Crohn’s disease is a complex gastrointestinal condition that can cause problems such as poor absorption of nutrients and inflammation throughout the digestive system. Because it is a disease of the digestive system, the Crohn’s disease diet can be an important way to help relieve symptoms and support patients’ remission.
You should talk to your doctor or gastroenterologist before making dietary changes, especially with a complex disease such as inflammatory bowel disease (the group of conditions to which Crohn’s belongs). In addition, patients with a stoma should take special care to talk to their doctor or dietitian about what they can and cannot eat, especially when an attack occurs.
We spoke to a doctor and a registered dietitian to discuss what to eat in a flare-up, on a remission, and what to eat to avoid getting into a bout of IBD. They offer their tips for managing this condition and the best way to take care of yourself if you are suffering from malabsorption of nutrients due to your illness.
What do we eat in case of fire?
Roxana Ehsany (Opens in a new tab)A certified dietitian and national media spokesperson for the Academy of Nutrition and Dietetics says it’s best to eat a light, low-fat, bland diet for the first few days.
“It’s important to stay as hydrated as possible, especially if you have a lot of diarrhea or vomiting,” she adds. It is important to eat drinks and foods rich in electrolytes. You can eat broth, such as bone broth, to get fluids, sodium, and protein. You can have sports drinks for abundant calories, easy absorption and tolerance of carbohydrates and electrolytes. If you can tolerate it, foods like yogurt — not for lactose intolerant — and crackers are easy for your gut to tolerate.
Some people may enjoy mint or ginger tea to soothe any nausea or upset stomach. Eat meals that are low in fat and low in fiber, as they will be easier for an upset stomach to tolerate, digest and absorb.”
Roxana Ehsani, MS, RD, CSSD, LDN
Roxana Ehsani is a board certified sports dietitian and national media spokesperson for the Academy of Nutrition and Dietetics. She holds a Bachelor of Science in Human Nutrition, Food, and Exercise from Virginia Tech, a Master of Science in Clinical Nutrition and Dietetics from the University of Pittsburgh and completed her nutrition training at the University of Pittsburgh Medical Center.
Deborah Lee, MD, from Dr. Fox Online Pharmacy (Opens in a new tab)During a seizure, he says, it’s best to eat a low-fiber diet and avoid too much fat:
- Low-fiber fruitMelons, peaches, nectarines, and cooked or canned fruits. The fruits should always be washed and peeled if possible – do not eat the peel.
- Low-fiber vegetablesStick to non-cruciferous vegetables — tomatoes, peppers, zucchini, asparagus, onions, carrots, spinach, and cucumbers. Always peel them first and cook them well – don’t eat them raw.
- lean protein: Chicken, fish, eggs and tofu are ideal. Red meat tends to be high in saturated fat, which can exacerbate symptoms. If you eat red meat, eat the best quality meat and cook it thoroughly until it is tender and easily digestible. Seedless nut butters, such as peanut butter, are another good protein option.
- fat fishSalmon, trout, mackerel, and tuna contain large amounts of omega-3 fatty acids, which are powerful anti-inflammatory. Walnuts and flaxseeds also contain large amounts of omega-3.
- Fats: Choose healthy, unsaturated fats, such as olive oil, avocado, or rapeseed oil. Don’t overdo it, stick to small amounts. Grill, bake or steam food instead of frying or roasting.
- Refined grains: White bread, rice, and pasta have less fiber. Stick to foods with less than 2g of fiber per serving.
- Probiotics and prebioticsProbiotics include yogurt made from live cultures, kefir, tempeh, and sauerkraut. Prebiotics include bananas and soy products.
Dr. Deborah Lee, MD
Having worked for many years in the NHS, initially as a GP, then as a principal physician to the Integrated Community Sexual Health Service, Dr Deborah Lee now works as a health and medical writer, with a focus on women’s health. She is a menopause specialist.
What to avoid in the event of a flare-up
Ehsani says it’s best to avoid any foods that are likely to build up in the stomach.
“Beverages that contain caffeine, such as coffee, soda, tea, or even sparkling water can be very difficult to tolerate,” she says. Avoid citrus fruits like lemons, limes, grapefruit, oranges, and tomatoes, as acidic foods can be too harsh on your stomach. Avoid most dairy products. Yogurt can be tolerated by some people, but all other forms of dairy should be avoided as it is difficult for most people to tolerate.
