Crohn’s disease and ulcerative colitis are the most common forms of inflammatory bowel disease. The digestive symptoms they cause can range from mildly annoying to life threatening. Many patients are quite confused about which foods are beneficial and which should be avoided.

Crohn’s disease and ulcerative colitis are both autoimmune diseases. They occur when the immune system attacks part of the intestines. Ulcerative colitis affects the large intestine (colon), whereas Crohn’s disease may affect the small and large intestine. They are both very common diseases and the symptoms they produce can significantly reduce quality of life. I am seeing an increasing number of young people with these diseases.

Inflammatory bowel disease typically causes diarrhea several times each day. The diarrhea can have mucus or blood in it. Symptoms can vary in intensity significantly over time; patients tend to experience flare-ups and then phases where they go into remission. Besides digestive symptoms, fatigue and low mood are typically present.

A number of medications are available to manage the symptoms of inflammatory bowel disease; the most common are steroids and drugs that modify the behavior of the immune system. A lot of people are uncomfortable with taking these drugs, either because the side effects are very unpleasant, or the long term risks are frightening.

The food you eat can have an immediate effect on your bowel function, and also a long term effect, influencing whether you will have a flare-up of the disease in the near future or not.

Fiber, starch and sugar can be a problem

We are usually told that increasing the amount of plants and increasing the fiber in our diet is the best thing we can do for our health. That’s usually not the case for people with inflammatory bowel disease. A few recent studies have shown that a low FODMAP diet may offer significant relief of symptoms. FODMAPs are a group of carbohydrates that are poorly absorbed by many people. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Some people have a very low tolerance to these foods, and eating them causes a great deal of digestive discomfort. They can cause secretion of fluid into the intestines, thus may trigger a bout of diarrhea.

If you want to try a low FODMAP diet, you may notice an improvement in bowel symptoms within a few days. Many commonly eaten foods are high in FODMAPs, including apples, pears, onion, garlic, cabbage, asparagus, and snow peas. Legumes and lentils are especially high in FODMAPs. Three observational studies and one randomized controlled trial have shown that a low FODMAP diet may improve gastrointestinal symptoms, including abdominal pain, bloating, diarrhea, flatulence, stool consistency and stool frequency.

For information on which foods are high and low in FODMAPs, have a look at this Monash University webpage.

Other diet tips for managing inflammatory bowel disease

  • Gluten, sugar and dairy products are best removed from the diet, as they can worsen auto-antibody production in those with autoimmune disease.
  • Cooked vegetables are usually better tolerated than raw salads. Try steaming or roasting your vegetables, or eat them in a stew or casserole.
  • Try to just eat 3 meals a day and minimize snacking. It’s best to give your digestive system a rest between meals. Fill up on protein-rich foods such as seafood, poultry, eggs, and meat. Fat is also satiating, so make sure you have adequate good fats such as olive oil, coconut oil, ghee, or animal fats.
  • If you have a weak digestive system take digestive enzymes in the middle of your meal and sip one to two tablespoons of organic apple cider vinegar diluted in 3 tablespoons of warm water 5 minutes before the meal.
  • Small intestinal bacterial overgrowth is present in almost all cases of inflammatory bowel disease. This can result in excessive fermentation in the gut and is the reason FODMAPs are often poorly tolerated. The herbal antimicrobial called BactoClear helps to eradicate bad microbes in the gut.
  • Berberine can help reduce diarrhea, abdominal pain, and excessive stool frequency. This is because it has an antimicrobial effect, reduces inflammation, and reduces leaky gut.

Reference

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.