When newly diagnosed with IBD, it can be relieving to finally be able to put a name to your symptoms, but where do you go from there? Even though you may have to make some lifestyle changes, it is completely possible to live a full and successful life. It can be overwhelming but these tips are helpful to get you started in managing your Crohn's or Ulcerative Colitis.  

Educate yourself on your condition and your treatment regimen

Understanding the options that are available regarding treatment and management options can be very helpful. Start by talking with your gastroenterologist to discuss treatment options. While there is no cure for IBD, it is a treatable condition. IBD treatment usually includes medication to suppress inflammation and control symptoms, as well as therapies to maintain remission and continue to prevent flares. It is extremely important to follow your treatment regimen, even when you are feeling better. If you are not experiencing symptoms, that means your treatment is working! Stopping your treatment will cause flares to start again. Every case of IBD is different, so it is normal for it to take some time to find the right treatment regimen for your body. The Crohn's & Colitis Foundation is can be a great resource of information and connections. The CCFA's "GI Buddy" tracks your symptoms, treatments, the food you eat, and other lifestyle factors. It also gives you reports that you can share with your doctor to help both of you better understand your condition.

Create a healthy lifestyle plan with diet and exercise

Maintaining a good diet and healthy weight can be crucial factors in reducing your symptoms and flares with IBD. It is recommended to eat smaller, more frequent meals that consist of foods that are easy to digest and nutrient dense. Foods that are difficult to digest can lead to intestinal cramping and lead to flares. While every case of IBD is different, these are the most common foods that cause irritation. You can always talk to your doctor about exploring diet options. It can also be beneficial to talk to a dietician.

Good sources of protein are:

• Lean red meat
• Skinless chicken
• Fish
• Eggs
• Lower-fat dairy products such as nonfat milk and low-fat cheeses or lactose free equivalents

Foods to avoid are:

• High-fat and high-fiber such as nuts, seeds, corn, and popcorn
• Caffeine
• Carbonated beverages
• Processed foods
• Sugary desserts

  Getting enough exercise is also very important! Stress affects the way food moves through your digestive system, but exercise helps combat that. It can be especially helpful to try yoga, deep-berating techniques, and meditation. For more information on exercising, check out our blog, Exercising With IBD. (link the blog here)

Have A Support System

Coping with any disease can be especially challenging when you are newly diagnosed. Your friends and family can be your biggest resource in the beginning. You should also consider finding a support group to attend if you feel that is the best option for you. Support groups are a wonderful resource because you can hear from others who have been in your shoes and probably experienced a lot of same things you are going through. You can connect with the IBD community through the CCFA and find a chapter near you to get involved in their events and support groups. Click "here" (insert link) to go to their website and find your chapter. https://www.crohnscolitisfoundation.org/chapters   Sources 5 tips for those newly diagnosed with Crohn's Disease Everyday Health (2017) https://www.everydayhealth.com/crohns-disease/living-with/tips-for-those-newly-diagnosed-with-crohns/   Support for recently diagnosed Crohn's & Colitis UK (2020) https://www.crohnsandcolitis.org.uk/support/support-for-recently-diagnosed   Newly Diagnosed Crohn's & Colitis Foundation (2020) https://www.crohnscolitisfoundation.org/what-is-ibd/newly-diagnosed  

Vitamin Deficiencies from IBD

Vitamins are important for your body because they maintain your body's optimal health and function. Vitamin deficiencies are a real problem in IBD patients. Inflammation, diet, and IBD treatments are big contributing factors that lead to these deficiencies. IBD causes inflammation in the gastrointestinal tract which inhibits the absorption of necessary nutrients from food. The lack of even one vitamin can cause a chain reaction, affecting the efficiency of other vitamins. Vitamins can be supplemented through food intake. Some foods can worsen symptoms of IBD, which is why most patients are on strict diets.

Did you know you can test your vitamin levels?

