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Deborah Howell: One on One with Regional One Health is your inside look at how we're building healthier tomorrows for our patients and our community. Join us for expert insight that empowers you to achieve a lifetime of better health. Today, Dr. Leonard Baidoo, a gastroenterologist with Regional One Health and a leader in the treatment of inflammatory bowel disease, is here to talk about how patients can help manage their condition through better diet. Welcome, Dr. Baidoo.

Leonard Baidoo: Thank you for having me.

Deborah Howell: Wonderful to have you on the podcast today. So how big a role does diet and nutrition play in managing Crohn's and ulcerative colitis?

Leonard Baidoo: This is a very important topic for patients with Crohn's and ulcerative colitis. Diet or nutrition or lack thereof does not cause Crohn's disease or ulcerative colitis, and very important that we understand that. Nutrition is important to maintain overall health and wellbeing, and also affects the IBD symptoms of patients. Without proper nutrition, the symptoms of Crohn's disease or ulcerative colitis can cause serious complications, including malnutritional deficiencies, weight loss, anemia, and maldigestion. Diet is not a replacement for medicines for treating IBD.

Like most people, certain foods will affect you adversely. And I will suggest to people that you stay away from these foods. The goal of nutrition in IBD patient is treatment and prevention of malnutrition, treatment of active inflammation and symptomatic treatment of specific situations as they occur in the course of your disease.

Deborah Howell: Okay. That's a great general description. Let's dial in a little bit. What are some foods that commonly trigger IBD symptoms or make them worse?

Leonard Baidoo: In spite of a lot of research that has been done on nutrition and IBD, there is no specific IBD diet. But we know a lot about foods and nutrition that will help patients get better if they have this disease. We tend to advocate a Mediterranean-type diet, which consists of a lot of fresh fruits and vegetables. These are helpful because our bodies do not completely digest these foods and they act as sewer for our microbiome, that's the bacteria in our gut to use, to produce molecules that fight inflammation. So in talking about diet in general, things that are useful are like things like grains, oatmeal, fruits, pealed or pureed fruits prepared well, vegetables, juices, lean white meat and oily fish.

A lot of times we forget about the importance of fluids. These diseases tend to cause diarrhea and patients can become dehydrated. So there are certain foods and certain drinks that you have to avoid as these will make your symptoms worse. The first thing to talk about is you have to try to avoid a lot of alcohol. Caffeinated drinks or carbonated drinks are not very good. And patients who have lactose intolerance should avoid dairy products. Your diet should be customized based on your specific disease, the extent severity and location of your disease and whether it's active disease or it's in remission

Deborah Howell: So these things differ from patient to patient. And how do you help patients learn their particular triggers?

Leonard Baidoo: Yes. The first thing to remember is that just like we a different people, different foods will affect you differently. So the fact that somebody who has the same condition is affected by certain particular diets does not mean it'll affect you in the same way. So you have to do a lot of trial and error to get the right combination of foods that will be helpful to you.

You do not have to go on a very restrictive. Remember that minimizing does not always mean stopping all the bad effects together. The important thing is the amount and the frequency of certain foods you eat that will affect you adversely. It's also important to realize that any particular food can be prepared in all sorts of ways. So for somebody, if it's cooked that affects you badly, you can try grilling or you can try baking. And over time, you get to know the particular type of foods that do not help you.

There are certain common trigger foods, however, that you should be aware of. And like I talked about before, alcohol usually is a triggering beverage. Sugary beverages or a lot of sugar in your drinks, fast foods, processed or red meat will affect your disease adversely, Low-fiber diets and food additive and emulsifiers that are present in a lot of things that are canned can affect you adversely. So with most patients, you must learn and see which foods affect you adversely, stay away from those and eat a lot more of those that help you to get better.

Deborah Howell: Fresh is always best.

Leonard Baidoo: Yes.

Deborah Howell: All right. Let's talk about the advice you give to patients in terms of what they can eat during a flare-up and during remission.

Leonard Baidoo: Right. During flare-ups, you definitely have to avoid some of those trigger foods that we talked about in the previous session. You must eat a low-fiber, low-fat diet, that somebody might say a bland diet. High-fiber diets during a flare just gives you a lot more poop to poop. So you want your food to be as low fiber as possible. It's also important that you eat smaller frequent meals rather than three large meals a day, because the smaller frequent meals tend to be absorbed easier and you keep replacing whatever little bit you are losing. Some people may talk about a liquid diet, but it's not always very helpful. Also, remember that when you have a flare, exercise, good sleep, and if you can reduce your stress, these are going to be helpful in your control of your disease. During maintenance, when you are not in the flare, the previous things we've talked about, high-fiber diet, fresh fruits, fresh vegetables, low-sugar diets are the things that you want to stay on.

Deborah Howell: Okay. What about things like Pedialyte?

Leonard Baidoo: Pedialyte is fine in the sense that it helps you when you have a flare to replace the fluids that you lose during your diarrhea, but it does not on its own cure you of any disease or make your disease better or worse, but it replaces the fluids that you lose.

Deborah Howell: So it gives you a temporary boost of energy.

Leonard Baidoo: Yeah.

Deborah Howell: Okay. So how can patients make sure they're getting enough nutrients and calories when they live with these conditions?

Leonard Baidoo: Yes. The important thing is to realize that the role of nutrition is to help avoid complications of the disease, not necessarily to cure this disease. So during your visits to your doctor, you want to discuss nutrition with him and tell him about foods that affect you badly. He must suggest the certain things that you should eat, sometimes even must encourage you to see a dietician. Your doctor will do all sorts of tests during your visits, like he will check your weight to make sure you're not losing weight even sometimes when you're not aware of it. He would do various blood tests, including to check for anemia, because one of the symptoms of your disease will be fatigue and anemia. He will check for the level of your vitamin B12, vitamin D, iron, calcium and even sometimes make you do a DEXA scan, because some of the treatments include steroids, which can lead to osteoporosis and all these can be found by your doctor doing specific tests to help you learn and control your nutrition.

Deborah Howell: Sure. Information is power. You got to know where you are at your baseline and then take it from there. Is there anything else you'd like to add to our conversation for those listening?

Leonard Baidoo: The important thing to remember is that nobody should be treated in a cookie cutter way. Every individual is different. So you have to talk to your patients differently. The patients have to discuss with you their particular problems and what they need because certain cultures may eat certain foods that maybe affecting them adversely. So it's important that you have an open mind and discuss it with your doctor what things will help you, and most doctors will be able to do that for you.

Deborah Howell: Sure. And I have a final question. Spicy foods, helpful or not?

Leonard Baidoo: It does not really matter whether the food is spicy or not, it will not affect your disease. It is whether the food contains a lot of sugar or a lot of fat that makes the difference. It's just not the spice. The spice, I say, will not harm you.

Deborah Howell: Okay. Wonderful news. Well, Dr. Baidoo, we really appreciate you taking time out of your day to share all this great information with us? It's been a pleasure to talk to you.

Leonard Baidoo: Thank you. It is my pleasure to be able to be of help to patients with inflammatory bowel disease. Thank you very much.

Deborah Howell: You're doing just that every day and we appreciate it. Dr. Leonard Baidoo is a gastroenterologist with Regional One Health. To make an appointment with Dr. Baidoo, call 901-545-6969. I'm Deborah Howell. Thanks for making One on One With Regional One Health part of your journey to better health. Join us next time as we cover another important topic to keep you on the path to a healthier tomorrow. Until then, be well.