Nutrition for Colitis and Crohn’s Disease

Colitis and Crohn’s disease are inflammatory bowel diseases (IBDs) that affect as many as one million Americans. Colitis is a chronic inflammation of the innermost lining of the large intestine (or colon) and the rectum. Open sores or ulcers may bleed and produce pus and mucus. Crohn’s disease is similar to colitis but can occur anywhere in the digestive tract and spreads deeper into the tissues. Nutrition is very important in managing these diseases and controlling flare-ups. Colitis and Crohn’s disease can cause diarrhea and rectal bleeding that result in the loss of fluids, nutrients, and electrolytes from the body. The intestinal absorption of carbohydrates, fats, vitamins, and other nutrients may also be affected and can result in malnutrition.

How Does Nutrition Affect Colitis and Crohn’s Disease?

Poor nutrition does not cause colitis or Crohn’s disease. However, these conditions are much more common in the developed world. It is possible that diets that are high in saturated fats from meat and dairy products, sugar, cholesterol, and processed foods may contribute to colitis and Crohn’s disease.

Most gastroenterologists recommend well-balanced nutrition for people suffering from colitis or Crohn’s disease, including:

  • A low-fat diet
  • A variety of fruits and vegetables
  • Plenty of fluids
  • Vitamins
  • Magnesium

Keeping a detailed food diary can help identify foods that appear to aggravate the symptoms of colitis or Crohn’s disease. Eating five or six small meals per day, rather than three large meals, can also be helpful.

People with colitis or Crohn’s disease often find that soft, bland foods cause less discomfort, and they may want to avoid the following:

  • Fats, especially saturated fat and high-fat foods such as fried foods, fatty red meat, mayonnaise, peanut butter, nuts, and ice cream
  • Butter, margarine, cream sauces, and pork products, which can cause diarrhea and gas if the fat is incompletely absorbed
  • Dairy products, particularly those who are lactose intolerant or have severe diarrhea
  • Gas-producing foods such as beans, cabbage, broccoli, and onions
  • Spicy foods
  • Sugar and artificial sweeteners
  • Carbonated beverages
  • Caffeine, including coffee and chocolate
  • Alcohol

Good nutrition for colitis or Crohn’s disease may include:

  • Low-fat protein, such as lean beef, poultry, and fish, baked or boiled rather than fried
  • Low-lactose dairy products, such as yogurt, hard cheeses like cheddar, and lactose-reduced milk
  • Fresh fruits and vegetables (peeled and with seeds removed) or canned varieties
  • Steamed, stewed, or baked vegetables without hulls, skins, or seeds

How Does Fiber Affect Colitis and Crohn’s Disease?

Although fiber is important for good nutrition, it sometimes aggravates symptoms of colitis and Crohn’s disease causing abdominal cramping and diarrhea. A low-fiber diet that includes steamed or baked rather than raw vegetables may help prevent acute symptoms.

High-fiber foods to avoid include:

  • Broccoli
  • Cauliflower
  • Raw apples
  • Whole grains
  • Foods with hulls such as nuts, seeds, and corn

How Does Fatty-Acid Nutrition Affect Colitis and Crohn’s Disease?

Omega-3 fatty acids are polyunsaturated fatty acids that are essential in human nutrition. They must be obtained from food because the body cannot manufacture them. The modern Western diet is relatively low in omega-3 fatty acids, which may contribute to the onset of inflammatory bowel diseases (IBDs). Omega-3 fatty acids may help prevent flare-ups of colitis and Crohn’s disease and help control diarrhea.

The omega-3 fatty acids that are important for nutrition are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). The human body converts ALA into EPA and DHA.

Good sources alpha-linolenic acid (ALA), include:

  • Flaxseeds, about 2.2 grams of ALA per tablespoon, and flaxseed oil, about 8.5 grams per tablespoon
  • Canola (rapeseed) oil, about 1.3 grams of ALA per tablespoon
  • Soybeans, soybean oil, and tofu
  • Walnuts and walnut oil
  • Pumpkin seeds and pumpkin-seed oil
  • Perilla-seed oil
  • Purslane

Cold-water fish are the main source of eicosapentaenoic acid (EPA) in the typical American diet. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in wild salmon, albacore tuna, halibut, mackerel, lake trout, herring, and sardines. They are also found in other marine foods such as algae and krill.

Some studies have indicated that soluble fiber, such as that from the husks of psyllium seeds, can stimulate bacteria in the colon to produce short-chain fatty acids that aid in healing the colon lining. Psyllium is added to some cereals to increase the fiber content.

How Are Vitamins and Minerals Involved in Colitis and Crohn’s Disease?

Nutrition problems in people with colitis or Crohn’s disease can include vitamin and mineral deficiencies. These may result from poor appetite, poor food absorption by the intestines, or excessive diarrhea.

People with colitis or Crohn’s disease often have low blood levels of folic acid (folate or vitamin B9) and their medications can interfere with folic acid absorption. Since 1998, folic acid has been added to all enriched grain products in the United States.

Nutritional sources of folic acid include:

  • Dark leafy greens, such as spinach, turnip, beet, and mustard greens
  • Asparagus and Brussels sprouts
  • Root vegetables
  • Lima beans, mung beans, soybeans, kidney beans, and white beans
  • Beef liver
  • Salmon
  • Oysters
  • Avocadoes
  • Orange juice
  • Milk
  • Whole grains
  • Wheat germ
  • Bulgur wheat
  • Brewer’s yeast

Other common nutritional deficiencies in colitis or Crohn’s disease include:

  • Vitamin B12
  • Vitamin D
  • Iron
  • Magnesium
  • Potassium
  • Calcium

What Are Other Nutritional Factors That May Affect Colitis and Crohn’s Disease?

Some evidence suggests that L-glutamine may help treat colitis and Crohn’s disease. Nutritional glutamine comes from animal and vegetable proteins, including:

  • Beef, pork, and poultry
  • Milk, yogurt, ricotta cheese, and cottage cheese
  • Raw spinach
  • Raw parsley
  • Cabbage

Probiotics is nutrition that includes healthy bacteria and yeast. Foods such as yogurt, which contains live cultures of Lactobacillus, can help heal the intestines and benefit those with colitis or Crohn’s disease.

Additional Resources

Diet and Nutrition” from the Crohn's and Colitis Foundation of America.

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