Food, Drink and IBD
Young people with IBD often worry about their food intake. You can feel sick and sometimes feel that eating food makes your symptoms worse. This can then result in poor nutrition, poor growth and weight loss. Every time you go to the clinic your weight and height are checked and recorded. This helps to see if you are growing. If you are losing weight or not growing, you will be referred to the dietician for advice.
Nutrition treatments aim to improve your nutrition and well being, and also to reduce the inflammation in the intestine in the same way as medicines can.
When you are diagnosed with IBD many people try to change their diet to control their symptoms. For most people with IBD we recommend you continue on a normal balanced intake. This will help make sure you get all the nutrients you need to grow and to stay well.
Some 'diets' advise you to avoid lots of different foods, but these are not suitable for young people as you will miss out on many nutrients. Sometimes it can help to keep a record of foods eaten to see if a particular food is making your symptoms worse.
Often you may need advice on eating well during busy school days and on ways to improve your diet. You may need extra help to increase your weight so supplemental drinks may be used. If you are missing out on particular nutrients, a medicine may be prescribed, such as as calcium, iron or vitamin D.
You should always continue the medications you have been prescribed. Some medicines such as steroids can affect your appetite so ask to speak to the dietician if you are concerned.
What are supplemental drinks?
Supplemental drinks are useful to boost your daily intake, especially if you have not been eating well. They are milk based or juice based and available in different flavours.
Each carton contains 200mls. Ihey contain extra protein, calories, vitamins and minerals so they provide missing nutrients and can help you to put on weight if needed.
Exclusive Enteral Nutrition (EEN)
One of the most effective nutritional treatments we use is called EEN. In this treatment, all normal foods and drinks are stopped and supplemental drinks are taken instead. You need to drink enough supplements to make sure you are not hungry, can put on weight and help control your symptoms. The dietitian wil meet you and help you plan this. Usually you will be able to start this treatment as an outpatient without having to come into hospital.
How does EEN work?
There are three main reasons why this treatment works:
- It gives you all the nutrients you need - this is especially important if you have lost weight or have had a poor appetite.
- It also gives your gut/bowel a rest, allowing it to heal.
- It alters the type of bacteria in your gut/bowel and this can help reduce your symptoms.
If EEN is working for you, you normally continue on it for 8 weeks. (If it isn't working by the end of 2 weeks then it is stopped and other medications are tried.)
If EEN does work for you then you should gain weight, have more energy and your symptoms will improve. At the end of the 8 weeks, foods are gradually reintroduced and the number of supplements is reduced. Usually it is a good idea to continue on 1-2 supplements daily to help you stay well.
Nasogastric tube (NG)
Sometimes if you are not able to drink the supplements, then it can be given through à naso-gastric tube (NG). An NG tube is a very narrow tube that goes down your nose and into your stomach. A supplemental feed is connected to the tube and is given into your Stomach overnight while you are asleep. A special pump regulates the amount of feed given.
You need to come into hospital for 3-5 days to learn how to do this. After this you can continue it at home and go back to school and your usual activities.
Total Parenteral Nutrition (TP)
PN is occasionally used as a treatment for IBD. It is nutrition which is delivered directly through a drip into the bloodstream. TPN allows for complete rest of the gut/bowel when symptoms are not responding to drug therapy or supplemental feeds. TPN gives you all the calories and nutrients your body needs. This treatment is usually given in hospital for short periods.