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cephalosporin, or tetracycline can prove effective in controlling

bacterial growth in the intestines. Diarrhea causes dehydration.

Doctors prescribe antidiarrheal agents like loperamide,

diphenoxylate, and codeine and lots of fluids and electrolytes to

combat diarrhea. Some fiber preparations like psyllium and

methylcellulose can help reduce cramps and pain. However, not all

can tolerate these medications.

Antibiotics prove effective in controlling bacterial growth in the

intestine. Bacterial growth increases in cases of various fistulas,

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strictures, and surgeries. Doctors prescribe Tacrolimus and

cyclosporine as alternative medications if your fistulas do not close.

Although these drugs are primarily for patients with organ

transplantation, they also provide relief for patients with Crohn’s

disease. This is specifically true for patients using steroidal

medications.

Nutrition Supplements

Children with Crohn’s disease show slow growth due to lack of

sufficient absorption of nutrients. Nutritional supplements can prove

beneficial for treating such children. Nutritional supplements are

available in the form of high calorie liquid formulas. Doctors advise

intravenous feeding of such supplements.

Such nutritional supplements can prove to be good alternatives for

your regular intake of food. You can take this through a catheter, a

tiny tube directly inserted into your blood vein in the chest.

Otherwise, you can take this intravenously through injections. Such

intravenous feeding helps provide sufficient rest to your intestines

and helps in thorough absorption of nutrients. Those suffering from

Crohn’s disease should better stay away from spicy foods, milk

products, alcohol, and foods of bulky grains.

Surgery

Surgery proves necessary at some or other time for all Crohn’s

disease patients. Rather, it is the only treatment option available

after all medications cease to be effective. Surgery can prove

effective in treating Crohn’s disease in two ways.

It can provide relief from inherent symptoms or correct Crohn’s

disease complications like perforations, blockages, bleeding, and

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abscesses. Surgery can remove abscesses, repair fistulas, or

remove obstructions in the intestine. Surgical removal of the

infected part of the intestine does not offer any permanent cure.

Inflammation soon starts at other parts of the intestine.

Surgical removal of the intestine can be either complete removal of

the intestine or cutting away the diseased part and rejoining

remaining parts of the intestine. Colectomy is the surgical removal

of the entire intestine. Doctors make a small hole near the

abdominal wall. This is a stoma. Doctors then connect the end of

the small intestine to the stoma. You need to wear a pouch near the

stoma. Waste accumulates within the pouch and you have to empty

the pouch when necessary. This bag is for life. It collects all waste

that can no longer pass through the anus. This treatment becomes

essential if you stop responding to all other treatment options.

Sometimes, it is sufficient to cut away diseased parts and connect

remaining intestine ends. However, surgical treatment for Crohn’s

disease may not suit all patients. You have to discuss post surgery

effects with your doctor. You can also take the help of group

therapists and other support groups.

Surgery is not a single time affair. You may require one or two

surgeries. It all depends on the severity of Crohn’s disease.

However, a major factor of Crohn’s disease is the possibility of

excessive infection. Around five to ten percent of patients suffering

from Crohn’s disease die of infection.

Alternative Therapies

Crohn’s disease causes lot of pain and discomfort. Alternative

therapists suggest a mind and body approach to combat and fight

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away pain. Such mind and body treatments include hypnotherapy,

biofeedback, sound and music therapy, guided imagery, and

relaxation techniques.

Tai Chi, postural therapies, and exercises help you concentrate on

specific choreographed movements that ease pain and discomfort.

These do not form any rigorous exercise regimen and offer soothing

relief from pain. Similarly, acupressure and acupuncture are also

remedial therapies for Crohn’s disease.

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Surgery for Crohn's Disease

Around two-thirds to three–quarters of people suffering from

Crohn’s disease require surgery at some point. Surgery cannot cure

your disease. It only alleviates pain and discomfort synonymous

with Crohn’s disease. Surgery could be a better option for some if

medications fail to produce desired results in controlling abscesses,

fistulas, perforations, and other blockages.

Before going for surgical treatment of Crohn’s disease, you should

weigh all the pros and cons. Surgery cannot offer any permanent

cure from Crohn’s disease. Surgery is only a temporary solution. All

symptoms of Crohn’s disease could reoccur a few years after

surgery. It is therefore best to collect all possible information from

medical journals, physicians, and other people facing or having

faced similar situations in the past.

The main aim of surgery is to conserve as much of the bowel as

possible. Surgery tries to bring down your dependence on steroids

and other medications and help you be free of their serious side

effects.

Surgery and Crohn’s Disease

There are four common types of surgery for Crohn’s disease.

These are:

1) Partial bowel resection

2) Correction of Fistulas

3) Strictureplasty

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4) Draining of Abscess

Partial bowel resection

Resection becomes necessary if a permanent partial obstruction

forms within your intestine. This is normally found in your terminal

ileum, ileocecal valve, and a part of the large intestine. Normally,

doctors cut out the diseased part of your intestine and rejoin the

healthy ends.

In some cases, there could be a mild inflammation all through the

intestine. It then becomes necessary to cut off infected parts of

intestine and rectum. Doctors instead create a small incision or hole

near the abdominal wall. They then connect the ileum to this hole or

stoma. They attach a pouch to this hole where all waste drains into

this pouch. You can empty the contents when it is necessary. This is

an ostomy.

