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What are first foods to introduce after liquids only? A big ARHGH!!!!! HELP

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Posted 9/26/2011 4:42 PM (GMT 0)
So it has been three months and I'm still flaring.  Tried Entecort and didn't work. Been on prednisone for three weeks now and barely getting by. Second ER visit this AM for servere abdonminal Pain. As of Oct 1 .. this Sat, I am covered on my husband's insurance and will probably have a colonoscopy or MRI, etc then. Pain meds now.  Low grade fever like I do with most Crohn's flares ... 99.5 degrees.

Seems like I drink Gatorade for a while and do well ... try to introduce foods .. yogurt, potatoes ... and then try meat/chicken ... maybe cottage cheese / cheese and then any thing else and I get explosive D and severe abdominal pains, usually upper left Q. Although this time I'm getting my period and I felt the pain in my lower abdominal region so that is new for sure.

Question is:  what are safe foods to eat during a flare? My husband would prefer I jsut drink gatorade and not eat anything ... this seems to be a constant source of discussion between the two of us. And I"m hungry since I'm on prednisone.  I don't do well on wheat so I stay away from that. I don't do good with any vegetable unless it is well a well cooked pototate or some root vegetble .... HELP!!!!!  And how long do I eat these things ... hw long do I taper .. when can I eat more.  I am on 40mg prednisone and usually it kicks in by now.  And I've had Crohns for 8 years now ... shouldn't I know this by now???  ARGH!!!!

Posted 9/26/2011 4:50 PM (GMT 0)
veggie broth always helped me... then i would add a bit of tofu and greens in progression. but very slowly. it depends on your system. mine recovered fast enough, within a month about 2 years ago. havent flared since but i always have my little box of organic veggie broth in case!

good luck!!
Posted 9/26/2011 6:03 PM (GMT 0)
When I have been on liquids only diet, docs usally move you first to full liquids which is creamy soups, cream of rice, etc. If those go down they slowly raise you to a soft and bland diet that consists of scrambled eggs, toast, baked chicken or turkey, rice and other bland and easy to digest foods. Then slowly back to a normal diet. I always have to do it slowly and that seems to work best for "me". Hugs!
Posted 9/26/2011 6:32 PM (GMT 0)
how slow? When do you know when to progress? How many days? Weeks? Hours?
Posted 9/26/2011 6:55 PM (GMT 0)
I would say take it very slow—days, depending on how your symptoms are improving. You don't want to start on solids if your body can't handle it, and there's no need to rush. If you can handle the pureed foods and some of the ones Nanners mentioned, give it a few days before you try some real solids, and only if your tummy feels up to it.

You might want to look at taking some digestive enzymes, and ask your GI for some cholestyramine, which will help bulk up the stool a bit.
Posted 9/26/2011 6:55 PM (GMT 0)
How quickly do you try to introduce other foods?

Are you saying that you can handle the foods you listed (yogurt, potatoes, chicken, cheese) but not anything else or are these foods also giving you trouble?

Have you tried a nutritional drink like Boost or Ensure while on a liquid diet? It can provide a lot of vitamins and calories that you are probably lacking in your current flare. If you drink 6 Ensure scattered throughout the day, that's 1500 calories. Although when I did that, my doctor advised me to work up to 6 a day and not just go from 0 a day to 6 in one day. Anyway, that should be more than half the calories your body needs in one day...it can get you by for short stints out of necessity, but it doesn't help make you feel full.

If it were me, and I had to go to the ER this morning due to abdominal pain, I'd probably stick to a clear liquid diet all day.

If I were feeling OK tomorrow, I'd probably bump it to a full liquid. Maybe clear liquid in the morning and full liquid at lunch? Full liquids can include ice cream, pudding, yogurt, nutriotional beverages (like Ensure), cream soups, in addition to anything you could eat on a clear liquid.

My problem with prednisone is hunger would lead me to eat too much, so I'd try to find something to focus my attention so I'm not always dwelling on how hungry I am. Even with full liquid, you could eat too much, and end up with continued abdominal pain.

As for Wednesday, it would really depend on how I felt after Tuesday. And given that you are trying to "stretch this out" to next week, if it were me, I'd probably give the full liquid only one more day, at least.

Wednesday or Thursday, I would eat an egg, some toast, maybe something lite with noodles, like mac & cheese or chicken noodle soup, crackers, mashed potatoes. Things like that. But you said wheat bothered you, so I don't know if you can eat crackers or noodles. On these days I'd still get the majority of my calories from the liquid options.

Friday and over the weekend, personally, I wouldn't add much more to that. I'd keep the diet bland and largely liquid.
Posted 9/26/2011 7:12 PM (GMT 0)

Roni said...
I would say take it very slow—days, depending on how your symptoms are improving. You don't want to start on solids if your body can't handle it, and there's no need to rush. If you can handle the pureed foods and some of the ones Nanners mentioned, give it a few days before you try some real solids, and only if your tummy feels up to it.

