If you have Crohn’s disease, you probably have found that certain foods trigger your intestinal symptoms, especially when the disease flares. Learning to avoid these food triggers may allow you to better self-manage your Crohn’s disease, reduce gastrointestinal symptoms, and promote intestinal healing.
Crohn’s disease is a type of inflammatory bowel disease (IBD). It can certainly cause issues when it comes to choosing what you eat and drink. Not only does the condition cause digestive tract inflammation and uncomfortable symptoms, but long-term consequences can even include malnutrition.
Foods do not cause Crohn’s disease and no special crohn’s disease diet has been proven effective in treating it. However, certain foods may cause flare-ups in Crohn’s disease symptoms for some people. Some foods that are more likely to cause symptoms are foods high in dietary fiber and fat, dairy and carbonated beverages.
To make matters more complicated, your dietary habits may worsen symptoms. While there’s no cure-all diet known for Crohn’s, eating and avoiding certain foods may help prevent flare-ups.
During a flare-up, the Crohn’s and Colitis Foundation recommend avoiding potential triggers. A person should eat foods that are soft and bland, but sufficiently nutritious.
There’s not a specific diet for Crohn’s disease,” she says. “Foods that might be a problem for one person can be totally fine for others.” And while there isn’t much research about Crohn’s and crohn’s disease diet, there are some usual suspects you might want to avoid when your gut is giving you grief.
Research has been unsuccessful at determining what specific foods are the culprit for everyone with this condition. Bottom line: there’s no one diet to alleviate Crohn’s disease. Yet, important steps in treatment for Crohn’s include keeping a detailed food diary, avoiding foods that cause symptoms and consulting with a registered dietitian nutritionist experienced in digestive health.
Following a healthy balanced diet and maintaining a healthy weight is important. Diet can also play an important role during a flare-up of Crohn’s disease, helping to alleviate symptoms, helping to maintain a healthy weight, and helping to prevent nutritional deficiencies.
Crohn’s Disease Diet
What Is a Crohn’s Disease Diet Plan?
You’ve probably read about different types of crohn’s disease diet. But the fact is, there is no scientifically proven diet for inflammatory bowel disease. Most experts believe, though, that some patients can identify specific foods that trigger their gastrointestinal symptoms, particularly during disease flares. By avoiding your “trigger foods,” you may find that your GI symptoms of gas, bloating, abdominal pain, cramping, and diarrhea are more manageable. At the same time, you will give your inflamed intestines time to heal.
This is even more important when you have a flare-up of your Crohn’s symptoms. Spicy or greasy foods, whole grains, high-fiber fruits and vegetables, nuts and seeds, caffeine, and alcohol can all be harder on your body during a flare-up.
If you have had problems absorbing nutrients due to Crohn’s disease, it’s important to follow a high-calorie, high-protein diet, even when you don’t feel like eating. In this setting, an effective Crohn’s disease diet plan, based on recommendations from experts, would emphasize eating regular meals — plus an additional two or three snacks — each day. That will help ensure you get ample protein, calories, and nutrients. In addition, you will need to take any doctor-recommended vitamin and mineral supplements. By doing so, you will be able to replenish the necessary nutrients in your body.
Crohn’s Disease: Foods to Avoid
Taylor emphasizes that you shouldn’t try to manage the disease with food alone. “Crohn’s isn’t something you can cure with crohn’s disease diet– you need to have a health care team treating this,” she says. “But if you’re having a flare-up, these are some foods you might want to avoid.”
The high amounts of fiber in foods like whole-grain bread, whole-wheat pasta, popcorn and bran can cause a lot of traffic through the gastrointestinal tract. “That can be irritating to someone experiencing a disease flare,” Taylor says.
Beans are a wonderfully nutritious food — when you’re feeling good, Taylor says. But during a flare, their high fiber content and tendency to cause gas is a lose-lose.
High-fiber fruits and vegetables
“Some people think they can’t eat vegetables with Crohn’s, and that’s not true,” Taylor says. “But you do have to be careful during a flare.” Aim for cooked veggies rather than raw to avoid irritating your gut. And avoid fruits and vegetables with skins and seeds intact.
Many people find that bananas or canned pears are gentler than an apple or bowl of raspberries, for instance. Also steer clear of gassy veggies like broccoli, cabbage and Brussels sprouts. “They’re high in fiber and gas-producing — kind of a double whammy,” Taylor says.
Nuts and seeds
Nuts and seeds can be rough — literally. Their sharp edges can be irritating to the lining of the GI tract. “But people often tolerate ground nuts or seeds,” Taylor says, so consider giving smooth peanut butter or sesame tahini a try.
Alcohol and caffeine
Alcohol can be irritating to anyone’s GI tract, especially people who are already experiencing stomach symptoms. That goes for all types of drinks, Taylor says. “Beer, wine and liquor are not great choices if you’re having symptoms.”
Caffeinated drinks, too, can be a problem. “Caffeine increases the wave-like motion of the GI tract, which is what propels waste through the system,” she says. “If you tend to have diarrhea with your Crohn’s flare, caffeine is not your friend.”
Sugary drinks like soda, fruit juice and lemonade can also cause more diarrhea when you’re having a flare-up. So-called “sugar alcohols” are also a problem. These are sweeteners used in sugarless gum, candy and some drinks.
They go by names like xylitol, sorbitol and maltitol, which are listed on the nutrition facts label. “In many people, these ingredients are poorly absorbed, which can cause gas, bloating and diarrhea,” Taylor says.
