Bowel disease:Nutritional strategies

You can modify the composition of your gut flora by optimising your diet and supplementing with high-quality probiotics, the ‘good’ bacteria.

* Fish oil is anti-inflammatory. Supplements providing 2.6 g of EPA/DHA or 3.5-7 oz/day of oily fish can reduce the recurrence of Crohn’s disease.

* Minimise sugar intake to cut your risk of developing ulcerative colitis (UC).

* Diets high in animal fat, cholesterol or margarine significantly increase the risk of developing or aggravating UC.

* Cut out the junk. Evidence suggests that people who eat ‘fast food’ at least twice a week have nearly four times the risk of developing UC than those who do not (Epidemiology, 1992; 3: 47-52).

* Rule out allergies. Some people with Crohn’s also have food allergies, and have been reported to do better when they avoid certain foods. The most likely culprits are cereals, dairy and yeast.

* Vitamin D malabsorption is common in Crohn’s and can lead to a deficiency. Vitamin D supplements can help, but first have a practitioner determine your vitamin D status to find the right level for your individual needs.

* Other deficiencies common in Crohn’s include zinc, folic acid, vitamin B12 and iron. Zinc, folic acid and B12 are all needed to repair intestinal damage due to the disease. Some doctors recommend 25-50 mg of zinc (balanced with 2-4 mg of copper), 800 mcg of folic acid and 800 mcg of B12. Have your iron status evaluated before supplementing.

* Vitamin A is needed for the growth and repair of cells that line both the small and large intestines.

* Colostrum-derived supplements improve gut mucosa status and may encourage natural gut flora growth. They may also exert regulatory activity on the gut immune system.

* Probiotics help the gut immune response and defenses. Helpful strains include lactobacilli, bifidobacteria, Saccharomyces boulardii and non-disease-causing strains of Escherichia coli and streptococci.

* Live yoghurt and kefir may also encourage normal flora growth.

* Investigate homoeostatic soil organisms (HSOs), beneficial organisms found naturally in soil that would have been a regular part of our diets pre-1930. Supplementation can reduce intestinal inflammation. HSO supplements are available from The Nutri Centre (www.nutricentre.com), £35.99 for 90 capsules. Primal Defense supplements are available on the Net.