Diet for Inflammatory Bowel Disease
What You Should Know:
- Inflammatory Bowel Disease (IBD) is a term for two specific and separate diseases: Crohn’s Disease and Ulcerative Colitis. Crohn's disease is a disease of unknown cause that can involve any portion of the digestive tract. Ulcerative colitis is an inflammatory disease of the colon or large intestine, which is often accompanied by bloody diarrhea.
- Sometimes surgery and/or medications are needed to treat these diseases.
- Inflammation in the colon can cause the colon to empty frequently, causing diarrhea.
- Stress or certain foods can exacerbate symptoms.
- There is no need to avoid foods unless they worsen your symptoms. It is best to restrict as few foods as possible to increase the chances that you are getting a balanced, nutritious diet.
- Many people with IBD are at increased risk for nutrient deficiencies and may require a vitamin/mineral supplement.
What You Should Do on a Regular Basis:
- Eat small, frequent meals.
- Consume a high calorie, high protein diet.
- Drink plenty of fluids, especially water.
- Eat a high fiber diet, including:
- 4 servings/day of whole grain breads and cereals (1 serving = ½ cup or 1 slice)
- 5 servings/day of fruits and vegetables (1 serving = ½ cup)
- Limit caffeine, alcohol, sorbitol, nicotine, and carbonated beverages.
- Limit lactose-containing foods (milk, cheese, etc) if you have gas, cramping or diarrhea after eating these foods. Lactaid capsules or products may help.
- Limit gas-producing foods, such as cabbage, broccoli, cauliflower, brussel sprouts, dried peas and lentils, onions, chives, and peppers.
- Reduce stress by practicing regular relaxation techniques.
- Exercise regularly.
- Aim for 20-30 grams of fiber/day.
- Eat a low fat diet. This will help decrease intestinal contractions right after meals.
- Keeping a record of foods eaten and then taking note of when symptoms worsen may help you identify patterns that indicate problem foods.
During an Exacerbation:
Follow a low fiber, low residue diet to relieve abdominal pain and diarrhea. This diet provides less than 10 grams of fiber/day and allows for the bowel to rest. It is only intended for short term use.
Foods to choose:
- White breads (such as French or sourdough)
- Toasted plain bagels or English muffins
- Corn or flour tortillas
- Cream of rice, grits
- Pretzels (salted or unsalted)
- Fat-free saltines, graham crackers
- Plain angel food cake
- Plain baked potatoes without skin
- Plain white rice
- Cold fat-free cereal (example: Corn Chex, Kix, Rice Chex, Rice Krispies, Honeycomb, or Corn Pops) eaten dry
- Plain cooked pasta (not egg noodles)
- Strong, hot tea
- Fruit Juice without pulp
- Tender, well cooked meats, poultry, fish, eggs
- Cooked asparagus, beets, carrots, spinach, green beans, zucchini
Foods to avoid:
- Fresh fruits and vegetables
- Caffeinated beverages.
- Bran, granola, or whole-wheat choices
- Cereals with raisins or other dried fruits or nuts
- Concentrated sweets such as juices, candy and soda
- Brown rice, barley
- Legumes and beans
- Nuts, seeds, kernels
- Dried fruit
- Corn, broccoli, cauliflower, cabbage
- If you are lactose intolerant, avoid milk products
Following an Exacerbation:
- Continue to follow a low residue diet and slowly add back a variety of foods.
- Begin with well-tolerated liquids and advance to soft solids, then solids
- Introduce one or two items every few days and avoid any foods that cause symptoms.
- Add fiber to diet as tolerated. Well-tolerated fiber sources include tender cooked vegetables, canned or cooked fruits, and starches like cooked cereals and whole wheat noodles and tortillas.
- Between flares, eat a wide variety of foods as tolerated. This includes fruits, vegetables, whole grains, lean protein, and low-fat and nonfat dairy products.