Nutrition with Crohn's-Colitis, Short-bowel Syndrome, or IBS-IBD
How should I eat during a flare or remission?
Watch those trigger foods
Some foods may trigger cramping, bloating, and/or diarrhea. Many of these “trigger foods” should also be avoided if you have recently had surgery or been diagnosed with a stricture (a narrowing of the intestine caused by inflammation or scar tissue). Certain foods are easier to digest and can provide you with the necessary nutrients your body needs.
It’s also important to maintain a diverse and nutrient-rich diet even when you are in remission and your symptoms have subsided or even disappeared. Introduce new foods slowly. Remember to stay hydrated with water, broth, tomato juice, and rehydration solutions. Consult with your doctor or dietitian before making any changes to your diet.
These foods can help you stay healthy and hydrated:
- Fiber-rich foods: oat bran, beans, barley, nuts, and whole grains, unless you have an ostomy, intestinal narrowing, or if your doctor advises you to continue a low-fiber diet due to strictures, or recent surgery.
- Lean protein: lean meats, fish, eggs, nuts, and tofu.
- Fruits and vegetables: try to eat as many “colors” as you can, and remove the peel and seeds if they bother you.
- Calcium-rich foods: collard greens, yogurt, kefir, and milk (if you are lactose intolerant, choose lactose-free dairy products or use a lactase digestive enzyme).
- Foods with probiotics: yogurt, kimchi, miso, sauerkraut, and tempeh.
- Refined grains: sourdough, potato or gluten-free bread, white pasta, white rice, and oatmeal.
- Fully cooked, seedless, skinless, non-cruciferous vegetables: asparagus tips, cucumbers, potatoes, and squash.
- Oral nutritional supplements or homemade protein shakes: ask your doctor or your dietitian about what supplements may fit your nutritional needs.
What are some helpful food preparation tips?
Here are some helpful hints for you:
- Eat four to six small meals daily.
- Stay hydrated — drink enough to keep your urine light yellow to clear — with water, broth, tomato juice, or a rehydration solution.
- Drink slowly and avoid using a straw, which can cause you to ingest air, which may cause gas.
- Prepare meals in advance, and keep your kitchen stocked with foods that you tolerate well (see list below).
- Use simple cooking techniques — boil, grill, steam, poach.
- Use a food journal to keep track of what you eat and any symptoms you may experience.
Short Bowel Syndrome (SBS) Nutrition Therapy
| SBS occurs when portion of intestin (small bowel and large bowel or colon) has been removed and not able to absorb enough fluids and nutrients to have healthy hydration and nutritional status. | Symptoms: diarrhea, steatorrhea (fat in stools, causing oily/greasy appearance), dehydration, eletrolyte issues (especially low potassium or magnesium) and unintended weight loss. | Over time (months to years) remaining bowel may start to work harder and improve absorption and decrease symptoms- adaptation. Eating can help promote adaptation. | Management may include diet changes, vitamin/mineral supplements, medications, fluids (IV or oral) and parenteral nutrition (IV nutrition). |
| Depending on remaining length of bowel and symptoms, Dr might decide you need less IV fluid or IV nutrition as bowel adapts. | Eat small, frequent meals and snacks (5-6 times a day). | Chew foods well. | Have drinks between meals, not with meals or snacks. |
| Eat salty foods and use table salt frequently, especially if you do not have a colon. | Avoid foods and drinks high in sugar. | Avoid stimulants such as caffeine and alcohol. | Limit sugar alcohols (sorbitol, mannitol, xylitol) found in many sugar-free products. |
| Only limit dairy products if lactose intolerant or if they have sugar added. | You may need to eat as much as 2-4 times more food than you did before SBS dx to maintain weight. | Choose diet moderate in complex carbs (40-50% of total calories), moderate to high in fat (30-40% of total calories), and adequate in protein (20% of total calories). | Foods high in fat provide additional calories but should not increase stoma output. |