Diet for ulcerative colitis and Crohn’s disease
Patients often present with diarrhea, mucus and blood stools, and abdominal pain, and have very similar symptoms. The difference between the two is that Crohn’s disease may affect all parts of the GI tract (e.g., esophagus, stomach, small intestine, colon), whereas the effects of ulcerative colitis are often limited to the large intestine. The extent of the lesions in inflammatory bowel disease is shown in the figure below.
Patients with IBD have damaged intestinal mucosa, severe symptoms in the digestive tract, reduced nutrient intake and absorption, and increased nutrient loss due to diarrhea and intestinal bleeding. Therefore, patients with IBD often suffer from nutritional deficiencies and protein-calorie malnutrition. This is manifested by weight loss, hypoproteinemia, anemia, electrolyte disturbances, vitamin deficiencies, etc. This malnutrition further leads to a decrease in the resistance of the intestinal tract and the body to infection and a decrease in the healing ability of ulcerated surfaces in the intestine.
Therefore, in the prevention and treatment of IBD, nutritional therapy is undoubtedly an important measure to stop the deterioration of the disease, improve the body’s nutrition, and provide adequate, favorable, and balanced nutrients for the recovery of intestinal function.
In the following, the principles of nutritional therapy for these two types of IBD are briefly described. It is important to note that because of the different sensitivity of individuals to food, please do not apply the dietary contraindications of the various reported “tofu blocks”, but keep a clear head and choose a nutrition plan that suits you.
1, ulcerative colitis nutrition treatment principles.
(1) Ensure adequate calories and protein: 2500-3500kcal of calories and 100-150g of protein daily to replenish the protein lost in the intestine and to meet the needs of the body’s basic metabolism and tissue damage repair.
(2) Ensure rich vitamins and minerals: especially vitamin B group, iron, zinc and calcium, etc.
(3) Food properties: less residue, liquid/semi-liquid/soft, non-irritating, high-calorie, high-protein food.
(4) If the patient has intolerance to the above mentioned foods, the intake should be reduced and replaced with other foods of similar nutrient composition under the guidance of the doctor and dietitian.
(5) Drink 1200-1600ml of water, especially if you have diarrhea.
When people think of “liquid/semi-liquid food”, they have the impression that it is low-calorie rice soup or noodle soup, which can hardly provide balanced and sufficient nutrition and calories for IBD patients. Appropriate amounts of lean animal and poultry meat, fish, eggs, milk, and vegetables containing less dietary fiber (such as certain melons) should be selected and given to patients after varying degrees of grinding or making a homogenous paste.
At present, the nutrition departments of major hospitals in China also have enteral nutrition preparations (including powder and suspension) for patients with intestinal diseases, and patients can consult their doctors when necessary to use natural food and nutrition preparations together.
For health food on the market such as “**protein powder”, “**algae”, “**weed”, etc., it is recommended that you use them under the guidance of your doctor.
2.The principles of nutritional treatment of Crohn’s disease
The scope of intestinal lesions in Crohn’s disease is more extensive than in ulcerative colitis, so protein-calorie malnutrition, anemia, vitamin deficiency and electrolyte disorders are more common. As the absorption of calcium is severely impaired, osteoporosis is likely to occur; when the lesion invades the end of the ileum, it also affects the absorption of fat.
(1) Ensure adequate calories and protein.
(2) Correct water and electrolyte imbalance and vitamin deficiency.
(3) Less residue, low-fat diet: daily fat intake should be less than 40 g. Oil or powder of medium-chain fatty acids (MCT) can be used, because the absorption of MCT can be eliminated through the intestine.
(4) The mucosal villous structure of the small intestine is damaged in Crohn’s disease, so the diet should be supplemented with elemental meals under the guidance of a doctor if necessary to promote the absorption of nutrients and improve the structure of the intestinal mucosa.
(5) The main food should be fine and coarse grains are prohibited. The side dishes should ensure lean meat, eggs, fish, soybean products and other high-quality protein. Milk is limited and those with intestinal intolerance should avoid drinking milk to prevent diarrhea and bloating.
(6) Try to compress the volume of food to improve the nutritional value per unit quantity.
(7) Cooking methods are: boiling, steaming, braising, boiling. Forbid the use of deep-fried and thick condiments.