Creating a Crohn's Disease Diet Plan

Medically Reviewed by Jabeen Begum, MD on July 15, 2024
Written by Debra Fulghum Bruce, PhD, Nicole Schmidt, Kristin Mitchell
11 min read

If you have Crohn's disease, you probably have found that certain foods trigger your intestinal symptoms, especially when the disease flares. Learning to avoid these food triggers may allow you to better self-manage your Crohn's disease, reduce gastrointestinal (GI) symptoms, and promote intestinal healing.

It's one of the two main types of inflammatory bowel disease (IBD) along with ulcerative colitis. Both involve an immune reaction against the intestinal tract.

Crohn's often inflames the small intestine, which can cause diarrhea and belly pain. You may have less appetite, and the inflammation makes it harder for your body to absorb nutrients from the food you do eat.

Surgery for Crohn's that removes part of your intestines can add to the absorption problem.

It can be hard to get enough nutrition and maintain a healthy body weight with Crohn's disease.

You've probably read about types of diets for Crohn's disease. But the fact is, there is no scientifically proven diet for IBD. Most experts believe, though, that some patients can identify specific foods that trigger their GI symptoms, particularly during disease flares. By avoiding your "trigger foods," you may find that your GI symptoms of gas, bloating, abdominal pain, cramping, and diarrhea are more manageable. At the same time, you will give your inflamed intestines time to heal.

This is even more important when you have a flare-up of your Crohn's symptoms. Spicy or greasy foods, whole grains, high-fiber fruits and vegetables, nuts and seeds, caffeine, and alcohol can all be harder on your body during a flare-up.

If you've had problems absorbing nutrients due to Crohn's disease, it's important to follow a high-calorie, high-protein diet, even when you don't feel like eating. In this setting, an effective Crohn's disease diet plan, based on recommendations from experts, would emphasize eating regular meals — plus an additional two or three snacks — each day. That will help ensure you get plenty protein, calories, and nutrients. In addition, you will need to take any doctor-recommended vitamin and mineral supplements. By doing so, you will be able to refill the necessary nutrients in your body.

Crohn's disease diet plan

Eating certain foods regularly can help reduce inflammation. When you're not having a flare-up, try to include high-fiber, starchy foods like potatoes, rice, oatmeal, or bread in your diet. Cooked, peeled, or blended fruits and veggies, like bananas, raspberries, squash, and leafy greens added to a smoothie, are good for reducing inflammation and are easier to digest. Protein is also important in a Crohn's disease diet because it helps rebuild muscle and speed up healing. Good sources of protein include lean meats, fish, eggs, yogurt, and soybean products.

During a flare-up, try to eat healthy foods that are gentle on your gut. Start with soft, bland foods like applesauce, bananas, potatoes, and cooked vegetables. Yogurt, fish, cereals, and low-fiber foods can also help you get the nutrition you need on a Crohn's disease diet without causing irritation. Hydration is good for digestion, so try to drink at least eight cups of fluids per day. If you're losing weight, add full-fat foods and, if recommended by your doctor, nutritional supplement drinks to your diet.

The foods that trigger symptoms differ for each person with Crohn's disease, but the only food that is generally recommended to avoid during a flare-up is fiber. To know which foods to leave out of your diet plan, you'll need to determine which foods, if any, trigger yours.

Many people with Crohn's disease find that one or more of the foods on the following list affect symptoms during disease flares. It's possible that at least some of these listed foods will trigger your symptoms:

  • Alcohol (mixed drinks, beer, wine)
  • Butter, mayonnaise, margarine, oils
  • Carbonated beverages
  • Coffee, tea, chocolate
  • Corn
  • Dairy products (if lactose-intolerant)
  • Fatty foods (fried foods)
  • Foods high in fiber
  • Gas-producing foods (lentils, beans, legumes, cabbage, broccoli, onions)
  • Nuts and seeds (peanut butter, other nut butters)
  • Raw fruits
  • Raw vegetables
  • Red meat and pork
  • Spicy foods
  • Whole grains and bran

Once you've identified foods that cause your symptoms to flare, you can choose either to avoid them or to learn new ways of preparing them that will make them easier to handle. To do that, you'll need to try a variety of foods. For example, if certain raw vegetables trigger a flare, you don't necessarily need to give them up. You may find that steaming, boiling, or stewing them will allow you to eat them without increased GI symptoms. If red meat causes symptoms, you could try eating ground sirloin to see if you can handle a leaner cut of beef. Or you might decide to rely on fish or low-fat poultry without skin as your main sources of protein.