Most people do not know what their vitamin levels actually are. It can be extremely beneficial for IBD patients to test and know their vitamin levels. There are easy steps you can take to get tested. The number one place to go to would be your healthcare provider. Your doctor will be able to give you the best guidance and advice. Especially being familiar with your condition, they will be able to tell you whether or not you will benefit from being tested. If the test is something you decide to pursue together, your doctor can order a vitamin level test which is usually taken using a blood sample. If you wish to take a different route, there are also independent services that provide vitamin testing. Here are a few websites you can visit to explore your options:

• SpectraCell Laboratories - https://www.spectracell.com/patients/patient-products-mnt-hormones-intro-page/
• Walk-In-Lab - https://www.walkinlab.com/vitamin-mineral-and-nutrition-tests.html
• Vitamin Mineral Testing - http://vitaminmineraltest.com

 

The most common vitamin deficiencies in IBD

Calcium

Most medications taken for IBD prevent calcium absorption in the body. Calcium is important for bone strength and if ignored, can lead to osteoporosis. It is most effective when taken with Vitamin D.

Vitamin D

Vitamin D helps control intestinal inflammation and increase bone density in IBD and has also been shown to help prevent certain cancers that are more common in IBD patients. A deficiency of Vitamin D can come from a lack of sun exposure, and from a lack of calcium.

B12

Vitamin B12 is absorbed through the small intestine. A lack of B12 can lead to fatigue. Supplementing this vitamin will promote energy and reduces inflammation.

Magnesium

Magnesium plays an important role in the functioning of the muscles, as well as maintaining health in the heart, bones, and nerves.

Iron

IBD patients can experience an iron deficiency because of chronic bleeding in the intestinal tract, along with malabsorption. Iron is a key part of hemoglobin which supplies your blood with oxygen. A severe lack of iron could lead to anemia.

Zinc

Zinc helps fight off bacteria and assists in tissue regeneration. Zinc is lost in stool which can become deficient in IBD patients who experience chronic diarrhea. A lack of zinc can cause weakness, slow healing, and a diminished sense of hearing, taste, and sight.

How IBDassist can help you

IBDassist contains all the vitamins that have been listed above, as well as Vitamin B6, Vitamin B9 (Folic Acid), Turmeric Powder, Ginger, Vitamin E, Vitamin A, Potassium, Black Pepper, Boswellia, and Turkey Tail Mushroom. We have partnered with our team of physician advisors to add all necessary substances to offer our patients the maximum symptom relief. If you decide that taking IBDassist is the right decision for you, we recommend monitoring your vitamin levels to see the changes from before taking it, to after. Every case of IBD is different. Some customers see results after 2 weeks while others start to see results after 2 months. We have put a lot of thought and effort into developing a unique formula that helps IBD patients have the best quality of life.  

Sources:

Very Well Health. Vitamin and Mineral Deficiencies in IBD. (2020). https://www.verywellhealth.com/vitamin-and-mineral-deficiencies-in-ibd-1943017 Crohn's & Colitis Foundation. Vitamin and Mineral Supplementation. (2020). https://www.crohnscolitisfoundation.org/diet-and-nutrition/supplementation

When managing your IBD symptoms, diet can be a big factor. There is not one specific diet that has proven to reduce symptoms, however, many IBD patients have reported that there are diets that work for them. Finding the right diet for you may have to happen through trial and error. Also, be sure to consult with your healthcare provider before trying any new diets to make sure you are getting the right nutrients.

Changing Your Eating Habits

It is typically recommended that IBD patients eat smaller, more frequent meals using simple cooking techniques such as boiling, grilling, steaming, and poaching. Typically about 4-6 small meals daily. It is extra important to stay hydrated and to drink fluids slowly without a straw. Using straws or having a fast intake of fluid can cause you to ingest air which may cause gas and irritation in your bowels. It is also useful to keep track of your diet using a food log to know what sort of symptoms you experience after eating certain foods. Doctors will commonly place IBD patients on an elimination diet where you eliminate certain foods and monitor how your body reacts. Even though every IBD case is different, there is a general rule of thumb for foods that commonly irritate symptoms and cause flares.

These are potential trigger foods for IBD:

• Insoluble fiber foods that are hard to digest such as fruits with the skin and raw veggies
• Lactose
• Non-absorbable sugars usually found in sugar free gum, candy, and ice cream
• Sugary foods
• High fat foods
• Fried or greasy foods
• Alcohol and caffeinated drinks
• Spicy foods

 

Special IBD Diets

The Crohn's & Colitis Foundation (CCF) created a list of diets that they have seen most commonly reported being used by IBD patients.

