HOST:
Crohn's Cast Number 1: Food: Friend or Foe?
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this podcast comes directly from individual patients with Crohn's disease. While the podcast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information visit www.crohnscasts.com.
In this episode, Dr. David Rubin will discuss the relationship between diet and Crohn's disease, and registered dietitian Tracie Dalessandro, who has inflammatory bowel disease, will talk about how Crohn's affects diet and nutrition and some common food concerns for people with Crohn's.
First, we spoke with Dr. David Rubin. Dr. Rubin is the program director for the fellowship in gastroenterology, hepatology, and nutrition at the University of Chicago Medical Center in Chicago, Illinois. He specializes in the treatment and assessment of digestive diseases.
Dr. Rubin, welcome.
DR. RUBIN:
Thank you very much. I'm happy to be here.
HOST:
Why is it important to discuss diet and nutrition in relation to Crohn's?
DR. RUBIN:
The number one question that my patients ask when it comes to their Crohn's disease is how can diet affect my disease, and what can I do to alter my diet to control my disease or give me better control of my symptoms?
HOST:
And how does Crohn's disease directly interfere with the patients' gastrointestinal tract?
DR. RUBIN:
Classically speaking, Crohn's disease could involve any portion of the GI tract from the mouth all the way down through to the anus. And because it causes inflammation of the bowel, patients have symptoms that may vary between diarrhea or pain. And therefore, those symptoms certainly are worse when they eat or have certain foods in their diet. So, patients naturally put together the connection between what they're putting in their mouth and is traveling through their intestinal tract and some of the symptoms they are experiencing from this chronic inflammation.
HOST:
So, what do you tell these patients? Why is good nutrition a critical part of managing Crohn's?
DR. RUBIN:
Well, there's a few different components to this. The first is understanding that patients who have inflammation of the bowel are at risk for malnutrition. They're at risk for malnutrition because they may not absorb nutrients properly due to the disease. But they're also at risk for malnutrition because they learn that when they eat less, they tend to have fewer symptoms and, inadvertently, they can actually be starving themselves. So, we first emphasize, very importantly, the issue of malnutrition, whether its malabsorption or just not eating enough of the right nutrients.
And the second thing we really emphasize is that food doesn't seem to drive the disease. In other words, the inflammation itself is not being caused by certain foods and, similarly, we're saying that the food is not going to turn off the inflammation. So what I really emphasize to my patients is that my job, to take care of them, is to control their disease so that they can achieve what we call an unrestricted quality of life. And that includes enjoying foods that they want to eat. We don't want people thinking about their entire existence with Crohn's disease to be revolving around bathrooms and around limited abilities to eat. So, we really work hard to emphasize that, for the most part, people should be able to enjoy the foods they want and they should be able to work with their physician to achieve that.
HOST:
Are there any specific nutrients that are more commonly deficient in people with Crohn's disease?
DR. RUBIN:
Well there are a few that we always look carefully for and one of them is vitamin B-12. So B-12 is the vitamin that's absorbed at the very end of the small bowel, which is the most common location for Crohn's. So people who have Crohn's disease in that location, who either have active disease or have required surgery in that area, if the disease or the surgery has been more extensive, they will often need a B-12 supplement, which can't be taken orally because the bowel is not absorbing it. It's actually given as an injection or as an inhaled nasal supplement.
The other one is iron. So of course, we're always monitoring peoples' blood counts. And iron may either be malabsorbed or patients with Crohn's disease who are bleeding in their bowel may actually lose enough blood so that their iron becomes too low. And so we monitor that very carefully.
And the third one is that we have to pay attention to calcium and vitamin D. And the reason these nutrients are important are because they're involved in bone metabolism and possibly other areas of our body. And patients with Crohn's do tend to have lactose intolerance, so that's a very common problem in our society, but patients with Crohn's disease may have it even more if the bowel is inflamed and they're unable to handle dairy products. And the milk-sugar of lactose that's in dairy products comes along with the calcium and vitamin D that most of us get from our dairy. So it's very important that we monitor bone health and calcium and vitamin D levels in these individuals as well.
HOST:
Is dehydration an issue with Crohn's patients?
DR. RUBIN:
Well it certainly can be and it can be a very serious issue. So patients who have Crohn's disease need to monitor how much fluid they're losing, either from active diarrhea or because they're not drinking enough fluid. And when people are actually quite ill with Crohn's disease and are vomiting, they're at high risk for dehydration.
HOST:
Any final words of advice for people with Crohn's?
DR. RUBIN:
Well, my general advice is to know your disease; where is it located and is it under adequate control? Because we don't want people who have this disease to have what we call "food phobia." We don't want you to be afraid of eating because you know it's going cause symptoms. I truly encourage all the patients who are listening and all of those who are seeing physicians to push their doctors and to discuss carefully how can I achieve that unrestricted quality of life? What will it take? And can I really get rid of some of the myths about limiting my food intake?
HOST:
Dr. Rubin, thanks so much.
DR. RUBIN:
My pleasure.
HOST:
Next, we spoke with Tracie Dalessandro. Tracie is a registered dietitian with the American Dietetic Association and received her Master of Science degree in nutrition from New York Medical College. She most recently wrote the top selling book, "What to Eat with IBD," a comprehensive nutrition and recipe guide for Crohn's disease and ulcerative colitis. An IBD patient herself, Tracie frequently speaks about nutrition and IBD for the Crohn's and Colitis Foundation of America.
