Eating a balanced diet is a major part of living a healthy lifestyle, but when you’re living with a chronic health condition, there can be some extra food rules to take on board.
As restaurants reopen and we get back to our old eating habits, a health expert explains how diet can affect IBD, and some key steps people can take to manage their symptoms…
What exactly is IBD?
“Inflammatory bowel disease (IBD) is a chronic, relapsing, remitting inflammatory condition affecting the bowel, as well as the skin, joints and liver,” says Dr Kevin Barrett, chair of the Primary Care Society for Gastroenterology.
He explains that Crohn’s disease and ulcerative colitis are the two main types of IBD that you’ll hear people talking about. “It’s often confused with irritable bowel syndrome (IBS) as the symptoms can be similar, and they are both life-long conditions with no clear cause and no known cure.”
While IBS can be incredibly disruptive to a person’s life, IBD can be a bit more invasive, as it can require immunosuppressive medication and sometimes surgery. Plus, he says that it also increases the risk of bowel cancer too.
Can diet affect your IBD symptoms?
Some people with IBD also find they get IBS-type symptoms, and many others have identified particular ‘trigger’ foods that cause them problems, according to Barrett.
However, he adds that while “there is a potential link with highly processed foods that can affect the gut microbiome and lead to an increase in symptoms,” there is no evidence that particular foods can cause IBD.
“There are several diets that can benefit people with IBD and help relieve symptoms. For instance, liquid polymeric diets are used to treat Crohn’s Disease in children and they can also be used in adults as an alternative, or alongside medications.”
Basically though, there is no one-size-fits-all solution: “This is why dieticians are an important part of the multidisciplinary teams which care for many patients with IBD,” stresses Barrett.
What kinds of foods can trigger symptoms?
“Food containing FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are known to cause bloating, pain and sometime diarrhoea in many patients, including those with both IBS and IBD,” says Barrett.
These include gluten, dairy products, many fruits and vegetables, garlic, and some artificial sweeteners. “Different people tolerate different amounts of each group, and the key to following a low-FODMAP plan is to exclude the foods for several weeks,” says Barrett. The idea is that you can then reintroduce them in stages and pinpoint the foods that disagree with you.
Don’t just chuck everything out of your fridge though, as it’s strongly recommended that patients with IBD follow a diet plan under the supervision of someone trained to do so. “There are many other diets that may work well, but these should always be tried with the advice of a dietician, as the risk of malabsorption for patients with IBD is higher than for most people,” explains Barrett.
What foods should you prioritise?
“I’d say it’s really important that people with IBD follow a healthy diet that supports their gut microbiome and provides enough micronutrients, as well as iron, calcium, and vitamin D,” says Barrett, “as these can be important to improve fatigue and bone health.”
He adds that fibre is important too, and all adults should aim to eat at least 30g each day.
What can you do if your IBD symptoms are affecting your day-to-day life?
The good news is there are many sources of support for patients with IBD, and you can learn to manage your symptoms, so it doesn’t get in the way of the activities you enjoy.
“Charities such as Crohns & Colitis UK have a wide range of resources on all kinds of subjects, and they also have emotional support lines,” Barrett recommends.
“IBD nurses are also amazing and can signpost local sources, while your GP can help direct you to sources of psychological help. While you’re there, your local surgery can also help exclude anaemia, which is often underdiagnosed in patients with IBD.”
Perhaps most important of all though, it’s important to talk to people at work, school or college about how you are feeling, as sharing your symptoms means they can better accommodate for your needs.
Barrett concludes: “If your friends or family are struggling to understand how it affects you, then the In My Shoes | It Takes Guts app is a great way for them to experience 24 hours in the life of a person with IBD.”