Crohn’s disease, therapies and the ideal diet

Abdominal pain, diarrhea and sometimes even fever: these are the main symptoms of Crohn’s disease, an inflammatory disease that often concentrates in the intestine, but which can affect any stretch of the digestive tract and which can also give rise to extraintestinal symptoms, for example in the joints.

Unfortunately, there is no cure; However, appropriate therapies can help to control the symptoms, from which in some cases it is possible to remain free for long periods of remission.

The role of anti-inflammatory drugs

Drug therapies can attack the disease in the acute phase (induction therapies) or help keep it in remission (maintenance therapies).

Often the first choice falls on anti-inflammatory drugs, especially aminosalicylates or corticosteroids.

The former include mesalamine – used to maintain remission of mild forms after a first isolated acute attack – and sulfasalazopyrine – used in case of joint symptoms.

Corticosteroids are instead used in the acute phase, especially at the first appearance of the disease. Sometimes, however, they are ineffective, or high dosages are required. Moreover, corticosteroid dependence is not uncommon; For this, if possible, we try to gradually reduce the amount of drug taken compared to the initial doses.

Other drugs

To minimize the use of corticosteroids it is also possible to rely on immunosuppressive drugs and biotechnological drugs.

The former help maintain a state of remission, but they have disadvantages: to be effective they must be taken for a few months, and can cause nausea and malaise.

The biotech drugs infliximab and adalimumab, approved for the treatment of moderate-to-severe forms, also help achieve remission. Initially, however, 20-40% of patients do not respond to therapy, and another 20% tend to lose response.

There are also side effects: other molecules (such as vedolizumab) have also been developed to reduce them, some of which are still being tested.

Finally, depending on the case, antibiotics, antidiarrheals, painkillers, probiotics or nutritional supportive therapy may be prescribed.

Help from nutrition

In fact, a proper diet can help control the symptoms of Crohn’s disease, especially when they are accentuated by taking specific foods.

Foods to be limited could include dairy products, potentially associated with pain, bloating and diarrhea.

In addition, some patients should avoid high-fat foods (such as butter, margarine, creams and fried foods), whose digestion can be impaired by the disease.

Foods rich in fiber should also be limited, especially cabbage, broccoli, cauliflower, nuts, seeds and corn, especially in case of intestinal narrowing. Eventually, to reduce the discomfort you can try to eat fruits and vegetables only after cooking them.

Finally, spicy foods, alcohol and caffeine could also aggravate the disorders triggered by Crohn’s.

The ideal diet against the symptoms of the disease, however, is not only made by the right foods, but also by healthy habits such as small meals, abundant hydration and, in case of absorption problems, multivitamins.

The last resort

If medication and nutrition are not enough, or in the presence of complications such as abscesses and fistulas, surgery may be necessary.

Unfortunately, however, the benefits are generally only temporary, and even after the operation it is advisable to take medication to reduce the risk of recurrence.