About inflammatory bowel disease

Crohn's disease and chronic ulcerative colitis are two diseases that are together classified as inflammatory bowel disease (IBD) and result in an inflammation of the intestines.

Symptoms during an attack may include:

• Abdominal pain

• Nausea and vomiting

• Frequent bowel movements

• Diarrhea

• Weight loss

• Dehydration

• Anemia

• Fever

These factors contribute to a loss of appetite in many individuals. In addition, IBD, particularly Crohn's disease, often is associated with poor digestion and poor absorption of dietary protein, fat, carbohydrates, water and a wide variety of vitamins and minerals. Much of what a person eats may never really get into the body. While dietary habits do not cause the disease, they do play a crucial role in managing it.

Eating plan

The same IBD diet does not necessarily work for everyone, but you can work with your registered dietitian to:

• Develop an eating plan that will help manage symptoms during the intense phases of a flare-up

• Help determine what types of foods may worsen symptoms

• Learn how to maintain a healthy eating plan that will promote recovery during remissions

In addition, the following dietary tips can help you manage IBD:

Meals

Use this advice when you eat:

• Eat small, frequent meals and snacks, instead of just a few large meals.

• Choose adequate high-protein foods, even during a flare up. This may help relieve IBD symptoms. Some examples include lean meats, fish, poultry and eggs or egg substitutes.

• Do not skip meals. This may cause pain and bloating when you finally do eat.

• Slow down when you eat.

• Chew food well and take small bites.

Meal planning

Plan your meals with these tips in mind:

• Choose adequate high-protein foods which may help relieve IBD symptoms. This is important even during a flare-up.

  • Lean meats

  • Fish

  • Poultry

  • Eggs or egg substitutes

• See if cooked vegetables are more easily tolerated than raw vegetables.

• Limit gas-producing foods, such as:

  • Cruciferous vegetables (broccoli, cabbage, cauliflower and brussel sprouts)

  • Dried peas, beans, legumes and lentils

  • Onions

  • Peppers

  • Carbonated beverages

Avoid caffeine and foods that contain sorbitol (sweetener used in foods). This may cause diarrhea.

• Limit fatty or greasy foods.

• Limit fried foods

• Avoid using excessive cooking oil.

• Limit high fat meats and dairy products.

Fiber

Know when to use and limit high-fiber foods:

• Try foods that are high in fiber, when IBD is under control:

  • Wholegrain breads, bagels, buns and pasta

  • Bran cereals

  • Whole grains, such as barley, corn, brown rice and quinoa

  • Dried fruits

  • Berries, oranges, apples and pears (with skins)

  • Green, leafy vegetables

• Limit high-fiber foods to help minimize symptoms during a flare-up.

Lactose intolerance

If you are lactose intolerant:

• Avoid lactose-containing (dairy) foods

• Try lactase enzymes and/or lactase-pretreated foods

Beverages

Include liquids in your diet:

• Drink plenty of fluids, especially water, to prevent constipation and to keep your body hydrated. This is sometimes a challenge during vomiting and diarrhea episodes.

Supplements

At a minimum, consider a Calcium + D supplement (600mg of Calcium + 200-400IU of Vitamin D).

Our Inflammatory Bowel Disease specialists

• Freddy Caldera, DO

• Ian C. Grimes, MD

• Mark Reichelderfer, MD

• Sumona Saha, MD

Our team includes fellowship-trained gastroenterologists, colorectal surgeons, general surgeons, nutritionists, a health psychologist, an ostomy nurse, IBD nurses, pathologists and radiologists.

Physician referrals

For urgent/active uncontrolled disease, second opinion and/or to transfer care to an inflammatory bowel disease specialist, contact the Inflammatory Bowel Disease Clinic at the Digestive Health Center at (608) 829-5000 or complete and fax our request for appointment form (pdf). The following information should be prepared and faxed (608-263-8254):

• Summary letter from physician (strongly encouraged)

• Results from all colonoscopies, endoscopies, liver biopsies or other GI procedures

• Physician records, including consultant reports

• Laboratory results such as blood tests, serology tests, metabolite levels, stool specimens

• Hospitalization admission and discharge summaries and surgical operative reports

• X-ray reports

• Pathology reports, which may be submitted for formal review by GI pathology