Can nutrition play a role in managing Inflammatory Bowel Disease (IBD)? The short answer is, yes. This topic comes up often with patients suffering from conditions like Crohn’s disease and ulcerative colitis, two forms of IBD. In this post, we discuss the various types of IBD and how nutrition and working with a Registered Dietitian can play a role in symptom management.
What is Inflammatory Bowel Disease?
Before we discuss the role of nutrition when treating Inflammatory Bowel Disease, let’s first discuss what IBD actually is. IBD is a chronic medical condition that involves inflammation of the digestive tract. It includes two main types: Crohn’s disease and ulcerative colitis (UC). It is estimated that 1.6 million Americans suffer from IBD. Both of these conditions involve chronic inflammation of the GI tract, but they differ in terms of the affected areas and symptoms.
- Crohn’s disease causes pain and swelling in the small intestine and upper part of the large intestine.
- Ulcerative colitis causes swelling and ulcers in the large intestine, which includes the colon and rectum.
The cause of IBD is not known, but it is believed to stem from a combination of genes, immune system dysfunction, environmental factors, and imbalances in the gut. IBD is a chronic condition, meaning that it is long-lasting and can go through periods of remission and flare-ups. Symptoms of IBD include:
- Abdominal cramps and pain
- Diarrhea that may be bloody
- Severe urgency to have a bowel movement
- Fever
- Weight loss
- Loss of appetite
- Iron deficiency anemia due to blood loss
What is the Role of a Registered Dietitian in Managing IBD?
Nutrition and Inflammatory Bowel Disease go hand and hand, so it makes sense to have a Registered Dietitian (RD) as part of one’s care team. A Registered Dietitian can play a significant role in helping a patient manage their IBD symptoms. In fact, RDs often work closely with GI doctors and other health care providers to ensure a multidisciplinary approach to IBD.
There are many ways that an RD will use nutrition to help a patient manage their Inflammatory Bowel Disease. An RD can…
- Assess medical history, current symptoms, dietary habits and food intolerances.
- Identify any nutrient deficiencies.
- Recommend appropriate dietary changes to prevent, alleviate or manage symptoms.
- Teach how to read food labels, prepare IBD-friendly meals, and make informed food choices.
- Identify individual food triggers and help a patient avoid them.
- Provide emotional support, motivation and accountability.
There is a great deal of information both online and off concerning nutrition and Inflammatory Bowel Disease. This information can seem overwhelming and even contradictory. Meanwhile, a dietitian can help a patient differentiate legitimate science from fads or misinformation.
How Does Nutrition Play a Role in IBD?
Nutrition can play a significant role in IBD management. Eating certain foods can help ease symptoms, while consuming other foods may make symptoms worse. Restoring and maintaining good nutrition is a balancing act. One’s diet needs to include enough calories and nutrients to avoid malnutrition, while avoiding foods that can exacerbate symptoms.
Ways that nutrition can improve IBD symptoms
Managing Inflammation: Certain nutrients have anti-inflammatory properties and can help reduce inflammation in the gut. Omega-3 fatty acids found in fatty fish, flaxseeds, and walnuts all have an anti-inflammatory effect.
Maintaining Nutrient Balance: IBD can lead to decreased absorption of nutrients due to inflammation and damage to the intestines. Nutrient deficiencies are common, so it’s essential to focus on a balanced diet that provides necessary vitamins, minerals, and other nutrients. Vitamin D can help control intestinal inflammation, especially when taken with calcium.
Fiber Intake: Dietary fiber is tricky, as it can be both helpful and problematic. Soluble fiber found in oats, bananas, and cooked vegetables can help promote healthy bowel movements. Insoluble fiber, found in raw vegetables and fruits, can sometimes promote symptoms during flare-ups. It’s important to find the right balance of fiber based on individual needs. We like this brand of soluble fiber supplement.
Hydration: Staying well-hydrated is crucial for managing IBD symptoms. Diarrhea and other symptoms can lead to dehydration, so consuming enough water (with electrolytes) throughout the day is important! Having a stylish water bottle can help with motivation to keep drinking.
Eating Smaller, Frequent Meals: Large meals can sometimes trigger pain for people with IBD. Eating smaller, more frequent meals high in protein can help avoid overloading the digestive system and reduce pain. Try eating meals on smaller plates to help.
Probiotics: Probiotics are live microorganisms that can benefit gut health. Some studies suggest that specific strains of probiotics may help manage IBD symptoms. We like this one.
