priori you should not stop consuming any of them. However, during the outbreak, be careful with the intake of milk and fiber in case these increase symptoms (diarrhea, intestinal obstruction) and limit their consumption.
At Epixlife you can find the foods that are most appropriate for your body based on your bioinformation.
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