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Bowel Disease: Changing Your Diet
Crohn's disease and ulcerative colitis are types of inflammatory bowel disease. They cause inflammation and sores (ulcers) in the digestive tract. This can lead to symptoms such as diarrhea, belly pain, loss of appetite, fever, bloody stools, and weight loss. Often symptoms are worse after eating.
If you have an inflammatory bowel disease, it may be hard to get important nutrients such as vitamins, minerals, and protein. Your intestines may not be able to take all the nutrients from the food you eat. You may lose nutrients through diarrhea. This can lead to problems such as anemia or low levels of vitamins, such as vitamin B12 and folic acid.
To control their symptoms, some people eat only bland foods, like pasta, and they avoid fruits and vegetables. But you need to eat a variety of foods to get the nutrients you need for good health. This topic can help you learn more about how to eat so you can manage your symptoms but still get the nutrition you need.
- Inflammatory bowel disease can make it hard to get the nutrients you need.
- It is important to eat a healthy, varied diet to help keep your weight up and stay strong.
- Some foods can make symptoms worse. Not eating these foods may help reduce your symptoms.
- No one diet is right for everyone with an inflammatory bowel disease. Keep a food diary to find out which foods cause problems for you. Then you can avoid those foods and choose others that supply the same nutrients.
- Because you may not be absorbing all the nutrients from the food you eat, you will need to eat a high-calorie, high-protein diet. This may be easier to do if you eat regular meals plus 2 or 3 snacks each day.
- You may need to take vitamin and mineral supplements to help get the nutrients you need.
How to eat when you have inflammatory bowel disease
No one diet is right for everyone with an inflammatory bowel disease. Foods that bother one person may not bother another. Your diet has to be tailored for you. But the following basic ideas can help you feel better and get the nutrition you need.
Find your problem foods
For many people, common problem foods include:
- Dairy products for people who are lactose-intolerant.
- High-fiber foods, such as raw fruits and vegetables, and whole grains. Often people have the most problems with gas-producing foods. These include beans, cabbage, broccoli, and onions, and foods with hulls, such as seeds, nuts, and corn.
- High-fat foods, such as fried foods, butter and margarine, mayonnaise, peanut butter, nuts, ice cream, and fatty cuts of red meat.
- Spicy foods.
- Foods with caffeine, such as chocolate and coffee.
- Carbonated drinks.
Find out your problem foods by keeping a food diary. As soon as you know what foods make your symptoms worse, your doctor or dietitian can help you plan a diet that avoids problem foods but gives you plenty of nutrients and enough calories to keep you at a healthy weight.
To make a food diary, get a small notebook and keep it with you. Make notes after each meal or snack.
- On the left side of the page, write down what you ate, about how much of each food you had, and what time you ate. Be honest—write down everything.
- On the right side of the page, note any symptoms you had and what time they occurred.
If you notice certain foods make your symptoms worse, talk to your doctor about these foods at your next visit.
Make smart food choices
During a flare-up, avoid or reduce foods that make symptoms worse. But instead of cutting out a whole group of high-nutrient foods, try replacing them with healthy choices.
- Choose dairy products that are low in lactose, such as yogurt or hard cheeses like cheddar. Or try drinking lactose-reduced milk.
- If you are having fat in your stools, choose low-fat foods instead of high-fat ones. For instance, some cuts of red meat have a lot of fat. A low-fat choice would be lean beef (such as sirloin, top and bottom round, chuck or diet lean hamburger), poultry, or fish, such as cod. Instead of frying foods, try baking or broiling them.
- Cook fruits and vegetables without hulls, skins, or seeds. Try different ways of preparing them, such as steaming, stewing, or baking. Peel and seed fresh fruits and vegetables if these bother you, or choose canned varieties.
Get the calories and nutrients you need
Your body may not be able to absorb all the nutrients it needs from the food you eat. To stay as healthy as you can:
- Eat a varied, nutritious diet that is high in calories and protein.
- Try eating 3 meals plus 2 or 3 snacks a day. It may be easier to get more calories if you spread your food intake throughout the day.
- Take vitamin and mineral supplements if your doctor recommends them.
- Try adding high-calorie liquid supplements, such as Ensure Plus or Boost Plus, if you have trouble keeping your weight up.
- Drink plenty of fluids. This can help you avoid dehydration, kidney problems, and gallstones.
- See your doctor or dietitian if your diet feels too limited or you are losing weight.
Other Works Consulted
- Decher N, Krenitsky JS (2012). Medical nutrition therapy for lower gastrointestinal tract disorders. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13th ed., pp. 610–644. St Louis: Saunders Elsevier.