Managing Crohn’s Disease
Crohn’s disease is a lifelong disorder. Once diagnosed, you will never be rid of it. However, with careful management, medication, and proper nutrition and health, you can put your symptoms into remission for weeks, months, or even years. In fact, about 40% of the 3 million people with Crohn’s in the United States are in remission. That means they experience few or no symptoms. While you can’t eat normally while in remission, you can enjoy your life pain-free, which hopefully you find more than worth giving up a few cups of coffee, cigarettes, or milk products.
Most Crohn’s disease management is divided into four parts; diet, lifestyle, medication, and mental health.
Managing Crohn’s with a Proper Diet
A ‘proper’ diet for a person with Crohn’s and without Crohn’s are two different things. But, many of the best foods for a healthy person are still extremely good for you, and you can enjoy most health foods guilt-free. Crohn’s is exacerbated by foods which cause acid or bacteria production in the stomach, namely:
- Foods your stomach has difficulty digesting
This means that you can automatically rule out several normal food groups:
Fats – High-fat foods like dairy will often cause flare-ups. However, you’ll also have to be careful around fatty beef (burgers), large quantities of red meat, bacon, salmon, avocados, and other high-fat foods. You can likely eat most of these foods in small quantities with no problems but it’s still important to experiment to decide which you can handle and which you can’t.
Acids – Acids can cause stomach inflammation and pain, and can antagonize Crohn’s disease. For example, you probably know that too much sugar or caffeine can cause an upset stomach. And if you drink coffee with alcohol, you’re much more likely to throw up. Some foods are obviously high in acid, like coffee and tomatoes or pineapple. Others are more difficult to spot. For example, did you know that protein actually produces acid in your stomach so your stomach can break it down? Like with fats, you don’t have to stop your consumption of acid-producing or acidic foods at all, you just have to watch your intake. Don’t eat too much meat, balance it out with fruits and vegetables, and make sure you’re not drinking more than a glass of soda or cup of coffee per day.
Difficulty Digesting – If you’ve ever experienced gas after eating a food, it’s likely because your stomach has difficulty digesting it. Many people have gas after drinking milk because their stomachs cannot handle or process lactose, a sugar found in the milk. Most types of legumes like beans cause gas for the same reason, they contain a sugar known as oligosaccharide which the body cannot properly digest. Gas happens when the sugar passes into the large intestine undigested and must be digested there, which can cause further pain and inflammation in the stomach. If you know a food gives you gas, you should probably avoid it.
Managing Crohn’s with Exercise
Getting enough exercise is an important part of managing many diseases, not only because it works to boost the mood, but in the case of Crohn’s, also because it helps you to improve your digestion. Getting regular exercise helps you to boost your mood and reduce stress, reducing extra stress on the intestines. It also works to reduce depression and anxiety, strengthen the immune system (which helps to reduce Crohn’s flare-ups), and helps you to manage your weight.
All of these things will positively impact Crohn’s. However, you don’t have to overdo it. Try getting in at least an hour walk a day, cycle to work, go swimming, take up yoga, or find a sport that you enjoy. Healthy and fit are often two different things, and your goal is to be healthy first.
Mental Health and Crohn’s
Your mental health can dramatically impact the health of your body. Emotions like stress and anger put a lot of strain on the body and can cause your Crohn’s symptoms to flare up and worsen. If you’re struggling with stress, chronic mental illness, see your doctor.
You should also consider learning stress management, taking up mindfulness or meditation, or doing a stress-relieving activity. Yoga and martial arts are great stress relievers. You can also likely relieve stress with hobbies, music, and doing things around the house that require attention. Why? Doing things with your hands that allow you to focus enough on what you’re doing to stop focusing on things you’re stressing or worried about gives you the opportunity to relax and destress.
Medication for Crohn’s
Most people will receive courses of medication to help manage Crohn’s. These courses of medication will typically be periodical, and may be prescribed for 1-6 months to reduce inflammation and allow the body to heal. This allows Crohn’s to go into remission, because the medication forces inflammation down.
In most cases, you will be treated with one of a few medications:
- 5-ASA (5-Aminosalicylic Acid) – Sulfasalazine – (Azulfidine) or Mesalamine (Asacol, Canasa, Pentasa), balsalazide (Colazol, Giazol), olsalazine (Dipentum).
- Corticosteroids – budesonide (Entocort), hydrocortisone (Cortef, Cortenema, Proctofoam), prednisol (Orapred)
- Immunosuppressants – azathioprine (Azasan, Imuran), cyclosporine, purinethol, prograf, methotrexate (MTX, Rheumatrex, Trexall)
Doctors will normally start out prescribing sulfasalazine medications, which are the safest way to reduce inflammation in the stomach. If you do not respond, they may prescribe immunosuppressants or corticosteroids. Corticosteroids are typically only prescribed if you have IBD, do not respond to other medications, or have a severe infection because they can cause severe side effects.
Managing Crohn’s mostly means watching your diet, taking care of your mental health, and getting exercise to boost your immune system. It also sometimes means taking medication, which will help to put Crohn’s into remission. However, if you follow through on everything, your Crohn’s symptoms will disappear, often for very long periods of time.
Have colitis? Click through to page 6 to learn more about it.