Nutrition in Inflammatory Bowel Disease

1 My Nutrition Nutrition in Inflammatory Bowel Disease (IBD). What is IBD? Disease as it can help in understanding Inflammatory Bowel Disease (IBD) is a symptoms. term used to describe Crohn's Disease and ulcerative colitis. They cause The gastrointestinal tract is like a long inflammation of the Bowel wall. Ulcerative muscular tube that starts at the mouth and colitis (UC) causes inflammation of the ends at the anus with digestive organs lining of the large Bowel . Crohn's Disease along the way. It breaks down our food to (CD) causes inflammation of the full fuel our bodies and gets rid of the waste. thickness of the Bowel wall and may occur anywhere in the digestive Digestion starts in the mouth and after (gastrointestinal) tract. we swallow the food goes down our oesophagus (food pipe) where it People with IBD will experience periods My My reaches the stomach and is broken when the Disease is active, known asNutrition a Nutrition down further.

2 Flare, but also times when it's not active, The partly broken-down food is slowly known as remission. released into the small intestine (which Microscopic colitis is an Inflammatory includes the duodenum, jejunum and Bowel Disease that affects the large Bowel . ileum). It is then broken down further It differs from UC and CD in that by digestive juices, so the nutrients can inflammation is not typically seen through be absorbed. colonoscopy, only through tissue samples. Once the nutrients have been Symptoms usually include watery absorbed so your body can use them, diarrhoea, and usually without blood. the waste is then pushed into the large intestine (also known as large Bowel How does the digestive system work? and includes the colon, rectum and Understanding the gastrointestinal system anus).

3 Can help you in understanding IBD. It is Water is removed and the waste is important to know the location of your stored as stool (faeces) until a Bowel movement is passed. This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: Developed: Sept 2019. Copyright: Due for review: Sept 2021. Used with permission from Mayo Foundation for Medical Education and Research. My My Nutrition What are the symptoms of IBD? Nutrition the development of IBD or Disease flares. As IBD causes inflammation in the Although many diets may claim to cure gastrointestinal tract it can cause IBD there is not enough science to symptoms including: support their use. Many of these diets Abdominal pain involve restricting food items which may Diarrhoea (+/- blood and mucous) result in a lack of nutrients.

4 Weight loss Why is diet important with IBD? Tiredness Diet is extremely important in ensuring Can diet cause or cure IBD? our bodies are well nourished. The cause of IBD is not completely A well-balanced diet ensures that your understood. Genetic, infectious and body receives the required nutrients. environmental reasons may play a role. The type of diet you need may change at different stages of your Disease . Currently, there is no strong evidence that Your dietitian will be able to assist any food or food additive causes either you. This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: Developed: Sept 2019. Copyright: Due for review: Sept 2021. What should I eat during a flare? What about a low fibre diet?

5 During a flare up, you may find you lose Your doctor or dietitian may suggest a weight without trying. This could be low fibre diet for a limited time if you have because you're not eating as much ( severe diarrhoea or a stricture (narrowing from pain or nausea) or that your body is of the Bowel ) to reduce symptoms such not absorbing important nutrients. as abdominal cramping and diarrhoea. Nutrition requirements can also increase If you are experiencing ongoing when inflammation or infection are constipation, seek medical advice before present. You may need to increase your changing your diet or taking any fibre intake of protein and calories (energy) to supplements. Some people with IBD can maintain your body weight during these experience constipation because of Bowel times.

6 Obstruction or blockage. High protein foods High energy foods Meat, chicken, fish Full cream dairy What about hydration? products Keep yourself well hydrated by drinking at Eggs Margarine, butter, salad dressing, oil least 8 cups of fluid per day to prevent Dairy products: milk Soft drinks, cordial, My dehydration and constipation. (plain or flavoured), chocolates, sweets, My cheese (all types), ice cream Nutrition yoghurt, custard Nutrition What about lactose? Meat alternatives High fat and/or high Unless you've been diagnosed with tofu, vegetarian sugar foods such as sausages chips, biscuits and lactose intolerance there is no need to shortbread avoid dairy products. What about foods that make me feel If you continue to have ongoing worse? symptoms not relating specifically to your During a flare up, you may avoid foods IBD please contact your dietitian.

7 You that make symptoms worse. When may be experiencing food intolerance(s). symptom-free, it is important to re- introduce those foods back into your diet. Exclusive Enteral Nutrition It might be helpful to keep a food and Exclusive enteral Nutrition (EEN) or liquid symptom diary to identify which foods are Nutrition may be prescribed by your IBD. tolerated best. team to help induce remission in CD. Please talk to your IBD team to determine if this is right for you. This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: Developed: Sept 2019. Copyright: Due for review: Sept 2021. What should I eat when the Disease is What about surgery? not active? Some people with IBD may need Follow a healthy balanced diet, eating surgery.

8 From the five food groups (breads and Most people can follow a healthy cereals, meat and alternatives, dairy, balanced diet with no restriction after fruit and vegetables) surgery. Consume at least 25g of fibre per day Some people who have had certain to keep your Bowel healthy and surgeries can be at risk of developing regular B12 deficiency or bile salt Aim for at least 8 cups of fluid per day malabsorption. Your dietitian will If still experiencing symptoms in advise if you need ongoing remission, you may have food monitoring. intolerances. Talk to your IBD team. Some people with strictures awaiting surgery may need to change the texture of their food or even have a liquid diet. Your dietitian will be able to help make sure you get enough My My Nutrition during this time.

9 Nutrition Nutrition Your IBD team will let you know if you need to make any specific changes to your diet. What about a multivitamin? People with IBD are at higher risk of vitamin or mineral deficiencies. Most people do not need regular vitamin and mineral supplements if they follow a healthy balanced diet. If you have concerns, discuss with your IBD team. Source: National Health and Medical Research Council This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: Developed: Sept 2019. Copyright: Due for review: Sept 2021. Iron deficiency capsules. It appears to be safe in Iron deficiency is common in people small doses. with IBD. There is not enough evidence to Main causes include: lack of iron recommend omega-3 fatty acids (fish intake, difficulties absorbing iron oil) or herbal remedies such as and/or blood losses.

10 Turmeric or curcumin currently. Diet is one method to increase iron intake discuss this with your Other approaches that have not been well dietitian. Other treatment includes iron studied but are commonly used are: tables or intravenous iron (via drip or hypnotherapy, reflexology, relaxation, needle). meditation and yoga. Additional or alternative medicines Please talk to your IBD team if you would The use of alternative therapies and like any further information on details medicines is common. However, the within this resource. safety and benefit of these therapies may not be clear from studies. Discuss Useful websites My alternative medicines with your IBD team MyCrohn's & Colitis Australia: Nutrition prior to taking. Nutrition Probiotics are live, beneficial IBD Support Australia: bacteria.