Supporting Crohn’s Disease with Diet, Lifestyle Changes, and Supplements 

Crohn’s disease is an inflammatory bowel disease. It causes inflammation of the digestive tract, leading to abdominal pain, severe diarrhea, tiredness, malnutrition, and weight loss. The exact cause of Crohn’s disease is unknown. Crohn’s disease originates in genetically susceptible individuals exposed to certain yet unknown environmental risk factors. [1-2]

Crohn’s disease may affect any portion of the digestive system, but it is most common in the ileum and colon. Inflammation may skip sections of the GI tract and affect more than one section at a time 

Symptoms include abdominal pain, fever, fatigue, weight loss, painful defecation, and frequent diarrhea. You may experience long asymptomatic periods between flare-ups or continuous and progressive attacks. 

Risk factors include a family history of the disease, Jewish ancestry, and smoking.

A typical environmental suspect is a Western-style diet rich in animal products, refined sugar, and unnatural fats, which increase inflammation and are detrimental to a healthy microbiome compared with a plant-based diet. [3-5] The interaction between environmental factors and the microbiome in genetically susceptible people may cause an impairment of the immune response. [6-10]

If you have Crohn’s disease, you may have discovered that certain foods may trigger flareups. Therefore, avoiding these triggers is a start when managing this form of inflammatory bowel disease. However, specific dietary recommendations for Crohn’s disease can help promote intestinal healing and reduce gastrointestinal symptoms, including abdominal pain, diarrhea, and constipation. 

Between 56-and 90% of patients diagnosed with inflammatory bowel disease modify their diet to prevent symptoms. [11] 

Although very restrictive diets are widely adopted in people with Crohn’s disease, they risk worsening malnutrition and flare-ups since people with Crohn’s disease are already at increased risk of malnutrition and weight loss. [12] In people with Crohn’s disease, nutrient deficiency is caused by decreased dietary intake or malabsorption.

60% of people with Crohn’s disease do not consume adequate folate, mainly found in leafy green vegetables. Vitamin C deficiency is also expected due to avoidance of fruits and vegetables, and 80% of people with Crohn’s disease have inadequate calcium intake. [13-16] The prevalence of zinc deficiency in people with Crohn’s disease is between 15% and 40%. [17] Zinc supports wound healing and immune and intestinal barrier functions. People who supplement with zinc have improved disease status. Zinc deficiency may also cause skin problems. [18]

Nutrient status should be assessed to decide if the nutrient should be supplemented.

It would be best to supplement any deficient nutrient to return it to optimal levels supporting healing. 

Diet is one of the leading environmental factors associated with the cause and development of Crohn’s disease.

Here are ways to support Crohn’s disease with proper dietary changes, lifestyle changes, and supplements:

1. Follow A Whole-Food, Plant-Based Diet

In contrast to popular belief, the research shows that a whole-food, fiber-rich, plant-based diet is ideal for helping people manage Crohn’s disease. A whole food plant-based diet (such as the Guerrilla Diet) has a protective effect on Crohn’s disease. [19-34]

Reduction or exclusion of meat and fish, to some extent, is a valuable part of the dietary recommendations for people with Crohn’s disease. Even dietary fiber in whole grains, which was thought to be a trigger to the symptoms of the disease, was found to be helpful for people with Crohn’s disease. 

However, one should note that fruits should be consumed separately from other foods. When consuming fruits, go for mono consumption of a specific fruit each time, which means that fruit salad is out of the question, especially as a dessert.

Legumes are an excellent source of protein, minerals (calcium, iron, zinc, phosphate), and vitamins (B1, B9, B3) and should be consumed skinned. To skin lentils, long cook them with their skin, and then remove the skin as much as possible using a sieve. When legumes are skinned, they become free from the insoluble part of their fiber and from phytates which are anti-nutrient compounds but remain with soluble fibers, vitamins, and minerals that support the patient’s health and the microbiome’s health. 

2. Avoid Dairy

For lactose-intolerant people, avoiding high-lactose dairy products is crucial as these will cause gas, bloating, stomach cramps, nausea, and diarrhea. However, avoiding dairy should not be limited to those who suffer from lactose intolerance. 

Many studies show a strong link between Crohn’s disease symptoms and dairy products. Dairy food, in general, was identified as foods thought to worsen symptoms. [14,34-36] 

Instead, I recommend trying dairy alternatives such as cheese made from almonds or cashews. Milk, yogurt, and kefir from these nuts are great dairy substitutes even during disease flare-ups if consumed as sugar-free natural nut milk. 

