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CEC TEST

/digestive-health/crohns-disease/crohns-disease-virtual-anatomy

Crohn’s disease (CD) is an inflammatory bowel disease of the digestive tract. Join your host, Kimberly, to explore the pain and suffering brought on by CD.

https://cectemplates.wpengine.com/wp-json/wp/v2/cec-subpage/820?_fields=id,type,url,title,uri,description,embedded,videoPlaylist,imageUrl,label,immersive,body,displayTitle,iframeId,_links,subpageTitle

Personal Path to Health: Living Well with Crohn’s Disease

/digestive-health/crohns-disease/video-heatlhsmarts-social-determinants-impact-crohns-disease

The severity of Crohn's disease is impacted by much more than just age, family history, or diet.

How the Social Determinants of Health Impact Crohn's Disease

/digestive-health/crohns-disease/need-to-know-about-crohns-disease

<p>Crohn&rsquo;s disease is an autoimmune disorder&nbsp;that&nbsp;occurs when the immune system, which usually fights infection, attacks the lining of the digestive tract, causing it to bleed and develop ulcers.&nbsp;</p>

<p>&ldquo;Crohn&rsquo;s disease is typically disruptive to people&rsquo;s lives,&rdquo; says Ernest DiGiovanni, DO, a gastroenterologist with Regional Medical Center Bayonet Point in Hudson, Florida. &ldquo;It&rsquo;s usually classified as mild-to-moderate or moderate-to-severe. A person can have excruciating pain or so many bowel movements a day that they can&rsquo;t leave the house. It can be disruptive for sure.&rdquo;&nbsp;</p>

<h2>Causes and symptoms of Crohn&rsquo;s disease&nbsp;</h2><p>
What causes Crohn&rsquo;s disease is unknown. &ldquo;It may be genetic, it may be infectious,&rdquo; says Dr. DiGiovanni. &ldquo;Researchers have found some genes that are potentially associated with the condition, and between 15 and 20 percent of people with Crohn&rsquo;s have a relative with Crohn&rsquo;s.&rdquo;&nbsp;</p>

<p>Infection, such as a viral or bacterial illness, or exposure to another environmental trigger could cause those with a genetically higher risk for Crohn&rsquo;s to develop the condition.&nbsp; &nbsp;</p>

<p>The most common features of Crohn&rsquo;s disease include abdominal pain, diarrhea, weight loss and fatigue. Depending on where in the body the Crohn&rsquo;s affects, other symptoms could include:&nbsp;</p>

<ul>
	<li>Mouth sores&nbsp;</li>
	<li>Eye inflammation&nbsp;</li>
	<li>Problems of the anus, including tears, ulcers, fistulas, infection and narrowing&nbsp;</li>
</ul>

<p>People with Crohn&rsquo;s may also have joint inflammation or arthritis, particularly in their larger joints, which tends to worsen during IBD flare-ups.&nbsp;</p>

<h2>Crohn&rsquo;s disease&nbsp;vs.&nbsp;ulcerative&nbsp;colitis&nbsp;</h2><p>
Crohn&rsquo;s disease can affect any part of the digestive tract. When inflammation is limited to the colon and rectum, it&rsquo;s known as ulcerative colitis.&nbsp;</p>

<p>Crohn&rsquo;s and ulcerative colitis are similar but different, DiGiovanni says. &ldquo;The main difference is what part of the body each affects,&rdquo; he says. &ldquo;Both affect the colon, but ulcerative colitis always affects the rectum&mdash;the most bottom part of the colon&mdash;and extends upward. In Crohn&rsquo;s, the most common affected area is in the last part of the small intestine, but it can affect anywhere in the gastrointestinal tract, including the stomach and even the mouth.&rdquo;&nbsp;</p>

<p>Crohn&rsquo;s disease and ulcerative colitis are the two main disorders known collectively as inflammatory bowel disease, or IBD. Keep in mind, IBD should not be confused with irritable bowel syndrome (IBS). &ldquo;IBS is a syndrome of exclusion commonly characterized by alternating constipation and diarrhea,&rdquo; says Dr. DiGiovanni, meaning that IBS is something that is diagnosed only when other likely diagnoses are ruled out.&nbsp;</p>

<p>Between 1 million and 1.3 million Americans have IBD. Colitis is slightly more common overall, and is more common in men than women, while Crohn&rsquo;s disease is more likely to affect women.&nbsp;</p>

<h2>Treatment options&nbsp;</h2><p>
There is no cure for Crohn&rsquo;s disease but there are many treatment options. The drugs used to help manage the condition, including steroids and antibiotics, aim to reduce inflammation. Since Crohn&rsquo;s is an autoimmune disease, immunotherapy drugs known as biologics can also help ease inflammation, but these medications can have severe side effects. Some healthcare providers will start a patient with the strongest drugs (the top-down approach), while others will save those drugs until after other treatments have failed (the step-up approach).&nbsp;</p>

<p>If medication doesn&rsquo;t help, the next option is surgery. One surgical option is removing part of the colon and then reattaching the two ends. If this isn&rsquo;t possible, a surgeon can make an opening in the abdomen, through which waste will exit the body and be collected in an ostomy bag. Another option is opening blockages in the bowel called strictures.&nbsp;</p>

<h2>Preventing flare-ups&nbsp;</h2><p>
There may be certain foods that could worsen your symptoms during&nbsp;a Crohn&#39;s disease&nbsp;flare-up, but it&rsquo;s also important to ensure that you&rsquo;re getting adequate nutrition. Many people with Crohn&rsquo;s have vitamin deficiencies because the intestines don&rsquo;t absorb nutrients as efficiently as in people without Crohn&rsquo;s, notes DiGiovanni.&nbsp;</p>

<p>Be sure to work with your doctor or a dietitian who specializes in IBD to develop a personalized eating plan that meets your individual needs.&nbsp; &nbsp;</p>

<p>It&rsquo;s also essential to avoid or quit smoking. Smoking increases the risk of developing Crohn&rsquo;s and may make the condition more severe. &ldquo;Smoking has been shown to be very detrimental,&rdquo; DiGiovanni says. &ldquo;The first thing you need to do is stop smoking.&rdquo;&nbsp;</p>


What You Need to Know About Crohn’s Disease

Crohn’s doesn’t have to disrupt your life.

/digestive-health/crohns-disease/crohns-topics-discuss-doctor

<p>Crohn&#39;s disease is a type of chronic inflammatory bowel disease (IBD) characterized by inflammation of the digestive tract. It can cause a number of serious complications, especially when left untreated.</p>

<p>If you have Crohn&rsquo;s disease, it is important to work with a healthcare provider to get treatment. Crohn&rsquo;s disease is typically treated by a gastroenterologist, a healthcare provider that specializes in the treatment of diseases and disorders that affect the digestive system.</p>

<p>Below are topics to discuss during your appointment with your healthcare provider. It is helpful to spend some time thinking about these topics and writing down notes before you go to your appointment. Once you have your notes, prioritize the topics that you feel are most important for this appointment and make those the focus of your discussion with your healthcare provider.</p>

<h2>Symptoms</h2><p>
Your healthcare provider needs to know about the symptoms that you are experiencing, any changes in symptoms since your last appointment, and any flare ups that you have experienced.</p>

<h2>Treatment</h2><p>
Discuss your current treatment plan for Crohn&rsquo;s, including:</p>

<ul>
	<li>How you feel your treatment plan is working.</li>
	<li>How you will know if a therapy is working.</li>
	<li>If you have questions about how a therapy works.</li>
	<li>If you&rsquo;ve had problems following your treatment plan&mdash;such as missing doses of medication or concerns about cost. In order to get the most benefit, it&rsquo;s important to follow a treatment plan exactly as directed.</li>
	<li>What to do if you miss a dose of medication.</li>
	<li>If you have experienced any side effects from treatment.</li>
	<li>What the next steps in your treatment are.</li>
	<li>What other steps you can take to manage Crohn&rsquo;s disease, such as changes to diet or lifestyle.</li>
</ul>