Tracie Dalessandro, welcome.
TRACIE DALESSANDRO:
Thank you.
HOST:
Tracie, can you tell me a little bit why this issue is important to you?
TRACIE DALESSANDRO:
Well, being an inflammatory bowel disease sufferer myself, I know the struggles and the trials and tribulations that go with having inflammatory bowel disease, and it was the reason I became a dietitian. I was diagnosed at a very young age. I was in college, and at that point, I realized the profound impact that diet had on my well-being and my overall heath. So, I just decided that it was going to be my passion to pursue helping other people that had inflammatory bowel disease.
HOST:
Ok, so I'm assuming their number one concern is just how to create a day-to-day life where diet and nutrition isn't negatively impacting it. How do you advise them?
TRACIE DALESSANDRO:
Well, I am very careful to look at their life as a whole; you know, whether they have children, whether they're going out to eat a lot, if they're cooking at home. Those are all factors that I have to consider when I'm looking at a patient's diet. But there are very specific factors that I will consider when I'm speaking to a client that has severe inflammation or is really in the throws of a flare; what we call a flare is when there is a lot of inflammation. And what I'll always tell them is definitely try to include fruits and vegetables but in forms that are easy to digest; such as cooked fruits and vegetables; taking off the skins; making sure you're not eating fruits and vegetable that have seeds in them; staying away from whole wheat and whole grain products that are very difficult to digest; things like hard fibers; things with seeds and nuts because they are very tough on the digestive tract.
I also advise clients many times to be careful of lactose. If they are intolerant of milk products, you can always transition to soy or almond milk or other products to get your calcium intake. But sometimes the milk products can cause a lot of bloating and gas and irritation through the GI tract. And I have all kinds of recipes in my book if people want to reference it as well.
HOST:
So Tracie, I understand that the symptoms that people with Crohn's can experience can be pretty intense. When you're sitting across from a patient and they're struggling with how to live day-to-day without that fear, what do you say to them?
TRACIE DALESSANDRO:
I say that this too shall pass. Be strong, use your medication, talk to your doctor, and use diet to help your body to heal and re-nourish yourself. You will get better, life will go on, and you can manage this disease, and you will be okay.
HOST:
Tracie Dalessandro, thanks so much.
TRACIE DALESSANDRO:
You're so welcome.
HOST:
Thank you for listening to this Food: Friend or Foe? episode of Crohn's Cast, Speaking from the Gut. In the next episode we'll talk about how people with Crohn's have found ways to enjoy eating again. You can find us online at www.crohnscasts.com.
HOST:
Crohn's Cast Number Two Enjoying Eating
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this podcast comes directly from individual patients with Crohn's disease. While the podcast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information visit www.CrohnsCasts.com.
In this episode, registered dietitian Tracie Dalessandro joins us again to talk about how people with Crohn's can maintain a healthy diet. She'll also share some diet and nutrition tips. Later, chef Baron will share his personal struggle with Crohn's and how he manages his dietary and nutritional issues. First, we spoke with Tracie Dalessandro. Tracie is a registered dietitian with the American Dietetic Association and received her Master of Science Degree in nutrition from New York Medical College. She most recently wrote the top selling book, "What to Eat with IBD," a comprehensive nutrition and recipe guide for Crohn's disease and ulcerative colitis. An IBD patient herself, Tracie frequently speaks about nutrition and IBD for the Crohn's and Colitis Foundation of America.
Tracie Dalessandro, welcome back.
TRACIE DALESSANDRO:
Thank you Tim, nice to be here.
HOST:
Ok, so Tracie, in this episode, we're focusing on enjoying eating. So, when you're sitting there with patients and you're advising them, what are your suggestions to them about maybe bringing some joy to the eating process?
TRACIE DALESSANDRO:
Well, the most important things that I can tell my patients are learn what foods help your bowel to reduce the risk of inflammation and flare ups. That's very important for them to understand and sometimes it's on a trial and error basis. You have to discover what foods help to re-nourish your body and promote energy and total health overall. It's very important also to understand what recipes you can prepare that have high nutrient values but don't cause distress on your bowel.
HOST:
So Tracie, in terms of diet, what advice can you give to patients to help reduce Crohn's symptoms?
TRACIE DALESSANDRO:
Make sure you have a plan for meals and that you know what helps your body to feel better and what foods irritate your body. So, if you go to the supermarket, make sure you have that list at hand, so that you can make appropriate food choices for yourself. And make sure that you're also setting goals for nutrition. It's very important that you make note of foods that are very nourishing to your body and foods that are more, not detrimental, but can cause distress and are less healthy for you to be eating. So, foods like fried foods, and foods that have very low nutritional value, like foods that are high in sugar. You want to make sure that you're not eating excessive amounts of those kinds of foods and that you're concentrating on foods that really bring good nutrition to your body.
HOST:
Tracie Dalessandro, thank you so much.
TRACIE DALESSANDRO:
You're so very welcome.
HOST:
Next, we spoke with chef Baron. Baron is the chef at his family-owned City Streets Riverside Restaurant in Sheboygan, Wisconsin. As a person with Crohn's, Baron has learned to create new and exciting meals that cater to his needs. To share his recipes with other people who have Crohn's, Baron is collaborating with his close friend to develop a cookbook of Crohn's friendly recipes called, "Adapt: Simple and Inspiring Recipes for People with Crohn's."
