Crohn’s Disease Diet: A Complete Guide
It’s important to note that you may have a reduced appetite.
This guide explores the Crohn’s disease diet and provides tips to better manage your nutrition intake during the different phases of the condition.
If you experience Crohn’s disease, these suggestions can help guide you toward better daily nutrition:
- Use steaming, boiling, and poaching cooking methods rather than frying.
- Eat small, frequent meals (aim for four to six), instead of larger, heavier meals.
- Use a food journal to track what you eat and any symptoms you may have.
- Stay hydrated and drink plenty of water. Aim for about 3 liters per day.
- Drink slowly and avoid using a straw, which can cause gas and bloating.
- Meal plan in advance and keep foods that you tolerate well.
Learn more health-promoting eating tips from Crohn’s disease.
There are certain foods that may exacerbate your symptoms when you’re experiencing a flare or that can trigger a flare itself. Your healthcare team may suggest an elimination diet, which means you omit certain foods to identify which ones cause problems. This can help you identify common foods and beverages to avoid during a flare.
Elimination diets should only be done under the supervision of your healthcare team and a dietitian so that they can ensure you are getting all the nutrients that you need.
Some common trigger foods and beverages you may want to avoid include:
|Insoluble fiber foods that are difficult to digest||foods with a lot of roughage, including fruits with skin and seeds, cruciferous vegetables, such as broccoli, cauliflower, and Brussels sprouts, whole grains, wheat bran, and whole nuts|
|Sugar alcohols||erythritol, xylitol, sorbitol, mannitol, and other sugar alcohols found in many sugar-free foods and gum|
|Lactose||dairy products, such as milk, cream cheese, and soft cheeses|
|High fat food||butter, nut and seed butters, margarine, heavy creams, coconut, and especially fried, greasy high fat food|
|Alcohol and caffeinated drinks||beer, wine, liquor, soda, coffee, and caffeinated tea|
|Spicy food||any food containing hot spices|
Learn more about foods to avoid with Crohn’s disease.
Certain foods, such as those that are easier to digest, are less likely to worsen your symptoms during a flare. These include:
- Low fiber fruits, such as bananas, cantaloupe, honeydew melon, and cooked fruits
- Lean protein, such as chicken breast, turkey, fish, lean cuts of pork, eggs (particularly the whites), and tofu
- Seedless, skinless, fully cooked, non-cruciferous vegetables, such as squash, the tips of asparagus, cucumbers, potatoes, and okra
When your disease is in remission, that means inflammation stops causing pain and damage to your colon. You may notice symptoms such as pain, fatigue, and diarrhea go away.
Introduce new foods slowly and monitor any symptoms that may arise. Certain foods may help you get the right amount of nutrients without worsening your symptoms.
Consult your doctor or dietitian before making any changes to your diet.
Some foods to consider when your disease is in remission include:
- Food with probiotics: Examples include kimchi, kefir, yogurt, miso, tempeh, and sauerkraut.
- Fiber-rich foods (especially soluble fiber): Oat bran, beans, barley, buckwheat, millet, and quinoa are beneficial, unless you have an ostomy, intestinal narrowing, or if your doctor advises you to continue a low fiber diet due to strictures, or recent surgery.
- Protein: Lean meats, fish, eggs, and tofu contain high amounts of protein.
- Fruits and vegetables: Try to get a wide variety of different colors, and exclude the peel and seeds if they bother you.
- Calcium-rich foods: These include kale, collard greens, okra, watercress, mustard greens, edamame, yogurt, and kefir.
Crohn’s disease can interfere with your body’s ability to digest food and absorb nutrients, which may lead to severe nutrient deficiencies and malnutrition.
Though Crohn’s may limit your dietary options, there are steps you can take to help prevent malnutrition. They can include:
- routine testing for vitamin and mineral deficiencies
- avoiding foods that exacerbate your symptoms
- working with your healthcare team to determine a list of foods and meal plans that may help you maintain a well-balanced diet, which typically includes foods like fruits, vegetables, and lean protein, but will depend on your specific situation
Different types of dietary fiber impact digestion differently. There are two main types of dietary fiber: soluble and insoluble. Most foods contain a combination of both but have a predominant type.
Additionally, a 2015 study found that a plant-based diet high in fiber reduced intestinal inflammation and promoted the overall health of people with the condition.
Furthermore, another 2015 study found that people with Crohn’s disease who did not avoid high fiber foods were approximately 40% less likely to experience a flare than those who did avoid them.
Collectively, the authors of these studies mentioned that a low residue diet without insoluble fibers might promote gut dysbiosis, which is an imbalance of microorganisms in the gut. They conclude that high amounts of dietary fiber may actually be advantageous to those who have IBD.
Be sure to consult your healthcare team for more personalized advice tailored to your individual dietary needs.
See a list of foods high in fiber.
Unless you have celiac disease, it may be unnecessary to restrict gluten in your diet for Crohn’s disease. However, some animal studies have shown that gluten may promote intestinal inflammation and permeability.
While several cross-sectional studies have suggested that a gluten-free diet may have some clinical benefit in those living with IBD, there is currently not enough evidence in human clinical trials in patients with Crohn’s.
Researchers concluded that the current data do not support the universal use of a gluten-free diet in people living with IBD.
Keeping a food diary is important for monitoring and helping identify any foods that trigger or worsen symptoms. This is the best way to determine what foods are causing you problems.
There are three main things to consider when writing a food diary:
- what you eat
- when you eat
- how much you eat
Recording these three pieces of information can help you in being better informed to make connections between foods and symptoms.
Omega-3 fatty acids are known to have anti-inflammatory properties and many other health benefits. Some people use omega-3 fatty acids to help reduce gastrointestinal inflammation that Crohn’s disease causes.
A 2019 literature review concluded that many studies have demonstrated the beneficial effects of using omega-3 fatty acids as an adjunctive therapy for the treatment or prevention of Crohn’s disease.
However, the authors of this review did mention that most studies had a small sample size and there were many differences in the mode of consumption and the source of omega-3 used.
Learn about when to take omega-3s.
A low residue diet restricts foods that contain indigestible components. It’s intended to reduce the demands on the gastrointestinal system. This causes the body to produce lower amounts of stool less often.
A low residue diet is usually recommended when you’re experiencing a flare or undergoing bowel surgery.
When following a low residue diet, common advice is to consume a maximum of 10–15 grams of fiber a day. You should also avoid most dairy products and high FODMAP foods.
Diet plays a crucial role in managing Crohn’s disease. Foods and beverages affect everyone living with Crohn’s disease differently.
If you suspect a food is worsening your symptoms, try removing it from your diet and see if your symptoms subside.
Continuing to see your doctor and dietitian for treatment and follow-ups is important. Be sure to tell them about any differences in symptoms you may have or any new symptoms that may occur.