In some cases, a temporary ostomy could be useful. After a period

of three to six months of initial surgery, doctors reattach bowels and

normalize processes. However, in severe cases, this may not be

possible. You would have to carry the pouch permanently. However,

clothing can cover your pouch and you can lead perfectly normal

lives even after ostomy.

In very severe cases of Crohn’s disease, doctors need to remove the

entire bowel. This is colonectomy. Surgery does not signify the end

of Crohn’s disease. It can crop up after few years and affect healthy

intestines. This relapse could be close to the place of your surgery.

However, you can take Pentasa or 6-MP to lessen the possibilities of

a relapse of Crohn’s disease after surgery.

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Correction of Fistulas

Crohn’s disease creates inflammation of the intestinal lining. This

inflammation could create channels within the intestine or between

parts of the intestine and other supporting organs. Fistulas then

become easy channels for waste to flow from one organ to another

thereby causing infection. Correction of fistulas involves closing

them to prevent intestinal contents from flowing through all nearby

organs.

Strictureplasty

This refers to surgical removal and opening of strictures. Strictures are small blockages in intestines. These restrict intestinal passage

and prevent easy flow within the intestine. Strictures cause

alternations between areas of normal intestine and damaged

intestine. Damaged and strictured parts of the intestine block

movement of digested food. Normal parts of the intestine push

against the strictured part. This causes severe pain and cramps.

Strictureplasty involves making an incision in a stricture. Doctors

pull together the incision lengthwise and sew it across. This shortens

the intestine but clears the blockage thereby helping in easy flow.

Draining of Abscess

An abscess is an eruption on the intestinal wall. These erupt due to

inflammation of the intestines. These eruptions contain fluids, which

are infectious. Doctors use medications initially to drain away the

abscess. If medications fail, surgery becomes essential as abscesses

spread infection.

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Surgical treatment of an abscess includes insertion of a needle to

draw out infectious material. Sometimes, surgeons remove

infectious material and place a wick inside to ease drainage and help

the abscess heal thoroughly.

You can treat recurrence of Crohn’s disease with regular

medications. Nevertheless, occasionally, a second surgery could also

be necessary to overcome Crohn’s disease.

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Medication for Crohn's Disease

There is no cure for Crohn’s disease. You can take medications to

alleviate symptoms and get relief. All medications for Crohn’s

disease have their own side effects. You can try using the ones that

suit your condition the best.

If you refrain from using medications, it would only worsen Crohn’s

disease. Medications can help keep the disease in check and prevent

excessive spreading.

Types of Medication for Crohn’s Disease

There are two main categories of medications for Crohn’s disease.

They are:

1) Drugs that reduce Inflammation

2) Drugs that treat symptoms

Inflammation Reducing Drugs

Major drugs under this group consist of Sulfasalazine, steroids, 5-

Aminosalicylate (5-ASA), antibiotics, immunosuppressive drugs, and

Infliximab.

Sulfasalazine: This drug restricts production of certain

inflammation causing chemicals that cause diarrhea. It can reduce

your flare-ups, although not all patients may have the same effect.

Common side effects of Sulfasalazine include vomiting, nausea,

allergic reaction, poor appetite, and possible bone-marrow

shutdown.

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Steroids: Glucocorticosteroids or glucocorticoids can treat

inflammation in patients with Crohn’s disease. These prove

beneficial in giving relief in patients with moderate and severe

attacks of Crohn’s disease. Common side effects of these steroids

include increased appetite and subsequent weight gain, acne,

redness of face, rounding of face, insomnia, night sweats, softening

of bones, glaucoma, ulcers, high blood pressure, mood changes,

and others.

5-ASA (5-Aminosalicylate): This drug helps treat moderate to

severe cases of Crohn’s disease. It can help reduce production of

diarrhea causing chemicals. Additionally, it disables oxygen radicals

that destroy tissue. Common side effects include headaches,

nausea, allergic reactions, and kidney damage if used for long

periods.

Antibiotics: Although a number of antibiotics can treat Crohn’s

disease, metronidazole is the most common of them. This antibiotic

is very effective against anaerobes, which are intestinal bacteria. It

can treat fistulas and abscesses forming near the anus region. This

antibiotic is primarily useful in controlling Crohn’s disease flare-ups

and suppresses chronic symptoms. It also delays or in some cases

prevents relapse of Crohn’s disease after surgery.

Common side effects of metronidazole include poor appetite,

constipation, nausea, vomiting, indigestion, and diarrhea. Prolonged

intake of this antibiotic can disrupt body balance due to extensive

damage to nerves in the legs. However, you can reverse this

damage, although only after months of discontinuing the antibiotic.

Side effects are more pronounced if you consume alcohol regularly.

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You could suffer from nausea, headaches, breathlessness, rapid

heartbeats, and excessive flushing of the face.

Immunosuppressive Drugs: Doctors prescribe these drugs only if

other anti-inflammatory drugs don’t get the desired results. Doctors

normally prescribe small dosages of this drug. Although there is no

conclusive proof of how it reduces inflammation,

Immunosuppressive drugs can control inflammation extensively.

The greatest side effect of immunosuppressive drugs is a reduced

immune system. You lose your resistance against infections. You

should consult your doctor for any minor ailments like cold, fever,

persistent sore throat, and similar other ailments. This drug poses

problems if you become a victim of any undiagnosable infection.

Infliximab: Doctors prescribe this anti-inflammatory drug if you do not respond to any other medication or treatment. This is the most

recent drug approved by U.S. Food and Drug Administration for

treatment of Crohn’s disease. This drug primarily reacts against

TNF-Alpha, which is the main inflammation-causing component.

