If a patient experiences a flare, restricting the diet does make sense in terms of reducing discomfort, Dr. Higgins said, but these patients run the risk of “dehydration, and rapid and significant malnutrition” if they continue to restrict their diets once the flare has quieted.
To lessen symptoms during a flare, patients can be counseled to eat smaller quantities of food, to eat bland food, and to steer clear of caffeine and alcohol, the former making motility worse, and the latter increasing dehydration.
Patients seeking to alleviate symptoms can benefit from “low residue” diets that are low in fiber. Overall, stress the importance of protein and caloric intake, even recommending that patients take liquid calorie supplements if necessary, particularly when sick.
To deepen and continue this kind of patient interaction in your clinic, Dr. Higgins said it is increasingly possible to find a balance between patient volume and interest in this model, registered dietitians – preferably those who can see patients on site, and third-party payers who will cover these services.
The meeting was sponsored by the Crohn’s & Colitis Foundation of America. Dr. Higgins has numerous financial relationships with pharmaceutical companies, including Abbott, Buhlman, Centocor, Millenium, and Pfizer.
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