3. Avoid Gluten If It Is a Trigger

Although very few people (0.6%) have both inflammatory bowel disease and gluten sensitivity together, of the people with Crohn’s disease consuming a gluten-free diet, over 65% reported improvement in gastrointestinal symptoms. Over 38% had fewer and less severe flareups, perhaps because gluten may create a pro-inflammatory environment in the intestines. [37-39].

Although avoiding gluten may help some, it does not help all people with Crohn’s disease and may cause too much restriction in the diet to handle. Therefore, when gluten found in natural wholegrain bread does not cause symptoms, it is unnecessary to avoid it. But avoiding gluten found in processed and industrialized foods is recommended for all people with Crohn’s disease. Processed industrialized foods can raise the risk for obesity and unbalanced nutritional compositions, which lead to nutritional deficiencies or excesses, leading to Crohn’s disease and other chronic diseases. [40-41]

4. Limit alcohol consumption

Limiting alcohol consumption if you have an inflammatory bowel disease is crucial. Chronic diarrhea is a common symptom in people with Crohn’s disease, resulting in dehydration. And as a diuretic, alcohol will dehydrate you, especially if you don’t drink enough water while drinking alcohol. Furthermore, alcohol can disrupt the gut microbiome and increase intestinal permeability. Also, alcohol can potentially interfere with the metabolism of medications, resulting in side effects. [42]

Some medications for Crohn’s disease may burden the liver, and taking these medications with alcohol, even not concomitantly, will only increase the risk of liver damage. Instead, aim to drink only plain freshwater, carbonated water, or unsweetened herbal teas that may be sweetened with stevia leaves if necessary or a squeeze of lemon. Avoid caffeinated drinks as caffeine is associated with more severe disease activity and the need for higher treatment steps in people with Crohn’s disease. [43-44]

5. Consume Omega-3 Rich Foods

A high intake of omega-3 fatty acids may have a protective effect on Crohn’s disease. One prospective study on the impact of dietary fat intake on relapse rates in people with inactive Crohn’s disease showed a worse prognosis when there was higher consumption of omega-6 polyunsaturated fatty acids than omega-3 polyunsaturated fatty acids. [44-49]

Another study showed that increasing omega-3 fatty acid intake effectively maintained Crohn’s disease remission. [50]

I recommend consuming plant-based omega-3 supplements three times a week.

6. Consume Probiotics or Preferably Prebiotics

Dietary changes influence the microbiome, which affects the quality of life, health, and clinical symptoms. A meta-analysis based on 22 randomized control trials suggested that probiotic supplements may effectively prevent the relapse of inflammatory bowel disease in remission. [51] However, it is essential to note that supplementation with probiotics without dietary change will have limited effect.

Probiotics reduced the need for systemic steroids, hospitalization, and surgery. People had lower disease activity, lower inflammatory mediator mucosal levels, and a lower recurrence rate than those taking a placebo. [52-56]

However, research shows that the consumption of prebiotic food products that promote the growth of microorganisms beneficial to the host is even more helpful than the intake of probiotic supplements. 

Prebiotic foods have non-digestible fibers and nutrients that promote a healthier gut microbiome by feeding the beneficial bacteria. Prebiotic-rich foods include asparagus, beets, garlic, onions, whole grains, and legumes. [57] 

In Crohn’s disease, prebiotic consumption altered susceptibility to the condition and reduced disease activity. I recommend consuming at least one of these prebiotic-rich foods daily. [58-59]

7. Vitamin D

Vitamin D deficiency is associated with inflammation [60-61]. Vitamin D supplementation has a therapeutic role for chronic inflammatory conditions, including inflammatory bowel conditions, since vitamin D helps maintain mucosal barriers and supports the function of immune cells. [62]

Therefore, if you have a vitamin D deficiency especially prevalent during the winter months and in groups of people who leave home fully covered, it is advisable to supplement with 1000-2000 IU of vitamin D3 five times a week. 

8. Iron

Iron deficiency anemia is common among people with Crohn’s disease. Anemia may be caused by decreased iron intake, impaired iron absorption, and blood loss. Iron deficiency anemia decreases the quality of life and can have long-term negative emotional and cognitive consequences, especially in children. Therefore, screening, early detection, and treatment are crucial in managing the disease. If you are deficient in iron, it is important to supplement intermittently with a gentle iron supplement, especially during flare-ups, to avoid the harmful effects of anemia. [63]

To conclude

A whole-food, dairy-free, primarily plant-based diet with natural sources of omega-3 fatty acids while excluding gluten when necessary is ideal for Crohn’s disease patients. It is inexpensive and has a biologically proven mode of action through high amounts of anti-inflammatory and antioxidant compounds, making it the ideal diet for this disease. It is a palatable and acceptable diet within social and professional life, even when strictly avoiding alcohol.

All references are found at this link: I keep this list updated. 

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