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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest An Appropriate Diet When Diagnosed With Crohn's Disease And Colitis

My common-law man has crohls & collities. He is taken 4 tablets twice daily-Pentasa 500 mg. He is a smokers - 2 pages a day! He has a small horny in his belly button/he has a fatty liver/ assist on his kidney. He just can t get up everyday - always lining in bed! His unemployment is now gone and has applied for medical E.I. Still waiting on! Can you please let me know what Randy should be eating? (crohls & collities) Please let me know. He gave up eating a lot of greasey foods. Thanks Darlene
Mon, 16 Oct 2017
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Dietitian & Nutritionist 's  Response
Darlene,
Thank you for writing HCM. First, it is your "man" that needs to want to make changes to make himself better. You ask questions that truly require the assistance of much nutrition education with a Registered Dietitian and your friend needs to be willing to make some serious lifestyle changes. These are some of the tips from my Academy Diet Manual for Crohns, but not for fatty liver:
Eat small meals or snacks every 3 or 4 hours. Avoid skipping meals.

When you have symptoms, or if you are taking prednisone, eat the foods in the Recommended Foods chart. These foods are lower in fiber. When diarrhea decreases, you may add small amounts of whole grain foods and higher-fiber fruits and vegetables. Try them one at a time. If you have abdominal pain or diarrhea, then stop eating the new food. You can try it again at a later date.

Drink a lot of fluids. Aim for at least 8 cups of fluid each day. Limit caffeinated, sugary drinks and sugar substitutes
.
Eat foods that have added probiotics and prebiotics. Ask your registered dietitian for good choices. Check with your doctor before starting probiotic supplements.

Take a chewable multivitamin with minerals. You may need more of some vitamins and minerals than you do when you are healthy. Ask your registered dietitian about taking supplements

Take a chewable calcium supplement include a variety of low fiber foods in your diet. If you are taking reflux medications (like Zyrtec), take calcium citrate.

If you are taking methotrexate or sulfasalazine, take an additional supplement of 1 milligram of folic acid daily, except on the day methotrexate is given.

Foods to Avoid - mostly high fiber, high fat

Dairy     Avoid higher fiber or higher fat foods that may not be tolerated as well.     Fruited yogurt or yogurt with granola or mix-ins
Whole milk
Half-and-half, cream, sour cream
Ice cream (unless it is low fat or nonfat)

Proteins           Fried eggs and meats, including sausage and bacon
Lunch meats, such as bologna or salami
Hot dogs
Tough or chewy cuts of meat (grilled steak or pork chops)
All dried beans, peas, and nuts
Chunky nut butters
Grains           Whole wheat or whole grain breads, rolls, crackers, or pasta
Brown rice and wild rice; quinoa
Cereals made from whole grain; oatmeal or fiber cereals
Any grain foods made with seeds or nuts; popcorn
Vegetables     The vegetables listed here are gas forming and/or have a high amount of fiber.
Beets
Broccoli
Brussels sprouts
Cabbage and sauerkraut
Cauliflower
Corn
Greens (mustard, turnip, collards)
Green peas
Lima beans
Mushrooms
Okra
Onions
Parsnips
Peppers
Potato skins
Spinach
Winter squash
Fruits           All raw fruits except peeled apple, ripe bananas, and melon
Canned berries, canned cherries
Dried fruits, including raisins
Prune juice
Beverages     Drinks with caffeine, such as coffee, tea, cola, some sport drinks
Alcoholic drinks
Avoid sweet fruit juices and soft drinks or other beverages made with sugar or corn syrup if they make diarrhea worse.
Other           Sugar alcohols (sorbitol, mannitol, xylitol) cause diarrhea in some people. These ingredients are often found in sugarless gums and candies, as well as some medications.

With Crohns or colitis, fiber is usually restricted to 13 grams or less, so peel all fruits, use low fiber foods like white bread instead of wheat

Foods to Include:
Foods Recommended

Food Group     Foods Recommended

lactose-free milk
Buttermilk and kefir
Yogurt, lactose-free yogurt, or soy yogurt without nuts, fruit, or granola or chocolate mix-ins; Greek yogurt usually lower in lactose
Mild cheese
Cottage cheese or lactose-free cottage cheese or take lactaid
Soy milk, rice milk, or almond milk (these are lactose free)
Sherbet
Tender, well-cooked beef, pork, poultry, or fish
Eggs, cooked until yolk is solid
Smooth nut butters (such as peanut, soy, almond, or sunflower)(may be too high in fat)
Tofu
     Note: Choose grain foods with less than 2 grams (g) of dietary fiber per serving.

