In case of chronic inflammatory bowel disease (IBD), if food does not cure it, it can relieve pain and other digestive disorders!
Crohn’s disease and ulcerative colitis (UC) are both IBD, which is characterized by inflammation of the lining of part of the digestive tract, linked to an overactive digestive immune system. They cause symptoms such as abdominal pain, diarrhea, nausea … And alternate between two phases: relapse and remission. During the first, the attention given to food is essential because the symptoms are very present. However, with a well-chosen diet, they can be reduced. Eva Milesi, dietician, clarifies certain points.
IBD: food does not cause inflammatory outbreaks
IBD are multifactorial diseases in which diet most certainly plays a role. But no food in itself causes an outbreak or promotes remission. On the other hand, the foods being in contact with the digestive mucosa, when it is inflamed, it is better to choose them.
IBD: adopt a residue-free diet
We can offer a diet without residues, that is to say without fruits, vegetables, or whole grains. The goal: to limit fibers, and therefore the work of the intestine, and reduce the frequency of bowel movements. It should not be continued for more than three to four weeks, at the risk of deficiencies.
IBD: splitting meals
Since digestive capacity is generally reduced, it is better to split meals to facilitate digestive work. We therefore reduce the volumes at the main meals, and add one to three snacks. You should also avoid skipping a meal : we tend to eat more the next time, which causes discomfort.
Limit coffee, avoid alcohol
Caffeine causes constriction of the digestive tract and may cause diarrhea. Better to limit its consumption. Alcohol is not recommended: prohibited during relapses, you can drink a glass occasionally in the remission phase, preferably during the meal.
Reintroduce food gradually
It is important not to exclude any food group, but the reintroduction should be gradual. For fruits and vegetables, for example, we will eat them first cooked and mixed, then in coarse pieces, then raw in juice, then sliced raw or macerated and finally coarse raw. The main thing is patience: we reintroduce a new food or a new preparation at a time, in small quantities (1 to 2 tablespoons), at home, and we wait 48 to 72 hours to ensure a good tolerance.
Drink a lot if you have diarrhea
You must first drink a lot (at least 1.5 liters per day, more if the daily episodes increase) to compensate for the losses. You can alternate water, herbal teas and teas, soups and vegetable broths… It is important to eat regularly, in small quantities, to eliminate frozen and carbonated drinks, to limit milk and dairy products, whole grains, raw fruits and vegetables. . On the other hand, we favor mashed carrots, pasta and rice, grated raw apple or applesauce, as well as cooked cheeses.
Limit meals high in fat to avoid bloating and gurgling
It is not necessarily the most painful, but it is embarrassing and unpleasant. We limit certain foods: cabbage, dried vegetables, onions, sweet products, dairy products, yeast products, soft drinks, chewing gum … We also pay attention to the way we eat: we eat slowly, without making big bites, chewing well, we do not drink through a straw, and we drink more before or after the meal than during . Also beware of meals rich in fat, which slow down transit and promote gas retention. Bonus greed: give preference to homemade pastries of which we know the composition.
Do not exclude any food group to avoid weight loss and deficiencies
Digestive symptoms, stress, fear of having pain with the consumption of certain foods can induce a monotonous, restricted diet, even as flare-ups increase energy requirements, while decreasing the absorption of nutrients. The risk of deficiency and weight loss exists. To avoid them, do not exclude any food group, and take advantage of the phases of remission to have a balanced diet. You can eat as soon as you feel hungry (even outside of meals), add raw butter to toast, minced meat or grated cheese in soups, powdered milk in mash … Nutritional monitoring ( weight measurements, regular biological checks) is necessary. Oral nutritional supplements can be prescribed when needed.
The vegetarian diet, under supervision
It is sometimes presented as being able to “cure” the disease. While the consumption of fruits and vegetables can generate discomfort. If you wish to follow this type of diet, it is necessary to be accompanied by a competent professional to ensure a sufficient intake of energy, proteins, vitamins and minerals (such as zinc and iron).
What about gluten-free or lactose-free diets?
Certain restrictive diets are sometimes presented as favorable but they are not recommended: the removal of a food that provides essential nutrients runs the risk of deficiency. The lactose is generally fairly well tolerated (without excess), and cheese does not contain any at all. As for gluten, it depends on the person: adjust your consumption in case of discomfort. We only advise to avoid ultra-transformed power, industrialized products and favor raw and organic products.
How to get help?
The François Aupetit Association (AFA) offers services to inform and support patients, among other things about food: telephone hotline every Tuesday from 2 p.m. to 6 p.m. with a specialized dietician, provision of a network dieticians trained in MICI specificities, a free application (MICI Connect) which offers personalized follow-up and (in particular) a diet module, recipe sheets on the Association’s website and the app.
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Article published in the issue Femme Actuelle Hors-série Santé of October 2020