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Nutrition Tips for Inflammatory Bowel Disease(Crohn's and Colitis) You Must Know About

Inflammatory Bowel Disease (IBD) is a term used for two specific and separate diseases: Crohn’s disease and ulcerative colitis. Nutritional recommendations are different for each disease and for each individual patient. It is important to discuss the treatments that are right for you with a registered dietitian and with your doctor.

Disease Definitions

  • Crohn’s disease — Crohn’s disease is a chronic inflammatory disease of unknown cause that can involve any portion of the digestive tract. Inflammation can extend entirely through the intestinal wall, often resulting in diarrhea, strictures (narrowing), fistulas (abnormal opening), malabsorption and the need for surgical resections of portions of the digestive tract.
  • Ulcerative colitis — Ulcerative colitis is an inflammatory disease of the colon, or large intestine, which is often accompanied by bloody diarrhea. This inflammation does not go through the entire wall of the intestines and therefore does not result in fistulas. However, extensive inflammation may eventually require surgery for removal of the affected area.

FAQ: Dietary Management of IBD

Information regarding dietary treatments for IBD is often confusing. Many people receive information telling them to avoid entire food groups or specific foods. However, there is no need to avoid foods unless they worsen your symptoms. It is best to restrict as few foods as possible to increase the chances that you are getting a balanced, nutritious diet. This is important for maintaining the function of your digestive tract and your overall health.

Can diet control IBD?

No specific diet has been shown to prevent or treat IBD. However, some diet strategies help control symptoms. See information below for diet strategies that may be appropriate for you.

How can I identify problem foods?

Keeping a record of foods eaten and then taking note of when symptoms worsen may help you identify patterns that indicate problem foods.
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What are dietary strategies for managing symptoms and when are they appropriate?

There are different approaches to diet during flares and in the absence of flares. Regardless of disease, do not overly restrict your diet. Adequate nutrition during illness is important. See below for specific recommendations.

Diet Recommendations for Ulcerative Colitis Flare

  • Follow a low residue diet to relieve abdominal pain and diarrhea.
  • Avoid foods that may increase stool output such as fresh fruits and vegetables, prunes and caffeinated beverages.
  • Decrease concentrated sweets in your diet, such as juices, candy and soda, to help decrease amounts of water pulled into your intestine, which may contribute to watery stools.
  • Decrease alcohol consumption.
  • Try incorporating more omega-3 fatty acids in your diet. These fats may have an anti-inflammatory effect. They are found in fish, including salmon, mackerel, herring and sardines.
  • Patients often find that smaller, more frequent meals are better tolerated. This eating pattern can help increase the amount of nutrition you receive in a day.
  • Consider taking nutritional supplements if appetite is poor and solid foods are not tolerated well (see section on recommended liquid supplements).

Diet Recommendations for Crohn’s Disease Flare

  • Follow a low residue diet to relieve abdominal pain and diarrhea.
  • If you have strictures, it is especially important to avoid nuts, seeds, beans and kernels.
  • Avoid foods that may increase stool output such as fresh fruits and vegetables, prunes and caffeinated beverages. Cold foods may help reduce diarrhea.
  • If you have lactose intolerance, follow a lactose-free diet. Lactose intolerance causes gas, bloating, cramping and diarrhea 30 to 90 minutes after eating milk, ice cream or large amounts of dairy. A breath hydrogen test may confirm suspicions of lactose intolerance.
  • If you have oily and foul-smelling stools, you may have fat malabsorption. Treat fat malabsorption by following a low-fat diet. Discuss these symptoms with your doctor or nutritionist.
  • Smaller, more frequent meals are better tolerated and can maximize nutritional intake.
  • If your appetite is decreased and solid foods not tolerated well, consider taking nutritional supplements (see section on recommended liquid supplements).

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