Written by: Bonnie Feldman, DDS, MBA, Anna Simon, Ellen M. Martin
As our knowledge about nutrition and food as medicine expands, using foods as health enhancers and therapy agents has become increasingly popular. Many patients, including autoimmune, are following dietary guidelines to help mitigate symptoms, based on the growing understanding that diet and nutrition can either exacerbate or reduce symptom severity.
Crohn’s disease is an inflammatory bowel disease (IBD). Approximately 780,000 individuals in the United States have already been diagnosed with Crohn’s, and studies have shown that prevalence seems to be rising in both children and adults in the US. The CDC currently estimates that 201 of every 100,000 adults has Crohn’s disease.
What is Crohn’s?
Crohn’s can affect any part of the gut, from the small intestine to the large colon, with waxing and waning symptoms that include abdominal pain, bloody stools, severe diarrhea, reduced appetite, unintended weight loss, fever, and fatigue. There is a possibility of more serious complications (bowel obstruction, chronic malnutrition, dehydration, fistulas, ulcers, and megacolon), but early diagnosis and careful management of the underlying disease can often minimize these more extreme symptoms.
Are There Best Foods For Crohn’s?
Certain foods and food components may help manage Crohn’s. The Internet offers an overwhelming amount of diet recommendations, including the gluten-free, specific carbohydrate, and GAPS diets. While we do believe that following a diet that emphasizes anti-inflammatory and antioxidant-rich foods should help people with Crohn’s, we don’t believe in a one-diet-for-all approach, because Crohn’s disease affects people differently and symptoms vary greatly among patients. For this reason, we recommend starting with some type of autoimmune-specific protocol, then personalize it for your unique symptoms. Check out our article on immune boosting foods to learn more.
That being said, there is some scientifically backed evidence to support certain foods over others for Crohn’s patients. This table offers a great starting point for any Crohn’s patient. We have constructed this table to highlight the abundant information on food and Crohn’s. In addition to a wide variety of scientific articles (1), we used information from Personal Remedies, which harnesses a knowledge base backed by science to suggest which foods to avoid and consume based on specific diseases. This service is offered to all, and shows individual food items and supplements that are the “best” for Crohn’s patients, in order of strength of scientific support. Combining their guidelines with our own knowledge, scientific research, and other scholarly tables, we’ve crafted our best foods for Crohn’s disease.
In general, following a generic autoimmune diet which broadly focuses on eliminating processed foods, dairy, and added sugar, while increasing consumption of vegetables, fruits, fish and other whole foods may be important for Crohn’s patients. Iron deficiency is common in Crohn’s patients, so making sure to eat lots of iron and take iron supplements if needed is recommended. Drinking plenty of fluids is important in keeping the digestive system moving. Eating plain, soft foods can reduce gastrointestinal symptoms – for example, cooking fibrous foods like vegetables helps with digestion. Another way to minimize stomach pain is to eat smaller meals and eat only when you’re hungry. We recommend keeping a food diary to track any potential foods that trigger your symptoms, or any foods your body responds well to.
The Worst Foods for Crohn’s
In contrast to these anti-inflammatory foods, there are also pro-inflammatory foods that should be avoided. These pro-inflammatory foods include processed meats, sodas, salty snacks, packaged sweets, and refined carbohydrates. Unfortunately, these foods are also easy to choose when stress eating or snacking. If you suffer from Crohn’s, these types of food are likely to intensify any symptoms you’re already experiencing.
In addition to these generic pro-inflammatory foods, there are some specific foods that might be harmful to Crohn’s patients. Spicy foods, fried foods, processed meats, nuts, seeds, and beans, raw vegetables, caffeine, alcohol, and sweets such as cakes, cookies, and brownies are some of the more obvious exclusion foods. Foods high in fiber (raw vegetables, whole grains, nuts) and foods that produce gas (beans, lentils, cruciferous vegetables) can irritate the gastrointestinal system, so avoid these as much as possible. We recommend cutting out dairy and gluten, as they can be triggers for some people.
Conventional products have more artificial chemicals (2), which could have greater effects on those with autoimmune diseases who already have compromised immune systems.
Other Tools for Managing Crohn’s
Engage in Mindful Eating
In addition to concerning yourself with what and what not to eat, other aspects of eating are also important. Eating smaller, balanced meals could help ease digestion and help fight flare-ups. With this, chewing your food slowly and engaging your jaw can help activate your robust oral microbiome and promote beneficial oral health. A key aspect of mindfulness is paying attention to your body’s short and long-term response to a food – if it stings or produces cramping, or diarrhea the next day, consider it a likely bad actor in your case.
What you drink matters too! Water normalizes the pH of mouth – healthy human saliva has a pH of 7.4. When acidic foods and beverages, such as fruit juice and soda, are consumed, oral pH is thrown out of balance (not to mention the additional sugar and calorie intake). When the pH within our mouths falls below 5.5 demineralization occurs, making you more susceptible to oral diseases such as dental caries and periodontal disease. Drinking plenty of water daily can help maintain a healthy mouth pH, in addition to keeping you hydrated. When drinking tea, coffee, juice or alcohol, we recommend drinking water alongside for optimal oral health.
Exercise, Exercise, Exercise
Staying active is incredibly important to maintain healthy living. It is even more important for those who suffer from Crohn’s and or other autoimmune diseases because it can help reduce inflammation and alleviate symptoms. Exercise can take on many forms from higher intensity training like running or playing sports to lower intensity exercises like walking, yoga or other movement therapies. Get our free ebook on movement therapy to explore more options!
Relax and Reduce Your Stress
Constant stress is one of the hallmarks of modern life. While our stress responses were beneficial in helping us avoid predation and other life-threatening situations, constant stressors brought about by modern society can be extremely harmful to our bodies. While helpful in short bursts, chronic stress that triggers our flight-or-fight responses, part of our sympathetic nervous system, can have harmful consequences. These effects include triggering or exacerbating autoimmune flare-ups. It is therefore important for those with Crohn’s to reduce overall stress.
One of the easiest ways to do this is to make sure you are getting enough sleep. Most people do not get the recommended 7-9 hours of sleep daily, and for autoimmune patients, this can have more serious consequences. Whether taking an afternoon nap or going to bed earlier, emphasis should be placed on restful sleep. Relaxation throughout the day is also important. This could mean an early morning workout, an afternoon yoga class, even taking 15 minutes in the middle of the day just to focus on your breathing. Figure out what works best for you and do it. Take the time to be the best version of yourself: your stress will go down, your body will feel better, and your productivity may even increase!
Crohn’s is an autoimmune disease that can affect patients differently. Following some sort of autoimmune-specific, anti-inflammatory diet may help mitigate symptoms. What worked for your friends or spouse might not work for you. Everyone is unique and experimenting with food therapy for Crohn’s may not be an easy fix. Try not to be overwhelmed by all of the recommendations and information out there, go slowly and trust yourself. At the end of the day, you are your best advocate and you know your body. Fearlessly experiment with your dietary options and be mindful of your reactions. Stay tuned for our new ebook on food therapy to learn more about what makes you unique and how to kick-start your journey to finding your optimal autoimmune specific diet.
- Donnellan et al. “Nutritional Management of Crohn’s Disease.” Therap Adv Gastroenterol. Vol. 6(3). 2013. 231-242. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625021/
- Smith-Spangler, C et al. “Are organic foods safer or healthier than conventional alternatives?: a systematic review” Annals of Internal Medicine. Vol 157(5). 2012. 348-366. https://www.ncbi.nlm.nih.gov/pubmed/22944875