Crohn's nutrition guide

Overview

Crohn’s disease, a type of inflammatory bowel disease (IBD), 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. To make matters more complicated, your dietary habits can worsen symptoms. While there is no cure-all diet known for Crohn’s, eating and avoiding certain foods may help prevent flare-ups.

Grains

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Grains are common dietary staples. Whole grains are often touted as providing the most dietary benefits because they are high in fiber and nutrients. The fiber factor is often problematic for people with Crohn’s disease because it can increase diarrhea and abdominal pain.

What to avoid/limit:

  • whole-wheat grains

Try this instead:

  • white bread, crackers, pasta, and rice

Depending on your individual symptoms, your doctor may recommend a lower fiber diet. This means you will have to limit the amount of grains you eat. According to the Crohn’s and Colitis Foundation of America (CCFA), two-thirds of Crohn’s patients may benefit from a low-fiber, low-residue eating plan to help treat small intestinal constriction. This type of diet reduces fiber and “scrap” that can stay and irritate the bowels.

Fruits and Veggies

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Due to their numerous benefits, it’s a shame to think that fruits and vegetables ought to be avoided by people with Crohn’s. The truth is that raw produce can cause problems for the same reason as whole grains: high fiber content. You don’t necessarily have to eliminate every fruit and vegetable from your diet, but some fruits and vegetables can be exceptionally hard on a Crohn’s digestive tract.

What to avoid/limit:

  • apples with skins
  • broccoli
  • cabbage
  • cauliflower
  • corn

Try this instead:

  • apple sauce
  • steamed vegetables

Instead of avoiding fruits and vegetables entirely, you can still reap some of their benefits by processing them differently. For example, baking and steaming can make the foods more easily digestible. Still, this process can also remove some of the important nutrients of fresh fruits and veggies, especially water-soluble vitamins and enzymes, so you may talk to your doctor and dietitian about ways to prevent any deficiencies.

Protein and Meat

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When it comes to Crohn’s flare-ups, your protein selections should be based on fat content. Meats with higher fat content should be avoided, while opting for proteins that are lower in fat is a better choice.

What to avoid/limit:

  • red meat
  • dark poultry

Try this instead:

  • eggs
  • fish
  • lean ground beef
  • peanut butter (creamy versions only)
  • white meat poultry
  • tofu

Dairy Products

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While you may be able to have a glass of milk here and there with no problems, other Crohn’s patients may not tolerate dairy very well. In fact, the Mayo Clinic advises people with Crohn’s disease to skip dairy products altogether. This is because lactose intolerance tends to coincide with IBD. Lactose, a type of milk sugar, can increase your risk for gas, pain, and diarrhea. High-fat dairy, such as butter, is an even greater concern because the fat may aggravate an already-swollen small intestine.

What to avoid/limit:

  • butter
  • full-fat dairy products

Try this instead:

  • dairy substitutes from plants like milk, yogurt, and cheese made from soy, coconut, almond, flax, or hemp
  • low-fat dairy products

If you do decide to indulge in dairy, make sure to opt for low-fat products, limit your intake, and use enzyme products (such as Lactaid) to help control any resulting flare-ups.

Beverages

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Considering the nature of Crohn’s disease, it’s generally a good idea to drink more fluids. The best beverage of choice tends to be plain water. Water also provides the best form of hydration — dehydration is often a risk in cases of chronic diarrhea.

What to avoid/limit:

  • coffee
  • tea
  • soda
  • wine, liquor, and beer

Try this instead:

  • water

Caffeinated beverages, such as coffee, tea, and soda increase diarrhea. Alcohol can have the same effect. Soda and carbonated water are not good choices either because they can increase gas.

If you can’t live without your daily caffeine or an occasional glass of wine, remember that moderation is the key. Try drinking water alongside these beverages to minimize their potential adverse effects.

Spices

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Spicy foods can act as a stimulant (similar to caffeine), and worsen your symptoms. As a rule of thumb, you should avoid anything overly spicy. On the other hand, turmeric (or curcumin), which has a slightly spicy flavor, has been linked to positively affecting Crohn’s disease flare-ups in preliminary studies.

What to avoid/limit:

  • all spice
  • black pepper
  • cayenne pepper
  • chili powder
  • cloves
  • curry (leaves and powders)
  • garlic
  • ginger
  • onions
  • paprika
  • wasabi

Try this instead:

  • turmeric

Vitamins and Supplements

Issues with foods may warrant a look at vitamins and supplements. According to the Mayo Clinic, a multivitamin may be one of the best choices for Crohn’s disease. These supplements can help prevent malnutrition caused by the small intestine’s inability to properly absorb the foods you eat. Furthermore, if your diet is very limited because of flare-ups, a multivitamin with minerals can help fill in missing nutrients. Calcium is another important supplement to consider, especially if you don’t eat many dairy products. Depending on the degree of the disease and inflammation, what medications you are taking and if any resection surgeries have occurred, folate, B-12, vitamin D, and fat-soluble vitamins are the most common nutrient deficiencies.

While supplements can help, you should discuss these with a doctor and dietitian first to avoid the potential for overdose and drug interactions.

Outlook and Other Dietary Considerations

Diet may help prevent flare-ups. However, food and drinks tend to affect Crohn’s patients differently. This means that one food might cause flare-ups for some people and not for others. In general, if you know that a certain food aggravates your symptoms, you should take care to avoid it altogether. Smaller, more frequent meals can also reduce stress on the digestive tract.

New areas of research in Crohn’s include the use of probiotics, the intake of omega-3s found in flaxseed oil, fish, fibrous foods like psyllium that remain undigested until the colon, and medium-chain triglycerides found in coconut.

It’s important to consider that it’s not just what you eat that can aggravate your symptoms — the way you cook and process your food can also make a difference. Fried, fatty foods are common flare-up culprits, so opt for baked and broiled items instead. Crohn’s disease can make the digestion of fats difficult, thereby worsening diarrhea and other symptoms.

Diet can play a crucial role in overall Crohn’s management, but it can’t cure the disease. In fact, the CCFA points out that few research studies have pointed to diet as the solution. This is because diet can help prevent and alleviate symptoms, but food and nutrition can’t prevent the underlying inflammation that causes the symptoms in the first place. Continue to see your doctor for treatment follow-up, and be sure to discuss any differences in symptoms. Nutrition counseling may also improve the efficacy of your medications and overall quality of life.