Diet for Crohn’s Disease: Which Foods Should I Eat or Avoid?
Crohn’s disease is a type of inflammatory bowel disease (IBD). It is a chronic, lifelong condition and can be a difficult diagnosis to manage. It affects up to 1.6 million people in the United States. Crohn’s disease is a disease that can cause inflammation anywhere in the digestive tract, from the mouth to the anus. Since the disease affects the digestive tract, people with Crohn’s often experience abdominal pain and frequent stools, especially in periods of time when they have disease flares.
The digestive tract includes the small and large intestines, and the small intestine is commonly affected by Crohn’s disease. Diet and nutrition are very important for people with Crohn’s disease because the digestive tract is where nutrients (macronutrients like carbohydrates and protein, and micronutrients like vitamins and minerals) are absorbed into the body. Nutrition plays a vital role in maintaining a healthy body weight without too much weight loss during flares of Crohn’s. It should be optimized during healthy times to ensure a person receives adequate calories, protein, fluid, and vitamins and minerals.
What Are the Dietary Concerns for Crohn’s Disease?
It is best to check with your doctor and Registered Dietitian before making any big diet changes when you have IBD. There are many nutrition and diet concerns for Crohn’s disease, including:
- Poor appetite and decreased intake of food and drinks by mouth
- Weight loss
- Nutrient deficiencies, especially for Vitamins A, D, E, and K, zinc, calcium, and iron
- Malabsorption, which means you don’t absorb nutrients from your food well
- Pain with trigger foods
- Malnutrition if the diet is not appropriate for the long term or if malabsorption is severe
- Poor growth in children and adolescents with Crohn’s disease
Is There an Ideal Diet Plan or Meal Plan for Crohn’s Disease?
In general, a healthy diet appropriate for an average person is good for a person with Crohn’s disease during periods of good health. No evidence-based diet works best for Crohn’s disease, and nutrition plans have to be individualized based on the person. Eating adequate amounts of fiber can help reduce having a flare.
The recommendation is 14 grams of fiber per 1000 calories for adults, so a person should eat 28 grams of fiber per day with a 2000-calorie diet. High fiber foods that are good sources of soluble fiber like apples, black beans, if tolerated, oatmeal, barley, carrots, and pears should be used to meet fiber goals ideally. Foods containing probiotics or healthy bacteria may also be beneficial when you are in remission. These foods include yogurt, sauerkraut, kimchi, and kefir.
Some people can identify trigger foods to avoid that help them feel less bloated, have less abdominal pain, or have less diarrhea. If you have experienced weight loss from symptoms of Crohn’s disease, it is best to follow a high protein and high-calorie diet with frequent meals and snacks. You should try to eat foods that you know you can tolerate, and you may also be prescribed multivitamin and mineral supplements.
Since weight loss is common and people with Crohn’s experience issues absorbing nutrients from food, they are sometimes prescribed oral nutrition supplements. These dietary supplements are special shakes with extra calories, protein, vitamins, and minerals. Dietitians can provide ideas on flavoring oral nutrition supplements or mixing them into shake recipes if you don’t enjoy the taste.
Specialized Diets for Crohn’s Disease
It is best to check with your medical team before making big diet changes when you have IBD. Sometimes, a doctor or dietitian might recommend these diets:
- Low Residue is a diet that is low in fiber and might be used if a person has a narrowed part of the intestine.
- A liquid diet requires that almost all daily calorie and nutrient needs come from oral nutrition supplements to give the intestinal tract a break from digesting solid foods.
- The FODMAP diet may be useful for people with Crohn’s. This diet focuses on reducing or eliminating foods that are sources of sugars, including fructose, lactose, and sugar alcohols like sorbitol and mannitol.
- Specific Carbohydrate Diet is a diet that has less evidence that it works and requires strict guidelines that remove all fructose, grains, and lactose from the diet.
Foods to Avoid During a Crohn’s Disease Flare
Though people with Crohn’s disease can eat a varied diet, and not every person will experience the same trigger foods, some foods should be avoided during a flare of symptoms. A person with Crohn’s disease should keep a food diary with symptoms to help determine if there are specific foods that are causing digestive issues. Common foods that may cause abdominal pain or other tolerance issues include:
- Dairy products that contain lactose
- Foods high in insoluble fiber, like fruits with skin and seeds, cruciferous vegetables (broccoli, Brussels sprouts, cauliflower), nuts, beans and lentils, and whole grains
- Raw fruits and vegetables
- Spicy foods
- High-fat foods, like fried foods or foods with a lot of butter or mayonnaise
- Alcoholic beverages
- Caffeinated beverages, like energy drinks, black or green teas, or coffee
- Carbonated beverages such as soda and sparkling water
- Sugar alcohols like sorbitol or mannitol
Life With Crohn’s Disease
While any chronic condition can pose many challenges, it’s not impossible to find a functional life forward with Crohn’s disease. By working with your doctor to identify the best path forward, you can learn which foods are best for your situation. Once you find which foods are right for you, you’ll likely feel more in control of your health.
Stories From Mighty Members Living With Crohn’s Disease
- How Diet Plays a Role in Managing My Crohn’s Disease
- 19 ‘Hacks’ That Can Make Dining Out With Crohn’s Disease Easier
- 36 Things People With Inflammatory Bowel Disease Wish Others Understood
Connect With Others Who Have Crohn’s Disease
The Mighty is a community for people who are living with Crohn’s disease and other chronic health conditions. You can read stories from others with similar experiences, join support groups, and even share your own story.