Symptom Treating Drugs

There are certain medications that can treat symptoms of Crohn’s

disease. These eliminate or reduce symptoms rather than reducing

inflammation. Such drugs include antidiarrheal, bile salt binders,

and bulk formers.

Antidiarrheal Drugs: These drugs reduce muscle activity of the

small and large intestines. It can make waste materials pass

through slowly. These drugs therefore control cramps, diarrhea, and

similar urgencies effectively. These prove safer than drugs that

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reduce inflammation. Doctors however do not prescribe these drugs

during flare-ups due to possible complications.

Common side effects of antidiarrheal drugs include abdominal pain,

constipation, and a sense of bloating. Among all antidiarrheal drugs,

Loperamide is the safest. Dosage is once or twice a day. You can

purchase it over-the-counter, as it does not require a prescription.

Bile-Salt Binders: Bile salts are liver products that help digest fat in the intestine. Ileum absorbs most of the bile salts. However, in

Crohn’s disease patients, the ileum does not function properly.

Therefore, most of the bile salts reach the colon and cause

excessive irritation. This leads to diarrhea. Bile salt binders help

bind the bile salt and thereby reduce diarrhea. Common side effects

of bile salt binders include nausea, digestion problems, vomiting,

abdominal pain, constipation, and bloating.

Bulk Formers: These are products of a natural fiber source like

psyllium seed. They are available in granules of various flavors.

These drugs help soak water content in stools and bind them. This

reduces frequency and looseness of stools. These drugs prove most

beneficial for patients with mild Crohn’s disease. It can help correct

looseness of stools, although frequency may be high.

A side effect of Bulk formers is that it could make you feel gassy

and bloated. These drugs give out a fine dust that could make you

allergic and cause serious reactions.

Although various effective drugs control symptoms and

inflammation of Crohn’s disease, a balanced, high nutrition diet is

essential. Physical exercise and an optimistic nature can help too.

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Cure Research for Crohn's Disease

Researchers and scientists are continuously trying their best to find

a cure for Crohn’s disease.

Antibiotics: Although doctors prescribe these for bacterial

infections that come with Crohn’s disease, researchers suggest that

antibiotics could prove to be the main source of treatment for

Crohn’s disease soon.

Anti-TNF: Body immune system produces a protein, tumor necrosis

factor (TNF). This is present in cells affected by Crohn’s disease.

TNF could be responsible for inflammations. Researchers feel Anti-

TNF could combat TNF and prevent it from reaching intestines and

causing inflammation. This could also close fistulas.

Interleukin 10(IL-10): This is a cytokine present in the body, which can reduce inflammation. Researchers are studying

effectiveness of synthetic IL-10 in treating Crohn’s disease.

Methotrexate and cyclosporine: These immunosuppressive drugs

treat Crohn’s disease. These seem to work faster than other

immunosuppressive drugs.

Zinc: Doctors believe that free radicals could be cause for

inflammation in Crohn’s disease. Free radicals are molecules

produced by your body due to stress, infection, and fat metabolism.

These damage body cells on interaction with other body molecules.

Zinc removes these free radicals from your bloodstream.

Researchers are therefore trying to study extent of zinc

supplementation in reducing inflammation.

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Budesonide: This corticosteroid proves as effective as usual

corticosteroids. However, the major benefit is that it causes fewer

side effects.

Medications: Researchers are trying to delve deeper into

effectiveness of various medications for treating Crohn’s disease.

Common medications include Neoral, Cyclosporine, SangCya, and

Sandimmune. As genetic factors play a role in Crohn’s disease,

researchers are trying to analyze their effect and how to combat

them.

Helminth Treatment: Helminths are parasites that breed in the

intestines. Researchers formed a formula using helminths found in

pig intestines and gave it to six people. Five of these experienced

remissions of Crohn’s disease symptoms while the sixth experienced

substantial reduction in symptoms. However, after all helminths

passed away through stools, all six people experienced reoccurrence

of all symptoms of Crohn’s disease.

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Complementary and Alternative

Treatments for Crohn’s Disease

Most Crohn’s disease treatments cause serious side effects. Many

Crohn’s disease patients prefer trying alternative and

complementary therapies to treat Crohn’s disease. National

Institutes of Health established the National Center for

Complementary and Alternative Medicine (NCCAM) to look for such

treatment options that could provide necessary relief.

Common complementary therapies include music or art therapy,

acupuncture or acupressure, tai chi, yoga, guided imagery,

massage, and hypnosis. The focal point of these therapies is not to

address the problem area alone. Instead, it addresses the entire

body and system as a whole. It alleviates pain and associated stress

from your mind thereby bringing relief in various Crohn’s disease

symptoms.

Stress does not cause Crohn’s disease; however, stress can

exaggerate flare-ups and other symptoms. Simple digestive

processes undergo noticeable changes due to stress. Stress can be

in the form of loss of job, death of a loved one, change of place, or

similar situations. Stress is unavoidable no doubt; nevertheless, you

can reduce its effects substantially. Simple stress busters include

biofeedback, exercise, meditation, yoga, and massage.

Biofeedback techniques reduce muscle tension and put you in a

relaxed state of mind. With a little help, you can practice such

techniques independently and reduce stress levels substantially.

Mild exercises are very beneficial. Exercises can be in the form of

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simple walking, stretching, or jogging. Exercises can reduce tension

and ease bowel functions extensively.

