First Line Dietary Advice for Crohn’s Disease
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What is Crohn’s Disease?
Crohn’s Disease is a form of Inflammatory Bowel Disease (IBD). IBD is a term used to cover a number of inflammatory conditions of the digestive tract. The major types of IBD are Crohn’s Disease and Ulcerative Colitis. Crohn’s disease can affect any part of the digestive tract and can cause inflammation, ulceration and stricturing (narrowing) within the digestive tract. This can cause a number of symptoms such as diarrhoea, abdominal pain and nausea.
Following a healthy balanced diet and maintaining a healthy weight is important. Diet can also play an important role during a flare-up of Crohn’s disease, helping to alleviate symptoms, helping to maintain a healthy weight, and helping to prevent nutritional deficiencies.
Here are the top 5 dietary tips for Crohn’s disease:
1) During a flare-up, foods that may make your symptoms worse:
- Spicy foods such as chilli or curry.
- Fatty foods such as fried foods, fish in batter or meat pies made with pastry.
- Large amounts of caffeinated drinks such as tea, coffee and cola.
2) If you are losing weight:
- Aim to eat 6 –8 times a day, including 2-3 small meals or snacks between meals, such as cheese & biscuits, milk puddings, yogurts, sandwiches, fruit cake.
- Include extra nutritious drinks such as: soups, hot chocolate or milkshakes.
- Have a pudding every day such as tinned or stewed fruit & custard, sponge cake, mousse.
- Use full fat milk and dairy products (or lactose free alternatives).
3) If you have diarrhoea:
During a flare-up, or if you have ongoing symptoms of diarrhoea it is recommended to follow a low-fibre diet, and to drink plenty of water to prevent becoming dehydrated. Once your symptoms have improved, you can start to reintroduce fibre back into your diet again. Ways of lowering the fibre in your diet:
- Choose low fibre cereals such as cornflakes or Rice Crispies® (rather than high fibre cereals such as Bran Flakes®, Shredded Wheat® and Weetabix®).
- Choose white bread instead of granary or brown bread.
- Peel fruit before eating or have tinned or stewed fruit instead. Avoid higher fibre fruits such as oranges, grapefruit and pineapple.
- Avoid raw vegetables and salads such as raw onions, tomatoes, cucumber, celery, peppers and coleslaw.
- Have peeled, well cooked vegetables and avoid higher fibre vegetables such as mushrooms and sweetcorn. Peel potatoes, or have the inside of a jacket potato. Avoid beans and pulses.
- Avoid dried fruit and nuts.
Soluble fibre may be better tolerated during a flare-up or if you become constipated. Soluble fibre is found in:
- Oats (porridge oats, oat cakes).
- Peeled fruit and root vegetables such as carrots, turnip, swede, parsnips.
- Beans and pulses (if tolerated).
If you have any ‘inflammation’ or ‘stricturing’ that is causing a ‘narrowing’ in the digestive tract your doctor may advise you to follow a low fibre diet, which is sometimes called a ‘low residue’ diet.
- Start by following the low fibre dietary advice above.
- Chew your food well.
- Have small frequent meals and choose softer foods.
- Ask your dietitian for a ‘Low Residue’ diet sheet.
4) Calcium and Bone Health:
It is important to maintain a good calcium intake to maintain optimum bone health and reduce the risk of developing osteoporosis. This is particularly important if you have Crohn’s disease and are on steroid medication. The main sources of calcium in our diets are:
- Milk, cheese, yogurts
- Bread and breakfast cereals
- Tinned fish such as sardines and anchovies
- Green, leafy vegetables
- Beans and pulses, including baked beans, kidney beans and lentils
Your dietitian can advise you further on an adequate calcium intake, and your IBD team will advise you if you need calcium supplements.
5) Lactose Intolerance:
Lactose intolerance can occur if you are not digesting the ‘lactose’ found in dairy products effectively. This can cause symptoms such as diarrhoea, wind and bloating. This maybe more likely to occur if your Crohn’s disease affects your small bowel. Sometimes the lactose intolerance is temporary, and you can re-introduce lactose into your diet once you are in remission from your Crohn’s disease.
- Lactose is found in dairy products such as milk, cheese, yogurts, cream.
- Following a ‘lactose free’ or ‘low lactose’ diet can help to relieve symptoms.
- Most people with lactose intolerance can tolerate small amounts of lactose in their diet.
- You can use alternative dairy products such as ‘lacto-free’, soya, rice or oat milks, yogurts and puddings–check they are fortified with calcium. Your dietitian can advise you further if you need to follow a low lactose diet.
Useful Contacts: Your Dietitian is: —————————Contact Number: ————————-
Inflammatory Bowel Disease Nursing Team: 01908 996955.
Crohn’s and Colitis UK: Information Line: 0845 130 2233 www.crohnsandcolitis.org.uk