IBD & Food: What to Eat to Manage Your Disease

Diet is important for everyone. Eating the right foods in the right quantities supplies your body with the nutrition it needs to stay healthy.

When you have inflammatory bowel disease, getting proper nutrition can be tricky. Your small intestine absorbs the nutrients from the food you eat. When you have chronic inflammation and other IBD symptoms, you may not absorb all the nutrients or digest things as well. That can lead to serious problems like malnutrition, weight loss and nutrient deficiencies. 

To prevent these complications and make eating enjoyable, you need to pay close attention to what you put into your body and how your digestive system reacts.

What’s in an IBD diet plan?

Crafting a diet specific to your condition, whether it’s Crohn’s disease, ulcerative colitis or inflammatory bowel disease that doesn’t fit into either category, is complicated. There is no one Crohn’s disease or ulcerative colitis diet. The foods that trigger your Crohn’s or colitis symptoms can be different than what causes problems for someone else. But there are several key ingredients to creating your own inflammatory bowel disease diet:

1. Smaller meals – Eat less, more often. Smaller meals — say six meals a day instead of a traditional breakfast, lunch and dinner — help reduce the load on your digestive tract.
2. Fluids and electrolytes – Frequent bouts of diarrhea deplete your body of water and nutrients. Drink half your body weight in ounces of water and replenish sodium, potassium and electrolytes with sports drinks.
3. Vitamins and minerals – People with Crohn’s disease are at greater risk for nutrient deficiencies. Those with ulcerative colitis are more likely to be anemic. You may need to take daily multivitamins or supplements to complement a well-balanced, nutrient-rich diet.
4. Protein – While many think of vitamins and minerals, protein is also a nutrient. Eat your weight in kilograms of protein and increase your intake to restore losses after flares.
5. Higher calories – When your body has trouble processing foods, you may have to up your intake to make up for it. Eating more calories is especially important in recovering from flares and restoring lost weight.
6. Trigger food avoidance – Some things are going to make your symptoms worse. Always monitor your symptoms after eating so you can avoid those foods in the future.

What foods reduce inflammation and other symptoms of IBD?

The goals of treatment for inflammatory bowel syndrome are to improve inflammation and, ideally, get rid of it altogether. Once the inflammation is under control, the other digestive issues go away too.

You may have heard about anti-inflammatory diets or anti-inflammatory foods. A good IBD diet is a type of anti-inflammatory diet, incorporating most of the standard recommendations for a healthy diet. While you still need to create your own list of foods to eat and foods to avoid based on the triggers you and your doctors have identified, there are some general guidelines you can follow.

Foods to Include in Your IBD Diet

Your triggers will inevitably reduce your food choices. But you should still aim to eat a diverse, nutrient-dense diet to help keep your inflammatory bowel disease under control. Your diet should include a healthy mix of:

1. Fiber – Fiber can be a problematic nutrient. It’s an essential part of a healthy diet, but one that commonly brings on symptoms during a flare. Focus on sources of soluble fiber (which help reduce diarrhea) like beans, fleshy fruits, oats and barley and eat other whole grains and high-fiber foods as you can tolerate.
2. Lean proteins – Too much fat can lead to poor protein absorption and make your symptoms worse. Stick to low-fat sources of protein like chicken, turkey, fish, eggs and tofu.
3. Fruits and veggies – Eating a colorful array of plants provides a diverse mix of vitamins and minerals. If the fibrous peels and seeds cause digestive troubles, remove those before eating.
4. Calcium-rich foods – IBD, and especially Crohn’s disease, can lead to lactose intolerance. So you may need to get your calcium from non-dairy sources canned fish or dark green vegetables. For your dairy fix, you can choose lactose-free or non-dairy alternatives to milk, yogurt and cheese.
5. Probiotics – Inflammatory bowel disease can flush the “good” bacteria out of your gut. Yogurt, kimchi, miso, sauerkraut, tempeh and other sources of live bacteria can help bring your gut bacteria back into balance.

Foods to Avoid with IBD

There is no reason to avoid any food unless it triggers or worsens your symptoms. You want to get as many nutrients from as many different sources as you can. But if you haven’t yet identified the foods that trigger your flares of Crohn’s, ulcerative colitis or IBD, these are common culprits:

• Fatty, greasy or fried foods
• Hot or spicy foods
• Raw, high-fiber fruits and vegetables
• Nuts, seeds and beans
• Caffeinated or sugary beverages
• Alcoholic beverages
• Candy, sweets and other sources of added sugar

Alcohol, caffeine and spicy foods can irritate anyone’s colon. So the problems can be worse if you have inflammatory bowel disease. Fat, sugar and fiber are all harder to digest. So you may need to stick to foods that are low in these categories or eat sources with higher contents in moderation.

What to Eat During a Crohn’s or Colitis Flare

Some foods trigger cramping, bloating or diarrhea — all things you want to avoid if your inflammatory bowel disease is flaring up. When your symptoms come back, it’s best to stick to the basics. Stay away from anything on the “Foods to Avoid” list that may make things worse. Instead, eat these foods plain and use boiling, grilling and steaming as your primary cooking methods:

• Vegetables: Carrots, spinach, asparagus, potatoes
• Fruits: Applesauce, canned pears or peaches, bananas, melons, avocados
• Refined grains: White rice, bread and pasta
• Proteins: Peanut butter, salmon, cooked eggs, plain chicken or turkey

Once your IBD flare-up is under control, you can slowly incorporate foods back into your normal diet, one or two at a time every few days. Start with things you know you can tolerate — liquids first, then soft solids. And slowly increase your calories, protein and fiber to return to a healthy diet that may have suffered from poor appetite or weight loss.

Whether you’re in remission or in the midst of a flare, your diet is one of the keys to managing inflammatory bowel disease. But like any diet, sticking with it isn’t always easy. When you work with an experienced team of IBD experts and dietitians, you can develop a diet plan to get adequate nutrition while avoiding your triggers — and still eat many of the foods you love.