19 years old, trying to figure out how to put on weight and what to eat

So I'm 19 year old male, I've always been slim. In first year of college/university, I ended up losing appetite for the cafeteria food. I was 5 hours from home, and was missing home cooked food. The dorms were 56 years old and beat up, carpet was orange, etc. I puked twice, about a month apart, out of almost no reason. I didn't really feel sick. I had early classes, and would nap everyday in the afternoon... and this time I woke up and puke, then went downstairs to the caf to meet friends for dinner. It was strange. I didn't like the food, or at least I thought I didn't, and would mostly drink like 3-5 glasses of white or chocolate milk and a few bites of something. Every morning I started the day off with orange juice and cereal with a regular appetite then. As of this point, the school year was ending, and I came home for the summer. I was feeling a bit tired, sick of caf food and had a couple weird vomit sessions at school (not alcohol related).

When I came home, I worked for my dad as a general labourer. To everyone's surprise, even mine, I didn't have an appetite of anything. I remember working Thursday and Friday 8-5 then going out for dinner with my family, almost vomiting at the sight and smell of the food I ordered. I was completely turned off. I drove myself home from the restaurant early, as my family was still eating with friends, and vomited around 7-8 pm. I slept for a few hours, then spent the rest of the night sleeping for 1 hour, then puking for 5 minutes then back to bed. My mom took care of me, she put a monitor in my room so she could hear when I was vomiting or not. By morning, I was on heavy gravol and slept the entire day and next night away. So I slept 36 hours straight. By Sunday morning, she was on the phone with her sister (nurse), getting advice. Trying to get sugar into my body, etc. We ended up driving to the emergency room in the hospital, I got on intravenous and they gave me lots of liquids, etc. This is about May 2014.

We spent the summer going through tons of blood tests and such and I was put on a few medications, eventually prednisone. I had scopes (both ends) done, x-rays, etc. The scopes revealed an extra fact, that I had a large hernia in my throat which caused a lot of burping. They had me on antibiotics for 7 days to see if I had some disease (I can't remember the specifics, there was a lot of testing). My mom likes to find natural solutions, while we waited for test results. She had me seeing her osteopath because I was complaining about back pain too. I spend a lot of time at a desk on the computer, as I'm studying computer science and am quite passionate about it. I was also tested for food intolerances, because she has a dairy intolerance. From what I understand, food intolerances is not something western medical really believes in. However, ever since she stopped eating dairy, her stomach aches have stopped. I was tested, and there were a number of high intolerance levels, the major ones were yeast and dairy. So while we waiting for a diagnosis of anything. No one even guessed Crohn's, it was mostly just a scramble of tests I felt. So I stuck to what I knew so far: stay away from dairy and yeast (wheat, etc).

By about August 2014 or so, I was finally diagnosed with Crohn's by a stomach specialist who my aunt (who is a nurse) works with and highly recommended. He presented a few different medications possibilities and the risk and benefit of each. Being in Canada and my parents willing to spend whatever it takes on my health, we chose Humira (every other week, 1 pen injection) which seemed to be one of the better, more expensive options.

Now I'm stuck in the position of wanting to gain weight, but not knowing what to eat. I have food intolerances, but it seems that western medical doesn't really believe in these intolerances. Western medical says to stay away from red meat, etc. My diet is pretty much down to fish, chicken, rice, and certain vegetables and it's hard to make 3 meals a day out of that. For milk, I am intolerant to dairy and almond, so I drink rice milk. When I have some dairy, say cheese on a pizza or butter in buffalo wing sauce, I feel bloated quickly. So in the morning I have gluten free cereal with rice milk or sometimes I'll push the yeast/gluten intolerance and have some toaster strudel to try to get some quick calories in my diet. Lunch is usually a cheat, since I'm at work or on campus and there's not a whole lot of selection. Dinner is pretty good, home cooked chicken or fresh fish.

Lately I've been feeling pretty good. I hate being so light/slim. I have a day where I feel sick about once every 2-3 weeks, and I take gravol and don't do a whole lot except sleep. Today is that day, so I figured I'd spend it doing some research.

Summary: I'm 19 male, second year student, from Canada. I am taking Humira, B12, vitamin A and other supplements. In the past 12-14 months, I went from about 6' 125 pounds to 6'2" 106 pounds (just weighed myself in the morning, no clothes and nothing in my stomach).

