The Relationship Between Food & IBD
Diet and nutrition concerns of patients with inflammatory bowel diseases (IBD) are
extremely common, and appropriate. Patients often believe that their disease is
caused by, and can be cured by diet. Unfortunately, that seems to be too simplistic
an approach, which is not supported by clinical and scientific data.
Diet can certainly affect symptoms of IBD, and may play some role in the underlying
inflammatory process, but there is no evidence that anything in your diet history
caused or contributed to IBD. Once you develop IBD, however, paying special
attention to what you eat may go a long way toward reducing symptoms and
promoting healing. Just remember, while a healthy diet can help you maintain good
nutritional status and manage symptoms, medications are recommended to effectively
Importance of good nutrition
IBD patients, especially people with Crohn's disease whose small intestine is affected,
are prone to becoming malnourished for several reasons:
- Loss of appetite a result of nausea, abdominal pain, fear of eating or altered taste sensation may cause inadequate food intake.
- Chronic disease tends to increase the caloric or energy needs of
the body; this is especially true during disease flares.
- IBD particularly Crohn's disease is often associated with poor
digestion and malabsorption of dietary protein, fat, carbohydrates, water, and a
wide variety of vitamins and minerals. Thus, much of what a person eats may never
truly get into the body.
Good nutrition is one of the ways the body restores itself to health. Therefore,
every effort must be made to avoid becoming malnourished. Restoring and maintaining
good nutrition is a key principle in the management of IBD for several reasons,
including the following:
- Medications tend to work more effectively in people with good nutritional status.
- When proteins and other nutrients are lost in IBD, more food must be taken in to
compensate for these losses; that may be difficult for many patients when intestinal
symptoms are active.
- Lost proteins, calories, and other nutrients may cause growth issues in children and teenagers.
- Weight loss in women and girls can have an impact on hormonal levels, resulting in menstrual changes or missed periods.
Foods to choose & foods to avoid
In general, most people with IBD should eat a well-balanced diet with a lot of variety.
However, it is recommended that you work with your doctor or dietitian to create
a customized diet based on:
- Which disease you have (Crohn's or ulcerative colitis)
- For Crohn's patients: Whether you have an intestinal stricture (narrowed areas of the bowel) or have ever had a blockage before
- What part of your intestine is affected
- If your disease is active (having symptoms) or inactive (remission not having symptoms)
If your disease is inactive
If you're not experiencing symptoms of IBD, focus on maintaining good nutritional status. The following chart can help:
Elements of a well-balanced, nutritious diet
- 8-10 glasses of water a day to prevent dehydration
- Carbohydrates with more soluble fiber (oat bran, legumes and barley)
- Proteins like lean meats, fish, eggs, nuts, poultry and soy
- Healthy fats like omega-3 fatty acids, olive oil and canola oil
- Deeply colored (skinless and seedless) fruits and cooked vegetables
- Vitamin and mineral supplements, if your doctor approves
- Dairy/calcium (dairy substitute if you're lactose intolerant)
If you have active disease
The following chart can help you make the right choices to help ease, or help prevent, discomfort during active disease:
How to eat when your disease is active
- Your trigger foods (foods that have caused you problems before)
- Certain high-fiber foods
- Nuts, seeds and popcorn
- High-fat foods
- Spicy foods
- Raw fruits and vegetables (especially ones with skins)
- Dairy products as tolerated
- Large food portions
- Fruit juices
- Applesauce and bananas
- Bland, soft foods
- Plain cereals, white rice and refined pastas
- Fully cooked vegetables and potatoes without skin
- Small, more frequent meals
- Nutritional supplements if loss of appetite
- Vitamins and mineral supplements, if your doctor approves
- Protein as tolerated, such as lean meats, fish and soy
Talk to your doctor or dietitian to learn more about the link between food and IBD, and to design a meal plan that meets your nutritional needs and helps you manage IBD.