Questions Answered By Expert
Karlee Ausk, MD
associate director of the Swedish IBD Center
A: There has never yet been a diet proven to help avoid flare-ups in adult patients with ulcerative colitis or Crohn’s disease. When in remission (symptom free), many people can eat a regular diet. However, there is not one diet that will suit everyone with ulcerative colitis or Crohn’s disease. I would recommend listening to your body and eliminating any foods you find trigger unwanted symptoms. During a flare, however, I will typically recommend a low dairy, low fiber/residue diet. This diet can help minimize symptoms that accompany a flare of inflammatory bowel disease. There are small studies in children suggesting that the Specific Carbohydrate Diet may be able to help control inflammatory bowel disease in some patients. More trials are being done and this is a potentially exciting new development in the treatment of inflammatory bowel disease. This diet is restrictive, however, so I would recommend that you discuss this further with your gastroenterologist and with registered dietician guidance. hide answer
A: I find that diet is such an individual topic that can not be generalized to groups of people. There is no diet identified that clearly causes or treats Crohn’s disease when studied in groups of patients. I would recommend that you avoid foods that give you symptoms. It sounds easy, but can be challenging to try to identify trigger foods. Adding foods back one at a time is the best strategy. A food diary can often be helpful as well. The CCFA has published a patient handout to help give advice (http://www.ccfa.org/resources/diet-nutrition-ibd-2013.pdf) and you may find it beneficial to meet with a registered dietician to help customize your diet. hide answer
A: Talk with your doctor! It will also be helpful to talk with your contact at the drug company. Some people are connected with a Humira Nurse that assists them. There are programs available through the drug company to help people with low cost or no cost medications based on need. There may also be other programs in your area that your care provider is aware of to help during this time. hide answer
A: These are not common symptoms after a colonoscopy. Because you are on Remicade, I would recommend being evaluated for sources of infection if you are having a fever. The treatment would become more clear once your care provider finds the source for the problem. hide answer
A: In clinical practice, there are not TNF tests available. Because of studies showing that a significant percent of people with ulcerative colitis have a good response (and a higher percent than respond to immunomodulators), they are frequently used when immunomodulators are not helping. All of these medications do carry risks that should be considered, but often the benefit of controlling difficult to manage ulcerative colitis outweighs those benefits. hide answer