What foods should be avoided to reduce bowel inflammation?

Foods to Avoid for Reducing Bowel Inflammation

The most important foods to avoid for reducing bowel inflammation are sugar-sweetened beverages, red and processed meats (especially for ulcerative colitis), and ultraprocessed foods high in added sugar and salt. 1

Primary Foods to Eliminate

High-Priority Avoidance

• Sugar-sweetened beverages: These have been directly linked to increased etiopathogenic risk and a more severe multiyear clinical course of inflammatory bowel disease in prospective cohort studies 1
• Red and processed meats: Specifically shown to reduce ulcerative colitis flares when eliminated from the diet, though evidence is weaker for Crohn's disease 1
• Ultraprocessed foods: Foods high in added sugar, salt, and artificial additives should be minimized 1

Secondary Foods That Commonly Worsen Symptoms

Based on patient-reported data and clinical evidence, the following foods frequently exacerbate bowel inflammation symptoms 2:

• Spicy foods and heavy seasonings
• Fried and fatty foods
• Alcohol
• Coffee and caffeine-containing products 3
• Carbonated beverages (soda)
• Fast foods and heavily processed condiments 3

Texture-Related Considerations for Active Disease or Strictures

If you have intestinal strictures or active inflammation, avoid high-fiber foods in their raw, unprocessed form 1:

• Raw fruits and vegetables (especially unpeeled apples, lettuce, and fibrous vegetables)
• Nuts, seeds, and popcorn 2, 3
• Whole corn
• Tough red meats 2

Critical caveat: These fibrous foods should NOT be permanently eliminated. Instead, they can be safely reintroduced by cooking, steaming, mashing, or blending them to achieve a soft texture that allows safe fiber intake 1

Dairy and Lactose Considerations

Dairy avoidance should be individualized based on actual lactose malabsorption testing, not blanket elimination 4:

• Lactose malabsorption prevalence is significantly higher in Crohn's disease involving the small bowel compared to colonic disease or ulcerative colitis 4
• Many IBD patients unnecessarily avoid dairy based on misconceptions rather than true intolerance 4
• Most affected persons can consume a glass of milk daily without discomfort 4
• If dairy is problematic, the issue may relate to long-chain triglycerides or milk proteins rather than lactose itself 4

Foods That May Help (What TO Eat Instead)

The 2024 AGA guidelines strongly recommend a Mediterranean diet pattern as the foundation 1, 5:

• Fresh fruits and vegetables (cooked/soft texture if strictures present) 1
• Monounsaturated fats (olive oil, nuts if tolerated)
• Complex carbohydrates (whole grains)
• Lean proteins (fish, poultry, shellfish, beans, legumes) 1
• Low-fat dairy if tolerated 1

Patient-reported foods that improve symptoms 2:

• Yogurt
• Rice and plain pasta 3
• Bananas and applesauce 2, 3
• Baked or broiled potatoes 3
• Plain fish, chicken, turkey 3

Critical Pitfalls to Avoid

• Do not adopt overly restrictive elimination diets: IBD patients are already at high risk for malnutrition (28% of Crohn's patients and 13% of ulcerative colitis patients have low muscle mass), and excessive restriction worsens nutritional deficiencies 5
• Do not permanently eliminate fiber: While raw fibrous foods may need temporary modification during flares or with strictures, fiber (especially soluble fiber) generates short-chain fatty acids like butyrate that have anti-inflammatory effects 6
• Do not follow carnivore or other extreme restrictive diets: These contradict evidence-based guidelines and eliminate essential nutrients 5
• Avoid emulsifiers in processed foods: Animal models show compelling evidence that emulsifiers in processed foods increase IBD risk 6

When to Seek Specialist Help

All patients with complicated IBD, malnutrition, or requiring complex nutrition therapies warrant co-management with a registered dietitian 5