Articles On Ulcerative Colitis Overview
Ulcerative colitis affects your colon, which is part of your digestive system. A lot of things can cause trouble in that general area, so how do you know what it feels like to have ulcerative colitis?
It depends on how severe it is, and on what part of your colon is affected.
Also, symptoms can come and go. You might not have any for weeks, months, or even years, and then they come back. Chances are about 50-50 that the effects will be mild.
Still, most people with the disease have a few common issues:
How Is Unexplained Weight Loss Diagnosed
To diagnose your weight loss, your doctor will give you a physical examination and ask you such questions as:
- How much weight have you lost?
- When did the weight loss begin?
- Are you taking any medications?
- Have your eating patterns changed?
- Are you exercising more?
- Are you depressed?
- How much alcohol do you drink per day?
The answers to these questions will help your doctor determine if other tests might be needed, such as blood work and imaging scans .
Add In Meal Replacement Shakes As Necessary
Many experts recommend meal replacement shakes or nutritional supplements, like Ensure Plus or Boost, to help with weight maintenance. Liquid supplements like these take up very little volume and are easy on the stomach, but they contain a relatively high amount of calories and protein.
I eat every two or three hours, even if its a couple of crackers, and drink a meal replacement shake. This helps me maintain my weight, said a member.
Note that these shakes often contain dairy products, so talk with your doctor for their recommendation, especially if you are sensitive to dairy or are lactose intolerant.
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Inflammatory Bowel Disease Management
Inflammatory bowel disease is not caused, nor can it be cured, by what you eat. Doctors and dietitians agree, however, that food may play some role in the underlying inflammatory process that causes IBD symptoms.
Certain foods may aggravate symptoms, while others may calm them and promote healing. Therefore, paying attention to what you eat and how your body responds to different foods is an important component of a total treatment plan for IBD.
A diet plan can supplement but should never replace medical treatment for IBD. Always take your medications exactly as prescribed by your doctor.
Managing The Emotional Toll Of Crohns Disease Weight Loss
Although its primary effects are physical, Crohns can carry emotional baggage too. Many people dont understand the disease and make comments that are hurtful or frustrating, says Frank J. Sileo, PhD, a psychologist in Ridgewood, New Jersey. Dr. Sileo, who has Crohns disease himself, has heard statements ranging from Youre so thin you need to put a little meat on your bones to I wish I had Crohns disease so I could lose weight.
My approach to these kinds of comments is to educate and use humor, Sileo says. I might say, This darn Crohns disease keeps getting in the way or You can have the diarrhea, joint pain, nausea, fever, and chills with that weight loss too. And if anyone tries to attribute your weight loss to an eating disorder, he suggests explaining that Crohns disease isnt an eating disorder or due to stress, but rather a form of IBD that requires medical attention.
It also might help to talk about your feelings. Sileo recommends contacting the Crohns and Colitis Foundation to find a support group in your area. A mental health professional who specializes in coping with chronic illness can also be helpful as you navigate emotions often associated with Crohns disease, he says.
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Diet Progression Following Flares For Ulcerative Colitis And Crohn’s Disease
- Continue to follow a low residue diet and slowly add back a variety of foods.
- Begin with well-tolerated liquids and advance to soft solids, then solids .
- Introduce one or two items every few days and avoid any foods that cause symptoms.
- Add fiber to diet as tolerated. Well-tolerated fiber sources include tender cooked vegetables, canned or cooked fruits, and starches like cooked cereals and whole wheat noodles and tortillas.
- Between flares, eat a wide variety of foods as tolerated. This includes fruits, vegetables, whole grains, lean protein, and low-fat and nonfat dairy products.
- Increase your calorie and protein intake following a flare. Abdominal pain, diarrhea and decreased appetite may have caused poor food intake. Steroids used to treat flares also can increase protein needs.
Suggestions for first foods after a flare include:
- Diluted juices
Traditional High Fat Choices Might Not Work
A dietician might prescribe full-fat foods but the problem with this is that many traditional fatty foods can worsen symptoms. Full example full-fat milk might cause a problem if you have problems with dairy whilst high-fat foods can increase gut motility and cause you to rush to the loo. So although these items do contain lots of fat theyre likely to worsen your symptoms and if you cant keep the food down, youre not going to see the benefit!
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Facing The Complications From Obesity
Knott is one of a growing number of people with inflammatory bowel disease who are struggling with weight issues.
A study published in February 2017 in the journal Nature Reviews Gastroenterology and Hepatology reported that 15 to 40 percent of people with IBD are overweight or obese. Diet and lifestyle changes over the past few decades have contributed to this shift. Certain drugs also play a role in weight gain.
Whats worse, obesity can also complicate the management of an IBD.
Obese patients with IBD may experience a more complicated course, be more prone to hospitalization, and spend more days in the hospital, says the studys coauthor, Siddharth Singh, MD, a clinical assistant professor of medicine in the division of gastroenterology and a postdoctoral fellow in the division of biomedical informatics at the University of California in San Diego School of Medicine in La Jolla. They may not respond to medication as robustly as nonobese patients, and may lose response to therapy quickly. They may need more surgeries, and in the case of surgery, obese patients are more likely to experience postoperative complications, particularly infections.