HOST:
Chef Baron, thanks for joining us.
CHEF BARON:
Thank you.
HOST:
Can you tell us why you'd like to share your personal experience with Crohn's?
CHEF BARON:
I would just like people to know that eating with Crohn's disease doesn't have to be blah, doesn't have to be bland, it can be exciting. You can't eat the foods that you probably grew up on, but there's a lot of alternatives out there that don't limit the flavor profile of the stuff that you can eat today.
HOST:
So, how long ago were you diagnosed?
CHEF BARON:
About three years.
HOST:
Once you were diagnosed how did Crohn's disease impact your life?
CHEF BARON:
When I first got diagnosed, I was scared. I mean, I had never heard of Crohn's disease or anything else like that before in my life. And I went online to see, well I've got this disease now, what can I eat, what can't I eat, what affects me here or there. Upon seeing my options of recipes, or of listed recipes, I decided well, I mean, due to my culinary experience there is no reason why people with Crohn's need to eat steamed broccoli the rest of their life. So, I came up with some new and inspiring recipes, coming out in a cookbook called, "Adapt: Simple and Inspiring Recipes for People with Crohn's."
HOST:
Everyone is different when it comes to eating with Crohn's, but what foods are more troublesome for you?
CHEF BARON:
Well, right off the bat, I knew red wine affected me so I cut that out. I cut out red meat and I also cut out dairy. My doctor recommended that I start a food diary to help me determine which foods were good and which foods to stay away from. So now, I pretty much limit my intake of dairy products, raw fish, raw fruit, high fat foods and any seeds or nuts. And spicy foods I also try to stay away from.
HOST:
Give me some foods that you've rediscovered or maybe discovered for the first time.
CHEF BARON:
A lot of fish I've rediscovered. Salmon in particular, also tilapia, fishes that are high in omega three's and fatty oils, I personally don't have a problem digesting at all. Also, simple salads, low residue foods, like a nice simple spinach salad with a raspberry vinaigrette, obviously straining the raspberries for the seeds. Just quick, simple, nutritional and delicious.
HOST:
How do you advise people to make sure they get all the nutrients that they need? Or maybe, more specifically, how are you doing it?
CHEF BARON:
Right now I'm on, I've been on a multi-vitamin for the last a year and a half, and I've found that that seems to work very good for me.
HOST:
Alright, so I'm not going to let you get out of here until you give me a couple Crohn's friendly recipes. Give me an entrée recipe, one of your favorites.
CHEF BARON:
Probably the seared salmon with a roasted red pepper topinyad on top.
HOST:
What about dessert?
CHEF BARON:
I'd have to say one of my favorites would be the crème brule. Coming from a lot of background in French cuisine, crème brule has always been one of my favorite desserts growing up. Once I was diagnosed with Crohn's and sticking to the low-fat diet, I knew I had to come up with something that was as close as I could get to the real thing.
HOST:
One more question for you, chef Baron. Any tips for Crohn's patients who dine out a lot?
CHEF BARON:
Usually when I go out to eat, I'll always try and stick to foods that I know don't aggravate my symptoms. Or restaurants that have ingredients listed underneath the entrees. If I'm out of town or something like that, I guess I usually like to go online seeing if they've got the menu's online, so I can make my selections beforehand, so it never becomes a chore of sitting there asking the waitress, well, "What's all in this?" "What's all in this?"
HOST:
Well, chef Baron, thanks so much.
CHEF BARON:
My pleasure.
HOST:
Thank you for listening to this Enjoying Eating episode of Crohn's Casts: Speaking from the Gut. In the next episode we'll talk about Crohn's disease and the symptoms of depression. You can find us online at www.CrohnsCasts.com.
HOST:
Crohn's Cast Number Three Understanding the Mind-Gut Connection
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this podcast comes directly from individual patients with Crohn's disease. While the podcast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information, visit www.CrohnsCasts.com.
In this episode Dr. David Rubin and Dr. Amy Trachter will discuss the relationship between depression and Crohn's disease. First, we spoke with Dr. David Rubin. Dr. Rubin is the program director for the fellowship in gastroenterology, hepatology and nutrition at the University of Chicago Medical Center. He specializes in the treatment and assessment of digestive diseases.
Dr. Rubin, welcome.
DR. RUBIN:
Thank you. I'm happy to be here.
HOST:
Why is it important to discuss depression as it relates to Crohn's disease?
DR. RUBIN:
Well, Crohn's disease is a chronic illness, and whenever we're dealing with an illness that's going to affect somebody for years, or a portion of their lifetime, we need to accept that it's going to be interpreted by the individual in a variety of ways. When people are told they have a chronic illness, often the image they have of themselves and their future changes. And understandably that can be associated with depression or anxiety. And in fact, in some studies, we appreciate that patients with Crohn's are at higher risk for these conditions.
HOST:
So, people with Crohn's disease are more prone to depression?
DR. RUBIN:
People with Crohn's disease are at higher risk for depression and anxiety disorders, and it's for fairly obvious reasons. It's a disease that affects their bowel, a disease that's not often easy to talk about or share with others, it's a disease that people who don't know you very well can't see, so they don't necessarily know how you're suffering, and it is a disease that can really restrict your social functioning. And all those things added up can lead to depression.
