Crohn’s disease is a type of inflammatory bowel disease (IBD). It can cause issues when you’re choosing what you eat and drink. Not only does the condition cause digestive tract inflammation and uncomfortable symptoms, but long-term consequences can include malnutrition.
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.
Grains are common dietary staples. Whole grains are often touted as providing the most dietary benefits because they’re high in fiber and nutrients.
But once you receive an IBD diagnosis and the disease is active, the fiber factor may be problematic. Depending on your symptoms, your doctor may recommend a low fiber diet.
This means you’ll have to limit the amount of whole grains you eat. According to the Crohn’s and Colitis Foundation of America (CCFA), people with Crohn’s may benefit from a low fiber, low residue eating plan to help manage small intestinal constriction or acute symptoms. This diet reduces fiber and “scrap” that can stay behind and irritate the bowels.
However, ongoing research questions the usefulness of low fiber diets in Crohn’s disease management. A small 2015 study using a plant-forward diet that included eggs, dairy, fish, and fiber showed a high rate of remission over 2 years.
Overall, the researchers also reviewed other studies and concluded that plant-based diets may help decrease intestinal inflammation and improve overall health. Researchers reported that the higher fiber intake didn’t result in unfavorable symptoms or outcomes.
Grains to eat:
- rice and rice pasta
- cornmeal and polenta
- gluten-free bread
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. However, this process can also remove some of their important nutrients, especially water-soluble vitamins and enzymes.
You may want to talk with a doctor and dietitian about ways to prevent any deficiencies.
Fruits and veggies to try:
- steamed or cooked vegetables
- peeled cucumbers
- bell peppers
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
While some 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:
- milk, yogurt, and cheese made from plants like soy, coconut, almond, flax, or hemp
- low fat fermented dairy like yogurt or kefir
If you have IBD, then eating lots of fiber may be problematic.
Insoluble fiber, found in fruit and vegetable skins, seeds, dark leafy vegetables, and whole wheat products, passes through the digestive tract intact. This may increase diarrhea and abdominal pain. However, other substances in grains may be to blame, like
Grains to avoid or limit:
- whole wheat bread
- whole wheat pasta
- rye and rye products
Fruits and vegetables
Due to their numerous benefits, it’s a shame to think you should avoid fruits and vegetables if you have Crohn’s. The truth is that raw produce also contains a lot of insoluble fiber, and this causes stomach and digestive pains.
You don’t necessarily have to eliminate every fruit and vegetable from your diet. Still, some fruits and vegetables can be exceptionally hard on a Crohn’s digestive tract, whether due to the fiber or FODMAP content.
Fruits and veggies to possibly limit:
- apples with skins
Protein and meat
Meats with a higher fat content should be avoided, as these can cause flare-ups.
Proteins to avoid or limit:
- red meat
- dark meat poultry
Dairy products to avoid:
- full-fat dairy products
If you decide to indulge in dairy, opt for low fat products, limit your intake, and use enzyme products such as lactase (Lactaid) or lactose-free products to help control flare-ups. You can also try these 13 dairy-free dinner recipes.
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.
Beverages to avoid or limit:
- black tea
- wine, liquor, and beer
Try these instead:
- plain water
- sparkling water (if tolerated)
- noncaffeinated herbal tea
Caffeinated beverages, such as coffee, tea, and soda, increase diarrhea. Alcohol can have the same effect. Soda and carbonated water aren’t necessarily good choices, either. They can increase gas in many people.
Remember that moderation is key if you can’t live without your daily caffeine or an occasional glass of wine. Try drinking water with these beverages to minimize their potential adverse effects.
Spicy foods can act as an irritant for some and worsen your symptoms. As a rule of thumb, you should avoid anything overly spicy. On the other hand, turmeric (or curcumin), has been linked to minimizing Crohn’s disease flare-ups in preliminary studies. It has a slightly spicy flavor.
Spices to avoid or limit:
- black pepper
- cayenne pepper
- chili powder
- white, yellow, or purple onions
Try these instead:
- chives or green onions
- lemon peel
- fresh herbs
Issues with foods may warrant a look at vitamins and supplements. Multivitamin supplements can help prevent malnutrition caused by the small intestine’s inability to properly absorb nutrients from the foods you eat.
Furthermore, if your diet is very limited because of flare-ups, a multivitamin with minerals may help fill in missing nutrients. Calcium is another important supplement, especially if you don’t eat many dairy products.
Depending on the degree of the disease and inflammation, the medications you’re taking, and if you have had resection surgeries, folate, vitamin B12, vitamin D, and fat-soluble vitamins (vitamins A, D, E, and K) are the most common nutrient deficiencies.
While supplements can help, you should discuss these with your doctor and dietitian first to avoid the potential for excessive doses and drug interactions.
Diet may help prevent Crohn’s flare-ups. However, foods and drinks tend to affect everyone with Crohn’s 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.
If you think a food is worsening your symptoms, try eliminating it from your diet and see if your symptoms improve. If you add it back in later and symptoms resume, it would likely be best to avoid it too. Smaller, more frequent meals can also reduce the work of the digestive tract.
New areas of research in Crohn’s include:
- the use of probiotics
- the intake of omega-3s found in fish and flaxseed oil
- fibrous foods like psyllium that remain undigested until the colon
- medium-chain triglycerides found in coconut
low FODMAP diet
- a high fiber enteral diet
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 commonly reported as flare-up culprits, so opt for baked and broiled items instead. Crohn’s disease can make the digestion of fats difficult, worsening diarrhea and other symptoms.
Diet can play a crucial role in overall Crohn’s management, but it’s a multi-factorial, complex disease. It often requires many supporting treatment methods, not just diet alone.
The CCFA notes that few research studies have pointed to diet as the solution. This is because diet can help prevent and alleviate symptoms, but food itself may not be enough to address the underlying inflammation and scarring that causes the symptoms in the first place.
Continue to see your doctor for treatment and follow-ups. Be sure to discuss any differences in symptoms. Nutrition counseling may also improve the efficacy of your medications and overall quality of life.
The free Bezzy IBD app can help you discover more resources for living with Crohn’s. This app provides access to expert-approved information on Crohn’s, as well as peer support through one-on-one conversations and live group discussions. Download the app for iPhone or Android.