IBD Diet Myths Debunked by an IBD Dietitian: Part 1

If you have Crohn’s Disease (CD) or Ulcerative Colitis (UC), chances are you’ve internet searched at least one of these questions at 2am:

“Should I stop eating fibre?”
“Is gluten making my IBD worse?”
“Do I need probiotics?”
“Why do I still feel awful when my tests are ‘normal’?”

You might start cutting out foods and notice symptoms get better. The only problem is that, over time that can leave you cutting out whole food groups. Then that leads to missing out on key nutrients! It’s a vicious cycle.

Everyone with inflammatory bowel disease IBD should have access to an IBD Specialist Dietitian at every stage of their disease. Unfortunately, this is not always available, so people often end up relying heavily on information online.

So, let's clear up some of the biggest myths I hear around diet and IBD and diet, using the latest evidence. 

First Things First: Is There One “IBD Diet”?

There is currently no single diet proven to work for everybody with IBD. 

This is because IBD is incredibly individual.

Some people with IBD tolerate oats really well but react badly to onions. Some struggle with high-fat foods during a flare. Others can eat high-fat, onions and spicy foods without any issue whatsoever.

This is for a few reasons, including:

• Whether your IBD is active or in remission
• Where your disease is affecting the gut
• Whether you have strictures or narrowing
• What your your current symptoms are specifically
• Whether IBS symptoms overlap with your IBD
• Your medications and supplements

Here are some specific diets for different scenarios:

1. Liquid diet

During a flare up, particularly in CD, a liquid diet (known medically as exclusive enteral nutrition), may be prescribed by a Specialist Dietitian. This is usually for six to eight weeks.

2. Crohn's Disease Exclusion Diet (CDED)

Sometimes a liquid diet is also paired with the CDED. This is a whole-foods diet designed to eliminate or reduce exposure to specific foods that may be triggers in CD. This is most effective to get people with mild-to-moderate CD into remission. There is no evidence to support the use of the CDED diet long term for people in remission though. 

3. A Low FODMAP Diet

A low FODMAP diet reduces a group of carbohydrates called FODMAPs, which are poorly absorbed and can trigger gut symptoms in people with IBS.

They can be useful for people with ongoing symptoms in remission, when there is overlapping Irritable Bowel Syndrome (IBS). This should only be done with the support of a Specialist Dietitian. It is important to note that this diet is not forever, and the reintroduction of foods is a crucial stage to understand your triggers.

4. Mediterranean Style Diet

When no specific diet has been recommended, the aim is to work towards a Mediterranean style diet. In UC this has shown to be beneficial in maintaining remission, specifically when the red and processed meats are limited.

Now that's cleared up, are you ready to bust some myths? Head to Part 2 where I debunk the most common IBD diet myths I hear as a Specialist Dietitian.