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Diet (in Crohn's disease)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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In general, there are no specific foods that have to be avoided by the Crohn's patient. Patients should try and eat a balanced diet and avoid food which upsets them. However, in particular situations then dietary modification is necessary:

  • high fibre foods, e.g. fruit and vegetables, may precipitate abdominal pain in some patients - especially those with small intestinal disease. In this group of patients a low residue diet, e.g. avoidance of vegetables, brown bread may bring symptomatic relief
  • low fat diets: if steatorrhoea is a main complaint
  • exclusion diet: this is as reliable as corticosteroids in producing remission in acute disease - success rate as high as 90%; however, most patients relapse soon after the resumption of a normal diet
  • fish oil - there is evidence that enteric-coated fish oil preparations may reduce relapse rate and maintain remission in patients with Crohn's disease
    • the anti-inflammatory omega-3-polyunsaturated fatty acids (PUFAs) from fish oils - the importance of dietary intake of PUFA has been gleaned from epidemiological observations that Eskimos have a low incidence of inflammatory bowel disease (IBD)
  • probiotics - there is ongoing interest in the use of probiotics in the treatment of IBD.
    • probiotics are live non-pathogenic organisms such as various Lactobacillus species, which aim to confer health benefits by improving the gut micro-organism environment (1)
  • vitamins and minerals: if there are specific nutritional deficiencies
  • malnourishment: if the patient has active disease or is perioperative then parenteral nutrition may be indicated

dietary measures for inducing remission in Crohn's disease (4)

  • enteral nutrition should be considered as an alternative to a conventional glucocorticosteroid to induce remission for:
    • children in whom there is concern about growth or side effects, and young people in whom there is concern about growth

Reference:

  1. Prescriber (2004); 15(5).
  2. Riordan, A.M. et al. (1993). Treatment of active Crohn's disease by exclusion diet: East Anglian Multicentre Controlled Trial. Lancet; 342: 1131-34.
  3. Belluzzi A et al (1996). Effect of enteric-coated fish oil preparation on relapses in Crohn's disease. NEJM;334: 1557-60.
  4. NICE (May 2019). Crohn's disease Management in adults, children and young people

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