If you have inflammatory bowel disease (IBD), you know how scary a flare-up can be. And no matter what you do, the inflammation that comes with conditions like Crohn’s disease and ulcerative colitis can seem like an inevitable consequence. Stomach ache, cramps, and diarrhea can make you feel miserable and overshadow your plans. And you’re wondering what, if anything, could change the course of your chronic symptoms?
Ulcerative colitis causes localized inflammation in your colon (large intestine) and rectum. Crohn’s disease can cause inflammation anywhere in your gastrointestinal tract, from your mouth to your anus. Believe it or not, both can get worse if certain types of foods trigger it, says registered dietitian Kendra Weekley, RD, LD.
“There is no specific diet for Crohn’s disease or ulcerative colitis,” he says. “But foods that are perfectly fine for one person may be problematic for others.”
Although there isn’t a lot of research on the ulcerative colitis diet or Crohn’s disease nutrition plan, there are some usual doubts you may want to avoid when your gut is giving you pain.
How does diet affect IBD?
Weekley emphasizes that you shouldn’t try to manage any of these diseases with food alone.
“Inflammatory bowel diseases are not something you can treat with diet; you need a healthcare team that treats them,” he says. “But if you’re experiencing a flare, these are some foods you may want to avoid or limit to reduce the severity and frequency of your symptoms.”
Foods to avoid when you have Crohn’s disease or ulcerative colitis
Remember: Trigger foods are different for everyone. So, if you’re not sure where to start, talk to a healthcare professional before you start cutting out the following foods:
1. Whole grains
High amounts of fiber can cause too much traffic in your gastrointestinal tract:
- Whole grain bread.
- Whole wheat pasta.
- Popcorn.
- Bran.
“These foods can be irritating for someone experiencing a flare-up,” says Weekley.
2. Beans
Weekley notes that beans are a wonderfully nutritious food; when you feel good. But during a flare-up, its high fiber content and tendency to cause gas is a lose-lose situation that can leave you feeling bloated from the pain.
3. High fiber fruits and vegetables
“Some people think they can’t eat vegetables with IBD, and that’s not true,” says Weekley. “But you have to be careful during a flare-up.”
Avoid fruits and vegetables with intact skins and seeds. Instead, aim for cooked vegetables rather than raw to avoid irritating your gut. Berries blended into a smoothie can be a great way to add a variety of fruits to your diet during a flare-up.
Many people find that a banana or canned pear is softer than, say, an apple or a bowl of raspberries. Also avoid other fizzy vegetables like broccoli, cabbage and Brussels sprouts. “They are rich in fiber and gas production, which is kind of a double whammy,” says Weekley.
4. Nuts and seeds
Nuts and seeds can literally be rough. Sharp edges can irritate the lining of your gastrointestinal (GI) tract. “But people generally tolerate peanuts or seeds,” Weekley points out, so consider trying smooth peanut butter, almond butter, or sesame tahini.
5. Alcohol and caffeine
Alcohol can irritate the gastrointestinal tract of anyone, especially those who already experience stomach symptoms. This goes for any alcoholic beverage.
“Beer, wine, and liquor are not great options if you have symptoms,” Weekley warns.
Caffeinated drinks can also be a problem. “Caffeine increases the wave-like motion of the digestive tract, which allows waste to move through the system,” he explains. “If you tend to have diarrhea with a Crohn’s flare, caffeine may make your symptoms worse.”
6. Sweeteners
Sugary drinks like soda, juice, and lemonade can also cause more diarrhea during a flare-up. So-called “sugar alcohols” are also a problem.
These are sweeteners used in sugar-free gum, candy, and some beverages. They are referred to by names such as xylitol, sorbitol and maltitol, which are listed on the nutrition facts label.
“In many people, these ingredients are poorly absorbed, which can cause gas, bloating, and diarrhea,” says Weekley.
7. Dairy Products
Weekley explains that, contrary to popular belief, many people with Crohn’s can actually consume dairy products without pain. But full-fat dairy products (like whole milk, ice cream, and sour cream) can cause problems when you have symptoms, so stay away from fettuccini alfredo.
“Lactose-free dairy products may also be better tolerated when you experience a flare. For example, lactose-free milk, yogurt, and low-lactose cheeses such as Swiss cheese, feta, parmesan, or cheddar are generally well tolerated,” she adds.
8. Spicy foods
If you have IBD symptoms, you probably won’t be willing to reach for the hot sauce.
“Most people with fever don’t eat spicy chili or burritos,” says Weekley.
Trust that instinct. Spices like cayenne pepper, cayenne pepper, and spicy curries can add heat to a burning GI tract.
9. Fatty, oily foods
“It’s hard for your body to handle the amount of fat in fast food and other fatty foods like sausages or salami,” says Weekley. When food is difficult to break down, it puts unnecessary pressure on the already stressed gastrointestinal tract. So maybe next time you’re considering a drive-thru, opt for lean grilled chicken instead.
What should you eat when you have a flare-up?
You may need to do some sleuthing to figure out what works (and doesn’t) for you. To look for clues about foods that make your stomach unhappy, try keeping a food diary, noting what you eat and any symptoms you notice. And if you get a flare-up, don’t put all foods on hold. To give yourself the nutrition you need without further upsetting your gut, try eating some of the following:
- Soft, bland foods.
- Fruits like applesauce or bananas.
- Low fiber foods.
- Yogurt or cottage cheese.
- Fish.
- Cereals.
- Potatoes.
- Cooked vegetables.
However, when you do not have symptoms, try to eat a balanced diet. You don’t want to regularly avoid foods like whole grains, vegetables, or beans. “Malnutrition can be a problem for people with IBD, so avoid certain foods during a flare-up only if those foods cause the onset of symptoms,” says Weekley.
Managing this lifelong disease can be difficult, but a dietitian can help you manage your nutrition goals every step of the way.
“Crohn’s is different for everyone, so work with someone who can help you design a personalized plan,” Weekley advises. “If you have a dietitian with you, they will be there for you, so if you have a problem they can point you in the right direction.”