In remission (all patients)

• Mediterranean diet: varied vegetables and fruit, whole grains, legumes, olive oil, fish twice a week Proven
• Reduce ultra-processed foods: fast food, sausages and processed meats, and sweetened drinks Proven
• In ulcerative colitis: reduce red and processed meat Proven
• Do not cut out dairy, wheat or fibre without a clear reason; unnecessary restriction can lead to malnutrition Proven
• If bloating or diarrhoea persist while tests show the inflammation is controlled, a temporary low FODMAP diet with a dietitian may help Proven

During active disease

• Crohn's disease: exclusive enteral nutrition (a special medical formula only, for 6–8 weeks) is a proven way to settle the disease, especially in children Proven
• The Crohn's Disease Exclusion Diet (CDED) with partial formula may settle mild to moderate disease, especially early in the disease, with stronger evidence in children Proven Use only under the clinic team.
• Ulcerative colitis: a specific exclusion diet (UCED) has shown encouraging early results May help
• During severe diarrhoea: soft, low-coarse-fibre foods for a short period with enough fluids and salts, then a gradual return to varied food as you improve; contact the clinic, as this may mean the disease is active.
• With severe diarrhoea: oral rehydration solution matters most; coconut water or broth do not replace it Proven

If you have a narrowing (stricture)

• Avoid coarse, poorly digested fibre: fruit skins, whole corn, whole nuts, popcorn, stringy raw vegetables and tough meat Proven
• Vegetables and fruit are allowed if peeled and well cooked, mashed, or as pulp-free juice.
• Chew well, and seek urgent care for vomiting with severe bloating or if you stop passing wind.

Vitamins and minerals

Iron, vitamin D, vitamin B12 (especially with disease or surgery of the last part of the small bowel) and zinc deficiencies are common. They are checked regularly and treated according to results Proven

• Calcium with vitamin D during steroid treatment, to protect the bones Proven
• Iron only when deficiency is proven; it may be taken every other day to be gentler on the stomach Proven, or given intravenously with active disease or intolerance Proven
• Folic acid with methotrexate or sulfasalazine, and before pregnancy Proven
• Zinc when deficiency is proven, for a limited time, and vitamin K1 on prescription with poor fat absorption Proven
• Do not take high-dose vitamins or "immune boosters" without testing, especially with biologics.

Complementary and traditional options

• Curcumin (standardised extract, about 2–3 g daily) added to mesalazine in mild ulcerative colitis helped in small trials. Turmeric in cooking alone is not enough.
• Psyllium seeds helped maintain remission in ulcerative colitis in one trial. Not for use with a stricture.
• Certain probiotics may help in mild ulcerative colitis, but the evidence is inconsistent. For recurrent pouch inflammation after colon-removal surgery, your doctor may prescribe a specific probiotic to prevent relapse. They have not been shown to help in Crohn's disease.
• A myrrh, coffee charcoal and chamomile combination matched mesalazine for maintaining remission in a German trial; it is usually not available locally.
• Indian frankincense (Boswellia serrata extract) has mixed results and failed in a Crohn's maintenance trial. Chewing or soaking Omani frankincense (luban) is a traditional practice with no evidence for gut inflammation.
• Black seed and honey are safe in food amounts, but no human trials show benefit for IBD.
• Cannabis may ease symptoms but does not reduce inflammation, and it is illegal in Oman.
• Omega-3 (fish oil) did not prevent Crohn's disease relapse in large trials; eating fish is better than capsules.
• Laban, yoghurt and kefir are usually well tolerated and a good source of calcium.
• Bone broth is nourishing and soothing, but it does not "treat" inflammation.
• Hijama (cupping): no evidence of benefit in bowel disease; ask your doctor first if you take immune-suppressing medicines or have anaemia, and use a licensed centre only.

Avoid completely

• Unpasteurised camel, cow or goat milk, and undercooked meat, especially on immunosuppressants or biologics; risk of brucellosis and listeria.
• Traditional cautery (wasm) and herbal mixtures with unknown ingredients.
• Indigo naturalis without specialist supervision; it can cause pulmonary hypertension.
• Colon cleansing, "cleansing" enemas and "detox" diets, and vitamin K3 (menadione), which is not used in humans.