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Food and Ulcerative Colitis

Many inflammatory bowel disease advocates avoid talking about food because it’s so complex. It can also be really frustrating when people have written about food and made broad sweeping statements about what one should, and should not consume.

So why is food so hard to write about, and to advise on for people with Crohn’s disease or ulcerative colitis?

Why food is so hard to write about with IBD

There really is no one size fits all for IBD. The disease can manifest in so many different ways, so what’s suitable for one person is not really relevant to the next. Symptoms vary so much, so you obviously can’t expect a person who has chronic diarrhea to be helped by your advice, if you suffer from severe constipation, can you?! It also involves a lot of trial and error.

What you can eat may also change over time, as disease flares and goes into remission, and due to surgery or disease progression. Sometimes investigations need to be carried out to better understand the cause of the symptoms before dietary advice can be given.

I am going to go through a couple of different scenarios, and what may be advised for each problem, to give a better understanding of how complicated it really can be!

Different aspects that complicate diet with Crohn's or UC

If one of the main symptoms is diarrhea, then restricting foods which usually increases stool output such as fruit, vegetables, and spicy food could be recommended.

If one of the main symptoms is constipation, then increasing fiber intake may be recommended, to help things move through the digestive tract. If that constipation is due to narrowing’s in the intestine (strictures), or adhesions, then increasing fiber, especially of the insoluble variety, could actually increase the risk of blockages.

If blockages are something that keeps happening, then a low residue diet may be recommended. A low residue diet may also be recommended following bowel surgery or during a flare. This means avoiding foods with high, and insoluble fiber such as nuts and popcorn, and avoiding or removing the skins and seeds from many fruits and vegetables.

Some people struggle to gain weight, whilst others struggle to lose it, and this is often due to dietary restrictions because of how our disease is presenting at the time, or, it could be because our body is not able to extract enough nutrients from the food we are able to eat.

Personal boundaries when it comes to nutrition and diet changes

This is precisely why no-one can ever recommend their own diet to you. We are living within our own personal boundaries. If you can access a dietitian then that can be really helpful, but as I said above, there can still be a lot of trial and error.

You need to figure out what triggers symptoms for you, individually. A food diary can be super helpful. I would suggest logging as much information as possible, like what you have eaten and when, and what the outcome of those food was; frequency, urgency, pain, gas, blood, and consistency.

Sometimes our bodies have an off day, just like everyone else’s, so I usually try a food three times before deciding it’s definitely a “no go” for me. It may be something you can eat at a later date if your disease goes into remission, or after surgery etc.

Identifying triggers and food restrictions

Changes in diet should always be discussed with your IBD specialist, so that they are aware of what’s going on, and they can also keep an eye on your blood results for nutritional deficiencies, which can often come about because of a restricted diet.

Personally, I have always tried really hard to keep my diet as balanced as possible within the restrictions I have at the time, even if that has meant having to make my own juices, soups, or smoothies, and then pushing them through a fine strainer!

It can be so hard and feel like an additional stressor on top of already feeling unwell, but I promise that taking care of you is worth it. You are worth it!

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