You might want to look at taking some digestive enzymes, and ask your GI for some cholestyramine, which will help bulk up the stool a bit.

I agree with the first paragraph.  Take it slow.  The schedule I outlined in my previous post is a speed I know that my body has handled in the past.  I also wasn't in so much pain that I had to go to an ER.  If you are waiting for insurance and the prospects of diagnostic tests, there's no reason to rush this week. 

What do they do at the ER?  Any kind of test, or you decline because of insurance?

As for the 2nd paragraph, I would advise against something like that.  If you have an issue with a stricture, you do not want to bulk up the stool. 

Posted 9/26/2011 7:49 PM (GMT 0)
Introducing foods/drinks slowly is key. You could have an underlying issue with lactose intolerance (it happend to me) that is being disguised by your CD...maybe get a lactose test done to confirm if you have lactose intolerance issues.

My best advice is to stay completely away from processed and fast-foods in general. Bottom line is, it's still individualistic for everyone. Red meat is one of the hardest to digest (they say) but I personally have no issues with it. I have friends that have no bowel issues but when they eat steak in particular it runs right through them...so again even healthy people may have issues with certain foods/drinks.

If you introduce things slowly, it may better help you determine what foods/drinks work against you causing you explosive D and such.

Good luck!
Posted 9/26/2011 7:57 PM (GMT 0)
When I had to switch to liquid/low residue earlier this year, I started keeping a daily food diary. I did it again for a couple of weeks while recovering from surgery and was allowed to add things back into my diet.

I wrote down what I ate, how much, frequency of BM's, and how I felt - pain, if any, where, how long it lasted, etc. This sort of thing helped me bridge the time up to my surgery, and steered me away from a couple of things that I didn't realize was bothering me.

And by "wrote down", I used an excel spreadsheet.
Posted 9/26/2011 8:35 PM (GMT 0)
Also, baby food is a good start (and a lot of people forget)...I tend to like the "baby's first" foods, especially the rice cereal, and I use soymilk usually to stir it up(and works well when on prednisone, because it as less sugars that way)...but yeah, when I'm ill like that, after the liquids, I go to baby food...
Good luck
Posted 9/26/2011 9:17 PM (GMT 0)
I agree with Clonehead to do it slowly, when you think your body has accepted the step up in diet (few days) then move up to the next step. Good luck!
Posted 9/26/2011 9:54 PM (GMT 0)
I think I push it way too much. Why don't doctor's teach you this much? None of the GI docs I have ever had (lived in three different cities) coached me ...

And what is your liquid of choice?

Does anyone blend food? Does the liquid part have to be clear? What is about clear liquids that is important in the beginning? Or is it not?

by the way, thank you all SSSOOO much!!!
Posted 9/27/2011 1:15 AM (GMT 0)
HI
If it were me I would first go to a bone broth. That is making a stock out of lots of beef or chicken bones. If you are feeling poorly you can usually buy a big bag of chicken legs for cheap. brown them off in a pan or even in the big pot, add some carrots a bit of onion, sage and savory a couple of bay leafs.
Then boil for 24 hours. Bring to a hard boil, then skim off the scum. Then a very low slow boil. Strain you can puree the carrots and onions even add some fresh ones that are very well cooked and pureed. Cooking for 24 hours is key to get gluten.
The gluten from the bones is very soothing, and the stock is super nutritious but very easy on the gut. This is a good first step.
I am blessed to feel good right now and I still eat this all the time and every time I eat I feel the happiness on my guts.
You can make this as thick or as thin as you have to. You can add as many or as few veg and meat as feels right.
Healing thoughts
Dave
Posted 9/27/2011 3:16 AM (GMT 0)
champagne, I did suggest you could look into cholestyramine to bulk up your stools, but clonehead is right, that if you have a stricture, you wouldn't want to take that. I couldn't see anywhere that you have a stricture...?
Posted 9/27/2011 4:27 AM (GMT 0)
I don't know if I have a stricture ... what are the symptoms? My frustration is taht I've been on prednisone for 3 weeks now and not getting any better ... one step forward, two back when I start to eat. I'm on 40mg of prednisone ... shouldn't I be feeling great?

Posted 9/27/2011 4:44 AM (GMT 0)
For my hubby we introduce solid food very slowly when recovering from a flare up. I usually make him some SCD chicken soup and a little mashed up plain rice. This he eats for a week or so while also drinking boost to keep his calorie count up. I then try plain baked chicken and plain boiled noodles. He also has saltiness crackers for a snack, and I make him homemade yogurt. He also has some plain white bread. He pretty much sticks to this for about a month, maybe more depending on how he's doing. During this whole time he supplements with pedialyte and boost glucose control.

After he is stable on this diet, I add French cut green beans and see how that goes for about a week. Then I try baked fish, very lean grilled hamburgers (no seeds on bun). And i slowly add very cooked veggies. If he does well, we slowly increase portion size to where he can reduce the liquid supplements.