<p>It is important to be as honest as possible with your healthcare providers. If you have concerns, talk about them.</p>

<h2>Quality of life</h2><p>
Talk to your doctor about the ways Crohn&rsquo;s disease impacts your quality of life, including work, relationships, hobbies, and your social life. Sleep, stress, and mental health are also important to discuss. Improving or maintaining a good quality of life should be an important aspect of managing Crohn&rsquo;s disease.</p>

<h2>Diagnosis</h2><p>
Diagnosing Crohn&rsquo;s disease can be challenging. Sometimes, a diagnosis of Crohn&rsquo;s disease will be changed to a diagnosis to ulcerative colitis (another form of IBD), another disorder, or another type of Crohn&rsquo;s disease&mdash;which may occur if a different part of the GI tract is affected.</p>

<p>If you have questions or doubts about your diagnosis, bring these up at your appointment. Ask your healthcare provider about the differences between Crohn&rsquo;s and other conditions and how diagnostic tests can help distinguish between Crohn&rsquo;s and other conditions.</p>

<h2>Take an active role</h2><p>
In order to get the most from treatment for Crohn&rsquo;s disease you need to be an active participant in your care. Take time to learn about the condition and treatment options. Take time to prepare for your appointments. Be honest about what you need from treatment.</p>


Crohn’s Disease: 5 Topics to Discuss With Your Doctor

Questions and topics to help you prepare for an appointment with your healthcare provider.

/digestive-health/ibd/avoid-stress-induced-ibd-flares

<p>Stress can have numerous negative impacts on your health, and for people living with inflammatory bowel disease, stress may lead to flare-ups or worsening symptoms. Here, we look at the relationship between IBD and stress and some strategies for how you might better manage your stress levels.</p>

<h2>What is IBD?</h2><p>
Inflammatory bowel disease (IBD) is a disorder that causes irritation and chronic inflammation of the gastrointestinal (GI) tract. The two major types of IBD are ulcerative colitis (UC) and Crohn&rsquo;s disease (CD). Ulcerative colitis involves inflammation of the inner lining of the large intestine (colon), while Crohn&rsquo;s disease involves inflammation that extends further into the intestinal wall and can affect any part of the gastrointestinal system.</p>

<p>It is not known why some people have IBD and others do not, but it is known that IBD is the result of abnormal immune system activity. In people who have IBD, the immune system reacts to environmental factors that trigger inflammation. These environmental factors could be due to allergic reactions, viral infections, or bacterial infections. There is also much evidence that suggests some people have a genetic predisposition to IBD.</p>

<h2>IBD flare-ups and stress</h2><p>
People with IBD typically experience periods of relapse and remission&mdash;symptoms are present at times and go into remission at others. Research shows that stress can be a significant factor in IBD flare-ups.</p>

<p>Being diagnosed with Crohn&rsquo;s disease or ulcerative colitis may increase worry, anxiety, or depression that could be exacerbated by day-to-day stress.</p>

<p>Stress is a topic that you should be discussing with your healthcare provider. If you are unable or uncomfortable visiting your healthcare provider&rsquo;s office during the pandemic, you may want to consider a telehealth appointment.</p>

<p>In addition to working with a healthcare provider and adhering to a treatment plan, people with IBD are also advised to practice stress management in order to help keep flare-ups in check.</p>

<p>Some stress management tools to consider are:</p>

<ul>
	<li><strong>Exercise daily. </strong>Regular physical activity can reduce stress levels, ease symptoms, and also benefit your overall physical and mental health. Because IBD can make exercise more challenging, people are advised to discuss safe approaches to exercise with their healthcare providers before starting a new routine or activity.</li>
	<li><strong>Participate in a support group. </strong>Speaking with others who are dealing with the same disease can ease your stress level and help you feel less alone. Many support groups meet online, which is helpful in limiting your exposure to coronavirus.</li>
	<li><strong>Keep a journal.</strong> Keeping a journal of how you are feeling each day&mdash;both physically and mentally&mdash;can provide useful information to both you and your healthcare provider and can help you recognize patterns in symptoms and moods. Journaling can also help you keep track of the things that are going well.</li>
	<li><strong>Work with a mental health practitioner. </strong>Approaches like cognitive behavioral therapy may help people with IBD manage the mental burden of the condition, including stress.</li>
	<li><strong>Mindfulness activities.</strong> These include things like yoga, meditation, and breathing exercises.</li>
</ul>

<p>Remember that treating IBD is not a one-size-fits all approach. This applies to both the physical symptoms as well as the emotional and mental burdens. The important thing is finding an approach that works for you.</p>


Understanding the connection between IBD and stress, with strategies to reduce stress.

/digestive-health/crohns-disease/supplements-your-body-craves-ibd

<p>You may think you&#39;re eating well to control your inflammatory bowel disease (IBD) symptoms, but ulcerative colitis and Crohn&#39;s disease can do a number on your nutrition behind the scenes. Living with IBD, taking certain medications and undergoing surgery can lead to problems from mineral absorption to dehydration to osteoporosis, explains Robin Miller, MD, an integrative medicine specialist and medical director of Triune Integrative Medicine in Medford, Oregon.&nbsp;</p>

<p>If you&#39;re living with a form of IBD, ask your healthcare provider (HCP) if you&#39;re at risk for these common nutritional problems and whether you should be taking vitamin or nutritional supplements.&nbsp;</p>

<ul>
	<li><strong>Iron:&nbsp;</strong>About one-third of people with IBD have an iron deficiency, which can be due to not getting enough iron in your diet, your body not absorbing iron very well or blood loss, says Dr. Miller. Your HCP may suggest a liquid iron supplement that&#39;s gentle on your stomach and easy for your body to absorb, or you may need to take iron by intravenous (IV) supplementation. The dosage varies according to how low your iron levels are.&nbsp;</li>
	<li><strong>Vitamin B12:</strong> About 10-20 percent of people with Crohn&#39;s disease are deficient in vitamin B12. Surgery to remove part of the ileum&mdash;the section of small intestine where vitamin B12 is&nbsp;absorbed&mdash;raises the risk of deficiency, and usually means you&#39;ll need to supplement your diet going forward. Vitamin B12 is often given as a monthly injection.&nbsp;</li>
	<li><strong>Folate:&nbsp;</strong>Nearly one-third of patients with Crohn&#39;s disease and about 10 percent of people with ulcerative colitis have a folate deficiency. Reasons include a poor diet, poor absorption and side effects of your medications (such as sulfasalazine and methotrexate). Usually 1 mg a day is enough, but your HCP will know what&#39;s right for you. Taking a folate supplement is recommended for people taking methotrexate or sulfasalazine and women who are pregnant, says Miller.&nbsp;</li>
	<li><strong>Calcium:&nbsp;</strong>In IBD, calcium deficiency is usually due to a poor diet, poor absorption and diarrhea. Corticosteroids can also lower your calcium absorption, which can lead to delayed growth in children and osteoporosis in adults, explains Miller. The recommended dosage is 1,000 to 1,500 mg per day, which should be divided into two to three doses of 500 mg each. Calcium citrate is the easiest form to absorb, especially if you&#39;re also taking a proton pump inhibitor, a medication that reduces stomach acid, says Miller.&nbsp;</li>
	<li><strong>Vitamin D:  </strong>As many as two-thirds of people with Crohn&#39;s disease and up to 45 percent of those with ulcerative colitis have a vitamin D deficiency, mostly due to a poor diet. In Crohn&#39;s, surgery that removes the small bowel makes absorption difficult. Most people with IBD need 1,500 to 2,000 IUs of Vitamin D3 daily, but you may need more if you&#39;re on steroids or if you&#39;re overweight, Miller says.&nbsp;</li>
	<li><strong>Magnesium:</strong> Anywhere from 10 percent to nearly 90 percent of IBD sufferers have a magnesium deficiency. Diarrhea can contribute to this problem, but taking magnesium supplements can make diarrhea worse. People need to be tested for magnesium deficiency and then treated based on the results. Intravenous supplementation is often used for severe deficiency.&nbsp;</li>
	<li><strong>Multivitamin: &nbsp;</strong>Because people with IBD tend to have trouble absorbing minerals and micronutrients, a general multivitamin is a good idea to help maintain healthy levels of essential nutrients.&nbsp;</li>
</ul>

<p>Remember, don&#39;t start taking any IBD supplements without talking to your healthcare provider first. During a routine checkup, your healthcare provider can evaluate your symptoms and perform blood tests to see which nutritional supplements you may need.</p>


Nutritional Supplements for People with Crohn's Disease

Common nutritional deficiencies in people who have IBD and the supplements that can help.

