A Look at foods and Crohn's

For a person with Crohn’s disease, eating a healthy diet isn’t as simple as it may seem. If you’re experiencing chronic diarrhea, you may have nutritional deficiencies to overcome, and this is especially true for children with Crohn’s disease that affects the small bowel. On top of this, certain foods — even foods that are considered nutritious, such as raw fruits and vegetables — can trigger a Crohn’s flare or worsen symptoms. “

Beware the Dangers of Dairy

If you have Crohn’s disease, it’s not uncommon to also be lactose intolerant. That means you don’t adequately digest lactose, the sugar found in milk, and as a result you may experience cramping, bloating, diarrhea, and gas, says Gina Jarman Hill, PhD, RD, an associate professor of nutrition at Texas Christian University in Fort Worth. “Dairy products are a good source of calcium, vitamin D, and protein, so if you completely avoid these foods, you must obtain these nutrients elsewhere," she says. To minimize Crohn’s symptoms while staying healthy, try getting these nutrients from green leafy vegetables, fortified juices and cereals, or supplements.

Skip on the Spicy Foods

When your Crohn's symptoms are in overdrive, spicy foods may result in even more pain for you, says Hill. “However, this is different from one person to the next," she adds, "so it is important to identify those foods that are or are not tolerated.” If you find certain spices irritating during a Crohn’s flare, mild herbs and small amounts of citrus juices for seasoning can provide flavor in their place — it makes sense to always have them handy for jazzing up your diet.

Use Caution With Fried or Greasy Foods

For people with Crohn’s disease, the fat in foods like fried chicken, french fries, heavy sauces, and creams is often not fully absorbed in the small intestine. This in turn leads to Crohn’s symptoms like cramping or loose stools. Rather than fried and greasy foods, choose foods that are baked, broiled, or steamed for yourdiet for Crohn’s, says Hill. “However, fat should only be restricted if you’re experiencing fatty stools.”

Steer Clear of High-Fiber Foods

Though most people should be getting plenty of fiber from sources such as whole grains, fruits, and vegetables, the opposite is true for many individuals with Crohn’s disease. When Crohn’s symptoms are at their worst, make refined breads and pastas part of your modified diet. “They are normally better tolerated than their higher-fibercounterparts,” Hill explains.

Look Out for Foods With Gluten

Hill notes that refined wheat products are usually a better choice than whole grain options for people with active Crohn’s flares, but this alternative won’t help if you can’t digest the gluten found in wheat products. “Some people with Crohn's disease may be gluten intolerant,” she says. If that’s the case, avoid all products that contain gluten in your diet.

Go Easy on Caffeine

If one of your Crohn’s symptoms isdiarrhea, stay away from beverages that contain caffeine. “Caffeine stimulates the intestines, resulting in worsening diarrhea,” says Hill. To get needed fluids — which is even more important when you’re experiencing diarrhea — drink water, sports drinks, and fruit juice (diluted with water if 100-percent juices bother you). “Take care to sip rather than gulp these liquids in order not to swallow extra air, as that will result in further gas,” she adds.

Abstain From Alcohol

As with caffeinated beverages, drinks that contain alcohol may also exacerbate the Crohn’s symptom of diarrhea. They can dry you out and prevent proper rehydration. It’s also possible that alcoholic drinks could negatively interact with Crohn’s medications, says James Church, MD, a colorectal surgeon at the Cleveland Clinic. Taking alcohol out of your diet for Crohn’s may be the best thing to do.

Say 'No' to Raw Fruits and Vegetables

Fresh fruits and vegetables in their pure, raw form are loaded with fiber and notable for causing gas. You may need to eliminate them from your diet, especially during a Crohn’s flare. “High-fiber foods are not completely digested in the small intestine and therefore may further exacerbate diarrhea during times of increased Crohn’s symptoms,” says Hill. Switch to cooked vegetables and fruits without the skins. But, she warns, you may need to pass completely on broccoli, cauliflower, cabbage, and beans. Again, afood diary will help you identify your particular triggers.

Traveling Preparations

Hear are some tips for traveling.