Yoga and deep breathing allows greater flow of air in and out of

your muscles. This helps in clearing passages within your body and

allows your abdominal muscles to function easily. This normalizes

bowel function extensively.

Practicing hypnosis through a trained professional is highly

beneficial. Professionals guide you to reach a relaxed state and

thereafter help you imagine your intestinal muscles becoming

smooth and easy. Although there is no set rule for these techniques,

the best recourse is to set aside a minimum of half an hour each

day and indulge in any activity that gives you maximum solace. This

could prove to be the best remedy.

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Part-IV: Preventing and Coping with Crohn’s Disease

Living with Crohn's Disease

Scientists and researchers are trying their best to find better and

more effective treatment options. Therefore, Crohn’s disease

patients try their best to adjust to disease symptoms differently.

Various factors combine to assess the severity of Crohn’s disease.

These include level of appetite, number of bowel movements in a

day, fever, and the number of days in a month you need to

schedule your work due to ailments like fatigue, diarrhea, and

similar symptoms. Additionally, doctors assign other factors like

depression, anger, and pain to measure intensity levels of your

disease.

Nevertheless, this is no yardstick for measuring the degree of

Crohn’s disease in a patient. A person with mild Crohn’s disease

could have serious symptoms while one with severe Crohn’s disease

could show very few symptoms.

Crohn’s disease may be chronic; however, it is not a constant

disease. You will be perfectly fine for most days in a month while

you could experience severe Crohn’s disease symptoms for a few

days in a month. Symptom patterns may not be the same always.

Sometimes symptoms could appear subdued while severe flare-ups

could be the order of the day on other days.

To adjust to the whimsical nature of Crohn’s disease, you should

follow a regular diet pattern. Diarrhea as in Crohn’s disease reduces

appetite, causes dehydration, and temporary lactose intolerance.

Fever causes an increased need for calorific energy. It could also

cause osteoporosis due to poor calcium intake and retention.

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Crohn’s disease patients would do well by increasing their calorific

intake in the form of minerals, proteins, vitamins, and trace

elements. Further, eating six half-sized meals in a day can reduce

the burden on your digestive system. Your dinner should be over

three hours before bedtime.

It is best to eat simple and normal meals. You can reduce your

intake of raw fruits and vegetables and whole grains during any

specific flare-up. Foods to avoid include spicy food, caffeine, alcohol,

and lactose. Your food should be rich in proteins and nutrients. You

should drink plenty of fluids to avoid dehydration.

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Diet and Nutrition for Crohn's Disease

Crohn’s disease causes loss of appetite and resultant fall in body

weight. You cannot assign any specific diet as the correct and best

diet for Crohn’s patients. Different people show different levels of

tolerance to different food items. Specific periods could induce

requirement of specific foods.

Nutritional Requirements of Crohn’s Disease

Crohn’s disease patients should eat a nutritious diet with sufficient

proteins, vitamins, and minerals. Additionally, your eating pattern

should restrict any huge stress on your digestive system. Ideally,

you should eat six small meals in a day rather than having three big

meals. Each of these diets should be of equal measure and contain

the same level of nutrients.

Lack of sufficient nutrition can cause improper functioning of body

systems. It could cause retarded growth in children. Women

experience menstrual irregularities and cramps due to poor

nutrition.

Diet Patterns of Crohn’s Disease

There is no specific diet pattern prescribed for every Crohn’s disease

patient. The common adverse factor for all Crohn’s disease patients

is the loss of appetite. This in turn leads to insufficient assimilation

of necessary nutrients in your body. You therefore become weak

and are unable to bear any form of physical or mental exertion. This

could lead to stress.

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Stress is a major deterrent for easy digestion of food. Stress causes

improper absorption of nutrients in the intestine. This leads to

frequent motions with symptoms similar to diarrhea. Therefore, you

cannot prescribe any specific single diet as the best for Crohn’s

disease. There are no specific dietary rules to follow. You should eat

foods that do not worsen your existing symptoms. Doctors can

prescribe necessary vitamins too.

Important Foods That You Should Include

Maintaining proper diet routines and consuming all essential

nutrients is a prerequisite for every person. Nevertheless, this

assumes greater importance for Crohn’s disease patients. The

predominant symptom of this disease is diarrhea, which causes

extensive depletion of body nutrients. You have to take in sufficient

quantities of all types of vitamins like A, B12, C, and D, folic acid

and minerals like zinc, calcium, and iron.

The best way to include them in your daily diet is by consuming a

balanced diet. You should consume foods from all the four important

categories like vegetables, meat, or alternative sources of protein,

cereals and grains, and dairy products. However, different protein

foods could suit different Crohn’s disease patients. You should

consume a particular food and notice how well your body accepts or

rejects it. Thereafter, you can make it a part of your regular diet.

Foods Better to Avoid

Specific foods could cause aggravation of Crohn’s disease symptoms

mostly. The level of aggravation could vary with different

individuals. In all, it is best to avoid such foods.

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It is difficult to digest high-fiber foods. Improper digestion of such

foods could cause severe contractions in your intestine. This leads

to severe abdominal discomfort. Therefore, restriction of high-fiber

diets can ease Crohn’s disease symptoms. Yet, there is no

conclusive evidence to support lower incidence of Crohn’s disease

symptoms if you take in a low-fiber diet.

Fried and spicy foods, fast foods, and specific fatty foods like

vegetable oil, margarine, butter, gravies, and processed snacks like

cookies and crackers could trigger abdominal cramps, indigestion,

and nausea. Such foods could restrict absorption of fats within the

intestine. Therefore, consume only those fatty foods that help in

easy absorption.