/digestive-health/crohns-disease/drug-options-colitis-crohns

<p>Recent years have given rise to a treatment revolution for the more than 1.4 million Americans who live with inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn&#39;s disease. &quot;Now, more than ever before, we can control these diseases, and we have options that really work,&quot; says David Rubin, MD, chief gastroenterologist at the University of Chicago Medicine and co-director of its Digestive Diseases Center.&nbsp;</p>

<p>The goal of treatment is to cut down on inflammation in order to stop your symptoms (known as remission), prevent flares and improve your quality of life. Your treatment plan is unique to your symptoms and disease, but most people with IBD need some prescription medication to keep the disease in check. These common drugs come in various formulations, including oral, topical, rectal, intravenous (IV) and injection.&nbsp;</p>

<p>To get your IBD under control, talk with your&nbsp;doctor&nbsp;about these colitis and Crohn&#39;s disease medications to see which option might be best for you.&nbsp;</p>

<h2>Aminosalicylates&nbsp;</h2><p>
These anti-inflammatory drugs (such as sulfasalazine, mesalamine,&nbsp;olsalazine&nbsp;and&nbsp;balsalazide) are often used to treat mild to moderate ulcerative colitis, and sometimes Crohn&#39;s disease. They&#39;re also called 5-ASA drugs because they contain 5-aminosalicylic acid. But they aren&#39;t the&nbsp;same thing as ASA, more commonly known as aspirin, which can actually worsen IBD. 5-ASA drugs take about two weeks to stop bleeding symptoms and about six weeks to achieve remission. They can be used both during active disease and as maintenance therapy to prevent flares.&nbsp;</p>

<h2>Corticosteroids&nbsp;&nbsp;</h2><p>
These fast-acting anti-inflammatory drugs (including prednisone, methylprednisolone, hydrocortisone and budesonide) work by suppressing the immune system. Most people feel better within a few days, but corticosteroids aren&#39;t a long-term solution. They can help you through a flare or jumpstart relief while you&#39;re waiting for slower-acting therapies to kick in. But they should be used only at the lowest dose for the shortest time, if at all. &quot;Corticosteroids carry serious side effects, including a high risk of infections. The goal of good treatment is to avoid steroid use,&quot; says Dr. Rubin.&nbsp;</p>

<h2>Immunomodulators&nbsp;</h2><p>
These drugs (including methotrexate,&nbsp;azothioprine, 6-mercaptopurine, cyclosporine A and tacrolimus) reduce inflammation by quieting an overactive immune system. They&#39;re a good standby choice when 5-ASA, corticosteroids and antibiotics don&#39;t work, or they can be used in combination with corticosteroids or biologics. They can take several weeks or up to six months to work and are intended to control IBD symptoms over the long term.&nbsp;</p>

<h2>Antibiotics&nbsp;</h2><p>
Antibiotics (such as metronidazole, ciprofloxacin and rifaximin) are mainly used to treat infections and sometimes flares. While you might read that antibiotics can be used as long-term therapy to control your symptoms, Rubin says that&#39;s not usually recommended.&nbsp;</p>

<h2>Biologics&nbsp;</h2><p>
This newest class of IBD drugs is a relatively safe, effective option for people with moderate to severe disease. In the past, biologics were recommended only after other therapies had failed, but now doctors recommend them earlier on to get the best response, says Rubin. The drugs (including adalimumab, infliximab, natalizumab, certolizumab pegol, golimumab and vedolizumab) contain engineered proteins that target specific parts of the immune system without dampening it down. The two types of biologic drugs&mdash;anti-TNF (tumor necrosis factor) inhibitors and selective adhesion molecule (SAM) inhibitors&mdash;work on different targets.&nbsp;</p>

<h2>Drugstore Options&nbsp;</h2><p>
Over-the-counter (OTC) medications may be used occasionally to boost symptom relief. These include pain relievers, antidiarrheal medications and laxatives.&nbsp;</p>

<p>For occasional pain relief&nbsp;for&nbsp;your&nbsp;Crohn&#39;s disease or colitis, try acetaminophen (Tylenol). Avoid other pain relievers (such as ibuprofen, aspirin or naproxen), which can damage the bowel wall or hinder its ability to heal, explains Rubin. And while it&#39;s okay to take loperamide (Imodium) for diarrhea sometimes, maybe before a social event, it&#39;s not wise to make it a habit. In fact, try not to make a habit of any OTC meds. &quot;We don&#39;t want patients relying on over-the-counter treatments to manage their disease,&quot; says Rubin. These options don&#39;t address the inflammation or damage, and they can mask your symptoms, meaning that your IBD doesn&#39;t improve and may actually get worse.&nbsp;</p>

<p><em></em></p>


Whether you have mild or severe IBD, these Crohn's meds can help stop your symptoms. 

/digestive-health/crohns-disease/crohns-treatment-surgery

<p>Many people with Crohn&rsquo;s disease will need surgery at some point during their lifetime.</p>

<p>There are a number of different surgical procedures that are commonly used to treat Crohn&rsquo;s disease. The type of surgery used will depend on the parts of the gastrointestinal tract that are impacted by Crohn&rsquo;s and the complications a person is experiencing.</p>

<p>The goals of surgery are to provide relief from symptoms and complications, improve quality of life, and preserve healthy tissue in the gastrointestinal tract.</p>

<h2>When surgery is recommended</h2><p>
Surgery for Crohn&rsquo;s disease may be recommended if the disease does not respond to treatment with medication or if medication must be discontinued due to side effects. Surgery may also be needed to address a complication from Crohn&rsquo;s disease, such as a blockage, perforation, abscess, or bleeding in the intestines.</p>

<h2>Types of surgical procedures</h2><p>
The type of surgical procedure will depend on the symptom or complications being addressed, and the location of the symptom or complication. There are several different surgical procedures that may be used to treat Crohn&rsquo;s disease. In some cases, these surgical procedures can be performed with endoscopy or laparoscopy.</p>

<ul>
	<li><strong>Strictureplasty.</strong> A stricture is a narrowing of a passage in the body. Crohn&rsquo;s disease can cause strictures in the intestinal tract. A strictureplasty is a procedure to widen a section of intestine that has become narrowed.</li>
	<li><strong>Resection.</strong> This procedure involves removing a portion of the intestine that has a stricture or has been damaged by Crohn&rsquo;s. Resection surgery can be performed on the small intestine (called a <em>small bowel resection</em>), the large intestine (called a <em>large bowel resection</em>), or the <em>terminal ileum</em> that connects the small intestine to the large intestine (called an <em>ileocecal resection</em>).</li>
	<li><strong>Abscess drainage.</strong> An abscess is a collection of pus (which is a mixture of white blood cells, germs, and dead tissue). Abscesses are a complication of Crohn&rsquo;s disease that can occur inside the abdominal cavity, in the pelvic organs, or the anal area. They can also be a complication following surgery. If an abscess cannot be drained with other methods, it may need to be drained surgically in addition to being treated with antibiotics.</li>
	<li><strong>Fistula removal.</strong> Abscess and ulcers in the intestines can cause fistulas&mdash;passageways between the intestines and adjacent parts of the body. These may require surgery to repair.</li>
</ul>

<p>In cases where the disease is severe or there are severe complications, the colon and/or rectum may need to be removed with surgery:</p>

<ul>
	<li><strong>Colectomy.</strong> This procedure involves the removal of the colon, which is part of the large intestine. Once the colon is removed, the small intestine will be connected to the rectum to allow waste to leave the body.</li>
	<li><strong>Proctocolectomy. </strong>This procedure involves removing the colon as well as the rectum. Surgeons will make a small opening in the abdomen that will allow waste to leave the body. This opening is called a stoma. After this surgery, a person will wear a pouch under their clothes to collect waste, which can be emptied as needed.</li>
</ul>

<h2>Work with your healthcare provider</h2><p>
As mentioned above, most people with Crohn&rsquo;s disease require surgery at some point. The best thing you can do as a patient with Crohn&rsquo;s disease is to work with a healthcare provider. Educating yourself about the disease, your treatment options, and the surgical procedures used to treat Crohn&rsquo;s disease can help you feel more confident when making treatment decisions.</p>


How is Surgery Used to Treat Crohn’s Disease

Learn about the types of surgery that are used to treat Crohn’s disease and complications from Crohn’s disease.

