Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel diseasethat may affect any part of the

gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea (which may be bloody if inflammation is at its worst), vomiting (can be continuous), or weight loss,[1][2][3] but may also cause complications outside the gastrointestinal tract such as skin rashes, arthritis, inflammation of the eye, tiredness, and lack of concentration.[1] Signs and symptoms of Crohn's disease can range from mild to severe and may develop gradually or come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission). When the disease is active, signs and symptoms may include: Diarrhea. The inflammation that occurs in Crohn's disease causes cells in the affected areas of your intestine to secrete large amounts of water and salt. Because the colon can't completely absorb this excess fluid, you develop diarrhea. Intensified intestinal cramping also can contribute to loose stools. Diarrhea is a common problem for people with Crohn's.
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Abdominal pain and cramping. Inflammation and ulceration may cause the walls of portions of your bowel to swell and eventually thicken with scar tissue. This affects the normal movement of contents through your digestive tract and may lead to pain and cramping. Mild Crohn's disease usually causes slight to moderate intestinal discomfort, but in more-serious cases, the pain may be severe and include nausea and vomiting.

Blood in your stool. Food moving through your digestive tract may cause inflamed tissue to bleed, or your bowel may also bleed on its own. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. You can also have bleeding you don't see (occult blood).

Ulcers. Crohn's disease can cause small sores on the surface of the intestine that eventually become large ulcers that penetrate deep into and sometimes through the intestinal walls. You may also have ulcers in your mouth similar to canker sores.

Reduced appetite and weight loss. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food. Other signs and symptoms People with severe Crohn's disease may also experience: Fever Fatigue Arthritis Eye inflammation

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Mouth sores Skin disorders Inflammation of the liver or bile ducts Delayed growth or sexual development, in children Crohn's disease is a chronic condition that causes inflammation in the digestive tract, which can result in frequent constipation, diarrhea, nausea and pain. Because the disease is related to the digestive tract, some of the negative symptoms associated with Crohn's disease can be controlled through consuming a proper diet.

Foods to Eat
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As with any diet for good health, balance and portion control are the keys to a diet for patients with Crohn's disease. Incorporating healthy sources of protein--such as chicken, turkey, fish, soy products or eggs--with fruits and vegetables and low-fat dairy products (for those who are not lactose-intolerant) are the dietary keys for patients with Crohn's. In order to ensure best digestion for these foods, those with Crohn's disease should aim to eat small meals throughout the day, such as grilled chicken breast and a sweet potato for lunch or a low-fat yogurt with fruit for a healthy snack containing protein and calcium. Patients with Crohn's disease may have a reduced appetite due to nausea-related symptoms. Consuming these types of healthy foods allows the Crohn's patient to receive needed nutrients while not disturbing the gastrointestinal tract.

Foods to Avoid
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Many Crohn's disease patients have trouble absorbing fats. For this reason, patients should avoid high-fat foods, such as cream-based sauces, fried foods, desserts or butter. These foods may cause diarrhea in Crohn's patients. Additionally, foods known to cause gas, such as beans, cabbage, broccoli, raw fruits or spicy food, should be avoided. Because carbonated beverages can also make gas symptoms more severe, avoid these as well.

Certain lifestyle changes can reduce symptoms, including dietaryadjustments Elemental diet, proper hydration, and smoking cessation. Smoking may increase Crohn's disease; stopping is recommended. Eating small meals frequently instead of big meals may also help with a low appetite. To manage symptoms have a balanced diet with proper portion control. Fatigue can be helped with regular exercise, a healthy diet, and enough sleep. A food diary may help with identifying foods that trigger symptoms. Some patients should follow a low dietary fiber diet to control symptoms especially if fibrous foods cause symptoms.[104]
Important nutrients

Youll want to maintain a diet rich in protein and vitamins, especially vitamins A, D, C, B-12 and folic acid. Also add foods that contain calcium, iron, and zinc. In order to make sure youre including the proper nutrients in your diet, its best to eat a variety of foods from the four basic food groups: y Meat and meat substitutes (protein, iron, Vitamin B-12) y Dairy (calcium, Vitamin D, Vitamin A) y Cereal and grains (zinc) y Fruits and vegetables (calcium, Vitamin C, B-12, zinc) You may also want to lay off the spicy food. Soft, bland foods may cause less discomfort than spicy or high-fiber foods when Crohn's is active. Alcoholic beverages may worsen symptoms as well by irritating the gastrointestinal tract. Think about reducing or eliminating your alcohol consumption, particularly when you are experiencing symptoms. Except for restricting milk in lactose-intolerant patients, most gastroenterologists try to plan flexible diets for their Crohn's patients. Talk to your gastroenterologist or a dietician about developing a healthy diet that is Crohns friendly.

