Is diet important in IBD management?
Do you want to know if diet impacts your IBD but don’t know where to start? - you’re not alone. Despite more evidence than ever supporting the use of nutrition in IBD management, 67% of people with IBD in the UK do not have access to specialist nutritional advice.
How can nutrition support me, and my IBD?
If you have IBD it can be difficult to meet your body’s nutritional needs, potentially leading to malnutrition and nutrient deficiencies. This can make it difficult for your body to function and means you are more likely to have a flare, go into hospital, or need surgery.
Good nutrition can prevent this, help you stay in remission for longer, prepare your body for surgery and improve symptoms such as fatigue.
Can nutrition treat my IBD?
In Crohn’s Disease (CD), nutrition can be used to treat inflammation. This is done by replacing your food with a nutritional liquid either fully (Exclusive Enteral Nutrition - EEN) or partly (Partial Enteral Nutrition - PEN) during a flare.
EEN is the recommended first treatment in children and can be an alternative to steroids for adults. PEN is less restrictive and can be used alongside your diet to keep you in remission or with the Crohn’s Disease Exclusion Diet (CDED) to reduce inflammation.
Can nutrition help my medical treatments work better?
Some nutritional therapies or dietary patterns can support your IBD medical treatment. Taking EEN/PEN alongside some biologics, such as infliximab or adalimumab, has been show to improve the likelihood of achieving remission in CD.
In Ulcerative Colitis (UC), following a mediterranean-style diet can keep you in remission for longer. Some supplements can also increase the effectiveness of medications. For example, curcumin, when given alongside mesalazine has been found to be effective in inducing and maintaining remission in UC.
How else can nutrition benefit IBD?
Nutrition can also help to manage IBD related conditions or complications. Up to 1/3 of people with IBD also have IBS-like symptoms in remission. Diet and lifestyle changes or the low FODMAP diet can help to manage these.
Orofacial granulomatosis (OFG), a condition associated with CD, can be managed by following a cinnamon and benzoate free diet or with EEN in children.
If you have a stricture (narrowing in the bowel) dietary adaptations like reducing bulk fibre, such as brown rice and raw vegetables, can reduce symptoms and prevent a blockage.
Takeaway
Although there is no special diet, nutrition still plays an important role managing IBD and can improve disease outcomes and quality of life for those living with it.
Everyone with IBD in the UK should have access to specialist nutrition advice.
If you need support, contact an IBD dietitian - like me.