Caffeine and alcohol stimulate the intestines extensively. They could

trigger flare-ups. Restrict or completely avoid such foods.

Essential Dietary Tips for Crohn’s Disease Patients

You can fulfill your protein requirements from chicken, meat, egg,

cheese, peanut butter, fish, tofu, and yogurt. Include one protein

item in every meal.

Fat provides more calories per gram than carbohydrates and

proteins. Therefore, eat foods containing extra fat like peanut

butter, nuts, butter, canola oil, and margarine. However, check your

tolerance to fatty foods.

Milk and milk products prove to be a good source of protein and

minerals. It also provides lot of essential nutrients. If you have

lactose intolerance, add few drops of Lactaid or drink Lactaid milk.

You can consume soymilk, soy ice cream, or soy yogurt to overcome

lactose intolerance. Further, milk products like hard cheese and

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yogurt have a lower content of lactose than milk. Therefore, these

products may not cause any upsets in digestion or cause any flare-

ups of Crohn’s disease.

Although Crohn’s disease could cause depletion of minerals and

vitamins from your body, you can include vitamin supplements like

a multi-vitamin, as recommended by your physician. This can rule

out any nutritional deficiencies. Nevertheless, these multi-vitamin or

vitamin supplements cannot take the place of foods containing

essential vitamins.

Hydration is very essential for patients with Crohn’s disease. You

should drink sufficient fluids. Normally, during persistent Crohn’s

disease symptoms or flare-ups, you may restrict your intake of food

and water. This could cause severe depletion of water content within

your body. The common prescribed amount of water intake in a

single day is an ounce for every pound of your weight. You can keep

drinking water and similar fluids in small quantities rather than

having huge measures at a time.

Specific Carbohydrate Diet

Dr. Sydney Haas and Dr. Merrill P. Haas have developed a special

carbohydrate diet. This diet does not guarantee freedom from your

Crohn’s disease symptoms nor does it assure any complete cure.

Crohn’s and Colitis Foundation of America advocate this diet.

Although it may not cause any increase or decrease of

inflammation, it does not harm you.

Important Constituents of the Diet

This diet does not allow any complex carbohydrates like sugar,

grains, and lactose, as these carbohydrates cause harmful bacteria

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to thrive in your intestine. Starving such bacteria can prevent them

from multiplying and causing discomfort. Complex carbohydrates

cause immense digestion problems. Improper digestion further

aggravates your Crohn’s disease symptoms.

You can include foods like fish, aged cheeses, beef, nuts, and

unsweetened juices. Stay away from oats, sugar substitutes, rice,

pasta, wheat, and potatoes. It sure is a difficult diet to follow due to

the various restrictions. You should follow this diet for a minimum of

one year to notice positive changes.

Raw vegetables and fruits could cause gas, diarrhea, and bloating in

many people. Specifically fibrous foods, vegetable, and those with

seeds could cause serious problems.

However, restricting your fruits and vegetable intake could cause a

decrease in the supply of vitamins and minerals to your body. You

can eat bananas, drink tomato juice, citrus juices, brown sugar, and

ketchup to ensure sufficient potassium supply to your body. Meat

can provide sufficient folic acid and iron requirements of your body.

Whole-grain cereals are good fiber sources, although you should

stay away from coarse fibers like apple skins, large seeds, and

celery.

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Travel Tips for People with Crohn's Disease

Crohn’s disease need not stop you from traveling. You can travel

anywhere you need to go with few extra precautions. This ensures

an enjoyable trip.

Essential Tips

Carry all your medications preferably in a separate kit. Purchase

sufficient medications to last your trip. Otherwise, collect names of

alternative medications from your gastroenterologist. Also, collect

generic names and foreign brand names of your medicine.

Keep your health insurance card and telephone number you're your

gastroenterologist handy.

Locate possible restrooms ahead of your travel if you are traveling

for short distances.

Carry sufficient undergarments and toilet paper for any

emergencies.

If you are going to a distant place or planning a long vacation,

locate a suitable gastroenterologist ahead of your travel. If you are

traveling abroad, American Embassy's Consulate Section can help

you locate a local gastroenterologist.

Take some time off and coordinate with your gastroenterologist for

a detailed medical history statement. This could highlight your

medical problems and possible remedial measures. You could ask

for written guidance from your gastroenterologist in case of any

emergencies.

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Find out in advance, if your health insurance is valid in the country

or place of your visit.

Locate in advance, if the mode of your travel, like buses or trains

have suitable toilets. You could reserve a seat close to the toilet to

have easier access.

Drink only boiled water in any new place. Be careful about instances

of swallowing water while bathing, brushing teeth, or swimming.

Use sealed and bottled water even for brushing your teeth. Do not

use tap water.

Do not use ice cubes. Do not eat any uncooked foods like salads,

raw fruits and vegetables if you cannot peel their skin, uncooked

dairy products, uncooked meat, shellfish, fish, food left at room

temperature, food from roadside vendors, and similar others. Do

not eat any prepared foods like potato or pasta salad.

Although you should drink sufficient quantities of water, always

drink boiled water. Do not drink any cold beverages like juices, iced

tea, and ice creams. Cold beverages accelerate minor symptoms

extensively.

Always be careful of any special symptoms of Crohn’s disease like

bloody diarrhea, high fever, severe abdominal pain or discomfort,

shivering and chills, dehydration, fainting or dizziness while

standing. These indicate infections and you require immediate

medical attention.

