Spicy Food & Crohnies: Making Smart Choices When You Have Crohn's

Most important is that when anyone suggests Crohn's disease is caused by eating certain foods, the appropriate response is, "Rubbish!"

I've also discovered that the foods Crohn's patients are able to tolerate vary greatly from one person to another. While partially affected by disease activity and prior surgeries, the digestive process in any individual is unique.

Aside from concerns about getting sufficient nutrition when the disease is active, "Crohnies" should be thinking about food choices for two important reasons. The first is safety. The second relates to comfort. Whether or not to eat spicy foods--in particular, Chinese cuisine--relates to both.

For excellent discussions of how food affects the digestive tract in Crohn's patients, see the Mayo Clinic Web site as well as that of the Crohn's Colitis Foundation of America (CCFA). A third excellent source is the book 100 Questions and Answers About Crohn's Disease and Ulcerative Colitis.

Safety issues: Many Crohn's patients with small-bowel disease find themselves with a lot of strictures caused by active as well as burned-out disease. I know this because I'm one of them. Three of my five small-bowel resections were performed due to narrowing of the intestine that prevented food from moving safely through the gut.

If your disease is active, or if you even suspect you have you have a narrowing, you must steer clear of foods that don't easily digest in the small intestine. If you don't, you could find yourself in the emergency room at midnight, dealing with a partial bowel obstruction and potential hospital stay. I've been there dozens of times before learning how to tailor my diet.

Comfort concerns: Although eating certain foods didn't cause your disease and won't force you out of remission, you can help yourself feel lots more comfortable by knowing what your body can easily tolerate on a given day. This is particularly true for Crohnies with a shortened small bowel, since they cannot digest everything they used to before surgery.

Now what does all this have to do with spicy food, Chinese in particular? Several things.

Spicy additives to food can irritate your small intestine. An irritated bowel cannot efficiently digest food to be sent on the digestive conveyor belt to the small intestine. An irritated bowel also results in diarrhea, bloating, and tons of gas in addition to reduced nutrient absorbtion.

This means when you develop an appetite for Chinese, Thai, Indian, or Italian food, you should steer clear of the spicier entrees. At the top of my hit list: Kung Pao beef, chicken, and shrimp. I also never order anything with curry or Hunan in its name.

As a Crohn's patient, you must also go beyond spicy considerations to think of immediate safety. Generally, you will want to order items with lower fiber content than others might select to avoid potential partial obstructions if the food gets caught in a narrowed area of the bowel.

My top no-no is anything with bean sprouts, followed by egg rolls. If I order a dish served with "tough" vegetables like steamed green peppers. onions, or sliced carrots in it, I carefully pick them out of the rice. Whether you choose beef, chicken, or pork, try to find an entrée with bits of baked, broiled, or browned meat rather than deep-fried pieces. Dishes with small broiled shrimp are usually a good choice if you have no shellfish allergy. And ordering from a buffet lets you choose larger amounts of a few goodies you can tolerate.

I love Chinese food but generally avoid ordering it in restaurants. Instead, I have come up with my own more-digestible version at home.

To minimize fat, which causes flatulence and diarrhea, I use one of two meat bases. I buy very lean ground beef, brown it in a non-stick skillet, drain it, then place it in another skillet. I next add canned mushrooms and peas, along with two of the canned Chinese vegetables I can tolerate. I might also add tiny pieces of (very) blanched red pepper if it's in season. To this I add soy sauce to taste and a small amount of spicy peanut sauce. The salt in the soy sauce brings out the peanut flavor, so only a small amount is necessary. When preparing the chicken version, I used either previously baked or canned chicken.

I then pull out my portion of the meal and place it on top of white rice, which is easier to digest than its brown cousin. I add fresh florets of broccoli, fresh carrots, and a few ears of baby corn to my husband's portion. Occasionally, I substitute noodles for rice.

What about eating out with the gang? Let's assume it's a payday Friday, and everyone at work is headed for the local Chinese place. What if you go overboard and feel it later?

I have always relied on a couple of days of ingesting only Ensure or Boost to give my stressed gut a rest. The food section of 100 Questions and Answers About Crohn's Disease and Ulcerative Colitis suggests you might even want to back up to beverages such as Gatorade or Crystal Light for relief.