Crohn’s disease, an inflammatory bowel disease (IBD) that causes inflammation of the digestive tract, can lead to loads of discomfort: abdominal pain, severe diarrhea, fatigue, weight loss, even malnutrition. Worse, it can be tough to pinpoint how to make the pain stop. Crohn’s varies in severity from mild to debilitating—and while it tends to affect your small intestine and colon the most, the disease can also impact any part of your gastrointestinal (GI) tract, pretty much from head to toe.
Changing your diet to optimize your GI health is an essential part of mitigating Crohn’s symptoms. However, how (and when) to do so will vary from person to person and even day to day, depending on the severity of each particular case. With that in mind, there are some key first steps everyone can take.
Make personalized changes
There’s no one diet or meal plan that works for everyone with Crohn’s. The condition varies from person to person, and can even change for the same person throughout the years. For that reason, “Dietary recommendations should be tailored individually for those with IBD and consider many factors including but not limited to disease activity, medications, age, food tolerances and intolerances, laboratory findings, clinical symptoms, as well as the person’s goals,” explains Emily Haller, R.D.N., a registered dietitian at Michigan Medicine who specializes in digestive health.
Keeping track of what you eat and how you feel eating it can help you identify foods that trigger flares as well as meals that agree with you. Since changes can be so individual and specific, working with a specialized GI dietitian can also help you pin down the diet that ultimately works best for you.
Avoid “problem” foods
And there are a lot of ‘em: Spicy foods, alcohol, and caffeine can all exacerbate symptoms by stimulating your intestines.
Carbonated drinks like seltzer and soda can also make your body produce more gas, which can be uncomfortable.
Fast food pit stops of greasy, fried foods can lead to diarrhea, gas, or both.
It might sound boring, but your best bet might be to stick with bland, soft foods.
Focus on fiber
If you don’t have strictures (scar tissue buildup that contributes to areas of narrowing in sections of your intestine) or obstruction symptoms (cramping, constipation, vomiting, swollen abdomen, inability to have a bowel movement—all signs your intestinal tract could be blocked) and have inactive (quiescent) Crohn’s disease, aim to eat 30 to 38 grams of fiber a day, suggests Haller.
“Fiber intake may protect against flares in those with Crohn’s disease,” Haller confirms. One recent study found those who ate 23 grams of fiber a day were 40 percent less likely to have a flare at six months compared to those who ate 10 grams per day. Fiber has been shown to benefit your microbiome, preserve gut integrity, and help maintain an essential, thick protective mucus layer in your gut, Haller says. Try gradually upping your intake by no more than three grams per day.
Not sure how? Fiber is generally found in plant foods. A few examples: one tablespoon of chia seeds provides five grams fiber, a half cup of black beans provides 7.5 grams of fiber, a cup of quinoa provides 5.2 grams of fiber, half a cup of raspberries provides four grams fiber, three-quarters of a cup of cooked oatmeal provides six grams of fiber, and a medium baked potato with the skin on provides four grams of fiber.
If you do have strictures or symptoms of obstruction, restricting your intake of certain high-fiber foods like nuts, seeds, and raw vegetables might be a better ticket for improved symptoms. Again, working with a specialized dietitian can help you understand the particulars of your individual situation.
Consider limiting dairy
Many people with IBD find that uncomfortable gut issues like diarrhea, abdominal pain, and gas improve after cutting out or cutting back on dairy.
You could be lactose intolerant—i.e., your body can’t digest the milk sugar lactose in dairy foods. Sparing your body the work of trying to do so may help you feel better.
Go easy on the sugar
Too much fructose—a naturally occurring sugar in fruit, certain vegetables, and honey, that is also present in many processed foods—can worsen gut symptoms in people with IBD, says Haller.
Notice bloating, pain, loose stools, or diarrhea? Try cutting added fructose from your diet.
Chronic intake of excess fructose has been shown to tank gut health by promoting microbial imbalance and weakening intestinal gut barrier function, says Haller.
Ingredients like high fructose corn syrup, fructose, and crystalline fructose (often found in soda, juice, ice cream, sweets, and baked goods) are common culprits to keep an eye out for, she says.
If your GI symptoms persist, touch base with a dietitian who can look into your diet and other potential triggers.