Crohn's Disease and Ulcerative Colitis Bloating: When to see your doctor
Anyone can experience belly bloating, but for people diagnosed with Crohn's disease or ulceration colitis the condition can be especially painful and even worrisome. Understanding how to manage bloating if you have IBD and when it is important to see your doctor can help lower your chances of complications and definitely make you more comfortable.
What causes bloating and when should you see your doctor?
Bloating and active IBD
Sometimes bloating is worse when Crohn's disease or Ulcerative colitis is active.
Inflammation in the gut causes the colon to swell and can also cause pain. Some foods are more difficult to digest than others and can produce excess gas leading to bloating.
The most common offenders of bloating from Crohn's or colitis, for some, might include:
- Foods with more fructose than glucose. Examples include watermelon, apple, pear, guava and melon, including honeydew.
- Fruit bars can also be high in fructose including those with dried pear or apple.
- Dried fruit sold as snacks could be hard to digest because of higher fructose. Popular choices include prune, raisin, apricot, currant and fig.
- High fructose corn syrup is sometimes hidden, making it important to read labels. BBQ sauce and jams and jellies and even ketchup contain HFCS that can lead to bloating.
Some people, with or without IBD can be lactose intolerant. Milk and milk products contain sugars that can't be digested by anyone lacking the enzyme lactase that if found in the small intestine.
Try weaning yourself from lactose to see if milk sugars might be the cause of bloating and excess gas.
Stone fruit: Plum, apricot, peach and nectarine for example. If eating stone fruits continues to cause bloating, try eating less. It's important to eat foods that are nutritious, so it might take some trial and error before you know your food triggers. You can also try eating the fruits without the skin.
As your IBD becomes better controlled you may be able to slowly add foods back into your diet.
Soluble fiber is actually a good choice to help curb abdominal bloating. Soluble fiber is different than fiber that is also call "roughage" in the diet.
Soluble fiber also promotes beneficial bacteria in the colon. Probiotics for instance are touted to keep our bellies flat in addition to helping maintain optimal immune function.
Soluble fiber foods, ("beans, beans, musical fruit") are known to cause gas, but after a while the body adjusts so less gas is produced. Some people with Crohn's disease may not tolerate beans at all.
Examples of soluble fiber foods that you may need to introduce into the diet slowly include:
- Wheat (depending on other factors including gluten intolerance, celiac or other conditions)
- Bread including white and brown
Eating fish might help with inflammation and bloating because it is is high in omega-3 fatty acids. You may also want to explore eating an anti-inflammatory diet that includes fermented foods or the FODMAP diet.
Bloating with Crohn's disease or colitis is often accompanied by diarrhea. You'll want to make sure you stay well hydrated if you have frequent loose or watery stools. You'll also want to avoid caffeine and contact your doctor if you become dizzy or experience a rapid heart rate, especially upon standing.
When to see your doctor
Never assume bloating that doesn't go away is just a normal part of your disease. Prolonged bloating, nausea and loss of appetite could be a sign that you have developed a stricture or other serious problem.
Bloating associated with Crohn's disease might be remedied by keeping a food diary to find what triggers the problem, eating smaller portions and avoiding fatty foods, raw vegetables and high fructose fruits and then slowly reintroducing them into the diet. It's also important to talk to your doctor about prolonged or painful swelling in the abdomen, especially accompanied by other symptoms. There just hasn't been enough research for your doctor to recommend any specific food choices or avoidance to control symptoms of IBD.
Malta Association of Crohn's & Colitis