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Introduction
Crohns disease is an inflammatory idiopathic chronic disease. The disease mostly affects a part of the gastrointestinal tract beginning from the mouth to the anus. Crohn disease brings about complications in the digestive system of a human being. The disease is thought to be caused by bacteria that live in the intestines. The disease also could be associated with genes of particular people. The interaction between intestinal bacteria and the environment causes an immune response, which is not normal. The abnormal immune response causes alterations in the functions of the mucosal barrier and hence increasing the permeability of diet antigens (Fuhler et al., 2014). Crohn disease causes a person to lose appetite and hence bringing about malnutrition. This paper aims at reviewing past literature concerning malnutrition due to bowel inflammation. The paper analyzes the causes of the Crohn disease and also discusses how malnutrition as a result of this disease can be overcomed.
Malnutrition is one of the main complications that come with Crohn disease. According to Matarese (2013), the disease causes weight loss and low body mass index among patients who are affected by the disease. The malnutrition is caused by anorexia, inflammation as well as the increased loss of intestines. Data from past researches on the disease indicates that malnutrition affects more than 65% of patients who have Crohn disease. Among pediatric patients, malnutrition brings about retarded growth and could bring about intestinal symptoms. Lomer et al., (2017) indicates that patients who have Crohn Disease (CD) have low body fat composition, and their muscle mass is very low compared to healthy individuals. The disease is also associated with a low density of the minerals in the bones. The main reason why individuals with Crohn Disease experience malnutrition is because the intake of food through the mouth decreases (Smith & Harris, 2014). Patients with CD find it difficult to eat due to the symptoms associated with the disease. These symptoms include; pain in the abdomen, nausea, vomiting, and diarrhea. Once patients experience these symptoms, they significantly reduce the quantities of food that they consume and hence they lack proper nutrition. Restriction in terms of the diet consumed brings about malnutrition for CD patients. Due to the inflammatory nature of the disease, patients are advised not to consume particular types of foods, which could aggravate the disease. This may therefore, cause the patients to take diets which are low in some nutrient and hence causing malnutrition.
The Crohn infection has no cure, and its patient has to undergo surgery especially during the first ten years after diagnosis. Also, more than 75% of Crohns patients who have been operated through surgery requires further surgery at least once in their lifetime. These surgeries are very critical; the healthcare specialist considers and optimizes the nutritious status to minimize surgical risk and other modifiable factors. The doctor prioritizes on advising the Crohns patient on the current nutrition guidelines that are in accordance with the general surgery for the Crohn disease. The administration route is selected in accordance with the patients presentation and conditions.
Researchers indicate that mal-absorption occurs among patients with CD. This means that inflammatory cytokines release immune cells to the intestine. Loss of nutrients in the intestines also occurs and hence resulting in malnutrition. Changes in ionic transport in the body cause electrons to disperse in the body. This leads to the bowel getting ulcers and hence bringing about chronic loss of blood and proteins within the intestines. Data indicate that the energy requirements by CD patients are very high. Tests conducted using the Harris-Benedict formula indicated that there is a significant difference in energy usage between people who have a normal weight and those with below normal weight. He also indicates that there is a huge difference in the oxidation of carbohydrates and lipids between patients who have CD and people who are not affected by the disease. CD patients exhibit high lipid oxidation while carbohydrate oxidation is low.
Dietary advice is very critical for people who have CD. This is because patients with this disease need to take the right diet in order for them to fight malnutrition. Proper diet for people with CD disease helps in improving the absorption of nutrients in the body and hence improve the health of the individual. Fowler, Jones, Hull & Ghosh, (2015) recommends that a person who has the disease must eat meals on a regular basis. It is also advisable that a person eats between two to three snacks every day. This ensures that a person who is affected by the disease gets enough proteins, calories as well as minerals, which are critical in the proper functioning of the body. Research has also established that patients suffering from the disease often experience deficiency of iron and calcium in their bodies. They should, therefore, focus on taking dietary supplements that are rich in iron and calcium in order to strengthen their bones. Studies have also indicated that vitamin A deficiency is 90% among patients with Crohn disease. This is as a result of low BMI as well as low intake of foods rich in vitamin A. Lack of vitamin A is associated with night blindness as well as a problem in the healing of wounds.