HOST:
Do we know how depression directly impacts Crohn's disease?
DR. RUBIN:
For years, patients and doctors have suspected that there's a mind-body connection. When I ask patients, "What do you think activated your disease and gave you a relapse?" Very often, either they, or the one sitting next to them, who's their significant other or a parent, will say, "Well, I think it might have been stress." And so, people are constantly trying to connect what's going on with their life outside of their body with what's happening on the inside of their body. What hasn't been proven yet, is really how that link works. But we have a lot of interesting information to suggest that when people aren't feeling well, there's definitely something that can either trigger depression, or when they're depressed, or anxious, or stressed, there is something that may trigger active bowel disease.
HOST:
And what should Crohn's disease patients do if they think they are experiencing depressive symptoms?
DR. RUBIN:
People who are suffering from depressive symptoms should know that they can talk to their doctor, and they can also see licensed psychologists or psychiatrists, who can work carefully with them to address what is purely a reactive set of symptoms due to the illness or being sick for a short period of time, compared to more chronic illness that might require some medication. Sometimes, it becomes difficult to separate the depressive symptoms from the bowel symptoms, because these things can overlap. And, so carefully working with a team of people who care about you and who can work through these things and separate them out and treat them effectively is really important.
HOST:
Dr. Rubin, thanks so much.
DR. RUBIN:
It was my pleasure.
HOST:
Next, we spoke with Dr. Amy Trachter. Dr. Trachter is a licensed clinical psychologist who has experience assisting people living with medical illnesses, particularly Crohn's disease, ulcerative colitis and irritable bowel syndrome. She holds Doctor of Philosophy and Doctor of Psychology degrees from Nova Southeastern University in Florida. Dr. Trachter is the author of, "Coping with Crohn's Disease: Manage Your Physical Symptoms and Overcome the Emotional Challenges."
Dr. Amy Trachter, welcome.
DR. TRACHTER:
Thank you.
HOST:
Dr. Trachter, first of all, can you tell us why you have such a strong interest in a) depression, and b) its relationship to Crohn's?
DR. TRACHTER:
Well, I'm a clinical psychologist who has lived with active symptoms of Crohn's disease since my early twenties. Therefore, when I was in grad school, I was interested in researching the connection of the mind with the body, and learning scientifically what I could do to help myself and help others. I know first-hand about how the disease can affect emotions, and I've worked with lots of people who live with the disease and have experienced difficulties coping with active symptoms.
HOST:
What should people with Crohn's know about depression?
DR. TRACHTER:
Well, the best way to fight depression is to identify the symptoms early. And, I think everybody feels depressed at one point or another at some point in their lives, regardless of whether or not they have Crohn's disease. The key to coping with depression is first to understand what the symptoms are, so that they can be treated. Early identification of symptoms allows you to get help. And it's important to be able to recognize the symptoms early enough to get help before it becomes overwhelming.
HOST:
And how do you define depression?
DR. TRACHTER:
Well, the first thing that's important to remember is that the actual definition of depression is less important than how you actually feel on a day-to-day basis. That said, if you've been feeling down in the dumps or blue, more often than not. And have also been feeling hopeless, helpless, noticed a change in your sleep or your appetite, and maybe you're sluggish and lethargic. You might, you know, consider seeking an evaluation from someone who's a qualified professional. When feelings of sadness, or loss, or anger, or frustration interfere with your everyday life, more days than not, for a two week period of time, it's time to get an evaluation and seek assistance.
HOST:
And, in your opinion, why do some people with Crohn's disease develop depressive symptoms?
DR. TRACHTER:
Well, everyone reacts to Crohn's disease differently. And for some people depression may surface for, you know, lots of different reasons. One is the realization that Crohn's disease is a chronic illness and there are symptoms that you may have to deal with for the rest of your life. There's frustration because you can't eat the foods you want. You may be tired all the time. You may have difficulty sleeping. There's stress due to having to take medication. Stress due to finances of facing hospital or medical bills, adapting to the changes in lifestyle, and dealing with, you know, sometimes very difficult physical symptoms. The stress of feeling the need to, you know, know where the nearest bathroom is regardless of where you are. Sometimes people find it easier to isolate themselves and withdraw rather than explaining why their condition is hampering they're day-to-day functioning. People with Crohn's disease can become so focused on bathroom habits that the thoughts of the disease symptoms, you know, take over and experientially, people feel as though the disease has taken over their life, rather than simply being a part of it.
HOST:
You've listed several of them, but can you run through some of the warning signs for depression?
DR. TRACHTER:
Sure, some symptoms can include persistent sadness, crying, anxiety, feeling hopeless or pessimistic, feeling frustrated, guilty, worthless, helplessness, a loss of interest or pleasure in hobbies and activities that you once enjoyed, decreased energy, fatigue, feeling slowed down, difficulty concentrating, forgetfulness, indecisiveness, insomnia or oversleeping, weight loss or weight gain, restlessness, irritability. If you're experiencing five or more of the symptoms I just mentioned, more days than not for longer than two weeks, you should really seek help from a qualified professional. And it's important to talk to you physician to find a mental health professional who has been, you know, experienced treating people who suffer from chronic illness.
HOST:
Dr. Amy Trachter, thank you so much.
DR. TRACHTER:
Thank you.
