Food and IBD

A balanced diet supports your treatment but does not replace it

• Balanced diet
• Enough fluids
• Dietitian

There is no single diet that suits everyone

A basic fact

The effect of food varies from one patient to another, depending on the type, location and stage of the disease. In most cases food does not replace medical treatment, but it supports your health and can ease some symptoms.

Strict diets without supervision can cause malnutrition and vitamin deficiencies.

An eating pattern that helps most patients

Calm periods

• Vegetables and fruit — a variety, in amounts that suit what you can tolerate
• Fish, pulses (beans and lentils) and poultry — good sources of protein
• Wholegrains — unless you have a narrowing (stricture) in the bowel
• Olive oil and healthy fats — instead of fried foods and saturated fats

Many patients are advised to follow a pattern close to the Mediterranean diet, with less processed food and added sugar.

How to eat during a flare-up

During a flare

• Small, frequent meals — instead of two or three large ones
• Enough protein — such as eggs, chicken and fish, and yoghurt (laban) if it suits you
• Enough fluids — to replace what is lost with diarrhoea, and oral rehydration solutions when needed
• Less fibre for a while — such as cooked vegetables and peeled fruit, if symptoms get worse

Gradually go back to a varied diet once the flare has settled.

Common deficiencies worth watching for

Micronutrients

• Iron — low because of bleeding or poor absorption; it is replaced with tablets or into a vein
• Vitamin D — important for healthy bones and muscles
• Vitamin B12 — especially when the end of the small bowel is affected or has been removed
• Calcium — especially with steroid use or when you eat few dairy foods

Do not take high-dose supplements without advice; we work out what you need with blood tests.

Watch out for weight loss

Malnutrition

Losing weight without trying, a poor appetite, or constant tiredness may be signs of malnutrition that needs assessment and a nutrition plan.

You may be referred to a clinical dietitian, and you may need liquid nutritional supplements.

How can a dietitian help you?

Dietitian

• Assessing your nutrition — weight, muscle mass and blood tests
• A plan that suits the stage of your disease — during active and calm periods, and if there is a narrowing
• Medical nutrition when needed — such as liquid supplements; exclusive liquid nutrition (exclusive enteral nutrition) can be a main treatment for children with Crohn's disease
• Following up and adjusting the plan — according to your response and changes in your condition

Food and the disease: the summary

Key messages

• There is no single diet for all patients
• A balanced Mediterranean-style pattern suits most patients
• During a flare: small meals, fluids and enough protein
• Iron, vitamin D and B12 levels are checked regularly
• Avoid strict diets without supervision

Contact the clinic if you have:

• Weight loss without trying
• Pain and bloating after eating
• A wish to start a special diet
• A poor appetite or repeated vomiting
• Severe diarrhoea with signs of dehydration
• A need to see a dietitian

If you have persistent vomiting with a swollen tummy and are not passing wind, go straight to the nearest emergency department.