What Is The Best Diet for Ulcerative Colitis and Crohn’s Disease?
A lot of patients want to know, “What is the best diet for Crohn’s disease and ulcerative colitis?” They’re on the right track by asking that question, because diet is one of the best natural remedies for ulcerative colitis and Crohn’s. However, the answer to that question is not the same for everybody. The best foods for ulcerative colitis and Crohn’s are based on a personalized approach to each case, weighing a person’s symptoms and other conditions.
In this blog post, I’ll dive into the reasons why you should care about diet if you have either one of these autoimmune diseases. Then I’ll take a look at the standard eating plans often used by patients with these disorders. Finally, I’ll address how to know which type of diet is best for you. Whether you are newly diagnosed or have been living with these conditions for years, this guide will provide you with the knowledge and tools you need to make informed dietary choices that can alleviate symptoms and improve your overall well-being.
Understanding Ulcerative Colitis and Crohn’s Disease
Ulcerative colitis and Crohn’s disease are two types of chronic inflammatory bowel diseases that affect millions of people worldwide. While they share similarities in symptoms and impact on daily life, the key difference is where the inflammation shows up in the gastrointestinal tract. Ulcerative colitis primarily affects the colon and rectum, causing inflammation and ulcers, while Crohn’s Disease can affect any part of the digestive tract, from the mouth to the anus. Living with these conditions can be challenging. Inflammation is like a burning fire, so having uncontrolled gut inflammation can cause abdominal pain, diarrhea, fatigue, weight loss, malnutrition, rectal bleeding, and reduced appetite.
Why Diet Matters for Ulcerative Colitis and Crohn’s
Many patients with gut symptoms suspect that the foods they eat are somehow contributing to their problems, even if they don’t know exactly what food or how it may be causing harm. Conventional medical doctors do not always recommend special diets for people with ulcerative colitis or Crohn’s disease. They may tell you that the foods you eat do not make a difference for your inflammatory bowel disease. However, in Functional Medicine, we believe foods can be a critical factor in gut health.
In my experience, if you have ulcerative colitis or Crohn’s, your diet can affect the degree of symptoms and disease progression, as well as your nutrition. Patients with ulcerative colitis or Crohn’s often have one or more of the following problems:
• Food sensitivities are an immune reaction to a food. These can create inflammation, especially in the gut lining. This inflammation activates an immune response to cause more damage and destruction, creating a vicious cycle.
• Food intolerances are another consideration. Rather than experiencing an immune response to a food, patients with food intolerances have problems digesting a food. Lactose intolerance is a case in point. People with lactose intolerance don’t have the lactase enzyme needed to break down lactose sugar from dairy products. They may experience diarrhea and cramping when they eat dairy products.
• Problems with nutrient absorption. Inflammation itself can lead to problems with absorbing key nutrients. But there are also components in foods that can lead to nutrient deficiencies in ulcerative colitis and Crohn’s patients. For example, lectins, which are found in grains and legumes, can interfere with the absorption of calcium, iron, phosphorus, and zinc. This means that lectins are essentially an anti-nutrient.
Common Diets for Ulcerative Colitis or Crohn’s Disease
If you have ulcerative colitis or Crohn’s, the best foods for you to eat (or the ones to avoid) depend on a lot of individual factors, which I’ll cover in this article. However, you will probably hear about the following types of ulcerative colitis and Crohn’s diets and wonder if they’re the right choice for you. So let’s review what each diet is all about:
Specific Carbohydrate Diet for Inflammatory Bowel Disease
On a Specific Carbohydrate Diet (SCD), you eliminate the worst foods for ulcerative colitis and Crohn’s, including sugars and carbs that are hard to digest like grains and some beans. The diet first became popular in the 1980s when Elaine Gottschall published a book that described how an SCD diet improved her daughter’s inflammatory bowel disease (IBD) symptoms.
The reason why this type of diet may work in people with ulcerative colitis and Crohn’s, is because people with these disorders can’t break down some types of carbohydrates. This means that undigested food particles remain in the intestines. Bacteria feed and grow on these undigested particles, which can result in an overgrowth of harmful bacteria. When bacteria grow out of control, they create chemicals that damage your gut lining, increase inflammation, and make you feel terrible. It can cause problems in the large intestine as well as small intestinal bacterial overgrowth (SIBO). On the SCD diet, you only eat easy-to-digest carbs, which blocks the growth of harmful bacteria.
Low FODMAP Diet for Ulcerative Colitis and Crohn’s
Like the specific carbohydrate diet, the Low FODMAP diet eliminates from the diet certain hard-to-digest carbs. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, which are fermentable short-chain carbohydrates. Your gut bacteria feed on these types of carbs, as well as plant fibers known as prebiotics, the milk sugar lactose, fructose, and sugar alcohols used as sugar substitutes. On a low FODMAP diet, you avoid eating these types of carbohydrates in order to starve out unfriendly bacteria and help your GI tract heal from the irritation these foods can cause.
