Digestive Disorders > IBD > Crohn's Disease

Nutrition with Crohn's disease: The essential guide

Dr. med. Andre Sommer

Dr. med. Andre Sommer

Those with Crohn's disease can control the inflammatory processes through their nutrition. This is particularly important to support the healing process in the course of an illness. However, chronic inflammation within the digestive tract often makes adequate nutrient intake difficult with Crohn's disease.

Areas of the small and large intestine are often affected, limiting the absorption of many nutrients. In addition, the inflammation is associated with painful symptoms such as abdominal pain and diarrhea. To increase your own well-being, adhere to a healthy and balanced diet, which also supports the longest possible flare-up-free phase.

What should you pay attention to in your Crohn's disease diet?

Crohn's disease often causes malnutrition, mainly caused by chronic inflammation in the small and large intestine. There are many reasons for this. On the one hand, there are absorption disorders in the inflamed areas of the digestive tract alongside an increased nutrient need caused by the healing process. On the other hand, many patients suffer from loss of appetite due to the painful symptoms that are exacerbated by eating.

For this reason, an adequate nutrient supply should be given great importance in Crohn's disease patients. An increased supply of energy is usually necessary, but so too is a high supply of micronutrients. The following micronutrients are often affected by a deficiency with Crohn's disease:

  • Iron
  • Calcium
  • Vitamin D
  • Vitamin B12
  • Folic acid
  • Zink
  • Magnesium
  • Vitamin A

These nutrient deficiencies should be examined and corrected if necessary with food supplements.

What should you eat during a flare-up phase?

Findings from microbiome research have shown that Crohn's disease patients often have dysbiosis (an imbalance of the microorganisms located in the intestine). In addition, there appears to be a connection between the composition of the intestinal flora and the activity of Crohn's disease, since the intestinal flora differs during the acute phase of the disease and the remission phase.

A balanced diet, rich in fiber, can have a positive effect on the intestinal flora (microbiota) of the intestine. This can prevent dysbiosis and possibly also prolong the remission phase. Therefore, a balanced diet is generally recommended during Crohn's disease remission. This includes an adequate supply of fresh fruits and vegetables, healthy fats (e.g. from nuts and seeds), as well as whole grains and legumes. In addition, milk and milk products need not be left out, provided there is no lactose intolerance. However, you should limit the consumption of red meat, such as pork, beef and lamb, and sugary and sweetened drinks, including juices. Eating heavily processed foods and fast food is also discouraged.

According to the European Crohn's and Colitis Organization (ECCO), there are currently no specific nutritional therapies for patients with Crohn's disease. Nevertheless, there are various diets that have been shown to alleviate symptoms in studies and case reports. However, there has been a lack of large, controlled studies so far that could give general recommendations for certain diets.

Specific carbohydrate diet (SCD)

One of these nutritional forms is the specific carbohydrate diet (SCD), which restricts the consumption of certain carbohydrates that could be fermented by bacteria in the intestinal flora.

Semi-vegetarian diet (SMD)

The semi-vegetarian diet (SMD), which is a lacto-ovo vegetarian diet, is also an option. This means that in addition to milk and eggs, fish may be eaten once a week and a piece of meat once every two weeks.

Low-FODMAP diet

The low-FODMAP diet—similar to the SCD—is a form of nutrition in which the food base of a large number of bacteria is removed from the intestinal flora by avoiding fermentable oligo-, di- and monosaccharides as well as polyols in your diet.

Table with foods for Crohn's disease

Recommended Not recommended
Fresh fruits and vegetables Refined sugar and sugary drinks
Shell fruits Drinks with sweeteners
Whole-grain products Juices
Nuts, seeds Sweets
Milk and dairy products Margarine, corn oil, safflower oil
Eggs Alcohol
Fish Red meat and processed meat products
White fish Fast Food

What should you eat during a flare-up?

What constitutes proper nutrition during an active Crohn's disease depends on the severity of the flare-up, the course of the disease so far, and the drug treatment. If it is possible to consume solid foods, special attention should be paid to a low fiber intake. Inadequate nutrient intake is particularly promoted by low food intake, absorption disorders, and an increased nutrient requirement due to active inflammation. Therefore, enteral nutrition (a fluid-based clinical diet) is often required to meet the patient's nutritional needs.

CARA CARE supports you with your digestive problems
Get the App

Is a vegan diet possible for Crohn's disease sufferers?

Since a balanced high-fiber diet is recommended for Crohn's disease, there is nothing to contradict a vegan diet. In a Japanese study, a semi-vegetarian diet (SVD) with a very low fish and meat content was considered very helpful in keeping Crohn's disease in remission. However, special attention should be paid to the supply of potentially critical nutrients in a vegan diet. These include:

  • Vitamin B12
  • Iron
  • Iodine
  • Vitamin D
  • Zink
  • Omega-3 fatty acids
  • Riboflavin (Vitamin B2)
  • Protein
  • Selenium

Above all, an adequate protein intake should be ensured because it is essential for the healing process. In addition, since a nutrient deficiency is very common in Crohn's disease patients, a doctor or a certified nutritionist should definitely be consulted before deciding on a vegan diet.

What should you eat with ulcerative colitis?

A balanced, high-fiber diet is also recommended for ulcerative colitis. However, it is not necessary to reduce the fiber intake during a flare-up. Furthermore, research has shown that a daily supplement with 4 g of psyllium can maintain the remission phase.

Chiba, M.,Abe, T. , Tsuda, H., Sugawara, T.,Tsuda, S., Tozawa, H., Fujiwara, K., Imai, H. 2010. Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet. World Journal of Gastroenterology, 16 (20), pp. 2484 – 2495. Online: https://www.wjgnet.com/1007-9327/full/v16/i20/2484.htm, downloaded on 21/03/2018.

Donnellan, C. H., Yann, L. H., Lal, S. 2013. Nutritional management of Crohn’s disease. Therapeutic Advances in Gastroenterology, 6 (3), pp. 231 – 242. Online: http://journals.sagepub.com/doi/10.1177/1756283X13477715, downloaded on 21/03/2018.

Haskey, N., Gibson, D. L. 2017. An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease. Nutrients, 9 (3), pp. 259. Online: http://www.mdpi.com/2072-6643/9/3/259, downloaded on 21/03/2018.

Owczarek, D., Rodacki, T., Domagała-Rodacka, R., Cibor, D., Mach, T. 2016. Diet and nutritional factors in inflammatory bowel diseases. World Journal of Gastroenterology, 22 (3), pp. 895 – 905. Online:https://www.wjgnet.com/1007-9327/full/v22/i3/895.htm, downloaded on 21/03/2018.

Dr. med. Andre Sommer

Dr. med. Andre Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara.

InfoAbout usPressFAQ
Download on the App StoreGet it on Google Play
© 2020 CARA.CARE All Rights Reserved. The CARA CARE website is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment.