Crohn's disease Q&As
Published by Bupa's health information team, March 2009.
Answers to questions about Crohn's disease
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Why are people with Crohn's disease more at risk of developing bowel cancer?
- Is smoking linked to Crohn's disease?
- If I have Crohn's disease, should I follow a special diet?
Why are people with Crohn's disease more at risk of developing bowel cancer?
Inflammatory bowel diseases like Crohn's disease are thought to cause prolonged damage to your bowel which over time can lead to bowel cancer.
Explanation
Crohn's disease is a chronic disease that causes your bowel to become inflamed. A chronic illness is one that lasts a long time, sometimes for the rest of the affected person's life. The term chronic refers to time, not how serious a condition is.
It's thought that over time the damage caused to the lining of your large and small bowel by Crohn's disease increases the risk of cancerous cells developing. If your condition affects the whole of your bowel for more than eight years or affects the left side of your bowel for more than 15 years, then you are more at risk of developing bowel cancer.
It's recommended that after you have had Crohn's disease for a certain length of time, you should be screened on a regular basis. Screening involves having a colonoscopy. A colonoscopy allows your doctor to look inside your bowel using a thin tube with a tiny light and camera at the end of it. This type of screening means that if you do develop bowel cancer, it can be detected and treated early.
If you have had your condition for 10 to 20 years, it's recommended that you should be screened every three years. When you have had it for 20 to 30 years, this will be reduced to every two years. After 30 years you will be screened every year.
If you have any questions about Cohn's disease or bowel cancer, talk to your doctor.
Further information
- National Association for Colitis and Crohn's Disease (NACC)
0845 130 3344
www.nacc.org.uk - Cancer Research UK
0808 800 40 40
www.cancerhelp.org.uk
Sources
- High risk groups for bowel cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 19 August 2008
- Wheeler JMD, Warren BF, Mortensen NJM, et al. An insight into the genetic pathway of adenocarcinoma of the small intestine. Gut 2002; 50:218-223
- Ballinger AB, Anggiansah C. Clinical Review: colorectal cancer. BMJ 2007; 335:715718
- British Society of Gastroenterology. Guidelines for Colorectal Cancer Screening in High Risk Groups. Gut 2002; 51:1-28
Is smoking linked to Crohn's disease?
Yes. You are more likely to develop Crohn's disease if you are a smoker. Also, if you continue smoking once you have been diagnosed, you are more likely to suffer relapses and need more treatment than non- or ex-smokers.
Explanation
Research has shown that if you smoke or have smoked, you are more at risk of developing Crohn's disease than people who have never smoked. Exactly how or why smoking is linked to Crohn's disease is not fully understood at present.
People who continue to smoke after they have been diagnosed with Crohn's disease are more likely to suffer relapses (when symptoms come back). These relapses are more common in heavy smokers (15 or more cigarettes a day) than lighter smokers. Smokers usually require more steroids and immunosuppressive medicines, and are more likely to need surgery and to relapse after surgery.
Stopping smoking is the best way to prevent relapses and reduce your need for medicine or sugery. Quitting also helps prevent other serious health conditions such as lung cancer or heart disease. Your GP will be able to give you support and advice about how to quit.
If you have any questions or concerns about Crohn's disease or smoking, talk to your GP or doctor.
Further information
- National Association for Colitis and Crohn's Disease (NACC)
0845 130 3344
www.nacc.org.uk
Sources
- Johnson GJ, Cosnes J, Mansfield JC. Review article: smoking cessation as primary therapy to modify the course of Crohn's disease. Alimentary Pharmacology & Therapeutics 2005; 21(8):921-931
- Crohn's disease: Lifestyle interventions to maintain remission in adults. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, accessed 15 September 2008
- Carter MJ, Lobo AJ, Travis SPL. Guidelines for the management of inflammatory bowel disease in adults. Gut 2004; 53:1-16
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:456-459
If I have Crohn's disease, should I follow a special diet?
The dietary advice for people with Crohn's disease is the same as for everyone else: follow a healthy, balanced diet. However, if you do find that a certain food makes your symptoms worse, find a substitute for it rather than cutting it out altogether (if possible) - this will ensure that you don't lose whole food groups from your diet. Also, if you have active symptoms, you may find it helpful to follow a low-fibre diet.
Explanation
There is no special diet that you should follow if you have Crohn's disease. Although, some people find that eating certain foods triggers their symptoms. Foods and drinks that are commonly reported to make symptoms worse, especially diarrhoea and bloating, include:
- milk and milk products
- wheat
- fibre
- spicy food
- chocolate
- foods with a high fat content
- deep fried foods
- sugars in fruit (fructose)
- artificial sweeteners (sorbitol)
- lactose
- caffeine (tea, coffee and cola drinks)
- alcohol
It's important for everybody, whether you have Crohn's disease or not, to eat a health, balanced diet. This means eating a wide variety of foods from the main food groups, including:
- fruit and vegetables, aim to eat five portions a day
- starchy foods such as bread, rice, potatoes and pasta, these should make up the bulk of your meal.
- dairy products, such as milk, cheese and yogurt
- protein, such as meat, fish, eggs and beans
- fats and sugars to provide energy, you only need a small amount of these in your diet so eat them in moderation
Try experimenting with food to find out what's right for you. If you suspect that a certain food or drink is causing symptoms, don't eat it for four to six weeks to see if your symptoms go away. Keeping a food diary of what you have eaten and your symptoms can also be helpful in understanding triggers.
If you do identify a food that causes symptoms, try to find a substitute for it rather than just cutting it out completely - cutting out foods can mean that you miss out on an entire food group and the nutrients it provides. For example, if you find that having butter causes symptoms, try switching to an olive oil-based spread instead.
Some people find that cutting out high fibre foods can ease symptoms when they are having a flare-up. This may be because they are intolerant to fibre and continuing to have it in their diet makes their symptoms worse.
Also, if you have a narrowing in your bowel (stricture), you may find it helpful to follow a low residue diet. This is when you don't eat or eat less of the foods that block or irritate the narrowed area of your bowel, for example high fibre foods, such as wholegrain bread or dried fruits, or milk.
If you have any questions or concerns about Crohn's disease and diet, talk to your doctor.
Further information
- National Association for Colitis and Crohn's Disease (NACC)
0845 130 3344
www.nacc.org.uk
Sources
- Managing diarrhoea. National Association for Colitis and Crohn's Disease. www.nacc.org.uk, accessed 15 September 2008
- Managing bloating and wind. National Association for Colitis and Crohn's Disease. www.nacc.org.uk, accessed 15 September 2008
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2009
Crohn's disease factsheet
Visit the Crohn's disease health factsheet for more information.
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