Eating in Public

For some Crohn’s sufferers, eating out in public may seem like a daunting proposition. With a little planning, however, it needn’t be a minefield.

Nutrition is an issue of special concern for people with Crohn’s disease. Because it affects the digestive system, Crohn’s may interfere with appetite. Even if a sufferer is able to eat a balanced diet, some forms of Crohn’s can interfere with the digestive tract’s ability to absorb nutrients, putting them at risk for malnourishment.

Nutritional Support

Some people with Crohn’s disease who have inflammation of the small intestine may experience difficulty absorbing fats from their diet—and up to 40 percent of people with Crohn’s will experience some difficulty absorbing carbohydrates. These sufferers may require nutritional support. 

In order to get enough calories and nutrients each day, they may require overnight feeding with a liquid nutrient formula. This enriched formula can be delivered through a (nasogastric) tube that is threaded through the nose directly into the stomach or small bowel. This type of nutritional support is called “enteral nutrition.” Another variation involves surgically implanting a tube directly into the stomach through the abdominal wall. Known as a gastrostomy, this procedure bypasses the discomfort some may experience with daily insertion and removal of a nasogastric tube through the nostrils.

In either case, patients are free to choose to eat solid foods without fear of becoming severely malnourished. There’s no reason why Crohn’s patients can’t enjoy going out to eat.

What’s on the Menu?

Every Crohn’s sufferer is different. Generally, any food that can be tolerated is probably OK to eat, whether it’s at home or out in public. Of course, choosing healthful foods is always a good idea.

If you’re prone to cramping and diarrhea, you may want to avoid high-fiber foods, such as fresh fruits and raw vegetables. Instead, eat bananas or applesauce, refined carbohydrates (such as white bread, white rice, or pasta), skinless potatoes, fish (avoid fried fish), and olive or canola oils.

Cold water fish—such as tuna, salmon, or swordfish—are rich in omega-3 fatty acids, and could be an excellent menu selection, especially when broiled, poached, or steamed. Omega-3 fatty acids are essential nutrients that exert anti-inflammatory effects in the body, possibly discouraging further digestive tract inflammation. It may be helpful to avoid spicy foods, or foods high in sugar or fat. Likewise, Crohn’s sufferers are advised to avoid whole grains, seeds, nuts, and popcorn. Based on these general recommendations, some restaurants, are likely to be better choices than others.

It’s also advisable to consume smaller portions than some restaurants tend to serve. Rather than being tempted to overeat, consider asking to have leftovers wrapped up for later.

The non-profit Crohn’s and Colitis Foundation of America recommend the following tips for enjoying yourself while dining out: 

Avoid eating out if you’re famished.

If you show up to a restaurant starving, you may be tempted to overeat, which could trigger symptoms. Eat a small snack that you’re likely to tolerate well before going out, to avoid overindulging at the restaurant.

Call before you go.

If you have concerns about the menu, call ahead. Many restaurants are happy to accommodate special requests, or to answer any questions that you may have about ingredients or cooking methods.

Don’t be shy—ask for help.

Feel free to ask for special considerations. Dining out should be a pleasant experience. At sit-down restaurants, ask your waiter for assistance in meeting your special needs. Call ahead to inquire if the chef is willing to alter the dishes to accommodate you.

Don’t overdo it—watch your portions.

Many restaurants offer appetizers or even child-size portions. Consider ordering these items to reduce the likelihood that you’ll overeat.

Indulge your cravings—sparingly.

While attention to good nutrition is crucial, everyone deserves to live a little occasionally. So-called “junk food,” which is high in calories or fat but low in nutritional value, can be consumed in small amounts as a special treat from time to time. Just avoid overdoing it—and enjoy!

Crohn’s, Kids, & Fast Food

Parents of children with Crohn’s disease may worry that fast food offers few truly nutritious options, but this may not be true. Ice cream or milk shakes, for example, can provide much-needed calories for energy and ample calcium for growing bones. Even foods like pizza can provide healthful nutrients. The cheese on pizza provides calcium, while tomatoes provide vitamin A and the antioxidant phytonutrient, lycopene. Pizza crust can be a source of B-vitamins. As with anything—especially regarding children—don’t overdue it. Any children’s meal plans, Crohn’s or not, shouldn’t be comprised of solely food from the drive-thru.