Episode 27: Inflammatory Bowel Disease with Clemmie Oliver

27 Jan

Healthily | 01/27/22

In today's episode, we hear from Clemmie Oliver, a nutritional therapist specialising in IBD. We cover the differences between IBD and IBS, what to look out for, and how to get your gut health assessed. This episode is also packed with really useful, practical information about the positive changes we can make our diet to bring about relief from symptoms and live a more comfortable life if you've been diagnosed with an inflammatory bowel condition.

TAKEAWAYs

✔️ Understanding IBD vs. IBS

IBD (Inflammatory Bowel Disease) includes Crohn’s disease and ulcerative colitis. It is serious and can be life-threatening, sometimes requiring surgery.
- Crohn’s disease: Can affect anywhere from the mouth to the anus.
- Ulcerative colitis: Affects only the colon.
IBS (Irritable Bowel Syndrome) is not life-threatening but can significantly affect quality of life.

✔️ Causes and Triggers

IBD is influenced by genetics but often triggered later in life by factors like food poisoning, infections, or trauma.
The incidence of IBD has increased over the last 50 years, suggesting lifestyle and environmental factors (e.g., diet, stress) play a role.
Migration studies show that moving from low-incidence to high-incidence regions increases IBD risk in subsequent generations.

✔️ Diagnosis and Screening

Early consultation with a GP is essential if you notice changes in bowel habits or blood in stool.

Common initial tests include:

Blood tests: CRP (inflammatory marker).
Stool test: Calprotectin (detects gut inflammation).

Persistent or elevated results may lead to referral to a gastroenterologist and further investigations like endoscopy.

✔️ Nutrition and Dietary Management

Diet plays a significant role in symptom management and overall gut health.

Western diet patterns (high in refined carbs, animal protein, low fiber, low micronutrients) are linked to increased IBD risk.
Managing symptoms may involve:

Reducing greasy/fried foods, spicy foods, and certain nuts/seeds during flare-ups.
Modifying fiber intake rather than eliminating it completely. Fiber supports gut microbes and long-term bowel health.
Reintroducing fiber slowly to avoid bloating and digestive upset.

✔️ Nutrient Absorption and Deficiencies

IBD can impair nutrient absorption depending on inflammation location:
- Crohn’s disease (small intestine): Risk of B12, folate deficiencies; lactose intolerance common.
- Ulcerative colitis (colon): Risk of iron deficiency due to bleeding.

Recommended nutrient monitoring: vitamin D, B12, folate, iron, and sometimes zinc.

✔️ Dairy and Gluten Considerations

Dairy: Lactose intolerance is common, especially with Crohn’s. Lactose-free products or hard cheeses can be better tolerated. Ensure calcium intake if eliminating dairy.
Gluten: Evidence is mixed. Some people notice symptom improvement with gluten reduction, but diversity in grains is key for gut health.

✔️ Probiotics and Gut Health

Not everyone needs probiotics; diet diversity is more effective for gut microbiome health.
Evidence-based probiotics like VSL#3/VivoMix may benefit ulcerative colitis or pouchitis.
Probiotic use should be discussed with your healthcare team, especially if on immunosuppressive medication.

✔️ Lifestyle and Mental Health

IBD impacts mental health due to chronic symptoms, fatigue, and “invisible illness” challenges.
Lifestyle factors—stress, sleep, movement, and psychological support—are crucial pieces of the health puzzle.
Mindful eating and proper chewing can improve digestion and reduce symptoms.

✔️ Key Practical Tips

Introduce high-fiber foods gradually; cook, mash, or blend for easier digestion.
Replace trigger foods with nutritionally adequate alternatives rather than just eliminating them.
Monitor nutrient status regularly with a healthcare professional.
Focus on dietary diversity and plant-based foods to support gut microbiome health.