/digestive-health/ibd/preventing-malnutrition-ibd

<p style="margin-left:0in; margin-right:0in">Good nutrition is one of the most important components of good overall health. But when you are living with a form of inflammatory bowel disease (IBD), maintaining good nutrition can be a significant challenge.</p>

<p style="margin-left:0in; margin-right:0in">IBD refers to Crohn&rsquo;s disease and ulcerative colitis (UC) two chronic conditions that cause attacks of inflammation in the gastrointestinal tract. Attacks are commonly referred to as flares or flare-ups.</p>

<p style="margin-left:0in; margin-right:0in">Reducing the duration, severity, and frequency of flares is a central goal of treating IBD. While there is no cure for either Crohn&rsquo;s disease or UC, there are therapies that can help manage these conditions, including medications and surgeries. Nutrition is also an important focus of treatment.</p>

<p style="margin-left:0in; margin-right:0in">While Crohn&rsquo;s disease and UC are separate conditions that impact the body in different ways, they share several overlapping symptoms, including diarrhea, pain, and bloody stools and bleeding from the rectum.</p>

<p style="margin-left:0in; margin-right:0in">Likewise, each condition is associated with a different set of potential complications, but there are several complications that overlap. One overlapping complication is malnutrition.</p>

<h2>What is malnutrition?</h2><p style="margin-left:0in; margin-right:0in">
Our bodies require a balance of specific nutrients, vitamins, and minerals to remain healthy. Malnutrition is what happens when the body does not get the right balance of those nutrients, vitamins, and minerals.</p>

<p style="margin-left:0in; margin-right:0in">This includes getting too few nutrients (<em>undernutrition</em>) as well as getting too many (<em>overnutrition</em>). Both are harmful to a person&rsquo;s health. For example, overnutrition can lead to being overweight or obese, which can have serious consequences to a person&rsquo;s health.</p>

<p style="margin-left:0in; margin-right:0in">Here, the focus will be undernutrition, which is the form of malnutrition that is commonly associated with IBD.</p>

<h2>IBD and undernutrition</h2><p style="margin-left:0in; margin-right:0in">
There are several different ways that IBD can contribute to undernutrition, including:</p>

<ul>
	<li><strong>IBD can ruin a person&rsquo;s appetite.</strong> The idea of eating anything can be very unappealing when you are experiencing symptoms like diarrhea and abdominal pain. As a result, a person with IBD may not consume enough food and nutrients.</li>
	<li><strong>Eating a balanced diet can be difficult.</strong> Different foods contain different nutrients, and it&rsquo;s recommended that a person eats a variety of foods. Because certain foods can trigger or worsen IBD symptoms, some people may avoid certain foods.</li>
	<li><strong>Malabsorption.</strong> Inflammation can impair the body&rsquo;s ability to absorb nutrients from food. This means that while enough nutrients end up in the GI tract, the body is unable to use these nutrients. Diarrhea can also contribute to poor nutrient absorption, causing food to move through the GI tract too quickly and incompletely digested.</li>
	<li><strong>Anemia.</strong> Many people with IBD experience bleeding in the GI tract. Blood loss can lead to iron deficiency and anemia, a condition where the body lacks enough healthy red blood cells. Poor nutrition and malabsorption can also contribute to anemia.</li>
</ul>

<p style="margin-left:0in; margin-right:0in">Every organ and system in the body depends on nutrients to function well, and being malnourished can cause many complications throughout the body. The muscles, bones, brain, immune system, kidneys, skin, and reproductive organs can all become damaged or function less well because of malnutrition.</p>

<h2>Avoiding and addressing malnutrition</h2><p style="margin-left:0in; margin-right:0in">
Your best source of information will be your healthcare provider. Blood tests can give an in-depth look at your nutrition, and it can help guide you and your healthcare provider in coming up with an eating plan that addresses your specific nutritional needs. Keeping a record of the foods you eat day to day, along with a record of how you feel, can provide helpful information.</p>

<p style="margin-left:0in; margin-right:0in">Your healthcare provider can also prescribe nutritional supplements or other therapies that can help boost the levels of any nutrients your body is lacking. Tell your healthcare provider about any medications, supplements (including herbal supplements), and over the counter drugs you are taking.</p>


Preventing Malnutrition When You Have Crohn’s Disease

Crohn’s disease can make it difficult to get enough nutrients, vitamins, and minerals to keep your body healthy.

/digestive-health/ibd/soluble-insoluble-fiber-ibd

<p style="margin-left:0in; margin-right:0in">Read any article or book about good nutrition, and you&rsquo;ll end up reading about dietary fiber&mdash;and for good reason. An adequate amount of dietary fiber helps promote good digestion, regulate blood sugar and cholesterol levels, lower the risk of colorectal cancer, and promote a healthy gut microbiome, among other benefits.</p>

<p style="margin-left:0in; margin-right:0in">Studies have found that many people with inflammatory bowel disease (IBD) consume less fiber than people who do not have IBD. Studies have also found that increasing fiber intake may have significant benefits for people with IBD, and adequate amounts of fiber may even help improve symptoms and reduce disease activity.</p>

<p style="margin-left:0in; margin-right:0in">Here, we look at the two main types of dietary fiber&mdash;soluble and insoluble&mdash;and why it&rsquo;s important for people with IBD to understand the difference.</p>

<h2>Crohn&rsquo;s Disease and UC</h2><p style="margin-left:0in; margin-right:0in">
Inflammatory bowel disease (IBD) refers to a pair of chronic inflammatory disorders that affect the gastrointestinal (GI) tract, also called the digestive tract. While Crohn&rsquo;s disease and UC are both IBD, it&rsquo;s important to understand that they are different conditions that impact the body in different ways.</p>

<ul>
	<li><strong>Crohn&rsquo;s disease</strong> can cause attacks or flares of inflammation anywhere in the GI tract&mdash;the mouth, throat, esophagus, stomach, small intestine, large intestine (colon), rectum, and anus. The most commonly affected areas are the colon and the ileum (the last part of the small intestine).</li>
	<li><strong>Ulcerative colitis (UC)</strong> causes attacks or flares of inflammation that only occur in the colon and rectum.</li>
</ul>

<p style="margin-left:0in; margin-right:0in">Symptoms can include diarrhea, bloody stools, bleeding from the rectum, pain, weight loss, and fatigue. Both conditions can cause a number of long-term complications.</p>

<h2>Soluble and insoluble fiber</h2><p style="margin-left:0in; margin-right:0in">
Fiber is a nutrient&mdash;more specifically, a carbohydrate. Unlike many other types of carbohydrates, fiber is not broken down as it passes through the digestive system. It passes through undigested.</p>

<p style="margin-left:0in; margin-right:0in">Dietary fiber comes in two main forms, soluble and insoluble:</p>