HOST:
Thank you for listening to this Understanding the Mind-Gut Connection episode of Crohn's Casts: Speaking from the Gut. In the next episode we'll talk about how people with Crohn's can cope with the emotional effects of the condition. You can find us online at www.CrohnsCasts.com.
HOST:
Crohn's Casts Number Four Coping with Crohn's
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this pod cast comes directly from individual patients with Crohn's disease. While the pod cast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information, visit www.CrohnsCasts.com.
In this episode, Dr. Amy Trachter will talk about how people with Crohn's cope with the emotional effects of the condition. And later Debra will share her experience with Crohn's disease and how she dealt with depression.
First we spoke with Dr. Amy Trachter. Dr. Trachter is a licensed clinical psychologist who has experience assisting people living with medical illnesses, particularly Crohn's disease, ulcerative colitis and irritable bowel syndrome. She holds Doctor of Philosophy and Doctor of Psychology degrees from Nova Southeastern University in Florida. Dr. Trachter is the author of, "Coping with Crohn's Disease: Manage Your Physical Symptoms and Overcome the Emotional Challenges."
Dr. Amy Trachter, welcome back.
DR. TRACHTER:
Thank you.
HOST:
So, Dr. Trachter, can you tell us why you're interested in helping people with Crohn's cope with their disease?
DR. TRACHTER:
I'm a clinical psychologist who has also personally lived with the disease for many years. So I know first-hand about how the disease can affect emotions and have worked with lots of people that wanted to improve how they live with the disease.
HOST:
Great. And what tips to you have to help patients with Crohn's cope with their disease?
DR. TRACHTER:
Well, it's important to realize that if you talk to ten different people with Crohn's disease, you're likely to get ten different stories. All people who live with Crohn's disease are normal, they just live with symptoms that sometimes cause feelings of being different. I say that because, you know, it's not uncommon for people to report "feeling different" or have a desire to "be normal again." And, you know, people who live with Crohn's disease are normal. If you're feeling bad about feeling down or your symptoms…it's ok to through a pity-party for yourself, but give yourself a time limit. If it lasts longer than a day or two, it can lead to increased feelings of sadness and you don't want that. Keep a journal. Write down all your thoughts and feelings about Crohn's disease. Get in touch with what you think about yourself as it relates to your illness and your symptoms. Be good to yourself. Do relaxing and pleasant activities that make you feel good about yourself, whether it's listening to music or taking a bath. Don't allow your disease to become your entire life. Allow yourself some time to feel sorry for yourself without becoming destructive. Try not to think about your disease and your symptoms all the time. And identify situations and events that stress you out. You know, specifically, do you behave differently when under stress? Do you smoke more? Drink more? Cry more? And how does your body respond? Do you get more stomach pain? Do you go to the bathroom more? Because that's going to help you cope better with the symptoms.
HOST:
And what are some outside resources that Crohn's patients can use?
DR. TRACHTER:
There are several outside resources that patients can use. Family and friends, first off, and you can certainly seek support with a mental health professional who is familiar with people who live with chronic illnesses. You can obtain social support from others who have the disease, as well as organizations such as the Crohn's and Colitis Foundation of America. You can obtain information about your disease, which will provide you with a greater understanding of how the symptoms affect you and your body, as well as medicines. Again, if you're having trouble coping with the emotional aspects of Crohn's disease it's important to seek out a mental health professional. And talk to your physician because they're going to be able to put you in touch with people who are having or who are living in similar situations whether they be professionals and/or patients.
HOST:
Dr. Trachter, thank you so much.
DR. TRACHTER:
Thank you.
HOST:
Next we spoke with Debra. Debra was diagnosed with Crohn's disease at the age of 16 after two years of various doctors' visits to determine the cause of her severe abdominal pain, diarrhea, vomiting and lack of energy. Today, at thirty-nine years old, Debra's disease is now under control.
HOST:
Debra, welcome.
DEBRA:
Hi.
HOST:
Debra, can you tell us why you would like to share your personal experience with depression and Crohn's?
DEBRA:
Because I don't want other patients to go through the things that I went through. When I was so depressed, I just felt so alone and I want other patients to know that they're not alone, that there are other people out there that are going through the exact same things that they are.
HOST:
Debra, how did Crohn's disease impact you? Can you describe a time when you had feelings of depression?
DEBRA:
Well, I've had Crohn's disease for over twenty years. I was diagnosed when I was about sixteen years old, and I was a junior in high school. I don't remember too much about high school because I was sick so often. I actually had to drop out of high school and get a GED. I remember at the time that I just felt so afraid and I felt like I was just so completely alone. All of my friends were in school, they're getting ready for graduation, they're getting ready to go off to college, and there I was at home, a high school drop-out, trying to figure out what my future was going to be now that I had this illness that was going to affect me for the rest of my life. I would get these waves of depression that would just come over me. They were so bad that I could almost feel the depression physically washing over me. That had to be probably the worst time in my life.
HOST:
So, Debra, did you seek out help from a mental health expert or did your doctor help you come to terms with your depression?
DEBRA:
When I was at the point that I was actually suicidal I did seek out some mental health professionals. I went ahead and I saw two psychiatrists they put me on anti-depressants. Once I was on the anti-depressants, I did start noticing an improvement. I did start feeling a lot better.
HOST:
And what advice do you have for your fellow Crohn's disease patients?
