Is there an anti-inflammatory diet that works for Crohn's disease?

Kathleen Blanchard's picture
What types of foods can help manage Crohn's disease and ulcerative colitis.

Knowing which foods to eat and which ones to avoid can be confusing for people dealing with Crohn's disease or ulcerative colitis that are the two most common types of inflammatory bowel disease (IBD). What do studies show about how food can promote inflammation and which diet might be right for you?

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When it comes to managing Crohn's disease inflammation it may be important to focus on specific foods in the diet that is increasingly recommended by experts. Though there is no one proven diet for everyone, it makes sense to focus on foods that are anti-inflammatory that is also the goal of drug treatment or Crohn's disease.

There are a variety of foods that promote inflammation while others have the opposite effect of curbing the inflammatory response of IBD or inflammatory bowel disease. Knowing what foods to eat and which to avoid can be confusing and may take trial and error, mostly because studies are conflicting and confusing.

The goal of eating foods if you are dealing with Crohn's disease or ulcerative colitis is to control the symptoms. There is no hard core dietary recommendation established that can ensure you will remain symptom free, but there are some general guidelines that are worth noting.

Avoiding red and processed meat might stop IBD for some

Most every disease contains an inflammatory component, whether it's a viral or bacterial infection, cancer, diabetes, heart disease, arthritis or Crohn's or other autoimmune disease.

The suggestion of eating anti-inflammatory foods has recently become popularized. Examples include eating Mediterranean foods, the Zone diet or Dr. Andrew Weil's anti-inflammatory diet - all of which incorporate heart healthy and disease preventing foods.

Some studies support the idea that eating a diet high in fish oil or taking supplements can be beneficial for Crohn’s disease and ulcerative colitis.

According to the Crohn’s and Colitis Foundation of America (CCFA), some foods should be avoided including fried and greasy food, seeds, nuts and corn or popcorn. You may also feel better eating smaller, more frequent meals.

But aside from avoiding certain foods, you should focus on food that is high in nutrients. Crohn’s disease can interfere with absorption of essential vitamins and minerals, making it important to choose food wisely.

If you have been diagnosed with lactose intolerance, it may be important to avoid milk products.

If you have been told you have a stricture, or narrowing of the intestines, raw fruits and vegetables should be avoided. Instead, try liquid nourishment. You can speak with your doctor or a dietitian about what diet is best for you during times of flare-up.

The Physicians Committee for Responsible Medicine (PCRM) supports the notion that a typical Western diet that includes red meat can promote inflammation of the colon, contributing to IBD prevalence and symptoms.

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One of the reasons is because animal protein releases hydrogen sulfide in the colon that is a toxin that also interferes with the anti-inflammatory molecule butryrate in the intestine.

Preliminary studies show red and processed meat increased relapses of IBD five-fold. A small pilot study showed focusing on plant based foods and restricting red meat resulted in a complete remission of IBD, though more studies are needed to confirm the finding. Still, other studies suggest all types of fat, even saturated fat in meats can be “intestinal friendly”, making it difficult to know what dietary approach is right for everyone.

Low FODMAP diet

A 2011 published study suggesting eating a diet that is low in fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) could eliminate pain, gas and bloating associated with Crohn’s disease and ulcerative colitis.

FODMAP examples that are a form of carbohydrates that can be poorly digested for those with IBD include:

  • Fructose
  • Lactose
  • Fructooligosaccharides
  • Galactooligosaccharides
  • Sorbitol
  • Mannitol
  • Xylitol
  • Maltitol

Adopting a low FODMAP diet is being increasingly recommended by gastroenterologists for managing Crohn’s disease. In contrast to some studies, all meats are included in the low FODMAP diet, even those that are processed. You can view the diet here, courtesy of Stanford University Medical System.

One study that seems to support the FODMAP diet found the benefit might come from CLA - conjugated linoleic acid - that is found in eggs and grass fed beef for example that eliminated symptoms of Crohn's disease in study participants.

Regardless of which diet works best for you, it’s important to eat a variety of foods to maintain optimum nutrition.

Dr. Ben Kim who is a holistic MD and chiropractor recommends eating an anti-inflammatory type diet for optimal digestive health that includes adding cod liver oil before or with a meal. His recommendation is one tsp. per 50 pounds of body weight. He also recommends eating fermented foods like sauerkraut and kim chi, in addition to minimizing red meat intake. You can view a diet plan from Dr. Kim here.

See vitamin D helps Crohn's symptoms

Most evidence suggests there is an anti-inflammatory diet and lifestyle approach that can help manage ulcerative colitis and Crohn’s disease, but there's also no doubt more studies are needed to help guide those suffering from IBD. Most experts also agree that controlling inflammation is the key to optimal health and well-being for everyone.

The take home message is that eating for IBD is different for everyone, and solid studies are lacking about which diet is right for everyone. To help control symptoms of Crohn’s disease and ulcerative colitis, it may be best to keep a food diary that can help you understand what diet is right for you. Regardless of what foods work, focus on variety to ensure you are getting enough vitamin D, calcium, selenium, B12 and other essential vitamins.

Speak with your doctor or a dietitian if you are having difficulty with appetite or diarrhea. It’s also important to stay well hydrated. Focusing on anti-inflammatory foods for Crohn's disease might help prevent flare-ups, but it's important to understand what works best for you.

Updated 8/27/2014

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Comments

Did the article mean to say that a plant based diet and restriction of red meat resulted in a "remission" of symptoms rather than a "relapse"?
Yes Steve :( Thank you and I fixed it!