Inflammatory bowel disease (IBD) is a term used to describe two diseases that cause the gastrointestinal (GI) tract to become inflamed: Crohn’s disease and ulcerative colitis. Both can cause sores or ulcers to occur in the GI tract. This may affect how the body is able to absorb food or make it hard or painful to eat.
Symptoms of IBD
Abdominal pain
Diarrhea with or without blood
Fever
Poor growth in children
Weight loss
Mouth ulcers
Nausea and vomiting
Why the Food You Eat Matters
The food you eat provides your body with the vitamins, minerals, protein and calories needed to grow and maintain your health.
When your disease is active, or inflammation is present, your body may need more calories and protein.
Foods You Should Eat
The American College of Gastroenterology recommends following a mediterranean style dietary pattern- choosing whole-foods, with a focus on lean protein sources, healthy fats, fruits, vegetables, nuts, and seeds.
IBD patients who have a history of strictures may have some dietary restrictions and should discuss with their dietitian.
Strive for a balanced diet with foods from all food groups (grains, milk and milk substitutes, meat and meat substitutes, fruits, and vegetables).
During Active Disease
When your disease is active, you may find it harder to eat due to gastrointestinal symptoms.
It is important to remember that everyone’s tolerance to food during flares can differ.
Keeping a food and symptom journal may be helpful to monitor foods that may worsen symptoms such as:
Lactose
If you have lactose intolerance, choose lactose-free dairy products and harder cheeses like cheddar and Swiss.
Try almond or coconut milk, lactose free milk (like Lactaid®) or use lactase pills.
Foods higher in sugar:
Fruit juice, soda, honey, dried fruits may worsen diarrhea.
Sugar alcohols:
Sorbitol, mannitol, and erythritol may worsen diarrhea.
Acidic foods or those higher in fat such as fried foods, butter, cream may worsen diarrhea.
Caffeine, acidic foods, and alcohol may make flares worse.
During flares, it may be helpful to modify the texture of foods that are higher in fiber to make it easier for your body to digest.
Modifying the texture of foods can look like:
Blending fruit into a smoothie.
Choosing applesauce instead of an apple or peeling the apple.
Cooking vegetables so they are soft and chewing to an applesauce consistency.
Choosing nut butters instead of trail mix.
Consuming blended soups.
Lower fiber fruits include cantaloupe, honey dew, mandarin oranges, fruit cocktail, and applesauce. For veggies, try zucchini, yellow squash, and bell peppers. Cooking vegetables can make it easier to tolerate them.
Eating smaller more frequent meals (every 3-4 hours) may be helpful.
If it is painful to eat or you are losing weight, try nutritional supplements like Boost®, Ensure®, and Breakfast Essentials®.
It is important to try and consume as much of a diverse diet as possible during flares to support your body.
Your dietitian can review your food log with you and help figure out food triggers as well as foods that may improve your symptoms.
Hydration
It is important to stay hydrated during IBD flares. Peppermint and ginger teas may help calm the gut.
Electrolyte drinks such as Pedialyte®, Gatorlyte®, DripDrop®, LiquidIV® can also be utilized during flares for electrolytes and hydration.
Vitamins and Minerals
You should take a complete multivitamin with minerals.
Common vitamin/mineral deficiencies in IBD include:
Vitamin D and calcium, especially with steroid use.
Folic acid if on sulfasalazine.
Iron and B12 due to bleeding and reduced intake.
Zinc due to diarrhea.
It is important to consult with a dietitian regarding adequate intake and monitoring for vitamin/mineral deficiencies.
Other Supplements for IBD
Many supplements are marketed for inflammation. More testing still needs to be done. Some patients have found that these help maintain a healthy gut or reduce symptoms. Others do not see any changes in their symptoms.
Prebiotics are a type of fiber that helps keep the bowels healthy. These feed the “friendly” bacteria in the gut. Onions, garlic, bananas, asparagus, avocado, and some whole grain cereals are good food sources of this fiber.
Probiotics are living bacteria that keep your gut healthy. You can find them in products like kefir, kombucha, yogurt and the label will say “Live Active Cultures.” The brand, Visbiome®, may help those with pouchitis.
Marine fish oils and flaxseed oils contain omega-3 fatty acids that may help IBD symptoms. If your body can handle fish, try eating fishlike salmon, cod, and tuna several times a week. You can also find fish oil and flaxseed oil in capsule form.
Turmeric or curcumin can act as an anti-inflammatory. Eating the spice in food or a capsule form may be helpful if you have ulcerative colitis. Curcumin should be taken with food. You and your dietitian can work together on a dose that is appropriate for you.
Talk to your doctor before starting any supplement.
To find out more about IBD, please visit:
www.ccfa.org
www.iffgd.org
www.naspghan.org/
Who to Call
If you have questions, please contact your provider through MyChart or call your provider listed in your After Visit Summary or After Hospital Care Plan.
For a list of UW Health Clinics, visit www.uwhealth.org/.