4 foods to eat – and 4 to avoid – when you have IBD
When you have inflammatory bowel disease (IBD), choosing the right foods can help you manage your condition whether you’re in a flare or in remission. While there’s no one-size-fits-all approach, certain foods can be beneficial—while others may worsen symptoms.
“Science is pointing in the direction of anti-inflammatory diets, like the Mediterranean diet, to use as a frame for how to create meals,” says Laura Manning, MPH, RD, CDN, Clinical Nutrition Coordinator at the Susan and Leonard Feinstein IBD Clinical Center at Mount Sinai Medical Center in New York City. “We want patients to eat mostly plants, minimal red meat, lots of fish—and steer away from heavily processed foods, like fast food.”
Your food choices, and food triggers, may change depending on whether or not you’re in a flare. But generally speaking, it can help to eat—and in some cases avoid—these foods when you have IBD.
Vegetables are an excellent source of dietary fiber, which helps aid digestion. “We encourage patients to focus their diet mostly on plants, which sounds scary to a lot of people, but the benefits of fiber have been shown to be protective,” explains Manning. “If you struggle to tolerate higher fiber foods, consider softer textured choices, such as well-cooked, peeled vegetables rather than tougher, rougher options.”
A general rule of thumb is that raw or leafy green vegetables can be irritating. “Leaning more towards starchy root vegetables like potatoes and squash can be helpful,” adds Manning.
Fruits are another quality source of fiber to add to your IBD diet. When you aren’t in a flare, you may find that you can tolerate most fruits well. If you are in the flare or if you’re more sensitive to textures, lean on softer options. “Cantaloupe, honeydew, mango, papaya, avocados, bananas, and peeled apples, pears, and peaches are all good fruit sources for people with IBD,” says Manning. “They don’t have a lot of thick skins or seeds in them, and they tend to be pretty soothing when eaten.”
Grains, like bread, rice, pasta, and barley, are essential sources of fiber, B-vitamins, iron, magnesium, and selenium. When you’re feeling well, be sure to incorporate plenty of whole grains in your diet; you may want to switch to refined grains during a flare, as they’re easier to digest.
“Oats are fantastic—and there are different ways of getting oats, like instant oats or steel cut oats, depending on your tolerance,” says Manning. “They can be used in cereals, breads, muffins, or overnight oats—there’s a million ways, and there’s a lot of really protective characteristics with oats.”
Protein is another important component of a healthy diet for IBD. You can get your daily intake of protein from a variety of sources—like meat, fish, poultry, and dairy. “Seed butters are also popular, and they’re easy-to-digest protein sources, along with Greek yogurt and cheeses,” adds Manning.
“It’s typical for caffeine to be problematic, whether it’s in coffee, tea, soda, or even chocolate,” says Manning. “Caffeine is a bowel stimulant—a lot of people use caffeine to go to the bathroom, but in IBD we don’t want that.” If you are in a flare or find that caffeine causes symptoms, it’s probably a good idea to dial back on your intake.
Like caffeine, alcohol is another gastrointestinal irritant, meaning it can lead to increased bowel movements—and it can also be dehydrating. “We don’t want patients to avoid alcohol completely forever. Just be mindful of it,” says Manning. Talk to your doctor about which medications you’re taking, as alcohol should be avoided with certain drugs. Otherwise, stick with the general recommendations of no more than one drink per day for women; two for men.
Avoid: Fatty foods
When you have IBD, it’s important to focus on nutrition—which means eating things like fast food and processed foods in moderation. “When you’re in a flare, bowels are very sensitive to food in general,” says Manning. “And an overload of grease in the food can exacerbate bowel movements more.” Avoiding fast food and opting for leaner foods can often lead to fewer symptoms, especially during a flare.
Avoid: Lactose, if necessary
“Having dairy products is healthy,” explains Manning. “They contain calcium and vitamin D, and can be part of a healthy diet.” While some people who have IBD are fine with dairy, others aren’t. “Some patients have a hard time tolerating dairy when they’re in a flare,” explains Manning. “In that case, things like lactose-free dairy products, hard aged cheeses, or even Greek yogurt are usually well-tolerated.”
Embrace trial and error
When it comes to eating with IBD, what works for some may not work for others. Food choices are a very individualized thing, and it can take time to figure out which foods are best for you. “It really has to be a lot of trial and error,” says Manning. “Start with some very simple, basic foods, and build on them.”
Medically reviewed by Matthew J. Hamilton, MD