Dietary considerations for GI Distress

Irritable Bowel Syndrome (IBS), Crohn’s Disease, and Diverticulitis are all conditions that affect the colon. People with these diseases may be able to reduce the severity of their symptoms (abdominal pain, cramping, diarrhea, constipation, etc.) through dietary intervention. Allergy testing should be performed to see if there are specific foods that a person should eliminate from their diet. If allergy testing is not an option, it would be beneficial for a person to do an elimination diet and then slowly introduce foods back into the diet.
Irritable Bowel Syndrome (IBS):
Dietary options:
Elimination/Challenge Diet to determine and eliminate irritating foods (specifically fatty foods, fiber, fructose, gluten, lactose)
FODMAPs Diet
Paleo Diet
Tips:
Chew food thoroughly
Increase water intake, consuming 64-80 oz. per day
Increase daily fiber consumption (as tolerated)
Avoid: refined carbs, foods additives, processed foods, and caffeine
Possible supplements: Probiotics; Prebiotics; Soluble fiber (psyllium) with meals; Vitamin D; Melatonin, Betaine HCl, and Pancreatic Enzymes
Consider testing for: Candida overgrowth/Small Intestinal Bacteria Overgrowth (SIBO); Food allergy/intolerance; Cortisol; and Serotonin
Consider increasing exercise
Examine sleep hygiene
Crohn’s Disease:
Dietary Options:
Elimination/Challenge Diet to determine and eliminate irritating foods
Anti-inflammatory Diet/Specific Carbohydrate Diet and restriction of gluten and dairy.
Tips:
Eating smaller meals
Increase soluble fiber intake from fruits and vegetables. (Note that a small portion of people have decreased symptoms from a low fiber diet). Decrease fiber when the disease is active and slowing reintroducing it.
Avoid: dairy (if not tolerant), fatty meats, yeast, beans, peas, nuts, raw fruits, raw vegetables, seeds, popcorn, high sugar drinks, juices, caffeine, alcohol, and sugar alcohols.
Possible supplements: Multimineral/multivitamin; Zinc (if Zinc is taken long term also supplement with Copper); Magnesium; Folic acid; Vitamin B12; Propionyl-L-carnitine; Thiamine; Vitamin B6; Vitamin B3; Vitamin A; Omega 3 fatty acids; Vitamin C; Vitamin D; Vitamin K; Iron; Potassium; L-Tryptophan; Carotenoids; Molybdenum; Selenium; Vitamin E; Dehydroepiandrosterone (DHEA); Probiotics; Chromium; Calcium; N-Acetylcysteine; Phosphatidycholine; Prebiotics; Butyrate. (Note that while Glutamine is good for the colon it is contraindicated and should not be used in the treatment of Crohn’s Disease)
Consider testing for: Candida overgrowth; RBC; Zinc; serum homocysteine; RBC Magnesium; Serum Iron; 25-OH Vitamin D
Focus on reducing stress
Diverticulitis:
Dietary Option:
Elimination/Challenge Diet to determine and eliminate irritating foods (specifically milk)
Tips:
Increase daily fiber consumption
Possible supplements: Probiotics; Butyrate
NOTE: It is best to work with a nutritionist or Health Care Provider to customize a meal plan and supplement protocol that is right for you.
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About the Author: Sam Tucker is a graduate of New York Chiropractic College with a Master's in Applied Clinical Nutrition. She has recently completed the required supervised hours to earn her CNS credential and is anxiously awaiting to hear the score from her CNS Exam. In addition to building her clinical practice, Sam lives in Kentucky with her husband and her children.
References:
1. Gaby A. Nutritional Medicine Second Edition. Fritz Pelberg Publishing. Concord, NH. C2017. Pg 421-432, 436, 461-465.
2. Rakel D. Integrative Medicine. Fourth Edition. Elsevier. Philadelphia, PA. C2018. pg 423-431, 501-516.
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