“To eat or not to eat? That is the question.” —Hamlet with Crohn’s
Low fiber or high fiber? Whole grains or no grains? With conflicting information about various diets, it can be hard to figure out what foods are the best to eat for Crohn’s disease — especially since every person with Crohn’s has different dietary needs!
Though there’s no specific diet to treat Crohn’s, these food guidelines can help you avoid trigger foods, get the nutrition you need, and still live deliciously.
It would be great if we could give you an all-inclusive list of things to eat for Crohn’s and call it a day. Unfortunately, it’s a little more complicated than that.
Since Crohn’s is a type of inflammatory bowel disease (IBD), you’d think a typical anti-inflammatory diet full of fruits, vegetables, and whole grains would be ideal. Yet many of these foods can actually trigger Crohn’s symptoms! So what do you do?
First, know your triggers, since certain foods may cause a flare-up. What triggers a flare-up can be different for everyone. Keeping track of what you eat can help you find out which foods to avoid.
Your healthcare provider may put you through an elimination diet to find what works for you. But you should not try an elimination diet on your own. It’s much more safe and effective when a healthcare provider or registered dietitian guides you through the process.
So, even if #GrainFreeLife is trending, let a pro help you find out which foods you need to feel better.
Second, keep in mind that how you eat when you have a flare and when you’re in remission may be two very different diet plans.
When you’re experiencing a flare, it’s best to stick to low fiber foods. That means all those nutrient-dense greens, fruits, and whole grains are out. But you likely don’t have to avoid fresh produce and grains forever.
When you’re in remission, eating whole grains, vegetables, and fruits is often recommended. Nutrient-dense foods help you get the vitamins and minerals your body needs, which is extra important for people with Crohn’s. A 2015 study suggests that a high fiber diet is actually beneficial to people with Crohn’s.
If you’ve had inflammation in your small intestine, you’re at an increased risk of deficiencies in vitamins A, B12, D, E, and K. Eating oily fish and eggs can boost your intake of these fat-soluble vitamins. Plus, including a rainbow of fruits and veggies in your diet can help get your nutrients up.
Low FODMAP diet
Some research suggests that a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can help heal Crohn’s. Since you’ve probably never said “Can I have extra FODMAPs with my meal, please?,” here’s a list of high FODMAP foods to avoid:
- high lactose foods like milk, yogurt, and ice cream
- wheat-based foods like bread, crackers, pasta, and cereal
- other high fiber foods like beans and lentils
- certain vegetables, like artichokes, garlic, onions, and asparagus
- some fruits, like apples, pears, cherries, and peaches
What’s left to eat? Actually, there’s still a decent variety of options. Some great low FODMAP foods are:
- protein sources like eggs and lean meat
- low lactose cheeses like cheddar, brie, and feta
- dairy-free products like soy milk
- easier-to-digest grains like rice, quinoa, and oats
- certain vegetables, like eggplant, potatoes, cucumber, and zucchini
- some fruits, including grapes, oranges, strawberries, and blueberries
The low FODMAP diet is a type of elimination diet that’s meant to be followed under the supervision of your healthcare provider or dietitian. The goal is to eliminate certain foods and then add them back one at a time to help you discover which ones may be triggering your symptoms.
Specific Carbohydrate Diet
If the low FODMAP diet doesn’t suit you (or if you’ve tried it and it hasn’t worked), the Specific Carbohydrate Diet (SCD) can also be used to help manage Crohn’s. This diet was developed in the 1920s to alleviate celiac disease, but there’s some evidence that it also works for Crohn’s.