Always keep antidiarrheal medicines handy like Imodium® A-D.

This can provide fast relief from your diarrhea problems. Consult

your gastroenterologist before using this medicine.

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Crohn’s disease need not chain you to any one place. You can travel

as necessary albeit with a few precautions. Prior planning can

prepare you for a smooth and enjoyable trip or vacation.

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Emotional Factors and

Coping with Crohn's Disease

Crohn’s disease is not the outcome of any emotional strain or

stress. Poor emotional control can never cause Crohn’s disease.

Nevertheless, Crohn’s disease causes a lot of emotional stress. The

disease does cause little irritation and anxiety. Stress and anxiety

can occur due to embarrassing symptoms of the disease, frequent

doctor visits, and pain associated with Crohn’s disease.

Stress does have an effect on your digestive system. It often causes

difficulty in normal digestion. Sometimes digestion rate accelerates

while sometimes it becomes slow. Improper passage of food

through your intestines can cause upsets, pain, cramps,

indigestions, nausea, vomiting, diarrhea, and numerous other

similar problems.

Coping with Stress and Emotional Factors

Crohn’s disease need not make you an emotional wreck. You can

adopt any suitable way of managing your stress and thereby lead a

full life without any huge worries.

Do not try to hide or suppress your stress. Stress is a normal

emotion and there is nothing embarrassing about it. This is

specifically true if you are suffering from any chronic illness like

Crohn’s disease. Get help from support organizations, counselors,

medical associations, and others. You should voice your problems

openly.

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Educate yourself about all aspects of Crohn’s disease. Collect

information about the disease from your gastroenterologist, medical

journals, and the Internet. Have a frank discussion with your

gastroenterologist. Be ready to face or withstand any possible

situation in your disease. Being forewarned helps you prepare for

possible eventualities anytime. This proves to be an excellent

stress-buster.

Practice relaxation techniques regularly. You can choose any

technique that suits you best like meditation, yoga, biofeedback,

deep breathing, or progressive relaxation exercises. Similarly, set

aside a specific time exclusively for you. Indulge yourself in any

activity you like the most like listening to music, gardening, reading

books, or watching favorite television shows.

Make it a daily habit of doing some mild physical exercise like

walking, swimming, or jogging.

Develop a proper support system. Discuss all your problems due to

Crohn’s disease openly with your family members, close relatives,

and friends. It is essential for all around you to understand and

remain aware of your condition. This can offer you necessary

support when you require it. It can prepare everybody for any

sudden outbursts of anger, fear, or tension. Further, you can also

take the help of support groups and counseling sessions.

A psychotherapist can also provide a lot of help and support if you

suffer from emotional stress due to Crohn’s disease. Ideally, you

can contact a psychotherapist well conversant with Crohn’s disease,

symptoms, and possible relaxation techniques.

Being prepared for possible eventualities can relieve your stress due

to Crohn’s disease considerably. Diarrhea attacks or gas could cause

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serious discomfort and stress in new places for Crohn’s disease

patients. It is therefore best to acclimatize with the new place well

in advance or immediately on arrival. You can identify restrooms

and medical facilities in shopping areas, restaurants, public

transports, and theaters. Carry sufficient toilet paper and change of

undergarments always.

Self-acceptance is another major issue that causes stress in Crohn’s

disease patients. Accept your disease and do not harbor any feeling

of guilt or self-reproach. Instead, tackle it pragmatically and be

ready to face any possible eventualities. This boosts your self-

confidence and brings down stress levels extensively.

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Simple Treatments and Lifestyle Changes

Crohn’s disease is a difficult disease as it causes lots of

inconveniences and sudden problems. However, it is possible to

tackle these inconveniences through small changes in your lifestyle

and adopting simple cures to prevalent symptoms of Crohn’s

disease. This can help you do your normal duties and chores with

Crohn’s disease.

Small Lifestyle Changes and Cures

Diet and Nutrition

Diet is a major concern for Crohn’s disease patients. There are

certain foods that could trigger a Crohn’s disease attack. It is always

best to avoid spicy and greasy foods. Bland and soft foods cause

little discomfort. Have a healthy diet with sufficient foods from each

group like poultry, fish, meat, fruits, vegetables, cereals, starches,

and dairy products if you do not have any lactose intolerance.

Maintaining necessary nutrition levels is essential for Crohn’s

disease patients. Improper digestion and bowel discomfort can

cause a substantial decrease in appetite levels. You however require

high calorific energy to combat such diseases. Poor absorption of

dietary fat, proteins, and carbohydrates can lower the level of body

nutrients. Restore and maintain normal levels by having a good

proper diet.

Exercise

Mild physical exercises are very essential for maintaining your

physical health. Crohn’s disease causes immense discomfort, pain,

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and disruptions in regular body routine. Simple exercises practiced

daily can alleviate these problems. Walking, jogging, remaining fit

and active can ease abdominal muscles and relieve you of cramps

and pain. Nevertheless, it is best to consult your doctor for advice

before starting with any exercise routine or regimen.

Small tips can make exercising easier and more enjoyable.

Exercising may increase body metabolism rates. Therefore, increase

your intake by having many small meals throughout the day. Each

meal should have sufficient proteins and calories. However, do not

have any solid food for three hours before your exercise. Drink lots

of water before and after exercises. This can keep you hydrated.

