More than 1.6 million people in the U.S. are living with inflammatory bowel disease (IBD). Despite how common the condition is, many myths about the condition persist.
IBD is an umbrella term for a group of chronic, inflammatory, gastrointestinal (GI) diseases. Crohn’s disease and ulcerative colitis (UC) are the two most common forms of IBD. Symptoms often include painful abdominal cramping and persistent diarrhea due to inflammation in the colon and GI tract. The chronic inflammation associated with IBD can also cause complications in other parts of the body. For instance, skin rashes in UC, such as psoriasis and Sweet’s syndrome, are among the most common non-GI symptoms of IBD.
Diet plays a huge role in symptom management and overall quality of life with IBD. Let’s clear up the myths.
Myth #1: IBD Is Caused by What a Person Eats
IBD is not caused by what a person does or does not eat. Instead, IBD is most likely caused by a combination of genetic and environmental factors. It remains unknown exactly what environmental factors lead to a person developing IBD, but likely risk factors include smoking and the use of antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs).
While food and diet may not cause IBD to develop, some foods can aggravate symptoms or cause flares in existing IBD. Common IBD trigger foods include:
- Sugars and artificial sweeteners
- Raw vegetables and fruits
- Spicy or fried and greasy foods
- Whole nuts and seeds
Myth #2: Following a Special Diet Will Cure IBD
Diet is an important part of successfully treating IBD in a multi-pronged treatment approach, which may also include medication, lifestyle changes, and surgery. Managing your diet to avoid trigger foods and support your overall health can help keep flares at bay, but IBD is a chronic, life-long condition for which there’s not yet a cure. You may enter periods of remission — when you have no active symptoms — but there’s a chance that symptoms will return.
Some people find an anti-inflammatory diet is helpful in keeping symptoms under control. Anti-inflammatory foods tend to overlap with those recommended for overall balanced, healthy nutrition and include foods such as:
- Olive oil
- Green leafy vegetables
- “Good fats” found in fatty fish
- Fruits rich in antioxidants
In some cases, a doctor may recommend enteral nutrition or tube feeding, which excludes whole foods entirely in favor of drinking or tube feeding a specially formulated, nutrient-rich liquid blend. Enteral nutrition isn’t meant to be a long-term or permanent solution. Rather, it’s prescribed for several weeks at a time to induce remission from an active flare.
Myth #3: Any IBD Diet Will Work
There isn’t a single, one-size-fits-all diet for people with IBD. In fact, there are many so-called IBD diets — from low-FODMAP to gluten-free to the specific carbohydrate diet and several others. It can take some trial and error to find one that helps you the most. Depending on your unique symptom and disease, including any complications and what medications you’re taking, some diets may likely be more successful than others in keeping you feeling your best. Try to work with your healthcare team to find the right approach.
IBD can impede the proper intake of food and nutrients. Malnutrition is of major concern for people living with IBD. Certain IBD treatments can also result in nutrient deficiency, so your treatment team may prescribe a special diet and additional supplements.
Myth #4: You Need to Peel Your Fruits and Vegetables Before Eating Them
In certain instances, your gastroenterologist may recommend you remove the skin of your fruits and vegetables before you eat them. Your doctor may recommend that you also thoroughly cook your vegetables. However, these steps are not a general directive to every person living with IBD. This step may become necessary if:
- Your GI tract has narrowed or developed strictures
- You are having an active flare
- You have previously had surgery on certain areas of your GI tract.
When you’re living with IBD, your dietary needs are as unique as you and your condition are. It is highly recommended that you work closely with your treatment team, including a nutritionist well versed in inflammatory GI diseases like IBD, to ensure that your diet is meeting your nutritional needs without exacerbating your symptoms.