Diet is a major issue in inflammatory bowel disease (IBD), and patients have been telling doctors for years that certain foods trigger their flares. Indeed, a study published in September 2020 in BMC Gastroenterology found a correlation between eating pro-inflammatory foods — dairy products and spicy food — and an increase in disease activity. Also, the researchers reported people were more likely to avoid specific foods than taking in foods that have beneficial in managing Crohn’s disease symptoms. Extensive research has shown a clear connection between inflammation in Crohn’s disease and some lifestyle factors, says David S. Lee, MD, a gastroenterologist at NewYork-Presbyterian in New York City. And when it comes to Crohn’s advice, it turns out the don’ts are just as important as the dos. Breaking bad habits will increase your sense of control and ultimately add up to a healthier you. Start by ditching these unhealthy habits.
2. Eating the Wrong Foods
Eating a well-balanced diet helps manage Crohn’s disease symptoms and prevent flare-ups. According to the Academy of Nutrition and Dietetics, foods high in fiber, fat, dairy products, and carbonated beverages such as soda can trigger a flare-up. Spicy food is another culprit, Dr. Butnariu says. “Most experts suggest a high-calorie diet, especially in those who are losing weight,” Dr. Lee says. But high in calories doesn’t mean high in fat. “Fatty foods are more difficult to digest and can increase diarrhea in people with Crohn’s,” says Richard P. Rood, MD, professor of medicine at Washington University School of Medicine in St. Louis. However, avoiding certain foods increases the risk of malnutrition.“People who live with Crohn’s disease are at a much higher risk of vitamin B12 deficiency, iron deficiency, anemia, and also deficiencies in trace elements like zinc, says Sophie Medlin, RD, a consultant dietitian at City Dietitians and chair for the British Dietetic Association for London.
3. Stressing Yourself Out
It can be stressful not knowing when your next flare-up will occur — and trying to find a bathroom when it happens. “It’s fair to say that not managing your stress and not taking care of your mental health can technically be triggers for Crohn’s disease flare-ups,” says Yezaz Ghouri, MD, at the University of Missouri Health Care in Columbia. He says people who are stressed also have sleep problems, which can worsen your health. A study published in May 2019 in Inflammatory Bowel Disease reported people who are stressed out tend to have a poorer quality of sleep, which increases the risk for relapse.
4. Overcaffeinating
Good news for coffee lovers: You don’t have to eliminate coffee altogether — just make sure you’re watching you’re not drinking too much caffeine. “It’s no different to if they were someone else who just drank too much caffeine and got diarrhea as a result of it,” says Medlin. “Everybody can get gut symptoms from having too much caffeine, and the reason for that is it speeds up every part of our body, including our small bowel. As a result, things rush through our small bowel a little more quickly, so patients with Crohn’s disease may notice that their symptoms are a bit worse if they have excess caffeine.”
5. Overdoing It With Alcohol
Alcohol can interfere with medication used in managing Crohn’s disease and cause nausea and vomiting. This is especially true of the drug Flagyl (metronidazole), Dr. Rood says. A study published in February 2018 in the Journal of Gastroenterology reported patients with Crohn’s disease who drink alcohol also tend to complain of worsening symptoms. Since alcohol disrupts the intestinal tract, the authors recommend against frequent or excessive consumption. No matter what your underlying illness, alcohol in excess is bad, Rood adds.
6. Taking the Wrong Pain Relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs), including Motrin (ibuprofen) and Aleve (naproxen sodium), can worsen the inflammation in Crohn’s disease, according to Lee. If you have pain and want to take something over-the-counter, Lee suggests Tylenol (acetaminophen). Celebrex (celecoxib) also appears to be safe for people with inflammatory bowel disease (IBD) in remission. The Crohn’s & Colitis Foundation recommends using Tylenol for up to 3,000 milligrams per day.
7. Skipping Your Doctor’s Visits
“The most important thing is understanding that Crohn’s disease is a lifelong condition and that patients will need to be followed by a healthcare professional. It’s not something that they have one time, and then it’s gone,” Butnariu says. Crohn’s has no cure, but it can be managed, so getting the right care should always be on your radar. Lee stresses the importance of having a gastroenterologist closely monitor your condition. And make sure to speak to your doctor if you notice any change in symptoms or if you have questions about your condition. Additional reporting by Jocelyn Solis-Moreira