<ul>
	<li><strong>Soluble fiber</strong> dissolves in water (and during digestion). In the GI tract, it has a gel-like consistency, which helps add bulk to stool and slow down digestion. Some examples of foods that contain soluble fiber include oatmeal, beans, barley, peas, apples, and citrus fruits.</li>
	<li><strong>Insoluble fiber</strong> does not dissolve as it passes through the GI tract, and it causes food to move more quickly through the digestive system. Whole wheat flours, nuts, potatoes, and green beans are some examples of foods that contain insoluble fiber.</li>
</ul>

<p style="margin-left:0in; margin-right:0in">A balanced diet should include both soluble and insoluble fibers, though the foods a person can tolerate will be different during an IBD flare.</p>

<h2>Fiber intake during a flare</h2><p style="margin-left:0in; margin-right:0in">
Flares, attacks, or episodes refer to times when symptoms get worse. Remission refers to times when symptoms go away, or at least become less severe. One key focus of treatment is to reduce the number of flares and increase the time symptoms are in remission. Medications and surgeries can help achieve this treatment goal. Nutrition is also an important focus of treatment.</p>

<p style="margin-left:0in; margin-right:0in">People with IBD are advised to avoid insoluble fibers during flares. Insoluble fibers are rough on the digestive system and cause foods to move more quickly through the GI tract, and may contribute to symptoms like diarrhea, bloating, and cramping.</p>

<p style="margin-left:0in; margin-right:0in">During a flare, people with IBD are advised to opt for lower-fiber foods (like bananas, cooked fruit, and cooked non-cruciferous vegetables), which are more easily digested but still contain important nutrients. Refined grains like oatmeal, white rice, and white pasta are all sources of fiber, and may be better tolerated than whole grains during a flare.</p>

<p style="margin-left:0in; margin-right:0in">It&#39;s important to remember that IBD affects different people in different ways, and your best source of information will be a healthcare provider.</p>

<p style="margin-left:0in; margin-right:0in">If you are living with IBD, one of the best things you can do is keep a record of the foods you eat and how you feel each day. This can help you and your healthcare provider identify foods that trigger symptoms, nutrients your diet is missing, and ways to get the most out of your treatment plan.</p>


Soluble Fiber, Insoluble Fiber, and Crohn’s Disease

Adequate amounts of fiber are a key to good nutrition, but Crohn’s disease can make eating enough of any nutrient a challenge.

/digestive-health/ulcerative-colitis/tips-living-ulcerative-colitis-crohns

<p>Learn how to feel better each day with IBD.</p>


6 Tips for Living Well with Crohn's Disease

/digestive-health/ibd/working-jobs-career-ibd

<p style="margin-left:0in; margin-right:0in">One of the most challenging aspects of living with a chronic disease like Crohn&rsquo;s disease is the ways in which it can interfere with normal everyday life, including things like jobs, work, and careers.</p>

<p style="margin-left:0in; margin-right:0in">Flaring symptoms can result in missed workdays. The fatigue that often accompanies inflammatory conditions can mean the hours you spend at work are less productive. Some jobs&mdash;particularly high stress jobs or physically demanding jobs&mdash;may be inadvisable and put your health at risk. Even when things are going well and Crohn&rsquo;s disease is in remission, the condition is still demanding to manage.</p>

<p style="margin-left:0in; margin-right:0in">Despite all this, many people living with Crohn&rsquo;s disease are able to work and build careers. Here, we look at some strategies that can help you manage everything from choosing the right job for you, to preparing for a day at work, to disclosing your diagnosis to an employer.</p>

<h2>Stick with your treatment plan</h2><p style="margin-left:0in; margin-right:0in">
This is the one step that will remain true no matter your job or career&mdash;the best way to keep Crohn&rsquo;s disease from interfering with work is to keep Crohn&rsquo;s disease well-controlled. This means taking your medications as prescribed, keeping your appointments with your healthcare provider, and avoiding triggers&mdash;even when the disease is in remission.</p>

<h2>Choose the right job for you</h2><p style="margin-left:0in; margin-right:0in">
When choosing a job, it&rsquo;s important to consider your own strengths, what you need from a job, and what accommodations you may need to succeed at both work and with Crohn&rsquo;s disease management.</p>

<p style="margin-left:0in; margin-right:0in">Avoiding triggers should be something everyone considers when searching for or applying to jobs. For example, stress is a potential trigger for Crohn&rsquo;s disease flares, and jobs that are high stress or require long hours may have a higher risk of derailing your Crohn&rsquo;s disease management. Fatigue is also common among people with inflammatory disorders, and jobs that are physically demanding may not be a good fit as a result. Because certain foods can trigger symptoms, people with Crohn&rsquo;s disease may want to avoid working in restaurants and food service jobs where it can be easy to eat foods that aren&rsquo;t part of a management plan.</p>

<h2>Maintain a healthy work/life balance</h2><p style="margin-left:0in; margin-right:0in">
Avoid becoming overworked and overstressed, which can lead to flares and other health issues. Take time for yourself after work to rest and relax and do things you enjoy, whether it&rsquo;s reading a book, watching a movie, or spending time with friends.</p>

<h2>Decide when and what to disclose</h2><p style="margin-left:0in; margin-right:0in">
Deciding to disclose a diagnosis of Crohn&rsquo;s disease to an employer is your decision and may not be required. Disclosing a diagnosis will be needed if you need to request accommodations from your employer.</p>

<p style="margin-left:0in; margin-right:0in">What is an accommodation? It is an adjustment that makes it possible for you to do your job while managing your condition. For example, you may request that your work area is near a restroom or request a flexible work schedule on weeks where you have an appointment with a healthcare provider. Under the Americans with Disabilities Act (ADA), people with Crohn&rsquo;s disease cannot be discriminated against for requesting reasonable accommodations. However, in order to be protected under the ADA, an employer must be made aware of your condition.</p>

<p style="margin-left:0in; margin-right:0in">While you may not need to disclose all the details, you will be required to provide documentation of your diagnosis, such as a note from your healthcare provider (although different employers may have different preferences). The Family and Medical Leave Act (FMLA) considers Crohn&rsquo;s disease a &ldquo;serious health condition,&rdquo; and it allows someone with a medical disorder to take up to 12 weeks off due to health issues related to their condition. Keep in mind that you are only eligible for these benefits after working somewhere for at least 12 months.</p>

<h2>Prepare for a day at work</h2><p style="margin-left:0in; margin-right:0in">
So you&rsquo;ve found a job that&rsquo;s a good fit for you and decided whether now is the right time to disclose your diagnosis to your employer. It&rsquo;s time to prepare for a day at work. Here are a few strategies that can help:</p>

<ul>
	<li>Learn your way around your workplace and know where the restrooms are.</li>
	<li>Bring medications, any medical supplies you need, and an extra set of clothes (in case of an emergency).</li>
	<li>Pack lunch and snacks. This will help you stick to your eating plan and avoid foods or eating habits that can trigger symptoms.</li>
	<li>If you are going out with coworkers, consider checking the restaurant&rsquo;s menu ahead of time&mdash;and if necessary, request alterations or substitutions when placing your food order.</li>
	<li>Consider learning simple meditation or breathing exercises to help with stress throughout the day.</li>
</ul>

<p style="margin-left:0in; margin-right:0in">Work and how work impacts your Crohn&rsquo;s disease management is also something that you can discuss with your healthcare provider.</p>


Tips for finding the right job, maintaining work/life balance, and preparing for a day at work.