Mediterranean Diet

A Mediterranean diet is rich in fiber and plant-based foods. It includes olive oil, low-fat dairy, herbs, and spices. There is little to no red meat involved and poultry, eggs, cheese, and yogurt are recommended in moderation. A lot of people refer to the Mediterranean diet as being very "clean".

Carbohydrate Exclusion Diet

In a carbohydrate exclusion diet, you exclude or limit your intake of grains, fiber, and certain sugars. The Specific Carbohydrate Diet (SCD) is being studied by the CCF in collaboration with the Patient-Centered Outcomes Research Institute (PCORI) to see if it can be a useful and successful diet for IBD patients. The SCD is very limited, as it eliminates all refined and processed foods, soy, lactose, table sugar, grains, potatoes, okra, and corn. It is important to know that the SCD can also cause your body to run low on vitamin B, calcium, vitamin D, and vitamin E, so it is crucial to get those vitamins supplemented in your diet.

Low-FODMAP Diet

FODMAP stands for "fermentable, oglio-, di-, monosaccharides, and polyols". This diet cuts back on a specific group of sugars that can be poorly absorbed by your GI tract. These sugars include fructose, lactose, sugar polyols (sorbitol and mannitol), fructans (found in garlic, leeks, artichokes, and wheat), and galacto-ogliosaccharides (found in lentils, chickpeas, and black beans). This diet can be especially helpful if you struggle with gas and bloating. However, it typically is not recommended if you are experiencing a flare.

Gluten Free Diet

The gluten free diet cuts out gluten which is a protein found in wheat, barley, and rye food products. Many IBD patients have reported that being gluten free has helped because it helps them feel less bloated and reduces their symptoms. However, gluten free products tend to have higher fat content which can lead to weight gain. Talk to your doctor before trying to go gluten-free, they may want to test you for celiac disease first.

Low-Fiber Diet

The low-fiber diet is recommended to help reduce both cramping and bowel movements by decreasing your fiber intake. When on this diet, you must avoid leafy green veggies, nuts, seeds, popcorn, whole grains, and raw fruits with peels. This diet can be especially helpful if you have a stricture or after a surgery when your gut may be a little extra sensitive.  

Sources

Crohn's & Colitis Foundation. What Should I Eat? (2020). https://www.crohnscolitisfoundation.org/diet-and-nutrition/what-should-i-eat Crohn's & Colitis Foundation. Special IBD Diets. (2020). https://www.crohnscolitisfoundation.org/diet-and-nutrition/special-ibd-diets

What is a flare?

When disease symptoms have a sudden reappearance, this is what we call a flare. Patients with IBD can be symptom free for up to months at a time and then experience a flare without warning. Flares can come in many forms, which is why it is important for you to be able to recognize how they arise in your body and know what to do to help. According to the Crohn's & Colitis Foundation, the most common flares of IBD are:

• Frequent and/or urgent bowel movements
• Diarrhea
• Bloody stool
• Abdominal pain
• Nausea and vomiting
• Weight loss

Flares can also appear in less obvious forms such as fatigue, lack of appetite, joint pain, or rashes.

What is causing my flares?

Most of the time the exact cause of a flare is unknown. Although, there are several factors that are known to make symptoms worse. These are things all IBD patients should be aware of and take the steps to help reduce the possibility of a flare. Preventing flares before they occur with an effective medical maintenance regimen can change the path of your IBD. Intervention can prevent a severe flare and avoid having to admit you to the hospital or perform surgery. Flares can be triggered by factors such as diet, medications, infections, antibiotics, stress, or underlying changes in the disease itself.

How can I manage my flares?

Diet

Food does not cause or cure IBD, but paying attention to your diet can help replace lost nutrients, promote healing, and reduce symptoms. Similarly, there is not one universal food that all IBD patients should stay away from. A helpful tip is to keep a food journal to track how your diet relates to your symptoms. This way you can easily see what foods bother you and what you should stay away from to prevent a flare. As a general guide, it is best to avoid foods high in fiber such as fruits, raw vegetables, and whole grains, avoid greasy and fried foods, and foods that are likely to cause gas such as beans, cabbage, broccoli, caffeine, and carbonated drinks. Moderation of alcohol intake is also advised.

