Crohn’s Disease Diet: Best & Worst Foods

Dr. Group
by Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM
Published on

Avocados are part of a Crohn's disease diet.

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that is becoming more common. People with this illness often find it debilitating and are always seeking new ways to improve their lifestyle and live with less discomfort and disruption. One of the ways people with Crohn’s alleviate symptoms of this condition involves a change in their daily menu. Adopting a Crohn’s disease diet along with a few other lifestyle changes can reduce your symptoms to improve your health, quality of life, and even encourage remission.

What Is Crohn’s Disease?

Crohn’s disease, sometimes called regional enteritis, is a chronic inflammatory bowel disease that causes chronic inflammation of the gastrointestinal (GI) tract. It is characterized as an autoimmune disorder. Crohn’s can affect portions of the gut from the mouth to the anus. The ileum portion of the small intestine is almost always affected, causing regional ileitis (inflammation of the ileum).[1]

If you have Crohn’s disease, your immune system launches an attack inside your digestive tract, causing inflammation in different parts of the bowels. This inflammatory pattern is unique to this illness. There is currently no cure for this disease, but several studies are investigating what triggers Crohn’s, and what can be done to encourage remission or reduce symptoms.

Crohn’s Disease Diet

One of the most promising techniques to reduce the unpleasant symptoms of Crohn’s involves changing your diet. Your GI tract absorbs vitamins, minerals, water, and macronutrients. When the lining of your bowel is compromised, it is harder to get these essential elements into your body. Because of malabsorption of vital nutrients, people with Crohn’s can become anemic – not having enough iron in the blood – making it that much more important to eat a nutritious, balanced diet.

Having Crohn’s can mean experiencing deficiencies in iron, vitamin B-12, and folic acid (B-9). Thus, eating a diet with foods rich in folic acid, vitamin B-12, iron, or supplements containing these vitamins can help provide the nutrients that might otherwise be missed.[2]

Talk to your healthcare provider or dietician for specific diet recommendations to reduce the symptoms of Crohn’s. Diet plans may be unique to each person and vary depending on symptom severity, medical history, or food allergies. Drinking plenty of water – specifically distilled or purified – is necessary to stay hydrated and keep waste moving through the digestive tract.

The Best Foods

The majority of foods suggested for Crohn’s disease have soothing qualities and are easy on the digestive tract. Some of these foods include:[3, 4]

The Worst Foods

Different foods can trigger symptoms of Crohn’s disease, even when a person is in remission. A diet high in fat and sodium contributes heavily to Crohn’s disease symptoms.[8] Avoid these foods:

Healthcare providers recommend Crohn’s patients embrace a gluten-free diet. This sticky protein found in wheat, barley, and rye can be difficult to digest and irritates the colon. It can also throw off the healthy balance of microflora in the gut.

It’s a good idea to consult your healthcare provider regarding your own personal Crohn’s, colitis, or IBD diet. Foods that are beneficial to some may have adverse effects on others.[5]

What Causes Crohn’s Disease?

Crohn’s disease is believed to be caused by a bacterial infection that damages the gut, triggering an autoimmune reaction. It’s unclear what initiates Crohn’s disease in any one person, but it’s known to have a genetic basis: people with a family history of digestive ailments are more likely to get this condition. Genetically-linked health conditions are often triggered by “gene-environment interactions.” What that means is that even if you carry the genes for a certain disease or condition, you can keep it at bay – or trigger its onset – by your lifestyle choices, diet, and what you are exposed to in your environment.

