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What you need to know about IBD

Have unexplained GI symptoms? Struggling to manage your IBD symptoms? Let’s talk IBD!

Do you have IBD and feel like your symptoms are running your life? IBD can be incredibly challenging, with many factors playing into the underlying causes of disease as well as its symptoms. In this post, we are diving into signs and symptoms of IBD, how diet affects IBD, our favorite supplements for symptom management, as well as our top diet and lifestyle tips to help minimize symptoms so you can live a happier and healthier life! 

IBD stands for inflammatory bowel disease where we see certain parts of the gastrointestinal tract (GI) inflamed. IBD encompasses two conditions: Crohn’s Disease and Ulcerative Colitis. In Crohn’s disease, there is often inflammation scattered throughout the digestive tract (think: stomach, small intestine, and large intestine).  Whereas, in Ulcerative Colitis the inflammation is more localized to the colon. There are many underlying causes of this inflammation ranging from diet to lifestyle to an abnormal immune response (often due to a viral infection) to family history – the list goes on! 

What is IBD? 

IBD is most commonly diagnosed through evaluation of signs and symptoms and endoscopy/ colonoscopy. Oftentimes the inflammation seen in IBD is irritating to the lining of the gut and often presents as a bunch of GI symptoms, but is not limited to the gut. 

Common Signs and Symptoms of IBD: 

  • Chronic Diarrhea 
  • Chronic Diarrhea 
  • Urgent Bowel Movements 
  • Bloody stools
  • Abdominal pain and cramping 
  • Lack of appetite 
  • Unintended weight loss 
  • Fatigue
  • Inflamed/ painful joints

The level of severity of IBD varies from person to person with some having minimal symptoms while others’ quality of life is significantly impacted. IBD is unique in that oftentimes people find they have times of remission (asymptomatic or lessened symptoms) and flares (aggravated symptoms). We believe that paying close attention to your diet and lifestyle in relation to your symptoms is a vital piece in managing IBD. 

Foods to focus on 

While there is no one end all be all diet for IBD, there are foods that are commonly well tolerated due to their various properties like being lower in fiber, higher in water, a source of pre or probiotics, and more! In working with clients who have IBD we have compiled a list of what we have found to be the best-tolerated foods to help manage IBD and soothe the GI tract and therefore symptoms. 

Foods that are well tolerated: 

  • Zucchini – low fiber and rich in water
  • Green beans – lower fiber vegetable 
  • Asparagus – good source of prebiotics 
  • Bone broth – good source of probiotics and gut-healing nutrients
  • Eggs – commonly well-tolerated and a good source of nutrients
  • Lean poultry – commonly well tolerated and a good source of protein
  • Organic grass-fed Meats (in small serving sizes around 3oz)
  • Beans (in small portions ~ ½ cup) 
  • Potatoes (might be better tolerated with the skin removed)
  • Cooked Carrots – lower fiber vegetable 
  • Ripe bananas – lower fiber and more easily digested
  • Applesauce – lower fiber and more easily digested

It is important to note that this list is just some foods that are commonly well tolerated and may be a helpful tool if you are in a flare-up. This does not mean that you are restricted to these foods. In fact, we do not recommend you limit yourself to just these foods! Instead, we suggest figuring out what foods are triggering and what foods are well tolerated by keeping a food journal. 

Foods that are common triggers

On the other hand, some foods have been found to be triggering for people with IBD meaning that they cause a flare in symptoms. These foods often tend to be processed rather than whole foods and contain inflammatory oils, added sugars, and artificial ingredients. 

Foods to limit: 

  • Caffeine 
  • Alcohol 
  • Spicy foods
  • Popcorn 
  • Foods high in fat ( think: fried foods, nuts, avocado  – note that healthy fats like nuts/seeds and avocado should still be incorporated in the diet but in lower quantities) 
  • Raw fruits and veggies (in larger quantities) 
  • Inflammatory oils (sunflower, canola, safflower, etc)
  • Dairy (if you’re sensitive)
  • Gluten (if you’re sensitive) 
  • Artificial sweeteners (think: Aspartame – Equal, Nutrasweet, Saccharin – Sweet’n low, Sucralose- Splenda,  Stevia -Truvia). 