 

Time Required: 1 week before the trip

Here's How:

1. In the days before the trip, consistently follow the best schedule of meals and medications for your condition. This is not the time to try new foods or unfamiliar restaurants.
2. Contact local tourist boards or an auto club to find restrooms on your route. If you do your research far enough ahead of time, you'll have time to ask the local tourist agencies to send you maps and information in the mail (many times this information is free).
3. If there are no rest stops are on the highway, plan your route on surface streets where you are more likely to find a fast food restaurant or grocery store that has a restroom.
4. If your destination is in an unfamiliar city, obtain a good map and make a note of areas that may have public restrooms. Some good places include tourist info centers, shopping malls, department stores, hotels, and restaurants.
5. Make sure you have enough medication for the duration you're traveling, and add some extra, just in case.
6. Many public restrooms aren't clean or well-stocked. Carry a travel pack containing extra undergarments and trial sizes of toilet seat covers, wet wipes, antibacterial hand wash, extra toilet paper, and anything else you might need. If you need to make a dash for the toilet, you can just grab your bag and be off.
7. Pack a book, sewing project, crossword puzzle, or video game -- anything that will occupy you while you're a passenger in the car.
8. If you think it will help you, pack a portable toilet. It may not be useful in urban areas, but when traveling off the beaten path it could be helpful.
9. When possible, arrange your meal schedule around your trip. If you know that you have to use the toilet about an hour after a meal, leave enough time between your last meal and the start of the trip for that bathroom break.
10. Ensure that your traveling companions know that when you say you need to stop and find a restroom you mean NOW. They can also help you scout for restrooms and help explain if you need to jump to the front of the line.

Tips:

1. Does driving help keep your mind off how far the next bathroom is? Then maybe you should drive.
2. Gas stations rarely have toilets anymore. Some public places that are more likely to have easily accessible public restrooms are fast food restaurants, diners, supermarkets, department stores, discount stores, large book stores, craft stores, and bed and bath stores.
3. Places unlikely to have an easily accessible restroom include electronics stores, furniture stores, drugstores, toy stores, restaurants (other than diners), and small shops or boutiques.
4. If the worst happens, politely ask to use the available facilities and explain that you have a serious medical condition.

What You Need

• Maps of the areas you're traveling
• Wet wipes, tissues, or toilet paper
• Hand sanitizer
• More than enough medications or medical supplies
• Portable toilet (optional)
• Sympathetic traveling companion
• Hobby or book to keep you occupied

Amber Tresca

Interesting Article by Amber Tresca on Colonoscopies

I subscribe to Amber Tressca's News Letter and from time to time post her articles here. This is a good article for those wanting information about the procedure. A colonoscopy is an effective test used in diagnosing inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and other digestive disorders. A gastroenterologist (a specialist in digestive disease) or a colorectal surgeon should perform the test. A long, flexible tube with a light and a camera on the end is inserted into the anus, and guided through the large intestine.In the days before having a colonoscopy, a patient must clean their colon of all waste materials. Doctors may prescribe different techniques for different patients. For example, a patient with severe diarrhea may not need as much prep as a person with a healthier bowel. Common methods include drinking a solution to stimulate the bowel, laxatives, and enemas. By following the doctors' instructions correctly, the large intestine will be clean and free of waste so problems can be more easily seen and diagnosed.Patients are sedated during the procedure (this is an important point to discuss beforehand with the doctor performing the test) through an IV. The doctor may also use a heart monitor, oxygen, and other monitoring equipment to ensure the safety and comfort of the patient. The entire procedure commonly takes about 30 minutes. The doctor may take some biopsies, a small sample of tissue that will be sent to a pathologist for testing to ensure an accurate diagnosis.After the colonoscopy, patients are monitored for another period of time to reverse the sedation and make sure no complications have occurred. Because the colonoscope introduces air into the colon, there will be some bloating that will be relieved by passing gas. Patients should arrange to have someone drive them home from the procedure, as they will be quite groggy. This person can also remember any further instructions given by the medical staff.A few days after the procedure, patients will meet again with the doctor to discuss the findings. The results of the biopsies will be available at this time.No, having a colonoscopy is not what anyone would consider "fun." It is, however, a useful diagnostic test. Without it, those of us with digestive problems might never get an accurate diagnosis or effective treatment.

