During an IBD attack, however, a low residue diet
may help give the bowel a rest and minimize symp-
toms. A low residue diet includes grains that are not
whole (enriched refined white bread, buns, bagels,
english muffins, plain cereals such as Cornflakes,
cream of wheat, Rice Krispies, or Special K, arrow-
root cookies, tea biscuits, soda crackers, plain melba
toast, white rice, refined pasta and noodles), fruits,
peeled when necessary (fruit juices except prune
juice, applesauce, apricots, cantaloupe, canned fruit
cocktail, grapes, melon, peaches), but avoiding raw
and dried fruits, raisins and berries. As for vegeta-
bles, they may include vegetable juices, potatoes
(without skin), well-cooked vegetables such as alfalfa
sprouts, beets, green or yellow beans, carrots, celery,
cucumber, eggplant, lettuce, mushrooms, green or
red peppers, squash, zucchini, while avoiding vege-
tables from the cabbage family such as broccoli,
cauliflower, brussels sprouts, cabbage, and kale.
Meats should be well-cooked, and tender, fish and
eggs fresh. Beans, lentils, all nuts and seeds, as well as
foods that may contain seeds (such as yogurt) should
be avoided.
Lactose-containing foods such as dairy products
should be avoided if lactose intolerance is present.
Calcium-fortified soy milk can be substituted.
During flare-ups, small frequent meals may be pref-
erable. A high protein diet with lean meats, fish and
eggs, may also help relieve symptoms.
Caffeine, alcohol and sorbitol should be restricted, as
these may exacerbate IBD symptoms. Sorbitol is an
artificial sweetener present in many brands of choc-
olate, snacks and candy.
Gas-producing foods such as cabbage-family vegeta-
bles (broccoli, cabbage, cauliflower and brussels
sprouts), dried peas and lentils, onions and chives,
hot or chilli peppers and carbonated drinks should be
restricted.
Fat intake should be reduced if part of the intestine
has been surgically removed, because high fat foods
usually cause diarrhea and gas for such patients.
Some studies suggest that fish oil and flax seed oil
may be helpful in managing IBD. Recent studies also
suggest a role in the healing process for probiotics
and prebiotics such as psyllium, a soluble fiber that
comes from a plant called Plantago afra. These may
also be helpful in helping the recovery of the
intestines.TherapyThe management of IBD depends on the type
diagnosed and pharmacologic and other therapiesare accordingly tailored to individual cases, depending
on severity and patient history. This also requires care-
ful selection of therapeutic agents based on symptom
severity and drug side effects. Since IBD is a chronic
illness with an important and unpredictable impact on
a person’s life, an effective therapy usually requires
much more than the simple treatment of symptoms.
Patient cooperation is crucial for improvement, as
dietary and lifestyle changes have been shown to be
beneficial. Whatever the symptoms, patients also need
to get enough rest while learning to manage the stress
in their lives, as intestinal problems tend to get worse
in overly stressed persons. The Crohn’s and Colitis
Foundation of America (CCFA) can provide patient
information on IBD and support groups that can
often help with the stress of dealing with IBD, with
useful tips for finding the best treatment and coping
with the disease.PrognosisThe outcome of the ulcerative colitis is variable. It
may be dormant and then worsen over a period of
years, or progress quickly. The risk of coloncancer
increases after ulcerative colitis is diagnosed.
There is no cure for Crohn’s disease, but it is not a
deadly illness. Periods of improvement are often fol-
lowed by flare-ups of symptoms. People with Crohn’s
disease have an increased risk of small bowel or color-
ectal cancer.PreventionIBD is not considered preventable, and once it
occurs it is a lifelong disease. However, it is possible
to prevent IBD secondary complications. For
instance, depression is a common problem in people
diagnosed with IBD. This may be the result of the
underlying diagnosis or the medications used to treat
these chronic inflammatory processes. Specific infor-
mation is available for patients and their families
about ways to manage their condition and treatment
and prevent themselves against becoming depressed.Resources
BOOKS
Sklar, J.The First Year: Crohn’s Disease and Ulcerative
Colitis: An Essential Guide for the Newly Diagnosed.
New York, NY: Marlowe and Company, 2007.
Dalessandro, T. M.What to Eat with IBD: A Comprehensive
Nutrition and Recipe Guide for Crohn’s Disease and
Ulcerative Colitis.New York, NY: iUniverse (Barnes
and Noble), 2006.Inflammatory bowel disease