Eating Tips and Strategies
Reviewed by: HU Medical Review Board | Last Reviewed: January 2018. | Last updated: November 2021
Maintaining a healthy, well-balanced diet is important for everyone, and is especially important for people with inflammatory bowel diseases (IBD) such as Crohn’s disease (CD) or ulcerative colitis (UC). This is because the inflammation in the digestive tract that the disease causes can make it more difficult for the intestines to digest food and absorb nutrients into the body.1
Finding a treatment strategy with medications that are working to manage the disease and control its symptoms is the first step in establishing a treatment strategy. Following a diet that is healthy and well balanced is important, because medications for IBD also tend to work more effectively when the person has a good nutritional status.
Once an effective treatment strategy has been found, a next step may be to try and identify whether there are certain foods that make symptoms worse, especially during flare-ups. Healthcare providers or specialists such as dietitians or nutritionists can provide advice about how to do this that is tailored to the specific person.
What are some components of a healthy, well-balanced diet?
A healthy, well-balanced diet includes consuming enough calories, proteins, and nutrients from all of the food groups:1
- Protein – from foods such as meat, poultry, fish, and dairy products
- Carbohydrates – from foods such as bread, cereal, starches, vegetables, and fruits
- Fat – from foods such as oils and margarine
While eating a healthy, well-balanced diet is ideal, it can often be very difficult for people with IBD to do this. For example, roughage can be difficult to digest, so people with IBD may have trouble consuming enough fruits and vegetables.
"Safe" foods for Crohn's or UC
People with IBD are often advised not to eat nuts, which are excellent sources of protein. In fact, some of the types of foods that many people with IBD find are “safe” for them to eat (such as non-chocolate candies, for example) may not be particularly healthy. This can make it even more difficult to get the right nutrients to help heal the body. Sometimes, a person with IBD is restricted to a diet only of soft foods and liquids, and special supplemental drinks may be recommended to make sure that the person is consuming enough nutrients.1
What are some eating tips for people with Crohn's and colitis?
No specific eating strategy or diet plan will work for everyone with IBD. However, there are some general tips that can be helpful for some people, especially during flare-ups. Diarrhea, discomfort, or cramping can tend to be more common during flares.1,2
Some people find that eating smaller, more frequent meals is helpful. This can help ease the digestive process, creating less discomfort or potential diarrhea. Eating smaller meals can be especially helpful during flare-ups.
What are trigger foods?
IBD is not caused by any specific food allergies, but people with IBD may find that they have certain “trigger foods” that can cause uncomfortable symptoms such as gas, bloating, cramping, or diarrhea.
Some people with IBD may find it helpful to begin keeping a food diary or journal. In doing so, the individual will begin to keep a log of the food and drinks they are consuming throughout the day. This will help a person to make any connections between certain foods or certain food groups that cause symptoms.1,2
What are some common types of trigger foods?
Certain types of fatty foods can cause diarrhea or gas if the fat is not fully absorbed in the intestine.1,2 To avoid this, it may be helpful to limit foods such as:
- Greasy or fried foods
- Butter or margarine
- Cream sauces
- Pork products
It is estimated that between 10%-20% of people with IBD have lactose intolerance, which means that consuming milk or milk products can cause abdominal cramping, gas, or diarrhea.2 Limiting those foods or taking a lactase supplement before eating those kinds of foods can help to reduce those symptoms. However, it is important for people with lactose intolerance to ensure they are meeting their daily requirements of calcium. This can be done by taking calcium supplements or eating lactose-free foods rich in calcium.
Gluten is a type of protein found in grains such as wheat, rye, and barley. Some people with IBD also have a gluten intolerance, which can cause abdominal pain and diarrhea after eating gluten.1
What is the link between fiber and inflammatory bowel disease?
Dietary fiber is essential for health and digestion. It can be found in fruits, vegetables, nuts, and grains. There are two main types of fiber. Soluble fiber is a type of fiber that can dissolve in water, which can help to reduce diarrhea.
Insoluble fiber is a type of fiber that does not dissolve in water. This type of fiber makes food move through the gut more quickly, which can aggravate symptoms of IBD. Some people with IBD may experience bloating, abdominal pain and diarrhea after ingesting insoluble fiber. Insoluble fiber can be found in:1,2
- Chinese vegetables
What are FODMAPS?
FODMAPs (fermentable oligo-di-monosaccharides and polyols) are a type of sugar found in certain foods including:1
- Dairy products
- Some vegetables
In some people, FODMAPs can cause symptoms such as bloating, excessive gas, diarrhea and abdominal pain. Some people find that limiting the amount of FODMAPS they consume may reduce these symptoms.1