The dramatic effects that dietary treatment may have on the health of a patient with Crohn’s disease has been brought home to me today. A young woman was referred because for months she had been chronically unwell, responding to no medication, even Infliximab, and her local physician thought that the only way forward would be surgery. After two weeks on elemental feeding she was transformed. She is in a steady relationship, and after two months on diet, found to her delight and amazement that she was pregnant! It is well known that active Crohn’s disease reduces a woman’s fertility, and many couples get perhaps a little careless about contraception. Such is the improvement which can follow control of the disease, however, that fertility rapidly becomes normal, and leads to some couples getting a big surprise! Fortunately pregnancy in Crohn’s managed by diet runs smoothly, and complications are no more frequent than in normal pregnancies. Indeed, many women find that during pregnancy they can eat foods which previously caused problems. After delivery however, the disease goes back to square one, and if mothers don’t keep to their original diet, they are likely to relapse. We therefore like to advise women starting on nutritional therapy to take great care about contraception until the final diet is established. When pregnancy occurs before the process of food testing is complete, they cannot be quite sure which foods will be safe after delivery – and food testing is much more trying when one has to deal with the demands of a tiny infant as well!
This article was first published on the original crohns.org.uk blog. Research has moved on since, so please check current advice with your IBD team.