To start with the good news, here are all the things you can eat on the SCD:
- meat and poultry without additives (deli meat and hot dogs are out)
- some legumes like lentils, navy beans, unroasted cashews, and peanuts
- some dairy, including homemade yogurt and cheeses like cheddar, colby, and Swiss
- most vegetables
- nuts and nut flours
- oils
- vinegar (without additives)
- tea (without additives)
- mustard (without additives)
- honey
Here’s what you can’t have when following the SCD:
- sugar (or any sweetener except honey)
- any grains (even corn)
- seaweed
- starchy root vegetables like potatoes and yams
- commercial mayonnaise (homemade is fine)
- dairy-based milk, cream, or ice cream
- candy
Due to the restrictive nature of the SCD, it’s important to work with your healthcare provider or registered dietitian to make sure your nutritional needs are still being met.
When to eat
Regardless of what you eat, when you eat can help keep flares away. Big meals are hard for your body to digest. Try to eat five or six small meals per day. This may help you avoid digestive pain, bloating, and the need to run to the bathroom.
Drink up
There’s one thing that can definitely help with Crohn’s: water! Staying hydrated helps your body function in every way and can be especially beneficial for IBD.
Drink enough so that your pee is a light yellow color. Start by drinking 64 ounces per day. Sipping small amounts of water throughout the day will help you stay hydrated.
Not to sound like a broken record, but Crohn’s is different for everyone. One person may eat a plate of broccoli and feel fine, while another will feel like a Macy’s Parade balloon after one bite. So keep track of your food triggers and eat what’s best for you.
Still, there are some general foods that almost everyone with Crohn’s should avoid:
- Alcohol. No surprise here: Alcohol is bad for you! It can be especially troubling for people with Crohn’s, so really try to cut back on the wine, beer, and spirits.
- Coffee. Coffee makes most people walk a little quicker to the bathroom. With Crohn’s, you usually don’t need any help in that department! Abstaining from coffee is highly recommended when you have IBD.
- Sugary foods. Foods with lots of sugar don’t play well with Crohn’s. That doesn’t mean you can never eat a candy bar, but stick with small portions and keep indulgences to a minimum.
- Sugar alcohols (and other nonabsorbable sugars). This category includes sugar substitutes like sorbitol and maltitol. Check the label on any sugar-free product, since these nonabsorbable sugars can trigger a flare.
- High fat foods. Fried foods and high fat meats like steak and sausage can also trigger flare-ups.
- Foods high in insoluble fiber. This goes against a lot of “healthy diet” advice but is very important for people with Crohn’s to know. Fruits with skin and seeds, cruciferous vegetables (like broccoli and cauliflower), whole nuts, whole grains, and pretty much anything with a peel should be avoided. These foods are hard to digest and can be very painful to eat if you’re having a flare.
- Spicy foods. You may want to put down the hot sauce, since foods that contain cayenne and other hot peppers can trigger Crohn’s symptoms.
Though the list of can’t-haves may seem daunting, there’s still a lot of delicious food to eat when you have Crohn’s. Lean meats, fish, and eggs are great choices. Beets, carrots, and squash are good veggie options, and bananas, melons, and applesauce can add a little sweetness.
These simple recipes should leave you nourished and satisfied.
Just keep an eye out for any ingredients that aren’t part of your specific diet plan.
When you feel a flare coming on, take steps to avoid your trigger foods immediately. If your intestines are inflamed, high fiber foods in particular can be painful to digest and make the flare worse.
Instead, be sure to drink lots of water and eat plain, easy-to-digest foods like bananas, applesauce, potatoes, and white rice.
It may be tempting to stop eating altogether due to pain and other symptoms you’re experiencing. But skipping meals can lead to fatigue, dizziness, and malnutrition. Try to keep eating what you can at regular intervals. Keep meals small to take it easy on your digestive system.
If a flare is worse than usual and you can’t eat, or if you start vomiting or have a high fever, see your doctor immediately.
When it comes to Crohn’s, there isn’t a one-size-fits-all dietary consensus. That’s why it’s best to talk with your healthcare provider about what works best for your unique and wonderful body.
While there’s no magic solution, avoiding trigger foods and making sure you get necessary nutrition can save you from a world of pain.