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Flare food vs. not flaring foods

My husband was told by his gi to start the low residue diet when he had his fist major flare that landed him in the hospital for 2 weeks. The gi doc said that after his flare subsides and he's in remission there is no reason he cannot go back to his prior eating habits. To keep a food log and if something bothers you jot it down and don't eat it. He went back to enjoying all of the foods he loves and wasnt really bothered by anything... I thought this was too good to be true!
Here he is flaring full force again already! Do most Crohns sufferers completely change their diets on or off a flare?
Thanks!
 

Jennifer

Adminstrator
Staff member
Location
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During a flare the Low residue diet is a good one to start with. If that's too much to handle than a liquid diet may be better. There are many supplement drinks out there to try (I recommend avoiding any that contain Carrageenan) and you can also make your own soups (low in sodium, you can also blend it up so there aren't any large bits in it or chop things finely) and drink the broth. If you do decide to try a liquid diet then please inform your doctor. Some members have also tried juicing to get nutrients that way. I haven't tried it yet because its too expensive for me. Keep in mind that excess sugar from certain fruits and vegetables may cause some diarrhea so do research on juicing before trying it (and if you juice beets, try the yellow or orange ones so you don't freak out from the red coloring in the toilet if you juice the red beets).

During remission though I don't avoid any particular foods. There are common ones that may cause diarrhea like fried food and for me anything that contains lactose because I'm lactose intolerant yet these symptoms go away after the food has passed. Thus far there aren't any particular foods that have been linked to causing a flare.
 
I think your doctor gave good advice. Many people do find adjusting their diet for a flare is helpful, maybe even necessary, as Jennifer said in the post above. But the diets that help most during a flare - low fibre/residue, maybe even a liquid diet - are not necessarily the healthiest way to eat long term. For example, trying to eat vegetables during a flare may make symptoms worse, but if your husband is able to tolerate them when not flaring, adding more vegetables to his diet may benefit his general health long term.

No way of eating is going to cause him to flare, so it makes sense for him to eat foods he likes when he is able to (assuming his normal diet isn't particularly unhealthy in other ways - e.g. causing excessive weight gain, lacking vitamins, etc.).

Many people with Crohn's have difficulties digesting properly even when not flaring though - or at least when tests show there's no sign of currently active inflammation. I think sometimes that given what our digestive systems go through, the intestines of some people with Crohn's are never going to be quite as good as the intestines of a person without the disease. So your husband may need to watch for things giving him trouble even when not flaring, though it sounds like he didn't have any problems last time he was in remission. :)
 
I think your doctor gave good advice. Many people do find adjusting their diet for a flare is helpful, maybe even necessary, as Jennifer said in the post above. But the diets that help most during a flare - low fibre/residue, maybe even a liquid diet - are not necessarily the healthiest way to eat long term. For example, trying to eat vegetables during a flare may make symptoms worse, but if your husband is able to tolerate them when not flaring, adding more vegetables to his diet may benefit his general health long term.

No way of eating is going to cause him to flare, so it makes sense for him to eat foods he likes when he is able to (assuming his normal diet isn't particularly unhealthy in other ways - e.g. causing excessive weight gain, lacking vitamins, etc.).

Many people with Crohn's have difficulties digesting properly even when not flaring though - or at least when tests show there's no sign of currently active inflammation. I think sometimes that given what our digestive systems go through, the intestines of some people with Crohn's are never going to be quite as good as the intestines of a person without the disease. So your husband may need to watch for things giving him trouble even when not flaring, though it sounds like he didn't have any problems last time he was in remission. :)
Thanks for the info! Yes, he sees to be tolerating just about everything, just steering clear of acidic foods like tomato sauces. Seems the flare started after he was tapered off the prednisone completely. It was roughly 1 week off the pred that he started having troubles again. He started back on pred this past Friday and it hasn't helped at all. Yesterday he had jello, scrambled eggs, applesauce and lots of Gatorade/ water. Not sure if this is typical during a flare, but even the water goes right through him and pill capsules are coming out as capsules! Feel so bad as he still has to go to work everyday, used all vac/sick time during his first major flare in feb/march. The toilet is full of bright red blood and large purple gross looking clots with every bowel movement.
Hopefully his doc will adjust his remicade and give him an infusion today!! Not sure how bad the flare has to be before upping the rem. Now wondering if it was the prednisone keeping the flare at bay and not the rem?
I have the utmost compassion for all of you that have to suffer from this disease and still have to continue with normal life and activities!
 

