How to Eat During an IBD Flare-up

Food Does Not Cause or Cure IBD But Eating Right During a Flare-up is Key

People with inflammatory bowel disease (IBD) often face an uphill battle when it comes to food, especially when the disease is active. Many people with IBD don't know what to eat when the Crohn's disease or ulcerative colitis is flaring. Everyone with IBD is different, and one person's flare-up diet isn't going to work for another, but there are some broad ideas that may work for many.

A flare-up diet isn't to be followed long-term, because it's somewhat restrictive and tends to exclude certain foods that are healthful. The goal should be to get the IBD inflammation calmed down and then start to introduce foods back into the diet. This could be a bit of a yo-yo experience, where a food is added and then if it doesn't go well, that food is taken back out for a bit before trying it again.

Many people with IBD tend to restrict foods when in a flare-up, which is understandable, because who wants more pain or diarrhea? However, more calories are needed during a flare-up, not fewer. Most people lose weight during a flare-up and so it's important to be taking in enough calories that the weight loss doesn't become too problematic. A physician can help in understanding weight loss and how much is too much.

Creating a diet plan isn't easy, which is why it's always a good idea to get professional help. Meeting, even just once, with a dietitian, can be a revelation in terms of diet and answering that question "what do I eat?" Our understanding of IBD and diet is always evolving, so fine-tuning a flare-up diet plan is an ongoing process, and checking in with a dietitian will be helpful.

To Eat: Protein

Hard-boiled egg on wood
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One important part of an IBD flare-up diet is protein. Sources of protein to eat during an IBD flare-up include lean meats, fish, eggs, and nut butters. It's important to avoid fattier cuts of meat, as well as meats that are low-quality or are heavily spiced. Nut butters should be smooth and free of pieces of nuts ("crunchy") and eggs should be cooked without adding fats (not fried).

To Eat: Easier to Digest Fruits

Fruits with a lot of seeds might be difficult during a flare-up, and should be avoided in most cases, which includes a lot of berries. Melons, however, are going to be a good choice for a fruit that is easy to digest. Some of the fruits that are going to be more friendly for people in an IBD flare-up include bananas, watermelon, cantaloupe, papayas, and honeydew. Eat these fruits when they're quite ripe and with all the seeds removed.

To Drink: Herbal Teas

Herbal teas are comforting during a flare-up and can break up the monotony of drinking plain water. Teas should be naturally caffeine-free and without any additives. Artificial sweeteners can cause diarrhea or stomach upset in some people, so those should be avoided if that's the case.

To Drink: Liquid Nutrition

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There are a variety of nutritional supplements on the market that can be found in grocery and drug stores. They do tend to be pricey, but they can add much-needed nutrients to the diet during a flare-up. A gastroenterologist can recommend a particular brand and offer advice on how often they should be used. Liquid nutritional supplements shouldn't be used as the sole source of calories, however, as they are meant to augment the diet until more foods can be added.

To Avoid: Coffee

Coffee
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Coffee has a reputation for making people "go." It might not be the caffeine content but rather a substance in the coffee that stimulates the bowels, which means that decaffeinated coffee will have the same effects. It might not be realistic to go cold turkey or cut back entirely, so lowering the amount of coffee you drink each day by a bit may help.

To Avoid: Milk Products

Milk products
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Foods made with cow's milk can cause problems for some people, which is why it's often recommended that people with IBD avoid them. A gastroenterologist can help in diagnosing lactose intolerance, and for those who do have an intolerance and find milk products cause gas and pain or other symptoms, avoiding those foods is the best idea. This includes foods like a glass of milk, cheeses, ice cream, pudding, and yogurt. Some foods will have a lower lactose content, or may even contain only traces of lactose, such as yogurt and aged cheeses (think cheddar, Colby, Parmesan, and Swiss).

To Avoid: High Fiber Foods

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Foods that are high in fiber might be a challenge during an IBD flare-up. Most Americans don't get enough fiber and need to eat more. During an IBD flare-up, however, fiber might not be tolerated very well. High fiber foods include brown rice, wild rice, popcorn, barley, oats, and anything made with whole wheat. These foods could be added back into the diet when a flare-up is over (unless strictures or blockages are an issue), but might need to be excluded for a time while a flare-up is going on.

To Avoid: Fried Foods

Fried foods taste good and restaurants throughout America offer a menu full of them. The problem is that fried foods are usually fatty. They're cooked in oil and while there's a wide variety of oils and frying methods, the end result is typically a huge amount of fat in that food, which is why they taste so good. It's not realistic to avoid all fried foods forever. However, while flaring, it's a good idea to avoid those "appetizer-type" foods that aren't nutritious and that we eat more for fun and taste than for nourishment.

It's impossible to name every food that falls into this category, but this includes foods like french fries, chicken fingers, mozzarella sticks, corn dogs, and fried chicken. Our bodies need a certain amount of fat, but too much can cause diarrhea, which no one with IBD wants during a flare-up.

To Avoid: Raw Vegetables

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Most people don't eat enough vegetables, so the recommendation is usually that people eat more of them. However, for people with IBD who are in a flare-up, vegetables can cause problems. Not eating vegetables shouldn't be a way of life: it should only be done for a short period of time. Adding vegetables back into the diet slowly should be a goal. Well cooked (not steamed) or canned vegetables might be a better bet in the short term, in order to get some nutrients without causing too much distress during a flare-up.

Most vegetables are easier to digest when they are cooked well, with some exceptions, but every person is going to find their own personal list of vegetables that work well. Some of the more problematic vegetables, even when cooked, include broccoli, Brussels sprouts, cabbage, cauliflower, corn, lentils, lima beans, mushrooms, parsnips,  peas, and winter squash.

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