Crohn’s disease is a type of inflammatory bowel disease that causes inflammation of the digestive tract. This can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Diet plays a key role in managing Crohn’s disease symptoms. There are some foods that people with Crohn’s may need to avoid as they can trigger or worsen inflammation.
Foods to Avoid with Crohn’s Disease
Here are some of the main types of foods that may need to be limited or avoided altogether when you have Crohn’s disease:
Dairy
Foods containing dairy proteins can trigger inflammation in some people with Crohn’s disease. This includes milk, cheese, ice cream, yogurt and sour cream. Switching to dairy substitutes made from almond, coconut, rice or soy milk is often recommended. Aged cheeses and probiotic yogurts may be better tolerated in small amounts.
Fiber
A high fiber diet can make Crohn’s symptoms worse for some people, especially insoluble fiber from foods like vegetables, fruits and whole grains. Soluble fiber from oatmeal, citrus fruits, carrots and psyllium may be better tolerated. Monitor your symptoms and reduce high fiber foods if needed.
Fatty Foods
Foods high in saturated fats like fatty red meats, sausage, bacon, fried foods and fast food can trigger diarrhea and abdominal pain. Limiting saturated fats from animal products and trans fats found in processed foods is often recommended.
Spicy Foods
Heavily spiced foods containing chili peppers, curry, garlic, onions and other pungent spices can irritate the digestive tract. Avoiding or limiting these foods may help ease Crohn’s symptoms.
Grains with Gluten
Wheat, barley and rye contain gluten, a protein that some people have difficulty digesting. About 10% of people with Crohn’s disease also have celiac disease or gluten sensitivity. Avoiding gluten with a gluten-free diet may help improve symptoms.
Popcorn, Nuts and Seeds
These high fiber, hard-to-digest foods may need to be limited or avoided to minimize irritation of the digestive tract. Cooking and grinding nuts and seeds into nut butters makes them easier to digest.
Raw Fruits and Vegetables
The insoluble fiber found in raw produce can aggravate Crohn’s symptoms. Cooked fruits and vegetables are often better tolerated, as cooking softens fiber. Peeling and pureeing fruits and vegetables into smoothies can also help.
Beans, Lentils and Legumes
These foods are high in insoluble fiber and fermentable carbs called FODMAPs, which can worsen gas, bloating and diarrhea. Try eliminating or reducing legumes and see if your symptoms improve.
Alcohol
Alcohol consumption is associated with worsening inflammation and other immune responses in Crohn’s disease. Limiting or avoiding alcohol completely may help control symptoms.
Caffeine
Coffee, tea, soda and energy drinks containing caffeine can stimulate the intestines and worsen diarrhea. A low-caffeine or caffeine-free diet may be beneficial.
Carbonated Beverages
The bubbles and gas produced by carbonated drinks like soda can cause bloating and abdominal discomfort. Try drinking non-carbonated beverages like water, juice or herbal tea instead.
High Sugar Foods
Foods high in added sugars like candy, pastries, sodas and other sweets can make diarrhea worse. Limiting sugar helps ease digestive symptoms.
Foods to Eat with Crohn’s Disease
While it’s important to avoid problem foods that can trigger Crohn’s flare-ups, there are many nutritious foods that are usually well tolerated and can be enjoyed as part of a Crohn’s-friendly diet. These include:
Cooked Vegetables
Well-cooked and peeled carrots, asparagus, spinach, squash, pumpkin, green beans and other non-cruciferous vegetables are usually gentle on the digestive system.
Well-Cooked Cruciferous Vegetables
Cruciferous vegetables like broccoli, cauliflower, Brussels sprouts and cabbage contain insoluble fiber. But cooking them thoroughly until very soft can make them easier to digest.
Cooked or Canned Fruits
The soluble fiber found in cooked, canned and peeled fruits like applesauce, peaches, pears and bananas is typically tolerated well.
Refined Grains
White bread, pasta, crackers, puffed rice cereals and instant oatmeal are made from refined grains, which are easier to digest than whole grains.
Tender Meat and Poultry
Soft, lean meats like ground turkey, chicken, fish, eggs and tofu are good protein sources that are gentle on the gut.
Low-Fiber Crackers
Plain crackers and pretzels made from refined flours are an easy-to-digest snack option.
Olive Oil
Olive oil is a healthy source of anti-inflammatory monounsaturated fats. Use it for cooking, on salads and as a bread dip.
Smooth Nut Butters
Look for brands with no added sugar. Peanut, almond and cashew butter are nourishing snacks that are easier to digest than whole nuts.
Herbal Teas
Chamomile, ginger, peppermint and marshmallow root tea can help ease intestinal inflammation.
Pureed Soups
Soups pureed until completely smooth provide hydration and nutrients without irritating fiber.
Low-Lactose Dairy
Yogurt, kefir, aged cheese and lactose-free milk are generally better tolerated than regular milk.
Clear Broth Soups
Sipping on vegetable, chicken or beef broth provides fluid and electrolytes without fiber.
Foods to Limit with Crohn’s Disease
Some foods don’t necessarily need to be avoided altogether, but limiting portion sizes or intake frequency may help reduce Crohn’s symptoms. These foods include:
Whole Grains
The insoluble fiber in whole wheat, brown rice, bran cereals, corn and quinoa may need to be limited. Oats, white rice and white flour products are usually better tolerated.
