DESPERATELY need dietary help for LOW-FIBER, LOW-FAT, HIGH-NUTRIENT diet! Please help me!

[Michelle19]

I desperately need dietary advice from anyone who has been in a similar situation...scroll down to skip history and get my specific dietary question.  Thanks!

I am experiencing only my 2nd severe flare-up with Crohn's, and have recently been released from a week long stay at the hospital.  I had been flaring for about a month, and was on antibiotics and steroids.  Nothing was helping, and my flare up was becoming worse seemingly daily.  A little over a week ago, I had to go to the ER with 103.3 fever and extreme pain.  They admitted me and over the course of the week ended up needing to give me a blood transfusion since I had been bleeding daily for a month with every bowel movement.  They also tried to control my Crohn's with a stronger steroid, antibiotics, the works.  Nothing was helping, and since I was scheduled to be getting my first dose of Remicade in a few days, they decided to give it to me in the hospital.  Within just 2 days my rectal bleeding had stopped and I started to feel better, so they released me.  I will be getting further Remicade soon.

My Crohn's personally is very very affected by fiber, so the whole time in the hospital and after I was released, I had been eating a very low fiber diet and feeling much better than before I went.  I've been drinking a boost in the morning for nutrients, plus I try to eat a lot of protein, and some fat for the calories.  My GI said to make smoothies with the boost, add some ice cream for calories, a banana for potassium/nutrients/light fat, etc.  I don't really eat any veggies or fruit (just while I'm flaring), unless they're low fiber like plain white soft potatoes. This was working excellently for me while in the hospital and after just being released, and along with the Remicade had turned my Crohn's from a nightmare to a simple annoyance of liquid (but no longer bloody and painful) stools. I was in heaven for a couple of days. (I was just released less than a week ago).

HOWEVER, in the week that I was in the hospital I lost 10 pounds, in addition to the 20 I had just lost in the month I was flaring before being admitted.  I am now a 22 year old female, 5'5", 110 pounds, sometimes as low as 106.  The past few days my stool has turned yellow and become horrible, cramping, gassy, painful, and frequent, diarrhea.  I am also having severe back pain.  GI says I'm severely malnourished and that this plus rapid weight loss can cause problems with the gallbladder and stones.  I had an ultrasound but am waiting for the results.  Looked up all this information and found out that I likely do have a gallbladder problem, which the symptoms are made worse most by FAT in the diet.  I am now in the dilemma of having to eat a LOW-TO-NO FIBER, LOW-TO-NO-FAT, and HIGH NUTRITION diet!  I have no idea what to eat.  Pretty much any fiber hurts my Crohn's (left side), any fat hurts my gallbladder (right side and back), and not eating will only starve me more.  I need to eat! I HAVE to drink the boost in the morning, that's no fiber but 4 g fat.  Fat-free yogurt seems to be good as it has nutrients but no fiber or fat.  I can tolerate egg whites only, the yolks are too fatty.  After that I'm lost.  I can't have the bananas or the ice cream the GI suggested to add calories, because the fat is now affecting me.

Does anyone have any suggestions as to meals I can make or buy that are fiber-free, fat-free, with some kind of nutrition to help me gain nutrients and/or calories?  I've been eating hard candies simply for the calories, and I'm sure all the sugar will eventually make me sick.  I can't sit around eating egg whites and fat-free, fruit-free yogurt all day!! I'm so bored with it that it makes me not hungry at all, and then I can't eat and become dizzy and faint, think I'm going to die of malnutrition but I just can't eat another stupid egg white.

PLEASE HELP!!!!