Sugar alcohols are found in sugar-free foods, diabetic-friendly foods, and in many gums and sweets, and it is best to avoid them as they may cause diarrhea. Alcohol should be avoided until the symptoms are gone as well.”
Lee lists the foods she encourages Crohn’s disease patients to avoid during an attack:
- Seeds and nuts: These foods are rough, hard to digest, rich in insoluble fiber and often pass through the gut undigested.
- certain fruitsAvoid anything with peel, such as raw fruits, or those that are particularly high in insoluble fiber. Do not eat dried fruits, including raisins and prunes, and avoid fruit pulp, such as fruit juices. Strawberries contain a lot of small seeds and it is best to avoid them.
- Specific vegetables: It is best to avoid cruciferous vegetables, such as Brussels sprouts, cauliflower, cabbage, kale, broccoli, arugula, and radishes, as well as raw vegetables, or vegetables that have skin left on. Everything you eat should be soft and well-cooked. Cooking food can break the fiber down a bit, changing it from insoluble fiber to soluble fiber, making it easier to digest, as shown in the journal Plant food for human nutrition (Opens in a new tab).
- Lactose: Crohn’s patients are more likely to be lactose intolerant, and large amounts of lactose can cause symptoms. Small amounts can be acceptable: as long as there is no real allergy to lactose. Dairy products are good sources of calcium, but this is why no more than two servings of dairy a day is usually recommended. If you are absolutely lactose intolerant, your doctor may recommend a calcium supplement.
- Sugar and sweeteners: Some studies suggest that a high-sugar diet can worsen Crohn’s symptoms. Artificial sweeteners, such as aspartame, can worsen symptoms. Xylitol and sorbitol are other potential culprits. They are all found in low-calorie sodas and drinks, ice cream, sugar-free gum and sweets, all of which should be avoided.
- Fatty/processed foods
- spicy food: “Capsaicin is the ingredient in chili peppers that activates mucosal receptors to give the scorching effect of the chili seasoning in the mouth,” Lee says. In one study, 41% of IBD patients believed that eating spicy foods made IBD symptoms worse. This means avoiding foods that contain hot peppers, chili powder, pepper, and paprika. It also included black pepper, mustard and horseradish. Don’t confuse this with turmeric, which contains curcumin, which can have an anti-inflammatory effect on the gut. “
Crohn’s disease diet: what to eat in remission
There is no specific diet designed for Crohn’s disease, but following medically approved dietary guidelines can help you stay in remission in the long term and reduce the symptoms you may experience. About 30% of individuals with IBD also have irritable bowel syndrome. For these individuals, a low-FODMAP diet may help control IBS symptoms, depending on the extent of their disorder.
Ehsani says the diet for Crohn’s disease when you’re in remission is less restrictive. “You can eat a well-balanced, nutrient-rich diet that contains good sources of lean protein, whole grains, fruits, vegetables, beans, nuts, and seeds,” she says. “You may feel better eating smaller meals and more frequent meals throughout the day because they are easier to tolerate and digest. I always recommend keeping a food symptoms diary and writing down your foods, along with your daily symptoms next to them, to see if there are any foods that might trigger to ignition.”
Lee also encourages patients to take time out for their meals and try to break them up into smaller meals:
- Eat 4-6 small meals a day
- Plan and cook your meals from scratch
- Take time to eat your food slowly, chewing every bite
- Drink plenty of water with your meals
- Keep a food diary
Crohn’s disease diet: Do you need a supplement?
Ehsany encourages those who suffer from prolonged periods of diarrhea to take the supplement, as malabsorption of nutrients can cause deficiency. “People with Crohn’s disease who have chronic diarrhea may be malnourished and can benefit from a multivitamin,” she says. “People with Crohn’s disease are also more likely to develop anemia, so regularly checking iron levels is important and supplemented when a reduction is necessary.”
He also mentions to me that it’s important to add calcium if you’re on steroids due to its impact on bone health. “Steroids affect bone metabolism and increase the risk of bone loss leading to osteoporosis and osteoporosis,” she says. Vitamin D is necessary for calcium absorption in the intestine, so it is best to take both together. Foods high in calcium include low-fat dairy products, leafy greens, salmon, sardines, tofu, and any calcium-fortified products.”
This article is for informational purposes only and is not intended to provide medical advice.
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