What Should I Eat?
It’s not always easy knowing what foods best fuel your body, especially when you have Crohn’s disease or ulcerative colitis. Your diet and nutrition are a major part of life with inflammatory bowel disease (IBD), yet there is no single diet that works for everyone.
Nutrition affects not just your IBD symptoms, but also your overall health and well-being. Without proper nutrients, the symptoms of your Crohn’s disease or ulcerative colitis can cause serious complications, including nutrient deficiencies, weight loss, and malnutrition.
We have several tips for a healthy diet that’s well-balanced and nutrient rich. These tips are for educational purposes only. You should work with your doctor or a dietitian specializing in IBD to help you develop a personalized meal plan.
Watch our Facebook Live conversation with Emily Haller, registered dietitian at Michigan Medicine! Tune in to hear Emily review diet facts, debunk myths, speak about restrictions, and highlight ongoing research.
Food Preparation and Meal Planning
While there is no one-size-fits-all for meal planning, these tips can help guide you toward better daily nutrition:
Eat four to six small meals daily.
Stay hydrated — drink enough to keep your urine light yellow to clear — with water, broth, tomato juice, or a rehydration solution.
Drink slowly and avoid using a straw, which can cause you to ingest air, which may cause gas.
Prepare meals in advance, and keep your kitchen stocked with foods that you tolerate well (see list below).
Use simple cooking techniques — boil, grill, steam, poach.
Use a food journal to keep track of what you eat and any symptoms you may experience.
Eating When You are in a Flare
There are certain foods you may want to avoid when you are in an IBD flare, and others that may help you get the right amount of nutrients, vitamins, and minerals without making your symptoms worse.
Your healthcare team may put you on an elimination diet, in which you avoid certain foods in order to identify which trigger symptoms. This process will help you identify common foods to avoid during a flare. Elimination diets should only be done under the supervision of your healthcare team and a dietitian so they can make sure you are still receiving the necessary nutrients.
Some foods may trigger cramping, bloating, and/or diarrhea. Many trigger foods should also be avoided if you have been diagnosed with a stricture, a narrowing of the intestine caused by inflammation or scar tissue, or have had a recent surgery. Certain foods can be easier to digest and can provide you with the necessary nutrients your body needs.
Potential Trigger Foods
Foods IBD Patients May Tolerate
Insoluble fiber foods that are hard to digest: fruits with skin and seeds, raw green vegetables (especially cruciferous vegetables such as broccoli, cauliflower, or anything with a peel), whole nuts, and whole grains
Low-fiber fruits: bananas, cantaloupe, honeydew melon, and cooked fruits. This is typically recommended in patients who have strictures or have had a recent surgery
Lactose: sugar found in dairy, such as milk, cream cheese, and soft cheeses
Lean protein: fish, lean cuts of pork, white meat poultry, soy, eggs, and firm tofu
Non-absorbable sugars: sorbitol, mannitol, and other sugar alcohols found in sugar-free gum, candy, ice cream, and certain types of fruits and juices such as pear, peach, and prune
Refined grains: sourdough, potato or gluten-free bread, white pasta, white rice, and oatmeal
Sugary foods: pastries, candy, and juices
Fully cooked, seedless, skinless, non-cruciferous vegetables: asparagus tips, cucumbers, potatoes, and squash
High fat foods: butter, coconut, margarine, and cream, as well as fatty, fried, or greasy food
Oral nutritional supplements or homemade protein shakes: ask your doctor or your dietitian about what supplements may fit your nutritional needs
Alcohol and caffeinated drinks: beer, wine, liquor, soda, and coffee
Spicy foods: “hot” spices
Video Length 00:02:05
What to Eat When in a Flare When you have inflammatory bowel diseases (IBD), and are in the middle of a flare, it is very important to avoid foods that may trigger additional symptoms and choose foods that are healing and nutritious. Watch and listen to learn more on dietary recommendations when in a flare.
Eating When You are in Remission
It’s important to maintain a diverse and nutrient-rich diet even when you are in remission and your symptoms have subsided, or even disappeared. Introduce new foods slowly. Remember to stay hydrated with water, broth, tomato juice, and rehydration solutions. Consult with your doctor or dietitian before making any changes to your diet.
These foods can help you stay healthy and hydrated:
Fiber-rich foods: oat bran, beans, barley, nuts, and whole grains, unless you have an ostomy, intestinal narrowing, or if your doctor advises you to continue a low-fiber diet due to strictures, or recent surgery
Protein: lean meats, fish, eggs, nuts, and tofu
Fruits and vegetables: try to eat as many “colors” as you can, and remove the peel and seeds if they bother you
Calcium-rich foods: collard greens, yogurt, kefir, and milk (if you are lactose intolerant, choose lactose-free dairy products or use a lactase digestive enzyme)
Food with probiotics: yogurt, kimchi, miso, sauerkraut, and tempeh
Video Length 00:02:10
Eating When in Remission When you are in remission with inflammatory bowel diseases (IBD), it is very important to focus on maintaining a diverse and nutrient rich diet. Watch and listen to learn more on dietary recommendations when in remission.
