Digestive health and inflammatory bowel disease -
A stool test can also reveal the presence of blood that may not be visible to the naked eye. The results are usually available in five to seven days. Endoscopic procedures—such as colonoscopy, upper endoscopy, sigmoidoscopy, and capsule endoscopy—are key to diagnosing IBD because they provide clear and detailed views of the gastrointestinal tract.
Although these two conditions share many symptoms, they affect different parts of the gastrointestinal tract. Your doctor decides which endoscopic test is appropriate based on your symptoms, medical history, physical exam, and the results of blood and stool tests.
This test provides live video images of the colon and rectum and enables the doctor to examine the intestinal lining for inflammation, ulcers, and other signs of IBD. Frequently, a doctor performs biopsies during a colonoscopy, in which he or she removes small tissue samples from the colon and sends them to a laboratory for analysis.
Before the procedure, a doctor asks you to avoid eating solid food for 24 hours. You are given a laxative solution to drink the night before so your bowels are empty during the exam.
To perform a colonoscopy, gastroenterologists use a colonoscope, a long, thin, flexible instrument with a camera and light embedded in the tip.
Doctors insert the colonoscope into the anus and slowly move it through the rectum and colon. The camera displays images of the colon on a nearby computer monitor.
The procedure typically takes about 30 minutes. Before the procedure, doctors usually administer a sedative to make you sleepy and to ease any discomfort. You can return home afterward, but a friend or relative should drive because you may still feel a little drowsy.
A flexible sigmoidoscopy is similar to a colonoscopy except the doctor only examines the rectum and lower part of the colon. This test may be recommended if your symptoms are limited to bleeding and inflammation around the anus and rectum. Occasionally, doctors perform this test to assess how well treatment is working.
Doctors may perform a biopsy during the procedure. Doctors use this procedure to examine the esophagus—the tube that connects the mouth to the stomach—as well as the stomach and first part of the small intestine.
An upper endoscopy may reveal inflammation, ulcers, bleeding, or obstruction in these parts of the gastrointestinal tract. The doctor uses a thin, flexible instrument called an endoscope to perform the test.
Before the procedure, he or she gives you a sedative to make you sleepy and ease any discomfort. Then the doctor inserts the endoscope into the throat and through the esophagus and stomach to the small intestine.
A camera at the tip of the device sends live images to a nearby monitor. Doctors often take tissue samples during an upper endoscopy. Lab tests can help determine the cause of inflammation.
An upper endoscopy procedure typically takes between 10 and 20 minutes. A capsule endoscopy may be recommended if your symptoms indicate you have a problem in the small intestine but other tests—including blood tests, colonoscopy, and an upper endoscopy—are inconclusive.
The small intestine is more difficult to visualize than other parts of the gastrointestinal tract because most of it is inaccessible. In this procedure, a doctor asks you to swallow a small capsule with a tiny camera inside.
This capsule is about the size of a multivitamin. As it passes through the digestive tract, the camera takes thousands of pictures that are transmitted via radio waves to a small receiver that you wear around your waist or place in a pocket.
It takes about eight hours for the capsule to pass through the gastrointestinal tract. It is excreted through a bowel movement and flushed down the toilet. Your doctor downloads the images from the receiver, paying special attention to those that are captured in the small intestine.
When performed in combination with endoscopic tests, imaging tests—such as X-rays, CT scans, and MRI scans—give doctors additional information about the gastrointestinal tract. They can reveal signs of IBD in the lining of the intestines, such as tears, bleeding, inflammation, or an obstruction.
Imaging tests can also be used to monitor the gastrointestinal tract and assess how well treatment is working. X-rays use electromagnetic radiation to take pictures of the gastrointestinal tract. They are particularly useful if doctors want to determine whether symptoms such as abdominal pain and constipation are caused by an intestinal obstruction or dilation of the bowel wall.
The following list includes some side effects that contribute to malnutrition. Nutritional needs are specific to the individual and differ with disease state, body size and age. A nutritionist can help you estimate your individual needs.
Calorie and protein needs are similar for Crohn's disease and ulcerative colitis. In both diseases, needs increase during inflammation and immediately after to restore losses.
The following are general statements about nutritional needs that may apply to you. At times, there are very few foods that are tolerated well. During these times it is important to eat high calorie foods in tolerable amounts as frequently as possible. During times when solid foods cause irritation or you have a poor appetite, liquid oral supplementation may help provide nutrition.
The following list includes liquid supplements for Crohn's Disease and ulcerative colitis. Because people with ulcerative colitis do not have malabsorption concerns, a supplement that contains partially broken down protein is not usually needed.
Standard supplements are fine but are more easily tolerated if they are isotonic or low concentration, which helps prevent diarrhea. Some formulas that may be helpful include Modulen IBD or Enlive see above.
People with ulcerative colitis may have increased needs for the following nutrients. Deficiencies depend on medications used and the extent of blood loss and diarrhea. Consult your doctor or nutritionist if you have concerns about deficiencies. Correct with supplements and nutrient-rich foods.