Keep in mind that these foods may or may not be triggering for you. Chances are you will not have to limit or avoid all of these foods, rather you may find just a few to be bothersome. Or maybe, you will find you can tolerate these foods in certain quantities, but not in others. Keeping a food journal and working with a dietitian can be very helpful in identifying your food triggers. 

Supplements for IBD

We find some supplements to be helpful in managing symptoms of IBD. Specifically, we love supplements/herbs that have anti-inflammatory, gut-healing, and digestive properties. 

Supplements/nutrients that may be beneficial for IBD: 

  • Omega 3’s – anti-inflammatory 
  • Curcumin – anti-inflammatory 
  • Aloe Vera Gel – may be soothing to the gut, but may stimulate bowel movements (not recommended for people with diarrhea). 
  • Ginger – soothing to the GI tract and may reduce symptoms!
  • Vitamin D – anti-inflammatory 
  • Glutamine – gut-healing
  • Multivitamin – we find many IBD patients have vitamin and mineral deficiencies because of malabsorption! 
  • Slippery Elm – anti-inflammatory and soothing
  • Digestive Enzymes – may be helpful to help your body digest foods

Helpful tips and  lifestyle 

Regarding diet, it is not all about what you eat rather it is also about how you eat!

This may look like: 

  • Focusing on cooked foods (especially fruits and veggies!)
  • Eating smaller more frequent meals,
  • Take your time to eat! (think: not eating on the go, sitting down, and Focusing on your meal in a distraction-free setting, thoroughly chewing your foods)
  • Avoid drinking a bunch of water before and after meals
  • Try to avoid eating 2+ hours before bed 
  • Incorporate herbal teas (ginger, peppermint) between meals to help soothe the GI tract and optimize digestion

Aside from diet, stress management plays a key role in the management of IBD. Stress does not just affect your mental state, but your physical body as well! Oftentimes when stressed, IBD symptoms are aggravated which is the last thing you need if you are already feeling stressed out! There are SO many ways to reduce stress levels or the way one responds to stress – although we admit it is easier said than done! 

Some of our top tips to reduce stress includes: incorporating restorative movement (think: yoga, pilates, or even a walk outside), getting acupuncture, engaging in breathwork (think: meditation), starting a gratitude journal, making time for yourself daily, making sure to do something daily that makes you happy, keeping in touch with friends/family, getting outside in the fresh air, read more here!

Our Approach to IBD  

Our approach to IBD involves evaluating one’s diet, lifestyle, medical history/ labs, and any other relevant factors who that we can get the full in-depth picture of what is going on and why! 

Oftentimes when clients first start working with us, we recommend they start a food journal so we can identify problematic foods. In this food journal, it is important to write down everything eaten (think: not just foods alone, but all ingredients like spices and oils) along with any symptoms experienced. Note that sometimes symptoms can present twelve to even twenty-four hours after so be sure to be consistent with logging how you feel. Then once you complete your food journal, we normally recommend our clients keep a journal for as long as we feel will be helpful (sometimes a short time period, sometimes longer) we walk through it with them trying to pinpoint food triggers. Next, we strategically and systematically eliminate and reintroduce foods so that we can be sure of food triggers to optimize symptom management. 

The Bottom Line

IBD is a complex condition that requires an in-depth approach to get to the root cause of what is triggering symptoms, as well as how it can best be managed. There are some foods that are often well-tolerated by people with IBD, while others tend to be troublesome. However, we believe an individualized approach to IBD is critical in symptom management and improving quality of life. 

Having trouble managing your IBD symptoms? Click here to work with us!

Written by Alison Richman MS, RDN