Diet for Crohn’s Disease
If you have Crohn’s disease, you know exactly how difficult choosing your next meal can be. But it is possible to develop a healthy diet plan that provides the nutrients and calories you need, while also excluding trigger foods that inflame your symptoms.
Crohn’s disease, which is a type of irritable bowel disease that causes chronic inflammation in the gastrointestinal (GI) tract, can make it difficult for your body to digest and absorb necessary nutrients from food. As a result, the food you eat can have great impact on how you’ll feel afterwards. Unpleasant symptoms that can result from Crohn’s include diarrhea, gas, bloating, abdominal pain, cramps, and even malnourishment. In some cases, it can also lead to anemia and reduce your levels of vitamin B12, folic acid, and iron.
Fortunately, there are ways you can avoid aggravating your symptoms and even promote healing in your GI tract.
One tip is to have three small meals a day and have a snack between each meal to avoid overeating, which has been found to make digestion even more difficult.
While some foods undeniably exacerbate Crohn’s, there are other foods that can be beneficial for Crohn’s sufferers. In fact, some actually include important nutrients that promote healthy digestion and should definitely be included in your diet. Here’s what you should add to your grocery list:
- Almond Milk
- Vegetable-Based Soups
- Tropical Fruits, including bananas, papaya, mango, and cantaloupe
- Pureed Beans
- Butter Lettuce
- Roasted Red Peppers (with the skin removed)
- White Rice
- Smooth Peanut Butter/Almond Butter
It’s important to point out that not everyone can tolerate the same foods; what might be safe for one may trigger symptoms in another. You might want to try different foods and keep a food journal to observe your body’s reaction to each. With that said, here’s a list of some common trigger foods to avoid:
- Dairy products, including butter, yogurt (for those who are lactose intolerant)
- Carbonated drinks
- Corn husks
- Foods high in fiber and fat
- Beans, nuts, seeds
- Raw fruits and vegetables
- Red meat and pork
- Spicy foods
- Whole grains and bran (only okay to eat if you’re not experiencing severe symptoms)
Crohn’s disease is a condition defined by chronic inflammation and irritation of the digestive tract, and, according to the Crohn’s and Colitis Foundation of America, an estimated 780,000 Americans suffer from Crohn’s disease. The cause isn’t fully understood, but the condition is known to run in families. In addition, one’s immune system and environment appear to play a role in the development of Crohn’s.
What Happens with Crohn’s Disease?
The exact process that causes the inflammation and irritation is unknown, but there has been some insight into the disease. Crohn’s disease often affects the lower part of the small intestine, but can manifest anywhere from the mouth to the anus. The immune system also plays a role in this condition.
Immune cells accumulate in the intestines, attacking bacteria, food, healthy body tissue and other harmless or even beneficial substances, causing symptoms such as abdominal pain, diarrhea, rectal bleeding, weight loss, fever and fatigue. These accumulating immune cells produce chemicals that promote inflammation, damage intestinal walls and cause the symptoms of Crohn’s.
How Is Diet Involved?
Foods do not cause Crohn’s disease and no special diet has been proven effective. However, certain foods may cause flare-ups in Crohn’s disease symptoms. Some common symptom-provoking foods are dairy, high-fiber grains, alcohol and hot spices.
Research has been unsuccessful at determining what specific foods are the culprit for everyone with this condition. Bottom line: there’s no one diet to alleviate Crohn’s disease. Yet, important steps in treatment for Crohn’s include keeping a detailed food diary, avoiding foods that cause symptoms and consulting with a registered dietitian nutritionist experienced in digestive health.
Nutrient deficiency is another common concern since inflammation from this condition interferes with nutrient absorption. As a result, people with Crohn’s disease need a nutrient-rich diet with adequate calories, protein and healthy fats.
Steroid medications often prescribed for Crohn’s disease may increase osteoporosis risk, so sufficient calcium, vitamin D, magnesium and vitamin K are needed for bone health. Long-term steroid use also may result in vitamin C, vitamin B12, folic acid, zinc and selenium deficiencies.
Healthy Eating Tips
If you have Crohn’s disease, consult with a registered dietitian nutritionist who can work with you to develop a personalized eating plan.
Some tips and guidelines may include:
- Eat small meals or snack every 3 to 4 hours. Stay hydrated. Drink small amounts of water throughout the day.
- During periods when you don’t have symptoms, include whole grains and a variety of fruits and vegetables in your eating plan. Start new foods one at a time, in small amounts.
- When you have symptoms, such as diarrhea or abdominal pain, follow the recommended food list provided by your registered dietitian nutritionist. Foods to avoid may include high-fiber foods, raw and gas-producing vegetables, most raw fruits and beverages with caffeine.
Your physician and registered dietitian nutritionist may recommend foods with added probiotics and prebiotics, as well as dietary supplements such as iron, calcium, vitamin D, folate, zinc and vitamin B12 to prevent or treat deficiencies.