Anyways, that's my story, I might even print it off so I don't forget stuff. I appreciate any thoughts on any of my dilemmas.

Greetings and welcome to the community. If I had Crohn's and wanted to put on weight, I would look into enteral nutrition. Not only does it help you get the nutrients you need and put on weight, but a myriad of studies have shown it can help induce and maintain remission as well.

All my best to you.

I definitely think enteral nutrition - whether supplementary (just to add calories) or used in one of it's therapeutic protocols (either exclusive for 6-8 weeks, or 90 % calories from formula/10% normal food for 6-8 weeks, or 50% with this diet, based on a small new study, all to induce remission if need be, or as 50% of your diet for maintenance) - might be very useful for you. But my first question would be has Humira got you into remission?

How are your inflammatory markers? Did you have raised inflammatory markers when you flared? How is your GI monitoring your response to Humira?

Where is your disease located? And do you have any stricturing or penetrating disease at this point? Asking because I wonder which type of imaging is best suited to monitor your disease activity...not just to be nosy

If your disease isn't fully under control - as well as being something you need to know - it may in large part explain your residual symptoms and might make it difficult for you to put on weight.

If you are wanting to try a diet, there is research into an SCD/Paleo based (but modified) diet for IBD called the IBD-AID diet in conjunction with meds. It can be easier to largely follow a diet that has been developed - rather than figure out your own using an elimination diet or use only a food diary, since there are so many variables. But if you are hoping to get symptomatic relief from a diet, you do tend to have to stick to it, those lunches and quick cheat foods can start messing things up Anyway here are some links http://www.umassmed.edu/nutrition/ib...aid-reference/
http://www.umassmed.edu/nutrition/ibd/ibd-aid/
diet chart with phases

The low FODMAP diet is another diet that some people with IBD have success with for the relief of symptoms from concurrent IBS

Hope you start feeling better

How long have you been on humira and have you gained weight or felt better since beginning it? How are your blood results (sed rate or CRP and hemoglobin)? Is your inflammation being controlled by Humira? If you have not been able to gain weight on Humira and you are eating well, I would suspect it's not working that well. What does your doctor say about your weight and very low BMI?

The best way to gain weight with Crohn's is to control the inflammation. When the inflammation is not controlled, appetite is usually down, there's early satiety and malabsorption as well as increased metabolism (the body needs more calories than normal). So it's extremely difficult to gain weight with diet alone when inflammation isn't controlled. High calorie supplements (like orgain or Boost or smoothies) can help get more calories in but it can be really difficult to gain when there's significant inflammation. I agree that EEN is something to consider.

I don't know what kind of testing you had and if there is validity to it but some food intolerance testing is bogus.

I had food intolerance tests that were not performed by conventional doctors in the past that were complete quackery - you do need to be careful about the kind of test you're having.

Conventional medicine does recognise some forms of food intolerance. For example: http://www.nhs.uk/Livewell/Allergies/Pages/Foodallergy.aspx Have you been tested for lactose intolerance and coeliac disease? (I realise coeliac isn't an intolerance.) I'm guessing you probably have as you've had extensive testing. Restricting your diet can make it harder to gain weight and to receive balanced nutrition so it's a good idea to check you're not excluding foods unnecessarily.

Alsocheck out the forum's weight gain support group: http://www.crohnsforum.com/showthread.php?t=71109

After Humira, I have not been vomiting and feeling better for the most part.

I'm not sure what my levels are at, but I believe hemoglobin may have been low. I just had another test a few weeks ago to recheck this.

As for where the disease is located, I'll have to get back to you on that. It was at a valve. My mother knows the specific name. I believe it was the Ileocecal Valve.

Without another reason for a low Hemoglobin, one would suspect active disease. I would definitely speak with your doctor and ask:
What are my inflammatory marker levels?
Given my low weight and low hemoglobin, (and other labs), do you think the inflammation is controlled? If not, what is the next step? If yes, what can I do to gain weight? Can you refer me to a nutritionist?

If your doctor thinks your inflammation is controlled and you are eating enough calories but failing to gain weight, I'd say that you'd need a second opinion.