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What Can I Eat With IBD? Gastrointestinal Diseases and Food Avoidance: Crohn's Disease, Ulcerative Colitis, GI Surgery

When people have a serious gastrointestinal disease such as inflammatory bowel disease (IBD,) food becomes a struggle. People with IBD, including Crohn's disease and ulcerative colitis, have plenty good questions about what to eat. The disease itself leads people to avoid foods that trigger symptoms. Surgeries are sometimes part of disease treatment, and that can further exacerbate intolerances to food. Many people with IBD have very distressing symptoms that are associated with eating all or certain foods. Symptoms such as urgent diarrhea, fecal incontinence, and severe abdominal pain that are associated with eating are enough to deter the patient from eating anything that might be a trigger.

person sitting at a table in pain

Over time, food avoidance can lead to malnutrition. Also over time, many people are able to find the right treatments that improve their disease and symptoms. Even with improvement in IBD markers and symptoms, many patients are fearful to try the foods that once caused really disruptive symptoms.

These food fears are normal and understandable. Still, with a slow and methodical approach of trying foods, many patients are able to expand the foods they can eat--especially once their disease is better managed with an appropriate medical or surgical treatment.

Which foods to start with will depend on each individual patient. Factors such as prior experiences with that food, history of surgery, and nutritional status play into that decision. Foods are often introduced with those more likely to be tolerated first, such as soft or cooked foods before hard and raw foods, and starting with small quantities. Many patients find it helpful to make only one change at a time so that it is clear what is causing a change in symptoms.

Often people will experience new and sometimes uncomfortable GI sensations with new food. These new sensations are often feared, and the instinct is to avoid any uncomfortable GI sensation. We try to normalize the normal sensations of digestion--even the uncomfortable ones--and separate those sensations from painful symptoms, which are reasonable to continue to avoid.

Trying new foods strategically combined with a reasonable expectation of outcomes can often help people expand what they are able to eat and enjoy. This really helps people with IBD, Crohn's disease, and ulcerative colitis know what to eat.

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