If you’re living with IBD, you know how challenging it can be to manage your symptoms. But did you know that your diet can play a crucial role in managing IBD symptoms? Too often I see the role of diet in helping to manage IBD, or even getting disease into remission, underplayed in favour of medications. In this post, we’ll introduce the idea of an IBD treatment diet and how it can help you feel better.
What is IBD?
Before we dive into the IBD treatment diet, let’s first define what IBD is. IBD stands for inflammatory bowel disease, and it refers to a group of conditions that cause inflammation in the digestive tract. The two most common types of IBD are Crohn’s disease and ulcerative colitis.
Symptoms of IBD can include abdominal pain, diarrhea, fatigue, and weight loss. While there is no known cure for IBD, there are several treatments available, including medication and surgery. However, diet can also play a significant role in managing IBD symptoms.
The IBD Treatment Diet
The IBD treatment diet is focused on reducing inflammation in the digestive tract and promoting gut health. More and more research is discussing the role of the gut microbiome in both the development and management of IBD. The gut microbiome refers to the trillions of microbes, including bacteria, yeast and fungi, that populate our large intestine and have a role in nearly every aspect of our health.
We know that dysbiosis, an imbalance in our gut microbiome, is now understood to be a major contributing factor to the development of IBD. In IBD, dysbiosis is characterized by a decrease in the diversity of the gut microbiome, specifically a decrease in abundance of certain beneficial bacteria and an increase in negative bacteria. Dysbiosis in IBD leads to a shift towards a proinflammatory environment with activated immune cells. Therefore, when we are considering how to use diet as a treatment for IBD a key focus needs to be addressing dysbiosis, and supporting the health of our gut microbiome.
Disclaimer: it is important to note that the foundation of a ‘gut health’ diet is a high fiber diet that includes a wide variety of different plant foods. During times of significant symptoms or an IBD flare, many people may be unable to tolerate a high fiber diet. It may be necessary to use medications to reduce inflammation or wait until symptoms have improved before trying the suggestions below.
Here are some of the key components of the IBD treatment diet:
- Anti-Inflammatory Foods
Foods that are high in anti-inflammatory compounds can help reduce inflammation in the digestive tract. Some examples of anti-inflammatory foods include:
- Fatty fish like salmon and tuna, which are high in omega-3 fatty acids
- Berries, which are high in antioxidants
- Leafy greens like spinach and kale, which are high in vitamins and minerals
- Turmeric, which contains the compound curcumin, known for its anti-inflammatory properties
Fiber is an essential component of a healthy diet, but it can be tricky for those with IBD. Some types of fiber can exacerbate symptoms, while others can be helpful. Soluble fiber, which is found in foods like oatmeal, bananas, and sweet potatoes, can help regulate digestion and promote gut health, since they contain prebiotics which feed our healthy gut bacteria. As symptoms improve, so will your tolerance for a wider variety of high fiber foods.
Probiotics are beneficial bacteria that can help maintain a healthy gut microbiome. This can be especially important for those with IBD, as research has shown that people with IBD may have an imbalanced gut microbiome. Fermented foods like live yogurt, kefir, kimchi and kombucha contain probiotics. There are also specific strains of bacteria (probiotics) which have demonstrated benefit specifically in IBD.
- Low-FODMAP Foods
FODMAPs are types of carbohydrates that can be difficult for some people to digest. For those with IBD, consuming high-FODMAP foods may exacerbate symptoms. Some examples of high-FODMAP foods include onions, garlic, and wheat. Following a low-FODMAP diet may help to reduce symptoms and improve overall gut health.
- Avoid Trigger Foods
Finally, it’s important to avoid foods that can trigger symptoms. This can vary from person to person, but some common trigger foods include spicy foods, caffeine, and alcohol.
Putting It All Together: IBD Meal Plan
So, what does a typical IBD treatment diet look like? Here’s an example of a day’s worth of meals:
- Breakfast: Oatmeal with blueberries and walnuts
- Snack: Apple slices with almond butter
- Lunch: Grilled salmon with a spinach salad and sweet potato fries
- Snack: Kefir with mixed berries
- Dinner: Chicken stir-fry with bok choy and brown rice
Here are some lifestyle tips to help you manage your IBD symptoms naturally:
- Focus on your diet: Your diet can play a significant role in managing IBD symptoms. Eating a balanced diet rich in fruits, vegetables, lean protein, and healthy fats can help reduce inflammation in the gut. It’s also important to avoid trigger foods that can aggravate symptoms. Common trigger foods include dairy products, spicy foods, and caffeine.
- Get enough sleep: Getting enough sleep is crucial for maintaining overall health and reducing inflammation in the body. Aim for 7-9 hours of sleep per night and establish a consistent sleep routine.
- Exercise regularly: Exercise can help reduce inflammation in the body and improve overall health. Aim for at least 30 minutes of moderate exercise most days of the week. Try low-impact exercises like yoga, walking, or swimming.
- Manage stress: Stress can exacerbate IBD symptoms. Try to manage stress through activities like meditation, deep breathing, or yoga.
- Consider supplements: Certain supplements can help reduce inflammation in the gut and improve IBD symptoms. Probiotics, omega-3 fatty acids, and vitamin D are all potential supplements to consider. Be sure to talk to your healthcare provider before starting any new supplements.
Nutrition therapy is an important factor in IBD management, both for improving symptom management as well as preventing malnutrition, micronutrient deficiencies, and other health concerns associated with IBD such as osteoporosis. It is important to note than an IBD treatment diet needs to be individualized, based on factors including the stage of the disease, individual food intolerances and the location of intestinal inflammation.
While there is no one-size-fits-all approach to managing IBD, the IBD treatment diet can be a helpful tool in reducing symptoms and improving overall gut health. Incorporating anti-inflammatory foods, soluble fiber, probiotics, low-FODMAP foods, and avoiding trigger foods can all be beneficial steps towards remission.
- ESPEN guideline on Clinical Nutrition in inflammatory bowel disease https://www.sciencedirect.com/science/article/pii/S0261561422004289
- Managing inflammatory bowel disease in the elderly: https://pubmed.ncbi.nlm.nih.gov/28375885/
- Exercise and IBD: https://pubmed.ncbi.nlm.nih.gov/35120159/
- Anti-inflammatory diet and IBD: https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-13-5
- Review of impact of diet on pathogenesis and management of IBD: https://academic.oup.com/ibdjournal/article/26/2/181/5610412?login=false
- A Review of Dietary Therapy for IBD and a Vision for the Future: https://www.mdpi.com/2072-6643/11/5/947