Dear Dr Moller
I am a 1st year student at the XXX. I am currently doing a report on a client with Crohn's disease. I need to look at ways to manage the symptoms of her disease. I have decided to use Nutrition as a teaching activity. I have visited the Nutrition Department at the XXX Hospital and they could not assist me. Are you able to send me some nutritional guidelines for people with Crohn's disease please. I have attached my teaching activity for your perusal. Could you please let me know if it makes sense.
kind regards Rowena
Gary Moller comments:
First of all, thanks for the promotion to MD, Rowena. Most appreciated!
I am not surprised that the Nutrition Department of your hospital is unable to assist and I will restrain myself from further comment about that one. And I still like to think that nurses have patients, rather than clients. After all, it is professional care of the TLC kind that you provide and it is hardly a business transaction - or is it nowadays?
I appreciate that your assignment must be in today, so here is a quick-fire set of guidelines:
The first step is to list all the medications that your patient is taking. From experience, it is usual for such patients to be placed on a bucket of pharmaceuticals. Most of these are totally unnecessary and may be causing serious ill health.
Then work through all of the known side effects and interactions (you might need a PhD to do this!).
Then challenge each medication: Does your patient really have to be on this and that medication? What is the worst that could happen if it was withdrawn? What are the natural alternatives to each one and why can't they be used? Get your patient off every medication that is absolutely not essential. Got the idea? Then you can practice effective nutrition.
Know what you are dealing with
Ok, you know that it is Crohn's but what might be contributing or even causing the condition? I would have your patient complete a vitamin D test since it is essential that levels be at or above optimum (not normal) for a robust immune system. My experience is your patient is likely to be clinically deficient due to malabsorption.
I would also have a Hair Tissue Mineral Analysis completed to determine exactly what mineral and vitamin deficiencies are affecting health. I would anticipate these to abound due to poor nutrition and medication side effects. Once you have these test results in you will know exactly what nutritional supplements are needed and how much. When repeated, you will know if your interventions are beneficial.
I would have your patient taking a daily broth made of either free range chicken bones or beef bones. Make a point of having lots of cartilage and gristle that is rendered down. The gelatin is very soothing to the gut surfaces, retains water in the gut and promotes healing of the gut wall as well as assisting the absorption of nutrients. These broths are rich in minerals and protein. Here is the recipe.
I would add daily home made yogurt and fermented milk - whole milk that is raw. Definitely not pasturised.
I would carefully review your patient's diet and eliminate just about every processed food and replace each with unprocessed versions. For example; replace gut-gooeying breads and pastas with starchy root crops, pumpkin, banana and so on.Supplements
Add daily fish oil, a natural vitamin D, and a probiotic to ensure the gut is populated with healthy flora. There are three probiotic preparations that should be taken and these can be obtained from me.
Your patient should also be taking a special digestive preparation called Intestamine which soothes the gut while promoting healthy digestion and healthy bowel action.
Further supplementation will be determined by the Hair Tissue Mineral Analysis.