[buckeyeroots]

I have a wonderful book that helped me sort out the diet nightmare.  You can get it at Amazon.  It's called "The New Eating Right for a Bad Gut" by James Scala.  It has excellent guidelines that have helped me immensly.  Basically, I live on chicken, ground turkey, Boca veggie protein (subst. for hamburger), Morningstar vegetarian sausage, peanut butter, fat free cottage cheese, and low fat cheese for my proteins.  I can tolerate very well cooked vegetables that are peeled - like carrots, green beans, potatoes.  Mashed avocado is good on sandwiches and is a good fat.  Absolutely no tomatoes, corn, peas, or raw veggies.  Same for fruit - canned or well cooked and peeled.  I am also diabetic, so things like pasta, breads, rice and other "white" foods are out for me, but would probably be okay for you.  I can almost always eat soups.  When you make it just peel everything, cook everything well, and puree it when it's done.  It seems to help fill me up and provides a good amount of nutrients.  I am lactose intolerant also, which is common for IBD patients, so I switched to Dairy Ease milk and Sargento has a low-fat lactose free cheese I like.  I cannot eat eggs in any way shape or form.  Everyone is different and what works for you may not work for someone else.  Plan to experiment and always have things like Boost around in a pinch.  You can also get protein powder at the health food store and make your own "Boost" shakes.  I have seriously considered beginning something online for sharing recipes with other Crohn's patients.  What do you think?  Would it be worth it, since everyone seems to have varying diet needs and tolerances?

[dreamsint]

Please go buy the SCD (Special Carbohydrate Diet).  You can find it online by typing in scd diet.  You can also find it on Amazon. This diet saved my life.  I felt better after 3 days.  I have been on this diet for 7 months and have never felt better.  I talks about what sugar, carbohydrates, wheat, and dairy does to your system.  My diet now consists of fresh fruit, vegetables and meat.

I hope you feel better soon

[PrincessKatie]

Michelle, I have a very similar situation to you. I am 21, 5'6 and at the moment 117. I used to weigh 150 until last year. I've had Crohn's 4 years now. Long story short, I had my gallbladder removed because it became diseased and stopped functioning. Now, any kind of fat goes right through me and it hurts the rest of my GI tract. So I can't eat fat. My Crohn's is really complicated and so I can't have high reside foods (ie. raw fruits and vegetables.). I also have a disease called Celiac Disease which makes me completely intolerant to gluten so there goes most of my fiber of what was left. So I cannot eat wheat, rye barley or oats. I also have lactose intolerance due to other issues.

So I'm, low-fat, low-residue, low-fiber, gluten-free, lactose-free.

I warn you against the SCD diet? The SCD diet is a great concept, but when I left the hospital at 110 two months ago, I could not put a single pound on while on the diet. We decided that first I needed to get my weight up and that then we will try the SCD. That might be a while since I can't gain any weight. Its ranging between 110-120 these days.

Now, what do I eat? Bleh. Well, everything I put in my mouth makes me sick. I also have been battling an infection in my gut called clostridium difficille that causes serious diarrhea. So, first, I pack in water as much as I can so that I don't have to go to the hospital. Second, I eat in small quantities. It helps my body deal. I get sick more times, but the times aren't as painful. I like poached chicken breasts, very lean cuts of beef in small quantities, egg whites with some salt, and well cooked/steamed vegetables and canned fruits. I cannot eat anything with a seed. I can't eat broccoli because of the little florets on the end. I cannot eat the tips of asparagus. I can eat a few really mushy carrots. I like well baked potatoes with a little bit of butter. Honestly, we are sick, so spices and flavor additives are not usually good. Obviously no leafy greens of any kind or beans. The Boost is a good thing to try. Try adding in some  canned peaches to blend up with it. I can do canned peaches and pears in their own fruit juice. I can do really well baked apples without skins. No skins, ever! I'm glad you can do yogurt! Try yogurt from the health food store with no added sugars or preservatives with something like peaches, vanilla, or whipped. I love strawberrys but I can only have them without seeds. I can't have any dairy. I drink soy milk but the only kind I will drink is the Harris Teeter Chocolate Soy Milk in the fridge. It is AMAZING! Soy is a lot higher in protein. I find all other soy milk barely tolerable, though I'm a very finicky eater. I don't do much juice because it causes diarrhea but I've found Welch's White Grape Juice to be tolerable if I water it half down (it's super sweet). Eating the candies is not a good way to get calories. Those calories aren't helping you. In a diet like ours we have to be careful of sugar intake since we aren't putting much in our bodies. Getting low blood sugars can make us feel horrible and isn't healthy. I also don't have anything with high fructose corn syrup because it causes diarrhea. The same goes with sugar-free sweeteners and cafeine.

