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Lifestyle and home remedies

By Mayo Clinic staff

Digestive Health

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Sometimes you may feel helpless when facing Crohn's disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

Diet
There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up. If you think eating certain foods make your condition worse, keep a food diary to keep track of what you're eating as well as how you feel. If you discover some foods are causing your symptoms to flare, it's a good idea to try eliminating those foods. Here are some suggestions that may help:

  • Limit dairy products. Like many people with inflammatory bowel disease, you may find that problems, such as diarrhea, abdominal pain and gas, improve when you limit or eliminate dairy products. You may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods. If so, limiting dairy or using an enzyme product, such as Lactaid, will help break down lactose.
  • Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Foods that may be especially troublesome include butter, margarine, cream sauces and fried foods.
  • Limit fiber, if it's a problem food. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. You may also find that you can tolerate some fruits and vegetables, but not others. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and nuts, seeds, corn and popcorn.
  • Avoid problem foods. Eliminate any other foods that seem to make your signs and symptoms worse. These may include "gassy" foods such as beans, cabbage and broccoli, raw fruit juices and fruits, spicy food, popcorn, alcohol, and foods and drinks that contain caffeine, such as chocolate and soda.
  • Eat small meals. You may find you feel better eating five or six small meals a day rather than two or three larger ones.
  • Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
  • Consider multivitamins. Because Crohn's disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful. Check with your doctor before taking any vitamins or supplements.
  • Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.

Smoking
Smoking increases your risk of developing Crohn's disease, and once you have it, smoking can make the condition worse. People with Crohn's disease who smoke are more likely to have relapses, need medications and repeat surgeries. Quitting smoking can improve the overall health of your digestive tract, as well as provide many other health benefits.

Stress
Although stress doesn't cause Crohn's disease, it can make your signs and symptoms worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one.

When you're stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acid. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.

Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:

  • Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
  • Biofeedback. This stress-reduction technique may help you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes without feedback from the machine. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.
  • Regular relaxation and breathing exercises. One way to cope with stress is to regularly relax and use techniques such as deep, slow breathing to calm down. You can take classes in yoga and meditation or use books, CDs or DVDs at home.
References
  1. Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/Crohns.pdf. Accessed June 20, 2011.
  2. Management of Crohn's disease in adults. Bethesda, Md.:American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/CrohnsDiseaseinAdults2009.pdf. Accessed June 20, 2011.
  3. Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 20, 2011.
  4. Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018b.html. Accessed June 20, 2011.
  5. Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
  6. Smoking and your digestive system. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/smoking/DD-52.pdf. Accessed June 23, 2011.
  7. Burakoff R, et al. Inflammatory bowel disease. In: Greenberger NJ, et al. Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y.:  The McGraw Hill Medical Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=6200149. Accessed June 20, 2011.
  8. Ford AC, et al. Glucocorticosteroid therapy in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:590.
  9. Colombel JF, et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. New England Journal of Medicine. 2010;362:1383.
  10. Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
  11. Farrell RJ, et al. Medical management of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
  12. Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
  13. Ford AC, et al. Efficacy of biological therapies in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:644.
  14. Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
  15. Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
  16. Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 12, 2011.
  17. Colorectal cancer screening guidelines. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm. Accessed July 12, 2011.
DS00104 Aug. 9, 2011

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