One important factor contributing to obesity in people with IBD is steroid use, says Dr. Singh. Roughly 10 to 20 percent of patients treated with steroids can gain 10 pounds or more, along with experiencing other complications.
Certain Foods Can Trigger Uc Symptoms In Some People
Has ulcerative colitis made you hesitant to eat for fear of causing painful symptoms? If you know for sure what foods make you feel worse, it’ll be easier to live with the disease. A Current Treatment Options in Gastroenterology noted that people with inflammatory bowel disease who had a diet full of fiber from fruits and vegetables, and low in animal fats, dairy, and processed food, had the fewest flares and best health outcomes. Doctors and nutritionists recommend that people who are diagnosed with ulcerative colitis change their dietary intake to ensure that they are consuming much-needed nutrients without exacerbating symptoms.
Whats the best way to identify what not to eat if you have UC? According to the research review mentioned above, starting an elimination diet for patients with Crohns disease or UC allowed 73 percent of patients to achieve remission in a six-week period. . Elimination diets, where patients remove certain foods from their diet to see if their symptoms abate, are a good way to identify common food triggers.
To get started on one, record all the food you eat during the day in a diary or journal along with any symptoms you experience. You can do this with pen and paper or with phone apps.
That said, there are certain foods that are known triggers for UC symptoms. Speak to your doctor to determine the best way to eliminate or limit these foods to ensure that you’re still meeting all your nutritional needs.
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Stock Up On Nutritious Convenient Foods
People experiencing a UC flare may eat unhealthy junk foods for convenience rather than seeking out healthier alternatives.
Stocking cupboards and the refrigerator with quick, nutritious foods that are enjoyable can help people make food choices that are better for their health and prevent them from snacking on nonnutritious foods.
Maintain A Healthy Diet
People with UC should eat a nutritious, well-balanced diet full of nutritious foods, including:
- Fruits and vegetables: People should try a variety of fruits and vegetables and remove the peel and seeds if they trigger a flare.
- Fiber-rich foods: These include whole grains, beans, nuts, oat bran, and barley. These foods are unsuitable for people with an ostomy or intestinal narrowing, and a person should avoid them if a doctor has advised them to follow a low fiber diet.
- Calcium-rich foods: These foods include milk, yogurt, kefir, lactose-free dairy products, and collard greens.
- Protein: Lean meats, fish, tofu, nuts, and eggs are good sources of protein.
- Food with probiotics: People can try including more yogurt, miso, sauerkraut, tempeh, and kimchi in their diet.
When experiencing a flare, a person may tolerate moderate portion sizes of the following foods:
- low fiber fruits
- lean protein, such as fish, poultry, soy, and eggs
- refined grains, such as sourdough, white pasta, potatoes, and oatmeal
- vegetables that are fully cooked and do not contain seeds or skin
Specific diets that a person may wish to discuss with a healthcare professional include:
- the Mediterranean diet, also known as the anti-inflammatory diet or IBD-AID
- the Paleolithic diet
- semi-vegetarian diets
- fasting diets
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Focus On Healing Inflammation
The small intestine is where most of our nutrients from food are absorbed. Since the small intestine is involved with Crohnâs disease, this can be a significant hurdle to gaining and maintaining weight.
Even though ulcerative colitis is only in the large intestine, it does not mean that those with UC shouldnât focus on healing inflammation. Thatâs because inflammation can occur from gut permeability, bacterial and fungal overgrowths, food sensitivities, and more â not just from inflammation directly from having IBD. Additionally, inflammation in the large intestine presents its own concerns.
The more inflammation you have, the more your body will struggle to absorb nutrients. That hurts your chances of achieving an adequate weight.
I saw improvements in my weight when I made my diet simple but nutrient-dense. I left out some of the âfunâ gluten-free snacks I enjoyed and zeroed in on proteins, grass-fed butter and extra virgin olive oil, bone broth, teas, and herbs.
I even swapped out some of the products I used on my skin and in my home to eliminate them as a potential source of stress for my body.
To start healing inflammation, focus on eating an anti-inflammatory diet and incorporating the best foods for gut health.
In general, an anti-inflammatory diet is low in sugar and free of refined grains. The focus should be on whole foods like quality proteins, fats, fruits, vegetables, nuts and seeds as tolerated, and water as the main source of hydration.
You’ve Lost Weight You Look Great
“My biggest pet peeve is comments about my weightanything weight-related,” said Marge McDonald, who ran a council on aging and senior center in Chelmsford, Mass., and was first diagnosed with UC in 2001. “We’re so focused on weight we don’t notice anything else.”
That might be due to the fact that when individuals with an IBD lose weight, they may be dealing with symptoms like severe diarrhea, abdominal pain accompanied by nausea, and frequent bowel movements, as noted by the Crohn’s & Colitis Foundation.
McDonald also recalled that when her motherwho also has UClost about 50 pounds, people kept saying how great she looked. McDonald said she would think, “No, she doesn’t. Her skin is hanging off her she looks gray.”
Thus, just because someone with an IBD has lost weight, that doesn’t mean that they feel good about itor about the fact that you’ve mentioned it.
