The Role of Diet in Inflammatory Bowel Disease

Diet is key in the treatment of Inflammatory Bowel Disease. Professionals must personalize them according to the symptoms and phases of each patient.
The Role of Diet in Inflammatory Bowel Disease

Last update: 20 June, 2020

Malnutrition is a common characteristic of people with digestive problems and this is why diet is very important; especially when it comes to Inflammatory Bowel Disease. This is because what you eat can decrease and alleviate your symptoms. Continue reading to find out more about it.

The digestive tract can suffer from all sorts of conditions that can influence one’s state of health, and Inflammatory Bowel Disease (IBD) is one of them. Thus, this term describes chronic diseases of the digestive tract, of unknown causes, characterized by inflammation.

The two most common IBDs are Chronic Ulcerative Colitis (CUC) and Crohn’s Disease (CD). In addition, there’s a third entity known as indeterminate colitis, it shares characteristics of the previous two and, as it evolves, can occasionally be identified with one or the other.

The human intestines.

Characteristics of Irritable Bowel Disease

Crohn’s disease

This can affect any part of the digestive tract, but the most frequent areas are the distal small intestine and the ascending colon. The lesions are segmented and can damage all layers of the intestinal wall.

Ulcerative colitis

It exclusively affects the colon and rectum. In addition, the lesions are continuous and appear on the mucous and submucous membrane. These diseases alter the function of the immune system of the digestive tract and it leads to a lingering inflammatory response.

Symptoms of Inflammatory Bowel Disease

The most frequent symptoms in both conditions are severe colic and chronic bloody diarrhea. But there may also be weight loss, malnutrition, fever, and skin, and joint injuries.

A person with Inflammatory Bowel Disease.

Injuries to the intestinal mucous membrane cause various associated nutritional problems, such as:

Causes of malnutrition

Malnutrition occurs due to various factors such as:

  • Decreased food intake
  • The disease leads to pain, diarrhea, and vomiting
  • Exclusion of certain foods
  • Increased requirements for fever, stress, and protein loss
  • Nutrient malabsorption
  • Interaction between drugs and nutrients. (According to the FEAD, the drugs used to treat these conditions are anti-inflammatories, corticosteroids, immunosuppressants, and antibiotics.)

What to eat if you suffer from Inflammatory Bowel Disease

Note that all IBDs have remission phases, but there are phases in which symptoms reappear with acute episodes. Therefore, the diet should depend on the stage you’re at. A healthy eating plan can be managed without unnecessary restrictions when there are no symptoms.

In the case of acute periods, you must adapt your diet to cover nutritional needs. It’s key that you make several meals throughout the day, consume plenty of safe water, and avoid extremely cold temperatures.

The short-chain low carb diet or FODMAP is beneficial in any treatment. Keep in mind the diet must have the following proportions:

  • 50 to 60% of the calories must be carbohydrates
  • 15 to 20% protein
  • 25 to 30% of fats, limiting them if there’s a loss due to diarrhea

We mustn’t forget that, in some cases, severe malnutrition can develop with intestinal compromise. In this situation, the option is parenteral or central feeding.

An array of food.

Types of food to avoid when there are symptoms

You must avoid any food that produces gas and discomfort during the symptomatic phase. Among them are:

  • Legumes and cereals
  • Dairy, mainly milk
  • Potatoes, sweet potatoes, corn, cassava, garlic, onion, cabbages
  • Hard and seasoned cheeses
  • Fresh and dried fruits
  • Honey, sugar, sweets, syrups, and jams sweetened with xylitol or sorbitol
  • Processed meats, sausages, and derivatives
  • Alcoholic, carbonated and soda drinks, fermented beverages, and coffee
  • Spicy or highly seasoned foods

In addition, you must evaluate whether there are vitamin and mineral deficiencies. You can resort to supplements in these cases.

Diet to follow when there are no symptoms

Due to all the above, you must gradually reintroduce restricted foods when the symptoms disappear. Generally, you can start with:

  • Cooked vegetables rich in soluble fiber such as squash, zucchini, carrots, and beets
  • Steamed or baked fruits such as apples, ripe bananas, apricots, peaches, pears
  • Refined cereals and their derivatives
  • Low-fat meat cuts such as fish and chicken

Finally, note that it can take several weeks to make progress in the diet and it must be individualized to a patient’s needs. The time between one progression and another depends on the symptoms. In conclusion, the key to eating in the case of Inflammatory Bowel Disease is adapting it to each patient’s symptoms and phases.

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