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

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.

What Are the Symptoms Related to Inflammatory Bowel Disease?

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.

ADVERTISEMENT