Environment

Smoking, secondhand smoke, air pollution, and other toxic conditions can contribute to an imbalance of healthy bacteria in the gut and weaken the immune system. Other elements that can contribute to disease onset or flare-ups include the use of antibiotics – especially in a child’s early year, nonsteroidal anti-inflammatory drugs (NSAIDs), and birth control pills.[6]

Hygiene

The effect of personal hygiene on inflammatory bowel disease has been studied to see if it affects Crohn’s disease. The hygiene hypothesis is a prevalent theory that compares children in both developed and developing nations to see if over-hygienic practices adversely affect the immune system. Some experts argue that when the body is not exposed to certain bacteria (particularly Helicobacter pylori, viruses, and other pathogens in childhood), healthy gut bacteria can be altered, keeping the immune system from developing properly. This underexposure is theorized to promote autoimmune diseases like Crohn’s disease.[7]

Even poor oral hygiene may negatively affect the healthy flora in the mouth and trigger symptoms of inflammatory bowel disease. Repeated or increased dental issues may be a result of either IBD or altered flora of the mouth.[8]

Appendectomy

The jury is still out on whether Crohn’s disease is triggered by an appendectomy. Removal of the appendix is often seen as harmless, but removing the appendix may affect immune function as it is thought to assist in the maturation of white blood cells and help populate the gut with healthy bacteria. Studies are being done to see if removal of the appendix directly affects or triggers symptoms of Crohn’s.[8] The appendix is far from a useless organ: it may contain reservoirs of beneficial bacteria, and removing it may have repercussions that we don’t fully understand.

Stress

Stress directly affects immune function. Chronic stress may damage the intestinal mucosa, exacerbating symptoms in people with inflammatory bowel disease. People with Crohn’s disease who have moments when they can’t get their stress levels under control can experience amplified symptoms of their illness – often putting a stop to whatever they are currently working on or doing.[9, 10]

Many people with Crohn’s disease turn to natural and holistic methods to help reduce stress, including keeping a journal or reaching out to others with the same affliction. Aromatherapy with essential oils like lavender and chamomile is known to reduce stress and its negative effects, as is exercise, meditation, and massage.

Crohn’s Disease Diagnosis

Crohn’s disease is usually diagnosed through endoscopy, in which a narrow tube with a light and camera is inserted either through the throat and down into the digestive system, or through the rectum into the colon; the latter type is called a colonoscopy. During this procedure, a biopsy or tissue sample is taken. Standard blood tests can rule out certain illnesses, and doctors will also look for blood in the stool. Most people with this disease are diagnosed between the ages of 13 and 30.[11]

Symptoms of Crohn’s Disease

People with Crohn’s disease describe symptoms as constant abdominal pain, gas, bloating, diarrhea, weight loss, anemia, and sores in the mouth and rectum. Feelings of lethargy and constant pain can significantly affect people’s ability to participate in social events and stay on task during the day.

Other symptoms include fever and mucus and blood in the stool. When it’s time to use the bathroom, there is no waiting, much like people with irritable bowel syndrome (IBS). People who regularly experience symptoms of Crohn’s say they feel like they are trapped between the bedroom and the bathroom.[12, 13]

The Difference Between Crohn’s Disease and Ulcerative Colitis

Ulcerative colitis is another inflammatory bowel disease that only affects the innermost lining of colon walls, while Crohn’s affects your entire digestive tract from mouth to anus. [12]

Are There Natural Solutions for Crohn’s Disease?

In addition to following a healthy diet, there are a few holistic practices that may help reduce the symptoms of Crohn’s disease.

Lifestyle Choices

Yoga, acupuncture, meditation, and the use of essential oils are some of the holistic methods many people affected by Crohn’s disease use to help alleviate their symptoms. Probiotic supplementation has also shown a positive effect on symptoms because of probiotics’ ability to populate the gut with healthy bacteria.[14]

People who are affected by Crohn’s disease may want to set realistic long and short-term goals so they can stay focused, get control, and not become overwhelmed.[15] It’s also important to seek medical care if symptoms get out of control.

Health Supplements

While eating a balanced, nutritious diet is always the best way to get your vitamins and minerals, people with Crohn’s may have to avoid certain foods that irritate the GI tract, causing them to miss out on some essential nutrients. Supplements can help fill the gaps in your nutritional intake. Omega-3 fatty acids are beneficial for individuals with Crohn’s. Taking a multivitamin that includes B-12, B-9 (folic acid), and vitamin D is particularly important. You can also take these vitamins individually. A well-rounded probiotic with multiple strains can ensure your gut functions optimally. [16]

What’s Your Story?

