The best diet for irritable bowel syndrome or Crohn's disease

Several conditions and diseases cause people gastrointestinal discomfort on a daily basis. Learning more about your health condition and personal peculiarities can help you enjoy life better on a daily basis. Here's a look at two conditions that, despite having similar symptoms, affect the digestive system in different ways: Crohn's Disease and Irritable Bowel Syndrome.

Crohn's Disease

Crohn's Disease is an autoimmune inflammatory bowel disease that can affect the digestive system from the mouth to the anus, but its damage is more often seen in the lower parts. These afflicted person’s immune cells attack their own tissues, bacteria, food ingested, etc. Food is therefore not the cause of Crohn's disease, and research has failed to identify a type of diet that would be effective in treating it. However, certain foods are associated with flare-ups or exacerbating the symptoms. 

Irritable Bowel Syndrome (IBS) 

Irritable Bowel Syndrome is a functional disorder of the gastrointestinal system. Thus, unlike Crohn's disease, no structural change is present, rather it is the function of the digestive system that is impaired. Symptoms, such as abdominal pain, gas, constipation, diarrhea, changes in bowel movements and a sensation of incomplete evacuation, are present. Nutritional treatment aims to normalize intestinal transit, reduce abdominal pain, flatulence and rectal gas, and control constipation and diarrhea. There is frequently a psychological aspect during the acute phases of the condition, so treatment designed to reduce anxiety, manage mood, or to increase physical activity has been shown to improve symptoms.

The list below shows behaviours and foods to choose/avoid in order to improve these symptoms:

Irritable Bowel Syndrome 

Top 5 things to do

1. Eat small meals (avoid large meals).
2. Get lots of fluid (ideally 2 to 2.5 liters of fluid per day).
3. Don’t skip meals to promote good elimination. 
4. Eat slowly and chew your food well.
5. Engage in physical activity and activities that can reduce stress.

Top 4 things to avoid Top 5 à éviter

1. To reduce bloating, limit your intake of foods that make you swallow air, such as chewing gum, carbonated drinks and carbonated water; drink those beverages through a straw).
2. Avoid a diet that is too rich in lipids, which could worsen the symptoms.
3. Avoid sugar alcohols (a type of sweetener), such as sorbitol, mannitol and xylitol, as these can cause or exacerbate diarrhea (sugar alcohols are mostly used to sweeten foods that have “no sugar added” or “sugar-free” indicated on their labels, such as sugar-free chewing gum, energy drinks, diet sodas, some cough syrups, and other liquid medications (such as antacids).
4. Try to eliminate fermentable foods that can cause gas, like legumes, onions, vegetables from the cabbage family, corn, celery, carrots, grapes, bananas, plums, wheat, peas, raw apples, and garlic.* Attempt to eliminate caffeine, alcohol and strong spices.*

Crohn's Disease 

Top 5 things to do

1. Eat small, frequent meals.
2. Stay properly hydrated throughout the day. Drink small amounts at a time, but frequently 
3. During symptom-free periods, reintroduce whole grains, fruits and vegetables into your diet, always being careful to reintroduce one food at a time to test your tolerance.
4. Certain probiotics, prebiotics and supplements may be considered in case of deficiencies, but should be taken in consultation with your attending physician or nutritionist.
5. Choose lean meats, fish, eggs, yogurt, light cheeses, fruits, cooked vegetables and monitor your fat intake.

Top 2 things to avoid

1. During a symptomatic period with diarrhea or abdominal pain, avoid certain foods, such as those rich in whole grains, raw or gas-inducing vegetables, raw fruits and caffeine*. 
2. Some other foods that can cause symptoms include dairy products (lactose), very  

Watch out for

1. Deficiencies in certain nutrients that result in malabsorption caused by inflammation. Some patients have higher energy and protein requirements. 
2. Frequently-prescribed corticosteroids can increase the risk of osteoporosis, increasing the importance of getting enough calcium, vitamin K, vitamin D, and magnesium to support bone health. 
3. Long-term use of corticosteroids can cause deficiencies in vitamin C, vitamin B12, folic acid, zinc and selenium. 

*If your symptoms haven’t improved after a few weeks, reintroduce these foods gradually to your diet. 

In the case of irritable bowel syndrome, keeping a food diary of foods eaten, foods avoided, menstrual cycle, stressful events, rest days or holidays can help identify sources of seizures. Identifying problematic foods and avoiding them is one of the goals of nutritional treatment.

Similarly, in cases with Crohn's disease, keeping a food diary and avoiding problematic foods may help improve the symptoms. Monitoring by a nutritionist specializing in digestive health during the restriction period is essential given the dietary restrictions, increased nutritional needs and risks of deficiencies.

Finally, although you can make a list of foods to avoid during symptom flare-ups for each of these health conditions, every individual is unique in their symptoms and the way they respond to different foods. There is therefore no general advice to follow, hence the relevance of being monitored by a health professional.

Familiprix in collaboration with Hubert Cormier