There is much more awareness nowadays of how what we eat may affect our general health and well-being. Unsurprisingly therefore, food and diet were topics that many people with a chronic health condition commented on. However, food and food-related issues such as eating out, kosher food preparation or sharing festive meals at special occasions were of particular importance for those affected by Crohn’s disease. Therefore this summary will focus on their experiences.
Crohn’s is a chronic inflammatory disease of the bowel which interferes with the absorption of nutrients into the body. Its symptoms include abdominal pain, diarrhoea, rectal bleeding and weight loss. Its exact causes are unclear, but research suggests that both environmental factors and genes play a part. Treatments to control the inflammation include powerful drugs such as steroids and antibiotics, but importantly, the type and range of food the person eats can also help to control the symptoms.
Some people with Crohn’s managed their condition by switching to a very bland diet – such as rice, potatoes and white fish – for a few days whenever they would experience a flare-up. Some would also use liquid food supplement to make sure they got essential nutrients whilst avoiding irritation to the bowel. However, the link between diet and symptoms was not straightforward and there seemed to be a lot of individual variation in terms of what people said they were able to eat. Most of them said there were certain foods that they tried to avoid as they were likely to cause a flare up of inflammation or make existing symptoms worse. The most frequently mentioned offending foods were tomatoes, citrus fruit and fruit juice, high fibre foods such as vegetables, other difficult to digest foods such as nuts and drinks such as coffee and alcohol.
People differed in their views of how much difference they thought diet made to controlling their symptoms. Many people said they had received little advice from health professionals on the subject. They had found out which foods to avoid by trial and error. But the process of cutting out foods one by one to see whether it made a difference could feel very restrictive and frustrating in itself.
For some people, taking medication had made a big difference. Being on tablets meant they could eat a wider range of foods than previously. One man with an arterial feed had to hook up to his tailor-made nutritional fluid every couple of days to avoid dehydration. Getting all the essential nutrients into his body this way freed him up to be less cautious with what he could eat and drink by mouth.
Food and enjoying festive meals together play a big part in Jewish culture. For some of those affected by Crohn’s disease, participating in the traditional customs and keeping to the dietary laws was at times difficult.
A few people with Crohn’s disease had been told by health professionals that the high fat content of a traditional Jewish diet might be one of the reasons why the condition is particularly common among Ashkenazi Jews. This suggestion was met with some scepticism, as arguably not everyone of Jewish ethnicity eats the same fatty foods and many traditional Jewish recipes have been adapted in line with modern ideas of healthy eating to have a lower fat content. Research seems to confirm that certain molecules produced during fat metabolism – ‘free radicals’ – may contribute to inflammation in Crohn’s disease. However, ‘free radicals’ are also produced when people experience stress or infection. Several people spoke of the importance of resting when they experienced a flare-up.
A couple of people spoke of the symbolic meaning of food and eating and the disruption Crohn’s had caused to these processes. One man who developed Crohn’s as a child described how his condition had affected the whole family. His parents had survived the Holocaust and themselves experienced long periods of starvation. Seeing their child unable to enjoy his food was especially difficult for them, and awareness of their unhappiness was difficult to bear for their son.