Nutrition and Inflammatory Bowel Disease
Both Ulcerative Colitis and Crohn’s Disease have direct involvement on the gastrointestinal tract and may have a profound affect on nutritional status. Dietary management involves a combination of increasing intakes of nutrients to replenish losses and prevent malnutrition while also restricting those foods that may worsen symptoms in order to facilitate healing.
Frequently asked Questions
Can diet control IBD?
Research has not shown that any specific diet will prevent or treat IBD, but there are some ways to help control certain symptoms. More details are described below.
How can I identify problem foods?
It is very helpful to keep a food diary of the foods that are eaten and noting when you have worsened symptoms. This will help you identify problem foods.
What are ways that I can manage symptoms through diet?
The most important thing to remember is to not overly restrict your diet because adequate nutrition is very important. There are approaches to managing symptoms during flare-ups and the absence of flare-ups. The recommendations for these are listed below.
Ulcerative Colitis Flare
Crohn’s Disease Flare
Diet Progression Following Flares for both Ulcerative Colitis and Crohn’s Disease
What is a Low-Residue Diet?
A low residue diet is designed to reduce the frequency and volume of stools while prolonging intestinal transit time. It restricts foods that increase bowel activity such as milk and milk products and prune juice. A low residue diet typically contains less than 10-15 grams of fiber per day. This is a diet that is meant to be followed only during flare-ups and is not meant to be followed long-term as it restricts many healthy foods that contain essential nutrients.
Foods to Avoid:
Suggested “First Foods” after a flare:
Are there any drug-nutrient interactions I need to be concerned about?
IBD flare-ups are often treated with corticosteroids (prednisone), cholestyramine, and 5-ASA compounds (Sulfasalazine).
*Be sure to talk to your doctor before starting vitamin and mineral supplements.
How does surgery affect nutritional status?
Surgery is sometimes needed for patients with severe inflammation, fistulas, strictures and abscesses. In ulcerative colitis the colon is removed and the ileum is then attached to the anus. In Crohn’s the part that is removed depends on the location of the digestive tract that is affected.
When parts of the small or large intestine are removed or inflamed it results in decreased absorption of essential nutrients. Therefore, it is not uncommon for people to become malnourished or have nutrient deficiencies during severe inflammation or after surgery. It is important to talk to your doctor or Registered Dietitian about which vitamins and mineral supplements you may need to take.
What are some factors that may affect nutritional status in IBD patients?
What are the specific nutritional needs for people with IBD?
Everyone is different and therefore have different nutritional needs based on body size, gender, age, activity level and disease state. Here are some general guidelines.
Are there specific nutrient deficiencies to be concerned about?
People with IBD may have deficiencies in certain vitamins or minerals based on medications and the extent of diarrhea and blood loss. With Crohn’s, nutrient deficiencies may be related to the portion of the intestine that is affected. Talk to your doctor or a dietitian if you have concerns about deficiencies. Increase your intake of nutrient-rich foods or use supplements to meet nutritional needs.