Inflammatory Bowel Disease: Answers from IBD Expert Dr. Steven Brant

About 1.5 million Americans suffer from IBD, and 25 percent of cases affect people under the age of 20. Dr. Steven Brant answers some common questions about Crohn's disease and ulcerative colitis.
Man clutching his stomach in pain

About 1.5 million Americans suffer from IBD, and 25 percent of cases affect people under the age of 20.

Dr. Steven Brant , director of the Meyerhoff Inflammatory Bowel Disease Center at Johns Hopkins , answered questions from followers in a recent Facebook chat.

What difference can a healthy diet play in preventing or weakening symptoms of Crohn’s disease?

A healthy diet is always better, and some patients report more Crohn’s disease flares when eating junk food. I suggest to my patients they limit sweets and sugary foods and decrease the relative proportion of meats as there have been some studies linking these foods to risks of developing Crohn’s disease.

If patients have a narrowing of their intestines, then they may need to be on a low residue diet as fibrous and poorly digested foods will not move through the narrowed bowel well and may cause worse symptoms and potentially even obstruction. Otherwise, well balanced diets such as the Mediterranean diets may be useful.

What is the difference between ulcerative colitis and Crohn’s disease?

Colitis is inflammation of the colon. Patients may have Crohn's colitis—which is Crohn’s disease—a chronic inflammatory disease where the entire thickness of the colon is affected from the inner to outer lining and usually only segmental portions of the colon, or they may have ulcerative colitis which is not Crohn's disease but has many overlapping features.

Ulcerative colitis (UC) always affects the rectum and continuous in the colon to a various extent from the rectum; UC also only affects the inner lining of the colon. In about 10 percent of patients, it’s not possible to differentiate between UC and Crohn’s disease. In most patients the two can be distinguished by a colonoscopy. Also, UC does not affect the small intestine or the anus.

I have acid reflux. When I wake up in the morning my stomach is flat, but as soon as I eat I experience bloating. What can I do?

You may be eating foods that are poorly digested. The first thing is to see if you are lactose deficient, as this is an extremely common problem and will leave you sensitive to dairy—most often causing bloating symptoms. I've found that the FODMAP Diet is helpful to many patients with bloating. It is a diet that reduces foods that tend to be more gas producing.

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