Nutrition & IBD

Inflammatory Bowel Diseases (IBD) are chronic, relapsing, inflammatory conditions of the digestive system. They are characterized by periods of remission and flare-ups, which include symptoms such as diarrhea, gastrointestinal bleeding, abdominal pain, fever, loss of appetite, and weight loss. More than 1.5 million Americans and 2.5 million Europeans are estimated to suffer from IBD. Inflammatory Bowel Diseases are the Ulcerative Colitis and the Crohn's disease.

Ulcerative Colitis: The disease affects the mucous membrane alone colon, in which it appears inflammation and developed small open sores, or ulcers, that produce pus and mucus main symptoms are pain, diarrhea and loss of blood from the rectum.

Crohn's disease: The disease mainly affects the the final section of the small intestine (ileum) and the initial part of the colon (cecum), but can appear in any part of the gastrointestinal tract from the mouth to the anus.

What causes the Idiopathic Inflammatory Diseases?

The exact cause that leads to the appearance of IBD remains unknown. Scientists believe that the following factors play a role as etiopathogenic factors of IBD.

1. Autoimmune Reaction: When the immune system of the body is directed wrongly against healthy cells of the body. It is believed that viruses and bacteria in the gut can trigger the immune system to attack the inner surface of the intestine, causing inflammation.
2. Genes (heredity): Research has shown that people, in which one of the 2 parents or brother/sister shows IBD, have increased chances of developing the disease. Also, you receive a higher incidence among monozygotic compared to dizygotic twins. Researchers continue to study the correlation between genes and IBD.
3. Environmental factors: Some studies have shown that certain environmental factors may increase the likelihood of an individual to develop IBD. Non-steroidal anti-inflammatory drugs, antibiotics, and birth control pills, appears to increase the chances of IBD. A diet rich in fat and processed sugars, and smoking, it seems that they may in a small degree to increase the likelihood of IBD.

What people are more likely to experience ΙΦΝΕ;

Crohn's disease

It can occur in people of any age. However, persons who have the highest risk of developing the disease are:

• Persons aged 20-29 years
• People with congenital (most often a parent or brother/or displaying IBD)
• Smokers

Ulcerative Colitis

It can occur in people of any age. However, persons who exhibit the highest risk of developing the disease are:

• People aged 15-30 years (www.cdc.gov/ibd)
• People over the age of 60 years old
• People with a relative who shows IBD

Main signs and symptoms of Crohn's disease

The most common symptoms are:

• Diarrhea
• Abdominal pains and cramps
• Weight loss
• Loss of blood from the rectum (at times)

Other general symptoms include:

• Tiredness
• Nausea and lack of appetite
• Fever
• Anemia (decreased number of red blood cells)

The symptoms may differ in each individual depending on the severity of inflammation and the point of the gastro-intestinal tract in which it appears.

Main signs and symptoms of Ulcerative Colitis

The most common symptoms are:

• A strong need for bowel movement
• Pain, diarrhea and loss of blood from the rectum
• Tiredness
• Nausea and lack of appetite
• Weight loss
• Fever
• Anemia (decreased number of red blood cells)

Other general symptoms include:

• Pains in the joints or muscle pains
• Inflammation and irritation of the eyes
• Rashes and skin irritation

Nutritional problems in patients with IBD

In patients with ΙΦΝΕ, mainly in the acute phase, there is often malnutrition, the degree of which depends on the duration, extent and severity of the disease.

Malnutrition is common in patients with ΙΦΝΕ and usually regards πρωτεϊνο-energy malnutrition, impaired body composition (mainly reduced muscle and bone mass) and micronutrient deficiencies.

• Malnutrition is strongly associated with poor outcome of patients.
• Surprisingly high is the percentage of IBD patients (mainly Ulcerative Colitis) who are overweight.

The nutritional intervention in patients with ΙΦΝΕ aims:

• To achieve and maintain a good state of nutrition.
• To limit the symptoms of the disease.
• To limit the side effects of medication.
• In achieving and maintaining disease remission (nutrition as a primary or complementary treatment for IBD).

During an outbreak

Avoid:

• Product wholemeal
• Legumes, seeds, nuts
• Raw and dried fruits
• Corn
• Raw leafy vegetables, cabbage, beets, cauliflower, mushrooms, okra, onions, peppers
• Fatty / fried foods
• Caffeine
• Alcohol
• Juices with sugar, sorbitol, xylitol miss.

Preference:

• White rice, potato
• Peeled apple, ripe banana, melon
• Drunk fruit and vegetable juices
• Compotes
• Well-cooked vegetables such as carrot, zucchini
• A lot of water

During the periods recession, patients should be encouraged to consume as much as possible a normal, unrestricted diet.

The recommended diet during the outbreak also depends on the points of the intestine are inflamed, malabsorption, intolerance, medication, possible stenoses/fistulas/blockages/abscesses, for this you need to consult a qualified clinical dietitian-nutritionist.

While these above dietary guidelines may offer relief to some people with Crohn's disease or ulcerative colitis, it is important to recognize that the experience of all the IBD is unique. What works for one person may not work for another, and the nutritional needs may change over time.