What Can You Eat When You Have Inflammatory Bowel Disease?

Ask a Doctor

I have inflammatory bowel disease, and I’m looking for info on diet. Is there a list of what not to eat with inflammatory bowel disease? What can you eat when you have IBD? What foods reduce intestinal inflammation?

Doctor's Response

Diet changes may be necessary for both Crohn’s and Ulcerative Colitis, which are inflammatory bowel disease types. It is important to eat a healthy diet. Avoid alcohol, caffeine, and junk food.

  • Depending on the person's symptoms, a health care professional may ask them to decrease the amount of fiber or dairy products in their diet.
  • Diet has little or no influence on the inflammatory activity in ulcerative colitis. However, diet may influence symptoms. For this reason, people with inflammatory bowel disease often are placed on a variety of diet interventions, especially low-residue diets. Evidence does not support a low-residue diet as beneficial in treating the inflammation of ulcerative colitis, though it might decrease the frequency of bowel movements.
  • Unlike ulcerative colitis, diet can influence inflammatory activity in Crohn's disease. Nothing by mouth (NPO status) can hasten the reduction of inflammation, as might the use of a liquid diet or a predigested formula.
  • When a person becomes extremely stressed, IBD symptoms may get worse. Therefore, it is important that patients learn to manage the stress in their lives.

Crohn’s Disease Diet

There is no specific diet that is recommended for everyone with Crohn's disease. However, many people with Crohn's disease can reduce their symptoms by changing their eating habits or avoiding certain foods.

Foods that often cause problems are milk and other dairy products, spicy foods, fatty or fried foods, and high-fiber foods. Foods such as raw or dried fruits and vegetables, nuts, seeds, and popcorn may also worsen your symptoms. People often learn which foods they can or cannot tolerate through trial and error. If you have strictures of the small intestine, you may need to be on a low residue diet.

There are many tasty foods that provide good nutrition and may not irritate your digestive tract. If you can tolerate dairy products, ice cream or milk shakes made with ice cream or yogurt are a good choice. Pizza or a cheeseburger may be a good choice. These foods are high in calories, satisfying, and taste good. However, a steady diet of high-fat, salty foods such as cheeseburgers can cause other problems such as heart disease or high blood pressure. You certainly don't need those problems on top of Crohn's disease. High-fat "junk" foods should not be daily fare. Consider them a treat once in a while if they do not exacerbate symptoms.

Ulcerative Colitis Diet

Foods do not cause ulcerative colitis, but certain food groups can cause symptoms to flare. Often it is a process of trial and error to find what foods need to be avoided.

  • Dairy foods: Some patients with ulcerative colitis may also have lactose intolerance that can make the diarrhea worse.
  • High fiber is often recommended to aid with bowel regularity, but may make the diarrhea worse in ulcerative colitis. Whole grains, vegetables, and fruit may worsen pain, gas, and diarrhea. Finding foods that are the culprit may require a trial and error approach.
  • Trial and error may also find other "gassy" foods like caffeine and carbonated beverages.
  • Small, frequent meals may be helpful in controlling symptoms. Grazing during the day may be better than 2 or 3 large meals.
  • The body can lose a significant amount of water with diarrhea, and drinking plenty of fluids to replace that loss is very important.
  • A less than rounded diet may require vitamin and mineral supplements, and visiting with a dietician is often an important step in maintaining good nutrition while controlling the symptoms.

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References
Ghazi, L. J. "Crohn Disease Treatment and Management." Medscape. Updated: Jan 26, 2017.
<http://emedicine.medscape.com/article/172940-treatment>

Crohn's & Colitis Foundation of America. "IBS and IBD: Two Very Different Disorders." Published June 1, 2012.
<http://www.ccfa.org/resources/ibs-and-ibd-two-very.html>

Crohn's & Colitis Foundation of America. "What are Crohn's & Colitis?
<http://www.ccfa.org/what-are-crohns-and-colitis/>

Farrell, R.J., MD., et al. "Overview of the medical management of mild to moderate Crohn disease in adults." UpToDate. Updated: Jul 28, 2016.
<http://www.uptodate.com/contents/overview-of-the-medical-management-of-mild-to-moderate-crohn-disease-in-adults>

Rowe, W.A., MD. "Inflammatory Bowel Disease." Medscape. Updated: Jun 17, 2016.
<http://emedicine.medscape.com/article/179037-overview>

Peppercorn, M.A., MD., et al. "Definition, epidemiology, and risk factors in inflammatory bowel disease." UpToDate. Updated: Nov 08, 2016.
<http://www.uptodate.com/contents/definition-epidemiology-and-risk-factors-in-inflammatory-bowel-disease>