Inflammatory bowel disease (IBD) is a group of conditions that cause ongoing inflammation in the digestive tract. The two main types are Crohn’s disease and ulcerative colitis.
Food does not cause or cure IBD, but it can affect digestive symptoms and your ability to get the nutrients you need. Some foods may be harder to tolerate during a flare, while avoiding too many foods can leave you short of important nutrients. The foods you tolerate may also change depending on whether you are experiencing a flare or are in remission.
This article explains which foods may worsen IBD symptoms, what to eat during a flare and how to identify your personal food triggers while maintaining good nutrition.
Is There an IBD Diet?
There is no blanket IBD diet that works for everyone with inflammatory bowel disease.
During an IBD flare, high-fiber foods may worsen symptoms such as diarrhea, cramping and abdominal pain. Your healthcare provider may recommend temporarily limiting fiber until symptoms improve.
During remission, a Mediterranean-style diet that includes fruits, vegetables, whole grains, legumes, healthy fats and lean proteins can help you maintain a balanced diet. Rather than focusing only on foods to avoid, this approach helps you prioritize nutritious foods that support your overall health.
Work with your healthcare team to find an eating pattern that meets your nutritional needs and helps you manage symptoms.
Foods That May Worsen IBD Symptoms
Foods that may worsen symptoms in some people include:
- High-fiber foods, such as whole grains, beans, nuts, seeds and some fruits and vegetables. These may be harder to tolerate for people with intestinal strictures (narrowing) or symptoms of an obstruction.
- Raw fruits and vegetables, particularly those with tough skins or seeds, if they cause discomfort.
- Fatty or fried foods, which may worsen diarrhea or abdominal discomfort.
- Spicy foods, which may aggravate digestive symptoms.
- Dairy products, particularly if you have lactose intolerance.
- Caffeine, including coffee, tea and energy drinks.
- Alcohol, which may worsen symptoms in some people.
- Sugar alcohols, found in some sugar-free gum, candy and beverages, which may contribute to gas, bloating or diarrhea.
Having symptoms after eating certain foods does not necessarily mean your intestinal inflammation is getting worse. Likewise, feeling better after changing your diet does not necessarily mean the inflammation is under control.
For this reason, you do not need to eliminate foods simply because you have IBD. Pay attention to how you tolerate them and talk with your healthcare team before making significant dietary changes. If you have a stricture or symptoms of a possible intestinal obstruction, ask your healthcare provider which foods and textures are safe for you.
What to Eat During an IBD Flare
During an IBD flare, some people find lower-fiber, easier-to-digest foods more comfortable to eat, particularly if they have a narrowing of the intestine (stricture) or symptoms of an obstruction. However, a low-fiber diet is not necessary for everyone during a flare.
Options to eat may include:
● Refined grains, such as white rice, white bread and plain pasta
● Cooked and peeled vegetables, such as carrots and squash
● Soft fruits, such as bananas, melon and applesauce
● Eggs
● Lean proteins, such as chicken, turkey and fish
● Lower-fat foods, particularly if fatty foods worsen diarrhea
● Fluids and electrolytes
You may also find it easier to eat smaller meals more often rather than larger meals.
Staying hydrated is especially important if you have frequent diarrhea or vomiting. These symptoms can cause your body to lose fluids and electrolytes. Drink fluids regularly and follow your healthcare team’s recommendations for replacing electrolytes.
Can Dietary Therapy Help Treat Crohn’s Disease?
Dietary changes can help people with IBD manage symptoms, but certain nutritional therapies may also help treat the disease itself. Some of these approaches are specifically used for Crohn’s disease.
- Exclusive enteral nutrition (EEN): This approach uses a nutritionally complete liquid formula as the sole source of nutrition for a set period. It can help induce remission, particularly in children with Crohn’s disease.
- Crohn’s disease exclusion diet (CDED): This structured diet limits certain foods that may affect the gut while emphasizing others. It is often combined with partial enteral nutrition, in which a liquid formula provides some of a person’s daily nutritional needs.
These therapies are not suitable for everyone and should be planned with an IBD specialist and registered dietitian. They do not replace the need for individualized medical care, and dietary changes should be discussed with your healthcare team.
How to Identify Your Food Triggers
Because food triggers vary from person to person, keeping track of what you eat and how you feel can help you identify patterns.
Consider keeping a food and symptom diary. Record what you eat and any symptoms you experience afterward. Over time, you may notice that certain foods or beverages consistently make your symptoms worse.
Keep these tips in mind:
- Avoid eliminating entire food groups unless recommended by your healthcare team. Unnecessary restrictions can make it harder to get the nutrients your body needs.
- Make changes gradually so you can better identify which foods affect your symptoms.
- Work with a registered dietitian if you need help creating a balanced eating plan or are having difficulty meeting your nutritional needs.
IBD can also increase your risk of certain nutritional deficiencies. Your healthcare team may recommend blood tests to check for low iron, vitamin D or vitamin B12 levels, particularly if you have active inflammation, unexplained weight loss, a restricted diet or Crohn’s disease affecting the end of your small intestine (ileum) or have had part of it removed. Regular nutritional assessments can help identify deficiencies and guide treatment.
Can Diet Prevent IBD Flares?
Diet can help manage digestive symptoms and support good nutrition, but it cannot replace medical treatment for IBD. Following your prescribed treatment plan is important for controlling inflammation and managing the disease.
Your healthcare team can also help you determine whether dietary changes may improve your symptoms while ensuring you get enough calories, protein, vitamins and minerals.
If you have IBD, there is no need to follow a one-size-fits-all diet. Learning which foods you tolerate, making appropriate adjustments during flares and maintaining good nutrition can help support your overall health.
Stony Brook Medicine’s Division of Gastroenterology and Hepatology provides expert, compassionate care for adults with diseases and conditions affecting the digestive tract and liver. Our experienced gastroenterologists and hepatologists offer comprehensive evaluation, diagnosis and treatment for a wide range of conditions, including acid reflux (GERD), inflammatory bowel disease, Crohn’s disease, ulcerative colitis and liver diseases. We offer specialized care in general gastroenterology, inflammatory bowel diseases and hepatology, using the latest advances in technology, research and evidence-based care to develop personalized treatment plans for each patient. Learn more or call to make an appointment at (631) 444-5220.
