There is a great Nutritionist at OLCHC sometimes when the medications don’t work alone, there are alternatives worth a try. Each child is different and we do not recommend stopping any medications until you check with your doctor even if the symptoms have subsided. Below are some of the diets that people have tried but make sure your child embarks on them with medical/nutritionist advice as they may lose important nutrients they need to get well and achieve remission.
Keeping a food diary can eliminate food triggers sometimes as children grow more aware of their own bodies and how they work with this disease.
Inflammatory Bowel Disease Diet & Nutrition-Michelle Hurley, Clinical Specialist Dietitian, OLCHC
Good nutrition has a big part to play in keeping healthy for all of us, and is also important when diagnosed with IBD. IBD is not caused by diet (the food you eat) but good nutrition can help your child stay well.
Children are different from adults as they need the right nutrition to help them grow and thrive at a time when their disease may be slowing them down. Many children with IBD will grow and thrive normally while others will need help or adjustments to their diet to stay well. The dietitian, working as part of the multidisciplinary team can help you to do this.
Growth & Development
The key to growth and development is to firstly ensure your child’s IBD is under control. Your child should take their medications as prescribed and attend their appointments so that the medical team and nurses can monitor this.
The team will check your child’s growth using special charts (percentile charts). Each time you attend the clinic your child’s weight and height is recorded and plotted on the chart. In this way, children who are not growing well, losing weight or are underweight can be identified and referred to the dietitian. If your child is not eating well – e.g. poor appetite, restricted intake, and losing interest in their food – they can be referred for advice.
Click on this link for a Growth chart app free on iTunes
Nutrition During Remission
When your child is well we encourage a normal varied intake – you can use the food pyramid to ensure your child is getting good variety in their food intake. (picture of food pyramid here)
Bone Health
All children are started on vitamin D supplements and should continue on these to help build strong bones. If your child does not eat enough foods containing calcium they may need a supplement. Calcium requirements vary from 3 portions (800mg) for younger children to 5 portions (1200mg) for older children and teenagers
Good sources of Calcium include:
200mls of Milk = 1 glass (preferably Avonmore Supermilk)
30 g of cheddar cheese = 1 matchbox size portion
125g yoghurt = 1 pot
safefood.eu
Steroid treatment
If you are on steroids then it is especially important to eat enough foods which contain calcium and vitamin D. Steroids can give you a huge appetite so it is important to ensure that nutritious foods form the basis of your child’s daily intake. Make sure they eat 3 nutritious meals daily, and then give low calorie snacks such as fruit, diet yoghurts, and water in between meals to satisfy their appetite.
Exclusive Enteral Nutrition
In some cases, depending on the site and severity of the disease, it may be recommended to follow a special dietary treatment called Exclusive Enteral Nutrition (EEN). This balanced nutritional plan involves stopping all usual food intake and taking liquid nutritional supplements to provide all the nutrients needed. The treatment usually lasts for 6 – 8 weeks.
The benefits are:
- It promotes intestinal healing
- It is not a medication
- There are no side effects
- It helps you increase your weight if you need to
- It increases your energy levels
- It improves your symptoms – such as diarrhoea, poor appetite and tummy pains
- It improves your nutrient intake.
It can be challenging to follow this treatment but families and the team can work together to encourage and motivate your child during this time. If you are starting on this treatment you will meet with the dietitian to discuss it in detail.
How easy or difficult was it on EEN?
Nutrition During Relapse or ‘Flare’
In general during a flare or relapse, a change in medications or additional medications may be needed to control symptoms. At this time you may notice that some foods make symptoms worse – in this case replace these foods with foods that are better tolerated and make sure enough fluids are taken. These foods can be reintroduced once the symptoms have settled. You may find that foods are better tolerated if prepared and cooked in a different way.
Food intolerance and food exclusions
When your child is well, they should be able to eat a healthy variety of food. If you notice that a particular food seems to cause pain or other symptoms, it can be worthwhile to keep a food and symptom diary. Be aware however that during a flare many foods can appear to cause worsening of symptoms.
You should discuss with the medical team and the dietitian before starting on any restrictive diets.If you are excluding a particular food, you need to replace the nutrients that food provides. For example if milk is excluded, then nutrients such as protein, calcium, vitamin D will need to be replaced with other foods.