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Diet Recommendations For Crohn’s Disease Flare
- Follow a low residue diet to relieve abdominal pain and diarrhea.
- If you have strictures, it is especially important to avoid nuts, seeds, beans and kernels.
- Avoid foods that may increase stool output such as fresh fruits and vegetables, prunes and caffeinated beverages. Cold foods may help reduce diarrhea.
- If you have lactose intolerance, follow a lactose-free diet. Lactose intolerance causes gas, bloating, cramping and diarrhea 30 to 90 minutes after eating milk, ice cream or large amounts of dairy. A breath hydrogen test may confirm suspicions of lactose intolerance.
- If you have oily and foul-smelling stools, you may have fat malabsorption. Treat fat malabsorption by following a low-fat diet. Discuss these symptoms with your doctor or nutritionist.
- Smaller, more frequent meals are better tolerated and can maximize nutritional intake.
- If your appetite is decreased and solid foods not tolerated well, consider taking nutritional supplements .
Does Ulcerative Colitis Cause You To Lose Weight
It can. Weight loss is a common symptom of UC, especially when the condition isnt managed. You may lose weight for a few reasons.
Symptoms like nausea and belly pain can make you less interested in eating. Diarrhea and some of the drugs you take to manage IBD can make it harder for your body to absorb nutrients from foods. And inflammation makes your body burn calories faster.
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Implications For Clinical Practice
This study has documented weight loss as a significant problem for many IBD patients at presentation, especially in younger age and CD with ileal involvement. However it is not universal particularly in older patients of whom nearly half do not experience any weight loss. To our knowledge, this is the first study to characterise weight loss prior to diagnosis in patients presenting with inflammatory bowel disease. Improved awareness of the presenting features of IBD should encourage wider use of screening tools and earlier investigative tests. Current tools used to help decide disease severity do not emphasize weight loss. The Harvey-Bradshaw Index does not incorporate any weight statistic into its calculation. The CD Activity Index does include a parameter for body mass, but its overall bearing on the total score appears limited.
Finding Treatment For Overweight People With Ibd
Among IBD patients with obesity, Bosworth says the approach to treatment varies. He stresses that diet is an important consideration, and that for people who are obese, weight loss is beneficial for their overall health and treatment.
Just a five percent weight loss can make a big impact on a patients therapeutic success, Bosworth says.
He explains that some people gain weight because their bodies are trying to control inflammation so well that the body actually adds fat to make up for the calories used to peel away inflammation.
When a person comes in and is given a new diagnosis, treatment really varies from patient-to-patient and diagnosis-to-diagnosis, Bosworth adds. A treatment for maintaining Crohns and losing weight at the same time could be right for one person but might not be right for everyone.
Bosworth laid out these helpful tips for people trying to manage their weight while also living with IBD:
Make a change of diet. Bosworth says changes to your diet could help. For instance, a high ironbased diet could help speed up the metabolism and spur weight loss.
Seek out surgery. I have had patients who are morbidly obese who have tried different types of diets and not found them to be effective, Bosworth says. Sometimes surgery has been the best path for these patients. I have had some obese patients who have needed to seek out bariatric surgery, for instance thats what they needed to improve their overall health and weight.
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Why Does Ibd Cause Weight Loss
IBD causes weight loss for a few reasons:
- You have diarrhea. During an active symptom flare, you can have six or more loose bowel movements per day. Frequent diarrhea strips your body of nutrients and can lead to weight loss. Some people with IBD eat less to avoid visiting the bathroom so often.
- You feel too sick to eat. Its hard to eat well with symptoms like nausea and belly pain. When you have no appetite, you may eat fewer of the calories and nutrients that you need to maintain your weight.
- You have inflammation. During flares, theres more inflammation in your colon, leading to severe symptoms such as diarrhea and decreased appetite, which may lead to weight loss.
- You experience chronic inflammation. An increased demand for protein is often the result of chronic inflammation. When this happens, your body may start to break down muscle and other fat-free areas of mass. The decrease in muscle mass can cause you to lose weight.
- Your doctor has put you on a liquid diet. Inflammation can leave areas of scar tissue called strictures in your intestines. You may need to stick to a liquid diet until the inflammation goes down and your intestine heals.
Ulcerative Colitis Symptoms: Weight Loss Due To Loss Of Appetite And Other Factors
Weight loss is quite common in ulcerative colitis, either due to loss of appetite or other factors. A type of inflammatory bowel disease , ulcerative colitis is often accompanied by painful flare-ups, so choosing the right foods to eat is often quite difficult.
Food plays a large role in ulcerative colitis because it can trigger a flare-up. Out of fear of feeling sick, some patients may avoid eating, cut down on their eating, or even lose their appetite altogether. All of these factors can result in unintended weight loss in ulcerative colitis patients.
Like many IBDs, ulcerative colitis may impact each person differently, so what may affect one patient may go unnoticed in the other. Although patients with ulcerative colitis may experience a host of differing symptoms, common ones include blood stools, bathroom urgency, loose stools, abdominal pain, worsening symptoms, inflammation, remission periods, and weight loss.
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