Specific foods don’t cause or trigger Crohn’s disease. You may need to use trial and error to see what helps (or hurts) your symptoms.
What, and how, to eat
by Amanda MacMillan
Crohn’s disease is a chronic, incurable inflammatory bowel disease (IBD). Symptoms include severe belly pain and diarrhea, among others.
Certain foods or eating habits can exacerbate Crohn’s disease symptoms, although they aren’t the underlying cause or trigger of the IBD, says Sunanda Kane, MD, professor of gastroenterology at the Mayo Clinic, in Rochester, Minn.
Each person is different, so you may need to use trial and error to see what types of food or eating habits help (or hurt) your symptoms.
Talk to a nutritionist
If you have Crohn’s disease and are concerned about your nutrition, it would be a good idea to talk with an RD, especially one who is familiar with IBD, says Julie Cepo, a registered dietitian who works with IBD patients at Mount Sinai Hospital, in Toronto, and is coauthor of the Crohn’s & Colitis
Write it down
Keep track of everything you eat, how you feel after you eat it, and the status of your disease to determine what types of food worsen your IBD symptoms. Because it’s different for every person, writing everything down is the best way to learn what your body can and can’t process.
Eat small, frequent meals
Portion control is important, because eating too much at one time can make it hard for the body to digest food.
Small, frequent meals can help. You can still eat three meals a day, but make them a bit smaller than usual, and supplement them with several well-balanced snacks in between.
Go easy on the grease
Fatty food can be hard for the body to digest and make diarrhea worse, especially if you’ve had certain parts of your bowel removed during surgery for Crohn’s disease. (Plus certain fats are bad for your heart.)
Try a reduced-fiber diet
Doctors and nutritionists may recommend a low-fiber diet (avoid whole-wheat and whole-grain products and unrefined flours) for those having a flare-up, healing after surgery, or experiencing bowel narrowing due to inflammation or scar tissue.
Be careful with dairy
Just like the general population, lots of people with Crohn’s disease have some level of lactose intolerance. The conditions are usually unrelated, but they do share many of the same symptoms.
For these people, dairy may explain some of the pain and GI problems associated with IBD.
Corn, beans, and stringy vegetables like raw celery and broccoli aren’t easily digested; in Crohn’s they can cause cramping, bloating, and diarrhea.
“We call it roughage, and it’s rough on your system,” says Dr. Kane. “For a healthy intestine, that is a good thing, but for an inflamed one, it can be bad. Having to process things that are still intact will make some people really uncomfortable.”
Prep foods in a new way
Many foods that are a problem when raw or whole can be eaten if prepared differently, says Cepo. “We try to focus on what people can still have; often that means cooking foods well, like string beans, cauliflower, or carrots and sweet potatoes.”
Water intake is always important, but critically so if you have frequent diarrhea.
Cepo cautions patients to limit beverages with caffeine, carbonation, or too much sugar—all things that can make GI symptoms worse.
Pump up your electrolytes
Replenish lost electrolytes like sodium and potassium if you’re having loose stools. “One option is to sprinkle salt liberally on your food,” says Cepo. You can also sip broths or bouillons, and choose salty snacks like pretzels, crackers, rice cakes, or potato chips
Don’t skimp on protein
People with Crohn’s disease often give up meat, beans, and cheese. But without protein, you can lose muscle mass.
“People say to me, ‘I gave up red meat because I can’t digest it,’ but it’s because they’re trying to eat a normal American-size helping of steak or a giant burger,” says Dr. Kane. “I tell them to eat 6 ounces of really good quality red meat; that way they’ll get the iron and protein they need without overdoing it.” Fish, tofu, beans, and eggs, if they’re well tolerated, are also good protein sources.
Season with ground spices
Spicy food can be a problem, but that’s no reason to ban all herbs and spices from your kitchen. “I see spice as an important part of any diet, especially since one of the side effects of IBD is having a depressed appetite,” says Cepo. “Anything we can do to stimulate people’s interest in food is a good thing.”
Consider a liquid diet
Although it’s not a long-term solution, people with Crohn’s—especially those with intestinal blockages who are unable to process solid foods—can try a temporary liquid diet.
A liquid diet can give the intestines a rest, which can help suppress symptoms. However, this diet should be carefully planned with your doctor to ensure you’re getting all the right nutrients.
Supplement with vitamins
All people with IBD should take a multivitamin, says Dr. Kane, because they’re probably not getting all the nutrients they need.
People who avoid dairy should also consider taking about 1,500 milligrams of calcium with 800 IU of vitamin D daily. Those who have had small-intestine surgery probably need extra vitamin B12, too.
Eat normally when you’re well
In between Crohn’s flare-ups, if you’re feeling better, eat normally and enjoy your food.
“It can be hard for someone, knowing that the last time they ate celery they had a terrible experience, but it may be tolerated again when the disease is in remission,” Cepo says. “Working with a dietitian or a doctor can help you build back up confidence and improve that relationship with food.”