Inflammatory bowel disease is a broad medical term that includes a group of gastrointestinal diseases associated with long term inflammation of the digestive tract. The most common form of bowel inflammation includes ulcerative colitis and Crohn’s disease. In ulcerative colitis, the inflammation is usually seen along the intestine; whereas in Crohn’s disease, the inflammation is rather localized and can be noted anywhere in the digestive tract from the mouth to the anus.
Bowel inflammation is closely associated with the diet followed by the patient. It is very important to keep a close watch over the food intake, as it has been seen that certain food item can act as trigger agent and can worsen the existing condition. Though the list of food capable of triggering inflammation varies from person to person, it has been noted that the following food item commonly causes bowel inflammation and thus should be avoided.
Which Foods Cause Bowel Inflammation?
The following food items are known to trigger flare up leading to worsening of the condition:
Dairy Products: These food items are known to trigger bloating and gas, which in turn can aggravate bowel inflammation. It is not uncommon to find patients with inflammatory bowel to have lactose intolerance as well.
Dry Fruits and Nuts: These food items are hard to digest and can act as an irritant against the lining of the gut. Solid nuts can be substituted with almond butter or peanut butter which is easier to digest.
Seeds Can Cause Bowel Inflammation: Seeds and grains may be present in fruits such as strawberries and raspberries, and also in breads, biscuits, cereals etc. This can act as an irritant in the digestive system as they are difficult to digest. Incomplete digestion can worsen the bowel inflammation and can even cause diarrhoea.
Popcorn: Corn has high content of fibre, which makes it very difficult to digest. Popcorn may contain hulls and shells of corn along with un-popped corn kernels, which do not get digested and can create problems.
Raw Vegetables and Fruits: Raw vegetables and fruits have high content of fibre, which is difficult to digest. Some fruits may be tolerated after removing the skin; however, it is best to avoid eating raw fruits and vegetables to avoid complications.
Carbonated Beverages: Carbonated beverages such as soda can add unwanted gas in the digestive system leading to pain and discomfort along with inflammation.
Caffeine and Chocolate can Cause Bowel Inflammation: Both these products have the property to stimulate the gut and thus can worsen the condition.
Spicy Food: Excess spice in food should be strictly avoided as it irritates the lining of the stomach and causes inflammation and ulcers.
Fatty Food: Fatty foods are not completely absorbed by the small intestine, which can cause cramping and worsening of the condition.
Alcohol Causing Bowel Inflammation: Alcohol consumption should be strictly avoided, as it promotes bloating and gastric irritation. It can cause dehydration and can also interfere with the normal uptake of medications prescribed for bowel inflammation.
How to Treat an Inflamed Bowel?
The diagnosis and treatment of inflamed bowel is done by an experienced gastroenterologist. Consultation with an experienced dietician or nutritionist may be necessary for planning a diet suitable for the patient. The diagnosis involves obtaining a detailed case history followed by a physical examination of the patient. Additional tests may be done to confirm a diagnosis and for ruling out other conditions. Blood tests are ordered to look for anemia and signs of infection. Faecal occult blood test (stool test) is also done by the physician to look for blood in the stool. Specialized tests such as endoscopic procedures are done, which may include colonoscopy, flexible sigmoidoscopy, upper endoscopy, capsule endoscopy, balloon assisted enteroscopy etc. In most of these procedures, a long tube in inserted into the digestive tract through the mouth of the anus with a camera attached to study the inner portion of the digestive tract. It is also used to obtain tissue samples from the digestive tract for biopsy and pathological studies. Imaging studies are also done to support the diagnosis and treatment plan. X-rays, CT (computerized tomography) scans and MRI (magnetic resonance imaging) are done for rightful diagnosis.
The treatment of inflamed bowel aims at reduction and control of the inflammation. The conventional treatment involves drug therapy and advanced cases may require surgery. The common treatment modalities and discussed below:
Anti-inflammatory Medications: This is often the first step in management of inflamed bowel. As the name suggests, these drugs help in arresting the inflammation and promotes healing. Anti-inflammatory drugs include corticosteroids, amino salicylates, olsalazine, balsalazide etc. The choice of medication depends on each individual’s condition.
Immune System Suppressors: These are specialised drugs which help in supressing the immune response which produced inflammation inducing chemicals in the intestine. The commonly used drugs include mercaptopurine, cyclosporine, methotrexate, azathioprine etc.
Antibiotics to Treat Bowel Inflammation: Antibiotics such as ciprofloxacin and metronidazole are prescribed based on the patient’s condition. These are prescribed if the condition is associated with bacterial infection.
Other Medications to Treat Bowel Inflammation: Other medications and supplements may be prescribed for management of associated signs and symptoms. Some of these medications includes:
- Anti-diarrheal Medications: Such as a fibre supplement (Psyllium powder or methyl cellulose) for adding bulk to the stool and control diarrhoea. Drugs such as loperamide are also effective.
- Pain Reliever: Pain killers such as Tylenol, Advil, Motrin, Aleve, and Voltaren may be prescribed for management of abdominal pain associated with inflamed bowels.
- Iron Supplements: These are often prescribed to prevent development of iron deficiency anemia from intestinal bleeding.
- Calcium and Vitamin D Supplements: Inflamed bowel may be associated with increased risk of development of osteoporosis. Thus, calcium and vitamin D supplements are often prescribed to manage this issue.
Dietary Modification to Treat Bowel Inflammation: It is important to avoid food items that trigger the condition, as described above and follow an easy to digest, low residue diet. In most of the cases, a special diet is recommended. In advanced cases, nutrition may be provided through a feeding tube or injected into veins. This is done to provide rest to the bowel to reduce inflammation. It is recommended to have smaller frequent meals, rather than spaced out large meals. Adequate hydration is also very important.
Lifestyle Modification: It is important to bring about few changes in lifestyle for management of this condition. It is advised to limit alcohol consumption and quit smoking. It is also important to stay physically active and exercise regularly. Measures should be taken for stress management.
Surgical Intervention: If medications along with dietary and lifestyle modification do not control the condition, surgical intervention is considered. Surgery may involve complete removal of the colon and rectum (protocolectomy). This is often followed by a procedure called as anal anastomosis, which eliminates the need to wear a pouch or bag to collect the stool. It is a procedure where a pouch is created from the end of the small intestine and attached directly to the anus for normal defecation.
Alternative Medications to Treat Bowel Inflammation: Alternative medications can be considered for management of inflamed bowels; however, these should be taken in conjunction with conventional treatment plan. The commonly suggested alternative mediations include probiotics, fish oil supplements, aloe vera extract, turmeric, acupuncture, prebiotics etc.
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