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The inflamed gut is unpredictable. Symptoms can range from mild to severe, and this depends on the degree and location of inflammation present. You may require a gastroscope and/or colonoscope to determine suitable treatments, and that has to be led by your gastroenterologists and their medical team who will carefully consider the risks and benefits of having a scope and prescribing suitable treatments.
From a fertility dietitian’s perspective, the best way to reduce the risk of flare-ups in pregnancy is to be in remission before falling pregnant. However, life happens and we cannot always have things planned and prepped. So what can you do if you fall pregnant and your gut starts acting up?
In pregnancy, flare-ups/active Crohn’s disease can impact the health of the unborn child, and cause damage to the foetus, putting the mum at risk of severe gut symptoms, malnutrition, or even miscarriage in some circumstances. My aim is not to scare you but to advise you to consider nutrition for healing the gut and for preventing harmful outcomes.
Crohn’s Disease (CD) is by default prone to nutrient deficiencies because of the inflamed gut. The severity of nutrient deficiencies depends on the degree and location of the gastrointestinal tract that is affected by Crohn’s. The inflamed ileum, for example, can decrease nutrient absorption. Then there’s the impact of any restrictive diet you may be following to manage CD. Leaving out food groups not eating enough essential foods and lacking appetite or variety are all considered restrictive. Medication is yet another aspect of nutrient deficiencies as some medications interfere with nutrient absorption. When I say nutrient deficiencies, I mean vitamins and minerals and even protein and perhaps carbohydrates and healthy fats in some situations.
If left untreated, the inflamed gut can cause the mum to be malnourished, and this can impact her foetus, e.g., fetal neural tube defects among other risks.
Perinatal nutrition therapy (the period between you falling pregnant till a year into you delivering your child) will assist you in improving that inflamed gut and have favorable pregnancy and postpartum outcomes as well as have a positive effect on the health of your unborn child.
So, about that nutrition therapy that has seen some promising results. Exclusive Enteral Nutrition (EEN), which is a liquid-only diet, can be used to give your body the nutrients it needs while also allowing your gut to rest and heal, at the same time. This form of nutrition therapy MUST be led by a dietitian trained in Crohn’s Disease management and managed with the support of a gastroenterologist. This also applies to treating fistulas and strictures.
Once the gut is healed, your dietitian will help you gradually transition back to solids, carefully monitoring the adequacy of your nutrition, taking special care in reintroducing dietary fibre to your gut, and looking after your nutrition requirements in pregnancy and after delivery as well.
If you are experiencing a flare-up and you are already pregnant… get in touch with me via email: joannaaaron@i-on-nutrition.com