Contrary to popular belief, many people with Crohn’s can actually consume dairy products without grief, Taylor says. But when you have symptoms, whole-fat dairy products (like whole milk, ice cream and sour cream) can be a problem, so step away from the fettuccini alfredo.
Odds are, you won’t be tempted to reach for the hot sauce if you’re having Crohn’s symptoms. “Most people who have a flare aren’t eating spicy chili or burritos,” Taylor says. Trust that instinct. Spices like chili powder, cayenne pepper and spicy curries can add heat to an on-fire GI tract.
Greasy, fatty foods
“It’s hard for your body to deal with the amount of fat in fast food and other greasy, fatty foods like sausage or salami,” Taylor says. Save the drive-through for another day.
What to Eat During a Flare
Refined grains have less fermentable fiber than whole grains, so they pass more quickly through the digestive tract. They tend to be easier on the gut and less likely to cause inflammation.
Examples of refined grains include:
- white breads
- white rice
- plain crackers
- rice snacks
Ready-to-eat cereals that are low in fiber are also a good option.
Also, fortified refined grains contain added essential nutrients, such as vitamins and minerals, so a person should look for fortified products.
Many breads, for example, are fortified with iodine and folate. Manufacturers also tend to fortify ready-to-eat cereals with:
- vitamins A, C, and D
Fruits and Vegetables
Fruits and vegetables have numerous health benefits, but they may cause problems for the same reason as whole grains: high insoluble fiber content.
Instead of avoiding fruits and vegetables entirely, you can still reap some of their benefits by processing them differently. For example, baking and steaming fruits and veggies can make them more easily digestible, although this process can also remove some of their important nutrients, especially water-soluble vitamins and enzymes.
You may want to talk to your doctor and dietitian about ways to prevent any deficiencies.
Fruits and veggies to try:
- steamed or well-cooked vegetables
- peeled cucumbers
- bell peppers
Oatmeal made from quick or rolled oats is a type of refined grain, with slightly less fiber than steel-cut oats. Manufacturers produce oats by removing the hulls.
When experiencing a CD flare-up, it is best to avoid foods containing insoluble fiber, which can worsen symptoms of diarrhea.
Oatmeal contains a soluble fiber called beta-glucan. It can help ease diarrhea by absorbing water in the intestines, forming a gel, slowing digestion, and adding bulk to stool.
Try adding oats to smoothies that contain peeled, low-fiber fruits. Breaking down food in a blender makes digestion easier.
Protein and Meat
When it comes to Crohn’s flare-ups, your protein selections should be based on fat content. Opting for proteins with lower fat is a better choice.
Proteins to eat:
- pork tenderloin
- peanut butter
- white meat poultry
- tofu and other soy products
Low-fiber fruits are easy on the digestive system, and they can help control diarrhea.
- honeydew melon
The amount of fiber in a piece of fruit changes as it ripens. Ripe fruits generally have less fiber than unripe fruits.
However, during a CD flare-up, it is always best to eat fruit in small servings.
While other people with Crohn’s may be able to have a glass of milk here and there with no problems, you may not tolerate dairy very well.
Instead, try eating dairy substitutes, which are widely available in food shops and supermarkets.
Dairy or dairy alternatives to try:
- dairy substitutes such as milk, yogurt, and cheese made from plants like soy, coconut, almond, flax, or hemp
- low-fat fermented dairy like yogurt or kefir
Cooked and Peeled Vegetables
Many vegetables are high in fiber, but as with fruit, peeling them removes a layer of insoluble fiber.
Some vegetables do not need peeling, such as asparagus tips and mushrooms, but it can help to remove the skins of potatoes, carrots, and squash.
Cooking vegetables also makes them easier to digest, and it can reduce the fiber contents.
However, avoid roasting or frying vegetables in oil or butter, because fats can irritate the digestive system and worsen symptoms of Crohn’s. Try boiling or steaming them instead.
Oily fish contain healthful fats, including omega-3 fatty acids. These combat inflammation and may help reduce the risk of heart disease and certain cancers.
Health experts often recommend eating at least 2 servings of oily fish per week. These can include trout, salmon, mackerel, herring, tuna, and sardines.
To keep fat levels as low as possible, grill the fish or bake them with small amounts of vegetable oil.
It is best to cook the fish, for easy digestion.
Drinking green tea may benefit people with CD.
Results of a 2018 study indicate that a chemical in green tea, epigallocatechin-3-gallate, helps combat inflammation in laboratory-cultured human intestinal cells. However, researchers have yet to test the chemical in people.
Green tea is also a healthful alternative to coffee and sugary drinks, both of which may aggravate symptoms of CD.
What Vitamins and Mineral Supplements Should I Take?
Crohn’s raises your risk for nutritional deficiencies because your body doesn’t digest food properly, meaning important nutrients may be expelled rather than put to good use. Flares, severe symptoms, surgeries, and other complications add to the difficulty of getting proper nutrition. Not helping matters, some medications you need to take can inhibit nutrient absorption, including prednisone, sulfasalazine, and methotrexate. Your doctor will do bloodwork and may prescribe supplements to help alleviate these deficiencies and prevent you from becoming malnourished.
Common deficiencies seen in Crohn’s patients are:
- Vitamin B12
- Vitamin D
- Vitamin A
- Vitamin K
- Vitamin E
Anemia—a condition in which you lack the healthy red blood cells needed to carry oxygen to the body’s tissues—is a common issue when iron levels are low.
It’s important to not take any supplements without the approval of your doctor, since some may contain ingredients like lactose, artificial colors, sugar alcohols or preservatives that can aggravate your Crohn’s disease symptoms.