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Nutritional Management of Children with Crohn’s Disease and Ulcerative Colitis

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Nutritional Management of Children with Crohn’s Disease and Ulcerative Colitis

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Crohn's disease and ulcerative colitis are inflammatory bowel diseases causing inflammation in the digestive tract. Read this article to learn about it.

Medically reviewed by

Dr. K. Shobana

Published At December 21, 2018
Reviewed AtFebruary 22, 2023

Introduction:

Inflammatory bowel disease (IBD) is used for two conditions, Crohn's disease and ulcerative colitis, that cause chronic inflammation in the gastrointestinal tract. These two conditions are very similar regarding their symptoms and etiological factors. Both these conditions are commonly found in teenagers and young adults. And proper nutritional therapy has to be followed in patients with these conditions.

What Are Inflammatory Bowel Diseases and Their Types?

As already discussed, inflammatory bowel disease (IBD) is a disorder involving the long-standing inflammation of the tissues of the digestive tract. The digestive tract comprises the following structures -

  • Mouth.

  • Esophagus.

  • Stomach.

  • Small intestine.

  • Large intestine.

The whole digestive system helps break down food, extract essential nutrients from it, and remove waste products and unusable materials from the body. Unfortunately, infections such as inflammatory bowel disease disrupt this normal digestion process and can be very painful and, in severe cases, life-threatening.

The types of inflammatory bowel disease include -

Crohn's Disease - This condition is characterized by the inflammation of the lining of the digestive tract and can also involve more profound layers of the digestive tract. It can affect any part of the digestive system but most commonly affects the small intestine and sometimes the upper part of the large intestine.

Ulcerative Colitis - This condition involves inflammation and ulcers along the large intestine and rectum lining.

What Are the Causes of Inflammatory Bowel Disease?

There is still some confusion regarding the actual cause of inflammatory bowel disease. Although three factors are considered to cause this condition such as -

  • Genetics - Genetics is considered one of the significant causes in patients with a family history of this disease.

  • Immune System Response - The immune system of the body protects against various foreign substances, such as harmful viruses and bacteria. But in patients with inflammatory bowel disease, the immune system of the body mistakes food for foreign substances and attacks them, leading to the symptoms of inflammatory bowel disease.

  • Environmental Triggers - People with a family history of inflammatory bowel disease usually acquire this disease after exposure to any environmental triggering factor such as smoking, medication use, stress, and depression.

The symptoms related to inflammatory bowel disease vary depending upon the severity of the disease. And the symptoms range from mild to severe, which can be seen in both Crohn's disease and ulcerative colitis, including -

  • Diarrhea.

  • Fatigue.

  • Abdominal pain and cramping.

  • Blood in stool.

  • Reduced appetite.

  • Unintended weight loss.

  • Stomach cramps and pain.

  • Urgent need to have a bowel movement.

  • Night sweats.

  • Irregular periods.

What Are the Differences Between Crohn’s and Ulcerative Colitis?

Both Crohn's and ulcerative colitis has several similarities; however, there are some critical differences between them which include -

  • Location of Inflammation- Crohn's disease can occur anywhere along the digestive tract, but ulcerative colitis only occurs in the colon (the longest part of the large intestine).

  • Degree of Inflammation - Ulcerative colitis causes contact inflammation along the entire colon, while Crohn's disease causes intermittent inflammation around the healthy tissue.

  • Unusual Symptoms - Some specific symptoms can only be seen in one of the disorders, such as Crohn's disease, including mouth sores, anal tears, ulcers, and narrowing of the intestine. And patients with ulcerative colitis may experience rectal bleeding or blood in stools more often than Crohn's disease.

How Are These Conditions Diagnosed?

Crohn's disease and ulcerative colitis have similar symptoms, and the diagnosis depends upon these symptoms. To make the diagnosis, the health care provider will take the complete history of the patient and advise a complete blood test along with a stool test for signs of any intestinal inflammation.

Some of the other tests that can be done for the diagnosis of inflammatory bowel disease are -

  • Colonoscopy to examine the large and small intestines by using a fiber optic camera.

  • EUS (endoscopic ultrasound) checks the digestive tract for swelling and ulcers.

  • Flexible sigmoidoscopy is used to examine the lower part of the rectum and anus.

  • Imaging scans, such as CT (computed tomography) or MRI (magnetic resonance imaging), are used to check for signs of inflammation or an abscess via three-dimensional images of the inside of the intestines.

  • Upper endoscopy examines the digestive tract from the mouth to the start of the small intestine.

  • Capsule endoscopy, in which the patient swallows a tiny camera, and the camera catches the images through the digestive tract.

How to Manage Crohn’s Disease and Ulcerative Colitis?

Primarily treating inflammatory bowel disease involves reducing the inflammation causing various symptoms in the body, which can be done medically or surgically. Other than that, diet and nutrition play an essential part in the children affected with Crohn's disease and ulcerative colitis. The diet plan can be formulated by consulting the health care professional to reduce the symptoms and prevent complications.

What Is a Crohn’s Disease and Ulcerative Colitis Diet Plan?

There is no scientifically proven diet plan for inflammatory bowel disease. Though the patients should avoid some triggering foods that cause symptoms such as gas, bloating, abdominal pain, cramping, and diarrhea. Some of the healthy food that can be given to a child with inflammatory bowel disease are -

Fruits and Vegetables:

Fruits and vegetables contain fiber and essential minerals like vitamin C, potassium, and folate.

Grains:

Grains are important sources of fiber, vitamin Bs, folate, and iron and provide energy that helps in the growth of the body.