Medication

Missing intake your prescribed medications or taking an incorrect dosage is never a good idea. If you are taking your medications as prescribed and still experiencing flares, speak up and talk to your doctor about changing your dosage or the type of medication. Non-steroidal anti-inflammatory drugs (NSAIDs) are also known to cause inflammation of the bowel. NSAIDs include aspirin, naproxen (Aleve®), and ibuprofen (Motrin®, Advil®, Nuprin®). It is recommended to take acetaminophen (Tylenol®) instead.

Stress

We know that reducing your stress is easier said than done, however there are a few simple things you can do to lead to less stress. The easiest is to make sure you are getting enough sleep. Additionally, taking just 30 minutes a day to practice yoga, meditation, or deep breathing can significantly improve your state of mind and reduce your stress levels. The Crohn's & Colitis Foundation has also developed a symptom tracker that is easy to use. Incorporating a symptom tracker into your lifestyle can help you learn about your IBD and how manage it, and it can also help you doctor understand your symptoms better. Symptom Tracker: https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/ibd-symptom-tracker.pdf  

Sources

Crohn's & Colitis Foundation. Managing Flares and IBD Symptoms. (2020). https://www.crohnscolitisfoundation.org/sites/default/files/2019-07/managing-flares-brochure-final-online.pdf Harvard Health Publishing, Harvard Medical School. Living with Crohn's disease: Recognizing and managing flares. (2019). https://www.health.harvard.edu/blog/living-with-crohns-disease-recognizing-and-managing-flares-2019112618410 Everyday Health. Is It a Crohn's Flare? How to Spot the Signs. (2019). https://www.everydayhealth.com/hs/crohns-disease-treatment-management/crohns-flare-spot-signs/

"Inflammatory Bowel Disease (IBD) is a broad term that describes conditions characterized by chronic inflammation of the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn's disease." (CDC 2020).

Common symptoms of IBD include fatigue, weight loss, rectal bleeding, abdominal pain, persistent diarrhea. The exact cause of the disease is unknown but results from a defective immune system. In IBD patients, the immune system responds to environmental triggers incorrectly which causes the gastrointestinal tract to inflame.

Diagnosis & Treatments

IBD is diagnosed either through a colonoscopy or endoscopy in combination with imaging studies such as magnetic resonance imagine (MRI), radiography, or computed tomography (CT).

IBD can be treated with several different types of medications such as corticosteroids, immunomodulators, and aminosalycylates. There are also vaccines that are recommended for patients with IBD to help prevent infections. In some severe cases, IBD may require surgery if the GI tract has been too damaged.

Crohn's Disease

Crohn's most often affects the small intestine, but can affect any part of the GI tract, mouth to anus. The damaged tissues appear in patches next to healthy tissues. It is estimated that Crohn's affects 3 million Americans, with both men and women bring equally as likely. It can occur at any age, but is most often diagnosed between the ages of 20 and 30.

There has also been evidence found of a genetic component to Crohn's. Between 1.5% and 28% of patients have a parent, child, or sibling who also is affected. However, it is impossible to predict who may be affected by Crohn's based on family history.

Ulcerative Colitis

Colitis affects the large intestine and the rectum. The damaged tissues are continuous, not patchy like Crohn's. It usually starts at the rectum and spreads further into the colon. Colitis affects men and women equally, however, elderly men are more likely to be diagnosed than elderly women. Like Crohn's, colitis can occur at any age, but is most commonly diagnosed in mid-30's.

There is also a genetic component to colitis. Between 1.6% and 30% of patients have a parent, child, or sibling who also is affected. Also like Crohn's, it is impossible to predict which family members will develop ulcerative colitis.

 

Sources:

Centers for Disease Control and Prevention. What is IBD? (2020). https://www.cdc.gov/ibd/what-is-IBD.htm

Crohn's & Colitis Foundation. Overview of Crohn's Disease. (2020). https://www.crohnscolitisfoundation.org/what-is-crohns-disease/overview

Crohn's & Colitis Foundation. Overview of Ulcerative Colitis. (2020). https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/overview