Fitness Friday: Inflammatory bowel disease – Have you got an angry gut?

If your tummy often feels sore, you regularly suffer with diarrhoea, have experienced weight loss and/or feel extreme tiredness, you could have an angry gut.

Whether it is just your intestines that are inflamed or your whole digestive tract is affected, the first step (once the inflammation has been confirmed) is to reduce your intake of any aggravating foods and drink.

But even before that, it is important to have a proper understanding of your condition and how it affects your body, so that you can take the right steps to adjust your lifestyle and diet to best address your inflammatory bowel disease.

What is inflammatory bowel disease (IBD)?

Inflammatory bowel disease is an umbrella term used to describe a group of conditions that cause the gastrointestinal tract to become inflamed and ulcerated in both adults and children.

It is important to note that an IBD is not the same as Irritable Bowel Syndrome (IBS), and mostly the term is used to refer to ulcerative colitis and Crohn’s disease.

As the inflammation tends to persist for a long time (often for life), it is called chronic. However, IBDs tend to vary in severity from person to person and often change over time. Flare-ups can alternate with (often extended) periods of calm, but symptoms usually return – particularly if appropriate dietary changes are not made.

Over time, the swollen tissues in the lining of the intestinal tract can lead to discomfort and digestive problems. For example, the intestines can become less efficient at absorbing nutrients from digested food as a result of the chronic inflammation and resultant tissue damage. This, in turn, can lead to the common symptoms of weight loss, diarrhoea and vomiting.

Unfortunately, IBDs are quite common, with around 1 in every 250 people in the UK thought to be affected. More particularly, it is thought that approximately 120,000 people in the UK have ulcerative colitis and 90,000 have Crohn’s disease.

What causes inflammatory bowel disease?

There are a number of theories as to how IBDs come about, but the definitive cause is not yet known. However, stress, poor diet, poor digestion and food allergies are all known to be contributory factors at the very least.

A popular theory is that inflammatory bowel disease is due to an autoimmune process that is triggered by a genetic predisposition, a viral illness and/or an environmental factor.

Inflammatory bowel disease symptoms

Early signs of inflammation are often subtle, which can mean that an IBD goes undiagnosed for months or even years until the person begins to develop more severe symptoms, which might include:

– abdominal pain and cramps
– frequent bouts of watery and/or bloody diarrhoea
– unexplained weight loss
– fever
– exhaustion
– bleeding from the intestines.

Ulcerative colitis

Colitis, one of the main types of inflammatory bowel disease, affects only the colon (or large intestine). The inner lining (mucosa) and rectum become inflamed and develop open, painful ulcers.

People with colitis may experience stomach pain, but discomfort is often worst in the rectal area as a result of frequent diarrhoea. Depending on the severity of the inflammation, mucus and blood may be present in the stool.

Crohn’s disease

Crohn’s disease, the other main form of inflammatory bowel disease, can affect any part of the digestive tract. Having said that, it usually affects the small intestine and the colon.

It affects the deeper layers of the digestive tract lining and can appear as “skip lesions” between healthy areas.

IBD diet

Inflammatory bowel diseases tend to respond very well to nutritional therapy (but it is, of course, important to first discuss any new diet or supplement program with your doctor).

As IBDs are most common in Caucasians who live in industrialised countries, it is logical to assume that diet is a major factor in the development of the disease, or at least in the aggravation of symptoms.

While there is no definitive inflammatory bowel disease diet, there are some helpful guidelines.

Since there is inflammation, it makes sense to avoid any foods or drinks that might contribute to, or aggravate inflammation. For example, acid-forming foods like red meat, dairy, saturated fats, sugar, alcohol and coffee, which all place a strain on the digestive system.

Instead, opt for an alkalising diet, packed with vegetables, fruit, lean protein (such as fish) and green leafy plants. These foods tend to be high in:

– alkalising mineral salts (which can help to neutralise acids)
– digestive enzymes (which help to ensure the proper breakdown of food and absorption of nutrients)
– non-irritating dietary fibre (which helps food to pass more easily through the digestive tract and prevents the build-up of toxins and bacteria often associated with constipation)
– protective nutrients like antioxidants, phyto-chemicals, essential fats, flavonoids, vitamins and minerals (which can act as anti-inflammatory agents, helping to relieve some of the strain on an angry gut).

A few other factors should be considered when formulating an IBD diet and supplement program. For instance, sensitivity to certain foods (most commonly gluten and dairy), can aggravate inflammation, so avoiding them might help too.

What’s more, as is often the case with anyone with digestive complaints, levels of good bacteria in the gut are likely to be low. Replenishing these with probiotic foods and supplements can be a good way to support overall digestive health and immunity.

Another important point to bear in mind relates to fibre. Your natural instinct may be to pack your diet with fibre when you have a problem with your digestion. While fibre is a natural and important constituent of any healthy diet, the wrong kinds of fibre can actually aggravate an IBD.

For example, be particularly careful with insoluble fibre, found in bran and whole grains. It is harsh on the bowel and doesn’t tend to suit a sensitive or inflamed digestive system. On the other hand, soluble fibre (found in oats, lentils, beans, fruit, vegetables and flaxseeds) is highly beneficial.