Alcohol and Crohn's disease

The sugar and sulfates in alcohol can irritate the GI tract and trigger a Crohn's disease flare-up. But that doesn't mean you have to stop drinking altogether. To reduce the harmful effects, try to drink in moderation and have one glass of water for every alcoholic beverage that you consume. Some research suggests that small amounts of red wine might reduce inflammation, but nonalcoholic anti-inflammatory options are still better for your gut.

 

A low-residue diet is one that's low in specific foods that add undigested food to the stool. Many individuals with small-bowel Crohn's disease have a narrowing or stricture of the lower small intestine (the ileum). For them, a low-fiber with low-residue diet can help food pass through the digestive system more easily, lessening abdominal pain, cramping, and diarrhea. And while scientific proof is lacking, this diet may also help decrease the frequency of bowel movements for some people.

Foods to avoid on a low-residue diet

If you're on a low-residue diet, you should avoid:

  • Corn
  • Nuts
  • Raw or dried fruits
  • Berries
  • Citrus
  • Seeds
  • Raw vegetables
  • Onions
  • Cabbage
  • Cauliflower
  • Broccoli
  • Brussel sprouts
  • Potato skins (cooked potatoes with no skin are okay)
  • Whole grain breads, pasta rice, and cereals
  • Tough, fibrous meats
  • Beans, peas, and lentils
  • Peanut butter
  • Popcorn
  • Jams, pickles, olives, and preserves

Dietary fiber is important for your overall health. It can help you keep your cholesterol, blood pressure, and weight at healthy levels. And getting about 23 grams of fiber a day can cut your risk of a Crohn's flare by as much as 40%. But while you're having a flare, high-fiber foods can aggravate your symptoms.

Soluble fiber vs. insoluble fiber

The best fiber choices when you have Crohn's are foods that contain soluble fiber, such as oat bran, barley, nuts, seeds, beans, lentils, peas, and certain fruits and vegetables. Soluble fiber soaks up extra fluid in your gut, slows down digestion, and can help ease diarrhea.

The other kind of fiber, insoluble fiber — found in wheat bran, vegetables, and whole grains — can increase the amount of water in your gut, speeding up digestion. This can lead to watery diarrhea, stomach cramps, or gas. At worst, too much insoluble fiber can cause a blockage.

Foods that come from plants are the best source of fiber. Most plant-based foods contain both soluble and insoluble fiber. Remove peels, skin, and seeds of fruits or veggies to cut down on insoluble fiber. Check labels for added fiber in unexpected foods like dairy products.

During times when you don't have active Crohn's symptoms, choose whole grains and a variety of fresh fruits and vegetables.

Yes. Keeping track of the foods you eat each day can help you identify the "offenders" — foods that may trigger symptoms. Avoiding these foods, especially when your disease is active, may give you better control of the symptoms.

You can also use a daily food diary to help you and your doctor confirm whether you're getting a properly balanced diet. It can show whether you're getting enough protein, carbohydrates, fats, and water. It may also show whether you're getting enough calories to maintain your weight and energy.

To start your diary, record the foods you eat each day and the serving sizes in a small notebook. Enter the date, food, and any symptoms you might feel after eating this food in the notebook.

After 1 or 2 months, set up a time to review your food diary with a registered dietitian. The dietitian can determine if you're getting essential nutrients in a well-balanced meal plan or if you might need supplements. Getting the right amount of nutrients helps your body heal itself and keeps you well. So having a nutrition discussion with a registered dietitian is important to your overall health and to the management of Crohn's disease.

Limiting some food triggers may help control your symptoms during disease flares. But don't restrict yourself so much that you make malnutrition, which often comes with  Crohn's disease, worse. You'll need to find other sources to replace calories, protein, carbohydrates, and fats that are in the foods you cut out of your diet. To do that, you'll need to focus on adding nutrient-dense foods in your diet plan.

