If you have inflammatory bowel disease (IBD), you know how horrible a flare-up can be. And no matter what you do, the inflammation associated with conditions like Crohn’s disease and ulcerative colitis may be an inevitable consequence. Stomach pain, cramps and diarrhea can make you feel miserable and get in the way of your plans. And you’re wondering what, if anything, can stem the tide of your chronic symptoms?
Ulcerative colitis causes localized inflammation in your colon (large intestine) and rectum. Crohn’s disease can cause inflammation anywhere in your gastrointestinal tract – from your mouth to your anus. And both, believe it or not, can be worse when you’re triggered by certain foods, says registered dietitian Kendra Weekley, RD, LD.
“There is no specific diet for Crohn’s disease or ulcerative colitis,” she says. “But foods that may be fine for one person may be a problem for others.”
While there isn’t much research on a diet for ulcerative colitis or a nutrition plan for Crohn’s disease, there are some common conjectures you may want to avoid if your gut is giving you grief.
How diet affects IBD
Weekley emphasizes that you should not try to combat these diseases with food alone.
“Inflammatory bowel disease is not something you can cure with diet; you need to have a care team treating it,” she says. “But if you are having a flare-up, these are some foods you may want to avoid or limit to reduce the severity and frequency of your symptoms.”
Foods to avoid if you have Crohn’s disease or ulcerative colitis
Remember: Trigger foods are different for everyone. So if you’re not sure where to start, talk to a healthcare provider before you start cutting out the following foods:
1. Whole grains
High amounts of fiber can cause a lot of traffic in your gastrointestinal tract, including:
- Whole grain bread.
- Whole-weat pasta.
- Popcorn.
- Bran.
“These foods can be irritating to someone experiencing a disease outbreak,” says Weekley.
2. Beans
Beans are a wonderfully nutritious food—if you’re feeling good, Weekley notes. But during a flare, the high fiber content and tendency to cause gas is a lose-lose situation that can leave you feeling bloated from the pain.
3. Fiber-rich fruits and vegetables
“Some people think they can’t eat vegetables with IBD, and that’s not true,” says Weekley. “But you have to be careful during a flare.”
Avoid fruits and vegetables that have their skins and seeds intact. Instead, try cooked vegetables instead of raw vegetables to avoid irritating your intestines. Mixed fruit in a smoothie can also be a great way to get a variety of fruits into your diet during a flare-up.
Many people find canned bananas or pears softer than, for example, an apple or a bowl of raspberries. Also avoid other gassy vegetables such as broccoli, cabbage and Brussels sprouts. “They produce a lot of fiber and gas, which is a double whammy,” says Weekley.
4. Nuts and seeds
Nuts and seeds can be rough – literally. Their sharp edges can irritate the lining of your gastrointestinal tract. “But people often tolerate peanuts or seeds,” notes Weekley, so consider trying smooth peanut butter, almond butter, or sesame tahini.
5. Alcohol and caffeine
Alcohol can be irritating to anyone’s gastrointestinal tract, especially those who already suffer from stomach upset. This applies to all types of alcoholic drinks.
“Beer, wine and liquor are not good choices if you have symptoms,” Weekley warns.
Caffeinated drinks can also be a problem. “Caffeine increases the wave-like motion of the gastrointestinal tract, which helps propel waste through the system,” she explains. “If you tend to get diarrhea during your Crohn’s attack, caffeine may worsen your symptoms.”
6. Sweeteners
Sugary drinks like soda, fruit juice, and lemonade can also cause more diarrhea when you have a flare-up. So-called “sugar alcohols” also pose a problem.
These are sweeteners used in sugar-free chewing gum, candy and some drinks. They have names like xylitol, sorbitol and maltitol, which are listed on the nutrition facts label.
“For many people, these ingredients are poorly absorbed, which can cause gas, bloating and diarrhea,” says Weekley.
7. Dairy
Contrary to popular belief, many people with Crohn’s disease can consume dairy products without distress, Weekley clarifies. But if you have symptoms, full-fat dairy products (like whole milk, ice cream, and sour cream) could be a problem, so step away from the fettuccini Alfredo.
“Lactose-free dairy may also be better tolerated if you experience a flare-up. For example, lactose-free milk, yogurt and low-lactose cheeses such as Swiss cheese, feta, parmesan or cheddar are generally well tolerated,” she adds.
8. Spicy food
Chances are you won’t be tempted to reach for the hot sauce if you have IBD symptoms.
“Most people having a flare-up don’t eat spicy chili or burritos,” says Weekley.
Trust that instinct. Spices such as chili powder, cayenne pepper and spicy curries can add heat to a burning gastrointestinal tract.
9. 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,” says Weekley. And when food is difficult to break down, it puts unnecessary pressure on the already stressed gastrointestinal tract. So maybe the next time you’re considering a drive-thru, go for some lean grilled chicken.
What should you eat when you have a flare-up?
You may have to do some digging to find out what works (and doesn’t work) for you. Try keeping a food diary – writing down what you ate and any symptoms you notice – to look for clues about the foods that are making your stomach unhappy. And if you find yourself in a flare-up, don’t put all the food on hold. Try eating some of the following to give yourself the nutrition you need without further stressing your gut:
- Soft, bland food.
- Fruit such as applesauce or bananas.
- Low fiber food.
- Yogurt or cottage cheese.
- Fish.
- Cereals.
- Potatoes.
- Cooked vegetables.
But if you have no symptoms, try to eat a balanced diet. You don’t want to regularly avoid foods like whole grains, vegetables, or beans. “Malnutrition can be a problem for people with IBD, so only avoid certain foods during a flare-up if those foods trigger symptoms,” says Weekley.
Managing this lifelong disease can be challenging, but a dietitian can help you achieve your nutrition goals every step of the way.
“Crohn’s disease is different for everyone, so work with someone who can help you create an individualized plan,” advises Weekley. “If you have a dietitian in your corner, they are there for you so that if you have a problem, they can steer you in the right direction.”