Crohn’s & Colitis

What is Crohn’s and Colitis?

Crohn’s disease and ulcerative colitis are both gastrointestinal diseases that can occur in children, adolescents and adulthood. These conditions are commonly known as Inflammatory Bowel Disease (IBD) and are very common within Australia. Australia has one of the highest prevalence rates worldwide, affecting more than 80,000 Australians. These conditions are very unpredictable with varying severity and symptoms affecting each person. Crohn’s disease can involve any part of the gastrointestinal tract ranging from the mouth to the anus, however, it most commonly affects the small intestine and/or the colon. Within the small intestine some parts of it may be diseased and others healthy. Crohn’s disease can affect all layers of the intestinal wall. This can cause the development of many complications such as:

Strictures (intestinal obstruction or narrowing of the intestinal wall)
Abscesses and skin tags
Fistulae (abnormal channels connecting different parts of the intestine together or to other body organs)
Fissures
Malabsorption and malnutrition.

In ulcerative colitis, inflammation occurs to the mucosa (lining) of the large intestine or colon. The inflammation usually occurs in the rectum and lower colon but can also occur in other parts of the colon. Inflammation to the colon reduces its ability to reabsorb fluid from the faeces which causes diarrhoea. Inflammation present in the rectum can cause sensations to have an urgent bowel movement.

What causes Crohn’s and Colitis?

It is not known what causes IBD, but it is believed to be a result of a combination of genetic, environmental and immunological factors. Exposure to environmental triggers such as viruses and bacteria may stimulate the immune system to go against its normal defense mechanism, in this case inflammation against a foreign substance. Prolonged inflammation eventually damages the walls of the gastrointestinal tract and causes the symptoms of IBD.

Symptoms of IBD include:

Abdominal cramps and pain
Frequent, watery diarrhoea (blood present)
Severe urgency to have a bowel movement
Fever during active stages of disease
Loss of appetite and weight loss
Tiredness and fatigue
Anaemia (due to blood loss)

How can Bites Dietitians help?

Crohn’s disease can damage and interfere with digestion and absorption of essential nutrients from food. During active phases of the disease, some people may avoid eating altogether in order to avoid onset of symptoms. However, by doing this, tiredness and fatigue worsens, weight loss occurs and the recovery period is longer. Due to the nature of this disease, it is essential that individuals eat a well-balanced diet with foods that are less likely to trigger symptoms to prevent malnutrition and maintain overall good health. Although you may be trying your best to eat a nutritious and balanced diet, malnutrition can still occur because of the reduced ability to absorb nutrients. Our dietitians are experts in calculating your specific needs and prescribing you a diet/meal plan that will ensure you are able to provide your body with the nutrients it needs to recover and manage your condition whilst reducing the foods in your diet that may be worsening your symptoms. This is particularly important for children and adolescents who are growing so that we can make sure they are receiving adequate energy and nutrients so as not to delay their growth and development. If poor nutrition occurs children may fail to develop or grow as normal, especially when they experience long periods of the disease being active and/or receive frequent or prolonged treatment with higher dosages of corticosteroids. With this, it is essential to ensure you and/or your child is receiving adequate nutrition and continues to eat even during periods of active disease. Our dietitians can prescribe a dietary prescription that includes a variety of foods ensuring all nutrient demands are being met. It’s also likely that you will have at least 2 different meal plans created during your consults with our dietitians, one for times where your condition is stable and a different meal plan to follow during periods of active disease that will be a bit easier for the gut to process/digest whilst it is inflamed.

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How can Bites Exercise Physiologists help?

When you are in the middle a flare up and fatigue sets in, exercise is that last thing you may feel like doing. However, research has proven that physical activity has huge benefits for improving fatigue levels as well as the obvious effects on overall health, including reducing stress levels which can play a role in worsening IBD symptoms. When exercising with IBD symptoms, it is essential that your exercise program is to set appropriate targets to improve your symptoms without overdoing it and reducing the ability of your body to recover. You and your Exercise Physiologist can establish your limits without overdoing it. Together you will scale your activities and discover what you are capable of when you are in remission, when experiencing low to medium severity of symptoms, and when a flare up is happening. Your Exercise Physiologist will create an exercise prescription that allows you to continue to exercise even when you are in the middle of a flare up, this will allow you to build on your fitness levels when in better health. In a flare up, it will be beneficial to focus on strength maintenance and low impact activities e.g. walking. In symptom free periods, you might have a more intense program where you would like to work towards increasing your fitness levels and physical capacity to do things.

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What improvements can you expect from a tailored dietary/exercise prescription?

By following a tailored dietary and exercise prescription your energy levels should increase and your symptoms should reduce. It’s important to be consistent with your plan for a good 2 months before expecting to see improvements as inflammation takes time to heal. In saying that, some people do report noticing improvements within 2 – 3 weeks! It usually takes a good 3 months to improve micronutrient stores such as iron stores/anaemia associated with chronic IBD. Following your exercise prescription and establishing your limits will allow you to maintain your fitness and strength levels even during periods of flare-ups. In summary:

Increased fitness levels
Improvements in nutrient levels such as Iron, vitamin D, B12 etc
Increased energy levels
Understanding your dietary triggers or potential GI irritants
Stabilised weight / No weight loss in times of flare-ups

Helpful things to bring/remember before your first appointment

Referral from your GP or Specialist if you have one (optional)
Pathology reports / scans / recent blood tests
Breath testing / allergy or intolerance testing results
List of current medications and dosages

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Contact Details

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305/29–31 Lexington Drive, Bella Vista NSW 2153

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0452 458 146

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