It is very slow going and needs a lot of discipline. He also keeps a food and bm journal to track how foods maybe affecting him.

I hope you feel better soon!

PV
Posted 9/27/2011 4:04 PM (GMT 0)
Stricture symptoms include: shooting pain in the abdomen (mostly from the location of the stricture), not passing gas or stool, swollen distended stomach with a very very full feeling, and vomiting.
Posted 9/28/2011 12:35 AM (GMT 0)
Wow, this is so helpful. Even after 8 years with Crohn's, I have to learn how to eat. I didn't realize how slow and restrictred my diet needs to be during a flare. This is only my second really bad one and the first resulted in an ilieus. So, yesterday, I started basically on just a liquid diet supplementing with shakes ... I'm shocked at the ingredients in some of them, especially Ensure. We live in a very rural area so selections are few and far between but they can order anything. Any suggestions?

Also, I ate canned butternut squash soup tonight and my the right side of my colon started to throb ... I thought maybe because it was soup, totally blended, that it would be okay, but I was wrong ... I wonder what it was about the soup (just butternut squash) that caused that reaction.

Thanks everyone!
Posted 9/28/2011 2:24 PM (GMT 0)
Champagne I have to tell diet is very individual for all of us. What works for one, doesn't always work for all. I would suggest you start keeping a food diary and keep tract of what agrees and what doesn't. You need to find the right diet for "you". Hugs!
Posted 9/28/2011 2:42 PM (GMT 0)
Hello!

Do not have personal experiences about this Ch. Yet. Who knows what to expect. A lot, some, but who knows what do I have. So. I have tried liquid diet, but real one, not Getorade. Here we have like NutriComp. No sugar, but it has soy and milk proteins. 500 kcl/500ml. I am not sure if you can tolerate them. I gain weight when was on it! Only liquid diet helped me not to loose wieght, in first months this year. Now I continue to loose it.

So - have you consider with elemental diet, since you are still in flare? Vivonex? Something like it. I have read that it helps slow down digestion and absorbtion of food is better. You must be loosing weight. Right?

There were Japanese trials where patients have 50/50 percent liquid on Elental and whatever they wanted to eat. Results were good.

Not to eat anything? It is hard, I can just imagine, how you feel. But onyl Getorade?

Hope that helped you some!

Hugs!
Posted 9/28/2011 6:25 PM (GMT 0)

champagnekindofgal said...
I think I push it way too much. Why don't doctor's teach you this much? None of the GI docs I have ever had (lived in three different cities) coached me ...

And what is your liquid of choice?

Does anyone blend food? Does the liquid part have to be clear? What is about clear liquids that is important in the beginning? Or is it not?

by the way, thank you all SSSOOO much!!!

 

So, yesterday, I started basically on just a liquid diet supplementing with shakes ... I'm shocked at the ingredients in some of them, especially Ensure. We live in a very rural area so selections are few and far between but they can order anything. Any suggestions?

Also, I ate canned butternut squash soup tonight and my the right side of my colon started to throb ... I thought maybe because it was soup, totally blended, that it would be okay, but I was wrong ... I wonder what it was about the soup (just butternut squash) that caused that reaction.

Thanks everyone!

Catching up on some old threads...two of your messages I can share my experiences/preferences and what has worked for me.  May or may not work for you.

I was trying to think how much of this food advice my doctors gave me.  I don't think too much.  It took a while for my Crohn's to get diagnosed, and my mom's effort throughout this diagnosis period was to feed me like I had a stomach bug.  So, easy to digest soups, toasted cheese sandwiches, eggs, crackers, etc.  Most times when I have a flare, I revert to the sort of things my mom would have fed me because that's my experience...neve checked in with a doctor about that.

I really only had to go to a liquid diet twice with Crohns...once about 7 years ago...I had a painful flare that kept me in bed all day...I only ate chicken broth that day.  And earlier this year, pretty bad stricture and eventual surgery.  It was the doctor who then recommended Ensure type beverage and this is the first time I have ever had to drink something like that. 

The idea of the clear liquids for me came from our various bowel screenings.  You have to have a clear liquid diet the day before colonoscopy or any other type of exam. Other types of liquids and foods create at least some bowel materials. 

So clear liquids would give you close to complete bowel rest.  My preferences are apple juice, gatorade, and jello because these actually provide some calories, where canned broth and water provide none.

As far as the Ensure type drinks, I don't like the faux chocolate, but both strawberry and vanilla taste fine to me, especially ice cold. 

Even though it is liquid, certain liquids will make me sick when flaring...especially citrus juices.  Even pulp free orange juice, grapefruit juice, etc is not my friend and will make me vomit.  Perhaps this was a similar issue with the butternut squash soup? 

My next step up foods, and I don't have any problems eating the same thing over and over for a week or more, are macaroni & cheese and eggs (not mixed together.) 

I was not in a flare on my wedding day, but I did not dare risk anything so my lunch was solely macaroni and cheese. 

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