Patient education: Diet for inflammatory bowel disease in adults (The Basics)

What is inflammatory bowel disease? — Inflammatory bowel disease, or "IBD," is a group of conditions that can affect the digestive tract (figure 1). The digestive tract is the part of the body that takes in and breaks down food. It includes the mouth, stomach, and intestines.

With IBD, the lining of the digestive tract becomes inflamed. The inflammation leads to symptoms, such as bloody bowel movements, diarrhea, lack of appetite, and weight loss. There are 2 types of IBD: Crohn disease and ulcerative colitis.

Do I need a special diet if I have IBD? — No specific diet or single food item has been proven to make IBD worse. But some people notice that certain foods seem to make their symptoms worse. For example, some people feel better if they avoid dairy foods like milk, yogurt, and cheese. Others might find that it helps to avoid foods that produce a lot of gas.

No specific diet works for everyone. The best diet for you will give you the nutrition your body needs and help you manage your symptoms. In general, eating a well-balanced, nutritious diet can help you feel good and keep a healthy body weight.

Talk to your doctor about your diet. Your doctor, nurse, or a dietitian (food expert) can help make sure that you are getting the nutrients you need. They can also help you with meal planning and talk to you about whether you need to take supplements.

What can I eat and drink if I have IBD? — It depends on whether or not you are having symptoms:

●You might need to eat differently when you have a "flare." (A flare is when your condition worsens and you have symptoms.)

●When you are not having symptoms, you probably will not need to change your diet as much. But you should still make healthy choices like limiting processed foods and sweets.

What can I eat and drink during a flare? — During a flare, some people feel better if they eat low-fat and low-fiber foods. Below are some examples of foods that might make you feel better.

●Grains – Breads and grains with less than 2 grams of fiber per serving. Examples are white bread, flour and corn tortillas, well-cooked white rice and white pasta, crackers, and cereal made from white flour or puffed rice or corn flakes.

●Dairy products – Low-fat and fat-free foods like milk, cheese, kefir, ice cream, and sherbet. Aged cheeses like cheddar, parmesan, provolone, and Swiss. Plain and flavored yogurt as long as there is no added fruit, nuts, seeds, or granola. Soy milk and products made with soy milk are better than other non-dairy alternatives.

●Meats and proteins – Lean, tender, well-cooked meats, chicken, and fish. Eggs, smooth nut butters, and tofu. Meats and proteins with no added fat.

●Fruits and vegetables – Fruits and vegetables, but do not eat the seeds, skins, or membranes. Fresh, canned, and cooked fruits and vegetables like bananas, applesauce, peaches, plums, melons, carrots, green beans, spinach, zucchini, cucumbers, squash, and potatoes. Fruit and vegetable juices without pulp.

●Fats and oils – Vegetable oils like canola, olive, and peanut oils. Choose oils more often than solid fats.

What foods and drinks should I avoid during a flare? — During a flare, some people feel better if they avoid high-fat and high-fiber foods. Below are some examples of foods that might make you feel worse.

●Grains to avoid – Whole-wheat and whole-grain breads, tortillas, pastas, and cereals. Brown rice, quinoa, kasha, barley, and popcorn. Cereals like oatmeal, bran flakes, and shredded wheat.

●Dairy products to avoid – Whole-milk and whole-milk products. Yogurt and ice cream with added fruit, nuts, or granola.

●Meats and proteins to avoid – Chunky nut butters, hummus, and beans and other legumes. Dried peas and lentils. Meat, poultry, and fish that is fried, fatty, stringy, or tough to chew, or that has gristle. Seafood with a tough or rubbery texture like shrimp and scallops. Processed meats like sausage, bacon, or hot dogs.

●Fruits and vegetables to avoid – Raw or undercooked fruits or vegetables. Fruits and vegetables with skin or seeds. Salads and leafy greens like kale and collard greens. Fruit and vegetable juices with pulp. Vegetables that commonly cause gas like broccoli, cauliflower, Brussels sprouts, and cabbage. Pineapple, corn, peas, dried fruits, berries, and foods or juices with these things in them.

●Other foods and drinks to avoid – Fried foods, sugar alcohols like sorbitol, and high-fructose corn syrup. High-fat desserts like pastries, cookies, cakes, and pies. Drinks with caffeine like coffee, tea, cola, and energy drinks.

What else should I know? — To help with your symptoms, you should also:

●Keep track of the foods you eat and any symptoms you have. This can help you find out which foods might make your symptoms worse.

●Eat smaller meals more often, and do not skip meals.

●Quit smoking, if you smoke. Smoking can make symptoms worse.

●Drink plenty of fluids to stay hydrated.

●Try to get regular physical activity. Even gentle forms of activity, like walking, are good for your health.

●Avoid medicines such as ibuprofen (sample brand names: Motrin, Advil) and naproxen (sample brand name: Aleve).

More on this topic

Patient education: Crohn disease in adults (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Low-fat diet (The Basics)
Patient education: Low-fiber diet (The Basics)

Patient education: Crohn disease (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)