Refined white flour products—for example, enriched white bread without seeds; pancakes/waffles; and crackers made with refined white flour
Cream of wheat
Grits (fine ground)
White bread, pasta, and rice
Cold and hot cereals made from white or refined flour
Vegetables     Canned and well-cooked vegetables without seeds, skins, or hulls
Mashed potatoes
Vegetable juice
Fruits     Canned, soft, and well-cooked fruits without skins, seeds, or membranes
Fruit juice without pulp
Fats and Oils     Note: Limit fats to less than 8 teaspoons a day. When possible, choose healthy oils and fats, such as canola and olive oils.

Butter
Oils
Cream
Cream cheese
Margarine
Mayonnaise
Other     Broth and strained soups made from allowed foods
Desserts (small portions) without whole grains, seeds, nuts, raisins, or coconut

Foods Not Recommended

Food Group     Foods Not Recommended
Milk and Milk Products     Milk and foods made with milk, if you are lactose intolerant
Yogurt with added fruit, nuts, or granola or chocolate mix-ins
Meat and Other Protein Sources     Tough meat, meat with gristle, or fatty meats
Fried meat, poultry, or fish
Luncheon meats such as bologna and salami
Sausage, bacon, or hot dogs
Dried beans, peas, or lentils
Sushi
Nuts
Chunky nut butters
Grains     Whole wheat bread
Brown rice, quinoa, kasha, barley
Whole wheat pasta
Whole grain and high-fiber cereals, including oatmeal or whole oats
Popcorn
Vegetables     Raw or undercooked vegetables
Alfalfa or bean sprouts
Cooked greens or spinach
High-fiber vegetables such as peas and corn
Gas-forming vegetables, including:
Beets
Broccoli
Brussels sprouts
Cabbage and sauerkraut
Lima beans
Mushrooms
Okra
Onions
Parsnips
Peppers
Potato skins
Fruits     Raw fruit
Berries
Dried fruit
Fruit juice with pulp
Prune juice
Fruit skin


With the fatty liver, avoid all fatty foods, quit any alcohol (same for Crohns),
use low fat cooking, cut fat off meats, let fat rise to top of gravies..

This gives you quite a bit to think about. I highly recommend a good lifestyle counselor that is also a Registered Dietitian to make this less overwhelming to him.

You are a kind angel..Kathy Shattler, MS, RDN
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Suggest An Appropriate Diet When Diagnosed With Crohn's Disease And Colitis

