Asal Tutorial : How to Eat an Inflammatory Bowel Disease Diet

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] 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.^[2]. 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.

EditSteps

EditAvoiding Trigger Foods

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.^[3]
- In your diary, note the date and what you have eaten anytime you have a flare up 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.
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.^[4]
- 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.
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.^[5]
- 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.^[6]
- Avoid vegetables that can cause gas. These include broccoli, cabbage, cauliflower and brussel 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.^[7]
- 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. ^[8]
Avoid fatty foods. If you are suffering from a flare of symptoms, fatty foods can make your diarrhea and abdominal pain even worse. Avoid consuming butter and margarine when you are having an attack.^[9]
- 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.
- Fried foods — like french fries, doughnuts, hush puppies, fried chicken, fish or shrimp — should be avoided. They add extra grease into your gastrointestinal tract.
- Fatty foods should especially be avoided if you have inflammation in the small intestine area of the gastrointestinal tract.^[10]
Avoid non-absorbable sugars. These are frequently found in pieces of candy and gum that have had chemical sweeteners added to them. These ingredients usually end with the letters -ol.^[11] Common culprits include:
- Sorbitol
- Mannitol
- Xylitol
- Maltitol
Avoid FODMAPs. Short for Fermentable-Oligo-Di-Monosaccharides and Polys, these are sugars that can be found in some carbohydrates.^[12]They include things such as:
- Fructose (commonly found in honey and corn syrup)
- Certain fruits such as apples, apricots, pears, plums and blackberries^[13]
- Sugars commonly found in cereals and pre-packaged granolas
- Lactose from dairy products
Avoid carbonated beverages. These can also cause extra air to get into the digestive tract, causing more gas and irritation.
- Similarly, avoid drinking beverages with a straw as this can also put additional air into the liquid when your drink.^[14]

EditBuilding a Healthy Diet

Be sure to hydrate. Because diarrhea frequently causes dehydration, it is crucial that patients with IBD remain hydrated.^[15]
- Drink at least 8 glasses of water every day (or 64 oz). 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 dehydrate the body.
Incorporate protein. Protein is an excellent source of vitamins, zinc, iron and other nutrients. If you are recovering from a flare, then consuming protein will be a good method for restocking lost nutrients.
- Choose lean proteins like poultry, lean cuts of pork, and fish as opposed to fatty forms of red meat, like hamburger or brisket.^[16]
- 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.^[17]
Incorporate probiotics into your diet. Probiotics are active microorganisms that can help encourage digestive health. They are commonly found in foods like yogurt. Talk to your doctor about incorporating probiotics into your diet as many IBD patients have had mixed results from their use.^[18]
- Your doctor may suggest taking a probiotic in a supplement form if you want to avoid lactose products such as yogurt.
Eat smaller meals more frequently. Because your digestive tract is in a sensitive state with IBD, it is best to eat four to five small meals a day as opposed to three large meals.
- Make pre-portioned snacks and meals to take with you throughout your day, especially if you are traveling.^[19]

EditSupplementing a Healthy Diet

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.^[20]
- 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 form.^[21]
- Check the ingredients on the vitamin before you consume it. Some vitamins contain non-absorbable sugars or other ingredients that could actually irritate your symptoms.
- Do not consume vitamins on an empty stomach. It's always best to take them with food.^[22]
- 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.
Exercise. 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. A exercise session of 30 minutes, 3-4 times a week, will benefit your cardiovascular system and your overall health.^[23]
- Moderate forms of exercise include walking, jogging, biking, swimming, yoga, or 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 flare up of symptoms and cannot eat, then you should cease exercising until you have recovered and can eat again. IBD often results in fatigue and joint pain; if you are experiencing these, do not exercise, as this could exacerbate your symptoms.^[24]
Beware of other complications. 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, and a disconnection from activities that you normally love.^[25]
- Your doctor may refer 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.