Dante Carrillo
Diet plays a crucial role in managing Crohn's disease, an inflammatory bowel disease (IBD) that affects the digestive tract and can cause malnutrition. While there is no cure-all diet, eating and avoiding certain foods can help prevent flare-ups and manage symptoms. During a flare-up, high-fibre foods, fatty meats, dairy, spicy or greasy foods, caffeine, and alcohol can aggravate symptoms, while soft, bland, and low-fibre foods are recommended. When not flaring, a Mediterranean diet with whole grains, fruits, vegetables, lean meats, fish, and eggs is suggested, along with high-fibre, starchy foods to reduce inflammation. Overall, a Crohn's diet should be customised to meet individual needs, working with a doctor and IBD-focused registered dietitian to develop a balanced and nutrient-rich plan.
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What You'll Learn
High-fibre foods to eat during remission
While there is no scientifically proven diet for Crohn's disease, dietary choices play a role in the development of inflammatory bowel disease (IBD), the disease course, induction or maintenance of remission, and reducing symptoms. During a flare-up, it is recommended to avoid foods high in fiber. However, when in remission, it is beneficial to include high-fibre foods in your diet, as they can help reduce the risk of IBD and increase the time spent in remission.
- Focus on maintaining a diverse and nutrient-rich diet, including plenty of plant-based foods such as fruits, vegetables, nuts, seeds, herbs, and whole grains.
- Include high-fibre, starchy foods like potatoes, rice, oatmeal, and bread. These foods are good sources of soluble fiber, which can help reduce inflammation and are easier to digest.
- Opt for cooked, peeled, or blended fruits and vegetables, such as bananas, raspberries, squash, and leafy greens. These can be added to a smoothie to make them more palatable and digestible while still providing their nutritional benefits.
- If you experience issues with lactose intolerance, which is common in people with IBD, opt for low-fat dairy products and consider using enzyme products such as lactase or lactose-free alternatives.
- While some trigger foods, such as whole grains, high-fiber fruits and vegetables, nuts, and seeds, may need to be avoided during flare-ups, they can be reintroduced when in remission.
- To improve overall health and reduce intestinal inflammation, consider a plant-forward diet that includes eggs, dairy, fish, and fiber.
- Include soluble fiber sources such as oat bran, barley, nuts, seeds, beans, lentils, peas, and certain fruits and vegetables. Soluble fiber helps slow down digestion and can ease diarrhea.
Remember, it is important to work with your doctor or an IBD-focused registered dietitian to develop a personalized diet plan that considers your specific needs and symptoms.
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Low-fibre foods to eat during flare-ups
While dietary fibre is important for overall health, it can aggravate symptoms during a Crohn's flare-up. Fibre stimulates the bowels, which can cause issues for people with inflammatory bowel diseases like Crohn's. A low-fibre diet is generally recommended during flare-ups to help manage symptoms and prevent intestinal constriction.
However, it's important to note that the impact of diet on Crohn's varies from person to person. While some people with Crohn's may be able to eat certain foods with no issues, others may find the same foods triggering. It's recommended that you work with a doctor or IBD-focused dietitian to develop a personalised diet plan.
- Opt for low-fibre fruits and vegetables, such as bananas, potatoes without skin, cooked vegetables (especially leafy greens), and peeled or blended fruits.
- Cooking, steaming, or blending fruits and vegetables can make them easier to digest. However, this can also reduce their nutrient content, so it's important to be mindful of how you prepare your food.
- Some people with Crohn's may find dairy difficult to digest due to lactose intolerance. If you can tolerate dairy, opt for low-fat products, and consider using enzyme products like lactase or lactose-free alternatives.
- Choose leaner meats, such as fish or low-fat poultry without skin, as fatty meats can worsen flare-ups and cause inflammation.
- Grains are common dietary staples, but whole grains are high in fibre and should be limited during a flare-up.
- Stay hydrated by drinking plenty of fluids, especially water, which is important for digestion and can help prevent dehydration during chronic diarrhoea.
- Eat smaller, more frequent meals throughout the day, and include snacks to ensure you're getting enough nutrition.
- If you're losing weight, add full-fat foods to your diet and consider nutritional supplement drinks, as recommended by your doctor.
- Keep a food journal to track the foods you eat and any symptoms you experience to help identify your trigger foods.
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The importance of hydration
Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract. It is a type of inflammatory bowel disease (IBD) that causes abdominal pain, diarrhoea, and weight loss. While there is no one-size-fits-all diet for Crohn's disease, maintaining proper hydration is of utmost importance. Dehydration can exacerbate Crohn's symptoms, and the disease itself can increase the risk of dehydration, leading to harmful health effects.
Staying hydrated is a critical aspect of managing Crohn's disease. Individuals with Crohn's are at a higher risk of liver damage and other severe health complications due to dehydration. Dehydration can lead to constipation, muscle cramps, dizziness, and even life-threatening consequences in severe cases. By prioritising hydration, people with Crohn's can reduce their risk of these adverse effects and improve their overall health.
Additionally, Crohn's disease can cause diarrhoea, which further increases the risk of dehydration. It is essential to manage diarrhoea and be creative with fluid intake to ensure adequate hydration. This may include incorporating liquids into your diet in various forms, such as soups, smoothies, or herbal teas. Tracking fluid consumption can also help individuals with Crohn's disease stay on top of their hydration goals.