DEBRA:
You need to learn as much as you possibly can about your Crohn's disease. And you need to make sure that you stay on top of all the current treatment options that are available to you. And you need to be able to take things one day at a time. There's just so many things you have to deal with when you have Crohn's disease. You're dealing with your doctors, and your medications, and your tests. And it's just so easy for anyone to go ahead and get overwhelmed. And you need to celebrate even the smallest of victories, it doesn't matter what it is. Even if it's something as small as getting your test results back and there's a slight improvement. You need to celebrate that. And on the days when you feel like you don't have anything to celebrate, you need to cut yourself some slack. But I think the most important thing that I could tell other Crohn's patients, is don't be afraid to ask for help.
HOST:
Debra, thank you so much for joining us today.
DEBRA:
Oh, you're welcome.
HOST:
Thank you for listening to this Coping with Crohn's episode of Crohn's Casts: Speaking from the Gut. In the next episode we'll talk about Crohn's disease and relationships. You can find us online at www.CrohnsCasts.com.
HOST:
Crohn's Casts Number Five Dating Dilemmas
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this pod cast comes directly from individual patients with Crohn's disease. While the pod cast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient, in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information, visit www.CrohnsCasts.com.
In this episode, Dr. Amy Trachter will discuss how to manage the challenges of relationships with Crohn's disease. And later, Jessica will provide a firsthand account of how Crohn's has affected her personal relationships.
First, we spoke with Dr. Amy Trachter. Dr. Trachter is a licensed clinical psychologist who has experience assisting people living with medical illnesses, particularly Crohn's disease, ulcerative colitis and irritable bowel syndrome. She holds Doctor of Philosophy and Doctor of Psychology degrees from Nova Southeastern University in Florida. Dr. Trachter is the author of, "Coping with Crohn's Disease: Manage Your Physical Symptoms and Overcome the Emotional Challenges."
Dr. Amy Trachter, welcome back.
DR. TRACHTER:
Thank you.
HOST:
So Dr. Trachter, why is it important to discuss the potential impact of Crohn's disease on relationships?
DR. TRACHTER:
Well, according to the Crohn's and Colitis Foundation of America, Crohn's disease is typically diagnosed between the ages of 15 and 35. So there's going to be many young single people living with Crohn's disease. And those people ostensibly are going to be living with Crohn's disease and dating. So, it's important to discuss.
Crohn's disease may or may not affect your relationships, depending on whether or not you have active symptoms and how intense those symptoms are. Many people live with active symptoms of Crohn's disease wonderfully. Everybody handles how the symptoms impact their relationships differently. It's important to realize that anyone, with who you are involved in a committed relationship, will want to know about you, all of you, not just the parts of yourself you choose to share. And at some point, talking about the symptoms that you currently have and/or past symptoms may become part of a discussion.
When discussing the symptoms with people you are in a relationship with, it's helpful to communicate things that are helpful to you during times when you're living with active symptoms. For example, if you tell your partner in advance, well, you know, "I'm fine right now, I have no active symptoms, but there may be times where I have to use the bathroom a lot. When that happens, do me a favor, don't ask me what I eat everyday because my mom already does that and it drives me crazy". And then this way, you've told your partner something that's helpful to you. And telling partners about your illness and how they can be of help to you, if necessary, builds trust and intimacy between two people.
HOST:
So what makes dating with Crohn's disease different?
DR. TRACHTER:
I think dating can be difficult for anyone living with a chronic illness. But for someone with Crohn's it may be especially anxiety provoking because the symptoms of the disease require talking about going to the bathroom and diarrhea, which is typically not socially acceptable conversation. And people don't always know what Crohn's disease is, so an explanation of the illness itself is often required as opposed to a disease like diabetes or asthma which are much more well known. Many times, um, people avoid certain dating situations such as going out on a boat, or going skiing, because of fear that they're not going to be near a bathroom. And starting new relationships may be difficult because they fear other people may not understand their symptoms and what they're going through.
HOST:
So you mentioned new relationships. Do you have any suggestions for Crohn's patients thinking about starting a new relationship?
DR. TRACHTER:
Be comfortable with yourself. It's important for someone living with Crohn's to know and understand their own feelings about their symptoms and their illness, so they know how and what to communicate to someone else, if and when this conversation arises. The more comfortable you are with yourself and your symptoms, the easier it'll be to talk about it with other people, especially those that you're dating. People take their lead from you, so the more comfortable you are with yourself, the more comfortable others will be with you.
HOST:
Is there a recommended length of time a person should date before talking about his or her Crohn's?
DR. TRACHTER:
There is no specific length of time you should date somebody before telling them you have Crohn's disease. You'll know when the timing is right by the level of comfortability and intimacy you have with the person. And everybody's different, you know, some people, you know, want to tell right way and they feel relieved by being up front. Some people choose to find a level of intimacy before talking about private information. And other people don't want to talk about it at all. They believe it's too private and personal to share. And in each of those cases, that's okay.
HOST:
And what advice do you have for those people who are going to share their experience with Crohn's, with their partner?
DR. TRACHTER:
Well, everyone has their own way of sharing their experience with Crohn's disease. Here are some tips that might make it easier. Match your verbal with your nonverbal communication. For example, if you say that living with Crohn's disease is no big deal, and you're crying when you do it, the people with whom you're speaking are not going to think it's not a big deal. They're going to think you're upset about it. How you present your illness to other people has a great deal to do with how people respond to you. So, talk to your date about Crohn's by offering basic facts about the disease, facts first! Regardless of whether or not someone has heard of Crohn's, it's important to share an explanation in your own words of what it is.