There are a variety of IBD diets used and discussed on the internet. Many of these diets are not suitable for children as they do not account for the extra needs children have in order to grow. A restrictive diet can cause long- term micronutrient deficiencies and calorie deficits. No long-term scientific studies have been carried out on using these diets with children and so it is not recommended to follow them.
Gluten and Wheat Free Diet
Tadhg attended Joe Fitzgibbon at the hermitage Clinic in Lucan and got great relief for a year on a Gluten & Wheat Free diet, (that was when we thought he was a Coeliac pre-diagnosis) after a year his symptoms came back worse than ever. W
e have kept him on the diet as it reduces bulk (which helps the constipation) and helps with his eczema rash a little.
There are plenty of products readily available in Ireland now, Kelkin, Glutafin and DS brands.
We also do a lot of home baking, Dove Farm flours and xantham gum (for binding).Tadhg likes to use his own recipes his aunt Dawn Farley created for him.
Getting children to a point where they have some control over what goes into their body can have have a very positive mental impact.
Lactose Free Diet
If you suspect you are intolerant or allergic to dairy products, you should go to your GP for diagnosis.
Food allergies and food intolerance are sometimes confused (like IBD and IBS) but it’s very important to understand the difference. A food allergy is an immune system response caused when the body mistakes an ingredient in food, usually a protein, as harmful. This causes the body to have an allergic reaction to the food. A food intolerance on the other hand, is when the body has an adverse reaction to some sort of food or ingredient.
For more information on lactose intolerance see:
HSE information on Lactose intolerance and allergies.
Information from The Dairy Council
Avonmore advice about lactose intolerance
Foods to include and exclude
The problem for those trying to avoid foods containing dairy products is that they include the most commonly used ingredients in food manufacture. It may become harder to buy ready-made foods and you will need to become an avid reader of labels and ingredients lists.
Specific Carbohydrate Diet
“Breaking the Vicious Cycle”
In order to understand how the diet works, it is important to understand the disease process occurring in the gut or, WHY the diet works.
“We must never forget that what the patient takes beyond his ability to digest does harm.”
Dr. Samuel Gee.
The Specific Carbohydrate Diet™ is predicated on the understanding that Ulcerative Colitis, Crohn’s Disease, Irritable Bowel Syndrome, and gluten therapy resistant Coeliac are the consequence of an overgrowth and imbalance of intestinal microbial flora. By altering the nutrition we take in, we can effect the constitution of our intestinal flora, and bring it back into balance, healing our digestive tracts and restoring proper absorption.
*Please seek medical or a Dietician’s advice when starting a child on this diet although there are amazing testimonials on how it has worked for individuals, it might also leave a child without essential nutrients.
The ‘Paleo’ diet or Stone Age Diet works on the basis of reducing animal fat, less carbohydrate, more vegetables and less grains.
Click on the link to the YouTube video on grains to avoid.
*Please seek medical or a Dietician’s advice when starting a child on this diet.
Submit any stories you have if any of the diets above have worked for you or your child with Crohn’s or Colitis to info@gutsykids.ie
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Drink the juice squeezed from green leafy vegetables such as cabbage (disgusting)
Drink broth made from seaweeds such as kelp
Omega-3 fatty acids from fish and flaxseed oil are also helpful.
Powdered psyllium in cold water followed by another glass of water will help to give stools more bulk
Boswellia (Ayurvedic herb) has been shown to reduce the immune cells that promote inflammation while increasing the number of immune cells that inhibit inflammation. In studies of patients with inflammatory bowel disease, ulcerative colitis and Crohn’s disease boswellia reduced gastrointestinal inflammation and tissue damage.
Triphala corrects occasional constipation, cleanses and tonifies the gastro intestinal tract
Detoxifies the whole body and improves digestion and assimilation
Promotes normal blood pressure and blood circulation
Promotes liver health
Very effective in digestive disorders
Supports the body’s natural inflammation response
Stimulates bile-flow and peristalsis
Imparts immunity, and improves mental faculties.
Ashvagandha promotes growth, strengthens immunity and joints, tissues, bones etc (mix with SCD yoghurt and water (lassi) and spoonful of raw honey or just take tablets.
Relieves stress
Strong rejuvenative
It supports a normal inflammatory response
Promotes sound sleep
Supports brain functions, (great brain tonic)
*Please seek medical or a Dietician’s advice when starting a child on this diet although there are amazing testimonials on how it has worked for individuals, it might also leave a child without essential nutrients.
