Diet and IBD

Did my diet cause IBD?

No. IBD seems to be caused by a mix of genes and things that damage the lining of the intestine. Together, these cause the immune system in the intestine to be exposed to the bacteria of the intestine more than usual. Inflammation in the intestine of a healthy person lasts for a short time, and then goes away. In people with IBD, the inflammation does not go away, and it stays inflamed.

Is IBD caused by allergies to foods?

No. Although some people with IBD have allergies to certain foods, neither Crohn's disease nor ulcerative colitis is caused by food allergy.

Do certain foods make the inflammation worse?

No. Although certain foods can make the symptoms worse, there is no proof that inflammation of the intestine is directly affected by food.

Can IBD be cured with a special diet?

No. There is no proof that any diet will truly stop or prevent the inflammation of IBD.

Is there any diet that helps IBD?

Yes, an all-liquid diet of nutrients, called an elemental diet, has been shown to reduce inflammation in the intestines. However, most people cannot tolerate it because it is given overnight through a tube that runs through the nose to the stomach. There are other diets that reduce the amount of different types of sugars that cause bacteria to create gas in the intestine, which can lead to a lot of symptoms of pain, bloating, and cramping. The best proven diet is the FODMAP™ diet.

Do I need to avoid milk and dairy?

No. Lactose intolerance is not a part of IBD. So unless you have been told you have lactose intolerance, there is no reason to avoid milk and dairy products.

Are there foods I should avoid?

Many people with IBD are not able to tolerate certain foods. A food diary can help you figure out which foods bother you. During an IBD flare many people find that caffeine, alcohol, dairy, sweetened food, and foods high in fiber, increase their symptoms.

Do I need to avoid fiber?

About 70% of people with Crohn's disease of the small intestine develop a stricture (narrowing) of the intestine. When that happens, a low-fiber or low-residue diet may help to reduce abdominal pain and other symptoms. This diet reduces the amount of food that is cannot be digested (solid residue) in the stool.

What about vitamins and minerals?

It is a good idea for all people with IBD to take a standard multivitamin every day. People with IBD who are doing well do not need any extra vitamins or minerals. If you have Crohn's disease is in the ileum (the last part of the small intestine) or the ileum has been removed you may need to take B12, calcium, or vitamin D. You may need iron supplements if you have blood loss during inflammation or reduced iron absorption as a result of inflammation. Diarrhea or vomiting can cause loss of potassium and magnesium. If you are lactose intolerant and avoid dairy products, this can lead to low calcium. Ask your doctor if you need to be tested for any of the above.

Should I change my diet during a flare?

During a period of active inflammation, any food can make pain, bloating, cramping, and diarrhea worse. However, you still need to eat during a flare. You also need to drink plenty of fluids with salt and water so that you absorb and retain fluid. Many people switch to a bland diet or to an all-liquid diet during a flare. Bland foods like rice, toast, bananas, applesauce, and nutritional drinks like Carnation® Instant Breakfast™, Boost®, or Ensure® can help.

A low-residue diet limits the amount of fiber and other material that cannot be digested as it passes through your small intestine. A low-residue diet reduces the size and number of your stools and helps relieve abdominal pain and diarrhea.

What are some low-residue foods?

White (refined) breads, cereals and pasta (with less than 1 gram of fiber/serving), white rice, poultry, fish, eggs, oil, margarine, butter, mayonnaise, smooth salad dressings, broth-based soups (strained), jelly, honey, syrup.

What are some high-residue foods?

Whole-grain breads, cereals, and pasta, whole vegetables and vegetable sauces, whole fruits, including canned fruits, yogurt, pudding, ice cream, or cream-based soups with nuts or pieces of fruits or vegetables, tough or coarse meats with gristle and luncheon meats or cheese with seeds, peanut butter, salad dressings with seeds or pieces of fruits or vegetables, seeds or nuts, coconut, jam, marmalade.