Living with Crohn's Disease

A diagnosis of Crohn's disease can mean different things to different people. If symptoms are severe, then it may mean certain lifestyle adjustments or uncomfortable conversations with family, friends, or co-workers. If symptoms are mild, then certain changes to diet, along with proper treatment and an honest conversation with loved ones about the disease, may be your best route to coping with the disease.

No matter how severe or mild your condition, however, Crohn's disease does impact your lifestyle and can also have an affect on your overall health and well being. It's important to be prepared for these changes and understand how you can better deal with them, as well as cope with the emotional challenges of the disease. Remember, many people with Crohn's disease lead active and productive lives.

• A few things to keep in mind
• Diet and nutrition
• Exercise
• Social events
• Managing stress

A few things to keep in mind

The key to living life the way you want is to develop your own guidelines for health and wellness. Following your gastroenterologist's advice, taking medicines as scheduled, and keeping your gastroenterologist's appointments are the first steps toward staying healthy. But good lifestyle habits — like eating a balanced diet rich in nutrients, managing stress levels, and getting enough of the right kind of doctor-approved exercise — may also play an important role in your health.

It's also important to maintain a positive attitude and find ways to reduce stress when possible. Do your best to continue to be physically active (always consult with a doctor before you start any new exercise program), and find people, such as family and friends, in whom you feel comfortable confiding. Build a support system comprised of people you can talk to about your condition.

Diet and nutrition

Most of food digestion occurs in the small intestine, which is situated just beyond the stomach. After digested food is broken down, it is absorbed through the surface of the small intestine and distributed to the rest of the body via the bloodstream. Anything that is not digested passes on to the large intestine, or colon. As the colon reabsorbs water that was added to the food in the small intestine digestion process, the residual food passes through the body in the form of a bowel movement.

However, when the small intestine is inflamed, as is often the case with Crohn's disease, it is less capable of breaking down food and absorbing necessary nutrients. These nutrients escape to the large intestines and ultimately out of the body. This is one of the reasons why people with Crohn's disease may feel tired. They may also be malnourished because their bodies are not absorbing the necessary nutrients. In addition, the water absorption process that happens in the large intestine may also be impaired by inflammation. This can cause diarrhea and dehydration.

Depending on the severity of their conditions, some people need to restrict their diets all the time, others just some of the time. Still others may eat a normal, unrestricted diet. It's important to have limited restrictions to your diet, otherwise you may become bored with what you eat. This can result in reduced energy levels and weight loss.

Important nutrients

You'll want to maintain a diet rich in protein and vitamins, especially vitamins A, D, C, B-12, and folic acid. Also, add foods that contain calcium, iron, and zinc. In order to make sure you're including the proper nutrients in your diet, it's best to eat a variety of foods from the four basic food groups:

• Meat and meat substitutes (protein, iron, vitamin B-12)
• Dairy (calcium, vitamin D, vitamin A)
• Cereal and grains (zinc)
• Fruits and vegetables (calcium, vitamin C, B-12, zinc)

You may also want to lay off the spicy food. Soft, bland foods may cause less discomfort than spicy or high-fiber foods when Crohn's is active. Alcoholic beverages may worsen symptoms as well by irritating the gastrointestinal tract. Think about reducing or eliminating your alcohol consumption, particularly when you are experiencing symptoms. Except for restricting milk in lactose-intolerant patients, most gastroenterologists try to plan flexible diets for their Crohn's patients.

Talk to your gastroenterologist or a dietician about developing a healthy diet that is "Crohn's friendly."

Exercise

First, always remember to consult your doctor before beginning an exercise program, especially if you're taking medications. Second, again with your doctor's help, find an activity you enjoy. Just being able to look forward to something can help motivate you to keep doing it.

Exercise is beneficial for Crohn's patients because it reduces stress and depression, and even helps normalize bowel function. Aerobic exercises, such as fast walking, swimming, and cycling, stimulate your endorphins, helping you to maintain a positive attitude and keep stress to a minimum. Yoga is another good way to stay in shape and can help you to relax and relieve stress. Just remember to always talk to your doctor about which exercises are right for you.

Social events

Feel more comfortable at your next social engagement with a little advance preparation. Here are a few suggestions:

• Ask about the facility where the event will be held. Where are the bathrooms? Is there an area where you might rest in case you need to do so?
• Find out about the menu. If the food is likely to aggravate your symptoms, then ask if a meal substitution is possible. You may request such a change from the host or the organizer of the event.
• Limit or eliminate your alcohol intake, especially if you are experiencing symptoms.
• Bring your medication with you in case you need it.
• Crohn's symptoms, like chronic diarrhea, can cause dehydration. Since you may not always have easy access to food and drink, carry a bottle of water to keep yourself hydrated.

Managing stress

Crohn's disease is not caused by stress; however, emotional stress can influence the course of the disease. The stress that people with Crohn's disease sometimes feel is often due to painful, embarrassing symptoms and the worry that accompanies trying to manage them. Managing stress starts with identifying and learning ways to handle emotions brought on by the reality of living with Crohn's disease.

Time to sit down, relax, and talk

It is normal to feel angry, afraid, guilty, or depressed about your condition. But dealing with those feelings constructively can help you better manage the stress you are feeling about Crohn's disease. Share you feelings with people in whom you trust and then manage expectations with friends and family. Keep the following in mind:

• You are not alone. Crohn's disease affects men and women across all ages and professions. There are ways to manage the often unpredictable symptoms and to lead an active, successful life.
• Allow yourself the right to feel unhealthy. Anticipating how well you may feel tomorrow — or on a special occasion two months from now — can be stressful. But there are ways to manage this anxiety. By accepting the reality of that unpredictability, you can help regain some control over how your Crohn's disease takes its course.
• Seek support in others. Communicate with family and friends so they understand what you need from them. Accepting that some physical limitations may exist from time to time and seeking understanding from loved ones may help you prepare for the times when you may not be able to go where you wish, or do what you had planned.
• Educate yourself. Fear arises from the unknown. If you've been recently diagnosed, explore the resources on this site. Sometimes experience is the best teacher. Regardless of how long you have had Crohn's disease, joining a support group can be valuable in helping you understand and relate to your own feelings about your disease.

Click here to learn about the best way to talk with your gastroenterologist.