And whether or not you decide to share your experience with someone you're dating, it's important to talk to someone about how you're feeling. And whether it's your family, or your friends, or support groups that are available through CCFA, it can be helpful to talk to others in similar situations.
HOST:
Dr. Trachter, thank you so much.
DR. TRACHTER:
Thank you.
HOST:
Next, we spoke with Jessica. Jessica is a sophomore at the University of Wisconsin in Steven's Point. Since suffering from Crohn's disease, Jessica has dealt with not only severe abdominal pain and drastic weight loss, but also the strain her disease has put on her relationship with her friends and her boyfriend. Now at the age of nineteen, Jessica has control of her Crohn's disease, and with the help of a strong support system, is able to enjoy living away from home for the first time.
Jessica, welcome.
JESSICA:
Thank you for having me.
HOST:
Can you tell us why you'd like to share your personal experience of dating with Crohn's?
JESSICA:
Sure. Well, I've lived with Crohn's disease now for about seven years, and I've actually been in a dating relationship for three and a half of those years.
HOST:
So, how has Crohn's disease impacted you're dating life?
JESSICA:
Well, what's nice is that when I first started dating my boyfriend, I knew I had Crohn's and I was actually in remission for Crohn's disease. But after we had been dating for a little while, I had a flare-up, and when I found out about my flare-up I ended up having to call my boyfriend and I had to tell him what a flare-up was and explain it to him, because he really didn't know. But, when I found out about my flare-up and my boyfriend found out, he actually went and did some research on his own. He went to the library and checked out all of the books they had on Crohn's. It's been pretty easy because I didn't have to answer all of the weird questions and that way her knew about Crohn's and he knew about my flare-up before I was in college, so it's been pretty nice.
HOST:
What are some other ways people can overcome dating challenges? It sounds like you were fortunate to have a boyfriend that did some research on his own and you two communicated. Are there some other ways people can overcome these challenges?
JESSICA:
Oh yes, definitely. Once you are comfortable in a relationship, you should definitely tell the person about your disease, even if you don't have any symptoms currently. Teach your significant other about your disease. That is really important especially if you have future flare-ups. Also, encourage your significant other to research Crohn's on their own and you don't have to answer any awkward questions if you don't feel like answering them. And sometimes if you're preparing for that first date, or a date along the lines, you may want to make sure you've taken a nap that day, maybe wear some comfortable clothing. If you're going out to dinner, eat a small meal beforehand so you know that you can eat something before you go.
HOST:
And right now as we speak, you're still in this relationship. How is Crohn's affecting your relationship right now?
JESSICA:
Right now, I think Crohn's has actually brought my boyfriend and I closer together.
HOST:
Wow, that's great. Thank you so much Jessica.
JESSICA:
Thank you.
HOST:
Thank you for listening to this Dating Dilemma's episode of Crohn's Casts: Speaking from the Gut. In the next episode, we'll talk about how Crohn's disease can affect your relationship with your spouse. You can find us online at www.CrohnsCasts.com.
HOST:
Crohn's Casts Number Six For Better Or For Worse
Welcome to Crohn's Casts: Speaking from the Gut, a program discussing relevant issues for people with Crohn's disease. This series is brought to you by Abbott. Some of the information discussed during this pod cast comes directly from individual patients with Crohn's disease. While the pod cast discusses certain tips and suggestions for handling the disease, the information presented may not be appropriate for every patient in every case. Therefore, we encourage all Crohn's patients listening to discuss these issues with their health care providers to ensure the approaches discussed today are the right approach for them. For more information, visit www.CrohnsCasts.com.
In this episode, Dr. Amy Trachter will talk about challenges people face when a spouse has Crohn's disease, and how to cope with them. Later, Bert and Heather will share how their marriage was affected by Crohn's and how they've dealt with it.
First we spoke with Dr. Amy Trachter. Dr. Trachter is a licensed clinical psychologist who has experience assisting people living with medical illnesses, particularly Crohn's disease, ulcerative colitis and irritable bowel syndrome. She holds Doctor of Philosophy and Doctor of Psychology degrees from Nova Southeastern University in Florida. Dr. Trachter is the author of, "Coping with Crohn's Disease: Manage Your Physical Symptoms and Overcome the Emotional Challenges."
Dr. Trachter, welcome back.
DR. TRACHTER:
Thank you.
HOST:
So, Dr. Trachter, why is it important to discuss how Crohn's disease affects relationships?
DR. TRACHTER:
Well, as a Crohn's patient and a clinical psychologist, I've talked to many couples about relationships and I've seen firsthand the affects that the disease can have on a committed relationship. Sometimes the strength of a marriage or committed relationship is tested by difficult times, like dealing with a chronic illness, such as Crohn's disease. Couples learn to lean on each other by involving one another in the process of diagnosis, and treatment, and management and it builds trust and intimacy. Some people may isolate their feelings from one another and that can sometimes lead to further frustration and helplessness. Communicating about the illness and feelings surrounding the impact of the symptoms, on the relationship, maintains the intimacy and trust you formed with your partner.
HOST:
And, how can Crohn's disease affect the relationship between spouses or any committed relationship?