Jennifer

Adminstrator
Staff member
Location
SLO
Prednisone is only meant for short term so be careful about taking it long term because it can cause more harm than good over time http://www.crohnsforum.com/showthread.php?t=50497. Prednisone helps treat active inflammation but does nothing to prevent it. Remicade can take a while to start fully working though. How long has he been on it?
 

Jennifer

Adminstrator
Staff member
Location
SLO
He had his first infusion in march and is scheduled
To have his fourth on June 28th.
He may still need the 4th infusion to see if its helping and if not then it may be possible to increase his dose. Another possibility is adding another medication on top of the Remicade such as Imuran. What dose of Prednisone did they give him?
 
He may still need the 4th infusion to see if its helping and if not then it may be possible to increase his dose. Another possibility is adding another medication on top of the Remicade such as Imuran. What dose of Prednisone did they give him?
Not sure what the dose of pred is, but they did say he was on the highest dose that could be prescribed. He is also on imuran still. He's been imuran and asacol for many years. They did scale back some when they started the rem though. Is it unheard of to move up one of the loading doses of rem? They seem to be very hesitant to do so. In jan he weighed 247 and dropped down to 190 after his first major flare. He had gotten back up to 210. Thank goodness for that as he's already down 14 lbs in the last week. Doc wants to ride out the pred and not see him until Wednesday of next week. I'm afraid there be nothing left of him in another week. Seems to lose 2 lbs/day!
 
He may still need the 4th infusion to see if its helping and if not then it may be possible to increase his dose. Another possibility is adding another medication on top of the Remicade such as Imuran. What dose of Prednisone did they give him?
He brought his arsenal of pills to work with him, but I will check when he gets home on the dose of pred.
 

Jennifer

Adminstrator
Staff member
Location
SLO
Is that the dose he started on? I took 60mg when I was an underweight teenager. I'm not sure about steroid dosing while on Remicade though.

As for the Remicade I know it can be moved to every 6 weeks but I haven't heard of any sooner than that. I'd have to do some research on it. I was only able to do 3 infusions before I had to stop it.

Edit: Maybe that is the highest dose of Prednisone he can do while on Remicade since, "Using inFLIXimab together with predniSONE can increase the risk of serious infections." http://www.drugs.com/drug-interactions/prednisone-with-remicade-1936-0-1336-797.html
 
Do most Crohns sufferers completely change their diets on or off a flare?
Thanks!
Search the forum/web for paleo/SCD/GAPS
This WORKS for many of us

"Today’s post will focus on how those 1500 mg of natural plant toxins damage the intestinal wall and its mucosal barrier, thereby bringing about infectious bowel diseases."
http://perfecthealthdiet.com/2010/0...i-healing-the-gut-by-eliminating-food-toxins/

Great series of talks on paleo and IBD by Dr. Joseph Brasco of the Huntsville Center for Colon and Digestive Disease and a few of his patients.
http://www.crohnsforum.com/showthread.php?t=48559

"For many people with gut problems like mine (IBS/IBD), following some gluten-free, low carb diet usually alleviates most of their symptoms within a few weeks/months. But sometimes, for some people, it doesn’t. In that case, specialized diets, all similar, but also each more restrictive than the previous, must be followed."
http://eugenia.queru.com/2012/12/08/the-gut-and-paleo-scd-gaps-fodmaps/

Give it 30 days - no cheating - and make up your own mind
(seems to work for diabetes, MS, obesity too)
 
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