/digestive-health/crohns-disease/crohns-preventing-flare-ups

<p>Crohn&rsquo;s disease follows a cycle of remission and relapse, where symptoms are controlled at times and flare at other times. While this cycle of relapse and remission can be unpredictable, there are steps you can take to help prevent flare ups.</p>

<h2>Seek treatment</h2><p>
The first step to controlling Crohn&rsquo;s disease is to work with a healthcare provider. Crohn&rsquo;s disease is a chronic condition that requires treatment and monitoring. Typically, treatment is overseen by a gastroenterologist, a doctor who specializes in the treatment of disease and disorders that affect the digestive system. A healthcare team may also include other healthcare providers and specialists.</p>

<h2>Follow your treatment plan</h2><p>
Your treatment plan for Crohn&rsquo;s will depend on a number of factors, including the part of the GI tract that are affected by the disease, the severity of symptoms, if you have any other health conditions, and your overall health.</p>

<p>The goals of treatment will be to control inflammation, ease symptoms, prevent and address complications, and keep the disease in remission. Treatment for Crohn&rsquo;s disease may include a combination of medications, bowel rest, and surgery:</p>

<ul>
	<li><strong>Medications.</strong> There are a variety of medications used to treat Crohn&rsquo;s disease, including medications that reduce inflammation and medications that act on the immune system to inhibit inflammatory processes in the body.</li>
	<li><strong>Bowel rest.</strong> This involves giving your digestive tract a break by not eating, or not eating certain foods, for a period of time. This process must be monitored by a healthcare provider. Nutrients may be delivered in liquid form that you drink, through an IV, or with a feeding tube.</li>
	<li><strong>Surgery.</strong> Surgery to remove damaged or inflamed sections of the GI tract is also used to treat Crohn&rsquo;s disease.</li>
</ul>

<p>It is important to follow all treatment steps outlined by your healthcare team. This means adhering to medication schedules, following the protocols for a bowel rest, and following steps to ensure a successful surgery.</p>

<h2>Avoid triggers</h2><p>
Triggers are things that cause symptoms to flare or make symptoms worse. While triggers can vary from person to person, there are some well-known triggers:</p>

<ul>
	<li><strong>Certain foods.</strong> Talk to your healthcare team about foods you should be avoiding. Because different foods are triggers for different people, keeping a food journal can also help you identify your trigger foods.</li>
	<li><strong>Smoking.</strong> Smoking is associated with more severe Crohn&rsquo;s disease, worse outcomes from treatments, and complications. If you smoke, quit. You also need to avoid secondhand smoke.</li>
	<li><strong>Stress.</strong> Stress can trigger flares and make Crohn&rsquo;s symptoms worse. Take steps to reduce stress. These can include mindfulness activities like yoga or meditation, or something as simple as scheduling time to yourself. You should also talk to your healthcare team about stress.</li>
	<li><strong>Medications.</strong> Some medications, including non-steroidal inflammatory drugs (NSAIDs) and antibiotics, can trigger flares. Ask your healthcare providers for a list of medications that you should avoid.</li>
</ul>

<h2>Eat well and exercise</h2><p>
Eating well and staying physically active are important components of a healthy lifestyle. There are no specific diet or exercise recommendations for people with Crohn&rsquo;s disease and everyone&rsquo;s specific needs will be different. You are encouraged to talk to your healthcare providers about these topics, including how Crohn&rsquo;s disease impacts your nutritional needs, and how to exercise comfortably and safely.</p>


How to Prevent Crohn’s Disease Flare Ups

Try these strategies to help keep Crohn’s disease symptoms under control.

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<p style="margin-left:0in; margin-right:0in">Quality sleep is an important component of a healthy lifestyle. Simply put, your body needs sleep to function. More specifically, your body needs sleep to remove cellular waste in the brain, to repair and restore damaged cells, and to regulate immune system activity (including inflammation).</p>

<p style="margin-left:0in; margin-right:0in">Unfortunately, many things can interfere with sleep, including many disorders and conditions. One example is Crohn&rsquo;s disease, which is one of the two main types of inflammatory bowel disease (IBD).</p>

<h2>Crohn&rsquo;s disease and sleep</h2><p style="margin-left:0in; margin-right:0in">
Anyone familiar with the symptoms of Crohn&rsquo;s disease should immediately understand how the condition can interfere with sleep. While the exact symptoms and the severity of those symptoms will vary from person to person, some of the common symptoms include persistent diarrhea, bloody stools, abdominal pain, constipation, frequent bowel movements, and the feeling that bowel movements are incomplete.</p>

<p style="margin-left:0in; margin-right:0in">Even when the disease is in remission, people with Crohn&rsquo;s disease may find it difficult to sleep. Remission refers to a state where the disease has become inactive and is not causing symptoms. Achieving and maintaining remission is a major goal of treating Crohn&rsquo;s disease. However, remission does not mean the disease is cured and symptoms can relapse. The uncertainty, unpredictability, and stress of not knowing when a relapse will occur can keep a person up at night.</p>

<p style="margin-left:0in; margin-right:0in">Sleep, stress, and relapses can also have a cyclical relationship. Stress can make it difficult to sleep. Stress and a lack of sleep can cause symptoms to relapse or worsen. Symptoms can disrupt sleep and cause more stress.</p>

<h2>Strategies for improving sleep</h2><p style="margin-left:0in; margin-right:0in">
If you have Crohn&rsquo;s disease, the best thing you can do for your health is to work with healthcare providers who have experience treating IBD. There is no cure for Crohn&rsquo;s disease, but there are treatments that can help control inflammation, ease symptoms, and prevent complications.</p>

<p style="margin-left:0in; margin-right:0in">Sleep is something that you should be discussing with your healthcare provider, especially if you find yourself struggling to get a good night&rsquo;s sleep. Keeping track of sleep in your symptom journal can provide helpful information during your appointment.</p>

<p style="margin-left:0in; margin-right:0in">Additionally, there are numerous strategies that can help improve the quality of your sleep:</p>

<ul>
	<li><strong>Have a consistent bedtime.</strong> Go to bed around the same time every night and get up around the same time every morning&mdash;including weekends.</li>
	<li><strong>Have a schedule.</strong> Nighttime rituals can help signal to your mind and body that it&rsquo;s time to go to sleep. Brushing your teeth, spending time reading a book, and meditating are some examples of things you may want to include.</li>
	<li><strong>Exercise regularly.</strong> Being physically active is associated with better sleep&mdash;just avoid working out too close to your bedtime, which may have the opposite effect.</li>
	<li><strong>Avoid eating too much or too little before bed.</strong> Being too full or too hungry can make it difficult to sleep. If you find that you get hungry in the evening, choose a light, healthy snack. Avoid caffeinated foods and beverages in the afternoons and evenings.</li>
	<li><strong>Avoid alcohol and nicotine.</strong> Alcohol and nicotine can interfere with Crohn&rsquo;s disease management and interfere with sleep.</li>
	<li><strong>Put away screens.</strong> Blue light from phone, tablet, and computer screens stimulates your brain, making it more difficult to sleep. Consider putting screens away at least an hour before your scheduled bedtime.</li>
	<li><strong>Use your bed for sleep and intimacy.</strong> Doing work, scrolling through the internet, or eating in bed can interfere with your nightly routine. Your brain should recognize your bed as a place for intimacy and rest.</li>
	<li><strong>Create a restful environment.</strong> Make sure your room is dark and cool. Consider using a white noise machine or a fan to drown out disruptive noises.</li>
</ul>

<p style="margin-left:0in; margin-right:0in">Remember, Crohn&rsquo;s disease is a different experience for everyone. Your healthcare providers will be your best source of information about your diagnosis, your treatment, and how to address the challenges of living with Crohn&rsquo;s disease.</p>


Crohn’s Interfering with Sleep? Try These Strategies

Understanding the cyclical relationship between sleep problems and Crohn’s disease and what you can do about it.

