How to Eat an Inflammatory Bowel Disease Diet

Co-authored by Erik Kramer, DO, MPH

Last Updated: July 20, 2021 Approved

Inflammatory Bowel Disease (IBD) is a broad term used to diagnose chronic inflammation of the gastrointestinal tract. Its two most common forms are ulcerative colitis and Crohn's disease. IBD is generally much more acute and serious than Irritable Bowel Syndrome (IBS), which affects the colon muscle's ability to contract.^{[1]
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Trustworthy Source

Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

Go to source} In IBD, the inflammation of the lower intestines often prevents food from being fully digested and stops the body from gaining nutrients from food. Symptoms include diarrhea, vomiting, chronic pain and cramping in the abdominal muscles, fever, and rectal bleeding. Although there is no known cure for IBD (and you should always seek treatment from a doctor if you have these symptoms), modifications to your diet may help ease some of your pain.

Method 1

Method 1 of 3:

Common Trigger Foods

1
Keep a food diary. Although IBD is not caused by your diet, certain foods may trigger painful inflammation in your intestines if you have this disease. It is important to know which foods cause symptoms like vomiting and diarrhea.^{[2]
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Mayo Clinic
Educational website from one of the world's leading hospitals

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- In your diary, note the date and what you have eaten anytime you have a flareup of symptoms. Over time, you should get a sense of what causes your symptoms and which foods do not.
- You may also experience symptoms such as fatigue, pain in your joints, weight loss, or anemia (the loss of red blood cells).
- Keep in mind that diet and IBD is very personal; your doctor may have some general guidelines, but what works for one patient—or even an entire sample study of patients—may not work for you.
2
Avoid dairy products. Many patients with IBD report experiencing diarrhea when they consume dairy products such as full fat milk, cheese (especially high fat soft cheeses), yogurt, and ice cream.^{[3]
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Mayo Clinic
Educational website from one of the world's leading hospitals

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- Being lactose intolerant (or incapable of consuming dairy) is often a complication of Crohn's disease and ulcerative colitis.
- If you are lactose intolerant, consider using a supplement such as Lactaid which can help minimize irritation if you consume dairy products. You may also want to switch to a non-dairy alternative, such as soy or almond milk.
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3
Be wary of fiber. Although it is commonly believed that fiber can help relieve digestive problems, many patients with IBD report that foods high in fiber can exacerbate their symptoms. Many fruits and vegetables are high in fiber, but there are ways you can incorporate them into an IBD diet.^{[4]
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- Cook vegetables thoroughly. When fruits and vegetables are thoroughly cooked, they are easier to digest than in their raw form.
- Remove the skin from fruits and vegetables. The skin has insoluble fiber in it, so you might need to peel the skin from your fruits and vegetables before consuming them.^{[5]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  
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- Avoid vegetables that can cause gas. These include broccoli, cabbage, cauliflower, and brussels sprouts. Gas will only further irritate your intestines if they are already inflamed.
- If consuming vegetables in their natural form is too irritating, consider using vegetable stock instead. You can add this to rice or pasta to add flavor and nutrients. It often has the same nutritional value as whole vegetables, but is generally easier to digest.
- Avoid nuts. Nuts are very high in fiber and can be especially difficult to digest.
- Pick better grains. If you are having a flare up of symptoms, avoid whole grains and breads like rye and whole wheat. Processed grains will be easier to digest. Look for breads like sourdough and French bread instead.
4
Avoid fatty foods. If you are suffering from a flareup of symptoms, fatty foods can make your diarrhea and abdominal pain even worse. Avoid consuming butter, margarine, and greasy or fried foods when you are having an attack.^{[6]
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Research source} Be especially careful of foods high in saturated fats, such as pastries, processed meats or fatty red meats, coconut oil, and full-fat dairy.^{[7]
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- Watch out for pastas that have cream sauces, or foods that have been baked with cream cheese or sour cream. These also add extra fat into your system.
- Avoid fried foods, like French fries, doughnuts, hush puppies, and fried chicken, fish, or shrimp.
- It’s especially important to avoid fatty foods if you have inflammation in the small intestine.
5
Avoid non-absorbable sugars. These are frequently found in artificially sweetened candy and gum. These ingredients usually end with the letters -ol.^{[8]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

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- Common culprits include sorbitol, mannitol, xylitol, and maltitol.
- If you’re concerned about avoiding sugar, some artificial sweeteners may be still okay for you to eat. For instance, non “-ol” sweeteners such as sucralose and aspartame are less irritating alternatives.
6
Avoid FODMAPs. Short for Fermentable-Oligo-Di-Monosaccharides and Polyols, these are sugars that can be found in some carbohydrates. ^{[9]
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Expert Source