Proteins:

Proteins can be found in food like meat, fish, eggs, and dairy products and in fruits and vegetables, soy, nuts, seeds, and beans.

Dairy:

Dairy products include milk and milk products that are high in protein, calcium, and vitamin D, which also help strengthen bones.

Healthy Fats:

Healthy fats include food like plant-based foods, avocados, fish, and fish oils. These foods absorb fat-soluble minerals and also fulfill the caloric demands of the body.

What to Do During the Flaring of Inflammatory Bowel Disease?

During the flare-up (that reoccurring of the disease after a remission) of inflammatory bowel disease, some of the following steps should be followed -

  • Eat small meals to avoid cramping.

  • Reduce the amount of fried foods in the diet.

  • Avoid the food that triggered the symptoms in the past.

  • Limit high-fiber foods during the flare, such as seeds, nuts, popcorn, beans, green leafy vegetables, wheat bran, and raw fruits and vegetables.

  • Restrict the milk or milk products if lactose intolerant.

  • Avoid caffeine or caffeinated beverages such as soda, tea, and coffee.

  • Consult a physician and take vitamin and mineral supplements such as vitamin D and calcium.

  • Encourage the children to drink more water and keep themselves hydrated.

Conclusion:

Inflammatory bowel disease is a lifelong condition, but it can be managed with proper treatment and dietary changes. In addition, the early treatment and diagnosis of IBD can prevent flares and have long periods of remission.

Frequently Asked Questions

1.

What Are the Types of Nutrition Therapy for Crohn’s?

There are two types of nutrition therapy used in the management of Crohn’s disease, which includes -
- Exclusive Enteral Nutrition (EEN) or Total Enteral Nutrition (TEN) - This formula is used for all meals, and water and other liquids may also be allowed.
- Partial Enteral Nutrition (PEN)- This formula is used along with some food, making it easier to follow the diet.

2.

What Is the Best Diet Plan For Crohn’s Disease Patients?

For Crohn’s disease, a low-residue diet is usually advised to the patient. This will add less residue in the stool of the patient, which reduces the symptoms like abdominal pain and diarrhea. The food products with low-residue include -
- Nuts.
- Raw fruits.
- Seeds.
- Raw vegetables.

3.

What Is the Treatment of Crohn’s Disease in Children?

 
Crohn’s disease is treated with the help of medicines and changes in diet, and in severe cases, surgery may also be required. The primary goal of the treatment is to relieve symptoms, prevent flare-ups, and heal inflamed intestines. The treatment plan involved -
- Anti-inflammatory drugs for inflamed intestines.
- Nutrition therapy to heal the bowel.

4.

What Should a Kid With Crohn’s Disease Eat?

Children with Crohn’s disease should not eat fried or greasy food. They should avoid food that makes their symptoms worse. Particularly high-fiber food should also be limited. The patient should eat the following foods which include -
- Whole grains. 
- Vegetables. 
- Fruits. 
- Healthy fats. 
- Lean meat. 
- Fish.
- Beans
- Eggs.

5.

What Type of Diet Is Considered Best for Ulcerative Colitis Patients?

Patients affected with ulcerative colitis should take a low-residue diet which includes -
- White bread.
- Refined breakfast cereals, such as cornflakes.
- White rice. 
- Pasta and noodles.
- Properly cooked vegetables.
- Lean meat and fish.
- Eggs

6.

What Is the Meaning of Nutrition Support Therapy?

Nutrition support therapy means providing enteral (taken by mouth) or parenteral (given by intravenous route) nutrients to treat malnutrition. It is used to maintain or restore the optimal nutrition status and health of the patient.

7.

Can Crohn’s Disease Cause Nutrition Deficiency?

Crohn’s disease can lead to nutritional deficiency due to reduced oral intake, malabsorption, and systemic inflammation. The small intestine is the targeted organ in this disease, and due to inflammation, less absorption of nutrients takes place, leading to deficiency.

8.

Is Nutrition Important in Irritable Bowel Syndrome?

Irritable bowel syndrome is a disorder causing pain and discomfort in the stomach and can cause diarrhea or constipation. This condition is usually associated with nutrition deficiencies which depend upon the severity and duration of the disease. Therefore fiber-rich food is advised to prevent certain symptoms.

9.

What Supplements Should Crohn’s Patients Take?

Patients affected with Crohn’s disease usually lack essential nutrients. Therefore multiple vitamin supplements can be prescribed, which include -
- Calcium.
- Folic acid.
- Iron.
- Vitamin B12 and D.
- Zinc.

10.

What Food Can Help in Reducing Intestine Inflammation?

Some food products can also help in reducing the inflammation of the intestine, which include -
- Diluted juices.
- Applesauce.
- Canned fruit.
- Oatmeal.
- Plain chicken, turkey, or fish.
- Cooked eggs.
- Mashed potatoes, rice, or noodles.
- White bread.

11.

How to Stay Healthy With Crohn’s Disease

Some of the following steps should be followed to stay healthy for Crohn’s disease -
- Small meals should be eaten every few hours rather than three large meals daily.
- Drink plenty of water and other fluids.
- The patient can take multivitamins, even in liquid form.
- Try to slowly add the food that is being avoided and boost the calories and protein content in the body.

12.

Is Probiotics Recommended for Crohn’s Disease?

Crohn’s disease is an inflammatory disorder causing multiple digestive problems. Probiotics may help in reducing the symptoms and improving the condition of the patient. These can be taken as supplements, such as yogurt.
Source Article IclonSourcesSource Article Arrow
Quadros Krystel Godfrey Lavina
Quadros Krystel Godfrey Lavina

Dietician

Tags:

ulcerative colitisinflammatory bowel diseasecrohn's disease
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