Good nutrition and a healthy diet are always important.  For patients with inflammatory bowel disease, these concerns are not only common but justified.  The severity of the symptoms associated with Crohn’s disease can make it necessary for families and individuals to re-evaluate their eating habits and develop a diet rich in nutrients. Eating right, avoiding foods that trigger Crohn’s disease symptoms, taking nutritional supplements and medications that treat Crohn’s symptoms, are positive steps in taking an active role towards managing your condition as well as maintaining your weight and overall health.

Some patients erroneously believe that their disease is caused by, and can be cured by diet alone. Unfortunately, this train of thought is not supported by clinical and scientific data. While proper diet can certainly affect symptoms of these diseases, and play some role in the underlying inflammatory process, it appears not to be the major factor in the inflammatory process.

It is quite natural to have questions about the digestive tract, diet and nutrition particularly in relation to crohn’s, ulcerative colitis or any other IBD.   Knowledge of appropriate nutritional intake and their source are important.  There are several key sources of important vitamins and minerals.  Some multivitamin and dietary supplements can be found at www.crohnsstore.com. Be sure to talk to your gastroenterologist about customizing a diet that suits your specific nutritional needs, as all of these foods may be right for you.  Here are some examples:

Nutrient	Source
Vitamin A	Liver, eggs, dairy products, fish liver oils, dark green leafy vegetables (e.g., green peas, spinach)
Vitamin D	Liver, fish liver oil, fortified food products (e.g., milk, butter, and cereals)
Vitamin C	Fruits (e.g., citrus fruits, bananas, apples)
Folic Acid	Liver, beets, corn, legumes, green leafy vegetables
Vitamin B-12	Meat, fish, poultry
Calcium	Cheese, ice cream, milk, yogurt, sardines
Iron	Red meat, fish, poultry, eggs
Zinc	Animal protein (e.g., beef, chicken), plant foods (e.g., legumes, bran, green peas)

You may be surprised to learn that there is no evidence that links anything in your diet to the history or cause of these diseases. Once an IBD has been diagnosed, however, paying special attention to what you eat may go a long way toward reducing symptoms and promote healing.  Although some people may have allergic reactions to certain foods, neither Crohn's disease nor ulcerative colitis is related to food allergy. People with IBD may think they are allergic to foods because they easily associate the symptoms of IBD with eating.

The digestive system performs most of its work in the small intestine, which lies just beyond the stomach. In the small intestine, digestive juices also known as bile, from both the liver and the pancreas are mixed with the foods we eat. This mixing is powered by the churning action of the intestinal muscle wall. Once digested food is broken down into small molecules, it is absorbed through the surface of the small intestine and distributed to the rest of the body by way of the bloodstream. Watery food residue and secretions that are not digested in the small intestine is passed into the large intestine (the colon). The colon then reabsorbs much of the water added to food in the small intestine.  Solid, undigested food residue is then passed from the large intestine as a bowel movement.

When the small intestine becomes inflamed as with Crohn's disease, the intestine becomes less able to fully digest and absorb the nutrients from food. Such nutrients, as well as unabsorbed bile salts, can escape into the large intestine to varying degrees, depending on how extensively the small intestine has been injured by inflammation. This is one reason why people with Crohn's disease become malnourished, in addition to just not having much appetite. Furthermore, incompletely digested foods that travel through the large intestine interfere with water conservation, even if the colon itself is not damaged. Thus, when Crohn's disease affects the small intestine, it may cause diarrhea as well as malnutrition. Should the large intestine also be inflamed, the diarrhea may become even more extreme.  In ulcerative colitis, only the colon is inflamed; the small intestine continues to work normally. But because the inflamed colon does not recycle water properly, diarrhea can be severe.