DR. TRACHTER:
Well, what I've noticed invariably amongst relationships is that both people have very similar feelings; they just come at them from different places. The spouse with Crohn's may experience guilt, or fatigue, or feelings of helplessness, because of disease symptoms, and that contributes to behavior changes. The partner without the illness may feel helpless and frustrated, or shut out because they can't do anything to help their loved one feel better. So, talking about similar feelings, even though they originate from different places, helps the couple communicate about the symptoms. And sometimes, you know, somebody feels left out or shut out by the other, and when you talk about it, it exposes the elephant in the room and makes it easier to deal with the symptoms and how they impact the relationship, because people can agree upon ways to handle their feelings, in the context of the relationship, instead of isolating themselves.
HOST:
What impact do the physical symptoms of Crohn's have on a relationship?
DR. TRACHTER:
Well, symptoms of Crohn's, such as fatigue and chronic diarrhea, may impact a person's mood or behavior, which in turn affects intimacy in a relationship. People with Crohn's may lack desire and energy as a consequence of their symptoms and they may lose interest in sex as a result of sleeplessness. It's not about the other person, it's about feeling physically ill, and that's not any different from anybody else who's physically ill and doesn't have Crohn's disease. Sometimes the symptoms affect feelings about oneself and the insecurity about having an accident or leakage during an intimate moment, can affect somebody's mood.
HOST:
And what advice can you give couples to overcome these obstacles?
DR. TRACHTER:
Well, obstacles may be a reality for people living with Crohn's. There are a few helpful tips to remember to make life a little easier. Always openly discuss your thoughts, your feelings, your concerns, with your partner. By doing this, you comfort and support one another during difficult times. Make sure your partner's aware that you're having symptoms, even though it's not necessary to share every pain and feeling. Try and keep things as positive as possible. In regards to intimacy, remember that you don't have to have sexual intercourse to feel connected. Cuddle, laugh, show affection, hug, touch. Those kinds of things go along way during periods of active disease. And of course, you know, if you feel like, you know, there are difficulties in your relationship and they are continuing to occur because of various challenges, consider visiting a couple's therapist or a Crohn's support group.
HOST:
Great. Thanks so much, Dr. Trachter.
DR. TRACHTER:
Thank you.
HOST:
Next we spoke with Bert and Heather. Bert had just finished college when he was diagnosed with Crohn's disease. Although his wife Heather knew about his disease, the emotional and physical affects had significantly impacted their relationship. Today at 42, and with his disease under control, Bert's relationship with his wife has improved. Bert and Heather have two children and are expecting their third.
Bert, Heather, welcome.
BERT:
Thank you very much.
HEATHER:
Thank you for having us.
HOST:
Bert, can you tell us why you'd like to share your personal experience of marriage and Crohn's?
BERT:
Yeah. I was diagnosed with Crohn's disease over 16 years ago, when I was 26, and it was before Heather and I started dating. I had worked in a small office, and the disease just was horrible. And I tried to keep it to myself, but clearly everybody knew that there was something wrong. So I ended up sharing it with my co-workers.
HOST:
So, Heather, did you know about Bert's Crohn's disease before you started dating?
HEATHER:
Yes. We worked together, um, for two years before we started dating. And I had realized that he had had issues. It really didn't affect us too badly back then. It's been the last six years that it has really put a strain on us and that we've been struggling to get through.
HOST:
So talk to me about the past six years. What has changed for you in your relationship?
HEATHER:
We've been married for a little over five years. We have two children, one is four and a half, and the other one is soon to be two, with another one on the way, due in February. Bert was in remission for a few years and he got very sick a month after we got pregnant with our second child. So here I am pregnant, dealing with the two year old, while my husband is sick constantly. We couldn't go anywhere. It was a struggle for us. It was hard for me to adjust to dealing with a two-year-old while being pregnant, when not having a lot of support and help from my husband because he was sick.
HOST:
That sounds like it was clearly the most difficult time for you in your relationship. How did you both work through that?
HEATHER:
Every day is still a challenge. He needs to obviously deal with his disease and I end up taking care of the kids in his absence. But we're both on the same page as parents. So it does make it a lot easier, when he needs to step aside due to his illness, then I just step in and take over, and it's worked out very well.
HOST:
Bert, what advice do you have for other Crohn's patients who are married or who are in committed relationships and are going through similar challenges?
BERT:
Absolutely don't give up. Marriage is definitely for better, for worse. With the disease you're going to go through some very, very tough times. And it's nice to go through it with somebody who you love and who supports you and is there for you. The Crohn's definitely puts a strain on the relationship, there's no discounting that. But with determination, understanding, and love and a good dose of sense of humor, we've been able to fight through it.
HOST:
And Heather, what about you as someone who is a partner with somebody with Crohn's, what advice do you have for people in a similar situation out there?
HEATHER:
It's difficult. But when you find somebody that you love and you want to spend your life with, it doesn't matter, to me it didn't matter. Whatever he was going through, we both went through. And that's what we do for people that we love and we're just happy that he's gotten the treatment that he needs and he's gotten better.
HOST:
Bert, Heather, thank you so much.
BERT:
Thank you very much, we enjoyed it.
HEATHER:
Thank you for having us.
HOST:
Thank you for listening to this For Better Or For Worse episode of Crohn's Casts: Speaking from the Gut. You can find us online at www.CrohnsCasts.com.