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Dietary Options for IBD
The Role of Diet in IBD
Diet can be a powerful tool when used alongside medications and/or surgery to support GI health. Because IBD affects each person differently dietary therapies are not one-size fits all and may be used at different stages and to achieve different outcomes. Diet can be used
Short term to:
- induce remission
- optimally prepare for surgery
- treat malnutrition
Long term to:
- manage symptoms
- impact inflammation levels
- maintain remission
Why Learn About Different Dietary Options?
Navigating nutrition within IBD is often more complex than other medical conditions. Those with Crohn's disease or ulcerative colitis often experience symptoms in relation to the foods they consume1,2,3, and there is no single recommended dietary therapy to guide them. Growing research shows a range of dietary IBD therapies to be effective4, and while many share common principles, some have subtle to significant differences. Although research continues to evolve, patients don't need to wait- many can benefit by exploring the nutrition options available today.
Below we provide an overview of the evidence-based nutrition options available for IBD.
References
- Whelan K, Murrells T, Morgan M, et al. Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients. Am J Clin Nutr. 2021;113(4):832-844. doi:10.1093/ajcn/nqaa395
- Holt DQ, Strauss BJ, Moore GT. Patients with inflammatory bowel disease and their treating clinicians have different views regarding diet. J Hum Nutr Diet. 2017;30(1):66-72. doi:10.1111/jhn.12400
- Gu P, Feagins LA. Dining With Inflammatory Bowel Disease: A Review of the Literature on Diet in the Pathogenesis and Management of IBD. Inflamm Bowel Dis. 2020;26(2):181-191. doi:10.1093/ibd/izz268
- Nutritional Therapy for IBD research
Healthy Eating Options
Healthy Eating Options offer a more flexible approach that can fit into everyday life, making dietary therapy feel more manageable for many patients. Using these options as part of treatment may reduce symptoms and inflammation, improve overall health, and improve quality of life. Healthy Eating Options were not designed specifically to treat IBD on their own, but are considered beneficial when used in combination with medications.
Therapeutic Diets
Therapeutic Diets are structured eating plans that have been specifically designed to support IBD and other auto-immune disorders. They have the potential to significantly affect inflammation. In some situations, healthcare providers and patients may decide together to try these diets as a main part of treatment.
Therapeutic diets follow clear food guidelines and strict compliance is essential for success. Because they often require more planning, time and lifestyle adjustments, they may be a better fit for those who feel ready to make more structured changes to their eating habits. Reviewing key considerations can help determine whether a therapeutic diet is the right option.
It is advised to work with a healthcare team, ideally an IBD-trained dietitian, to help ensure these therapeutic diets are followed safely and effectively.
These diets are listed according to historical timeline of development, with SCD as the first and CDED as the most recent. This order does not indicate preference. All diets, except for CDED, can be incorporated into both Crohn's disease and ulcerative colitis treatment plans. CDED is the most extensively researched diet for Crohn's disease.
Enteral Nutrition
Enteral nutrition involves the use of a nutritionally complete liquid diet that provides either all or a certain percentage of daily calories. This liquid diet is often an over-the-counter meal replacement formula. There are two different forms of enteral nutrition: Exclusive Enteral Nutrition (EEN) and Partial Enteral Nutrition (PEN).
EEN is a well-established approach for inducing remission in some patients and growing research suggests that PEN as part of treatment may help some patients maintain remission.
It is important that patients receive guidance from their healthcare professionals to implement Enteral Nutrition.
Options for Improving Noninflammatory symptoms (DGBI, IBS)
Sometimes inflammation is well controlled, but symptoms still continue. In these situation, additional dietary strategies may be helpful.
For those living with IBD who also experience and IBS-like symptoms or Disorders of Gut-Brain Interaction (DGBI), a short trial of the Low-FODMAP diet (about four weeks) may be considered. Because this diet can be difficult to follow correctly, it is best done with guidance from a dietitian and should be used only short term, with planned reintroductions of foods.
Many of those with IBD also notice that certain foods trigger symptoms regardless of inflammation levels. Identifying and limiting these personal trigger foods may help resolve ongoing symptoms.