Darlene, Thank you for writing HCM. First, it is your man that needs to want to make changes to make himself better. You ask questions that truly require the assistance of much nutrition education with a Registered Dietitian and your friend needs to be willing to make some serious lifestyle changes. These are some of the tips from my Academy Diet Manual for Crohns, but not for fatty liver: Eat small meals or snacks every 3 or 4 hours. Avoid skipping meals. When you have symptoms, or if you are taking prednisone, eat the foods in the Recommended Foods chart. These foods are lower in fiber. When diarrhea decreases, you may add small amounts of whole grain foods and higher-fiber fruits and vegetables. Try them one at a time. If you have abdominal pain or diarrhea, then stop eating the new food. You can try it again at a later date. Drink a lot of fluids. Aim for at least 8 cups of fluid each day. Limit caffeinated, sugary drinks and sugar substitutes . Eat foods that have added probiotics and prebiotics. Ask your registered dietitian for good choices. Check with your doctor before starting probiotic supplements. Take a chewable multivitamin with minerals. You may need more of some vitamins and minerals than you do when you are healthy. Ask your registered dietitian about taking supplements Take a chewable calcium supplement include a variety of low fiber foods in your diet. If you are taking reflux medications (like Zyrtec), take calcium citrate. If you are taking methotrexate or sulfasalazine, take an additional supplement of 1 milligram of folic acid daily, except on the day methotrexate is given. Foods to Avoid - mostly high fiber, high fat Dairy Avoid higher fiber or higher fat foods that may not be tolerated as well. Fruited yogurt or yogurt with granola or mix-ins Whole milk Half-and-half, cream, sour cream Ice cream (unless it is low fat or nonfat) Proteins Fried eggs and meats, including sausage and bacon Lunch meats, such as bologna or salami Hot dogs Tough or chewy cuts of meat (grilled steak or pork chops) All dried beans, peas, and nuts Chunky nut butters Grains Whole wheat or whole grain breads, rolls, crackers, or pasta Brown rice and wild rice; quinoa Cereals made from whole grain; oatmeal or fiber cereals Any grain foods made with seeds or nuts; popcorn Vegetables The vegetables listed here are gas forming and/or have a high amount of fiber. Beets Broccoli Brussels sprouts Cabbage and sauerkraut Cauliflower Corn Greens (mustard, turnip, collards) Green peas Lima beans Mushrooms Okra Onions Parsnips Peppers Potato skins Spinach Winter squash Fruits All raw fruits except peeled apple, ripe bananas, and melon Canned berries, canned cherries Dried fruits, including raisins Prune juice Beverages Drinks with caffeine, such as coffee, tea, cola, some sport drinks Alcoholic drinks Avoid sweet fruit juices and soft drinks or other beverages made with sugar or corn syrup if they make diarrhea worse. Other Sugar alcohols (sorbitol, mannitol, xylitol) cause diarrhea in some people. These ingredients are often found in sugarless gums and candies, as well as some medications. With Crohns or colitis, fiber is usually restricted to 13 grams or less, so peel all fruits, use low fiber foods like white bread instead of wheat Foods to Include: Foods Recommended Food Group Foods Recommended lactose-free milk Buttermilk and kefir Yogurt, lactose-free yogurt, or soy yogurt without nuts, fruit, or granola or chocolate mix-ins; Greek yogurt usually lower in lactose Mild cheese Cottage cheese or lactose-free cottage cheese or take lactaid Soy milk, rice milk, or almond milk (these are lactose free) Sherbet Tender, well-cooked beef, pork, poultry, or fish Eggs, cooked until yolk is solid Smooth nut butters (such as peanut, soy, almond, or sunflower)(may be too high in fat) Tofu Note: Choose grain foods with less than 2 grams (g) of dietary fiber per serving. Refined white flour products—for example, enriched white bread without seeds; pancakes/waffles; and crackers made with refined white flour Cream of wheat Grits (fine ground) White bread, pasta, and rice Cold and hot cereals made from white or refined flour Vegetables Canned and well-cooked vegetables without seeds, skins, or hulls Mashed potatoes Vegetable juice Fruits Canned, soft, and well-cooked fruits without skins, seeds, or membranes Fruit juice without pulp Fats and Oils Note: Limit fats to less than 8 teaspoons a day. When possible, choose healthy oils and fats, such as canola and olive oils. Butter Oils Cream Cream cheese Margarine Mayonnaise Other Broth and strained soups made from allowed foods Desserts (small portions) without whole grains, seeds, nuts, raisins, or coconut Foods Not Recommended Food Group Foods Not Recommended Milk and Milk Products Milk and foods made with milk, if you are lactose intolerant Yogurt with added fruit, nuts, or granola or chocolate mix-ins Meat and Other Protein Sources Tough meat, meat with gristle, or fatty meats Fried meat, poultry, or fish Luncheon meats such as bologna and salami Sausage, bacon, or hot dogs Dried beans, peas, or lentils Sushi Nuts Chunky nut butters Grains Whole wheat bread Brown rice, quinoa, kasha, barley Whole wheat pasta Whole grain and high-fiber cereals, including oatmeal or whole oats Popcorn Vegetables Raw or undercooked vegetables Alfalfa or bean sprouts Cooked greens or spinach High-fiber vegetables such as peas and corn Gas-forming vegetables, including: Beets Broccoli Brussels sprouts Cabbage and sauerkraut Lima beans Mushrooms Okra Onions Parsnips Peppers Potato skins Fruits Raw fruit Berries Dried fruit Fruit juice with pulp Prune juice Fruit skin With the fatty liver, avoid all fatty foods, quit any alcohol (same for Crohns), use low fat cooking, cut fat off meats, let fat rise to top of gravies.. This gives you quite a bit to think about. I highly recommend a good lifestyle counselor that is also a Registered Dietitian to make this less overwhelming to him. You are a kind angel..Kathy Shattler, MS, RDN