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Inflammatory Bowel Disease Diet Guidelines

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 is the food I eat important?

The food you eat provides your body with the vitamins, minerals, protein and calories needed to grow and maintain your health. It is not easy for people with IBD to absorb the nutrients from the foods they eat; and, therefore, they need more vitamins, minerals, protein and calories than other people. They are more likely to have poor growth and be malnourished. They may eat less because they don’t feel well or are afraid to eat because eating makes them feel worse.

What should I eat and drink?

Eat a high-calorie, high-protein diet. Strive for a balanced diet with foods from all food groups (grains, milk and milk substitutes, meat and meat substitutes, fruits, and vegetables).

The food you eat should be based on what you like and what your body can handle.

Lactose intolerance is common in people with Crohn’s disease, but some people do not have issues when eating dairy products.

Try eating smaller, more frequent meals and snacks (eating every 3-4 hours)

If it is painful to eat or you are losing weight, try supplements like Boost, Ensure, and Breakfast Essentials .

Your fluid needs are increased with chronic diarrhea and acute flares. Drink more fluids during flares (>/= 8 cups per day).

When your disease is active, a low-fiber, low-fat diet may reduce symptoms.

When IBD is active it may help to:

  • Limit dairy that is high in lactose.

    • You might be able to handle yogurt with live active cultures or Greek-style yogurts.

    • You might be able to handle hard cheeses like cheddar and Swiss.

    • Try almond or coconut milk, lactose free milk (like Lactaid®) or use lactase pills.

  • Limit fructose.

    • High amounts are found in fruit juice, soda, honey, and dried fruit.

  • Limit sorbitol (used as sweetener, common in sugar free candies/chocolates).

  • Limit high fat foods like butter, cream, red meats, chocolate, fried or fast foods.

  • Limit high fiber foods like whole grains, beans, and fruits and vegetables with skin.

    • You might be able to handle fruits and vegetable with skins peeled off.

    • Lower fiber fruits include cantaloupe, honey dew, mandarin oranges, fruit cocktail, and applesauce. For veggies, try zucchini, yellow squash, and bell peppers.

    • Try well cooked vegetables and vegetable juice.

    • Try low fiber grain products like white bread, white rice and pasta and low fiber cereal and crackers.

  • Caffeine, acidic foods, and alcohol may make flares worse.

It may help to keep a food log. Your dietitian can review your food log with you and help figure out food triggers as well as foods that may improve your symptoms.

Should I take extra vitamins and minerals?

Yes, you should take a complete multivitamin with minerals.

If you take steroids or limit your intake of dairy products, you should also take extra calcium (500 mg, 3 times per day) and vitamin D (800-1000 IU per day).

If you are take sulfasalazine you may need to take folic acid.

Iron and vitamin B12 deficiencies are common with IBD, so you may need to have blood tests to measure these nutrients.

With prolonged diarrhea, you may also need magnesium, zinc and potassium supplements. An electrolyte drink, such as Drip Drop, may help add these nutrients back into your body.

Check with your doctor if you are concerned about your nutrition.

What about other supplements for treating IBD?

Prebiotics, probiotics, fish oil, and flaxseed oils may be helpful. 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 promote 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. They are referred to as the “good germs.” You can find them in products like yogurt and the label will say “Live, Active Cultures.” The brand, VSL #3 can help those with ulcerative colitis and pouchitis.

Vitamin D: Low Vitamin D may cause more severe IBD which puts patients at an increased risk for surgery, hospital stays, colon cancer, and C-diff infection. Taking a vitamin D supplement improves disease activity and quality of life.

Marine fish oils and flaxseed oil contain omega-3 fatty acids that may help IBD symptoms. If your body can handle fish, try eating fish like 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.

Talk to your doctor before starting any supplement.

To find out more about IBD, visit:

Teach Back

  • What is the most important thing you learned from this handout?

  • What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions, please contact UW Health at one of the phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.