Crohn’s and Colitis can be difficult to live with, to say the least. And because there is currently no known cure, the only way to keep this disease in remission is to avoid any flare ups. While your battle plan will always begin with your doctor’s recommendations, such as medications, there are many other triggers that can contribute to a flare. Smoking, drugs, stress, lack of sleep, and many food and drink selections can all trigger your flare ups. Now we know that the doctors define a flare up as the disease becoming active due to an increase in the inflammation, but when we say flare up, we often mean the symptoms have been made worse without necessarily activating the process of inflammation. You already know that smoking and drinking alcohol can cause your flare ups, and I’m sure by now you are aware of a number of food and drink choices that can exacerbate your symptoms, but we are going to look a little closer at those foods and drinks and discuss a little bit more about why they make things worse, so that you can make better choices for yourself.
Food, Glorious Food
Why do some foods give you more trouble than other foods and why can some people you know with Crohn’s or colitis eat them without any trouble? We don’t know why. Unfortunately, there are no set rules or guidelines that tell us what foods or drinks to avoid or choose over other choices. While everyone will react differently to different foods or drinks, we can at least learn why some foods cause problems and which foods may make things better. You really need to listen to your own body – even over the advice of others – when deciding what to eat or drink and what to limit or avoid altogether.
Food Allergy Versus Food Intolerance
The difference between food allergies and intolerance lies in the immune system. While food allergies are reactions that involve your immune system, food intolerances do not. When chemicals are released during ingestion that trigger an alert in your body of danger, you are experiencing a food allergy. During food intolerance, your body may not be able to produce enough digestive enzymes, such as lactase (which digests lactose), which may in turn cause intolerance responses like gas, diarrhea, and bloating.
Artificial Sweeteners and Fructose
Sugar substitutes, or artificial sweeteners, are commonly used in diet foods and diet drinks (like diet sodas). Included are brands, such as NutraSweet, Equal, Sweet’N Low, Splenda, Sweet One or Sorbitol. Artificial sweeteners are not limited to only diet food or drinks, however, and may also be found in processed foods, like baked goods, dairy products, jellies, jams, canned foods, puddings, and candies. When checking ingredients, look for the following items: acesulfame potassium, aspartame, saccharin, sorbitol, and sucralose. Artificial sweeteners are usually very good substitutes for people who are on special diets due to trying to lose weight or diabetes, but may cause problems for people with IBD such as Crohn’s or colitis.
Artificial sweeteners are very big molecules and your body cannot absorb them through your intestines. Because they are so big, they can cause you to have diarrhea, which exacerbates Crohn’s and colitis symptoms. During an active inflammation, your body may not be able to absorb natural sugars, either, such as fructose, and may become fructose intolerant. If this happens any foods containing fructose (such as tomatoes, strawberries, and corn syrup) may cause worsened symptoms of bloating, diarrhea, and pain.
Your body may not be able to absorb fat during the process of acute inflammation. When unabsorbed fat is excreted out in your stool, it smells extra bad and is extra messy. The more fat you eat, the more often you will poop out extra stinky diarrhea. While this is not considered an actual flare up, it is very uncomfortable and may lead to pain and dehydration.
Fiber is normally very healthy for your body. It not only helps decrease the risk of colon cancer, but can also prevent constipation, reduce blood cholesterol, decrease your risk of heart disease, and regulate your blood sugar. Fiber also helps to remove the old cells from your intestinal lining.
However, a diet that is too high in fiber may lead to bloating and abdominal distention. This occurs due to the bacteria inside your intestine fermenting the fiber and creating gas. If you experience regular abdominal pain and bloating, you may want to avoid foods that are very high in fiber. These foods include the following:
- All-Bran cereal
- Canned black-eyed peas
- Cooked artichoke
- Cooked peas
- Cooked spinach
- Dried figs
- Fresh green peas
- Pinto beans
Foods high in fiber may also make your stool much bulkier, which can cause your intestines to contract harder in order to push the stool out. This may cause scraping of the tissue, pain, and damage to the mucosa, when your intestines are inflamed.
Another problem related to fiber can occur if you have a narrowing of your intestines (such as a stricture) and the fiber in your food causes a blockage. If these symptoms happen to you, take a break from eating anything that has high fiber and seek medical assistance if it goes on for more than a couple of days as this may be a sign that you need hospital admittance and possibly surgery.
Caffeine, which is added to a lot of energy drinks and soft drinks and naturally found in coffee, tea, and chocolate, is a stimulant that keeps people awake, both late at night or early in the morning. Caffeine is a major stimulant to your body’s metabolism and nervous system and while there are some positive studies showing that if you drink coffee, you may be less likely to get cancer, diabetes, Parkinson’s Disease, stroke or dementia, there are quite a lot of negative effects on your body as well.
While the exact impact that caffeine has on people with Crohn’s or colitis is not completely understand, it does seem to make some symptoms worse. Studies have, however, proven that caffeine does act as a laxative, so it makes sense to assume that drinking or eating it would make the symptom of diarrhea worse or possibly cause it to occur. Caffeine also seems to make stress worsen, which causes hormones to trigger digestive issues due to the diversion of blood from your intestines to your brain, heart, muscles, and other organs.
Most doctors suggest that everyone should avoid drinking caffeinated beverages, but stress this avoidance even further for those suffering from Crohn’s or colitis. Doctors also state that anyone who consumes very large amounts of coffee should wean themselves back slowly, rather than stopping cold turkey, in order to avoid the withdrawal symptoms of nausea, severe headaches, and possibly vomiting.
Sensitivity to dairy products is very common in people with Crohn’s or colitis and the consumption of products like milk or ice cream may cause severe pain, gas, diarrhea, fatigue, and possibly even skin rashes. Lactose, which is one of the primary sugars found in cow’s milk is often added to a variety of foods for flavor and casein, which is the primary protein in cow’s milk is often added to foods to help break down very large fat molecules and as a protein supplement. Some food and drink products that contain casein include:
- Coffee creamers
- Fortified cereals
- Ice Cream
- Infant formulas
- Nutrition bars
- Processed meats
- Salad dressings
- Whipped toppings
It’s time to take control of your life. By making smarter choices about what you eat, what you avoid, and other changes in your life, you can start feeling better. As an IBD sufferer, your disease does not have to control you, but if you want to start feeling better, you have to take control of it. You may have Crohn’s or colitis, but it does not have you and it does not have to define who you are anymore.