Diet and nutrition for inflammatory bowel disease

Most people with inflammatory bowel disease (ulcerative colitis or Crohn's disease) can eat a normal diet and do not need to avoid any particular foods. However, the following suggestions may be helpful. Some situations require extra attention to your diet.

• If you find that foods such as milk, alcohol, spicy foods, or foods high in fiber bother you, it makes sense to avoid them. A low-fiber diet may be helpful if a section of your small intestine is narrowed because of inflammation or scarring from Crohn's disease. However, you don't need to avoid any food that does not worsen your symptoms.
• Some people with inflammatory bowel disease (IBD) may not be able to eat dairy foods, which contain a nutrient called lactose.
• Eat a diet that includes plenty of nutrients. Vitamin or mineral supplements usually are not needed as long as you eat a balanced diet with plenty of fruits, vegetables, and whole grains. In Crohn's disease, absorption problems can occur with vitamin B12 in the lower small intestine and with iron in the upper small intestine. Some people with rectal bleeding also may lose iron.
• When symptoms are severe, your doctor may recommend supplemental nutrition, such as high-calorie liquid formulas. This may be needed especially for children whose growth is slow or for people with Crohn's disease in large areas of the small intestine.
• If the disease is so severe that your intestines are not able to absorb enough nutrients from food, your doctor may recommend other ways to get nutrition. You may receive nutrition through a needle in a vein (total parenteral nutrition, TPN) to allow the bowel to rest and heal. TPN often requires an initial hospital stay, after which you or a family member can learn to do it at home.

Research is being done on nutritional supplements to improve the symptoms of ulcerative colitis. Early studies of omega-3 fatty acids are promising, but the supplement is not yet recommended. Other supplements being studied include zinc, calcium, and folic acid.

Restricting sugar and dairy products in the diet is being studied in Crohn's disease. More research is needed before a particular diet can be recommended.