Tuesday, January 29, 2013

Nutrition & Crohn's Disease: Vitamins & Supplement Information From WebMD

If you have Crohn's disease, good nutrition is crucial so you can stay as healthy as possible. Unfortunately, the disease -- as well as treatments for it -- can make it much harder to get enough of the vitamins and minerals you need.
Doctors often recommend vitamins for Crohn's disease to work around this problem. Whether you need Crohn's disease vitamins -- and which ones -- depends on your case and the your medical treatments.  
Here's a rundown of the minerals and vitamins for Crohn's disease that your body might not be getting -- and advice on how to get more of them.

Crohn's Disease Nutrition

Poor nutrition has real risks if you have Crohn's disease. You may feel run-down and sick. Medications may not work as well. In children and teens, poor nutrition related to Crohn's disease can stunt growth.
Why does Crohn's disease affect nutrition? There are several reasons.
  • Inflammation and damage to the small intestine fromCrohn's diseasecan make it hard for the body to absorb substances from food, such as carbs, fats, water, and many vitamins and minerals. Surgery for Crohn’s may also make it more difficult to absorb nutrients.
  • Reduced appetite -- from pain, diarrhea, anxiety, and changes in taste -- makes it hard to eat enough.  
  • Some medications for Crohn's disease make it harder to absorb nutrients.
  • Internal bleeding in the digestive tract can lead to anemia, which can cause low levels of iron.

Crohn's Disease Nutrition: What's Missing?

What vitamins and minerals are missing in your diet? People with Crohn's disease are likely to have lower levels of:
  • Vitamin B12. After surgery in the ileum -- the lower section of the small intestine -- it may not be possible to absorb enough vitamin B12. Dietary changes and oral vitamins can help. Some people with Crohn's disease need injections of vitamin B12 or a B12 nasal spray.
  • Folic acid. Some drugs for Crohn's disease, such as sulfasalazine or methotrexate, can lower levels of folic acid. A daily 1 mg dose of a folate supplement could help. 
  • Vitamin D. Studies have shown the people with Crohn's disease often have low levels of vitamin D, which helps your body absorb calcium for strong bones.  Many people with Crohn's disease take an 800 IU supplement of vitamin D daily.
  • Vitamin A, vitamin E, and vitamin K can be low in people who have trouble absorbing fats because of surgery for Crohn's disease.
  • Calcium. Steroids for Crohn's disease can weaken bones and affect your body’s ability to absorb calcium. On top of that, some people with Crohn's disease avoid milk because they're also lactose intolerant, further reducing calcium. Up to 50% of people with Crohn's have osteopenia, or thinning of the bones. Taking additional supplements -- often 1,500 mg of calcium a day -- can help keep bones strong and prevent other problems.
  • Iron. People with active Crohn's disease may develop anemia from blood loss in the intestines. The best treatment for anemia is with iron. Most people take iron tablets or liquid, but some get infusions instead.
  • Potassium, magnesium, and zinc may be lower in people with Crohn's disease. Taking a daily supplement can help.
  • Vitamins for Crohn's Disease: Diet vs. Supplements

    In general, any dietitian or nutritionist would tell you it's better to get your nutrition from whole foods instead of supplements.
    For some people with Crohn's disease, that's just not possible. Because of absorption problems, pain, and nausea, it may be hard to eat enough of the healthy foods that would give you the nutrition you need.
    What's more, Crohn's disease -- especially when it's active -- can make your body work harder. You may need more calories and nutrients than normal -- precisely at the time when it's hard to eat. Some healthy foods, such as high-fiber nuts and seeds, can also trigger flares in some people with Crohn's disease.
    In these cases, vitamin supplements for Crohn's disease can help fill any gaps in your nutrition. 

    Crohn's Disease Nutrition: Working With Your Doctor

    While supplements can be a good idea for some people with Crohn's disease, don't start treating yourself with handfuls of vitamins every day. That's risky.
    Talk to your doctor first. Some supplements could interact with your medication or make your Crohn's symptoms worse.
    Before suggesting supplements, your doctor may want to check you for nutritional deficiencies. The doctor may test your levels of iron, vitamin D, vitamin B12, and other vitamins and minerals. The vitamins you need may also depend on where the damage is in your small intestine.
    Schedule an appointment with a doctor. Getting good nutrition -- whether it's through dietary changes or supplements -- is essential to protect your health and help you feel better with Crohn's disease.

    WebMD Medical Reference
    Reviewed by Louise Chang, MD on April 02, 2012

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