Special Events

Crohn’s disease need not restrict your social activities like outings,

attending events, ceremonies, and similar others. A little planning

can help you enjoy and participate in the event. If you are visiting

restaurants or shopping arcades, identify bathrooms first to tackle

emergencies. If eating out, eat small quantities of food and do not

gulp it down. Take time to chew your food. Avoid alcohol. Always

carry all necessary emergency medications with you.

Relationships and Physical Intimacy

Crohn’s disease symptoms cause emotional stress and physical

discomfort. Have a frank discussion with your family and friends.

Make clear all your symptoms, discomfort, and possible

embarrassing situations. Chart out plans of coping and tackling

these problems effectively so that you are able to maintain and

bond well with your close ones without your disease posing any

problems.

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Common symptoms of Crohn’s disease like abdominal cramps,

diarrhea, and gas could lower your sex drive. This can cause

frustration in your spouse. The best way to overcome this is by

disclosing everything. Collect information from various support

groups and counselors on how best to tackle Crohn’s disease and

prevent it causing little upsets in your sexual life. Being aware of

possible upsets can help both of you to tackle all problems jointly.

Stress Management

Stress does not cause Crohn’s disease. Common Crohn’s disease

symptoms like embarrassing situations, medications, pain, and

frequent doctor visits can bring on undue stress. This causes serious

upsets in proper digestion and assimilation of your food.

It is therefore essential to lower stress levels. Being aware of the

disease by collecting all possible information can educate you on all

details of Crohn’s disease. Nevertheless, do not shy away from

necessary counseling sessions with psychotherapists. You can

additionally take the help of support groups.

Another option is to take part in simple regular exercises to

normalize bowel functioning. You can also adopt relaxation

techniques like listening to music, yoga, meditation, deep breathing,

biofeedback, and others. Form a support system around you

through your relatives, family, friends, and other support groups.

This can help you to relax and be tension free. This can subdue your

Crohn’s disease symptoms substantially.

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Management of Crohn’s Disease

Crohn’s disease is not any serious disease; it is mainly a chronic

disease. Chronic disease symptoms often cause disruptions in your

normal routine. Additionally, it can cause upsets in family functions,

reunions, gatherings, and similar others. Simple management

techniques can help you tackle such upsets and make it easy in

managing Crohn’s disease.

Crohn’s disease is mainly due to intestinal inflammation and

subsequent consequences. Therefore, choose and stick to a specific

diet plan. Eat foods that prove easy on your intestine. Make sure

you get sufficient sleep, as insufficient sleep can cause stomach

upsets and consequent flare-ups in Crohn’s disease patients.

Maintain a regular schedule of medication. You should continue with

your medications even if you are fine, and do not have any apparent

Crohn’s disease symptoms.

Crohn’s disease patients undergo various difficult situations.

Nevertheless, managing a Crohn’s disease patient is equally

stressful. A spouse with Crohn’s disease could push more familial

responsibilities on the other partner. This could cause complex

situations in life as being unable to attend all social events or take

part in gatherings just like others.

However, having a frank discussion with other family members can

lower the intensity of all such problems. If one of your children has

Crohn’s disease, you need to give the child extra time and attention.

Taking joint family decisions and explaining the child’s condition to

all family members, especially other children in the family can make

most of your work easy and manageable.

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Sometimes severe Crohn’s disease patients become very anxious

and often depressed. Instead of looking at your disease as a

problem, try to gather all possible information about the disease

and tackle it effectively. Being more conversant and knowledgeable

about your situation can help you take suitable remedial measures.

You can talk to doctors, nurses, and social support organizations

about how best to overcome your shortcomings due to Crohn’s

disease. You can take your family members to such meetings so

that they are able to understand and analyze your situation better.

A compassionate and understanding family can prove to be a pillar

of strength.

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Support Groups for Crohn's Disease

Support groups for Crohn’s disease are non-profit organizations

providing all necessary information, support, and advice to Crohn’s

disease patients. Some of these support organizations can also

provide educational material to medical professionals.

Support group for Crohn’s disease could also constitute of a group

of persons with similar ailments. All members of this group come

and offer solace to each other. Additionally, each member can prove

to be a living example to others by divulging all their problems and

their possible solutions due to Crohn’s disease.

Ailments can make you feel lonely within your family. You could feel

as if you are singled out, although your family members do not

harbor any such feelings. Yet, this feeling creeps into your mind.

Support groups help you overcome this shortcoming. Within a

support group, you find yourself within a group of people suffering

from the same disease and therefore facing the same uncomfortable

situations you find yourself in.

Support groups can be in the form of chat rooms, message boards,

or simple group associations. You can organize regular meetings,

discuss any special developments about your ailment, listen to

other’s woes, comfort them, and discuss other things. You may find

people with more debilitating symptoms and feel your symptoms to

be nothing. You can comfort others and this could boost your spirits

extensively.

Support groups help you discover yourself extensively. You may feel

awkward elaborating your Crohn’s disease symptoms to your family

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members. However, with support group members, it is a different

story. You find others going through the same situation as you. This

relieves your loneliness and makes you feel light. This can bring a

substantial reduction in your Crohn’s disease symptoms.

Part-V: FAQ and Glossary Terms

Crohn’s Disease FAQ

What is Crohn's disease? Crohn's disease is inflammation of the

gastrointestinal tract. This disease is of a chronic nature. There is no

permanent cure for this disease at this time. Inflammation can be

anywhere from the mouth to the ileum and to the anus.

Inflammation causes irritation in the intestines leading to pain,

diarrhea, rectal bleeding, and various other ailments.