/digestive-health/crohns-disease/crohns-talking-doctor-about-fatigue

<p>Fatigue is a common symptom of Crohn&rsquo;s disease as well as ulcerative colitis (the other main type of inflammatory bowel disease). There are a number of reasons that people who have Crohn&rsquo;s disease may feel tired, exhausted, or worn down. Here, we look at some of the ways Crohn&rsquo;s disease can contribute to fatigue and how to discuss fatigue with your healthcare providers.</p>

<p>One strategy that applies to all of the potential contributing factors listed below&mdash;talk to your healthcare provider about your energy levels and how you are feeling. Crohn&rsquo;s disease is a different experience for everyone, and your healthcare providers are your best source of information about your health.</p>

<h2>Inflammation</h2><p>
Under normal circumstances, inflammation is an immune response that protects the body from things like injury and infection by attacking and removing damaged tissue. However, inflammation can damage the body when it lasts too long or when it occurs in healthy tissue. When a person has an autoimmune disease, such as Crohn&rsquo;s disease, the immune system attacks healthy tissue.</p>

<p>Inflammation results in fatigue for a number of reasons:</p>

<ul>
	<li>Like other processes in the body, the cells that cause inflammation require energy, which means less energy for other things.</li>
	<li>Proinflammatory chemicals can disrupt the normal interaction of the nervous system and hormone-producing glands in the body.</li>
	<li>Inflammation can impact appetite, making it difficult to eat, or eat enough.</li>
	<li>Inflammation can also contribute to feelings of anxiety and depression, which can feel like fatigue.</li>
</ul>

<p>If you are living with Crohn&rsquo;s disease, keeping inflammation under control is an important focus of treatment. There are steps you can take to help keep inflammation under control:</p>

<ul>
	<li><strong>Adhere to your treatment plan.</strong> There are several medications that are used to reduce and control inflammation. If you have been prescribed a medication for Crohn&rsquo;s disease, it is important to follow your dosing schedule exactly as prescribed.</li>
	<li><strong>Avoid triggers.</strong> Triggers are things that cause symptoms to flare. Stress, smoking, certain medications (such as NSAIDs) and certain foods are common Crohn&rsquo;s triggers.</li>
	<li><strong>Adopt a healthy lifestyle.</strong> Regular exercise and eating a nutritious diet can help reduce inflammation. Talk to your healthcare provider about exercising safely and the foods you should be eating.</li>
</ul>

<h2>Malnutrition</h2><p>
Inflammation or damage in the digestive tract can disrupt the normal digestion of food and absorption of nutrients. Pain, cramping, diarrhea, and other uncomfortable Crohn&rsquo;s disease symptoms can make it difficult to eat or eat enough. As a result, people with Crohn&rsquo;s disease are at risk for malnutrition and nutritional deficiencies.</p>

<p>Nutritional deficiencies that are common among people with Crohn&rsquo;s disease include deficiencies in B12, calcium, folate, selenium, zinc, iron, and vitamin D.</p>

<p>Deficiencies in iron, B12, and folate can result in anemia, a condition where the body does not have enough healthy red blood cells to supply organs and tissues with oxygen. Blood loss, due to bleeding in the digestive tract, can also contribute to anemia.</p>

<p>Bloodwork and exams can help identify nutritional deficiencies and your healthcare providers can recommend ways to address deficiencies. This may include changes to diet and adding vitamins and/or supplements to your diet. People with Crohn&rsquo;s disease may find it helpful to work with a registered dietitian or nutritionist.</p>

<h2>Sleep disturbances</h2><p>
Many people with IBD, including Crohn&rsquo;s disease, have trouble sleeping. Physical symptoms like pain, cramping, and gas can make it difficult to get a good night&rsquo;s rest. The mental burden of the disease can also contribute to poor sleep quality. Changes in sleeping habits can also be a symptom of depression and anxiety.</p>

<p>If you are having trouble sleeping or have noticed a change in your sleep habits, share this with your healthcare provider. Poor sleep quality is also associated with higher disease activity and worse outcomes for people with IBD.</p>

<p>You should also talk to your healthcare provider about the moods, emotions, and feelings you are having. Mental and emotional health should be a focus of treatment for Crohn&rsquo;s disease and IBD.</p>

<h2>Medications</h2><p>
Fatigue is a side effect of many medications, including medications used to treat Crohn&rsquo;s disease. Ask your healthcare provider if fatigue could be a side effect of the medications you are taking. Your healthcare provider may be able to suggest a different medication, or strategies for lessening fatigue.</p>


Crohn’s Disease: Talking to Your Doctor About Fatigue

Learn four ways Crohn’s disease contributes to fatigue and how to discuss fatigue with your healthcare providers.

/digestive-health/crohns-disease/crohns-how-to-eat

<p>The foods you eat can play an important role in managing Crohn&rsquo;s disease. Certain foods can trigger or exacerbate symptoms. Adopting or following different eating habits may help prevent flare ups and reduce inflammation. Eating well is also important to overall health and may help you feel better.</p>

<p>Below are some eating strategies to think about. Remember that your best source of information about your health is your healthcare provider, and you should not make any drastic changes to your diet without talking to your healthcare provider.</p>

<h2>What to avoid</h2><p>
Eating certain foods can trigger symptoms or make symptoms worse. These trigger foods can vary from person to person, but some are more common than others. This list of foods includes:</p>

<ul>
	<li><strong>Lactose.</strong> Milk and dairy products may aggravate symptoms such as gas, abdominal pain, and diarrhea. You may want to choose lactose-free alternatives.</li>
	<li><strong>Non-absorbable sugars.</strong> This includes sorbitol, mannitol, and other sugar alcohols. These are found in sugar-free gum, ice cream, and candy, as well as some fruit juices, including prune, peach, and pear juice.</li>
	<li><strong>Sugary foods and drinks.</strong> The obvious ones include candy, soda, and sugary pastries. Also be wary of juices, which can be high in sugar. The best thing to do is look at the nutritional facts on the foods you eat and check the sugar content.</li>
	<li><strong>High fat foods.</strong> While you are checking the nutritional label, also have a look at the fat content. You want to avoid saturated fats and consume recommended amounts of unsaturated fats. Greasy and fried food should be avoided.</li>
	<li><strong>Insoluble</strong> <strong>fiber.</strong> People with Crohn&rsquo;s who are at a high risk of an obstruction are advised to eat a diet that is low in insoluble fiber, and all Crohn&rsquo;s patients are advised to avoid insoluble fiber during flare ups. Insoluble fiber can make symptoms like cramping and diarrhea worse. Examples of insoluble fiber include seeds, nuts, the skins on apples and other fruits, vegetables (especially raw vegetables), and whole grains.</li>
	<li><strong>Spicy foods.</strong> Avoid spicy foods, condiments, and ingredients, such as spicy peppers, hot sauce, chili powder, and cayenne pepper.</li>
	<li><strong>Alcohol.</strong> The relationship between alcohol and Crohn&rsquo;s disease symptoms is unclear and requires more research. But it is recommended that people with Crohn&rsquo;s disease limit drinking and pay attention to what they drink and how it affects them. Some research shows that certain alcoholic beverages may trigger symptoms more than others. Alcohol may also interact with medications.</li>
	<li><strong>Caffeinated drinks.</strong> Including coffee, tea, soda, and energy drinks.</li>
</ul>

<p>As mentioned above, trigger foods can vary from person to person. One thing you can do to help understand your trigger foods is keep a food journal, where you record what you eat, the quantities you eat, the times you eat, and your symptoms.</p>

<h2>What to eat</h2><p>
There is no specific diet or meal-planning approach that is recommended for people with Crohn&rsquo;s disease. General recommendations are that people with Crohn&rsquo;s disease follow a nutrient-rich diet, eat a variety of foods, and pay attention to trigger foods. People with Crohn&rsquo;s disease are also advised to eat between four and six smaller meals per day instead of three large meals.</p>

<p>Components of a nutrient-rich diet include adequate amounts of lean proteins, colorful fruits and vegetables, probiotic foods, and calcium-rich foods. It is also important to stay hydrated and drink plenty of water.</p>

<h2>What to ask your HCP</h2><p>
Working with a healthcare provider is paramount to managing Crohn&rsquo;s disease. In addition to your primary care physician and gastroenterologist, you may also want to work with a registered dietitian.</p>

<p>Crohn&rsquo;s disease impacts everyone differently, and there is no substitute for individual assessment and attention to your treatment plan. Your healthcare providers can help you come up with an eating plan based around your nutritional needs. They can also advise you on supplements that can address nutritional deficiencies and malnutrition that may occur as a result of Crohn&rsquo;s disease.</p>


How to Eat When You Have Crohn’s Disease

Foods to avoid and how to take a general approach to eating healthy when you have Crohn’s disease.

