Crohn's Disease and Cycling - More Crohn's and Sports info

Crohn's disease and cycling

From Cycling News.com Article

I'm a 28-year-old recreational rider who likes to ride four to five times a week, I start by building up easily and when I'm in shape, my longest rides are about 160 km (ore about 100 miles). I also like climbing the French mountains, but also at a recreational pace. As you notice, I'm not exactly a pro, but I always like to get in better shape.
I've been recently diagnosed with Crohn's disease, which is also a cause of anaemia (lowest hematocrit ever measured was 27, most of the time it's about 35). This of course doesn't help my riding. The doctors at the hospital were very helpful and gave me all the medicines I need to control my disease, but they couldn't give me much info about Crohn's and sports.

There are two big issues:
My body refuses to absorb iron. I take iron supplements (each day I take 3 times the dose a normal person should take and extra vitamin C, because it helps the iron absorption (both on doctors prescription), but my hematocrit and haemoglobin levels stay low
Because of the disease, my body doesn't absorb much proteins either. I take protein supplements after hard trainings, but would it help if I would drink protein drinks on a more regular (daily) basis?
S
o, apart from more training, what could help me to get in a better shape? Proteins? More iron supplements? Any other training tips for Crohn's patients?
Bram

Pam Hinton replies:

As you are well aware, Crohn's disease is a type of inflammatory bowel disease. Although the inflammation and scarring can affect any region of the gastrointestinal tract, typically the ileum (part of the small intestine) and colon are affected. The inflammation caused by Crohn's disease damages the mucosa, where nutrient absorption occurs. As a result, the ability of the intestine to do its job is severely compromised.

Weight loss is common due to reduced intake because of abdominal pain, cramping, and diarrhoea. In addition, the ability of the intestine to absorb the energy-yielding macronutrients, in particular, protein and fat, may be reduced. Special liquid diet formulations are available that provide partially digested proteins, as amino acids (elemental diet) or small peptides (polymeric diet). These require a physician's prescription, but you can also buy liquid supplements with partially hydrolysed proteins that may increase the amount of protein you absorb. Consumption of small amounts of protein at higher frequency may also increase the amount absorbed.

Iron deficiency is common in individuals with Crohn's disease due to poor intake and blood losses via the gastrointestinal tract. Deficiency of vitamin B12 is also common, as it is absorbed in the ileum. Anaemia can result from deficiency of iron and/or vitamin B12. Both B12 and iron can be administered via injection if needed. Individuals with Crohn's are at risk for osteoporosis (loss of bone) because of both the disease and the corticosteroids that are used to treat the disease. Therefore, most individuals take supplemental calcium and vitamin D.
If you haven't already done so, you might talk to a dietitian who specialises in inflammatory bowel disease. Good luck!