TIPS FOR CHOOSING THE RIGHT DOCTOR FOR YOU

Let me start by apologizing for not updating for a couple of weeks. I have been busy creating a new design for this blog and helping a friend create a new website for his auto repair business.

I have an appointment on 6-18-2012 for a new CT Scan and an appointment with my GI Sanadra Kane at Mayo Clinic Rochester, MN.

This article is about selecting the right GI for you. I have heard form many patients on the ButtBook Forum (GI Monitor) that they are unhappy with their GI or are switching or considering switching to a different GI.

Choosing the right GI can be challenging. Many patients feel they just don’t have a choice in doctors. Some patients feel helpless or don’t know what to do.

I have learned first hand that you do have a choice and and that it is up to me to make sure I have the best care possible.

Clearly, the doctor that you choose will have a direct impact on how well you do,  especially when you need treatment for a complex gastrointestinal condition. This will be an important relationship in your life so it's worth investing some time and energy into finding the right doctor.

RESEARCH

With a little research and effort you can find the right doctor for you.

Get the names of several doctors and hospitals that offer the newest, most effective treatments as well as clinical trials that compare the latest drugs with experimental drugs, which may provide even better results.

Ask you General Practioner for information regarding your disease. The willingness of providers to give you as much information as possible is a good sign. It shows that they are dedicated to maintaining and improving their quality and responsiveness to patients, and that they are confident in their capabilities.

One source of information that many people do not take advantage of is your insurance company.  It’s a good idea to call both your insurance company and the doctor’s office to confirm that your health plan will cover the doctor’s services. For instance, you might ask your insurance company for recommendations of specialists who are in your network

Check with "local universities and medical schools, especially if they specialize" in inflammatory bowel disorders such as Crohn's disease. Ideally, the same name or names should come up from different sources.

Look for a gastroenterologist who is board certified by the American Board of Internal Medicine, the organization responsible for certifying subspecialists in internal medicine. Board-certified gastroenterologists, for instance, have spent a certain number of hours practicing endoscopy, a type of diagnostic test essential in diagnosing Crohn’s disease. Other sources such as The American College of Gastroenterology, The American Gastroenterological Association, The Crohn’s and Colitis Foundation of American are all good sources for a selection of doctors in your area.

Your disease management will likely involve more than just your gastroenterologist, so it’s essential that you feel comfortable with the other health care providers on your medical team. Your primary care doctor might still treat you for non-Crohn’s related issues and may coordinate referrals, depending on your insurance. Nurses and the support staff will play a major role as well. Depending on your treatment needs, you might need to see a registered dietician, a mental health counselor, or a colorectal surgeon. Coordination and communication between different medical professionals involved in your care is extremely important, so ask who will be taking the lead role in making this group a high-quality team

Choosing a qualified and competent medical team is important, but at the end of the day you’re the one living with Crohn's. It is important to educate yourself as much as possible. “the Crohn’s & Colitis Foundation of America Web site is a good resource to find out about new developments in IBD research.”

GETTING COZY

When you have done your research and think you have found the right doctor, you need to remember this is your care and you and your GI are going to have a long term relationship.

You need to feel comfortable, safe, secure and confident that this is the right doctor for you.

The Crohn’s & Colitis Foundation of America recommends writing down your questions before your appointment/consultation, to ensure you don’t forget to ask something you particularly need to know. Take a pen and paper with you on your visit so you can write down the doctor’s answers and review them later.

The way in which the doctor interacts with you on a personal level should put you at ease, not make you feel more stressed about your condition. It is especially important to choose a doctor you can easily talk with openly and honestly.

Do I feel comfortable with this doctor? Am I satisfied with his or her answers to the questions I asked? Was I seen on time when I arrived for the consultation? Was the office staff helpful, knowledgeable, and friendly? All the little issues that you’d consider when choosing your primary care physician are just as important when choosing a specialist to work with you on managing your disease.

Choosing the right doctor is essential and important relationship in your life so it's worth investing some time and energy into finding the right doctor.