Diet
There is no current data that specific diets cause or cure Crohn's disease. In general, there are no adequate controlled trials to show that specific diets can induce remission. The exception to this is giving nutrition via elemental formulas, in which food is pre-digested. However, proper diet and nutrition can certainly impact the symptoms and prevent complications. Crohn's patients with intestinal narrowing and symptoms of partial bowel obstruction often do better with frequent smaller meals and avoidance of hard-to-digest foods and those that cause bloating and gas. In addition, vitamin supplementation is very important in patients with Crohn's disease in the small intestine, where nutrients are absorbed. Low-fiber, low-fat, bland, or lactose-free diets: These different types of diets may be recommended by physicians for Crohn's patients depending on the nature of the inflammatory tissue damage and the extent of the Crohn's disease involvement. The idea is to provide nutrition while minimizing the risk of triggering symptoms. The rationale for a low-fiber diet, for example, is that fiber is poorly digested and can worsen the symptoms of intestinal obstruction. In some people, both fats and lactose can worsen inflammatory response in the intestines. Highly seasoned food and dairy products stimulate bowel activity, while bland and lactose-free diets do not tax the digestive system. Fluids: Because of diarrhea, the risk of dehydration can be high. Drinking plenty of fluids, particularly during warm weather, is a key to managing Crohn's disease. Elemental diets and enteral nutrition: These are special, liquid meals that contain nutrients necessary for the body to function but do not tax the digestive system. They are offered in several formulations, depending on whether patients are lactose intolerant or need certain dietary ingredients. There are a number of commercially prepared elemental diets and enteral feeds. There is evidence that elemental diets can be effective in decreasing Crohn's disease inflammation and inducing remission. Total parenteral nutrition (TPN): TPN is an intravenous nutritional support in which nutrients, vitamins, and minerals are given through a thin, flexible tube that goes directly into a large vein.

This nutrition support is used for Crohn's patients who are unable to digest foods or to provide bowel rest while medical therapies take effect. However, this means of nutritional support is more expensive than enteral nutrition and has a higher risk of complications, including intravenous line infections and liver abnormalities. Nutrition Although diet cannot cause or cure Crohn's disease, some studies suggest that people who eat foods high in saturated fat and sugar or who eat processed foods may be more likely to develop the disease. Certain foods may also reduce symptoms and make recurrences of the disease less likely.
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Eating fruits and vegetables, lowering fat, and eliminating sugar may reduce the risk of developing Crohn's disease. Although a low fiber diet is one of the risk factors for developing Crohn's disease, some people with Crohn's disease find that fiber makes symptoms worse. If fiber bothers you, steam or bake your vegetables rather than eating them raw, and avoid high fiber fruits, such as apples. Certain foods may aggravate symptoms of Crohn's disease most often, dairy products, fats, and spicy foods. People with Crohn's disease may want to avoid these foods. Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell peppers). Eat foods high in B vitamins, calcium, and magnesium, such as whole grains (if not bothered by fiber), dark leafy greens (such as spinach and kale), and sea vegetables. Avoid refined foods such as white breads and pastas. Eat 5 - 6 smalls a day. Avoid caffeine, alcohol, and tobacco. If symptoms are severe, an elemental diet may be recommended. Elemental formulas are liquid diets that contain only the basic building blocks of food and do not need to be broken down into smaller substances along the digestive tract. Some people find it hard to stick to an elemental diet, but after a period of time, often other foods can be reintroduced. One study suggests that adding omega-3 fatty acids to an elemental diet may boost its nutritional content and make it more likely that people with Crohn's disease will stick with it. Elemental diets should only be undertaking under the supervision of a physician.

Vitamins and Minerals Because of decreased appetite, malabsorption, chronic diarrhea, side effects of medication, and surgical removal of parts of the intestine, many people with Crohn's disease don't get enough of some vitamins and minerals. In particular, people with Crohn's disease may lack adequate vitamin D, B12, and K, plus folic acid, calcium, and zinc. Your doctor may recommend that you take a multivitamin daily.
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Zinc (25 mg), folic acid (800 mcg), vitamin B12 (800 mcg) -- The body uses these vitamins and minerals to repair cells in the intestine. In addition, drugs such as sulfasalazine and methotrexate may cause levels of folic acid in the body to drop, so that

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you need a supplement. Getting too much Zinc can be immunosuppressive, folic acid in high doses over long periods of time has had some controversial reports associating it with certain illnesses. Speak with your doctor to determine the proper type and level of supplementation for your individual case. Vitamin D (1,000 IU per day) -- is necessary to maintain strong bones. People with Crohn's disease, especially those who take corticosteroids, often have low levels of vitamin D and are at risk for osteoporosis. Calcium (1,000 - 1,200 mg per day) -- is also needed for strong bones. Ask your doctor if you need a calcium supplement. Omega-3 fatty acids, such as those found in fish oil (2.7 g per day) -- may help fight inflammation and reduce the chances of recurrence, but studies have been mixed. The study with the most positive results used a special type of fish oil "enteric coated free fatty acid form" that is not sold commercially. Some researchers suggest that measuring the blood levels of different types of fatty acids may help determine if fish oil would be useful. Do not take high doses of a fish oil supplement if you take blood thinning medication. Probiotics, especially Saccharomyces boulardi (250 mg 3 times per day to 500 mg 4 times per day) -- One small study indicated that this type of "friendly" bacteria helped people with Crohn's disease reduce the incidence of diarrhea. However, other studies have shown mixed results. People with allergies to yeast should avoid Saccharomyces boulardi. People with very weak immune system should check with their doctor before using probiotics. N-acetyl glucosamine (NAG) -- Preliminary research suggests that N-acetyl glucosamine supplements or enemas may improve symptoms of inflammatory bowel disease, but more studies are needed to know whether glucosamine would have any effect on Crohn's disease. There is some concern that NAG may raise blood sugar in patients with diabetes and may worsen asthma symptoms. NAG may interact with blood thinning medications, such as Warfarin (Coumadin) and certain cancer drugs. Glutamine (400 mg 4 times per day) -- is an amino acid found in the body that that helps the intestine function properly. While there is no evidence that glutamine specifically helps reduce symptoms of Crohn's disease, it may be good for overall intestinal health. Glutamine is best taken on an empty stomach. Do not take glutamine is you are diabetic or have seizures suffer from bouts of mania, severe liver disease with difficulty thinking or confusion, or if you are sensitive to monosodium glutamate (MSG).