Diet and nutrition
What are some common myths or misunderstandings about food and inflammatory bowel disease?
Many people have mistaken beliefs about the relationship between food and inflammatory bowel diseases (IBD) such as Crohn’s disease (CD) and ulcerative colitis (UC).1 For example, some common misconceptions are:
- That IBD can be caused by an allergic reaction to eating certain foods or kinds of foods
- That eating certain kinds of foods can worsen the inflammation caused by IBD
- That following a certain kind of diet can “cure” IBD
- That a person has IBD because of their diet/previous lifestyle choices
None of these beliefs are true according to scientific evidence. IBD is not related to food allergies of any kind. Although eating certain types of foods may make symptoms of the disease worse for some people, especially during flare-ups, there are no foods that worsen the inflammation that IBD causes: the disease itself is what causes the inflammation, not the foods that a person eats.1
What are some common myths about diets and inflammatory bowel disease?
Another common myth is that following some kind of special diet can “cure” anyone with IBD. In fact, there are certain types of diets that are marketed to people with IBD, such as “The Specific Carbohydrate Diet.” However, there is no scientific evidence that the diet works, and it can be difficult to follow.1
The bottom line is that no specific diet or dietary recommendation will work for everyone with IBD. Certain strategies work for certain people, but not for others. This is because every person’s disease is unique in terms of which parts of the digestive system are affected. Furthermore, what works for a person at one time may not work at another time, because the disease itself is constantly changing. Maintaining healthy eating habits with a well-balanced, healthy diet is the most important strategy. It is also very important for people with IBD to make sure that they drink enough fluids that they do not become dehydrated, which is a side effect of chronic diarrhea.1
There are a range of healthy eating tips for people with IBD, as well as strategies for figuring out if certain foods can sometimes make symptoms worse for some people.
How are diet and nutrition related to inflammatory bowel disease?
The digestive tract is responsible for digestion, absorption of nutrients from foods and beverages, and elimination of waste. Many patients with CD have inflammation in the small intestine. This can affect the patient’s ability to fully digest and absorb nutrients from the food that they eat. If not enough of the right kinds of nutrients are absorbed into the body; this can lead to nutritional deficiencies or malnutrition, which is a lack of essential nutrients in the body. Improperly digested food can also cause diarrhea, abdominal pain and cramping.1,2
Avoiding dehydration is an important strategy for anyone, whether they have IBD or not. Our bodies are 60% percent water and thus require regular frequent intake of water to stay hydrated. Patients with CD or UC who are experiencing recurring diarrhea are especially at risk of becoming dehydrated. Everyone should attempt to drink at least 8 8oz glasses of water every day. For some people with IBD, it could be beneficial to avoid beverages with caffeine, such as coffee and tea, because it could increase frequency of bowel movements. Some examples of good beverages include water, low-sugar sports drinks, and fruit juices that have been diluted in water.1,2
What are the most common nutritional deficiencies associated with inflammatory bowel disease?
Because their intestines are not able to absorb enough nutrients, it is common for patients with IBD to have insufficient levels of some vitamins and minerals, such as:2
Healthcare providers will regularly assess patients with IBD for nutritional deficiencies using physical examination and blood or fecal testing. Symptoms such as unintentional weight loss can also be a sign of nutritional deficiency.
It is important to remember that there are many very ill IBD patients who are either of average weight or overweight, but that does not always factor in to how a person is feeling. Another common misconception about IBD revolves around weight. In many cases loved ones, the general public, and even healthcare providers assume that people who are sick are necessarily underweight or very thin. This is not true: as with so many issues related to IBD, there is no “one size fits all” indicator for every patient. A person can be average or overweight and still be very ill due to the disease. While weight can indeed be an indicator of good health, it is not the only indicator.
Based upon advice from a healthcare provider, nutritional deficiencies can be treated by increasing the amount of food that contains those nutrients in the patient’s diet, or by taking multivitamins or specific vitamin or nutritional supplements.
It is important to treat nutritional deficiencies, because if left untreated, they can cause health problems such as:1,2
- Chronic Diarrhea
How are serious nutritional deficiencies treated?
If a patient has serious nutritional deficiencies, healthcare providers may recommend treatment with enteral or parenteral nutrition.2
Enteral nutrition is a form of nutritional therapy that can be taken by mouth or delivered through a feeding tube. If taken through a feeding tube, the tube is inserted directly into the patient’s stomach or small intestine. The liquid preparation is a combination of proteins, carbohydrates, fats, vitamins and minerals. This form of therapy is especially helpful for children with serious nutritional deficiencies, as acquiring essential nutrients is important for growth.
Parenteral nutrition is a form of nutritional therapy that is used when a patient is unable to absorb nutrients through the small intestine via enteral nutrition. Parenteral nutrition is delivered through an intravenous tube called a catheter. This way, the liquid nutrients are delivered directly to the blood stream. This is typically used when patients are experiencing severe symptoms.
- Diet, Nutrition, and Inflammatory Bowel Disease. Crohn's & Colitis Foundation of America. Available at http://www.crohnscolitisfoundation.org/assets/pdfs/diet-nutrition-2013.pdf. Accessed 1/26/18.
- Eiden KA. Nutritional Considerations in Inflammatory Bowel Disease. Practical Gastroenterology 2003;5:33-54.