What symptom relief can be expected?
When it comes to symptom relief, results can vary from person to person depending on the severity of the disease and how a patient responds to treatment. When nutrition is on point, there are a variety of positive benefits a patient may see:
Reduced Inflammation: IBD causes inflammation in the digestive tract, leading to symptoms like abdominal pain, diarrhea, and rectal bleeding. Reducing inflammation can improve these symptoms.
Improved Bowel Movements: With appropriate treatment, the frequency and consistency of bowel movements can become more normal versus diarrhea and loose stools.
Pain Management: Stomach pain and cramping are common symptoms of IBD. Pain medications can help alleviate pain. Speak to your doctor before trying any new medication.
Nutritional Improvement: IBD can lead to weight loss and nutrient deficiencies due to malabsorption and little to no appetite. Meanwhile, a Registered Dietitian can work with the patient to identify and mitigate any deficiencies.
Maintaining Remission: Remission is a state of reduced or no symptoms. Once in remission, individuals experience a significant decrease in symptoms and an improvement in overall well-being.
Improving Quality of Life: Reduced symptoms and better disease control allow individuals to engage in their daily activities without constant disruption.
Meanwhile focusing on nutrition to help manage IBD is just one facet of treatment. A multidisciplinary approach is recommended. This includes involving GI doctors, Registered Dietitians, mental health professionals, and other specialists to address various aspects of the disease and its impact on a person’s life.
Is there an “IBD Diet”?
Knowing the role that nutrition can play when it comes to IBD, it’s no wonder that we are often asked if there is an IBD-specific diet. The short answer is no. It’s important to note that the impact of dietary changes can vary based on the individual, and what works for one person might not work for another. Always consult with a healthcare professional or a Registered Dietitian before making major changes to your diet. The goal of any eating plan is to manage symptoms, promote gut healing, and improve overall well-being.
Three types of diets that can sometimes improve IBD symptoms
The Mediterranean Diet focuses on whole foods like fruits, vegetables, whole grains, fish, and olive oil and has potential anti-inflammatory effects. A more recent study published in the Journal of Gastroenterology stated that a percentage of patients with Crohn’s disease and UC found the Mediterranean diet improved their nutritional status. This diet also improved IBD activity, inflammatory markers and quality of life over six months.
Low FODMAP Diet restricts a certain type of carbohydrate that can lead to symptoms like bloating, gas, and loose stools. It’s used to manage symptoms of irritable bowel syndrome (IBS), which can sometimes coexist with IBD. It is a diet that cuts back on a group of fibers and sugars that can be poorly absorbed by your GI tract. It’s meant only for short-term use and it may be recommended to help reduce your IBD symptoms.
Low-Residue Diet limits the consumption of high-fiber foods, which can help reduce the number and volume of stools. It can also reduce symptoms of ulcerative colitis, such as stomach pain and cramping. It’s a short term solution, often used during flare-ups to give the digestive system a rest. When adding fiber back into your diet, make sure to increase it slowly and to drink a lot of water.
Are There Other Things to Help Aside from Nutrition?
Managing IBD often requires a multi-system approach to address symptoms and improve overall well-being. The goal of IBD treatment is to reduce the inflammation that triggers your signs and symptoms. In the best case, this may lead not only to symptom relief, but also remission. IBD treatment usually involves either drug therapy or surgery, although in the case of Crohn’s disease, the results of surgery are usually not a long-term solution. When it comes to medications, these are prescribed by a Primary Care Physician (PCP) or a Gastroenterologist. Here are some common medications that are prescribed to treat IBD:
- Anti-inflammatory drugs – usually the first step in the treatment of UC.
- Immune system suppressors – work to suppress the immune response that releases inflammation-inducing chemicals into the body that can damage the lining of the digestive tract.
- Antibiotics – used in addition to other medications or when infection is a concern. Frequently prescribed antibiotics include Cipro and Flagyl.
- Biologics – help neutralize proteins in the body that are causing inflammation. Some are given via IV infusions and others are shots you give yourself. Humira is the most popular one on the market.
Meet with a Registered Dietitian
A Registered Dietitian can assess your nutritional status and review other biomarkers, which will give you a true understanding of your overall health. Having the support of a professional is key to making informed decisions and coming up with a plan that is best suited to your unique needs.
If you need help adding more fiber rich foods into your diet, we also have a robust meal planning program that can help!
Ready to use nutrition to manage your IBD symptoms? Book an appointment with a Registered Dietitian by clicking the button below.
