What to eat with IBD

Pamela Haddad, RD, MS

Pamela Haddad, RD, MS

Whether you are newly diagnosed or a long time patient with Inflammatory Bowel Disease (Crohn’s disease or Ulcerative Colitis), you most likely have or will have questions about your diet. Many of my clients that I have worked with over the years have told me that they have heard that they should eat whatever they like and to not restrict any specific foods, because diet has no effect on the disease.

I want to tell you that this not necessarily true. We have learned much about the role of and the importance of diet and nutrition when it comes to IBD. Paying attention to what you eat can have a major impact on your healing. Nutritious food choices are essential to everyone’s good health, but for the individual with a chronic illness such as IBD, eating a well-balanced diet can be a challenge and is crucial to recovery. We know that diet alone does not cause IBD, but giving attention to your diet can certainly help lessen the severity of some of the symptoms and help in the healing process. The high incidence of poor nutrition and weight loss that is associated with IBD is not only due to malabsorption in the inflamed diseased gut and the pain, nausea and diarrhea, but also due to the fear of eating that is brought about by these symptoms.

Here are some basic tips that you may want to consider to help lessen the severity of some of the symptoms of IBD:

  • Eat small frequent meals (large meals cause bloating)

  • Avoid processed sugar and processed foods as much as possible

  • Choose foods with as few ingredients as possible

  • Chew food completely for better digestion

  • Avoid artificial sweeteners, sugar free mints, gum

  • Avoid using a straw (can cause bloating)

  • Avoid or limit carbonated beverages

  • Limit or avoid caffeine

  • Avoid spicy or fried/ greasy foods

  • Drink plenty of fluids to prevent dehydration

  • Try a low/no sugar, wheat free or grain free diet

 

When you are in the midst of a flare up, I would recommend that you choose more soothing type foods. This would involve peeling and cooking all fruits and vegetables, avoiding high fiber, whole grain breads and cereals and sticking to lower fat meats such as fish and poultry. Eggs are a good source of protein as well. If you tolerate dairy, choose aged cheese, homemade 24 hour fermented yogurt and farmer’s cheese, which are lactose (milk sugar) free.  It is best to avoid nuts and seeds during a flare up, since they can be irritating and hard to digest. Creamy nut butters are ok.  This may sound like the opposite of what we consider to be a healthy diet because of the reduction in fibrous foods, but when the gut is inflamed and ulcerated it is better to stick to lower fiber, lower residue foods.

There are other types of dietary intervention that have become more popular and found to be very helpful. You may have heard of a few of them, the SCD (Specific Carbohydrate Diet), GAPS or Paleo diet. The theory or reason behind these diets is what we call “leaky gut”, which involves the small intestine. Our small intestine contains microscopic pores to let the nutrients from our digested food into the bloodstream, where they can be carried to various parts of the body for energy. These pores are small enough to let nutrients through into the blood stream and keep waste out. To better understand this, picture a window screen, which lets the air in, but keeps the bugs and dirt out. If the screen becomes damaged or torn, then unwanted debris can come into the home.

When you have a leaky gut, this means the pores in your small intestine are wider than normal. This allows undigested food particles and waste that is supposed to be blocked, to make its way into the bloodstream. These are not supposed to enter our bloodstream and are seen as foreign invaders. The immune system starts to attack and ends up damaging healthy cells as well. This can cause the inflammation that is seen in autoimmune disease such as IBD.

There is no known single cause of leaky gut. There may be many factors, such as overgrowth of unhealthy bacteria, allergies and genetics.  A change in diet can address many of these possible causes.  Some of the basic recommendations include the avoidance of processed sugar and most grains, the inclusion of fruits and veggies, healthy fats, meats from pasture raised animals and naturally cultured /fermented foods. Homemade broths or stocks (bone broth) from chicken or beef bones can also be very healing and nutritious.

The most important advice I can leave you with here is that eating a balanced, nutritious diet is what is most important.  Good nutrition aids in the healing process and helps to maintain and increase energy. I would not recommend unnecessarily eliminating certain foods from your diet until you understand more about your specific nutrient needs. These suggestions are just a start and you may want to investigate more as to how you could incorporate these various dietary guidelines into your daily eating.

Pamela Haddad is a Registered Dietitian with a private practice in Farmington Hills, MI.  She specializes in providing nutrition counseling for a variety of nutrition related conditions that include Weight Management, Diabetes Management and Gastrointestinal disorders.  For more information visit her website at www.pamshealthyway.com.