It’s best to get a list from your functional medicine provider of which foods to eat and which foods to eliminate on a low FODMAP diet. In general, legumes, processed meat, dairy (with the exception of some cheeses), grains, apples, watermelons, stone fruits, and ripe bananas are high in FODMAP while grapes, strawberries, pineapples, eggs, and tofu are low FODMAP foods.
Autoimmune Protocol Diet (AIP)
The AIP diet can help some people. When following this diet, patients avoid grains, legumes, nuts, seeds, nightshade vegetables, eggs, and dairy. Alcohol, coffee, and sugars are also avoided. The diet encourages eating fresh, nutrient-rich foods, unprocessed meat, fermented foods, and bone broth. This diet may relieve gut inflammation and therefore lead to improvement in ulcerative colitis and Crohn’s symptoms.
What’s The Best Ulcerative Colitis and Crohn’s Disease Diet?
The answer to that question is a personal one. It’s important to remember that everyone’s body is unique. What works for one person may not work for another. That’s why creating a personalized diet plan is crucial for long-term success.
We usually figure out which diet is best from a patient’s health history and a questionnaire that we have them fill out, so we know what symptoms are predominant in a particular patient. If we expect that a patient has small intestinal bacterial overgrowth (SIBO) based on their symptoms, then we will automatically go more towards the low-FODMAP diet, but if somebody doesn’t have SIBO symptoms such as bloating with every food they eat, and they come to us with the diagnosis of ulcerative colitis or Crohn’s, we go more towards the SCD diet route.
We typically start with a diet that we feel will be the best starting place that will eliminate the most problematic food for the person using their history and questionnaire. We personalize it for each person, so once we get labs in we know more specifically what foods to avoid. We also may combine approaches, for example using a modified specific carbohydrate diet. Even if we start somebody on the specific carbohydrate diet and later we find out that person has insulin resistance problems, then we still will look at the glycemic impact of certain foods.
As we progress throughout treatment, our goal is to ultimately add back as many foods into the diet as the person can tolerate. Ultimately, that’s really what a healthy maintainable diet is, it’s a very diverse diet, and one that will support a healthy microbiome and a healthy gut lining in the long term.
Do You Have To Be On Autoimmune Disease Diets Forever?
Our goal isn’t to stay on a restricted diet forever. If we start someone on a low FODMAP diet, but then their symptoms start to decrease—they’re not getting bloated, they’re feeling better, they’re having good bowel movements—then we can start to increase their diversity in their diet and add back those high FODMAP foods until we can get them to eat most foods again.
Our goal is to use a short-term elimination of certain foods as a tool to figure out why the person is having those reactions. Is it a food sensitivity? Is it an intolerance? Is it leaky gut? And then we dig deeper by asking, “What is the root cause of the root cause?” In that way we can fix the problem that’s causing all this inflammation in the first place.
These types of diets are not meant to be followed forever. They’re not maintainable long term for most people. People who do follow them long-term end up with more food intolerance and more problems down the line. This is because they limited their microbiome diversity so much by eating the same food over and over again, that it created even more challenges. Remember, the microbiome needs a wide variety of healthy foods.
The goal isn’t to use a restricted diet as the fix. We use it for information. To be able to help resolve the problem and to figure out the root cause of the reaction.
The two exceptions are gluten and sugar. Most people with ulcerative colitis or Crohn’s disease don’t do well on those. Even so, when we get patients to a really stable place, they can sometimes have a little bit of those foods here and there.
To summarize our process at Caplan Health Institute:
- Look at a patient’s symptoms
- Determine which foods cause the most problems
- Start a customized diet
- Eliminate the worst dietary culprits
- Once a patient begins to improve, add certain foods back into the diet, one at a time.
- For foods that still provoke a reaction, figure out the pattern and why the patient is having a reaction in order to fix the root problem.
Discover What Foods To Avoid with Ulcerative Colitis or Crohn’s
As a Functional Medicine provider, I can work with you to find a good diet for ulcerative colitis or Crohn’s disease that’s personalized to your symptoms and concerns. Sign up for a free 15-minute discovery consultation, and if you come on board as a patient, I’ll develop a personalized dietary approach to resolving your ulcerative colitis or Crohn’s symptoms. The foods you eat are a critical piece in stopping and reversing ulcerative colitis or Crohn’s disease. By figuring out what foods are causing your gut inflammation, we can help calm down your angry intestines so that they are calm, comfortable, and predictable again. No more weeks secluded at home nursing your bad belly with Crohn’s or colitis flares. Here’s to feeling better and enjoying your life to its fullest again!
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