Special IBD Diets
Special IBD Diets
There may be times when modifying your diet may be helpful, particularly during a flare. Some diets may be recommended at different times by your healthcare team. Other than enteral nutrition, no diet has yet been scientifically proven to prevent or control IBD. Some of these diets can be very restrictive, leading to weight loss and/or malnutrition. There is a lot of debate in the medical community regarding the benefit of these diets. Keep in mind that the best diet is the one that meets YOUR nutritional needs while helping you better manage your IBD symptoms.
Work with your healthcare team or dietitian to create a diet that’s right for you - NEVER attempt one of these diets without speaking to your healthcare team and/or dietitian. The Crohn's & Colitis Foundation does not endorse any of these diets and is providing information for educational purposes.
Carbohydrate Exclusion Diets
Carbohydrate exclusion diets exclude or limit certain sugars, grains, and fiber. Some of the more popular diets include:
Specific Carbohydrate Diet (SCD)™:
SCD eliminates refined/processed foods as well as soy, lactose, sucrose, and grains, and certain vegetables such as potatoes, okra and corn. This diet can be low in certain nutrients, such as B vitamins, calcium, vitamin D, and vitamin E. It is important to work with your medical team while following this diet to ensure nutritional adequacy needed for healing.
The Crohn’s & Colitis Foundation and the Patient Centered Outcomes Research Institute (PCORI) are sponsoring the DINE-CD research study to compare the effectiveness of two different diets – the Mediterranean Diet and the Specific Carbohydrate Diet™. Click here for more information on the DINE-CD study.
Low FODMAP Diet:
FODMAP is an acronym for Fermentable, Oligo-, Di-, Mono-saccharides And Polyols. It describes a group of sugars that can be poorly absorbed such as fructose, lactose, sugar polyols (sorbitol and mannitol), fructans (found in garlic, leeks, artichokes, and wheat), and galacto-oligosaccharides (found in lentils, chickpeas, and green peas). A low FODMAP diet can help reduce IBD symptoms, but research doesn’t support its use for reducing IBD inflammation (it is not recommended if in a flare or to be followed long-term).
Those on a gluten-free diet avoid wheat, barley, and rye food products. Some people may find a reduction in symptoms when following a gluten free diet, but current evidence does not support a gluten-free diet for reducing IBD inflammation. There are risks associated with following a gluten free diet. For example, gluten-free foods don’t contain the same nutrients as their gluten containing counterparts, and many gluten-free foods contain more fat, which can lead to weight gain. Your doctor may want to do testing to make sure you don’t have celiac disease before you start a gluten-free diet.
These have been suggested for IBD patients because there is some evidence that diets high in meat and fat (and low in fruits and vegetables) may be associated with an increase in developing IBD.
These diets have not been well-studied, except in Japan where it is more common for doctors to recommend hospitalized patients with IBD to follow the Semi-Vegetarian Diet(1), which includes eggs, yogurt, fruit, vegetables, legumes, brown rice, miso, and pickled vegetables on a daily basis with occasional milk and green tea. Meat is eaten once every two weeks and fish once a week - so animal proteins are significantly limited. There was one small study which found that patients on the diet were less likely to relapse with a flare after two years as compared to patients who did not follow this diet.
(1) Chiba M, et al. World J Gastroenterol 2010
This diet is rich in fiber and plant-based. It also includes olive oil, low fat dairy, herbs, and spices. Poultry, eggs, cheese, and yogurt are eaten in moderation, and red meat is eaten rarely.
Low Fiber Diet
A low fiber diet is often used to reduce bowel movements and cramping by decreasing fiber intake and avoiding green leafy vegetables, nuts, seeds, popcorn, whole grains, and raw fruits with peels. This diet can be helpful after surgery, when your gut may need a little more time to recover before getting back to a regular diet.
For more information about special IBD diets, watch our webinar IBD: Diet and Nutrition