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The role of foods in Crohn’s disease

Is there a relationship between Crohn’s disease and food? Many patients with Crohn’s feel that certain foods can trigger flare ups and inflammation. A delayed IgG food allergy may play a role in CD.

Crohn’s disease (CD) is a chronic inflammatory disease which most commonly affects the end of the small bowel and the beginning of the colon, but may affect any part of the gastrointestinal tract. Like ulcerative colitis, CD can be both painful and debilitating. People suffering from CD often experience loss of appetite and may lose weight as a result. A feeling of low energy and fatigue is also common. CD is a chronic disease, so this means patients will likely experience periods when the disease flares up and causes symptoms, followed by periods of remission when patients may not notice symptoms at all.

Diagnosis of CD

There is no single diagnostic test for the diagnosis. Instead, it is the sum of several examinations like blood analysis, stool test, ultrasound scan, colonoscopy or gastroscopy. To ensure the right therapeutic steps, the extent and the severity of the inflammation need to be defined.

Crohn’s disease and food

As CD is an inflammatory disease. Recent studies indicate that foods can trigger such inflammation, for example through a type III food allergy. A diet based on the elimination of such foods could supplement the standard drug therapy with anti-inflammatory medications such as corticosteroids. 

In a study published in 2010, an exclusion diet was performed upon presence of IgG to food. 79 CD patients and 20 healthy persons in a control group were examined for IgG. Afterwards, the clinical relevance of these food IgG antibodies was assessed in a double-blind cross-over study with 40 patients. Based on the IgG antibodies, an elimination diet was planned. Increased quantities of food-specific IgG antibodies were detected in CD patients. A statistically significant reduction in stool frequency compared to the control group was achieved when the CD patients complied with the specific elimination diet.

Another 2012 study aimed to show the effect of the intake of IgG positive food in CD patients in remission. In all patients, increased markers of intestinal inflammation, abdominal symptoms as well as histological evidence were found after a 3 day food challenge with IgG positive food. The authors concluded that foods with raised IgG antibody levels and food additives can provoke the symptoms and may stimulate the inflammation in patients with CD.

Read more about IgG testing and Crohn’s disease. 

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