/digestive-health/crohns-disease/crohns-disease-mental-health

<p>Crohn&rsquo;s disease is a chronic disorder that causes inflammation in the digestive tract. It is one of the two main types of inflammatory bowel disease (IBD). The other type is ulcerative colitis (UC).</p>

<p>Depression and anxiety are more prevalent in people who have IBD, though the relationship between these conditions is not fully understood. It is believed that the relationship is complex and there are a number of factors at play, including:</p>

<ul>
	<li>Living with a chronic relapsing condition like IBD can cause feelings of chronic stress, uncertainty, poor self-image, and other negative emotions. These feelings may make existing symptoms of depression and anxiety worse.</li>
	<li>Stress and negative emotions can have physical effects on the body, disrupting the normal functioning of the gut and the immune system, and promoting inflammation. Stress and negative emotions can trigger or exacerbate flares of IBD symptoms.</li>
	<li>Living with depression and anxiety can also make it harder to adhere to the necessary steps a person must take to effectively manage IBD. This may lead to worse outcomes.</li>
</ul>

<p>Remember that you do not have to cope with IBD or negative emotions on your own. Your healthcare providers can help.</p>

<h2>Making mental health a focus of treatment</h2><p>
It is important to make mental health a focus of treatment for IBD. In order to provide you with the best treatment possible, your healthcare providers need to know how you are feeling. Tell your healthcare providers about:</p>

<ul>
	<li>The moods and emotions you are experiencing.</li>
	<li>How IBD symptoms are impacting your quality of life</li>
	<li>How moods and emotions are impacting your quality of life</li>
	<li>How moods and IBD are impacting your relationships</li>
	<li>Any difficulties you are having following your treatment plan for IBD</li>
</ul>

<p>Your healthcare team can recommend strategies for coping with the challenges of living with IBD and can refer you to other healthcare providers who can help, such as a therapist or psychiatrist who can accurately diagnose what you are experiencing and provide you with appropriate care.</p>

<h2>Symptoms of depression</h2><p>
Depression is a serious medical condition that requires treatment. It is important to be able to recognize the symptoms of depression in yourself, and in a loved one. These symptoms may include:</p>

<ul>
	<li>Persistent feelings of sadness, anxiety, or feeling empty</li>
	<li>Feelings of hopelessness and/or pessimism</li>
	<li>Feelings of guilt, worthlessness and/or helplessness</li>
	<li>Irritability and restlessness</li>
	<li>Loss of interest in activities or hobbies that you enjoy</li>
	<li>Loss of interest in sex</li>
	<li>Fatigue and decreased energy levels</li>
	<li>Difficulty concentrating, remembering details, and/or making decisions</li>
	<li>Changes in sleep habits, including insomnia, waking early in the morning, or excessive sleeping</li>
	<li>Changes in eating habits, including overeating or appetite loss</li>
	<li>Thoughts of suicide</li>
</ul>

<p>If you or someone you know is having thoughts of self-harm or suicide, seek help immediately. Licensed mental health professionals are available at the National Suicide Prevention Lifeline. These professionals can listen to what you have to say and guide you through steps that can keep you safe. To contact the National Suicide Prevention Lifeline, call 1-800-273-8255 or call, text, or chat 988.</p>


How Crohn’s Disease Impacts Mental Health

How to get help for feelings of depression and anxiety when you have IBD.

/digestive-health/ulcerative-colitis/video-mind-your-health-ulcerative-colitis-myhv2

When building a treatment plan for ulcerative colitis and Crohn's disease, you should focus on your mental health and physical condition.

Mind Your Health: Ulcerative Colitis, Crohn's Disease, and Mental Health

/digestive-health/ibd/avoid-stress-induced-ibd-flares-myhv2

<p>The COVID-19 pandemic has been a stressful time for many people. Concerns about health and safety, a 24-hour news cycle beckoning for attention, changing routines, distance from friends and loved ones, and all the other aspects of &ldquo;the new normal&rdquo; have demanded significant amounts of emotional energy and led to increased stress.</p>

<p>Stress can have numerous impacts on your health, and for people with inflammatory bowel disease, stress may lead to flare-ups or worsening symptoms.</p>

<p>Here, we look at the relationship between IBD and stress and some strategies for how you might manage stress levels during the pandemic.</p>

<h2>What is IBD?</h2><p>
Inflammatory bowel disease (IBD) is a disorder that causes irritation and chronic inflammation of the gastrointestinal (GI) tract. The two major types of IBD are ulcerative colitis (UC) and Crohn&rsquo;s disease (CD). Ulcerative colitis involves inflammation of the inner lining of the large intestine (colon), while Crohn&rsquo;s disease involves inflammation that extends further into the intestinal wall and can affect any part of the gastrointestinal system.</p>

<p>It is not known why some people have IBD and others do not, but it is known that IBD is the result of abnormal immune system activity. In people who have IBD, the immune system reacts to environmental factors that trigger inflammation. These environmental factors could be due to allergic reactions, viral infections, or bacterial infections. There is also much evidence that suggests some people have a genetic predisposition to IBD.</p>

<h2>IBD flare-ups and stress</h2><p>
People with IBD typically experience periods of relapse and remission&mdash;symptoms are present at times and go into remission at others. Research shows that stress can be a significant factor in IBD flare-ups.</p>

<p>Being diagnosed with Crohn&rsquo;s disease or ulcerative colitis may increase worry, anxiety, or depression that could be exacerbated by day-to-day stress.</p>

<p>Stress is a topic that you should be discussing with your healthcare provider. If you are unable or uncomfortable visiting your healthcare provider&rsquo;s office during the pandemic, you may want to consider a telehealth appointment.</p>

<p>In addition to working with a healthcare provider and adhering to a treatment plan, people with IBD are also advised to practice stress management in order to help keep flare-ups in check.</p>

<p>Some stress management tools to consider are:</p>

<ul>
	<li><strong>Exercise daily. </strong>Regular physical activity can reduce stress levels, ease symptoms, and also benefit your overall physical and mental health. Because IBD can make exercise more challenging, people are advised to discuss safe approaches to exercise with their healthcare providers before starting a new routine or activity.</li>
	<li><strong>Participate in a support group. </strong>Speaking with others who are dealing with the same disease can ease your stress level and help you feel less alone. Many support groups meet online, which is helpful in limiting your exposure to coronavirus.</li>
	<li><strong>Keep a journal.</strong> Keeping a journal of how you are feeling each day&mdash;both physically and mentally&mdash;can provide useful information to both you and your healthcare provider and can help you recognize patterns in symptoms and moods. Journaling can also help you keep track of the things that are going well.</li>
	<li><strong>Work with a mental health practitioner. </strong>Approaches like cognitive behavioral therapy may help people with IBD manage the mental burden of the condition, including stress.</li>
	<li><strong>Mindfulness activities.</strong> These include things like yoga, meditation, and breathing exercises.</li>
</ul>

<p>Remember that treating IBD is not a one-size-fits all approach. This applies to both the physical symptoms as well as the emotional and mental burdens. The important thing is finding an approach that works for you.</p>


Avoiding Stress-Induced IBD Flares During the Pandemic

Understanding the connection between IBD and stress, with strategies to reduce stress during the pandemic.

/digestive-health/ulcerative-colitis/video-meditation-ulcerative-colitis-myhv2

Meditation can bring lasting improvements to quality of life when you have inflammatory bowel disease.

9-Minute Meditation for Ulcerative Colitis

<p>Crohn&rsquo;s disease is one of the two main types of inflammatory bowel disease. In this guide, get questions and topics to discuss with your healthcare provider. You can also find information about preventing flare-ups, treating Crohn&rsquo;s disease with medication, surgery for Crohn&rsquo;s disease, nutrition, and taking care of your mental health.</p>


Overview

Mind Your Health

Treatment

Living with Crohn’s Disease

Understanding and Treating Crohn’s Disease

The digestive system includes all the parts of the body that process food and expel waste, from your mouth to the end of your digestive tract. Diseases of the gastrointestinal tract prevent your body from effectively using the food you eat. Learn more about digestive health from our experts.