While fast foods should normally be avoided in a healthy diet plan, sometimes they can give your diet a needed boost when used from time to time. Some fast foods can offer a valuable supply of key nutrients and calories. For instance, pizza offers calories, protein, and nutrients such as calcium and vitamins A, B, C, and D. A milkshake is high in calories and calcium. Of course, if you are lactose-intolerant, you need to remember to take the proper medication before drinking a milk product.

Ask your doctor or dietitian about vitamin and mineral supplements. For example, many people with Crohn's disease have a vitamin D deficiency. A study published in the American Journal of Preventive Medicine reported that higher doses of vitamin D (1,000-2,000 IU each day) may be good for you, particularly in reducing the risk of colorectal cancer, which may be higher in people with IBD. A dose of 600 IU/day of vitamin D is generally recommended. But it's still important that you check with your doctor to see what dosage is ideal for you.

Some research suggests that liquid diets might help people with certain health conditions, and there is evidence that some people with Crohn's disease may benefit from a high-calorie liquid diet, particularly during a flare. By giving the intestines a much-needed rest, the liquid diet can help suppress symptoms of Crohn's disease. In addition, the liquid diet or special high-calorie liquid formulas can help people with Crohn's who need extra nutrition short-term or those whose intestines cannot absorb proper nutrition from whole foods.

Enteral nutrition

People who have a hard time absorbing food and nutrients use enteral nutrition for nutritional support. You can drink liquid supplements, like Ensure Plus or Boost Plus, in addition to or instead of regular food. These supplements can also be delivered through a feeding tube. Enteral nutrition is often helpful for children with Crohn's who may have stalled growth or late puberty because of the disease.

Parenteral nutrition

If you have a severe flare, are very malnourished, or have lost much of your small intestine to surgery, your doctor may recommend bypassing your gut entirely. In this case, liquid nutrients are delivered through a tube or catheter directly into your bloodstream. This gives your intestines a break and can help ease symptoms. Your doctor might call this a bowel rest.

You can get all the necessary vitamins and minerals from a well-balanced diet. However, flare-ups and other complications of Crohn's disease can make it difficult for some people to get enough nutrients from food alone. Always talk to your doctor before starting supplements, including over-the-counter products.

Omega-3 fatty acids

Many studies using fish oil and flaxseed oil suggest that healthy fats help reduce inflammation. However, the findings aren't all the same on whether omega-3 fatty acids specifically reduce inflammation in IBD. If you want to add omega-3 supplements to your diet, talk to your doctor first.

Probiotics

Other studies are starting to explore whether probiotics — live microorganisms that support "good" bacteria in the body — may be helpful for people with Crohn's disease and ulcerative colitis. Probiotics are sold as dietary supplements in the U.S., so they aren't regulated in the same way that pharmaceutical drugs are, making them harder to study. Some studies suggest that probiotics might help ease GI symptoms, but the quality of these studies varies. More research is needed to confirm whether these supplements can actually heal the intestine in IBD.

Food is a big part of managing Crohn's disease. Identifying trigger foods and adopting a healthy diet can help reduce flare-ups and lower digestive discomfort. It's important to talk to your doctor or a dietitian to find a dietary plan that fits your specific needs and symptoms. Taking a proactive approach to nutrition can improve your overall quality of life and help you better manage Crohn's disease in the long term.

What can I drink with Crohn's disease?

Water is the best thing you can drink if you have Crohn's disease, especially during episodes of diarrhea. Broths, smoothies, or oral rehydration solutions can also be helpful in managing symptoms. Try to limit caffeine, alcohol, and sugary drinks.

What should a person with Crohn's disease eat for breakfast?

Breakfast foods like oatmeal, eggs, yogurt, smoothies, and bananas are easy on the digestive system for those with Crohn's disease. Try to avoid whole grains, coffee, and tea.

What are the 10 worst foods for inflammation?

Red meat, processed meat, deep-fried foods, foods high in added sugar or trans fat (including jams, sodas, and margarine), refined carbs (like white bread or commercial baked goods), and alcohol are all known to cause inflammation.

What is life expectancy with Crohn's disease?

People with Crohn's can expect to live as long as people who don't have the disease. By making a few lifestyle adjustments, you can still lead a fulfilling life with Crohn's.