Raw Vegetables
Salads and raw veggies are healthy, but can be hard to digest. Lightly cooked vegetables are an easier starting place when symptoms flare.
Sweeteners
Honey, maple syrup, sucrose and other added sugars can worsen diarrhea when consumed excessively. Limit sweets to small portions.
Fried Food
The high fat content of fried items like french fries can stimulate intestinal contractions and cramping. Eating these foods occasionally in small portions may be ok.
Skinless Nuts and Seeds
Nut and seed skins provide insoluble fiber, making them harder to digest. Try small portions of nuts and seeds occasionally.
High-Fiber Fruits
Dried fruits, berries and fruits with edible skins are higher in fiber. Limit portion sizes and avoid fruits with seeds.
Caffeinated Drinks
Coffee and tea contain gut-stimulating caffeine. Limit intake to 1-2 cups per day and avoid caffeine if it worsens diarrhea.
Unpeeled Fruits and Vegetables
The skin or peel contains insoluble fiber. Peeling fruits and vegetables when possible makes them easier to digest.
Gas-producing vegetables
Onions, garlic, scallions, artichokes and mushrooms contain FODMAPs. Limit portion sizes and avoid if they cause bloating.
The Crohn’s Disease Exclusion Diet
A more restrictive short-term diet called the Crohn’s Disease Exclusion Diet (CDED) is sometimes used to induce remission during flares. Foods excluded on the CDED include:
- Gluten sources like wheat, barley and rye
- Lactose containing dairy products
- All grains and cereals (even refined grains)
- Fatty meats like sausage, bacon and deli meats
- All vegetables except carrots and potatoes
- All fruits except bananas
- Legumes like beans, lentils and peas
- Nuts, seeds and nut butters
- Added sugars and sweets
- Processed foods and deep fried items
- Caffeinated beverages
- Alcohol
Foods allowed on the CDED include:
- Peeled and cooked carrots, potatoes and banana
- Skinless chicken, turkey, fish and eggs
- Clear broths and pureed soups
- Well-cooked rice pasta
- Olive oil, safflower oil and flaxseed oil
- Decaffeinated herbal teas
- Salt and pepper for seasoning
This elimination diet is very restrictive but can help determine trigger foods. It should only be followed for 4-6 weeks under medical supervision to induce remission during flares.
The Low FODMAP Diet for Crohn’s Disease
The low FODMAP diet is emerging as an effective diet therapy for managing IBD symptoms. FODMAPs refer to fermentable carbohydrates that can worsen digestive symptoms:
- Fermentable Oligosaccharides (fructans and galacto-oligosaccharides)
- Disaccharides (lactose)
- Monosaccharides (fructose)
- And Polyols (sweeteners ending in ‘-ol’)
Studies show that a low FODMAP diet reduces abdominal pain, bloating, diarrhea and other symptoms in over 70% of people with inflammatory bowel disease.
To follow a low FODMAP diet:
- Avoid high FODMAP foods for 4-8 weeks, then gradually reintroduce them.
- Limit foods high in fructose, lactose, fructans, galactans, and polyols like apples, milk, garlic, beans and sweeteners ending in ‘-ol’.
- Enjoy low FODMAP foods like bananas, blueberries, carrots, spinach, chicken, eggs, rice, oats and olive oil.
- See a registered dietitian for guidance on food lists, meal plans and reintroduction.
The low FODMAP diet should only be followed under the guidance of your healthcare team. Eliminating too many foods long-term risks nutritional deficiency.
Tips for Following an IBD Diet
Making dietary changes can significantly improve gut inflammation, abdominal pain, diarrhea, constipation, fatigue and other Crohn’s disease symptoms. Here are some tips for following an IBD-friendly diet:
- Keep a food diary – Track foods and your symptoms to identify triggers.
- Read food labels – Check for problem ingredients like milk, wheat, high fiber and high sugar.
- Cook vegetables well – Steaming and boiling make vegetables easier to digest.
- Limit sugar and fat – These nutrients can stimulate diarrhea.
- Drink plenty of fluids – Stay hydrated to prevent constipation.
- Eat smaller meals – Large volumes are harder to digest.
- Allow time to digest – Don’t eat too frequently. Let your stomach rest.
- Manage stress – Anxiety can worsen gut inflammation and motility.
Working with a registered dietitian knowledgeable about IBD is recommended to develop an individualized diet plan. Nutritional supplements may also help fill any gaps in nutrients.
The Bottom Line
Determining which foods worsen or improve your Crohn’s disease symptoms is an important self-management step. While there are many common trigger foods to avoid, tolerance can vary from person to person. An elimination diet like the CDED or low FODMAP diet can help identify your unique trigger foods.
Emphasizing cooked vegetables, lean meats, limited dairy and refined grains may be a gentler starting point. Keeping a food diary, reading labels, proper cooking techniques and managing stress levels can also improve your dietary success.
Work closely with your healthcare providers to find an IBD diet that provides the nutrients you need for health while minimizing your unique symptom triggers. With the right dietary changes, you can manage Crohn’s disease flare-ups and improve your quality of life.