Do you have Crohn’s disease or another form of inflammatory bowel disease? Have you changed your diet as a result, and has this positively influenced your symptoms and daily routine? We’d love to learn more. Your experiences help us understand a more personal account of how this disease affects people. Tell us your story in the comments section below.

References (16)
  1. Baumgart D, et al. "Crohn's disease." Lancet. 2012;380(9853),1590-605. Accessed 12 Apr. 2018.
  2. C Gasche, et al. "Iron, anaemia, and inflammatory bowel diseases."Gut. 2004;53(8), 1190–1197. Accessed 12 Apr. 2018.
  3. Triggs C, et al. "Dietary factors in chronic inflammation: food tolerances and intolerances of a New Zealand Caucasian Crohn's disease population." Mutat Res. 2010;690(1-2):123-38. Accessed 12 Apr. 2018.
  4. MacDermott R. "Treatment of irritable bowel syndrome in outpatients with inflammatory bowel disease using a food and beverage intolerance, food and beverage avoidance diet." Inflamm Bowel Dis. 2007;13(1), 91-6. Accessed 12 Apr. 2018.
  5. Brown A, et al. "Does evidence exist to include dietary therapy in the treatment of Crohn's disease?" Expert Rev Gastroenterol Hepatol. 2010;4(2),191-215. Accessed 12 Apr. 2018.
  6. Natalie M, et al. "Environmental Risk Factors for Inflammatory Bowel Disease." Gastroenterol Hepatol (N Y). 2010; 6(5), 339–346. Accessed 12 Apr. 2018.
  7. Natasha K, et al. "Hygiene hypothesis in inflammatory bowel disease: a critical review of the literature." World J Gastroenterol. 2008; 14(2), 165–173. Accessed 12 Apr. 2018.
  8. Jacques C, et al. "Prior appendectomy and the phenotype and course of Crohn’s disease." World J Gastroenterol. 2006; 12(8), 1235–1242. Accessed 12 Apr. 2018.
  9. Singhal S, et al. "The role of oral hygiene in inflammatory bowel disease." Dig Dis Sci. 2011;56(1),170-5. Accessed 12 Apr. 2018.
  10. Mawdsley J, et al. "Psychological stress in IBD: new insights into pathogenic and therapeutic implications." Gut. 2005; 54(10), 1481–1491. Accessed 12 Apr. 2018.
  11. "Crohn's disease: also called: regional enteritis, regional ileitis." National Library of Medicine. MedlinePlus. NIH. Accessed 12 Apr. 2018.
  12. Waugh N, et al. "Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation." Southampton (UK): NIHR Journals Library; 2013 (Health Technology Assessment, No. 17.55.) Appendix 1, Comparison of ulcerative colitis, Crohn’s disease, irritable bowel syndrome and coeliac disease. Accessed 12 Apr. 2018.
  13. Segal A, et al. "Making Sense of the cause of crohn’s – a new look at an old disease." F1000Research 2016;(5): 2510. PMC. Accessed 12 Apr. 2018.
  14. Mario G, et al. "A natural approach to treatment of inflammatory bowel disease." Br J Clin Pharmacol. 2008; 65(4), 468–469. Accessed 12 Apr. 2018
  15. "Take steps to prevent or reverse stress-related health problems. The relaxation response appears to manage stress and some chronic conditions at the deepest levels." Harvard Medical School. Harvard Health Publishing. Harvard Health Letter. harvard.edu. 2017. Accessed 12 Apr. 2018.
  16. Schäffler H, et al. "Vitamin D administration leads to a shift of the intestinal bacterial composition in Crohn's Disease patients, but not in healthy controls." J Dig Dis. 2018. Accessed 12 Apr. 2018.

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