From the Guidelines
To avoid exacerbating Crohn's disease (CD), it is recommended to follow a Mediterranean diet rich in a variety of fresh fruits and vegetables, monounsaturated fats, complex carbohydrates, and lean proteins, while limiting ultraprocessed foods, added sugar, and salt 1. This dietary approach can help reduce inflammation and irritation in the digestive tract, potentially decreasing symptom severity and frequency. Some key foods and drinks to limit or avoid include:
- High-fiber foods like raw vegetables, fruits with skins and seeds, whole grains, nuts, and seeds during flares, as they can irritate the digestive tract
- Dairy products if lactose intolerant, as many CD patients are
- Fatty, greasy, or fried foods which can trigger symptoms and are harder to digest
- Spicy foods, caffeine, alcohol, and carbonated beverages that can irritate the digestive system and worsen inflammation
- Processed foods containing artificial sweeteners, preservatives, and emulsifiers that may disrupt gut bacteria and increase inflammation
- High-FODMAP foods like certain fruits, vegetables, and grains that can cause gas and bloating during flares It is essential to note that each person with CD may have different trigger foods, so keeping a food diary can help identify specific triggers and create a personalized diet plan 1. Additionally, patients with stricturing Crohn’s disease may need to limit dietary fiber and fibrous foods, and consider supplementation with enteral or parenteral nutrition to achieve energy and nutritional requirements 1. Overall, a balanced and varied diet, along with personalized dietary advice, can help manage CD symptoms and improve quality of life 1.
From the Research
Foods and Drinks to Avoid in Crohn's Disease
There is no direct information in the provided studies about specific foods and drinks to avoid in Crohn's disease.
General Guidance on Crohn's Disease Management
- The primary agents used in the treatment of Crohn's disease are aminosalicylates, corticosteroids, immunomodulators, and biologics 2.
- The choice of initial biologic therapy should be determined through shared decision-making between the patient and provider 2.
- Effective control of inflammation reduces the risk of penetrating complications, although more than half of patients will develop complications that require surgery 3.
- Adverse reactions to therapy include antibody formation and infusion reactions, infections, and cancers associated with immune modulators and biologics and toxicity to the bone marrow and the liver 3.
Treatment Options for Crohn's Disease
- First-line therapy generally consists of steroids for rapid palliation of symptoms during initiation of anti-tumor necrosis factor α therapy 3.
- Other treatments may include monoclonal antibodies to IL-12/23 or integrin α4β7, immunomodulators, combination therapies, or surgery 3.
- Infliximab monotherapy, infliximab combined with azathioprine, adalimumab, and ustekinumab were associated with significantly higher odds of inducing remission compared to certolizumab pegol 4.
- Adalimumab after loss of response to infliximab and risankizumab were associated with higher odds of inducing remission than vedolizumab 4.