Crohn's Disease and Diet

Contributors: Nour Zibdeh, MS, RD, CLT


Crohn's disease and ulcerative colitis are two types of conditions known as inflammatory bowel disease, or IBD. Crohn’s disease is defined by chronic inflammation and irritation of the digestive tract. Ulcerative colitis also results in inflammation, but specifically in the colon and rectum. According to the Crohn's and Colitis Foundation of America, an estimated 3 million Americans suffer from IBD. The cause isn’t fully understood but the condition is known to run in families. In addition, one's immune system and environment appear to play a role in the development of IBD.

What Happens with Crohn's Disease?

The exact process that causes the inflammation and irritation is unknown, but there has been some insight into the disease. Crohn's disease often affects the lower part of the small intestine, but can manifest anywhere from the mouth to the anus. The immune system also plays a role in this condition.

Immune cells accumulate in the intestines, attacking bacteria, food, healthy body tissue and other harmless or even beneficial substances, causing symptoms such as abdominal pain, diarrhea, rectal bleeding, weight loss, fever and fatigue. These accumulating immune cells produce chemicals that promote inflammation, damage intestinal walls and cause the symptoms of Crohn's.

How Is Diet Involved?

Foods do not cause Crohn's disease and no special diet has been proven effective in treating it. However, certain foods may cause flare-ups in Crohn's disease symptoms for some people. Some foods that are more likely to cause symptoms are foods high in dietary fiber and fat, dairy and carbonated beverages.

Research has been unsuccessful at determining what specific foods are the culprit for everyone with this condition. Bottom line: there's no one diet to alleviate Crohn's disease. Yet, important steps in treatment for Crohn's include keeping a detailed food diary, avoiding foods that cause symptoms and consulting with a registered dietitian nutritionist experienced in digestive health.

Nutrient Needs

Nutrient deficiency is another common concern since inflammation from this condition interferes with nutrient absorption. Plus, certain nutrients may be lacking when foods are avoided. As a result, people with Crohn's disease need a nutrient-rich diet with adequate calories, protein and healthy fats.

Steroid medications often prescribed for Crohn's disease may increase osteoporosis risk, so sufficient calcium, vitamin D, magnesium and vitamin K are needed for bone health. Malabsorption also may result in vitamin C, vitamin B12, folic acid and zinc deficiencies.

Healthy Eating Tips

If you have Crohn's disease, consult with a registered dietitian nutritionist who can work with you to develop a personalized eating plan.

Some tips and guidelines may include:

  • Eat small meals or snack every 3 to 4 hours. Stay hydrated. Drink small amounts of water throughout the day.
  • During periods when you don't have symptoms, include whole grains and a variety of fruits and vegetables in your eating plan. Start new foods one at a time, in small amounts.
  • When you have symptoms, such as diarrhea or abdominal pain, follow the recommended food list provided by your registered dietitian nutritionist. Foods to avoid may include high-fiber foods, raw and gas-producing vegetables, most raw fruits and beverages with caffeine.

Your physician and registered dietitian nutritionist may recommend foods with added probiotics and prebiotics, as well as dietary supplements to prevent or treat deficiencies.

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