I know it feels like everything is off the list, but butter and salt make a lot of bland food tolerable to me. I hope this helps!

[Michelle19]

Thanks everyone so much for all your help!  

My problem is that I've only really flared badly twice in my life, the first was last september and it was very quickly controlled with Prednisone.  This flare up currently though is in a league of its own.  I'm wondering if, once I become healthy, I should stay on these restricted fiber/fat/lactose diets, or if its better to go on something like the SCD to prolong remission.  There's so many different views... a lot of doctors seem to think that high-fiber diets extend remission, but then why when I get sick do I need to eat the opposite to get back to remission?  I do know that I could definitely NOT do the SCD diet right now...no raw fruits or veggies for me, I think I would die! I've lost so much weight lately that people actually give me weird looks out in public, like I'm anorexic or something.  They don't realize that if I could, I would grab the cheeseburger out of their hands and eat it! It's so hurtful...anyone else gotten that look?  

I think everyone should definitely post their own recipes all together somewhere, just describe your particular symptoms/conditon, what bothers you and what you can handle, and then list your recipe.  That way we can all compare and see if we're bothered by the same things and use that recipe.  

Take care, and keep the suggestions coming!

Michelle

[dreamsint]

Hi

While on SCD diet, I dont eat raw fruits and vegetables, I cook them.  If you are looking for some great recipes, put scd diet in the search engine, there are quite a few websites where people write in and give their recipes.  I stay away from wheat and instead bake bread with Almond flour.  It is very high in fat since it is almonds and it might help you to put on weight.  Check out www.pecanbread.com, and click on recipes, another website to check out is scdrecipe.com.  Like I said you dont have to go on the diet or buy the book but you might find some receipes that you can eat.  I hope this helps you.  

[PrincessKatie]

I have this recipe for cookies that taste amazing but basically only has almond flour, honey, raisins and maybe one or two other things in it. its part of the SCD diet, but I'm still eating them even though I can't do the diet. I'll eat them like snacks cause the almond flour is sooooo high in neutrients.

[newcronie]

My GI gave me a very easy to follow food plan and I feel much better when I follow it.  It is low-fiber and low-residue.  I imagine it is not irritating my insides at all.  Here it goes: (about.com has another variation that is very good):

Refined, enriched bread, english muffins, tea biscuits and pasta, potatoes(no skins), white rice - no whole grains

No nuts, seeds, hulls, husks except if pulverized - hummus, refried beans (I'd get the canned no-fat kind) and peanut butter (the fat's hard on me too but I'm doing full disclosure her lol) are ok, for example.  I am staying away from the pepper grinder.

Tender, well-cooked veggies - no seeds, skins - I cut around them - note that tomatoes may be too acidic.  No broccoli, cabbage, cauliflower, kale nor any other cruciferous veggies - no onions, garlic.  Raw lettuce is fine.  Baby spinach needs to be cooked.

Tender, well-cooked, lean meat, poultry, fish, eggs (full disclosure again, lol)

Canned fruit cocktail, fresh fruit like melons - cut away seeds

Avoid citrus

Veggie juice is good

Jell-o, ice pops

No lactose

No coffee, tea - although weak and diluted are ok for me

That's it - I have noticed I feel best if I eat lean beef - I guess b/c it has more iron.  Also GI recommended I take multi-vitamin.  I want to caution you against any vitamins/supplements with herbs.  They can really react badly with your medication.  

This sounds restrictive but it really isn't and my GI assures me it is just for now until my innards calm down.  I feel so much better I don't care if it's permanent.

I really hope you feel better.  Keep us posted!