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There are a few factors such as infection (upper respiratory and digestive tract), cigarette smoking and

NSAID intake, which can aggravate the symptoms of CD. The role of stress in the exacerbations of the disease symptoms has not been proven but most patients believe stress can be a factor. General recommendations therefore include elimination of stress, quitting smoking and avoiding other exacerbating factors.

There is no evidence of the impact of the diet on the development and course of CD; however, to the perception of most patients, some foods cause or worsen the symptoms of a disease. Elimination of milk and processed milk products from the diet is sometimes recommended. A CD patient's diet should be similar or identical to the general population. Diet modification can be tailored to the individual needs based on the disease symptoms. An interesting observation is that an increasing number of CD patients come from developed countries, which is related to the impact of environmental factors including diet. Dietary recommendations include frequent and small quantity meals 5-6 times per day, high calorie and diversified diet, fluid intake of 2-2.5 L/day, vitamin and microelement supplementation and elimination of alcohol and carbonated beverages.

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