IBD diet and nutrition are important aspects of IBD management. “Diet” refers to the foods we eat. “Nutrition” is a term that refers to properly absorbing food and staying healthy. A well-balanced diet with adequate intake of protein, carbohydrates and fat, as well as vitamins and minerals, is necessary for nutrition. This can be achieved by eating a variety of foods from all the food groups (see table). Meat, fish, poultry and dairy products are sources of protein. Bread, cereal, starches, fruits and vegetables are sources of carbohydrates. Butter, margarine and oils are sources of fat.
Is there an IBD Diet?
There is no evidence to suggest that any particular food or diet causes, prevents or cures IBD. There is no one special IBD diet.
Developing an Individual Diet
Many people with IBD can consume a normal diet during times of disease remission but may need to alter their diet during flares. Other people with IBD, such as patients with intestinal strictures, will need to stay on a modified diet until the stricture is successfully treated medically or surgically.
The individual diet should be based on:
*Symptoms (diarrhea, constipation, abdominal pain, etc.)
*Whether the person is in remission or experiencing a flare
*Location of disease
*Presence of narrowing of the small intestine (strictures)
*Any prior surgeries
*Whether there are any specific nutritional deficiencies (such as iron deficiency)
Impact of Certain Foods
During flares, certain foods or beverages may irritate the digestive tract and aggravate symptoms. Not all people with IBD are affected by the same foods, and it may be necessary to experiment to discover which foods affect symptoms the most.
Keeping a food journal may help you to track how your diet relates to your symptoms and identify trigger foods. The journal can help you identify foods you are unable to tolerate during a flare. It can also reveal whether your diet is providing an adequate supply of nutrients. Tracking foods along with symptoms will be helpful when speaking to your physician or registered dietitian. When eliminating foods, it is important to substitute other foods, that provide the same nutrients. For example, when eliminating dairy products, be sure to obtain calcium and vitamin D from other sources.
However, there are some basic principles and guidelines to help you decide how and what to eat, especially during flares. People with IBD should maintain a diverse and nutrient-rich diet. When experiencing symptoms, it may help to:
*Eat smaller meals
*Have more frequent meals
*Eat in a relaxed atmosphere
*Avoid trigger foods
*Limit food with insoluble fiber (i.e., seeds, nuts, beans, green leafy vegetables, fruit and wheat bran)
*Reduce the amount of greasy or fried foods It is important to remember that all IBD patients have different food intolerances. One may be sensitive to spicy food while another might be sensitive to popcorn.
Ask your doctor about products that help to manage or reduce symptoms, including anti-diarrheal medications, antispasmodics or lactase supplements.
Inflammatory bowel diseases (IBD) diet
|Food Group||Recommended Foods||Foods to Avoid|
|Vegetables||Vegetables that are easier to digest (e.g., asparagus, potatoes)|
Cooked, pureed or peeled vegetables
Vegetable stock added to rice or pasta for additional nutrients
|Vegetables that are gas-producing (e.g., broccoli, Brussels sprouts)
Vegetables that have a tough skin
|Fruits||Fruits that are easier to digest and have less insoluble fiber (e.g., applesauce, melons)|
Cooked, pureed, canned or peeled fruits
|Fruits with a high fiber content (e.g., oranges, dried fruit)|
|Grains||Grains that are more refined with less insoluble fiber|
Oatmeal, potato, sourdough and French breads
|Grains with seeds and nuts|
|Protein||Lean sources of protein (e.g., fish, chicken, eggs and tofu)|
Smooth nut butters (peanut, almond, cashew)
|Whole seeds and nuts
Fatty, fried or highly processed meats
Low-sugar sports drinks
Fruit juices diluted with water
|Ice-cold liquids (can cause cramps in some cases)
Caffeine in coffee, tea and other beverages (caffeine can act as a stimulant to “rev” up the bowel and result in diarrhea)
Alcoholic and caffeinated drinks dehydrate the body. Alcohol abstinence may not be required, but moderation is advised. Be sure to ask your health care provider about alcohol use.