Who can be affected by Crohn’s disease? Crohn’s disease can

affect anyone. There is no discrimination of men or women. Most

cases are within the age of fifteen and thirty-five. In some cases, it

is within the family. A family member having Crohn’s disease would

have a brother or sister with the same disease or a similar disease

popular as ulcerative colitis.

What Causes Crohn's Disease? There is no specific proven cause

for Crohn’s disease. Most doctors are of the opinion that

inflammation in the intestine cause the body's immune system to

react negatively to the present bacterium or virus within the

intestine. Additionally, Crohn’s disease could be due to virus

infection, harmful chemicals present in the environment or genetic

factors.

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Does emotional stress cause Crohn’s disease? No, emotional

stress does not cause Crohn’s disease. However, stress can

aggravate present symptoms.

What are the main symptoms of Crohn's disease? The earliest

symptoms of Crohn’s disease are severe abdominal pain, specifically

in the lower part of the right side and diarrhea. Since these

symptoms are similar to those of appendicitis and ulcerative colitis,

many often mistake Crohn’s disease for these. Other important

symptoms of Crohn’s disease are ulcers, sores, skin tags or

hemorrhoids, and cracks around the anus. In some cases, blood

could pass with the stool.

Are there any more symptoms of Crohn’s disease? Yes, other

symptoms of Crohn’s disease include tiredness, loss of appetite,

fever, weight loss, vomiting, and skin rashes, itching around the

anus, and pain around the anus after passing of motions.

What happens in Crohn's disease? This disease causes many

changes in the bowel wall. Inflammation, ulcerations, and formation

of fistulas or channels within and outside the intestine are common

as the disease progresses.

How is Crohn’s disease diagnosed? Doctors initially inquire

about your symptoms before diagnosing Crohn’s disease. Crohn’s

disease symptoms are similar to those of gastrointestinal infection

or irritable bowel syndrome. Therefore doctors conduct a series of

tests.

Tests could be blood or stool tests. Thereafter, doctors conduct

bowel examinations through colonoscopy and sigmoidoscopy.

Doctors also take x-rays and sometimes examine a piece of infected

tissue under the microscope. This is a biopsy.

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A Barium enema can also indicate presence of Crohn’s disease. This

involves the insertion of barium liquid through the rectum into the

colon. Thereafter, doctors take x-rays to get clear pictures of

affected parts. Barium is a chalky colored liquid that acts like a dye.

What is the difference between Crohn's disease and

inflammatory bowel disease? Inflammatory bowel disease is a

group of diseases affecting bowel movements due to inflammation

in the digestive tract. Crohn’s disease is one of the diseases under

inflammatory bowel disease. Another important disease in this

group is ulcerative colitis.

What are the diet restrictions for Crohn’s disease patients?

There is no specific diet, which can provide you immediate relief

from Crohn’s disease symptoms. Normally, it is best to avoid spicy

and greasy foods, alcohol, high-fiber foods, and milk for lactose

tolerant people. Eat nutritious food and have many small meals

instead of few big meals. Further, you should have vitamin

supplements as advised by your doctor.

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Glossary of Crohn's Disease Medical Terms

Abscess: Infected area outside or on the bowel wall causing pain

and high fever

Barium Enema: Taking x-rays after inserting special barium dye

through a tube in the rectum into colon. This produces clearer x-

rays.

Colonoscopy: Inserting an electronic imaging scope through the

anus into the colon for thorough colon examination. Projection of

the image is on a screen.

Fissure: Deep cuts around anus causing extreme pain in bowel

movements

Fistula: Improper opening on diseased part of intestinal wall

forming a loop to another part of the intestine or any other organ

like bladder, anus, or abdominal muscle.

Flare-up: Exaggeration of existing symptoms of a disease

Gastro duodenal CD: Crohn’s disease affecting the top part of the

small intestine covering the duodenum and stomach

Granulomatous Colitis (Crohn's Colitis): Crohn’s disease of the

colon only

Ileitis: Crohn’s disease of the last portion of small intestine, which is the ileum

Ileocolitis: Crohn’s disease of the first part of the colon and the

ileum.

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Immunoregulators: Same as immunomodulators or

Immunosuppressives; a specific class of drugs that lowers the

response of the body’s natural immune system.

Inflammatory bowel disease: Specific classification of disease

that includes ulcerative colitis and Crohn's disease.

Jejunoileitis: Crohn's disease of jejunum. Jejunum lies between

ileum and duodenum and is the largest part of the small intestine.

Obstruction: Particular segment of intestine with major portion of the insides blocked off. Chronic inflammation, acute inflammation,

or regular remissions and relapses causing build-up of scar tissue

can cause obstruction.

Osteoporosis: Gradual loss of bone density. This disease often occurs due to lack of proper and timely treatment of Crohn’s

disease.

Remission: Specific period or time when disease symptoms are

very few.

Sigmoidoscopy: Gently inserting flexible fiber-optic scope of sixty millimeters through the anus for a clear view of sigmoid colon and

rectum.

Steroids: Specific class of drugs primarily in use for treating chronic inflammatory conditions as prevalent in Crohn's disease, ulcerative

colitis, lupus, and rheumatoid arthritis

Stricture: Small part of narrowed intestine

Total parenteral nutrition (TPN): Feeding balanced solutions

containing essential nutrients like carbohydrates, proteins, and fats

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through a major body vein, normally under the collarbone. Such

feeding is possible at home or in the hospital.

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