IBD And Loss of Appetite

IBD Can Lead To Problems With Diet, But Help Is Available

Salad
Does a salad send you running? Eating well during a flare-up of IBD can be a challenge. Photo © Master isolated images

One of the common signs of inflammatory bowel disease (IBD) is a loss of appetite. In the United States, we have an obesity epidemic, and a loss of appetite might seem desirable at times. It's true that eating too much or eating the wrong foods is not healthful, but eating too little is also a problem. Even a person who is overweight needs to take in a certain number of calories and nutrients every day through food.

A chronic illness, especially one that causes inflammation, may actually lead to an increased need for calories to fight the disease, rather than less. A lack of appetite can be a major obstacle to wellness, especially in people with IBD, who often have a difficult relationship with food. Not feeling like eating is common, but there are a variety of ways to stimulate your appetite and get more calories in your body.

Why Does IBD Cause A Lack of Appetite?

There are several reasons why people with Crohn's disease and ulcerative colitis experience a decrease in appetite. One main problem is that eating is often associated with symptoms such as nausea, pain, bloating, and diarrhea. Another reason is that symptoms of nausea and diarrhea tend to make people feel less like eating. Complications from IBD, such as mouth ulcers, can also prevent people with IBD from eating certain types of foods. Fatigue can also be a factor -- if you're tired, you're less likely to prepare and consume healthy meals.

Problems Caused By a Lack of Appetite

If eating causes pain or bloating and there is a general lack of appetite, people with IBD may not eat enough calories during the day. Not eating enough calories to sustain a healthy weight can result in weight loss and a lack of nutrients. Some people with chronic digestive disease like IBD (ulcerative colitis in particular) may need to take in more calories from food, and more nutrients in order to combat the lack of vitamins and minerals being taken up by the small intestine.

Dealing With A Loss of Appetite

Of course, the first step in treating a lack of appetite is to consult your health care team. Your gastroenterologist or internist can help you treat the IBD. Treating a flare-up of IBD will help increase appetite by relieving any negative symptoms that are associated with eating, as well as help you to feel better overall.

A dietitian can also help in making sure that you are eating the foods that will provide you with the nutrients you need. There are many factors that go into an eating plan, including age, weight, other diseases and conditions, and activity level. Eating when you're in a flare-up might feel like a scattershot -- you might only be eating the foods that you feel you can tolerate. A dietitian can evaluate your diet and help tweak it so that it's the best it can be, considering any dietary restrictions.

Other Tips That May Help

While your health care team is working to get the flare-up under control, and you're learning how to eat more healthfully, you can also try these other tips that might increase your appetite.

  • Eating smaller meals is a good idea -- whether or not IBD is flaring. Eating small meals has many benefits, including keeping your blood glucose level constant throughout the day, which in turn keeps your energy level up. Eating a smaller meal also means that you are not eating a larger, heavier meal. A larger meal is going to be more likely to lead to symptoms such as abdominal bloating, which is not desirable at any time, least of all during an IBD flare-up.
  • Eating foods you enjoy can help in taking in more calories. Food should be healthful and nutritious, but it should also be something that you actually want to eat. Try incorporating your favorite foods, as long as you can tolerate them.
  • Changing the temperature of food might help. If very hot or very cold food or drinks tend to bring on symptoms like nausea, try eating food that is at a temperature more palatable to you (whatever that might be).
  • While you need to drink plenty of fluids during the day, drinking can also make you feel full. If you find that you're feeling full from drinking, you might try eating first, and then taking in your fluids. Drinks can also include calories, and in some cases, adding drinks with calories to your diet may be helpful (check with your doctor).

The Bottom Line

It's important to take in enough calories to keep the body nourished. Going for weeks or months eating very little can leave a body malnourished. Food and eating should be a pleasant experience, so taking any steps you can to make mealtime stress-free and enjoyable is very important.

Sources:

Lomer MC. "Dietary and nutritional considerations for inflammatory bowel disease." Proc Nutr Soc 2011 Aug;70:329-335. 28 Jan 2016.

Prince A, Whelan K, Moosa A, Lomer MC, Reidlinger DP. "Nutritional problems in inflammatory bowel disease: the patient perspective." J Crohns Colitis 2011 Oct;5:443-450. 28 Jan 2016.

Sasaki M, Johtatsu T, Kurihara M, et al. "Energy Expenditure in Japanese Patients with Severe or Moderate Ulcerative Colitis." J Clin Biochem Nutr 2010 July; 47: 32–36. 28 Jan 2016.

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