Cheifetz (2013) indicates that foods which trigger Crohn symptoms differ from one patient to another. He however, notes that there are some foods that should generally be avoided by patients who have CD. These foods include; alcohol, carbonated drinks, coffee, butter and margarine, corn as well as dairy products (Porter et al., 2017). Others include raw fruits, spicy foods, whole grains as well as foods which produce gases. People who are affected by the disease should, therefore, avoid the above foods or find new ways of preparing the food in order to minimize the negative impact on their health.
Suskind et al., (2016) indicate that a low residue diet can be critical in the treatment of Crohn disease. A low residue diet is one that is low in specific foods which bring additional residue to the stool. This is important since most of the people who have Crohn disease have narrow small intestines. A diet that does not have a lot of fiber helps in reducing abdominal pain, cramps as well as diarrhea. It is also critical for a person with Crohn disease to keep a diary of the food that they consume on a day to day basis. Keeping track of the food that a person consumes helps in identifying foods that trigger stomach inflammation. This, therefore, helps in taming the symptoms which come with the Crohn disease and hence improving the nutrition of a particular person. Additionally, a daily diet plan enables a person to maintain a diet that is highly nutritious. This happens because a person is able to observe if they are consuming food, which is rich in nutrients important to the body.
Consumption of foods with a lot of liquids is critical in avoiding malnutrition among people with Crohn disease. Carlsson & Persson (2015) indicate that people with CD should consume a high-calorie liquid diet, especially at times when the disease is very active. The liquids help in making digestion easier and hence reducing the impact of the disease (Cope, 2015). This enables a person to eat healthier foods and hence minimizing malnutrition in a patient with the disease. Research has also established that dietary supplements such as omega-3 fatty acids help in minimizing the effects of the disease. Several studies conducted using fish oil as well as flaxseed oil indicate that the foods have an anti-inflammatory effect. The foods help in minimizing symptoms that are related to the disease. This supplement also improves the nutrition of a person who finds it difficult to consume food that is rich in other fats and oils. This, therefore, improves the nutrition of patients who have Crohn disease.
Total parenteral nutrition is another technique popularly used in controlling the Crohn disease. This is a type of therapy where individuals with this disease are advised to stay for a long duration without eating. This technique, however, has a risk of infection and may result in reduced integrity of the intestines. A study conducted among 51 patients with the disease indicated that remission occurred in 71% of the patients. This means that the strategy is highly effective in combating CD.
Conclusion
Crohn disease is an inflammatory bowel disease that has a profound effect on the health of patients. The disease causes malnutrition among patients due to several factors. The main reason why the disease causes malnutrition is because patients tend to avoid foods that bring about inflammation. This, therefore, means that a person may fail to consume diets that are rich in some nutrients and hence resulting in malnutrition. This paper has discussed the strategies which are used to reduce malnutrition among patients who suffer from CD. Patients suffering from the disease are advised to take dietary supplements that are recommended by their doctors. The patients are also advised to avoid foods that are likely to cause inflammation of the bowel. Foods that are rich in vitamins and which have enough liquids also help in managing the disease.
References
- Carlsson, E., & Persson, E. (2015). Living With Intestinal Failure Caused by Crohn Disease. Gastroenterology Nursing, 38(1), 12-20.
- Cope, G. (2015). Overview of dietary choices for ulcerative colitis and Crohn’s disease. Gastrointestinal Nursing, 13(1), 35-41.
- Cheifetz, A. S. (2013). Management of active Crohn disease. Jama, 309(20), 2150-2158.
- Fowler, S., Jones, J., Hull, P. R., & Ghosh, S. (2015). Extracorporeal photopheresis for the treatment of Crohn’s disease. Transfusion and Apheresis Science, 52(2), 183-186.
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- Smith, C. J., & Harris, H. (2014). Crohn disease: Taking charge of a lifelong disorder. Nursing2018, 44(12), 36-42.
- Suskind, D. L., Wahbeh, G., Gregory, N., Vendettuoli, H., & Christie, D. (2014). Nutritional therapy in pediatric Crohn disease: the specific carbohydrate diet. Journal of pediatric gastroenterology and nutrition, 58(1), 87-91.
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