Crohn’s disease is an inflammatory condition that affects the gastrointestinal tract. It is a chronic, or long-term, form of inflammatory bowel disease (IBD).

While Crohn’s disease usually affects the colon and the end of the small intestine, an area called the ileum, it can affect any part of the gastrointestinal tract. Symptoms include abdominal pain, bloating, and diarrhea.

Scientists believe that the diet may play a crucial role in Crohn’s disease, and some people find that regularly adapting their meals can help counter their symptoms as they come and go.

In this article, learn about the links between the diet and Crohn’s disease and specific food strategies for managing symptoms.

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In a person with Crohn’s disease, the symptoms may improve or disappear for a while and then return, in periods known as flare-ups.

The cause of the disease is unclear, but it involves an inflammatory response that leads to bloating, pain, diarrhea, and other digestive symptoms.

What a person eats and drinks may affect their symptoms and how often they experience flare-ups.

Researchers continue to explore the potential links between the diet and Crohn’s disease. So far, findings indicate that:

  • Some foods appear to worsen symptoms, while others are easier to tolerate.
  • Dietary changes may help balance the populations of bacteria in the gut, and this may reduce inflammation.
  • Absorption issues and limiting food intake can result in nutritional deficiencies.
  • Some dietary habits may increase the risk of IBD, as it appears to be more prevalent in places with Western diets.

People with Crohn’s disease often find that certain foods and drinks can trigger symptoms or make them worse.

Specific triggers vary from person to person, but they may include:

  • spicy foods
  • alcohol
  • fried foods
  • high-fat foods
  • high-sugar foods
  • caffeinated drinks, such as coffee and some teas and sodas
  • dairy products, for people with lactose intolerance
  • wheat, barley, rye, and oats, for people with gluten intolerance

Keeping a food journal can help a person with Crohn’s disease track their meals and symptoms and identify the likely triggers.

A person may need to adapt their diet according to their symptoms — some foods may be fine when no symptoms are present but harder to tolerate at other times.

During a flare-up

When symptoms are present, suitable foods likely include:

  • low-fiber fruits, such as bananas, melons, and cooked fruits
  • sources of lean protein, such as fish, lean pork, eggs, and firm tofu
  • refined grains, such as sourdough bread, white pasta, and oatmeal
  • non-cruciferous vegetables, such as potatoes and squash, which should be well cooked
  • any nutritional supplements a doctor recommends

It is important to try to maintain a balance of nutrients, even while avoiding some foods. Also, drink plenty of water to stay hydrated.

During remission

When symptoms are mild or gone, a person might add to their diet:

  • fiber-rich foods, such as whole grains, oat bran, beans, barley, and nuts, unless a doctor advises otherwise
  • a wider variety of fruits and vegetables
  • foods rich in calcium, such as dark leafy greens and dairy, if the person can tolerate it

A person might also try foods containing probiotics, such as kefir, miso, sauerkraut, kimchi, and tempeh. It remains unclear whether these actively help manage symptoms.

Having a balance of nutrients is important for everyone. For a person with Crohn’s disease, following a specific diet may help achieve this balance and counter symptoms.

A diet rich in omega-3 fatty acids

Dietary fatty acids are generally an important part of a balanced diet, and some have specific benefits. Omega-3 fatty acids, for example, may reduce inflammation in people with Crohn’s disease.

Foods rich in omega-3s include:

  • flax
  • shellfish
  • cold water fish
  • certain nuts
  • chia seeds

Although omega-3 supplements have shown promise in reducing inflammation in people with IBD, determining whether these supplements should be part of treatment for everyone with IBD requires more research.

The low-residue diet

When symptoms flare up, the doctor may recommend a low-residue diet, which aims to reduce the amount of residue that food leaves after digestion, as this residue may irritate the bowel.

Foods to avoid are:

  • high-fiber foods
  • the fat, gristle, and skin of meat
  • dairy products
  • fish skin and bones

Other ways to avoid residue include:

  • chewing slowly and thoroughly before swallowing
  • blending soups and vegetables
  • opting for smooth nut butters
  • choosing juices without pulp

Other diets for IBD

Other special diets that a person may follow for a longer time include:

Anyone planning to change their diet should first speak with a dietitian or physician, who can recommend ways to avoid nutritional deficiencies.

Gluten intolerance

Celiac disease involves a severe autoimmune reaction to gluten, a protein in wheat and some other grains. A 2015 study found that people with celiac disease are up to 10 times more likely than others to develop a type of IBD, such as Crohn’s disease.

Meanwhile, people with Crohn’s disease may have a higher risk of adverse reactions to gluten, even if they do not have celiac disease.

This suggests that a gluten-free diet may help some people with Crohn’s disease.

Gut bacteria and Crohn’s disease

There is growing interest in the role that gut bacteria might play in inflammatory diseases such as Crohn’s. The gut contains a balance of bacteria that support the immune system and help prevent inflammation. An imbalance may increase the risk of Crohn’s symptoms.

A 2019 review found that people with Crohn’s disease may have less variation in their gut bacteria than those without it. The researchers also cited differences in gut flora between people with Crohn’s in remission and those with current symptoms.

Some scientists have proposed using probiotics and prebiotics to help restore the balance of the bacteria, but they have not yet developed an effective treatment.

Although some studies suggest that probiotic supplementation may help some people with Crohn’s disease, the overall results have been mixed. Anyone interested in taking probiotic supplements for Crohn’s symptoms should first consult a healthcare provider with experience in this area.

People with Crohn’s disease may need to take other nutritional supplements, including B12, zinc, iron, and vitamin D, to avoid deficiencies.

Crohn’s disease is a long-term inflammatory condition that affects the intestines. The symptoms usually flare up and recede in a cycle.

A person with Crohn’s disease should try to maintain a varied, balanced diet even as they make changes to accommodate their symptoms. The goal is to maximize the intake of nutrients, avoid trigger foods and drinks, and prevent nutritional deficiencies. To this end, a doctor may recommend supplements.

Keeping a food diary can help a person track their meals and identify specific foods and drinks that trigger their symptoms. Also, a dietitian or physician can help a person develop a tailored diet that helps keep their symptoms to a minimum.