People with Crohn's disease may be at increased risk for deficiencies of the following nutrients. A variety of factors affect risk for nutrient deficiency including medications used, portions of the digestive tract removed, degree of inflammation and the patient's ability to take adequate nutrition.
Nutrient deficiencies are treated with supplements and nutrient-rich foods. UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
Check out this list of calcium rich foods. You will find a breakdown of calcium content in various vegetables, fruits, nuts, legumes, grains, fish and more. Calcium is important for the maintenance of healthy bones and teeth. Calcium needs are highest during times of growth and after menopause in women.
Learn more. The dietary reference intake for folate, or folic acid, is micrograms mcg per day. Nevertheless, many people fall short of this goal. Learn more here. Patient Education.
Related Conditions. Irritable Bowel Syndrome. Crohn's Disease. Ulcerative Colitis. Disease Definitions Crohn's disease Crohn's disease is a chronic inflammatory disease of unknown cause that can involve any portion of the digestive tract.
Inflammation can extend entirely through the intestinal wall, often resulting in diarrhea, strictures narrowing , fistulas abnormal opening , malabsorption and the need for surgical resections of portions of the digestive tract.
Ulcerative colitis Ulcerative colitis is an inflammatory disease of the colon, or large intestine, which is often accompanied by bloody diarrhea. This inflammation does not go through the entire wall of the intestines and therefore does not result in fistulas.
However, extensive inflammation may eventually require surgery for removal of the affected area. FAQ: Dietary Management of IBD Information regarding dietary treatments for IBD is often confusing. Can diet control IBD? How can I identify problem foods?
Continue reading What are dietary strategies for managing symptoms and when are they appropriate? Diet Recommendations for Ulcerative Colitis Flare Follow a low residue diet to relieve abdominal pain and diarrhea.
Avoid foods that may increase stool output such as fresh fruits and vegetables, prunes and caffeinated beverages. Decrease concentrated sweets in your diet, such as juices, candy and soda, to help decrease amounts of water pulled into your intestine, which may contribute to watery stools.
Decrease alcohol consumption. Try incorporating more omega-3 fatty acids in your diet. These fats may have an anti-inflammatory effect. They are found in fish, including salmon, mackerel, herring and sardines.
Patients often find that smaller, more frequent meals are better tolerated. This eating pattern can help increase the amount of nutrition you receive in a day. Consider taking nutritional supplements if appetite is poor and solid foods are not tolerated well see section on recommended liquid supplements.
Diet Recommendations for Crohn's Disease Flare Follow a low residue diet to relieve abdominal pain and diarrhea. If you have strictures, it is especially important to avoid nuts, seeds, beans and kernels. Cold foods may help reduce diarrhea. If you have lactose intolerance , follow a lactose-free diet.
Lactose intolerance causes gas, bloating, cramping and diarrhea 30 to 90 minutes after eating milk, ice cream or large amounts of dairy. A breath hydrogen test may confirm suspicions of lactose intolerance. If you have oily and foul-smelling stools, you may have fat malabsorption.
Treat fat malabsorption by following a low-fat diet. Discuss these symptoms with your doctor or nutritionist.
Smaller, more frequent meals are better tolerated and can maximize nutritional intake. If your appetite is decreased and solid foods not tolerated well, consider taking nutritional supplements see section on recommended liquid supplements.
Diet Progression Following Flares for Ulcerative Colitis and Crohn's Disease Continue to follow a low residue diet and slowly add back a variety of foods. Begin with well-tolerated liquids and advance to soft solids, then solids see below for liquid and solid food suggestions.
Introduce one or two items every few days and avoid any foods that cause symptoms. Add fiber to diet as tolerated.
Well-tolerated fiber sources include tender cooked vegetables, canned or cooked fruits, and starches like cooked cereals and whole wheat noodles and tortillas.
Between flares, eat a wide variety of foods as tolerated. This includes fruits, vegetables, whole grains, lean protein, and low-fat and nonfat dairy products. Increase your calorie and protein intake following a flare. Abdominal pain, diarrhea and decreased appetite may have caused poor food intake.
Steroids used to treat flares also can increase protein needs. Suggestions for first foods after a flare include: Diluted juices Applesauce Canned fruit Oatmeal Plain chicken, turkey or fish Cooked eggs or egg substitutes Mashed potatoes, rice or noodles Bread — sourdough or white FAQ: Treatments and Nutritional Side Effects Do any medications have nutritional side effects?
Prednisone causes decreased absorption of calcium and phosphorus from the small intestine. It also causes increased losses of calcium, zinc, potassium and vitamin C. With continual use of high doses of prednisone, the result may be bone loss and development of bone disease.
People on prednisone may need up to milligrams a day. Protein needs also are increased for people taking prednisone because it increases protein breakdown in the body. Cholestyramine decreases absorption of fat-soluble vitamins A,D, E and K , as well as folate, vitamin B, calcium and iron.
Sulfasalazine interferes with folate absorption. People taking this drug also should take a 1 milligram folate supplement each day. Can surgery affect nutritional status?
What side effects of IBD can cause malnutrition?
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