Diet and food in Inflammatory Bowel Disease

  • Fitterfly - Team Nutrition

  • Posted On August 28, 2019

inflammatory disease

Inflammatory bowel disease (IBD) represents a group of disorders that involve chronic inflammation of digestive tract, anywhere from the mouth to anus. The two most common types of inflammatory bowel disease are – Crohn’s disease and Ulcerative Colitis.

IBD can be very painful, disrupt the normal process of food digestion, and in few cases, it may even be life-threatening. If you have been diagnosed with IBD, it may be severely affecting your quality of life but proper dietary management and care can make things easier.

Let us find out more about IBD, its symptoms, and the role of lifestyle choices in treatment of Inflammatory bowel disease.

What are the symptoms of Inflammatory bowel disease?

IBD symptoms vary, depending on the severity of inflammation and area affected. Symptoms may range from mild to severe. There may be periods of active disease followed by periods of remission.

Some common symptoms are:

  • Persistent diarrhoea
  • Abdominal pain and cramps
  • Blood in stools
  • Unintended Weight loss
  • Fatigue
  • Reduced appetite

What is the role of food and diet in Inflammatory bowel disease?

Although no specific diet has been shown to cause, prevent or treat IBD, dietary changes may be helpful in relieving your symptoms. It is also important to know about certain problem foods that can aggravate your signs and symptoms.

How can I identify problem foods?

Keeping a food diary with a record of foods eaten, as well as how you feel and taking note of when symptoms worsen may help you identify problem foods.

What are the dietary guidelines to manage symptoms of IBD?

There are different approaches to diet during flares and in the absence of flares. Regardless of disease, do not overly restrict your diet. Adequate nutrition especially during illness is important to prevent deficiencies.

What are the Diet Recommendations for Ulcerative Colitis Flare-up?

  • Follow a low residue diet to relieve abdominal pain and diarrhoea. Low residue diet is a restricted diet that reduces the amount of fiber and other undigested material that pass through your colon.
  • Avoid foods that may increase stool output such as raw fruits and vegetables, and caffeinated beverages.
  • Decrease concentrated sweets in your diet, including juices and aerated drinks.
  • Decrease alcohol consumption.
  • Try incorporating more omega-3 fatty acids in your diet.
  • Eat small meals. You may feel better eating five or six small meals a day rather than two or three larger ones.

What are the Diet Recommendations for Crohn's Disease Flare-up?

  • Follow a low residue diet to relieve abdominal pain and diarrhoea.
  • Avoid nuts, seeds, beans and kernels.
  • Avoid foods that may increase stool output such as raw fruits and vegetables, and caffeinated beverages.
  • Limit dairy products. Many people with inflammatory bowel disease find that their symptoms improve by limiting or eliminating dairy products. You may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods.
  • Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat normally. Try avoiding butter, cream sauces and fried foods.
  • Smaller, more frequent meals are better tolerated and can maximize nutritional intake.

What are the diet recommendations during remission phases for Ulcerative Colitis and Crohn's Disease?

  • Continue to follow a low fiber 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, cooked fruits, and starches like cooked cereals.
  • Increase your calorie and protein intake.
  • Try cooking fruits and vegetables by steaming, baking or stewing.

What are the examples of foods to include in inflammatory bowel disease diet?

  • Refined grains: white breads, white rice, pasta
  • Oatmeal made from quick or rolled oats
  • Low-fiber fruits– bananas, watermelon, muskmelon, peaches
  • At least 2 servings of oily fish per week. These can include trout, salmon/ (rawas), mackerel (bangda), herring (hilsa), tuna (chura)and sardines (pedve)
  • Soy (if not allergic to), eggs, and tofu 
  • Lean poultry or fish
  • Mashed potatoes
  • Low FODMAP foods –Orange, banana, pineapple, corn, capsicum, beans to name a few.

What are the examples of foods to avoid in inflammatory bowel disease?

  • High-fiber foods, such as fresh raw fruits and vegetables and whole grains
  • Avoid cabbage family, including broccoli and cauliflower
  • Nuts, seeds, corn and popcorn.
  • Fatty, fried foods
  • Spicy foods
  • Creamy sauces
  • Caffeinated beverages
  • Sweets including toffees, candy, and juice
  • Alcohol
  • High FODMAP foods – Apple, pear, watermelon, Wheat based foods, lactose-based foods to name a few.

Apart from food what other measures can help in management of IBD?

  • Drink plenty of liquids. Water is best.
  • Learn how to manage stress, breathing exercises, meditation, yoga etc.
  • Smoking increases your risk of developing Crohn's disease, and once you have it, can make it worse. Though smoking may help prevent ulcerative colitis, its harm to overall health outweighs any benefit, and quitting smoking can improve the general health of your digestive tract.
  • Exercise. Even mild exercise can help reduce stress, and normalize bowel function.
  • Multivitamins supplements. Diarrhoea, abdominal pain and cramping along with limited diet, interferes with nutrient absorption. Check with your doctor before taking any minerals or vitamins supplements.
  • Talk to a dietitian. You dietician may also be able to guide you regarding dietary changes, meal plans, and other diets such as - carbohydrate exclusion, semi-vegetarian, Mediterranean, low fibre, low residue, and gluten free.
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Disclaimer: All information here, including text, images, tables, videos and any other content is for your knowledge only and we do not guarantee any specific result by following these recommendations as it may vary from person to person. The information is not a substitute for qualified medical advice from a doctor or other medical health expert.