Finally, it is worth noting that individuals with an ileostomy or a family history of Crohn's disease may be at an even higher risk of dehydration. Hospital readmissions within 30 days of an ileostomy procedure due to dehydration have been reported in approximately 3% of cases. Factors such as older age, more severe disease status, and high blood pressure further contribute to this risk. Therefore, for those with Crohn's disease, staying hydrated becomes an essential component of their overall health management.
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Dairy products and lactose intolerance
Dairy products are often one of the first foods that people with Crohn's disease eliminate from their diets. This is because lactose intolerance tends to coincide with inflammatory bowel disease (IBD), which includes Crohn's disease. Lactose is a type of milk sugar found in most dairy products, and people with lactose intolerance lack the natural enzyme lactase, which is needed to digest it.
Lactose intolerance can cause symptoms such as gas, abdominal pain, and diarrhea, which are similar to those experienced by people with Crohn's disease. However, not everyone with Crohn's disease is lactose intolerant, so avoiding all dairy may not be necessary and could even be counterproductive. Dairy is an excellent source of calcium, which is particularly important for people with Crohn's disease as certain drug treatments and malabsorption may cause a calcium deficiency.
If you have Crohn's disease and want to include dairy in your diet, it is recommended to opt for low-fat products and limit your intake. You can also use enzyme products such as lactase (Lactaid) or choose lactose-free products to help manage flare-ups. Greek yogurt is a good option as it has less lactose than other commercial yogurts and more protein per serving. Goat's milk also has slightly less lactose than cow's milk, and some people find they tolerate it better. Fortified plant-based milk products are another option, as they provide extra vitamins and minerals, although they may not provide enough protein.
If you are unsure whether you are lactose intolerant, you can try an elimination diet to identify any food allergies or intolerances. This involves keeping a food journal and noting how you feel after eating certain foods. If you find that dairy is a trigger for your symptoms, you can try to substitute it with lactose-free or lower-lactose alternatives to get the necessary calcium.
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Working with a dietitian
While there is no scientifically proven diet for inflammatory bowel diseases (IBD) like Crohn's disease, dietary changes can help manage symptoms and prevent flare-ups. Working with a registered dietitian can help you develop a personalized diet plan that considers your specific needs and restrictions. Here are some tips for working with a dietitian to manage your Crohn's disease:
- Find an IBD-focused dietitian: Look for a registered dietitian who has experience working with patients with IBD. They will have specialized knowledge about the dietary needs and restrictions related to Crohn's disease.
- Identify trigger foods: Work with your dietitian to identify specific foods that trigger your gastrointestinal (GI) symptoms, especially during disease flares. Common trigger foods for people with Crohn's disease include spicy or greasy foods, whole grains, high-fiber fruits and vegetables, nuts, seeds, caffeine, alcohol, and dairy. However, trigger foods can vary from person to person, so it's important to identify your unique triggers.
- Limit trigger foods: Once you have identified your trigger foods, try to limit or avoid them, especially during flare-ups. This may help reduce symptoms such as gas, bloating, abdominal pain, cramping, and diarrhea.
- Focus on anti-inflammatory foods: Include foods in your diet that have anti-inflammatory properties. During a flare-up, start with soft, bland foods like applesauce, bananas, potatoes, and cooked vegetables. Yogurt, fish, cereals, and low-fiber foods can also be gentle on your gut and provide necessary nutrition.
- Ensure adequate protein intake: Protein is essential for tissue repair and healing, so make sure to include lean protein sources in your diet, such as chicken, turkey, fish, eggs, and tofu. Opt for proteins with lower fat content to better support your digestive health.
- Consider a plant-based approach: Research suggests that plant-based diets may help decrease intestinal inflammation and improve overall health in people with Crohn's disease. Include a variety of tolerated plant-based foods, such as fruits, vegetables, nuts, seeds, herbs, and whole grains.
- Maintain hydration: Dehydration is a risk for people with Crohn's disease, especially during chronic diarrhea. Drink plenty of fluids, preferably plain water, to stay hydrated and support digestion.
- Supplement with care: If you are at risk of malnutrition or have difficulty absorbing nutrients, your dietitian or doctor may recommend vitamin and mineral supplements. Always consult with your healthcare provider before taking any dietary supplements.
- Keep a food diary: To better understand your triggers and manage flare-ups, consider keeping a food diary. Note the foods you eat and any symptoms you experience. This can help you and your dietitian identify patterns and make informed dietary adjustments.
- Be kind to yourself: Remember that everyone's journey with Crohn's disease is unique. Your diet should be tailored to your specific needs and may evolve over time. Be patient and compassionate with yourself as you navigate dietary adjustments.
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Frequently asked questions
There is no single diet for Crohn's disease, and foods that can be tolerated by some people might be a problem for others. However, it is recommended to follow a low-residue, low-fiber diet to help manage small intestinal constriction or acute symptoms. It is also important to stay hydrated, and drink plenty of water.
Foods that are known to irritate the GI tract and trigger flare-ups include spicy foods, greasy foods, whole grains, high-fiber fruits and vegetables, nuts and seeds, caffeine, and alcohol. Meats with a higher fat content should also be avoided, as they can worsen flare-ups and cause inflammation.
Eating high-fiber, starchy foods like potatoes, rice, oatmeal, or bread can help reduce inflammation. Cooked, peeled, or blended fruits and vegetables, such as bananas, raspberries, squash, and leafy greens added to a smoothie, are also good options. Protein-rich foods like lean meats, fish, eggs, yogurt, and soybean products are important as they help rebuild muscle and speed up healing.
