Dietitian and Nutritionist for Crohn's Disease Support

Name: JM Nutrition
Price range: $$

JM Nutrition’s dietitian and nutritionist for Crohn’s Disease provides tailored strategies and meal guides to help manage and reduce associated symptoms. Book your appointment today and receive the care you need!

JM Nutrition Dietitians on Crohn's Disease Support

Important information on Crohn’s Disease management by our registered dietitians:

What is Crohn’s Disease?

Crohn’s Disease (CD) is one of the main subtypes of Inflammatory Bowel Disease (IBD), which is a condition that involves chronic inflammation of the digestive system. With Crohn’s Disease in particular, this inflammation can be present anywhere in the gastrointestinal (GI) tract, from mouth to anus.

Crohn’s Disease is technically an autoimmune disorder, and so the treatment of it is often complex.

Crohn’s involves therapeutic management, including medicinal management (i.e. steroids, biologics, anti-inflammatory medications, etc.), surgical management (in severe cases) and dietary management with the help of a dietitian.

Crohn’s interventions of a dietitian vary

Our dietitians and nutritionists note that Crohn’s Disease can vary in severity from person to person. Some may go their whole diagnosis without needing significant medical intervention, while some may be on medication(s) long-term, and potentially even require surgical procedures to remove severely affected and damaged areas of their GI tract.

Although Crohn’s can be present anywhere in the GI tract, it most commonly affects the small intestine. Specifically, it affects the end of the small intestine, referred to as the terminal ileum, in addition to the top section of the large intestine (cecum).

There are three different states that someone with Crohn’s can be in, which correlate with direction of treatment.

1. Remission state:

When there is no active (or very little) inflammation present. Someone with Crohn’s Disease in a remission state would be asymptomatic (or have very mild symptoms), their inflammatory markers would be within normal range, and scopes (i.e. colonoscopy or endoscopy) would not find any active sites of inflammation. There are typically no major dietary restrictions involved, or impact to quality of life/day-to-day function in this state.

2. Flare-up state:

When there is active inflammation present in part(s) of the GI tract. Inflammatory markers in bloodwork would be high, and scopes would find variable levels of active inflammation.

Those in a flare-up state would be symptomatic, and their diet and quality of life would be impacted to some degree.

In the peak of a Crohn’s flare-up, symptoms often consist of nausea, vomiting, unintentional weight loss, abdominal pain, and frequent, urgent loose stools – which may or may not contain blood (hematochezia). For some, symptoms are less obvious and can affect people more indirectly.

For example, they may develop fatigue related to anemia from nutrient malabsorption. They might experience other symptoms of immune distress, such as joint pain, mouth sores or skin reactions

3. In-between state:

When you are coming out of a flare-up and working towards remission. Severe symptoms and inflammation have typically improved in this state, but not fully resolved.

As a result, there are usually lingering symptoms and dietary adjustments that need to be made. Inflammation is typically still present, whether it be seen in bloodwork and/or imaging.

As a result, it may be important to seek the services of a dietitian who can provide guidance around Crohn’s Disease management with dietary interventions.

How can a dietitian and nutritionist help manage Crohn's Disease?

The dietary management of Crohn’s Disease can therefore be very individualized. It is also important to note that dietary adjustments on their own, are generally not enough to treat Crohn’s, especially more severe cases of it.

As per our dietitians, dietary adjustments are based on the state of Crohn’s Disease that someone is in.

That said, our dietitians and nutritionists can help manage Crohn’s in a number of ways:

Flare-up state management:

When the most dietary adjustments are made.

For many, especially those experiencing persistent diarrhea, nausea/vomiting and/or intestinal bleeding, a low-residue (low-fibre) diet is implemented.

If a CD flare-up is severe enough to warrant hospitalization, then a liquid diet would be started before a low-residue diet.

For some, however, CD flare ups can even warrant the need for enteral nutrition (tube feeding) or parenteral nutrition (IV feeding).

Once a low-residue diet is tolerated, typically aided by medical treatment, then we would gradually work towards a ‘regular’ or ‘remission’ diet.

Evidence suggests that some people with Crohn’s Disease can better manage their condition with the support of a low-FODMAP diet as well. Gluten-free and/or dairy/lactose-free diets can be helpful in some cases as well.

Remission state management:

When the least dietary adjustments are made. Because Crohn’s Disease is an autoimmune disorder, dietitians and nutritionists often try to work towards some version of an anti-inflammatory diet, such as the Mediterranean Diet to help retain remission.

Foods that increase inflammation (i.e. sugar, ultra-processed foods, fried foods, sugar, red meat, etc.) have been shown to increase the frequency of flare-ups.

Some may require modifications to their anti-inflammatory diet, if perhaps they have gluten, dairy/lactose and/or FODMAP sensitivities.

Fibre modifications may have to be made if a flare-up or surgery has resulted in scarring and narrowing of certain sections of the GI tract, or an ostomy bag.

The Crohn’s Disease Exclusion Diet (CDED) is another type of anti-inflammatory diet specifically designed to support the remission of CD.

In-between state management:

Often involves a hybrid of a flare-up and remission diet.

Dietary restrictions are often not as strict, but because there are some ongoing symptoms experienced in this state, restrictions are typically gradually phased out while we work towards an anti-inflammatory diet.

When tolerated, foods rich in soluble fibre are introduced first, before graduating to foods with a higher insoluble fibre content.

Research suggests that high-fibre intake can prevent the recurrence/frequency of flare-ups.

There are not many supplements that have been researched to specifically support the management of Crohn’s Disease. However, supplementation is a very relevant topic for this population, as the GI tract is responsible for nutrient absorption.

Nutrient deficiencies therefore become quite common, particularly deficiencies in vitamin B12, iron and folic acid, as these three are absorbed mostly in the small intestine, where Crohn’s commonly flares up.

Because many factors contribute to the management of Crohn’s in each individual, working with a Registered Dietitian (RD) to develop a strategy and plan tailored to your personal needs and situation can be extremely valuable.

Our dietitians for Crohn’s Disease can also help as follows:

A crohn’s dietitian and nutritionist can also carefully assess your current diet and suggest areas for improvement.
Develop a personalized meal plan to help manage symptoms associated with the condition.
Make recommendations for food product substitutions or similar products, if available.
Provide follow-up sessions to modify the meal plan, if or when needed.
Work in conjunction with your doctor.
Address related or co-existing conditions.
And more.