Roy Nattiv, MD
Board Certified Gastroenterologist

Expert Interview. 18 December 2020.}They include things such as:
- Fructose (commonly found in honey and corn syrup)
- Certain fruits, such as apples, apricots, pears, plums and blackberries
- Sugars commonly found in cereals and pre-packaged granolas
- Lactose from dairy products
7
Avoid carbonated beverages. These can also cause extra air to get into the digestive tract, causing more gas and irritation. Many people with IBD report that drinking soda makes their symptoms worse.^{[10]
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- Similarly, avoid drinking beverages with a straw as this can introduce extra air into your stomach and intestines.^{[11]
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Method 2

Method 2 of 3:

Healthy Food Choices

1
Be sure to hydrate. Because diarrhea frequently causes dehydration, it is crucial to stay hydrated when you have IBD.^{[12]
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Research source} Drink at least 8 glasses of water every day, or 64 fluid ounces (1.9 L). Foods that have a high water content (like watermelon) can also count toward this minimum.
- If you have a severe attack of diarrhea, you are likely to lose electrolytes. In these cases, you might need to consume beverages such as Pedialyte or Gatorade to help replenish them. If you are consuming sports drinks or fruit juices that are high in sugar, you may need to dilute them with water or look for a low-sugar version. Fill half of the glass with juice and the other half with water.
- Moderate your intake of caffeinated drinks like coffee and tea as well as alcoholic drinks as these can make diarrhea worse.^{[13]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
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2
Incorporate protein. Protein is an excellent source of vitamins, zinc, iron, and other nutrients. If you are recovering from a flareup, then consuming protein is a good method for restocking lost nutrients.^{[14]
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- Choose lean proteins like poultry, lean cuts of pork, and fish as opposed to fatty forms of red meat, like hamburger or brisket.
- Smooth nut butters like peanut and almond butter are also a great way to get the protein of nuts without the irritation of eating them whole.
3
Add probiotics to your diet. Probiotics are active microorganisms that can help encourage digestive health. They are commonly found in foods like yogurt. Talk to your doctor first before incorporating probiotics into your diet, as many IBD patients have had mixed results from their use.^{[15]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

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- Your doctor may suggest taking a probiotic in a supplement form if you want to avoid lactose products, such as yogurt.
4
Eat smaller meals more frequently. Because your digestive tract is in a sensitive state with IBD, it is best to eat 4 to 6 small meals a day as opposed to 2-3 large meals.^{[16]
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Mayo Clinic
Educational website from one of the world's leading hospitals

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- Make pre-portioned snacks and meals to take with you throughout your day, especially if you are traveling.
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Method 3

Method 3 of 3:

Supplemental Treatments

1
Incorporate vitamins and other nutrients. Diseases like Crohn's or ulcerative colitis can deplete the body of vital nutrients we normally take in from food. Talk to your doctor about which kinds of vitamins you should focus on reintroducing, either through food or through supplements.^{[17]
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Research source}
- You might want to avoid taking vitamin supplements in pill form as these can be difficult to digest. Instead, try to take vitamins in a powder or liquid (isotonic) form.^{[18]
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  University of California San Francisco Health Center
  Research hospital associated with UCSF, a leading medical university, providing innovative patient care and public health resources
  
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- Check the ingredients on the vitamin before you consume it. Some vitamins contain non-absorbable sugars or other ingredients that could actually worsen your symptoms.
- Do not consume vitamins on an empty stomach. It's always best to take them with food.
- Many patients with IBD have deficiencies in zinc, iron, calcium, and folic acid. Talk to your doctor if you need extra supplements in these areas.
- Avoid taking excessive single vitamins or minerals like vitamin A, D, or E. they are fat-soluble and can be stored in the body, possibly causing toxicity.
2
Exercise regularly. Low to moderate forms of exercise have been shown to be beneficial for IBD patients. In addition to releasing positive endorphins, which enhance your mood, exercise can help strengthen your muscles and joints, which are often weakened by IBD. An exercise session of 30 minutes, 3-4 times a week, will benefit your cardiovascular system and your overall health.^{[19]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

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- Moderate forms of exercise include walking, jogging, biking, swimming, yoga, and gardening. If you are going for a walk, you might want to plan a route that includes a bathroom stop.
- Know your limits. If you are experiencing a flareup of symptoms and cannot eat or are experiencing fatigue, take it easy until your symptoms have calmed down.^{[20]
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- IBD often results in joint pain. If you’re not sure how to exercise without irritating your joints, ask your doctor or a physical therapist to recommend low-impact options, such as water aerobics or gentle stretches.
3
Talk to your doctor if you’re depressed. IBD can be a frustrating and difficult condition to live with. Some patients experience depression as a result of the physical pain and the difficulties of managing a diet with IBD. Be sure to talk to your doctor if you feel yourself becoming moody, irritable, or experience constant crying, a feeling of helplessness, or a disconnection from activities that you normally love.^{[21]
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Mayo Clinic
Educational website from one of the world's leading hospitals

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- Your doctor may refer you to a psychiatrist for treatment. You might undergo a course of cognitive behavioral therapy, medication, or a combination of both.
- Search online for support groups. Speaking with others who can relate to what you're going through may help.
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