Although there is no substantial evidence that diet alone can treat or cure inflammatory bowel disease (IBD), clinical practice and scientific evidence show that proper nutrition and specific dietary changes may help manage many challenges that come along with the disease. Amongst these challenges are dietary issues associated with IBD, including: energy and nutrient deficiencies, weight loss, fatigue, and individual food intolerances that may worsen symptoms. In order to address these major issues, dietary management of IBD should be focused on two major areas – meeting energy and nutrient needs, and symptom management.
Meeting Energy and Nutrient Needs
Individuals with IBD are at a higher risk of becoming malnourished as a result of a loss of appetite (secondary to symptoms), increased caloric demands of the body due to chronic disease, and poor digestion and absorption of nutrients in the small and large intestines. This can result in worsened feelings of fatigue, weight loss, nutrient deficiencies, and a decrease in overall health. To prevent this, it is important to focus on preventing malnutrition with a healthy and balanced diet. Some patients need to be more careful, making sure to eat small and frequent meals and snacks every 2-3 hours, and monitor blood levels of nutrients at risk using supplements when necessary.
The dietary strategies that may be used in conjunction with drug therapy for symptom management of IBD are to avoid or limit foods that trigger symptoms, and to increase foods of benefit to overall health. Dietary intake may change quite a bit when experiencing a flare compared to remission. During a flare, individuals with IBD often find relief by consuming a low fibre diet. Whereas when in remission, it is recommended that high fibre foods are gradually added back in for optimal health. Certain foods that may not cause symptoms during remission may trigger them during a flare.
One of the challenges with IBD is that there is not one particular diet that works for everyone with the disease. Foods that worsen symptoms for one individual may be very different than foods that worsen symptoms for the next. It is important that each individual with IBD find his/her own specific food intolerances. The first step to pinpointing food intolerances, is to record a food and symptom journal. After the first few weeks of doing so, common problem foods may come to light. In many cases, finding food intolerances is not easy. It may be necessary to try a type of food elimination diet to discover which foods may be aggravating your symptoms. Two of the more successful elimination diets that exist to date for individuals with IBD are the Specific Carbohydrate Diet and the Low FODMAP diet. These diets may provide more success with the help of a physician or registered dietitian specializing in digestive health disorders.