Diet and IBD: eat this, not that

Living with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, can feel overwhelming, especially when it comes to food. While there’s no single “IBD diet” that works for everyone, making smart choices can help reduce symptoms, support healing, and improve your quality of life. This article breaks down what changes are usually recommended and aims to clear up the confusion about fiber intake and IBD.

Why Diet Matters in IBD

IBD causes chronic inflammation in the digestive tract, which can lead to pain, diarrhea, fatigue, and nutrient deficiencies. Food itself doesn’t cause IBD, but what you eat can influence symptoms and flare-ups. The goal is to maintain good nutrition while minimizing discomfort. In general, the following food behaviors may help lessen the chance of a flare-up or ease the discomfort of an active episode:

Staying hydrated. While everyone is advised to drink several cups of water daily for better health, this advice is even more critical for people with IBD as diarrhea can lead to dehydration which can lead to other health issues compounding a flare-up. 

Eating smaller, but more frequent meals. Large meals can stress the gut. Eating every 3 to 4 hours may cause less stress. Good choices here include leaner proteins like chicken, turkey, fish, and tofu which may also help repair inflamed tissue and increase strength and stamina.

Focusing on gentle foods. Well-cooked vegetables (think carrots, zucchini), peeled fruits (apples, bananas), and blended soups may be easier to digest. “Healthy” fats such as those rich in Omega-3 (salmon, walnuts) can also help calm inflammation.

Avoiding triggers. This may be the most difficult part, especially in the early days of a diagnosis: avoiding foods that once brought comfort. High-fat fried foods, spicy dishes, alcohol, caffeine, and items with added sugars or artificial sweeteners are known to trigger IBD episodes. This is especially important when away from home and out of routine like when on vacation, out to dinner at a restaurant, or at a work or social event.

What About Fiber?

For years, people with IBD were told to avoid fiber, especially during flare-ups. In recent years dietary experts have started to revisit that advice given that fiber is important for gut health (but how it is eaten matters). Fiber, which improves bowel regularity, may also reduce inflammation and actually help prevent flares. Soluble fiber, which dissolves in water, can ease diarrhea. This is found in foods like oats, bananas, applesauce, and peeled potatoes. Insoluble fiber has the opposite effect and may help with constipation -- think whole grains, raw nuts, and skins of fruits and vegetables.

During a flare, it is wise to stick to low-fiber foods like white rice, refined bread, and well-cooked vegetables without skins. As the episode improves, fiber should be reintroduced slowly - think pureed fruits and well-cooked vegetables. And believe it or not, texture matters. Blending fruits for example can make fiber easier for a person to tolerate.

When figuring out the elements of a diet that work well for IBD, keep in mind everyone is different. Overall, these pieces of advice may help:

• Keep a food diary: Track what is eaten, how it is cooked, and when it is consumed
• Talk to your doctor about supplements: If it seems like a struggle to get enough nutrients, ask about the possibility of adding iron, calcium, vitamin D, or omega-3 supplements
• Work with a dietitian: Personalized advice is key, especially if you have strictures, fistulas, or are recovering from a surgery

There’s no one-size-fits-all diet for IBD, but focusing on hydration, gentle cooking, lean proteins, and the right kind of fiber may make a big difference. Always pay attention to your body’s signals. With the right approach, diet can be a powerful tool to help someone live well with IBD.